ABSTRACT
There is currently no specific treatment for patients with coronavirus disease 2019 (COVID-19). Confirmed cases of severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) should be treated with effective conditions of isolation and protection, in addition to infection control;Critical cases should be admitted to the intensive care unit as soon as possible. Those subjects with chronic diseases, such as diabetes, obesity,and hypertension, are identified as groups with a higher risk of contagion and severe COVID-19. There are a significant number of pharmacological targets, such as virus life cycle, viral routes of entry, and immune regulation, however, there is currently no evidence from randomized clinical trials that any potential therapy improves outcomes in hospitalized patients with COVID.-19, there are no data to support any prophylactic therapy, much less that they are harmless. The disease pandemic caused by the new SARSCoV-2 presents an unprecedented challenge for medical personnel, including the endocrinologist, as they face a new nosological and therapeutic challenge. Los casos confirmados de infección por el coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2) deben tratarse con condiciones efectivas de aislamiento y protección, además del control de infecciones;los casos críticos deben ingresarse a la unidad de cuidados intensivos lo antes posible. Se identifican como grupos de mayor riesgo de contagio y de COVID-19 severa, a aquellos sujetos con enfermedades crónicas, como diabetes, obesidad e hipertensión. Existe un número significativo de objetivos farmacológicos, como el ciclo vital del virus, las vías de entrada viral y la regulación inmunitaria, sin embargo, actualmente no hay evidencia procedente de ensayos clínicos aleatorizados de que cualquier terapia potencial mejore los resultados en pacientes hospitalizados con COVID-19, tampoco existen datos que respalden alguna terapia profiláctica, y mucho menos que sean inocuos. La pandemia de la enfermedad causada por el nuevo SARSCoV-2 presenta un desafío sin precedentes para el personal médico, entre ellos el endocrinólogo al enfrentarse a un nuevo reto nosológico y terapéutico.
ABSTRACT
Ecuador has been one of the most affected countries by the Corona Virus Disease 19 (COVID-19) pandemic, by April 2020 this country presented the highest rates of mortality in Latin America. The purpose of the present study was to identify behaviors during confinement and sociodemographic variables associated with the mental health status of confirmed or suspected COVID-19 patients who were part of the epidemiological surveillance program in Ecuador that included mandatory confinement and self-isolation. A cross-sectional study was performed from March 22th to April 18th, 2020 using an online survey. The survey collected socio-demographic information and severity of depressive symptoms using the Patient Health Questionnaire-9 and anxiety symptoms through the Generalized Anxiety Disorder-7. A total of 759 patients completed the questionnaire, 20.3% presented moderate to severe symptoms of depression and 22.5% moderate to severe symptoms of anxiety. Being a woman and from the Coastal region were risk factors. Exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to an hour was associated with better mental health. Regression analysis indicated that the mentioned behaviors explained approximately 17% of the variance for depression sum scores and 11.8% of the variance for anxiety sum scores while controlling for gender and region. Understanding the association between sociodemographic variables and psychological states in patients with COVID-19 is relevant to tackle future public mental health problems and to implement health policies that are intended to palliate further psychiatric complications. Promotion of modifiable behaviors such as exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to less than an hour is recommended.