Masticatory Functionality in Post-Acute-COVID-Syndrome (PACS) Patients with and without Sarcopenia

Musculoskeletal symptoms are common in both acute COVID-19 disease and post-acute sequelae (Post-Acute COVID Syndrome). The purpose of this study is to investigate whether there are reduced levels of masticatory function in patients with PACS (Post Acute COVID Syndrome) who suffer from sarcopenia, under the hypothesis that the latter may also involve the masticatory muscles. This study includes 23 patients hospitalized for COVID-19 between February 2020 and April 2021 and currently suffering from PACS. Among these PACS patients, 13/23 (56%) suffer from sarcopenia, 5/23 (22%) complain of asthenia but do not suffer from sarcopenia and the remaining 5/23 (22%) do not present muscle symptoms (non-asthenic non-sarcopenic). Oral health indices of all patients were collected. The masticatory strength was assessed with a gnathodynamometer based on piezoresistive sensors, and the masticatory effectiveness was measured by administering the 'chewing gum mixing ability test';by having patients perform 20 masticatory cycles on a two-color chewing gum and analyzing the outcome through the ViewGum©software. Moreover, we gathered data with a hand grip test and gait speed test. The data collected in this study show that PACS sarcopenic patients have decreased masticatory effectiveness and strength compared to PACS asthenic non-sarcopenic patients and PACS non-asthenic non-sarcopenic patients.

Lifestyle changes during the first and second waves of the COVID-19 pandemic in medical college students: are there gender-related differences?

BACKGROUND AND AIMS: The COVID-19 pandemic has seriously affected young people. The present study aims to explore the effects of COVID-19 on lifestyle in 500 undergraduate students both during the acute phase of the pandemic (so-called "first wave") and during the second spread of infections (so-called "second wave"). Gender differences were also explored.  Methods and results. During the first wave we found weight gain in 48.6% of subjects, a switch to an unhealthy diet (43%), and an increase in the amount of food introduced (35%). Interestingly, women showed higher intake of food in order to cope, while men privileged higher wine consumption as a coping mechanism. We observed a sharp reduction in physical activity, increased sedentary behaviours and deterioration in sleep quality. Stress correlates with eating to cope (r=0.86; p<0.001); drinking to cope (r=0.83; p<0.001). Contrary to expectations, the second wave led to a situation similar to the first. We have detected a further deterioration in quality of sleep (67% vs 77%; p<0.01) and also a reduction in sleeping time (68.6% vs 77.7; p<0.01). CONCLUSIONS: The long pandemic has led to unhealthy lifestyle changes in the student population of our municipality in Northern Italy. There are gender differences in lifestyle modifications developed during the pandemic that suggest a different response to stress. Moreover, the persistence of pandemic-related stress due to the "second wave" has severely affected the lifestyle habits of undergraduate student.

The perceived impact of the COVID-19 pandemic on dental undergraduate students in the Italian region of Emilia-Romagna.

INTRODUCTION: The outbreak and diffusion of the novel SARS-CoV2 coronavirus have caused an emergency status in the dental education system. MATERIALS AND METHODS: An anonymous survey composed of 34 questions was delivered to students of the Master Degree Programme in Dentistry and Dental Prosthodontics of the Universities of Emilia-Romagna, the fifth Italian region most affected by the pandemic. The psychological impact of COVID-19 was assessed by means of the Generalised Anxiety Disorder-7 scale (GAD-7). Numerically recoded data were analysed using the Analysis of Variance (ANOVA), whilst to investigate the association between quantitative variables, the Pearson correlation coefficient (R) was computed. RESULTS: The questionnaire was completed by 399 students (75%) out of 532. Most students experienced difficulties in working at the thesis during the COVID-19 emergency. For over half of them, online teaching could only partially replace traditional face-to-face lessons. The negative impact on the study career was judged as particularly high by sixth-year students. Clinical training activities were considered as exposing to the risk of contracting COVID-19 infection by the majority of the students. The level of concern of contracting COVID-19 infections during future university activities was positively correlated to risk perception related to clinical training. CONCLUSION: The results of this survey could be used to train students to a correct risk assessment. Students reported experiencing concern whilst thinking of COVID-19 and 6.5% of them showed symptoms related to high levels of anxiety. These data may guide Universities in trying to reduce students' anxiety by means of correct communication strategies.

COVID-19 Dentistry-Related Aspects: A Literature Overview.

A new coronavirus (Sars-CoV-2) was detected in China at the end of 2019 and has since caused a worldwide pandemic. This virus is responsible for an acute respiratory syndrome (COVID-19), distinguished by a potentially lethal interstitial bilateral pneumonia. Because Sars-CoV-2 is highly infective through airborne contamination, the high infection risk in the dental environment is a serious problem for both professional practitioners and patients. This literature overview provides a description of the clinical aspects of COVID-19 and its transmission, while supplying valuable information regarding protection and prevention measures.

