Epidemiological and clinical characteristics of children with COVID-19 cared for in a private health provider in Uruguay

Background: After the detection of the first cases of SARS-CoV-2 and the declaration of a health emergency in the country, community transmission of the virus remained low to moderate until November 2020, later becoming medium and high. Children under 15 years of age constitute the least affected group. The diagnosis is confirmed by RT-gPCR. The usefulness of the CT (cycle threshold) is discussed. Aim: To describe the epidemiological and clinical characteristics of children infected with SARS-CoV-2 and the relationship between the CT value and clinical presentation. Method: A descriptive, retrospective study was carried out in patients under 16 years of age with SARS-CoV-2 infection, assisted by a health provider in Montevideo between epidemiological week (EW ) 3 of 2020 and EW 9 of 2021. Clinical variable, epidemiological notion, severity and evolution were described. The CT value at diagnosis was recorded and compared with the presence of symptoms. Results: Patients under 16 years of age represented 16.6% of the total infected (794 in 4,792). 70% of the cases occurred between the months of January and February 2021. 67.6% presented intradomiciliviry contact. The mean age was 7.5 +/- 4.1 years, 51% were male. 55% presented symptoms and 45% were asymptomatic;no significant differences were observed in the mean, mode and age range of both groups. None presented comorbidities. hi the group of 440 symptomatic patients, 55% presented feva: 32% associated with other symptoms, mainly upper respiratory symptoms, and 23% as the only symptom. The CT value was Obtained in 536 of the 794 patients (67.5%). The mean CT was 29.7+5.8 in the symptomatic group vs. 31.5 +/- 5.7 in asymptomatic patients (p > 0.05). Three patients were hospitalized, none required intensive care and none died. Conclusions: The prevalence and incidence of SARS-CoV-2 infection in children accompany that of adults and the majority had mild or asymptomatic forms, without complications. In this series, the CT value was not different in symptomatic and asymptomatic children. Close household contact was the main source of infection.

Psychological impact of the COVID-19 health crisis on employees

Purpose of the study: During the COVID-19 pandemic, the changes in working conditions, the fear of being contaminated at the work place and job insecurity can have a significant impact on the mental health of employees. The objective of this study was to measure the impact of the pandemic on the mental health of employees under follow-up in an occupational health service and to identify the factors associated with stress and fear at work. Method: An anonymous and confidential questionnaire was offered to employees coming to occupational health visit in early October and November 2020. Results: Among the employees, 1797 responded. Nearly 40% had manifestations of anxiety disorders and 20% had depressive signs. From the beginning of the crisis, almost a third of employees were more stressed than before and 21% happened to be afraid at work. Being more stressed at work was associated with gender, number of employees, seniority, working in the health sector, feeling affected by SARS-COV2, being at risk of severe covid-19, feeling exposed to SARS-COV2 at work, feeling insecure at work and having difficulties to apply barrier measures. The multivariate model analysis looking at factors associated to fear at work had similar findings. Conclusion: This study confirms and quantifies the importance of stress, feelings of insecurity and tensions at work. These results emphasized the role of an occupational health service in the face of a health crisis to best support employees and employers. © 2022 Elsevier Masson SAS

Retentissement psychologique de la crise sanitaire du COVID-19 sur les salariés Psychological impact of the COVID-19 health crisis on employees

RESUME Objectif: Dans le contexte de crise sanitaire, le bouleversement des habitudes de travail, la crainte d’être contaminés sur leur lieu d’exercice, ou la fermeture de certains établissements font présager un impact important sur la santé mentale des salariés. L’objectif de cette étude était de mesurer l’impact de la crise sanitaire sur la santé mentale des salariés suivis par un service de santé au travail et d’identifier les facteurs associés au stress et à la peur au travail. Méthode: Un questionnaire anonyme et confidentiel était proposé aux salariés se rendant en visite médicale début octobre et novembre 2020. Résultats: 1797 salariés ont participé. Près de 40% présentaient des manifestations d’anxiété et 20% des signes dépressifs (score HAD >=8). Près d’un tiers des salariés déclarait être plus stressés au travail depuis le début de la crise. 21% déclarait qu’il leur arrive d’avoir peur au travail depuis le début de la crise sanitaire. Le fait d’être plus stressé était associé au genre, à la taille de l’entreprise, à l’ancienneté, au secteur sanitaire et social, au fait de s’être senti affecté, au fait d’être à risque de forme grave de COVID-19, au sentiment d’être exposé au SARS-COV2 dans le cadre de son travail, au sentiment d’insécurité au travail et au fait d’avoir des difficultés dans l’application des mesures barrières. Le modèle multivarié pour expliquer la peur au travail présentait des similitudes. Conclusion: Cette étude permet de confirmer et de quantifier l’importante augmentation du stress, du sentiment d’insécurité au travail, des tensions vécues vis-à-vis du public. Ces résultats amènent une réflexion approfondie sur le rôle essentiel d’un service de santé au travail face à une crise sanitaire pour accompagner au mieux nos adhérents.

