Mental health, eating habits and physical activity levels of elite Iranian athletes during the COVID-19 pandemic Santé mentale, habitudes alimentaires et niveau d'activité physique des athlètes iraniens de haut niveau pendant la pandémie de COVID-19

Background: The COVID-19 pandemic has changed life styles of millions of people worldwide. This study investigated changes in the health, physical activity levels and eating habits of elite athletes during the COVID-19 pandemic lockdown in Iran. Methods: 383 (248 female and 135 male) elite athletes (168.82 ± 0.07 cm;63.92 ± 7.42 kg;the body mass index (BMI): 22.3 ± 0.78 kg/m2) participated in this study. The International Physical Activity Questionnaire (IPAQ), Depression Anxiety Stress Scales (DASS-21) and the Impact of Event Scale-Revised (IES-R) study tools were used to measure levels of physical activity and mental health status, respectively. The Emotional Eater Questionnaire (EEQ) was used to assess food consumption related to emotion. Pearson and Spearman correlation analysis test were used in data analysis. Results: Levels of depression and stress were mild and moderate, while levels of anxiety were severe and very severe in most elite athletes. There were levels of low emotional eating by elite athletes during the COVID-19 pandemic. Physical activity levels were negatively correlated with psychological mood measures (p≤0.05), while there were positive correlations between emotional eating behaviours and psychological mood measures (moderate correlation;p≤0.01) and light physical activity levels (weak correlation;p≤0.05). Conclusion:  This study provides the first preliminary evidence showing that the COVID-19 lockdown conditions negatively influenced the eating habits and levels of physical activity and mental health in elite athletes. Regular high intensity physical activity as health strategy in elite athletes and the general population remains a strategy to improve overall health during the COVID-19 pandemic. Additionally, these findings suggest the need to devise strategies to improve the life styles of elite athletes during pandemics such as the Covid-19 pandemic.

Mental health, eating habits and physical activity levels of elite Iranian athletes during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has changed life styles of millions of people worldwide. This study investigated changes in the health, physical activity levels and eating habits of elite athletes during the COVID-19 pandemic lockdown in Iran. METHODS: 383 (248 female and 135 male) elite athletes (168.82 ± 0.07 cm; 63.92 ± 7.42 kg; the body mass index (BMI): 22.3 ± 0.78 kg/m2) participated in this study. The International Physical Activity Questionnaire (IPAQ), Depression Anxiety Stress Scales (DASS-21) and the Impact of Event Scale-Revised (IES-R) study tools were used to measure levels of physical activity and mental health status, respectively. The Emotional Eater Questionnaire (EEQ) was used to assess food consumption related to emotion. Pearson and Spearman correlation analysis test were used in data analysis. RESULTS: Levels of depression and stress were mild and moderate, while levels of anxiety were severe and very severe in most elite athletes. There were levels of low emotional eating by elite athletes during the COVID-19 pandemic. Physical activity levels were negatively correlated with psychological mood measures (p≤0.05), while there were positive correlations between emotional eating behaviours and psychological mood measures (moderate correlation; p≤0.01) and light physical activity levels (weak correlation; p≤0.05). CONCLUSION: This study provides the first preliminary evidence showing that the COVID-19 lockdown conditions negatively influenced the eating habits and levels of physical activity and mental health in elite athletes. Regular high intensity physical activity as health strategy in elite athletes and the general population remains a strategy to improve overall health during the COVID-19 pandemic. Additionally, these findings suggest the need to devise strategies to improve the life styles of elite athletes during pandemics such as the Covid-19 pandemic.

