The Psychological Impact of COVID-19

COVID-19 pandemic has emerged as one of the most dreadful nightmares which humanity had to witness in the recent times. The pandemic has affected every human being in one way or the other. The psychological impact of COVID-19 on general public includes uncontrolled fear and pervasive anxiety of getting infected and getting quarantined or admitted in COVID care facilities alone, leading to disabling loneliness, frustration, and boredom due to reduced socialization, monotonous daily routine, and worries related to income and livelihood. The pandemic has led the healthcare workers to work beyond normal working hours for months together. They have been going through the feelings of anxiety, and fear of getting infection from the patients while discharging their duties. The frontline healthcare workers are also facing issues like remaining isolated during their duty periods, undergoing quarantine for several weeks, remaining away from their families, and staying alone in hotels/accommodation provided by the employers. Similarly the pandemic has led to significant negative impact on the life of women, children and adolescents, elderly, and persons with various illnesses. As the pandemic is about to stay for a while, it is expected that there can be more long-standing mental health effects of the pandemic on human beings in the near future. Therefore, strengthening mental health resources, taking timely mental health support and help from mental health professionals, destigmatizing mental illnesses, and implementing the awareness programs of mental health are the need of the hour. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2021.

Impact of Covid-19 Pandemic on a British Columbia Children's Hospital Youth Advisory Committee

Purpose of Study: Between September 2020 and November 2021, a survey was developed in partnership with children, youth, and community members experiencing vulnerabilities in a Vancouver Inner City Neighbourhood (ICN) to explore challenges encountered during the COVID-19 pandemic. In the survey, participants were asked questions about their financial status, housing security, food accessibility, and other social determinants of health. Other equity-seeking groups in Vancouver, including youth experiencing developmental and/or other medical diversity, wished to adapt the ICN COVID-19 survey to explore the impact of the pandemic in their community. These youth are active members of the province's pediatric tertiary care teaching hospital's Youth Advisory Committee (YAC), and in sharing their lived experience as patients, they strive to improve the quality of healthcare for children and youth throughout British Columbia. The objectives of this study were to: 1) adapt the COVID-19 survey to capture the views and needs of youth experiencing developmental and/or other medical diversity;and 2) identify how the COVID-19 pandemic impacted this group's social determinants of health. Methods Used: Ethics board approval was obtained for this observational, cross-sectional study (H20-00987). The research team and YAC co-constructed an adapted COVID-19 survey via Zoom dialogues. YAC members completed the survey online via Qualtrics from May 2022-August 2022. Demographic information and survey results were analyzed using descriptive statistics. Summary of Results: In total, 12 participants completed the survey, including 11 youth and 1 staff member. The median age of the youth participants was 23 years (n=11, min=14, max=29). During the COVID-19 pandemic, 82% (9/11) of youth reported changes in their ability to attend work or school, 36% (4/11) reported concern around reliable and affordable access to medications/medical treatment, and 46% (5/11) reported difficulty in caring for themselves. 46% (5/11) of youth also reported difficulty in caring for older adults or people in their families with disabilities. Many youth (6/11;55%) reported they had less than five people to turn to for support in times of stress, and 46% (5/11) of youth reported the pandemic changed their ability to connect with these people. Furthermore, 82% (9/11) of youth reported experiencing some level of distress related to the pandemic. 73% (8/11) of youth reported heightened anxiety, 82% (9/11) reported worsened mood, 55% (6/11) reported difficulty sleeping, and 64% (7/11) reported difficulty exercising. Conclusion(s): Youth with developmental and/or other complex medical diversity experienced difficulties accessing work and education, reliable and affordable medical care, and social support due to the COVID-19 pandemic. The pandemic negatively impacted the social, emotional, and physical wellbeing of these youth, indicating a need for future dialogue and advocacy to ensure the views and voices on rights of children and youth are honoured.

