Impact of isolation on the biopsychosocial functioning of older people with COVID-19.

INTRODUCTION: COVID-19 is a highly contagious coronavirus disease that has had a significant impact on the functioning of society. On 11 March 2020, due to the rapid spread of the virus, the WHO declared a global pandemic. By the end of 2021, 5 variants of SARS-CoV-2 had been identified since the beginning of the pandemic. The course of the disease varied depending on the age of the patients and the presence of possible comorbidities. Most patients were asymptomatic or sparsely symptomatic of the infection; however, in about 6% of cases, the course of the disease was critical. Typical symptoms of COVID-19 include: fever, muscle pain and headache, lack of smell and taste, cough, dyspnea, diarrhoea and nausea. According to epidemic guidelines, infected patients were subjected to isolation, which harmed their mental state, especially the elderly. OBJECTIVE: The aim of the study was to assess the impact of isolation on the biopsychosocial functioning of elderly patients with COVID-19. MATERIAL AND METHODS: The study was conducted among 360 elderly patients in hospital wards operating as a unit in a hospital complex dedicated to patients infected with the SARS-CoV-2 virus. Data were collected using standardized questionnaires: ADL Scale, IADL, GDS, SF-36 Quality of Life Scale, Multidimensional Scale of Perceived Social Support, and supplementary questions about, among others, the oxygen therapy provided, length of stay in the unit, and the support received from relatives. RESULTS: Almost half (48%) of the subjects received oxygen therapy, and 36% had a length of disease of 7-14 days. A correlation was observed between the quality of life and the above-mentioned factors. Correlations of quality of life indicators with the length of illness were moderate (except for the level of pain) and positive, meaning that the longer the patients were ill, the lower their quality of life. Correlations of disease severity were moderate for pain, vitality, and emotional limitations, while vital for physical functioning and limitations and general and mental health. The intensity of oxygen therapy was moderately correlated with physical and emotional limitations and general health and strongly correlated with physical functioning, vitality and mental health. Correlations between functional status and mental status of elderly patients were also studied. Analysis of variance showed that the constructed model was an excellent fit to the data, F = 37.14; p < 0.001, explaining 42% of the variance in the dependent variable (R2= 0.42). As many as 80% of the respondents felt that isolation harmed their well-being. Examining the impact of quality of life on their well-being showed that most of the associations tested were statistically significant, and all were positive. Associations of moderate strength were shown for physical functioning, physical limitations and general health, while strong associations were shown for vitality, emotional limitations and mental health. Pain complaints were associated with changes in well-being at the level of statistical trend (p = 0.055). This means that the lower the patients' quality of life, especially in terms of vitality and mental health, the more significant the impact of isolation on their well-being. The study also investigated the effect of social support on mental state. The model proved to be an excellent fit to the data, F = 5.91, p = 0.002, and explained 23% of the variance in the dependent variable (Adjusted R² = 0.23). At the same time, support from friends turned out to be the only significant predictor (Beta = 0.53), and this means that the more support the subjects received from them, the lower the level of depression they manifested. CONCLUSIONS: 1) The better the functional state of a senior and the support received from relatives, the lower the severity of depression. 2) The lower the quality of a senior's life, especially in terms of mental state, the greater the negative impact on his/her well-being in isolation. 3) The low quality of life of a senior increased the likelihood of depression. 4) The quality of life of older Covid-19 patients was higher in those without chronic disease. 5) The quality-of-life level was lower in patients with a more severe course of COVID-19, and longer duration of disease and oxygen therapy.

COVID-19, wywołany przez wirus SARS-CoV-2, jako choroba zawodowa osób wykonujących zawody medyczne

Wprowadzenie i cel: COVID-19, wywołany przez wirus SARS-CoV-2, w duży stopniu oddziałuje na osoby wykonujące zawody medyczne. Należy wskazać, że do 4 stycznia 2021 roku odnotowano w Polsce 145 zgonów wśród osób wykonujących różne zawody medyczne z powodu (pośredniego lub bezpośredniego) zakażenia COVID-19. Do 5 stycznia 2021 roku odnotowano 84 821 przypadków osób zakażonych tym-że wirusem oraz 287 162 przypadków skierowań do odbycia kwarantanny. Celem pracy jest przedstawienie zagadnienia COVID-19 jako choroby zawodowej osób wykonujących za-wody medyczne. Metody przeglądu: Przegląd bazy: PubMed, SCOPUS, Google Scholar oraz Legalis. Do przeprowadzenia przeglądu wykorzystano następujące słowa kluczowe: „COVID-19”, „SARS-CoV-2”, „warunki pracy”, „choroby zakaźne”, „choroby zawodowe”. Opis stanu wiedzy: Dane z opublikowanych badań oraz raportów wskazują, że przedstawiciele zawodów medycznych są najbardziej narażeni na zakażenie COVID-19 w miejscu wykonywania lub świadczenia pracy. W artykule, oprócz omówienia zagadnień związanych z sytuacją epidemiologiczną, a w szczególności danych dotyczących zakażeń, zgonów oraz kwarantanny odbywanej przez przedstawicieli zawodów medycznych, oraz kwestii związanych z ryzykiem zakażenia się w miejscu wykonywania pracy lub świadczenia usług, pod-niesiono także zagadnienia związane z uznaniem COVID-19 jako choroby zawodowej. W tym celu przedstawiono zarówno orzeczenia sądów powszechnych, jak i stanowiska doktryny w tej kwestii. Wskazano także na podjęte przez Ministerstwo Zdrowia oraz Główny Inspektorat Sanitarny działania, a przede wszystkim na wydane wytyczne i rekomendacje. Podsumowanie: Sytuacja epidemiologiczna, warunki pracy, a w szczególności bezpośredni kontakt z pacjentem przemawiają za tym, aby wirus SARS-CoV-2 wywołujący COVID-19 był uznany za chorobę zawodową, która dotyka przedstawicieli zawodów medycznych.Alternate abstract: Introduction and objective: COVID-19, caused by the SARS-CoV-2 virus has serious consequences for medical professionals. It should be noted that until 4 January, 2021, there were 145 deaths in Poland among members of various medical professionals due to (direct or indirect) COVID-19 infection. Until 5 January, 2021, there were 84,821 cases of persons infected with the virus, and 287,162 quarantine referrals. The aim of the study is presentation of the problem of COVID-19 as an occupational disease of medical professionals. Review methods: A review of scientific literature was performed, using scientific medical databases, such as PubMed, SCOPUS, Google scholar, and legal database: Legalis. The following keywords were used to conduct the review: ‹COVID-19›, ‹SARS-CoV-2›, ‹working conditions›, ‹infectious diseases›, and ‹occupational diseases›. Abbreviated description of the state of knowledge: Data from studies and reports indicate that medical professionals are most at risk for COVID-19 infection in their workplace. The article, in addition to discussing issues related to the epidemiological situation, in particular data on infections, deaths and quarantine of health care professionals, risk of infection at the place of work or provision of services, also arouses questions related to the recognition of COVID-19 as an occupational disease. For this purpose both, the common court decisions and doctrinal positions are presented. In this regard, the actions undertaken by the Ministry of Health and the Chief Sanitary Inspectorate were also indicated, especially the issued guidelines and recommendations. Summary: The epidemiological situation, working conditions of medical professionals and, in particular, direct contact with patients indicate that the SARS-CoV-2 virus causing COVID-19 should be recognized as an occupational disease affecting medical professionals.