CONTEXTE: La pandémie de COVID-19 a changé les modes de vie de millions de personnes dans le monde. Cette étude a examiné certains indicateurs de bonne santé, les niveaux d'activité physique et les habitudes alimentaires d'athlètes Elite iraniens pendant le confinement lié à la pandémie de COVID-19.Méthodes : 383 (248 femmes et 135 hommes) athlètes élites (168,82 ± 0,07 cm ; 63,92 ± 7,42 kg ; indice de masse corporelle (IMC) : 22,3 ± 0,78 kg/m2) ont participé à cette étude. Le questionnaire international sur l'activité physique (IPAQ), l'échelle DASS-21 (Depression Anxiety Stress Scales) et les scores de l'auto-questionnaire Impact of Event Scale-Revised (IES-R) ont été utilisés pour mesurer les niveaux respectifs d'activité physique et de l'état de santé mentale. L'Emotional Eater Questionnaire (EEQ) a été utilisé pour évaluer les altérations de la prise alimentaire liées à l'émotion. Le test d'analyse de corrélation de Pearson et Spearman a été utilisé pour l'analyse des données.Résultats : Les niveaux de dépression et de stress étaient légers et modérés, tandis que les niveaux d'anxiété étaient sévères à très sévères chez la plupart des athlètes élites. Il y avait des niveaux de faible alimentation d'origine émotionnelle chez ces athlètes pendant la pandémie de COVID-19. Les niveaux d'activité physique étaient corrélés négativement avec les mesures de l'humeur psychologique (p≤0,05), tandis qu'il y avait des corrélations positives entre les comportements alimentaires émotionnels et les mesures de l'humeur psychologique (corrélation modérée ; p≤0,01) et les niveaux d'activité physique légère (faible corrélation ; p≤0,05). CONCLUSION: Cette étude apporte une preuve préliminaire que les conditions de confinement liées au COVID-19 ont influencé négativement les habitudes alimentaires et les niveaux d'activité physique et de santé mentale chez des athlètes élites. L'activité physique régulière à haute intensité aussi bien chez les athlètes élites que pour la population générale reste une stratégie pour améliorer la santé globale pendant la pandémie de COVID-19. De plus, ces résultats suggèrent la nécessité de concevoir des stratégies pour améliorer les styles de vie des athlètes élites lors de pandémies, telles que celle de Covid-19.

Effects of home confinement on physical activity, nutrition, and sleep quality during the COVID-19 outbreak in amateur and elite athletes.

Introduction: Despite the progress in the management of the pandemic caused by COVID-19, it is necessary to continue exploring and explaining how this situation affected the athlete population around the world to improve their circumstances and reduce the negative impact of changes in their lifestyle conditions that were necessitated due to the pandemic. The aim of this study was to analyze the moderating influence of physical activity (PA) and dietary habits on the impact of the COVID-19 pandemic experience on sleep quality in elite and amateur athletes. Materials and methods: A total of 1,420 elite (40.1%) and amateur (59.9%) athletes (41% women; 59% men) from 14 different countries participated in a cross-sectional design study. Data were collected using a battery of questionnaires that identified sociodemographic data, sleep quality index, PA levels, dietary habits, and the athletes' perception of their experience during the COVID-19 pandemic. Means and standard deviations were calculated for each variable. The analysis of variances and the correlation between variables were carried out with non-parametric statistics. A simple moderation effect was calculated to analyze the interaction between PA or dietary habits on the perception of the COVID-19 experience effect on sleep quality in elite and amateur athletes. Results: The PA level of elite athletes was higher than amateur athletes during COVID-19 (p < 0.001). However, the PA level of both categories of athletes was lower during COVID-19 than pre-COVID-19 (p < 0.01). In addition, amateurs had a higher diet quality than elite athletes during the pandemic (p = 0.014). The perception of the COVID-19 experience as controllable was significantly higher (p = 0.020) among elite athletes. In addition, two moderating effects had significant interactions. For amateur athletes, the PA level moderated the effect of controllable COVID-19 experience on sleep quality [F (3,777) = 3.05; p = 0.028], while for elite athletes, the same effect was moderated by dietary habits [F (3,506) = 4.47, p = 0.004]. Conclusion: Elite athletes had different lifestyle behaviors compared to amateurs during the COVID-19 lockdown. Furthermore, the relevance of maintaining high levels of PA for amateurs and good quality dietary habits by elite athletes was noted by the moderating effect that both variables had on the influence of the controllable experience during the COVID-19 pandemic on sleep quality.

