The association of management and leadership competencies with work satisfaction among pharmacists in Lebanon.

BACKGROUND: Pharmacists are at the core of the healthcare system and are the most accessible healthcare professionals. Their new roles involve leadership skills, among others. Work satisfaction of pharmacists might affect the quality of the services they provide. Hence, the primary objective of this study was to evaluate the management/leadership skills and work satisfaction of pharmacists and working pharmacy students. The secondary objective was to establish the relationship between management/leadership competencies and work satisfaction. METHODS: This cross-sectional study enrolled 415 Lebanese pharmacists and fifth-year pharmacy students (undergraduates) working in different pharmacy sectors across Lebanon from August 2021 through October 2021 using the snowball sampling technique and validated tools to assess management/leadership competencies and work satisfaction. RESULTS: Management/leadership competencies were significantly correlated with work satisfaction (B = 0.288) and inversely associated with being engaged/married (B = - 2.825) and living outside Beirut or Mount Lebanon (B = - 1.873). Pharmacy students did not significantly differ in their leadership/management level from graduate pharmacists. Work satisfaction was significantly associated with management/leadership competencies (B = 0.062) and inversely related to education level (B = - 0.644). CONCLUSIONS: Pharmacists' work satisfaction and management/leadership competencies are interrelated, although the level of satisfaction seemed lower than the declared level of competencies. These concepts are differentially affected by personal and work-related characteristics. More efforts should be exerted to improve both the satisfaction and management/leadership competencies of pharmacists in Lebanon.

Cognitive function in recovered COVID-19 Lebanese patients with schizophrenia.

INTRODUCTION: It remains unclear whether COVID-19 which is an infectious disease caused by the SARS-CoV-2 virus is associated with the deterioration of cognitive function among patients with schizophrenia. This study aimed to evaluate changes in cognitive function before and after COVID-19 and associated factors among patients with schizophrenia at the Psychiatric Hospital of the Cross (HPC). METHODS: A prospective cohort study was conducted among 95 patients with schizophrenia followed from mid-2019 until June 2021 at the Psychiatric Hospital of the Cross (HPC). This cohort was divided into a group diagnosed with COVID-19 (n = 71) and another not diagnosed with COVID-19 (n = 24). The questionnaire included the Brief Assessment of Cognition in Schizophrenia (BACS), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Activities of Daily Living (ADL). RESULTS: The repeated-measures ANOVA showed no significant effect of time and the interaction between time and being diagnosed or not with COVID-19 on cognition. However, being diagnosed or not with COVID-19 had a significant effect on global cognitive function (p = 0.046), verbal memory (p = 0.046), and working memory (p = 0.047). The interaction between being diagnosed with COVID-19 and cognitive impairment at baseline was significantly associated with a higher cognitive deficit (Beta = 0.81; p = 0.005). Clinical symptoms, autonomy, and depression were not associated with the cognition (p > 0.05 for all). CONCLUSION: COVID-19 disease affected global cognition and memory: patients diagnosed with COVID-19 had more deficits in these domains than those without COVID-19. Further studies are necessary to clarify the variation of cognitive function among schizophrenic patients with COVID-19.

COVID-19 outbreak in a psychiatric hospital: what makes it worse?

BACKGROUND: Psychiatric patients could be at risk of worse outcomes from COVID-19 than the general population. The primary objective of the present study was to describe the symptoms and clinical characteristics of COVID-19 patients living in long-term hospital for mental illness in Lebanon. The secondary objective was to evaluate the factors related to COVID-19 disease severity among these patients. METHODS: A retrospective observational study was conducted from September 2020 to January 2021 at the Psychiatric Hospital of the Cross. The total number of COVID-19 patients in the infected floors is 410 out of 548. The outcome variable was the severity of COVID-19 illness classified into five categories: asymptomatic, mild, moderate, severe and critically ill. RESULTS: The rate of infection in the affected floors was 74.81%. Almost half of the patients were asymptomatic (49.3%), 43.4% had hyperthermia and only 28.0% had tachycardia and 25.1% developed hypoxia. The multivariate regression analysis showed that higher temperature (ORa = 6.52), lower saturation (ORa = 0.88), higher BMI (ORa = 1.12), higher CRP (ORa = 1.01), being a female (ORa = 4.59), having diabetes (ORa = 8.11) or COPD (ORa = 10.03) were significantly associated with the increase of the COVID-19 severity. CONCLUSIONS: The current study showed that a high rate of infection from COVID-19 was detected in a psychiatric hospital with the majority having asymptomatic to mild symptoms. Female psychiatric patients, desaturation, increase inflammation and comorbidities such as diabetes and COPD were associated with the severity of COVID-19 among psychiatric patients. Future studies are needed to better understand the causal relation of the factors with severity and long term effects or sequelae of the disease.