Retentissement psychologique de la crise sanitaire du COVID-19 sur les salariés

SUMMARY Purpose of the study: During the COVID-19 pandemic, the changes in working conditions, the fear of being contaminated at the work place and job insecurity can have a significant impact on the mental health of employees. The objective of this study was to measure the impact of the pandemic on the mental health of employees under follow-up in an occupational health service and to identify the factors associated with stress and fear at work. Method: An anonymous and confidential questionnaire was offered to employees coming to occupational health visit in early October and November 2020. Results: 1797 employees responded. Nearly 40% had manifestations of anxiety disorders and 20% had depressive signs. From the beginning of the crisis, almost a third of employees were more stressed than before and 21% happened to be afraid at work. Being more stressed at work was associated with gender, number of employees, seniority, working in the health sector, feeling affected by SARS-COV2, being at risk of severe covid-19, feeling exposed to SARS-COV2 at work, feeling insecure at work and having difficulties to apply barrier measures. The multivariate model analysis looking at factors associated to fear at work had similar findings. Conclusion: This study confirms and quantifies the importance of stress, feelings of insecurity and tensions at work. These results emphasized the role of an occupational health service in the face of a health crisis to best support employees and employers. RESUME Objectif: Dans le contexte de crise sanitaire, le bouleversement des habitudes de travail, la crainte d’être contaminés sur leur lieu d’exercice, ou la fermeture de certains établissements font présager un impact important sur la santé mentale des salariés. L’objectif de cette étude était de mesurer l’impact de la crise sanitaire sur la santé mentale des salariés suivis par un service de santé au travail et d’identifier les facteurs associés au stress et à la peur au travail. Méthode: Un questionnaire anonyme et confidentiel était proposé aux salariés se rendant en visite médicale début octobre et novembre 2020. Résultats: 1797 salariés ont participé. Près de 40% présentaient des manifestations d’anxiété et 20% des signes dépressifs (score HAD >=8). Près d’un tiers des salariés déclarait être plus stressés au travail depuis le début de la crise. 21% déclarait qu’il leur arrive d’avoir peur au travail depuis le début de la crise sanitaire. Le fait d’être plus stressé était associé au genre, à la taille de l’entreprise, à l’ancienneté, au secteur sanitaire et social, au fait de s’être senti affecté, au fait d’être à risque de forme grave de COVID-19, au sentiment d’être exposé au SARS-COV2 dans le cadre de son travail, au sentiment d’insécurité au travail et au fait d’avoir des difficultés dans l’application des mesures barrières. Le modèle multivarié pour expliquer la peur au travail présentait des similitudes. Conclusion: Cette étude permet de confirmer et de quantifier l’importante augmentation du stress, du sentiment d’insécurité au travail, des tensions vécues vis-à-vis du public. Ces résultats amènent une réflexion approfondie sur le rôle essentiel d’un service de santé au travail face à une crise sanitaire pour accompagner au mieux nos adhérents.

SARS-CoV-2 infection in children: Clinical characteristics and dynamics of SARS-CoV-2 transmission in a private health center. Uruguay

BACKGROUND: To date, the prevalence and severity of the COVID-19 disease in children is lower than in adults. There are controversies regarding the dynamics of transmission and the role they play in the spread of the disease. AIM: To describe the clinical characteristics and transmission dynamics of patients under 15 years of age reported for suspicion and/or contact for COVID-19 in the period March 13 - November 20, 2020, in a private comprehensive health provider (Medica Uruguaya Medical Assistance Corporation, MUCAM). METHODS: Descriptive, retrospective study, in which clinical manifestations, epidemiological notion, secondary cases, severity and evolution are described. The risk and rate of secondary intradomiciliary attack were estimated. RESULTS: 539 patients met the inclusion criteria. The diagnosis was confirmed in 29 (5.3%): 13 (7.0%) of the 351 symptomatic children and 16 (4.5%) of the 188 asymptomatic. 100% of the confirmed cases and 85% of the unconfirmed cases had the notion of contact (p < 0.05). The OR for infection from an indoor contact was 26.5 (9.8-71.7) and the rate of secondary indoor attack 23% +/- 4.1. CONCLUSIONS: In this series, mild and asymptomatic forms predominated in patients under 15 years of age. One in five exposed indoors contracted the disease, this notion of contact being decisive to indicate confirmatory studies. Most of the children did not continue the chain of transmission.