Mental health outcomes in patients discharged after COVID-19 hospitalization: the case report of a male nurse in the context of occupational surveillance program of health care workers

This case study draws attention on mental health sequelae that emerged in the context of the COVID-19 outbreak after recovery from hospitalization, even in subjects without personal psychiatric history. The case involves a 65-year-old male shift nurse who took SARS-COV-2 infection through a co-worker and that had been hospitalized for interstitial pneumonia from April 6 to April 17. After recovery, he developed psychiatric symptoms overlapping between different dimensions of psychiatric disorders and started to be followed by the Occupational Health Department of a Major University Hospital in central Italy. He reported a score of 28 at the Peritraumatic Distress Inventory and of 39 at the Self-Rating Anxiety State. He was treated with a combination therapy of SSRI and NaSSA antidepressants with clinical remission. In this case study, authors discuss the possible overlapping role of post-traumatic stress and anxiety symptoms in patients discharged after COVID-19 hospitalization that may deserve appropriate classification, treatment and follow up with the future goal to refine clinical management of post and long COVID syndromes of subjects who present low abnormalities in other specialty investigations.Copyright © 2022 EDIZIONI MINERVA MEDICA.

Flu vaccination coverage in healthcare workers during a 3-year period in the context of the pandemic : Giuditta Scardina

Background Vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs and maintain essential healthcare services during influenza epidemics. With the present study we aimed to evaluate the efficacy of measures implemented during the three flu campaigns of 2018/19, 2019/20 and 2020/21 in a university hospital in Pisa, Italy, through the assessment of vaccination coverage (VC) in HCWs and to assess attitudes toward flu vaccination. Methods Flu VC was stratified according to sex, age, job and vaccination status for each season and the association between each variable and vaccination status was explored. In 2020, a survey collecting data on knowledge and attitudes on flu vaccination was distributed. Results Starting from the 2018/19 campaign, an increasing flu VC rate was registered: contained in 2019/20 (from 11.6% to 14.3%, Δ%=23.1) and significant (VC = 39.6%, Δ%=177.6) in 2020/21 as compared with the previous year. Physicians were the professionals most willing to get vaccinated during all seasons. Considering age the situation changed greatly over the study period, with VC rising in 2020/21 in those age groups marked by low VC in previous years (<30 and 41-50 years old, Δ%=293). Having been vaccinated in the previous year represented the most important variable to predict likelihood of accepting flu jab. However, while previously vaccinated HCWs were 13 times more likely to get the flu jab in 2019/20 compared with the others;in 2020/21 they were only 3 times. Only half of HCWS considered themselves at higher risk of contracting influenza compared to the general population, while 71% totally agreed that receiving the flu jab in 2020/21 was more important than the previous years due to COVID. Conclusions A significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years, due to the COVID pandemic that positively influenced vaccination uptake. Key messages • This study evaluates the impact of subsequent flu vaccination campaigns implemented in a large university hospital in Italy through the assessment of flu VC among HCWs. • A significant increase in flu VC among HCWs was observed in 2020/21, especially in those categories characterized by lower VC rates in the previous years, more likely due to the COVID-19 pandemic.

Suicidal ideation and suicide commitment in Health Care Workers during COVID-19 pandemic: a review of the literature

Introduction: Suicide represents an important public health concern since it leads to more annual deaths globally than violence, war and natural disasters combined. During this pandemic year, the phenomenon acquires even greater importance especially in the categories at risk, such as health care workers (HCWs). This review aims to analyze literature evidence regarding health care providers' suicidal ideation (SI) and suicide commitment during the first year of the COVID-19 pandemic. Methods: International databases and digital worldwide media reports were screened between March 2020 to March 2021. The authors conducted a systematic review and described evidence using a narrative approach with some focus points based on the PICO framework. Inclusion or exclusion of literature is done according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations. Results: The review showed range of SI varied from 4% to 8% and the main risk factors seemed to be loneliness, not having children and personal history of mental disorders. Conclusion: SI, and in worst cases suicide commitment, seem mental health outcomes not to be underestimated, especially in an emergency that is protracting. They require monitoring by health surveillance systems with a goal of prevention and support. © 2022 Occupational Health and Safety Society of Nepal. All right reserved.

Different COVID-19 outcomes in male and female healthcare workers of University Hospital in Italy

We analyzed the different clinical outcomes in male and female healthcare workers (HCWs) infected with Covid-19, followed up over the first three months after the COVID-19 outbreak in Italy. The population under study was composed of 64 healthcare workers among the 3585 HCWs infected with COVID-19. Patients reporting dyspnea and/or needing hospitalization were classified into the “severe disease” group;HCWs with mild symptoms of Covid-19 (such as fever, dry cough, etc.), with no need for hospitalization, were classified into the “mild disease” group. The 19 % and 25.6 % of workers, among the males and females’ groups respectively, were asymptomatic. Males showed higher percentage of severe symptoms (47.1 %, vs 15.6 %). Furthermore, as regards symptomatic workers, the hospitalization was more frequent in men than in women (52.9 % vs 15.1 %). Through a binary logistic regression, with prevalence of “severe symptoms” considered as a dependent variable and “sex” and “age” as an independent variable, the Odds ratio M/F was equal to 4.8 (CI: 1.247, 18.482), whilst “age” seemed to play no role. Despite the limited size of the population under study, our results confirmed that HCW men are more likely than women to experience worse clinical outcomes. © 2022 Elsevier Masson SAS