Exploring the association between lifetime traumatic experiences and positive psychotic symptoms in a group of long-stay patients with schizophrenia: the mediating effect of depression, anxiety, and distress.

BACKGROUND: Positive psychotic symptoms of schizophrenia are generally characterized by hallucinations and delusions. We propose to assess the relationship between total composite trauma and positive psychotic symptoms, along with the mediation effect of cognition, fear of COVID-19, insomnia, anxiety, distress, and depression of Lebanese patients with schizophrenia. METHODS: A cross-sectional study was carried out, between June and July 2021, by deriving data from 155 long-stay in-patients diagnosed with schizophrenia. RESULTS: Depression, anxiety, and distress but not cognitive impairment, insomnia, and fear of COVID-19) mediated the association between lifetime traumatic experiences and positive psychotic symptoms. Higher traumatic experiences were associated with greater depression, anxiety, and distress, indicating a significant positive total effect on positive psychotic scores. Moreover, higher depression, anxiety, and distress were significantly associated with higher positive psychotic symptoms. CONCLUSION: Our results contribute to the existing knowledge by suggesting other possible intervention paths through mediating factors. Interventions that improve anxiety, depression, and distress severity may be effective in reducing positive psychotic symptoms among patients with schizophrenia having experienced lifetime trauma.

The association between fear of COVID-19 and depression, anxiety, and psychosis among Lebanese chronic patients with schizophrenia: any moderating effect of spirituality?

AIM: To assess whether fear of coronavirus disease 2019 (COVID-19) is associated with depression, anxiety, and psychosis and to evaluate if these variables are correlated with the interaction between spirituality and fear of COVID-19. METHODS: Between September and November 2020, this cross-sectional study enrolled 118 chronic schizophrenia patients. The interview with patients included Fear of COVID-19 Scale, Lebanese Anxiety Scale-10, Montgomery-Asberg Depression Rating Scale, Positive and Negative Syndrome Scale (PANSS), and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-12. The results were analyzed by using linear regressions (Enter method), with anxiety, depression, total PANSS score, positive PANSS, negative PANSS, and general psychopathology PANSS subscales as dependent variables. Spirituality, fear of COVID-19, and the interaction of spirituality with fear of COVID-19 were independents variables. RESULTS: Fear of COVID-19 was positively correlated with increased total PANSS scores (Beta=0.90, P=0.030). Higher spirituality was significantly associated with lower anxiety (Beta=-0.14, P=0.009), lower depression (Beta=-0.21, P=0.001), lower total PANSS score (Beta=-0.90, P=0.004), lower negative PANSS score (Beta=-0.23, P=0.009), and lower general psychopathology PANSS score (Beta=-0.61, P=0.001). In patients with high fear of COVID-19, having low spirituality was significantly associated with higher anxiety, depression, and psychotic symptoms. CONCLUSION: This study suggests a positive correlation between fear of COVID-19 and higher psychosis among inpatients with schizophrenia. The interaction of spirituality with fear of COVID-19 was correlated with reduced anxiety, depression, and psychosis.

Violence Against Women During COVID-19 Pandemic.

The objectives of this study were to correlate several factors - including depression, anxiety, stress and self-esteem levels in both men and women - with the occurrence of domestic violence against women (VAW) during quarantine. This cross-sectional study was carried out in April 2020, in the midst of the COVID-19 pandemic when lockdown procedures were implemented; 86 married couples participated in this study amounting to 172 responses in total. A different questionnaire was set for women and men; the couple filled out their respective questionnaire simultaneously, but privately where one did not see the answers of the other. Inclusion criteria included married couples of all ages that are living together during the lockdown of COVID-19. The results of this study showed that a higher total abuse score was found in 39 females (45.3%; CI: 0.34 - 0.56). Being a Muslim female (Beta =24.80) and females having higher anxiety (Beta=0.97) were significantly associated with higher total abuse scores, whereas higher stress score in female (Beta=-0.61) was significantly associated with lower total abuse scores. In conclusion, this study focuses on VAW as a serious problem while demonstrating its further emergence during quarantine. This study also focused on the effects brought on by lockdown policies, including social and economic factors, and their implications in the increase of VAW during this pandemic.

