Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis.

Purpose: Secondary bacterial or fungal infections are one of the most important medical complications among patients with Coronavirus Disease 2019 (COVID-19). The emergence of multidrug-resistant (MDR) candida can cause many problems such as treatment failure, adverse clinical outcomes, and even disease outbreaks. This systematic review and meta-analysis aims to investigate the prevalence and outcomes of fungal drug-resistant in COVID-19 patients. Methods: PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for peer reviewed-articles published in English up to May 20, 2021. Heterogeneity across studies was evaluated using Cochrane's Q test and the I2 index. The pooled point prevalence and their corresponding 95% confidence intervals (CIs) were considered to estimate the prevalence of fungal drug resistance infection in COVID-19 patients. Results: Eight eligible articles were included in our meta-analysis. The number of COVID-19 patients with fungal co-infection varied from 5 to 35 among selected studies. The overall pooled prevalence of fungal drug resistance among patients with co-infections of fungal and COVID-19 was 69% (95% CI: 37%, 94%) by using a random-effects model. In terms of specific species, the pooled meta-analysis for Candida Auris was estimated to be 100% (95%CI: 98%, 100%; I2 = 0%), for Multi-Candida 59% (95%CI: 38%, 79%; I2 = 12.5%), and for Aspergillus 15% (95%CI: 0%, 42%; I2 = 0%). Conclusion: Our study shows the high prevalence of fungal drug resistance in COVID-19 patients and emphasizes the need to strengthen antimicrobial stewardship programs, close monitoring for treatment failure, and the emergence of resistance upon treatment. Supplementary Information: The online version contains supplementary material available at 10.1007/s12281-022-00439-9.

Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis

Purpose Secondary bacterial or fungal infections are one of the most important medical complications among patients with Coronavirus Disease 2019 (COVID-19). The emergence of multidrug-resistant (MDR) candida can cause many problems such as treatment failure, adverse clinical outcomes, and even disease outbreaks. This systematic review and meta-analysis aims to investigate the prevalence and outcomes of fungal drug-resistant in COVID-19 patients. Methods PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for peer reviewed-articles published in English up to May 20, 2021. Heterogeneity across studies was evaluated using Cochrane’s Q test and the I2 index. The pooled point prevalence and their corresponding 95% confidence intervals (CIs) were considered to estimate the prevalence of fungal drug resistance infection in COVID-19 patients. Results Eight eligible articles were included in our meta-analysis. The number of COVID-19 patients with fungal co-infection varied from 5 to 35 among selected studies. The overall pooled prevalence of fungal drug resistance among patients with co-infections of fungal and COVID-19 was 69% (95% CI: 37%, 94%) by using a random-effects model. In terms of specific species, the pooled meta-analysis for Candida Auris was estimated to be 100% (95%CI: 98%, 100%;I2 = 0%), for Multi-Candida 59% (95%CI: 38%, 79%;I2 = 12.5%), and for Aspergillus 15% (95%CI: 0%, 42%;I2 = 0%). Conclusion Our study shows the high prevalence of fungal drug resistance in COVID-19 patients and emphasizes the need to strengthen antimicrobial stewardship programs, close monitoring for treatment failure, and the emergence of resistance upon treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s12281-022-00439-9.

A Report of the Telepsychiatric Evaluation of SARS-CoV-2 Patients.