Résultats cliniques différents de COVID-19 chez les personnels soignants masculins et féminins de l'Hôpital Universitaire en Italie Different COVID-19 outcomes in male and female healthcare workers of University Hospital in Italy

Nous avons comparé les résultats cliniques de l'infection à la Covid-19 parmi les personnels de la santé masculins et féminins, suivis pendant les trois premiers mois après l'épidémie de COVID-19 en Italie. La population étudiée était composée de 64 des 3585 travailleurs de la santé qui ont développé une infection au COVID-19. Les sujets qui ont signalé une dyspnée et/ou qui ont dû être hospitalisés ont été classés dans le groupe « maladie grave ». Les travailleurs de la santé qui ont signalé la présence de symptômes mineurs (comme fièvre, toux sèche, etc.) sans avoir besoin d’une hospitalisation ont été inclus dans le groupe « maladie bénigne ». Les personnels asymptomatiques à la COVID-19 étaient respectivement de 19 % et 25,6 % dans les groupes d'hommes et de femmes. Les hommes présentaient un taux plus élevé de symptômes graves (47.1%, Vs 15.6%). Aussi, parmi les travailleurs symptomatiques, les hommes ont eu besoin d'unehospitalisation plus fréquemment que les femmes (52.9% Vs 15.1%). Utilisant une régression logistique binaire, avec la prévalence de « symptômes graves » comme variable dépendante et « sexe » et « âge » comme variable indépendante, l’odds ratio H/F était égal à 4,8 (IC 1.247, 18.482), tandis que « âge » ne semblait pas avoir un rôle. Malgré les limites liées à la petite taille de la population étudiée, nos résultats confirment que les soignants hommes sont plus susceptibles que les femmes d'avoir des pires résultats cliniques.

Résultats cliniques différents de COVID-19 chez les personnels soignants masculins et féminins de l'Hôpital Universitaire en Italie

Résumé Nous avons comparé les résultats cliniques de l'infection à la Covid-19 parmi les personnels de la santé masculins et féminins, suivis pendant les trois premiers mois après l'épidémie de COVID-19 en Italie. La population étudiée était composée de 64 des 3585 travailleurs de la santé qui ont développé une infection au COVID-19. Les sujets qui ont signalé une dyspnée et/ou qui ont dû être hospitalisés ont été classés dans le groupe « maladie grave ». Les travailleurs de la santé qui ont signalé la présence de symptômes mineurs (comme fièvre, toux sèche, etc.) sans avoir besoin d’une hospitalisation ont été inclus dans le groupe « maladie bénigne ». Les personnels asymptomatiques à la COVID-19 étaient respectivement de 19 % et 25,6 % dans les groupes d'hommes et de femmes. Les hommes présentaient un taux plus élevé de symptômes graves (47.1%, Vs 15.6%). Aussi, parmi les travailleurs symptomatiques, les hommes ont eu besoin d'unehospitalisation plus fréquemment que les femmes (52.9% Vs 15.1%). Utilisant une régression logistique binaire, avec la prévalence de « symptômes graves » comme variable dépendante et « sexe » et « âge » comme variable indépendante, l’odds ratio H/F était égal à 4,8 (IC 1.247, 18.482), tandis que « âge » ne semblait pas avoir un rôle. Malgré les limites liées à la petite taille de la population étudiée, nos résultats confirment que les soignants hommes sont plus susceptibles que les femmes d'avoir des pires résultats cliniques. We analyzed the different clinical outcomes in male and female healthcare workers (HCWs) infected with Covid-19, followed up over the first three months after the COVID-19 outbreak in Italy. The population under study was composed of 64 healthcare workers among the 3585 HCWs infected with COVID-19. Patients reporting dyspnea and/or needing hospitalization were classified into the “severe disease” group;HCWs with mild symptoms of Covid-19 (such as fever, dry cough, etc.), with no need for hospitalization, were classified into the “mild disease” group. The 19% and 25.6% of workers, among the males and females’ groups respectively, were asymptomatic. Males showed higher percentage of severe symptoms (47.1%, Vs 15.6%). Furthermore, as regards symptomatic workers, the hospitalization was more frequent in men than in women (52.9% Vs 15.1%). Through a binary logistic regression, with prevalence of "severe symptoms" considered as a dependent variable and "sex" and “age” as an independent variable, the Odds ratio M/F was equal to 4.8 (C.I. 1.247, 18.482), whilst “age” seemed to play no role. Despite the limited size of the population under study, our results confirmed that HCW men are more likely than women to experience worse clinical outcomes.

Quarantine and Mental Health Challenges for Occupational Medicine: The Case Report of a Nurse Infected With SARS-CoV-2.

This case study draws attention to the psychosocial difficulties that emerged in the context of the coronavirus disease 2019 (COVID-19) outbreak in relation to the remote management of subjects with psychiatric vulnerabilities following exposure to prolonged quarantine. The case involves a 56-year-old hospital nurse, followed by the Occupational Health Department of a major university hospital in central Italy for mood instability in the context of a cyclothymic temperament. She was quarantined for occupationally acquired COVID-19 and remained positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via swab test for more than 2 months between March and May 2020. In this case study, we discuss the challenges presented by the risk of a prolonged quarantine in a psychologically vulnerable employee, the need for occupational medicine to provide adequate health surveillance of all health care workers during the COVID-19 pandemic, the effectiveness of telepsychiatry, and the difficulties in formulating a proper treatment strategy.