Financial Wellbeing and Quality of Life Among a Sample of the Lebanese Population: The Mediating Effect of Food Insecurity

Background Lebanon is undergoing multiple overlapping crises, affecting the food security, financial well-being, and quality of life (QOL) of its residents. Objective The primary objective was to assess the food insecurity (FI) status of a sample of the Lebanese population. The second objective was to explore factors related to QOL parameters and evaluate the mediating effect of food security between financial well-being and QOL. Methods The study was cross-sectional and enrolled 412 participants recruited online using the snowball sampling technique. The survey included questions related to sociodemographic and economic characteristics of Lebanese households and validated scales to assess FI, QOL measures, financial well-being, and fear of COVID-19. Results Almost 43% of the study participants reported being food insecure, with 31% experiencing mild FI, 10% moderate FI, and 1.5% severe FI. Compared to food-insecure participants, food secure participants had a significantly higher income (58.5% vs. 39.2%, p < 0.001), a university education level (96.6% vs. 88.1%, p = 0.002), an average perceived financial status (83.9% vs. 65.9%), higher financial well-being scores (5.14 vs. 3.19, p < 0.001), and lower crowding index (0.94 ± 0.4 vs. 1.09, p = 0.002). Multivariate analysis showed that FI was not associated with physical (Beta = −1.48, 95% CI: −3.10;0.13) and mental (Beta = −1.46, 95% CI −3.68;0.75) QOL, after adjusting for other demographic and socioeconomic correlates. This association remained non-significant when introducing the financial well-being variable to the model. Mediation analyses showed that the FI variable mediated the association between financial well-being and physical QOL (Beta = 0.19, 95% CI: 0.02;0.36), but not the mental QOL (Beta = −0.02, 95% CI: −0.20;0.14). Conclusion Food insecurity was prevalent in our study sample, and it mediated the association between financial well-being and physical, but not mental, QOL parameters. These findings call for evidence-based policies and programs to help improve the food security and well-being of Lebanese households amidst these unprecedented circumstances.

The Combined Outcomes of the COVID-19 Pandemic and a Collapsing Economy on Mental Well-Being: A Cross-Sectional Study.

Objective: This study aimed to examine the outcomes of COVID-19 and a collapsing economy on the mental well-being (MWB) of the general Lebanese population. Methods: A cross-sectional study was conducted online in May 2020 and enrolled 502 adults. Results: Mental well-being had a mean of 14.80 (14.37; 15.24). A lower MWB was associated with female gender (beta=-1.533 [-2.324; -0.743]), university education (beta=-2.119 [-3.353;-0.885]), fear of COVID-19 (beta=-0.131 [-0.199; -0.063]), fear of poverty (beta=-0.232 [-0.402;-0.063]), verbal violence at home (beta=-3.464 [-5.137; -1.790]), and chronic disease (beta=-1.307 [-2.283; -0.330]). Better family satisfaction (beta=0.380 [0.235; 0.525]) and better financial situation (beta=0.029 [0.003; 0.055]) were significantly correlated with better MWB. In the subsample of workers/looking for a job, additional factors affected MWB: physical exercise (beta =1.318 [0.370; 2.265]) was associated with better QOL, while being a previous waterpipe smoker, being self-employed before the crisis (beta=-1.22 [-2.208;-0.231]), working from home since the economic crisis (-1.853 [-3.692; -0.013]), and worrying about the long-term effects of the crisis on one's employment status (beta=-0.433 [-0.650; -0.216]) were associated lower MWB. It is noteworthy that closure of the institution yielded a borderline result (B = -1.2; p = .094), while the fear of COVID-19 was not significantly associated with MWB (B = -0.054; p =0.192). Conclusion: This study showed that, during the pandemic, economic and other factors, directly or indirectly related to COVID-19, significantly affected quality of life. The fear of COVID-19 and fear of poverty mainly impacted the MWB of the general population. However, the fear of COVID-19 lost its significance among workers, who reported that factors negatively affecting their MWB are directly related to their employment and the already collapsing economy in Lebanon.