Exploring the Digital Revolution in Education in India during the COVID-19 Pandemic

One important response to COVID-19 was the intensification of the use of digital media to deliver education. However, the results are paradoxical, since the digital revolution did not lead to improvement of the social quality of teachers' working circumstances. We ana-lyze "internal” or subjective oriented constitutional and "external” or objective orientated conditional factors related to teachers that determine the adaptation of digitalization, taking a social quality perspective. Through a case study in the most advanced educational hub of India—Delhi—we find that the digital revolution helped India to address the first-order problems in digital transformation, namely concerning objective infrastructural facilities. The second-order problems, particularly changing the subjective belief structures of teachers related to the integration of technologies, appear to remain a challenge. As India has recently adopted a new education policy (2020), the findings of our study have significant relevance to improving the accessibility and utilization of digital technology in educational spaces. © The Author(s).

Play Therapy via Telemedicine in a Child with Sudden-onset Emotional Disorder During the COVID-19 Lockdown Period: A Case Report

The mental health of children and adolescents has been significantly affected by the COVID-19 pandemic, and recent data suggests there had been an upsurge of psychiatric morbidity in this subgroup of population. Nonpharmacological behavioral intervention in the form of play therapy has been regarded as one of the best treatment strategies in children with emotional disorders. During lockdown, we attempted a play therapy via telemedicine. In this case report, we describe the case of a four-year-old girl who had sudden-onset behavioral problems following an unplanned hair cut during the lockdown, which was managed with teleplay therapy. Copyright © 2022, Matrix Medical Communications. All rights reserved.

Mucormycosis and COVID-19: An intersecting crisis

There has been an increasing propensity of opportunistic fungal infections such as mucormycosis occurring in COVID-19 patients. It is imperative that we are aware of clinical presentation, rate of spread of mucormycosis and prescribes medications such as corticosteroids judiciously, especially in severely ill patients, and uncontrolled diabetics with ketoacidosis. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Impact of the COVID-19 pandemic on cervical cancer diagnosis and treatment in Botswana

Background: The COVID-19 pandemic rapidly altered cancer care delivery globally, providing a compelling opportunity to empirically study how these changes impacted persistent disparities in care. Cervical cancer is one of the most common female cancers worldwide, with approximately 90% of cases and deaths occurring in low- and middle-income countries (LMICs). In Botswana, a LMIC with a particularly high prevalence of HIV and cervical cancer, delays in cervical cancer diagnosis and treatment have been documented but is unknown how these delays may have been mitigated or exacerbated since the pandemic. Methods: The objective of this analysis is to evaluate patterns of cervical cancer diagnosis and treatment initiation before (January 2015-March 2020) and during the pandemic (April 2020-July 2021) using longitudinal clinical and patient-reported data from a cohort of over 1,000 patients receiving care for gynecologic cancers in Botswana. The primary outcome is timeliness of treatment defined by the number of days between first clinical visit and initiation of first-line treatment and categorized dichotomously (> 30 days classified as delay). Primary exposure is the time period (prepandemic and pandemic) defined by the month of first visit. We calculated unadjusted proportion of delays and covariates stratified by time period and used bivariate analysis to examine factors associated with each time period. We used multivariable logistic regression models to examine the association between delay and time period, adjusting for all covariates (age, stage, HIV status, rurality, screening history, and partner status). Results are presented as unadjusted proportions, adjusted odds ratios (AOR), and 95% confidence intervals. Results: Of the 1,200 patients treated for cervical cancer at the multidisciplinary clinic, 990 (82.5%) were diagnosed pre-pandemic and 210 (17.5%) during the pandemic. Among all patients with gynecologic cancers (n = 1,568), the proportion of patients with cervical cancer significantly decreased from 78.6% pre-pandemic to 68.0% during the pandemic (p < 0.001). In comparison to pre-pandemic, patients with cervical cancer during the pandemic were significantly less likely to have attended a screening clinic prior to their treatment (57.6% vs 15.3%;p < 0.001) and significantly more likely to experience treatment delays (61.6% vs 92.9%;p < 0.001). In the multivariable model, patients diagnosed during the pandemic had a 7-fold higher likelihood of treatment delays than those patients diagnosed pre-pandemic (AOR: 7.95;95% CI: 4.45-14.19). Conclusions: The pandemic significantly increased delays in treatment for nearly all patients with cervical cancer in Botswana. Given persistent global disparities in cervical cancer, there is a great need to implement evidence-based strategies for improving screening and timeliness of care in Botswana and other LMICs.

