ABSTRACT
Objectives: Electroconvulsive therapy (ECT) is important in the management of major, life-threating, and treatment-resistant psychiatric illness. The COVID-19 pandemic has significantly disrupted ECT services. The need for new infection control measures, staff/resource redeployment and shortages, and the perception that ECT is as an 'elective' procedure have caused changes to, and reductions in, ECT delivery. The aim of this study was to explore the impacts of COVID-19 on ECT services, staff, and patients globally. Method(s): Data were collected using an electronic, mixed-methods, cross-sectional survey. The survey was open March to November 2021. Clinical directors in ECT services, their delegates, and anaesthetists were asked to participate. Quantitative findings are reported. Result(s): One hundred and twelve participants worldwide completed the survey. The study identified significant impacts on services, staff, and patients. Based on quantitative results, most participants (57.8%, n=63) reported their services made at least one change to ECT delivery. More than three-quarters (81.0%, n=73) reported their service had identified at least one patient who could not access ECT. More than two-thirds (71.4%, n=67) reported their service identified at patients who experienced a relapse in their psychiatric illness due to lack of ECT access. Six participants (7.6%) reported their service had identified at least one patient who died, by suicide or other means, due to lack of ECT access. Participants' qualitative responses were detailed, averaging 43 words. Three qualitative themes were identified: (1) Service provision, about the importance of ECT services continuing during the pandemic, (2) Preparedness, through guidelines and environmental design, and (3) Personal protection, about strategies to increase staff safety. Conclusion(s): This is the first multi-site, international survey to explore the impacts of COVID-19 on ECT services, staff, and patients. Its findings can be used to inform evidence-based ECT practice. This supports the ongoing safe, effective operation of ECT services. Research Category and Technology and Methods Clinical Research: 2. Electroconvulsive Therapy (ECT) Keywords: Survey, Mixed Methods, COVID, Service changes;Copyright © 2023
ABSTRACT
Background: The coronavirus disease 2019 (COVID-19) pandemic has led to reported change in electroconvulsive therapy (ECT) services worldwide. However, minimal data have been published demonstrating tangible changes across multiple ECT centres. Objectives: To examine changes in patients receiving ECT and ECT service delivery during the COVID-19 pandemic. Methods: We retrospectively assessed data collected on ECT patients within the CARE Network during a 3-month period starting at the first COVID-19 restrictions in 2020 and compared data with predicted values based on the corresponding 3-month period in 2019. Mixed-effects repeated-measures analyses examined differences in the predicted and actual number of acute ECT courses started and the total number of acute ECT treatments given in 2020. Sociodemographic, clinical, treatment factors and ECT service delivery factors were compared for 2020 and 2019. Findings: Four Australian and one Singaporean site participated in the study. There were no significant differences between the predicted and actual number of acute ECT courses and total number of acute ECT treatments administered in 2020. During 2020, there were statistically significant increases in the proportion of patients requiring ECT under substitute consent and receiving ECT for urgent reasons compared to 2019. Conclusion: This multisite empirical study is among the first that supports anecdotal reports of changes in the triaging and delivery of ECT during COVID-19. Results suggest that ECT was prioritised for the most severely ill patients. Further data assessing the impacts of COVID-19 on ECT are needed.
ABSTRACT
In the scenario of COVID-19, the social interaction is limited and distancing. It causes several drawbacks such as decreasing the social constraints among relations and growing the troublesomeness of daily activities. However, this way helps to isolate the infectious disease as well as reduce the number of patients. To overcome these troubles, the service robot plays an excellent solution in this circumstance. Instead of servants, robot could carry the heavy cargo, continuously operate with numerous orders and do not hesitate the hazardous environment. Especially, it can not be affected by the infected disease and ease to disinfect by various chemicals. Therefore, in this paper, an interactive model for the autonomous robot in the healthcare service is proposed. Firstly, several coefficients related to interaction are denoted for the clarification and initial establishment. Later, a model of working space for human that interact with others, is suggested. These zones are categorized based on the needs of socially collaboration and comfortably communication in reality. In our research, the autonomous robot must work in the medical area where both patients and nurses stay. Hence, the missions of robot are not only to avoid obstacles but also cleverly manipulate in the crowd. Owing to this model, the service robot could behave intelligently, perceptively and safely. To validate the our work, the fully interactive model is simulated in the pre-determined situations. The robot must obey the desired commands while the medical constraints are still preserved. From these test results, it could be easily seen that our approach such the interactive model of robot is effective, feasible and reasonable for the healthcare service to prevent the infectious disease in the period of global pandemic. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Lymphopenia and immune dysfunction in COVID-19 is increasingly recognized and studied. This case report details a secondary infection following lymphopenia with CD4+ count drop in a COVID-19 patient with no history of immunosuppression or infection with HIV. The mechanism of lymphopenia, both CD4+ and CD8+ T cell count drops, in COVID-19 needs further study.