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Introduction: The COVID-19 pandemic has had serious consequences for the mental health of individuals, especially health care providers, who have experienced symptoms of stress, anxiety and depression that affect their personal, family and social lives. This situation has led health entities to evaluate the negative effects and to design interventions. Objective: To establish the relationship between burnout syndrome, anxiety, depression and work well-being, considering sociodemographic and work variables, including differences according to the type of work. Methods: The present study is non-causal, comparative, cross-sectional and prospective. The sampling was intentional non-probabilistic, with a total of 366 participants from three hospitals in Ancash (Peru) under COVID-19 conditions during the second wave. For the measurement of the variables, the Maslach Burnout Inventory, the Goldberg anxiety/depression subscales and the Sánchez-Cánovas work well-being subscales were used. Results: The results indicated multiple relationships among burnout syndrome, anxiety, depression and work well-being (p <0.05). Likewise, these relationships were also presented considering some sociodemographic and labor variables (p <0.05). Conclusions: The variables studied have a significant relationship in the health care personnel examined. Based on these findings, it is possible to have a baseline of the mental health of health personnel to plan interventions that emphasize those variables and groups at risk that require special attention. © 2022, Editorial Ciencias Medicas. All rights reserved.
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BACKGROUND AND AIMS: Patients on maintenance hemodialysis (HD) experience a heavy burden of the disease and frequently report poor quality of life (QoL) scores.[1,2] During the coronavirus 2019 (COVID-19) pandemic, additional challenges were posed to this vulnerable group. Restriction policies affected social contact and physical activity, even leading to intradialytic exercise programs' suspension.[3] Few studies analyze the impact of the pandemic on the QoL of this population. Thus, we aimed to assess the QoL of HD-dependent patients during the pandemic. METHOD: This is a retrospective single-center study. Demographic data originated from electronical medical records. The health-related QoL EQ-5D-5L questionnaire, developed by the EuroQol Group in 2005 and widely used for various diseases, was applied and assessed the five following self-reported scores: health (0-100 points), mobility (1-5 points), self-care (1-5 points), usual activities (1-5 points), pain/discomfort (1-5 points) and anxiety/depression (1-5 points).[4] With the exception of health, higher scores relate to greater difficulties, as inverted scales. Patients undergoing regular HD who filled in the questionnaire during the pandemic and at least one year prior were included. IBM® SPSS ® 27 software was used for statistical analysis. RESULTS: A total of 71 patients were included with a predominance of the male gender (54.9%). The median age was 77 years (IQR = 18 years) and the median time on HD was 78 months (IQR = 99 months). Thirty patients had diabetes (42.25%). During the pandemic, 12 patients (16.9%) had COVID-19. Analyzing the different QoL scores, no difference was reported concerning health (mean score 67.89 ± 18.3 versus 65.23 ± 20.6;T = 1.059, P = 0.297, IC (95%) = (-2.1;7.6);d = 0.126), usual activities (mean score 1.8 ± 1.09 versus 1.97 ± 1.32;T (71)= -1.136, P = 0.260, d = -0.135), pain/discomfort [mean score 1.8 ± 0.95 versus 2.07 ± 1.13;T (71) = -0.894, P = 0.260, d = -0.374], and anxiety/depression [mean score 1.8 ± 0.82 versus 1.94 ± 1.04;T (71) = -1.055, P = 0.295, d = 0.125] comparing with the pre-pandemic period. There was a statistically significant decrease in mobility (mean score of 1.96 ± 1.09 versus 2.44 ± 1.34) with moderate size effect [T (71) = -3.525, P < 0.001, d = -0.418]. There was also a statistically significant decrease in self-care (mean score of 1.45 ± 0.86 versus 1.82 ± 1.43) with small size effect [T (71) = -2.983, P = 0.004, d = -0.354). There were no differences in any score when adjusting to diabetes or COVID-19. CONCLUSION: During the pandemic, most QoL scores appear to have been unaffected. Higher resilience among these patients and the support from caregivers and healthcare professionals might have contributed to better coping during this period. Nonetheless, mobility seems to have become compromised and movement restrictions could have accelerated this process. Therefore, even in such times, promoting physical activity may play a role in improving the QoL of HD-dependent patients.
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Purpose: To better know the impact and characteristics of Covid-19 in renal patients, the Spanish Society of Nephrology set up a voluntary registry in March, 2020 Methods: Retrospective observational study of KT recipients included in the Spanish Covid-19 Registry (1st March to 14th November, 2020). We applied Cox multivariate analysis to identify risk factors for mortality and Kaplan-Meier and log rank survival analysis. Results: 1080 KT with Covid-19 were registered, having 937 (86.1%) their outcome reported (cure or death). Most were men (63.2%), mean age 60 years infected a median of 72 months postransplantation. Death occurred in 204 patients. Multivariate analysis found age, neumonia and KT within the last 6 months before Covid-19 were risk factors for mortality and gastrointestinal symptoms were protective. Survival analysis showed significant increasing mortality risk in four subgroups: age<65 years&postransplant time> 6mo (n=526), age<65×<6mo (n=49), age>65× >6mo (n=325) and age>65×<6mo (n=31)($$graphic). Of 1080 cases, 605 correspond to the first wave (1stW until June2020) and 475 to the second wave (2ndW). In the 2ndW, KT were younger (56.4 vs 61.1yr;p=.000), 15.8% were asymptomatic (p=.000) and presented less pneumonia (50.3% vs. 78%;p=.000). Fever, lymphopenia and respiratory symptoms were less frequent but gastrointestinal symptoms similar (30.9% vs. 34.2%;p=.256). Treatment has changed, with more use of remdesivir (p=.000) and steroids (p=.018), no use of ritonavir/lopinavir, hidroxycloroquine andazitromycin (p=.000), and no treatment in (37.1% vs 6.3% in 1stW, p=.000). Hospitalization decreased (89.2% vs. 63.2%;p=.000) but more KT were admitted to critical care units (14.5% vs 20%;p=.058). We found lower mortality (overall 26.4% vs 14.8%;p=.000, hospitalized 29% vs 23%;p=.088). Multivariate analysis of the 2ndW shows again that age, pneumonia and recent transplant (< 6 months) are mortality risk factors. Conclusions: Over a thousand KT have suffered Covid-19 in Spain with a high mortality rate in the first and second waves, mainly related with age, pneumonia and recent transplantation. The interaction between age and time after transplant has to be considered when selecting recipients in the Covid-19 pandemic.
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This document offers estimates of the possible changes in the social structure of the countries of Latin America derived from the consequent economic contraction from the Covid-19 pandemic, and explores the possible costs and benefits of different types of interventions to cushion its impact. The analysis forecasts that the number of people living in poverty (extreme and moderate) would increase by up to 44 thousand million people in the region. It also finds that the policy with the highest benefit-cost ratio is the postponement of payroll taxes and social security contributions. Other alternatives such as granting support to unemployed persons, temporarily doubling the benefits of existing social programs, and the transfer of income to self-employed workers also generate a favorable benefit-cost ratio, with differences among countries.