The reduced environmental impact of American society of Clinical Oncology's 2021 virtual annual meeting

Background: In response to the threat of the COVID-19 pandemic, the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting transitioned to a virtual, online conference. As medical conferences around the world have transitioned to virtual formats, numerous benefits have been uncovered;however, the environmental effect of reduced travel on carbon emissions remains largely unknown. Today, it is estimated that conference attendance accounts for 35% of a scientist's total carbon footprint. Given that the climate crisis is a growing threat to human health and oncology outcomes, it is imperative to begin to quantify, understand, and promote sustainable practices. We aim to highlight the reduced travel-related greenhouse emissions associated with the transition of ASCO's 2021 Annual Meeting to a virtual platform in comparison to a hypothetical in-person conference. Methods: Attendee demographic data was collected online from the ASCO 2021 Annual Meeting. The distance traveled per attendee to a hypothetical in-person conference in Chicago, Illinois (the location for the 2022 Annual Meeting) was estimated using reported attendees' home country and a hypothesized centralized location. Approximate airline miles and associated carbon dioxide (CO2) emissions were calculated using the Environmental Protection Agency's Greenhouse Gas Tools. It was assumed that all attendees had non-stop airfare and traveled in economy class. The approximate CO2 emissions for the virtual conference was estimated based on assumed internet usage (8 hours/day for the 5-day conference period). Results: A total of 32,950 conference attendees were identified - 14,150 domestic attendees and 16,050 international attendees. For the hypothesized in-person conference, the total carbon footprint for all assumed transportation was determined to be 28,468,031.25 lbs. of CO2 emissions, with an average of 863.0 lbs. of CO2 emissions per attendee. Alternatively, emissions related to virtual conference internet streaming accounted for a total of 436,258 lbs of CO2. Total emissions spared with the transition to a virtual platform was an estimated 28,031,773.25 lbs of CO2., the equivalent emissions of 1,531 U.S. homes' energy use for one year. Conclusions: Incorporating options for virtual attendance at academic conferences has the potential to significantly reduce carbon emissions. However, many believe that virtual networking cannot replace in-person interactions particularly for early-career attendees. Regardless, our professional societies have an obligation to investigate and promote greater sustainability of our annual meetings.

Managing a COVID-Positive Health-Care Worker with Recent Suicide Attempt through Telepsychiatry

COVID-19 pandemic has emerged as a major problem for the health-care workers (HCWs). Many HCWs are facing adverse psychological outcomes, during the COVID pandemic. HCWs are not only expected to carry out duties in COVID areas but are also expected to stay in isolation during the period of quarantine. Various models have been proposed to address the psychological issues in HCWs using telepsychiatry. However, there are no clear-cut guidelines, for managing people with suicidal behavior. In this report we present a HCW, diagnosed with recurrent depressive disorder, current episode severe depression without psychotic symptoms, who attempted self-harm and was shortly diagnosed with COVID-19 infection leading her to getting admitted in the COVID-19 ward. She was managed with supportive psychotherapy during her COVID ward stay through telepsychiatry. We discuss the challenges faced and how these were handled.

