Acute pericarditis as a clinical manifestation in COVID-19 infection in a district hospital setting.

The global outbreak of coronavirus disease 2019(COVID-19) pandemic has heavily impacted the health service, leading to increased mortality and morbidity. Although known to manifest primarily as a respiratory illness, there are reports of cardiac involvement as extrapulmonary manifestation. We are reporting a case of pericarditis in a young patient who presented with only cardiac symptoms in COVID-19. He was admitted to the hospital for observation and treated with oral colchicine and oral ibuprofen. His conditions improved and subsequently discharged well. Acute pericarditis can present as part of the COVID-19 extrapulmonary spectrum. Therefore, it is important and challenging for clinicians to recognise the atypical presentations of COVID-19 to reduce morbidity and mortality.

Pre-crisis commitment human resource management and employees' attitudes in a global pandemic: The role of trust in the government

Studies of human resource management (HRM) have produced plentiful results on commitment HRM, but its effects during a crisis have rarely been examined. Incorporating the commitment HRM view and the cognitive phenomenological framework, we examined whether and how commitment HRM practices implemented prior to the COVID-19 mitigate employees' negative cognitive evaluations and attitudes during the pandemic. Moreover, a pandemic is a situation that requires strong government interventions, and we further examined whether employees' trust in the government would play a moderating role in explaining the effects of commitment HRM. With a multilevel framework, we measured commitment HRM via an analysis of big data provided online prior to the pandemic and matched the information to employees' responses collected from a survey after the outbreak of the pandemic. With data from 1010 employees and 52 companies, we found that employees in organizations with a higher utilization of commitment HRM showed less threat appraisals. Moreover, those experiencing fewer threat appraisals showed more commitment to their organizations. In addition, we found that the negative link between a company's commitment HRM and its employees' threat appraisals was pronounced when they had a lower level of trust in the government. Theoretical and practical implications are discussed.

A retrospective cross-sectional study on the risk factors and survival outcome of End Stage Kidney Disease patients receiving regular maintenance haemodialysis with COVID-19 infection in Hospital Enche' Besar Hajjah Khalsom, Kluang

INTRODUCTION: COVID-19 pandemic has affected healthcare services around the globe as hospitals were turned into designated hospitals to accommodate high risk groups of patients with COVID-19 infection including end stage kidney disease (ESKD) patients. In Malaysia, there was insufficient data on COVID-19 infection among ESKD patients. This study aims to determine factors and survival outcomes associated with COVID-19 infection among ESKD patients in a designated COVID-19 hospital in Malaysia. METHODS AND MATERIALS: A retrospective cross-sectional study involving 80 haemodialysis (HD) patients recruited from March 2020 till March 2021. Patients' information and results was retrieved and evaluated. Risk factors affecting the COVID-19 mortality were analysed using a one-way analysis of variance (ANOVA) and binary logistic regression. RESULTS: The mean age of the patients was 54 years who were predominantly Malays (87.5%) and living in rural areas. Majority of them had comorbidities such as diabetes mellitus (71%) and hypertension (90%). The most common presentations were fever (46%) and cough (54%) with chest radiographs showing bilateral lower zone ground glass opacities (45%). A quarter of the study population were admitted to the intensive care unit, necessitating mechanical ventilation. This study found that 51% of the patients were given steroids and 45% required oxygen supplementation. The COVID-19 infection mortality among the study population was 12.5%. Simple logistic regression analysis showed that albumin, Odd Ratio, OR=0.85 (95% Confidence Interval, 95%CI: 0.73, 0.98)) and absolute lymphocyte count OR=0.08 (95%CI: 0.11, 0.56) have inverse association with COVID-19 mortality. C-reactive protein OR=1.02 (95%CI: 1.01, 1.04), lactate dehydrogenase OR=1.01 (95%CI: 1.00, 1.01), mechanical ventilation OR=17.21 (95%CI: 3.03, 97.67) and high dose steroids OR=15.71 (95%CI: 1.80, 137.42) were directly associated with COVID-19 mortality. CONCLUSION: The high mortality rate among ESKD patients receiving HD was alarming. This warrants additional infection control measures to prevent the spread of COVID- 19 infection among this vulnerable group of patients. Expediting vaccination efforts in this group of patients should be advocated to reduce the incidence of complications from COVID-19 infection.

Telepsychiatry in the Age of COVID: Some Ethical Considerations.

The COVID-19 pandemic has necessitated a rapid escalation in the use of telepsychiatry. Herein we revisit some of the ethical issues regarding its use, including patient benefice, distributive justice, privacy, and autonomy. Based on these considerations we would hold that telepsychiatry is a vital aspect of providing psychiatric care, and ethically should be offered as a format for treatment, likely beyond the pandemic period. Investigative and advocacy efforts will need to continue to determine its exact role within psychiatric care, and expand its availability for those most in need.