Global Implications of COVID-19 Pandemic on Adults' Lifestyle Behavior: The Invisible Pandemic of Noncommunicable Disease.

COVID-19 pandemic, with its subsequent lockdown and mobility restriction is a public health emergency that has obliged substantial modifications in daily routines and lifestyle of people worldwide. The drastic measures of social isolation and home confinement has impacted to a great extent the physical and psychological health. The resultant abrupt in lifestyle-related behavior such as physical inactivity, unhealthy dietary habit, sleep disturbance, stress, tobacco use, and alcohol intake, is directly linked to the rising global burden of non-communicable disease. This review aims at gaining a rich and extensive understanding of the potential negative impact triggered by COVID-19 on lifestyle-related behaviors that will influence long-term physical and mental wellbeing. Electronic database search was conducted on PubMed, ScienceDirect, Google Scholar, and Scopus from January 1, 2020 to March 15, 2021. Data related to COVID-19 impact on lifestyle habits were extracted from these studies. Articles were included if meeting the inclusion criteria (i.e., assessed the impact of COVID-19 on physical inactivity and sedentary behavior, dietary habits, sleep, mental health, vitamin D, and substance use among adults. Further search was conducted to address these behavioral changes among athletes. While physical isolation is a necessary public health measure to protect the population, outcomes of this review indicate that in light of adverse lifestyle changes brought by the pandemic, noncommunicable disease remains a critical concern. Hence, adopting healthy lifestyle behavior is essentially important especially during the current time to boost immunity and reduce the risk of COVID-19 infection. Recognizing the pandemic collateral effects offers a forward-looking perspective to guide the government and health authorities in planning prevention and control programs that focus on resilient and sustainable behavioral change.

Can melatonin reduce the severity of post-COVID-19 syndrome?

This short review aimed at (i) providing an update on the health benefits associated with melatonin supplementation, while (ii) considering future potential research directions concerning melatonin supplementation use relative to Coronavirus disease of 2019 (COVID-19). A narrative review of the literature was undertaken to ascertain the effect of exogenous melatonin administration on humans. Night-time melatonin administration has a positive impact on human physiology and mental health. Indeed, melatonin (i) modulates the circadian components of the sleep-wake cycle; (ii) improves sleep efficiency and mood status; (iii) improves insulin sensitivity; and (iv) reduces inflammatory markers and oxidative stress. Melatonin has also remarkable neuroprotective and cardioprotective effects and may therefore prevent deterioration caused by COVID-19. We suggest that melatonin could be used as a potential therapy in the post-COVID-19 syndrome, and therefore call for action the research community to investigate on the potential use of exogenous melatonin to enhance the quality of life in patients with post-COVID-19 syndrome. See also Figure 1(Fig. 1).

Is there a diurnal variation of COVID-19 patients warranting presentation to the health centre? A chronobiological observational cross-sectional study.

BACKGROUND: The circadian clock regulates the function of the immune system, the replication of viruses, and the magnitude of infections. The aim of this study was to analyse whether hospital attendance in Coronavirus disease 2019 (COVID-19) patients presents a diurnal variation. METHODS: Data from the electronic medical records of 1094 COVID-19 patients who presented to a Health Centre in Qatar during the month of July 2020 was retrospectively analysed. The following demographic (i.e. time of day (TOD), sex, age), clinical (i.e. cycle threshold (CT), temperature, oxy-haemoglobin saturation and resting heart-rate), biochemical (i.e. uraemia, glycaemia and albuminia) and haematological (i.e. leukocytes, erythrocytes ad platelets) parameters were collected. RESULTS: Univariate analysis showed a significant effect of TOD on hospital admission (p < 0.001), with patients attending the health care centre more during the active behavioural phase (08h00-00h00) compared to the resting phase (00h00-08h00). COVID-19 infection blunted the circadian rhythms of core body temperature, neutrophils and leukocytes family and shifted the circadian rhythms of resting heart-rate and uraemia. Correlation analysis showed a near perfect negative correlation between the age of patients and the TOD (r=-0.97), with older patients attending the care centre earlier during the day. CONCLUSION: COVID-19 infection affected the circadian rhythms of the host through disrupting the circadian rhythms of core temperature and innate immunity mediators. Old patients attend the health care centre earlier compared to younger ones. However, CT during polymerase chain reaction-test was unaffected by the TOD, which limits the conclusion that COVID-19 viral infection exhibits diurnal variation.