CRITICAL APPRAISAL OF GI ENDOSCOPY CLINICAL PRACTICE GUIDELINES DURING THE COVID-19 PANDEMIC

Background Clinical Practice Guidelines (CPGs) are integral during a pandemic, offering guidance to clinicians through uncertainty. Existing literature has established that the need for rapid publication of CPGs during previous infectious disease outbreaks resulted in less rigorous guidelines. CPGs were rapidly developed since the onset of the pandemic in December 2019, providing guidance in gastrointestinal (GI) endoscopy, an area where COVID-19 may pose risk of transmission. Aims To evaluate the quality of GI endoscopy guidelines developed during the COVID-19 pandemic and to compare these with (a) endoscopy CPGs developed prior to the pandemic;(b) CPGs for other endoscopic topics unrelated to COVID-19;and, (c) non-endoscopic CPGs published during the pandemic. Methods We systematically searched Medline, Embase and Scopus for CPGs published by GI societies from January 1, 2018 to December 31, 2020. A grey literature search was conducted. Two authors screened full-texts. In this interim analysis, CPGs were grouped based on publication year: before 2020, or 2020. Endoscopy CPGs published in 2020 were categorized as COVID or non-COVID related. Two authors independently assessed the CPGs using the AGREE II tool, consisting of six domains for evaluating guidelines. A domain score of 60 was set as a threshold to indicate good quality. Results There were 70 endoscopy guidelines and 27 CPGs focused on other GI topics. The mean overall scores were 69% (±12%) for endoscopy CPGs published before 2020 (n=28), and 51% (±23%) for CPGs published in 2020 (n=42). For individual AGREE II domains, mean scores for pre-2020 CPGs ranged from 33.11 (±17.39) in Applicability to 81.55 (±10.37) in Clarity of Presentation. For CPGs published during COVID-19, mean domain scores ranged from 34.18 (±10.52) in Applicability to 75.26 (±13.85) in Clarity of Presentation. 21 of 42 CPGs published in 2020 were related to COVID. Mean overall scores were 35% (±20%) for COVID-related CPGs and 67% (±13%) for non-COVID-19 CPGs. For COVID-19 CPGs, scores ranged from 27.88 (±20.31) in Rigour of Development to 69.58 (±10.81) in Scope and Purpose. For non-COVID CPGs, the scores ranged from 37.30 (±8.93) in Applicability to 84.52 (±5.93) in Clarity of Presentation. Conclusions The difference in overall scores between COVID-19 endoscopy CPGs and non-COVID endoscopy CPGs may suggest that the urgency to disseminate COVID-19 information decreased CPG quality or completeness of reporting. This interim analysis is limited by the lack of distinction between peer-reviewed CPGs and non-peer reviewed recommendations. Given the importance of CPGs in clinical decision making, it is important to ensure that the rapid development of guidelines does not compromise quality and rigour. Funding Agencies None

Comparison of demographic profile and psychological problems related to coronavirus disease 2019 outbreak among the general public (18 years and above) in a Northern State of India: A web-based cross-sectional survey

Background: The psychological impact of the general public during a pandemic is complex and incompletely understood. There is a dearth of studies reporting the psychological problems in the general public during the coronavirus disease 2019 (COVID-19) crisis in India, including a comparison as per demographic profile. Materials and Methods: An online survey was conducted from April 17, to May 1, 2020 using the principles of the snowball recruiting technique. The psychological problems of the potential study subjects were evaluated using the Hindi version of the Patient Health Questionnaire-4 (PHQ-4) scale. There were a total of 1826 responses, out of which 391 were excluded from the analysis. Results: The mean age of the subjects was 41.95 years (Median = 50, SD = 19.05, range: 18-86 years) and around 45% of respondents were with an age range of 18-39 years. The mean and standard deviation of the PHQ-4 was 1.81 (2.34), and the overall prevalence of psychological problems was 30% as per the cutoff of PHQ-4. The estimates of anxiety and depression among study subjects were 11% (158/1435) and 16.1% (232/1435), respectively. Younger age, female gender, unmarried, and rural residential status were significantly associated with increased psychological problems in this setting. Conclusion: The psychological response to the COVID-19 varies with sociodemographic status, and about one-third of the people reported having psychological problems in the early phase of the COVID-19 pandemic in this setting. There is a need to expand the mental health services to each stratum of the society with a focus to provide personalized care as per the sociodemographic profile.

