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Objectives: The objective of this study is to assess the clinical benefits and potential risks of using venovenous extracorporeal membrane oxygenation (VV ECMO) as a treatment for COVID-19 patients with severe respiratory failure. Method(s): Relevant studies were identified through searches of electronic databases, including PubMed, EMBASE, and the Cochrane Library, from January 2020 to December 2022. We included observational studies on adult patients who received venovenous (VV) ECMO support for COVID-19-induced ARDS. The primary outcome was in-hospital mortality, 3-month mortality, and complications associated with VV ECMO. Statistical analysis was performed using R version 4.0.3 and the metafor and meta packages. Result(s): The final analysis included 39 studies comprising 10,702 patients. In-hospital mortality for adults receiving ECMO was 34.2% (95% CI: 28.5% - 40.3%;I2 = 93%), while the 3-month mortality rate was 50.2% (95% CI: 44.4% - 56.0%;I2 = 51%). Bleeding requiring transfusion occurred in 33.7% of patients (95% CI, 23.9 - 45.1;I2 = 96%). The pooled estimates for other complications were as follows: overall thromboembolic events 40.9% (95% CI, 24.8 - 59.3;I2 = 97%), stroke 8.7% (95% CI, 5.7 - 13.2;I2 = 72%), deep vein thrombosis 15.4% (95% CI, 9.7 - 23.6;I2 = 80%), pulmonary embolism 15.6% (95% CI, 9.3 - 25.1;I2 = 92%), gastrointestinal haemorrhage 8.1% (95% CI, 5.5 - 11.8;I2 = 56%), and the need for any renal replacement therapy in 38.0% of patients (95% CI, 31.6 - 44.8;I2 = 84%). Bacterial pneumonia occurred in 46.4% of patients (95% CI, 32.5 - 61.0;I2 = 96%). Conclusion(s): Venovenous extracorporeal membrane oxygenation (VV ECMO) may be an effective treatment option for COVID-19 patients with severe respiratory failure. The use of VV ECMO was associated with reduced in-hospital and 3-month mortality. However, bleeding is a common complication that should be closely monitored. Further research is needed to determine the optimal use of VV ECMO in this patient population and to identify factors that may predict a favourable response to treatment.
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INTRODUCTION: Radiologic technologists (RTs) are among the healthcare staff negatively impacted by job dissatisfaction, occupational stress, and unhealthy lifestyle behaviors, especially during the COVID-19 pandemic. The aim of this study was to assess job satisfaction, lifestyle behaviors, occupational burnout symptoms, and associated factors among RTs in Saudi Arabia. METHODS: A survey study was conducted from January 2021 to February 2022 using a self-administered questionnaire. The questionnaire gathered socio-demographic information, answers to the Minnesota Satisfaction Questionnaire, lifestyle behaviors, and frequency of occupational burnout symptoms. Data were analyzed to obtain descriptive and inferential statistics. RESULTS: A total of 261 RTs completed the survey. Participants were predominantly male and most were working in public hospitals. The overall mean score for job satisfaction was 3.77 (of 5), indicating moderate job satisfaction, with two items showing low satisfaction- compensation (3.33) and advancement (3.28). The overall mean score for lifestyle behaviors was 2.00 (of 3), indicating moderate lifestyle behaviors, with the lowest scores reported in sleep quality (1.92), healthy diet (1.85), and relaxing and unwinding (1.86). For burnout symptoms, the overall mean score was 2.30, indicating moderate burnout level, with the highest score reported in experiencing physical symptoms (2.72). There were significant relationships between job satisfaction, lifestyle behaviors and burnout symptoms. A positive and moderate relationship, r = 0.53 (p < 0.05), was found between job satisfaction and healthy lifestyle behaviors. The burnout relationships with job satisfaction, r = -0.615 (p < 0.05), and healthy lifestyle behaviors, r = -0.524 (p < 0.05), were negative and moderate relationships CONCLUSION: The interrelationships between job satisfaction, lifestyle behaviors, and occupational burnout symptoms suggest that improving lifestyle behaviors and managing burnout symptoms could contribute to higher job satisfaction. IMPLICATIONS FOR PRACTICE: Policymakers should focus their efforts in the workplace health promotion programs to play essential roles in promoting healthy lifestyle behaviors and occupational stress management, as well as, improvements of RTs career advancement and compensation.
Subject(s)
Burnout, Professional , COVID-19 , Occupational Stress , Burnout, Professional/epidemiology , COVID-19/epidemiology , Female , Humans , Job Satisfaction , Life Style , Male , Pandemics , Saudi Arabia/epidemiologyABSTRACT
Background: There are little researches taken discussed the effect of IP-10 and MCP-1 in the coronavirus infection. Therefore, our study mainly aims to estimate whether IP-10 and MCP-1 is associated to disease severity in a samples of Iraqi patients with COVID-19. Methods: The Cross-sectional study included 90 patients infected with covid-19 virus divided in to (45) with severe infection and (45) with mild infection,51 males and 39 females. Serum levels of MCP-1 and IP-10 was measured by sandwich ELISA test. Results: MCP-1 chemokine in severe COVID-19 patients was significantly higher (P=0.000) than in mild patients. Also, IP-10 chemokine showing a higher significant association (P =0.025) with severe patients group. There is a highly significant difference of Oxygen saturation in the distribution of mild and severe patients (P= 0.000). The Computed Tomography, Ferritin and D.dimer showing a higher significant association with severe patients (P=0.000) compared with mild patients. Conclusion: According to the current study the serum levels of Interferon Gamma Induced Protein 10 (IP-10) and Monocyte Chemotactic Protein 1 (MCP-1) showing a significant association with the severe COVID-19 infections.