FIFA World Cup 2022: What can we learn from the inspiring Tokyo 2020 Olympic Games held in COVID-19 times?

Preparation for the FIFA World Cup 2022 (WC2022) comes in the time of the COVID-19 pandemic. This study aims were to (i) provide a brief overview of the 2020 Tokyo Olympic and Paralympic games in the context of the COVID-19 pandemic, and (ii) highlight the potential challenges and opportunities central to the hosting of the FIFA WC2022. The organisation, public health policies and prevention protocols of the postponed 2020 Olympic/Paralympic Games (Tokyo July-August 2021), the infection rates during the event, as well as the upcoming WC2022 and its related preparations and challenges, were analysed. An unparalleled International Olympic Committee (IOC) effort, together with the Japanese government and people's perseverance and drive, enabled the safe delivery of the Tokyo Olympic/Paralympic Games, which left a legacy beyond sport. This has been aided by the collection of critical data and lessons learnt throughout the games. The stringent public health policies and especially the tight bubble system for players and their respective delegations have certainly been the key components that ensured the successful containment of COVID-19 within the targeted population. One of the most significant lessons learned from the Tokyo 2020 Olympics is the improvement made in controlling COVID-19 in the context of mass gathering events. Strict infection control strategies to prevent future COVID-19 transmission during the FIFA World Cup 2022 are an immediate priority in Qatar and are constantly being prepared. The planned measures and health care strategies appear to be well adjusted to the risk, especially for the large anticipated number of visitors, and can provide sufficient guarantees to conduct relatively "safe" mega sports events.

COVID-19 lockdown: Impairments of objective measurements of selected physical activity, cardiorespiratory and sleep parameters in trained fitness coaches.

The COVID-19 outbreak resulted in the shutdown of athletic training facilities. Although the effects of these restrictions on daily activity and sleep patterns have been widely analyzed, the employed tools often lacked accuracy, and were based on subjective measures. This study assessed the effects of home confinement on objective physical activity (PA), physiological and sleep parameters in active individuals. Sixteen male elite fitness coaches (age: 29±3 years; height: 183±6 cm; body mass: 82±5 kg, body mass index: 24.7±1.8 kg/m2) participated in this retrospective study. One-way analysis of variance was conducted to analyze selected PA, physiological and sleep parameters collected by smartwatch (Garmin Fenix 6 pro, USA) data during four consecutive months [i.e., pre-confinement, 1st and 2nd months of confinement, and post-confinement, year 2020]. Ramadan intermittent fasting (RIF) month occurred during the 2nd month of confinement. Compared to pre-confinement, significant changes were registered for almost all parameters during the 1st and/or the 2nd month of confinements (p<0.001), with (i) higher values for resting heart rate, sleep latency, and total, light and rapid eye movements sleep times (% change=7-523 %), and (ii) lower values for PA parameters, calories/day spent, average and highest respiratory rates, and deep sleep time during the home confinement period (% change=5-36 %). During the post-confinement month, all parameters regained pre-confinement values. In conclusion, home confinement-induced detraining negatively influenced the objective measurements of cardiorespiratory and sleep parameters among fitness coaches with a deeper effect during the 2nd month of home confinement, possibly due to the effect of RIF.

Football in Times of COVID-19: A Recapitulation of Preventive Measures and Infection Control Policies Aiming at a Safe Game Environment.