Bibliometric Study of Publications on Impact of Covid-19 and Sleep Disorders

The paper examines global research output (1656 records) on "Impact of Covid-19 on Sleep Disorders", based on publications indexed in Scopus database. The global publications on this theme averaged 15.05 citations per paper. About 19.02% share of its total publications on this theme received external funding support and averaged 34.59 citations per paper. Ninety five countries unevenly partcipitated in global research output on "Impact of Covid-19 on Sleeping Disorders", of which the top 10 most productive countries accounted for 87.62% and more than 100% share in global publications and citations. The USA, China and Italy led in global publications ranking and productivity as against China (2.52), U.K.(2.26) and Italy (1.67) leading in terms of relative citation index.The 527 organizations and 773 authors participated in global research on this theme, with top 15 most productive organizations and authors contributing to 21.62% and 6.28% global publications share and 63.70% and 56.20% global citations share. Huazhong University of Science & Technology, China, and Tongji Medical College, China and Harvard Medical School, USA were the most productive global organizations (with 40, 38 and 33 papers) and Capital Medical University, China (153.85 and 10.22), Wuhan University, China (109.33 and 7.26) and Renmin Hospital of Wuhan University, China (108.10 and 7.18) were the leading most impactful organizations in terms of citation per paper and relative citation index. Z. Liu, S. Grover and G. Wang were the most productive authors (with 9, 8 and, 8). L.Kang (395.17 and 26.26), Y. Wang (395.17 and 26.26) and, S. Ma (322.0 and 21.4) were the most impactful authors. International Journal of Environment Research & Public Health, Sleep Medicine and Frontiers in Psychiatry were the most productive journals (with 73, 69 and 49 papers). Brain, Behavior & Immunity (86.04)., Asian Journal of Psychiatry (46.78), Psychiatry Research (41.15) were the most impactful journals.

Impact of Covid-19 on Mental Health: A Bibliometric Assessment of Publications from India

Aim:The paper assesses the India's research output on "Impact of Covid-19 on Mental Health" indexed in Scopus database. Materials and Methods: The Scopus database was used to search for the articles published from India. Results: The search showed that since the onset of the pandemic upto 24th of April 2021, 1210 publications emerged from India, amounting to 6.87% share of the global output on the topic and averaged 5.97 citations per paper. India stood at 5th position in terms of number of publications on mental health, with highest number of publications emerging from United States (26.9%), followed by United Kingdom (13.35%), China (9.83%) and Italy (8.27%). About one-third (30.91%) of the publications involved international collaborations, with maximum number of collaborations were with United States, followed by United Kingdom, Australia, Italy, Canada, and Brazil. The most common keywords in the research included, 'mental health', followed by 'anxiety' and 'depression'. The research output came from 478 organizations, with maximum research coming from National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, All India Institute of Medical Sciences (AIIMS), New Delhi and Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh. About three-fourth (76.85%) of the mental health research emerged from institute other than these 3 institutes. Five out of the 10 most productive authors and 5 out of the most impactful authors were from institutes other than the 3 major institutes. Conclusion: To conclude, this bibliometric analysis suggest that, researchers from India contributed to about 7% of the global mental health research on Covid-19 and India stood at 5th position among the various countries in terms of global mental health research on Covid-19.

The Impact of Covid-19 on Mental Health: A Global Analysis of Publications

Covid-19 infection, which emerged in late 2019, spread across the world rapidly and was declared as a pandemic on 24th March 2020 by the World Health Organization. Besides other implications, Covid-19 pandemic led to significant mental health issues in the general public, those infected with the virus and the health care workers. Over the period of 15-16 months, a significant amount of literature has emerged on the mental health issues in the context of Covid-19 pandemic. This paper aims to evaluate the research trends in mental health related to Covid-19 infection by using the bibliometric analysis. Using the Scopus database, as on 21st of March 2021, 15,223 records focusing on "Covid-19 and Mental Health" were identified. The research on this theme averaged 8.90 citations per paper with 13.77% publications supported by funding agencies from global research agencies/firms were published. Researchers from 158 countries participated in mental health research on Covid-19, with top 12 countries accounting for 95.91% share of the global output and a major share of global citations in the subject. Although researchers from USA, U.K. and China led the global publication share (ranging from 10.40% to 26.56%), but researchers from China, France and Australia registered higher relative citation index (ranging from 1.19 to 2.31). Researchers from Harvard Medical School, USA, University of Toronto, Canada, and King's College, London, U.K. were the most productive (with 299, 270 and 222 papers). Researchers from the National University of Singapore (51.84 and 5.83), King's College, London, U.K. (27.23 and 3.06), Huazhong University of Science and Technology, China (23.65 and 2.66) were most impactful in terms of citation per paper and relative citation index. To conclude, this bibliometric analysis provides an overview of the extent of research activities in Covid-19 and mental health.