Objective: During the current coronavirus disease 2019 (COVID-19) pandemic, telemedicine has been brought to the forefront of attention. This report aimed to assess psychiatric comorbidities in COVID-19 patients by utilizing telepsychiatry. Methods: COVID-19 patients admitted in Fasa University Hospital and nonhospitalized outpatients of Fasa city were interviewed by a psychiatrist through video chat for a 1-month period (March-April, 2020). Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Assessment (GAD-7), and Perceived Stress Scale-14 (PSS 14) questionnaires were administered for all patients. Each patient's mental status was recorded, and if any psychiatric problem was diagnosed, supportive psychotherapy, pharmacotherapy, and follow-up visits based on the patient's condition were started. Result: From a total of 82 COVID-19 patients who entered the study, 32 (39.03%) and 50 (60.97%) subjects were inpatients and outpatients, respectively. Moreover, 32 (39.03%) subjects were male and 50 (60.97%) were female. Insomnia seen in 24 (29.3%) patients and adjustment disorder in 13 (15.9%) patients were the most common psychiatric disorders among a total of 33 (40.2%) patients suffering from mental illness. Female and hospitalized patients presented significantly more frequent comorbidities than males and outpatients. Conclusions: Psychiatric disorders were significantly more common in patients with hospital admission than those without and more frequent in female versus male subjects. There were no significant differences between male and female subjects with and without admission according to the PHQ-9, GAD-7, and PSS-14 scores. It was concluded that telepsychiatry in the early stages of mental problems during a catastrophic event like the coronavirus pandemic, can be an efficient instrument for the screening of psychosomatic comorbidities, so that pharmacological treatment (considering possible drug interactions with COVID-19 medications) and psychotherapeutic intervention can be optimized by psychiatrists.

Caregivers' perception of the caring challenges in coronavirus crisis (COVID-19): a qualitative study.

BACKGROUND: The nurses act as the guardians of people's health by preventing, controlling, and curing emerging diseases, including coronavirus, a highly infectious and contagious disease which has presented the caregivers in the Iranian healthcare system with many clinical challenges. In view of lack of research on the clinical challenges which arise during health crises, emerging diseases included, there is need for further investigation of those clinical challenges and dilemmas. The aim in present study was to describe the caregivers' experiences of the caring challenges in patients with coronavirus (COVID-19). METHODS: The present study is a qualitative work with a phenomenological-descriptive design. Data were collected via semi-structured, in-depth, individual interviews. The collected data were analyzed according to Colaizzi's method. The participants were 23 members of the medical staff responsible for coronavirus patients in Iran who met the inclusion criteria. The participants were selected via purposeful sampling which was continued to the point of data saturation. RESULTS: The results yielded 3 main themes "psychological tension", "inefficient management", and "contextual factors" with 11 categories. CONCLUSION: In dealing with coronavirus patients and providing quality care to them, nurses face various clinical challenges which affect their performance. Administrators must, alongside giving instructions to people on how to prevent the coronavirus disease and taking effective safety measures, make sure that clinical centers are managed efficiently in order for nurses to fulfill their caring objectives satisfactorily.

Health Professionals' Perception of Psychological Safety in Patients with Coronavirus (COVID-19).

BACKGROUND: Medical personnel act as the protectors of people's health by preventing, controlling, and treating emerging diseases, including the coronavirus infection. COVID-19 is a highly infectious and contagious disease which has presented the Iranian healthcare system with a variety of clinical challenges. There is a lack of research on clinical challenges in health crises especially those caused by emerging diseases, hence a need for more exploration of these clinical challenges and dilemmas. The present study aims to determine the different aspects of health professionals' perception of the psychological safety of patients infected with the coronavirus (COVID-19). METHODS: The present study is a qualitative work which uses conventional content analysis. The participants were 17 health professionals who were responsible for COVID-19 patients and met the inclusion criteria. They were selected via purposeful sampling. The study lasted from February to March 2020. Data were collected through semi-structured, individual interviews which were conducted via video call. The collection of data was kept up to the point of saturation. The collected data were analyzed using the conventional content analysis method. RESULTS: Three themes such as "respect for dignity", "comprehensive support" and "peaceful environment" with 11 categories were extracted from the findings of the study. CONCLUSION: According to the results of the present study, patients infected with the coronavirus should be given care in a peaceful environment where they receive comprehensive support and have their dignity respected. Such conditions can guarantee the psychological safety of these patients and produce positive behavioral results on their part. Thus, it is essential that the cultural, professional, and organizational prerequisites of protecting all the dimensions of the psychological safety of these patients be provided.