Coronavirus disease 2019 (COVID-19) resulted in sporting event suspensions and cancellations, affecting competition calendars worldwide during 2020 and 2021. This challenged high-performance athletes' capacity to complete physical, technical, or tactical training during restricted movement measures (lockdown). With the Football World Cup organized in the last quarter of 2022, the past period of training and match disturbances challenged footballers concerning their performance and potential higher risk of injury at official matches' resumption. There has been considerable debate about the management of resuming professional football (soccer) during the COVID-19 pandemic. Governing bodies worldwide implemented measures to ensure a safe resumption of football. These precautionary measures aimed to protect the health of players, their support staff, and officials around the pitch and ensure the enjoyment of the event by spectators in the football stadiums. We have therefore narratively reviewed scientific papers about how football has resumed on the pitch and in the stands with special focus on the COVID-19 infection control strategies allowing footballers to perform again and supporters to enjoy the game after the 2020 global stop to sport.

Ramadan Observance Exacerbated the Negative Effects of COVID-19 Lockdown on Sleep and Training Behaviors: A International Survey on 1,681 Muslim Athletes.

Objective: Disrupted sleep and training behaviors in athletes have been reported during the COVID-19 pandemic. We aimed at investigating the combined effects of Ramadan observance and COVID-19 related lockdown in Muslim athletes. Methods: From an international sample of athletes (n = 3,911), 1,681 Muslim athletes (from 44 countries; 25.1 ± 8.7 years, 38% females, 41% elite, 51% team sport athletes) answered a retrospective, cross-sectional questionnaire relating to their behavioral habits pre- and during- COVID-19 lockdown, including: (i) Pittsburgh sleep quality index (PSQI); (ii) insomnia severity index (ISI); (iii) bespoke questions about training, napping, and eating behaviors, and (iv) questions related to training and sleep behaviors during-lockdown and Ramadan compared to lockdown outside of Ramadan. The survey was disseminated predominately through social media, opening 8 July and closing 30 September 2020. Results: The lockdown reduced sleep quality and increased insomnia severity (both p < 0.001). Compared to non-Muslim (n = 2,230), Muslim athletes reported higher PSQI and ISI scores during-lockdown (both p < 0.001), but not pre-lockdown (p > 0.05). Muslim athletes reported longer (p < 0.001; d = 0.29) and later (p < 0.001; d = 0.14) daytime naps, and an increase in late-night meals (p < 0.001; d = 0.49) during- compared to pre-lockdown, associated with lower sleep quality (all p < 0.001). Both sleep quality (χ2 = 222.6; p < 0.001) and training volume (χ2 = 342.4; p < 0.001) were lower during-lockdown and Ramadan compared to lockdown outside of Ramadan in the Muslims athletes. Conclusion: Muslim athletes reported lower sleep quality and higher insomnia severity during- compared to pre-lockdown, and this was exacerbated by Ramadan observance. Therefore, further attention to Muslim athletes is warranted when a circadian disrupter (e.g., lockdown) occurs during Ramadan.

Lockdown Duration and Training Intensity Affect Sleep Behavior in an International Sample of 1,454 Elite Athletes.

Objective: To investigate the effect of 1) lockdown duration and 2) training intensity on sleep quality and insomnia symptoms in elite athletes. Methods: 1,454 elite athletes (24.1 ± 6.7 years; 42% female; 41% individual sports) from 40 countries answered a retrospective, cross-sectional, web-based questionnaire relating to their behavioral habits pre- and during- COVID-19 lockdown, including: 1) Pittsburgh sleep quality index (PSQI); 2) Insomnia severity index (ISI); bespoke questions about 3) napping; and 4) training behaviors. The association between dependent (PSQI and ISI) and independent variables (sleep, napping and training behaviors) was determined with multiple regression and is reported as semi-partial correlation coefficient squared (in percentage). Results: 15% of the sample spent < 1 month, 27% spent 1-2 months and 58% spent > 2 months in lockdown. 29% self-reported maintaining the same training intensity during-lockdown whilst 71% reduced training intensity. PSQI (4.1 ± 2.4 to 5.8 ± 3.1; mean difference (MD): 1.7; 95% confidence interval of the difference (95% CI): 1.6-1.9) and ISI (5.1 ± 4.7 to 7.7 ± 6.4; MD: 2.6; 95% CI: 2.3-2.9) scores were higher during-compared to pre-lockdown, associated (all p < 0.001) with longer sleep onset latency (PSQI: 28%; ISI: 23%), later bedtime (PSQI: 13%; ISI: 14%) and later preferred time of day to train (PSQI: 9%; ISI: 5%) during-lockdown. Those who reduced training intensity during-lockdown showed higher PSQI (p < 0.001; MD: 1.25; 95% CI: 0.87-1.63) and ISI (p < 0.001; MD: 2.5; 95% CI: 1.72-3.27) scores compared to those who maintained training intensity. Although PSQI score was not affected by the lockdown duration, ISI score was higher in athletes who spent > 2 months confined compared to those who spent < 1 month (p < 0.001; MD: 1.28; 95% CI: 0.26-2.3). Conclusion: Reducing training intensity during the COVID-19-induced lockdown was associated with lower sleep quality and higher insomnia severity in elite athletes. Lockdown duration had further disrupting effects on elite athletes' sleep behavior. These findings could be of relevance in future lockdown or lockdown-like situations (e.g., prolonged illness, injury, and quarantine after international travel).