COVID-19 and dentistry: a new challenge

OBJECTIVES A new virus has been identified in China between the end of 2019 and the beginning of 2020. In few months, this coronavirus spread quickly all around the world, leading to an acute respiratory syndrome often asymptomatic but potentially lethal. This new coronavirus, named Sars-CoV-2, belongs to a pathogen family named Coronaviridae and presents a genomic sequence overlapped to SARS-CoV and MERS-CoV. Epidemiological and genetic studies performed on Chinese infected subjects led to the hypothesis that this pandemic originated from a transmission between animal and humans, followed by a contagion between humans. Sars-CoV-2 transmission potential is extremely high and infection pathways are different. This virus appears highly infective through droplets originated by cough, sneeze or exhalation of infected patients, but also through direct contact of hands or other body parts with contaminated surfaces. Incubation period seems to vary from three to fourteen days but some cases with a longer incubation period had been reported. Also patients in the incubation phase or asymptomatic subjects are considered potential virus carriers. Since the contagion window seems to be open already in the early phase of infection and seems to include also asymptomatic subjects, the difficulty in restricting the infection transmission is evident. Symptomatic patients mostly present fever, asthenia and dry cough, weather dyspnoea affects more severe subjects. In the worst cases, a severe involvement of respiratory functions leads to hospitalization. Form a clinical point of view, Sars-CoV-2 infection shows a bilateral interstitial pneumonia, radiographically evident as a bilateral opacity with no lobar involvement. In this environment, the high infection risk of dental professionals is undeniable. MATERIALS AND METHODS This work is a literature review on this topic, since current published articles have been selected and valuable indications are given to the dentist. COVID-19 features, transmission and clinical aspects are given to the reader, as well as prevention and protections aspects in dentistry. CONCLUSIONS Telephonic triage, an accurate anamnesis and a careful hand hygiene of both patients and operators are considered essential preliminary aspects to be considered. Moreover, big attention has to be placed on antimicrobial agents for personal hygiene effective on coronaviruses and on disinfectant agents for instruments and surfaces. Various methods for environment sanification are reported, through air changing and purification. For the most practical aspects instead, expedients suggested are the use of rubber dams, high-speed ejectors and anti-retraction handpieces. Very important is also the selection of the most adequate personal protection devices for airways and ocular protection. Differences between surgical masks and respirators are illustrated, highlighting indications towards Sars-CoV-2. Also indications and information are provided about eye protection devices. These aspects play an important role mostly in this historical period featured by the coronavirus diffusion. CLINICAL SIGNIFICANCE This contribution highlights the risks of coronavirus contamination in dental environments and provides practical indications on preventive and protective systems that can be implemented in daily clinical practice.

Epidemiological Aspects and Psychological Reactions to COVID-19 of Dental Practitioners in the Northern Italy Districts of Modena and Reggio Emilia

<p>The outbreak and diffusion of the Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-CoV-2) and COronaVIrus Disease 19 (COVID-19) have caused an emergency status in the health system, including in the dentistry environment. Italy registered the third highest number of COVID-19 cases in the world and the second highest in Europe. An anonymous online survey composed of 40 questions has been sent to dentists practicing in the area of Modena and Reggio Emilia, one of the areas in Italy most affected by COVID-19. The survey was aimed at highlighting the practical and emotional consequences of COVID-19 emergence on daily clinical practice. Specifically, it assessed dentists’ behavioral responses, emotions and concerns following the Sars-CoV-2 pandemic restrictive measures introduced by the Italian national administrative order of 10 March 2020 (DM-10M20), as well as the dentists’ perception of infection likelihood for themselves and patients. Furthermore, the psychological impact of COVID-19 was assessed by means of the Generalized Anxiety Disorder-7 test (GAD-7), that measures the presence and severity of anxiety symptoms. Using local dental associations (ANDI-Associazione Nazionale Dentisti Italiani, CAO-Commissione Albo Odontoiatri) lists, the survey was sent by email to all dentists in the district of Modena and Reggio Emilia (874 practitioners) and was completed by 356 of them (40%). All dental practitioners closed or reduced their activity to urgent procedures, 38.2% prior to and 61.8% after the DM-10M20. All reported a routinely use of the most common protective personal equipment (PPE), but also admitted that the use of PPE had to be modified during COVID-19 pandemic. A high percentage of patients canceled their previous appointments after the DM-10M20. Almost 85% of the dentists reported being worried of contracting the infection during clinical activity. The results of the GAD-7 (General Anxiety Disorder-7) evaluation showed that 9% of respondents reported a severe anxiety. To conclude, the COVID-19 emergency is having a highly negative impact on the activity of dentists practicing in the area of Modena and Reggio Emilia. All respondents reported practice closure or strong activity reduction. The perception of this negative impact was accompanied by feelings of concern (70.2%), anxiety (46.4%) and fear (42.4%). The majority of them (89.6%) reported concerns about their professional future and the hope for economic measures to help dental practitioners.</p>