Outcome of patients with upper gastrointestinal bleeding during the covid-19 pandemic

Introduction: The COVID-19 pandemic has created challenges in upper gastrointestinal bleeding (UGIB) management due to concerns regarding aerosolization during endoscopy and patient hesitancy in presenting to hospital. The impact of the pandemic on UGIB outcomes is not well described. Methods: We described adults with UGIB admitted to general medicine services or intensive care units (ICU) during the first wave of the COVID-19 pandemic (March 1-June 30 2020) at 7 hospitals in Toronto and Mississauga, Ontario. The historical control group consisted of patients admitted to these hospitals from March 1-June 30, 2018 and March 1-June 30, 2019. We compared primary (inhospital mortality) and secondary outcomes (ICU utilization, transfusion requirements, persistent bleeding, and need for angiographic/surgical management of bleeding) using multivariable regression models, controlling for patient demographic factors, comorbidities, severity and etiology of bleeding, and admitting hospital. Results: There were 363 admissions for UGIB from March 1-June 30, 2020 (COVID-19 period) and 950 admissions from March 1-June 30 2018 and 2019 (historical control period). There were no differences between the two groups with respect to baseline variables of age, sex, underlying cirrhosis, Charlson comorbidity index, and the modified Glasgow-Blatchford and pre-endoscopy Rockall mortality risk scores (Table 1). Patients in the COVID-19 time period were less likely to undergo endoscopy (64% vs. 71%, p=0.015). There were no differences between the two groups for the primary outcome of in-hospital mortality or any secondary outcomes (Table 1). On multivariable analysis, patients admitted with UGIB during the COVID-19 time period did not have greater inhospital mortality (odds ratio [OR]50.72, 95% confidence interval [CI] 0.30-1.57), or any differences in ICU utilization, number of red blood cell units transfused, persistent bleeding, and angiographic/ surgical management. Conclusion: Although fewer patients admitted to hospital with UGIB during the first wave of the COVID-19 pandemic received endoscopy, there was no difference in clinical outcomes.

Impact of covid-19 on mental health of children & adolescents: A bibliometric assessment of global publications

This study aims to evaluate the global research focusing on the mental health of Children & adolescents during the COVID-19 pandemic by using bibliometry. The bibliometric parameters considered for this study include the country of origin of the publications, organizations of the authors, keywords of the research focusing on the issue, and the citations received by these publications. Scopus database was used to search for the publications on “Impact of COVID-19 on Mental Health of Children and Adolescents” by using different key words, published upto 1st of May 2021. The Scopus search engine yielded 1797 publications related to the impact of COVID-19 on the Mental Health of Children & Adolescents. It was seen that researchers from top 10 most countries contributed to the 95.55% share of international publications output, with researchers from the United States, China, and United Kingdom accounting for 28.05%, 13.97%, and 13.69% of the global publication share. The most common keywords, in terms of focus of research included mental health, followed by anxiety and depression. The top 10 Universities and authors were from the high-income countries with highest representation from the United States. To conclude, this bibliographic analysis suggests that over a short span of time 1797 publications have emerged on the impact of COVID-19 pandemic on the mental health aspects of the children and adolescents, with majority of the publications emerging from high income countries.

Parents views about online classes during the ongoing covid-19 pandemic: A web-based cross-sectional survey

Aim: To assess the impact of online classes (started in view of COVID-19 pandemic) on the physical and psycho-behavioural parameters of children as perceived by their parents. Methodology: A cross-sectional web-based survey was carried out among the parents of children attending the online classes due to the ongoing pandemic. Results: 289 parents (either mother/father, or any other relative;67.8%-mothers) responded to the survey. The majority of the responders perceived online classes to be less comfortable, less satisfactory;and reported that their children had poor attention and concentration, had a lower level of learning in the theoretical and practical aspect of the subject. Most parents reported their child gets distracted and engages in surfing the internet or participating in online competitions. About half of the parents reported an increase in irritability (45.0%), the increased demand to go to school (45.0%), and a reduction in self-hygiene/care (43.3%). The other common behavioural problems as reported were stubbornness (36.3%), demanding behaviour (30.0%), tantrums (27.3%), and manipulativeness (27.0%). Conclusion: These preliminary findings suggest that the level of learning with in-person school-based classes is far superior to the online classes. The online classes might have a negative impact on the behaviour and physical health of the children.