A Narrative Review on Prevention and Early Intervention of Challenging Behaviors in Children with a Special Emphasis on COVID-19 Times.

Background: COVID-19 and the measures stemming from efforts to control it have affected the psychosocial wellbeing of children and adolescents. The increasing trend of challenging behavior has exerted further pressure on parents and schools. Understanding socioemotional development and interrelating triggers is the key to management. Early interventions prevent the future threat of mental illness and risky acts. Effective strategies are ones that primarily focus on strengthening parent-child interactions. Aim: The purpose of this paper is to review the literature on the (i) psychosocial and behavioral impacts of COVID-19 on children/adolescents and (ii) approaches to identify determinants of challenging behaviors as a principal guide to effective interventional strategies for children and their families. Methodology: Electronic database searches of PubMed, ScienceDirect, Medline, and Scopus were conducted to identify studies meeting the inclusion criteria that address the impact of COVID-19 on behaviors, contributing factors, and management in the context of families/schools. The content of the selected articles was themed under five categories, namely the developmental milestones, the Pyramid Model, the Positive Behavioral Support, the management strategies, and the impact of COVID-19 on children/adolescents' behavior. Results: The present review demonstrates considerable influence of COVID-19 on children and adolescents' behavior and mental wellbeing. It stresses the importance of early family-based interventions focusing on the triggers of challenging behavior. Functional Behavioral Assessment and Behavioral Intervention Plan provide a systematic analysis with a strategic plan that support children's self-regulation and socioemotional intelligence. Regular behavioral screening is vital to promote prevention and early management. Conclusion: Managing behavioral difficulties remains an area of deficit for parents, teachers, and health care providers. With a quality support, parents and schools will be able to clearly characterize the challenging behavior, understand the causes, reinforce parent-child interactions, and consequently, gain the strategic skills required to apply it within natural settings. Timely interventions will limit the risk of future misconduct and mental disorders.

COVID-19 and screen-based sedentary behaviour: Systematic review of digital screen time and metabolic syndrome in adolescents.

