Social media exposure and mental health problems during coronavirus disease 2019 pandemic in Indonesia.

BACKGROUND: Several preventive measures were used by governments around the world to suppress the transmission of SARS-CoV-2, including quarantine. During quarantine more people are at risk of developing mental health problems as social media exposure was increasing. OBJECTIVES: The objective is to investigate the impact of social media exposure during coronavirus disease 2019 (COVID-19) pandemic on depression, anxiety, and stress. MATERIALS AND METHODS: A cross-sectional study was conducted between April and May 2020 during the large scale social restriction in Indonesia using online questionnaire Indonesian citizens over 18 years of age were invited to take part by answering online questionnaire through Google forms (http://bit.ly/duniamayaCOVID). Data gathered were demographic data, depression, anxiety, and stress that were assessed using Depression Anxiety Stress Scale-21, duration of social media usage, and social media platforms used during COVID-19 pandemic. Data was analysed using Pearson Chi-square and ANOVA. Statistically significant variables and additional risk factors was analyzed using multinomial logistic regression. RESULTS: The median age was 24 years (range 17-56 years), 121 (55,0%) samples were female. The three most frequent social media platforms used by participants were Instagram, WhatsApp, and YouTube. Female were more likely to suffer from mild-moderate depression compared to male (odds ratio [OR]: 2.344; 95% confidence interval [CI]: 1.105-4.972; P = 0.026) and more likely to suffer from severe-extremely severe anxiety (OR: 2.066; 95% CI: 1.019-4.187; P = 0.044). Social media exposure was associated with less likelihood to suffer from severe-extremely severe depression, mild-moderate, and severe-extremely severe anxiety, mild-moderate stress. CONCLUSION: Social media exposure was associated with less depression, anxiety, and stress in the COVID-19 pandemic era. Medical professionals and government officials could use social media to disseminate knowledge about COIVD-19 to bring positive psychological effect.

Inflammatory and hematologic markers as predictors of severe outcomes in COVID-19 infection: A systematic review and meta-analysis.

BACKGROUND: Laboratory testing is commonly performed in patients with COVID-19. Each of the laboratory parameters has potential value for risk stratification and prediction of COVID-19 outcomes. This systematic review and meta-analysis aimed to evaluate the difference between these parameters in severe and nonsevere disease and to provide the optimal cutoff value for predicting severe disease. METHOD: We performed a systematic literature search through electronic databases. The variables of interest were serum procalcitonin, albumin, C-reactive protein (CRP), D-dimer, and lactate dehydrogenase (LDH) levels in each group of severity outcomes from COVID-19. RESULTS: There were a total of 4848 patients from 23 studies. Our meta-analysis suggest that patients with severe COVID-19 infections have higher procalcitonin, (mean difference 0.07; 95% CI 0.05-0.10; p < 0.00001), CRP (mean difference 36.88; 95% CI 29.10-44.65; p < 0.00001), D-Dimer (mean difference 0.43; 95% CI 0.31-0.56; p < 0.00001), and LDH (mean difference 102.79; 95% CI 79.10-126.49; p < 0.00001) but lower levels of albumin (mean difference -4.58; 95% CI -5.76 to -3.39; p < 0.00001) than those with nonsevere COVID-19 infections. The cutoff values for the parameters were 0.065 ng/mL for procalcitonin, 38.85 g/L for albumin, 33.55 mg/L for CRP, 0.635 µ/L for D-dimer, and 263.5 U/L for LDH, each with high sensitivity and specificity. CONCLUSION: This meta-analysis suggests elevated procalcitonin, CRP, D-dimer, and LDH and decreased albumin can be used for predicting severe outcomes in COVID-19.

The Use of ACE inhibitor/ARB in SARS-CoV-2 Patients: A Comprehensive Narrative Review

The three most common comorbidities that are associated with increased mortality in COVID-19 patients are Hypertension, Diabetes, and Cardiovascular disease, Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II receptor blockers (ARB) are the drugs most commonly prescribed for the management of these diseases. Recent experimental study in animals and humans have found that SARS-CoV-2 uses ACE2 as the receptors for entry. Moreover, in an animal study, the use of ACE inhibitor/ARB increases the level of ACE2 expression that can lead to increased SARS-CoV-2 infectivity. On the other side, some evidences suggest that the ACE2 receptor is not necessary for SARS-CoV-2 entry into the cell and suggested that there is a cofactor that play part. Experimental studies in humans also showed that there is no association between ACE inhibitor/ARB with SARS-CoV-2 infectivity and mortality. In conclusion, there is still insufficient data to stop the use of inhibitor/ARB in SARS-CoV-2 patients. Therefore, we suggested that in line with the recommendations from ESC and AHA/ACC, the use of these two drugs in SARS-CoV-2 patients with cardiovascular comorbidity should still be continued.

Coronavirus disease 2019 and cardiovascular system: A narrative review.

At the end of 2019, a viral pneumonia disease called coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV2), emerged in Wuhan, China. This novel disease rapidly spread at an alarming rate that as a result, it has now been declared pandemic by the World Health Organization. Although this infective disease is mostly characterized by respiratory tract symptoms, increasing numbers of evidence had shown considerable amounts of patients with cardiovascular involvements and these were associated with higher mortality among COVID-19 patients. Cardiac involvement as a possible late phenomenon of the viral respiratory infection is an issue that should be anticipated in patients with COVID-19. Cardiovascular manifestation in COVID-19 patients include myocardial injury (MI), arrhythmias, cardiac arrests, heart failure and coagulation abnormality, ranging from 7.2% up to 33%. The mechanism of cardiac involvement in COVID-19 patients involves direct injury to myocardial cells mediated by angiotensin-converting enzyme 2 (ACE2) receptors as suggested by some studies, while the other studies suggest that systemic inflammation causing indirect myocyte injury may also play a role. Combination of proper triage, close monitoring, and avoidance of some drugs that have cardiovascular toxicity are important in the management of cardiovascular system involvement in COVID-19 patients. The involvement of the cardiovascular system in COVID-19 patients is prevalent, variable, and debilitating. Therefore, it requires our attention and comprehensive management.