Depression and burden in caregivers of onco-hematologic patients during SARS-Cov-2 pandemic

Aims: Onco-hematologic diseases (lymphomas, myeloma, leukemia) require intensive treatment regimens and represent a burden at the affective and instrumental level for their caregivers. The aim of this study was to investigate the link between caregiving burden and depressive symptoms in caregivers of onco-hematologic patients during the SARS-CoV-2 pandemic. Method(s): A convenience sample of 101 caregivers of onco-hematologic patients were recruited at the Hematology Unit of the Holy Spirit Hospital, Pescara, Italy. Most of the caregivers were female (80%) with an average age of 41 years old (SD = 14.01). Participants were administered the Caregiver Burden Inventory (CBI), the Patient Health Questionnaire-9 (PHQ-9) for depression, and the Fear of Covid-19 Scale (FCV-19S) during two months of the COVID-19-related stay-at-home period (April-May 2021). Result(s): Moderate-to-severe depression (PHQ-9 > 10) were reported by 36% of caregivers. Depressive symptoms were associated with caregivers' time-dependence (r = 0.43), developmental (r = 0.61), physical (r = 0.72), social (r = 0.60), and emotional burden (r = 0.43) (all ps < 0.001). CBI explained 53% of the PHQ-9 variance, particularly the physical (beta = 0.54, p < 0.001) and the social (beta = 0.30, p < 0.01) dimensions of burden. Unexpectedly, COVID-19 was not associated with caregiver burden and depressive symptoms. Conclusion(s): Caregivers of onco-hematologic patients may experience depression due to the burden of caregiving, which is related mostly to the patients' disease rather than extraordinary, even dramatic events such as the pandemic. Psychological interventions are needed for them.Copyright © 2023

One-year mortality in COVID-19 is associated with patients' comorbidities rather than pneumonia severity

Background: In patients with pneumonia or ARDS who survived hospitalization, one-year mortality can affect up to one third of discharged patients. Therefore, significant long-term mortality after COVID-19 respiratory failure could be expected. The primary outcome of the present study was one-year all-cause mortality in hospitalized COVID-19 patients. Method(s): Observational study of COVID-19 patients hospitalized at Papa Giovanni XXIII Hospital (Bergamo, Italy), during the first pandemic wave. Result(s): A total of 1326 COVID-19 patients were hospitalized. Overall one-year mortality was 33.6% (N 446/1326), with the majority of deaths occurring during hospitalization (N=412, 92.4%). Thirty-four patients amongst the 914 discharged (3.7%) subsequentely died within one year. A third of these patients died for advanced cancer, while death without a cause other than COVID-19 was uncommon (8.8% of the overall post-discharge mortality). Inhospital late mortality (i.e. after 28 days of admission) interested a population with a lower age, and fewer comorbidities, more frequentely admitted in ICU. Independent predictors of post-discharge mortality were age over 65 years (HR 3.19;95% CI 1.28-7.96, p-value=0.013), presence of chronic obstructive pulmonary disease (COPD) (HR 2.52;95% CI 1.09-5.83, p-value=0.031) or proxy of cardiovascular disease (HR 4.93;95% CI 1.45-16.75, pvalue=0.010), and presence of active cancer (HR 3.64;95% CI 1.50-8.84, p-value=0.004), but not pneumonia severity. Conclusion(s): One-year post-discharge mortality depends on underlying patients' comorbidities rather than COVID19 pneumonia severity per se. Awareness among physicians of predictors of post-discharge mortality might be helpful in structuring a follow-up program for discharged patients.

Release of ammonia, particulate matter and nitrogen oxides during the Covid-19 quarantine: what is the role of livestock activities?

Several gases contribute to air pollution and most of all to the formation of secondary particulate matter (PM2.5), which is recognized as a source of severe risk to human health. Even if huge steps forward have been done worldwide, traffic, industrial activities, and the energy sector are mostly responsible for the release of NOx and SOx, while the agricultural sector is mainly responsible for the emission of NH3 deriving from the barn, the manure storage, management and final field application. In this study, the emission of PM2.5, NOx and NH3 is analyzed in the main provinces of the Lombardy region in which livestock activities are carried out, comparing emissions of 2016-2019 and those of 2020 during the lockdown determined by the spread of Covid-19 disease. The aim is to understand if and how a change in air emissions can be identified. The results show that PM2.5 and NOx reduced, most of all in urban areas, whereas NH3 maintained the same trend of previous years. From the statistical analysis emerges also that NH3 has a different behavior respect to PM2.5 and NOx, these latter being much more correlated between each other than NH3. However, further studies should be carried out on a bigger spatial and temporal scale.

Burnout Status of Italian Healthcare Workers during the First COVID-19 Pandemic Peak Period

The pandemic of 2019 coronavirus disease (COVID-19) has burdened extraordinary psychological stress on the healthcare workforce. The present survey aimed to examine the personal resources and psychological symptoms associated with burnout in 933 healthcare workers in Italy during the COVID-19 outbreak period. Sociodemographic and occupational data, depression, anxiety, burnout, and post-traumatic symptoms, as well as psychological well-being, were cross-sectional assessed through an online questionnaire. A considerable part of the sample scored over the clinical levels of depression (57.9%), anxiety (65.2%), post-traumatic symptoms (55%), and burnout (25.61%). Working in the front-line (p <.05), being part of the medical staff (p <.05), experiencing lower levels of psychological well-being (p <.001), and higher levels of post-traumatic symptoms (p <.001) independently explained 38% of burnout variance. The healthcare industry, services, and professionals should be aware of the harmful effects of COVID-19 on healthcare workers and take adequate preventive measures.