AIM: The COVID-19 pandemic has prompted governments around the globe to implement various restriction policies, including lockdown, social distancing, and school closures. Subsequently, there has been a surge in sedentary behaviour particularly screen time (ST) together with a significant decline in physical activity that was more marked amongst children and adolescents. Excessive screen exposure in adolescents has been correlated with cardio-metabolic risk factors including obesity, hypertension, high cholesterol, and glucose intolerance that may have adverse morbidity and mortality implications in adulthood. Thus, the current study aimed to synthesize the literature on the relationship between ST of various types and the risk of metabolic syndrome (MetS) in adolescents in the context of the COVID-19 pandemic. METHODS: In August 2021, a systematic search of the literature was undertaken using electronic databases: PubMed, PsycINFO, and the Cochran library. Studies were considered if they met the following key eligibility criteria: (i) Measure of ST as an exposure (TV, computer, videogames, internet, smartphone, tablet), using quantified duration/frequency either self-reported or observed; (ii) Measure of MetS as an outcome with standard definition and/or criteria required to establish MetS diagnosis. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias. RESULTS: A total of ten studies met the inclusion criteria, and the majority were cross sectional studies. Most studies met fair bias scoring. Overall, the review revealed considerable evidence that suggests a significant negative association between ST and components of MetS among adolescents with dose-response association. CONCLUSION: During the pandemic, screen usage may become more prevalent through periods of school closures, lockdowns, social isolation, and online learning classes. Public health policies and health promotion strategies targeting parents are needed to raise awareness of the adverse health effects associated with screen-based sedentary behaviour as a precursor of NCDs. Parent or home focused interventions might be effective in limiting adolescents' screen exposure, alternatively substituted with an appropriate level of physical activity. PROSPERO REGISTRATION NUMBER: PROSPERO 2021 CRD42021272436.

Age and clinical signs as predictors of COVID-19 symptoms and cycle threshold value.

Many COVID-19 infected people remain asymptomatic, and hence the diagnosis at first presentation remains a challenge. Assessment at a presentation in primary care settings is usually done by visual triaging and basic clinical examination. This retrospective study involved investigating the medical e-records of COVID-19 positive patients who presented to a COVID-19 centre in Qatar for July 2020. The presence (symptomatic group) or the absence (asymptomatic group) of symptoms along with objective vital examination (ie; heart-rate (HR), temperature, haemoglobin saturation (SpO2)) were analysed and linked to the viral load (ie; cycle threshold (Ct)) of COVID-19 positive patients. Four hundred eighty-one symptomatic (230 males) and 216 asymptomatic (101 males) patients were included. Compared to the asymptomatic male group, the symptomatic male group was older, had lower Ct value and SpO2, and higher temperature and HR. Compared to the females asymptomatic group, the symptomatic females group had lower Ct value, and higher temperature. Compared to the asymptomatic group, the symptomatic group had lower Ct value and SpO2, and higher temperature and HR. Compared to the asymptomatic group, the symptomatic group had lower Ct values (age groups [21-30], [31-40], [41-50] and [51-60]), higher temperature (age groups [21-30] and [31-40], Ct ranges [20.01-25.00] and [25.01-30.00]), higher HR (age groups [21-30] and [31-40], Ct range [15.01-20.00]); and lower SpO2 (age groups [41-50] and [51-60], Ct ranges [15.01-20.00] and [35.01-40.00]). Compared with asymptomatic patients, symptomatic patients with COVID-19 are most likely to be febrile, tachycardic, hypoxic and having higher viral load. Higher viral load was associated with higher HR, higher temperature, lower SpO2, but there was no relation between viral load and age.

BNT162b2 COVID-19 Vaccine Hesitancy among Parents of 4023 Young Adolescents (12-15 Years) in Qatar.

Parental vaccine hesitancy (VH) remains a barrier to full population inoculation, hence herd immunity against the SARS-CoV-2 virus. We aimed to determine parental VH rate, subgroups and influencing factors related to the BNT162b2 COVID-19 vaccine among their young adolescents (12-15 years old) in Qatar. A retrospective, cross-sectional study was conducted from 17 May to 3 June using vaccination booking records of 4023 young adolescents. Sociodemographic characteristics (i.e., age, sex, and nationality), health status and BNT162b2 COVID-19 vaccination booking status were analysed. Among respondents, the VH rate was 17.9%. Parents of 12-years adolescents were more hesitant (21.6%) as compared to the 13- (16.0%) and 15- (15.2%) years groups (p < 0.05). Parents of adolescents belonging to Gulf Countries (97% Qatari) were more hesitant (35.2%) as compared to the four remaining groups of nationalities (Asiatic; excluding Gulf Countries), North-African, African (excluding North-African), and European/American/Oceanian, 13.3-20.4%, (p < 0.001). Parental VH rates were higher when adolescents suffered from chronic disease as compared to those without the chronic disease (21.3% vs. 17.4%, p < 0.05) or who previously were COVID-19 infected as compared to non-previously COVID-19 infected (24.1 vs. 17.5%, p < 0.01). Results of logistic regression revealed that age groups, nationalities, and recovery from COVID-19 were the main predictors of VH level. Precisely, parents of 12 years old adolescents were 38% more likely to be hesitant as compared to the parents of the 15 years old adolescents (OR = 1.38; 95%CI: 1.12-1.70). Compared with the Gulf countries, parents of adolescents belonging to the other nationality categories; namely North-African, African, Asiatic and European/American/Oceanian were 48% (95%CI: 0.36-0.65), 41% (95% CI: 0.27-0.62), 38% (95%CI: 0.29-0.50) and 34% (95% CI 0.21-0.56) less likely to be hesitant, respectively. Furthermore, parents of young adolescents being previously COVID-19 infected were 37% more likely to be hesitant as compared to those with no previous COVID-19 infection (OR = 1.37; 95%CI: 1.02-1.84). Effective communication strategies specifically targeting Gulf Country populations, parents of younger children aged 12 years and of those with chronic disease or have been previously infected with COVID-19 are crucial to build community trust and vaccine confidence, thereby increasing COVID-19 vaccine uptake.

Organising football matches with spectators during the COVID-19 pandemic: What can we learn from the Amir Cup Football Final of Qatar 2020? A call for action.

The COVID-19 pandemic is a potential threat to professional sporting events when they eventually return to their usual calendar with spectators' capacity of football stadiums usually exceeding 40,000 seats for important events. Hence, a strategy for safe return to sporting events is needed in the COVID-19 pandemic to pave the way towards a new normalcy. We reviewed the guidelines and policies implemented in organising the Amir Cup Football Final of Qatar, which hosted about 20,000 fans. The authors evaluated the publicly available information on the official websites of the various organizations involved and highlight the importance and usefulness of the Covid-19 Rapid Antigen Assay-Kit as a tool for screening sports spectators as well as the importance of a rigorous spectator pathway, including their accurate traceability thanks to a specific mobile phone application. Despite the surging of COVID-19 all over the world, a big football event with around 20,000 spectators in the same stadium has been hosted under strongly controlled preventative measures. These preventative measures show that it is possible to organize a major football match held outdoors, with the presence of thousands of supporters. This article is a call for action for the organisers of such events where the supporters' health status is traceable to provide the scientific community with actual data of post-event infection rates. Therefore, it is suggested to consider using procedures like the ones described in the present article as a potential model in the process of organizing big sporting events with spectators in times of COVID-19.

Covid-19 and diabetes in primary care - How do hematological parameters present in this cohort?

Objectives: Changes in hematological parameters are becoming evident as important early markers of COVID-19. Type 2 Diabetes Mellitus (T2DM) has been shown to be associated with increased severity of COVID-19. In this study, we aim to explore the various hematological variables in COVID-19 positive patients with T2DM, so as to act early and improve patient outcomes.Methods: Medical e-records of seventy adult patients with T2DM who were COVID-19 positive have been analyzed in this retrospective cohort study. Demographic, clinical and laboratory parameters for these patients were examined.Results: Of the seventy patients with T2DM, 48.88% had poorly controlled diabetes. 70.69% were pyrexial, 56.25% were tachycardic and 38.58% were asymptomatic on presentation. Amongst the hematological parameters, anemia was seen in 10% of males and 15.38% of females. 20% had a high red-blood-cell-distribution-width (RDW). 7.27% had thrombocytosis and 3.64% had thrombocytopenia. 73.3% had a high platelet-distribution-width (PDW) and 44.44% had an increased mean-platelet-volume (MPV). 16.36% were neutropenic and 16.67% had lymphocytopenia.Conclusion: Diabetic COVID-19 positive patients have been shown to have prominent manifestations of the hemopoietic-system with varied hematological profiles. Recognizing the implications of these variables early in primary-care, can help clinicians aid management decisions and dictate early referral to secondary-care services, to help improve prognosis.