Factors related to pregnancy status and unwanted pregnancy among lebanese women during the COVID-19 lockdown: a cross-sectional study.

BACKGROUND: Home confinement and lockdowns have created challenges and vulnerabilities, causing relevant changes in sexual health and couple stability, particularly in women. The objective of this study was to evaluate the socio-economic and psychological factors related to current pregnancy status and unwanted pregnancy among Lebanese women during the COVID-19 lockdown. METHODS: A cross-sectional online study conducted between June 8 and August 1, 2020, enrolled 369 Lebanese women using the snowball technique for data collection. All married women between 18 and 51, with access to the internet and currently living with their partners, were eligible to participate. Current pregnancy status and unwanted pregnancy were assessed using binary questions. The SPSS software 25 was used for data analysis, and multivariable analysis was performed, taking the pregnancy status and unwanted pregnancy as the dependent variables. The statistical significance was set at a p-value < 0.05. RESULTS: Our results showed that 11.1% of women were pregnant, of whom 22.0% reported unwanted pregnancies. Having children (ORa = 0.183) and taking contraceptives (ORa = 0.231) were significantly associated with a reduced chance of becoming pregnant. Higher psychological violence would negatively affect pregnancy, but the association was not significant (p = 0.065). Regular visits to the physician for routine checks were also linked to a decreased risk of unwanted pregnancy (ORa = 0.053). Higher psychological violence would affect unwanted pregnancy; however, the association was insignificant (p = 0.056). CONCLUSION: The study findings showed that having children and taking contraceptives are associated with a reduced pregnancy. Additionally, psychological violence was found to be related to current pregnancy status and unplanned pregnancy. During a pandemic, vulnerable women should be identified and given adequate care, knowledge, and awareness regarding their reproductive health.

Should samples be weighted to decrease selection bias in online surveys during the COVID-19 pandemic? Data from seven datasets.

BACKGROUND: Online surveys have triggered a heated debate regarding their scientific validity. Many authors have adopted weighting methods to enhance the quality of online survey findings, while others did not find an advantage for this method. This work aims to compare weighted and unweighted association measures after adjustment over potential confounding, taking into account dataset properties such as the initial gap between the population and the selected sample, the sample size, and the variable types. METHODS: This study assessed seven datasets collected between 2019 and 2021 during the COVID-19 pandemic through online cross-sectional surveys using the snowball sampling technique. Weighting methods were applied to adjust the online sample over sociodemographic features of the target population. RESULTS: Despite varying age and gender gaps between weighted and unweighted samples, strong similarities were found for dependent and independent variables. When applied on the same datasets, the regression analysis results showed a high relative difference between methods for some variables, while a low difference was found for others. In terms of absolute impact, the highest impact on the association measure was related to the sample size, followed by the age gap, the gender gap, and finally, the significance of the association between weighted age and the dependent variable. CONCLUSION: The results of this analysis of online surveys indicate that weighting methods should be used cautiously, as weighting did not affect the results in some databases, while it did in others. Further research is necessary to define situations in which weighting would be beneficial.

COVID-19 and psychosis, depression, obsession and quality of life in Lebanese patients with schizophrenia: Any changes after 5 months of quarantine?

BACKGROUND: Previous research revealed an absence of any previous studies reporting the impact that pandemics may have on psychotic symptomology, nor on the physical health of people with psychosis in response to the epidemics of the COVID-19. The direction of the impact of the COVID-19 on schizophrenia is unknown, as the risk of infection could vary from patients to patients according to clinical comorbidities, cognitive impairment, acute symptoms, and family support. To the best of our knowledge, no study has provided details on the variation of symptoms in patients with schizophrenia during the quarantine of COVID-19 outbreak. Therefore, the primary objective of the study is to investigate the variation of psychotic symptoms, depression, obsession and quality of life in patients with schizophrenia before and after 5 months of quarantine and evaluate factors associated with these variations during the quarantine period. METHODS: A cross-sectional study was performed on a sample of 190 chronic patients institutionalized for schizophrenia for more than 1 year at the Psychiatric Hospital of the Cross. The baseline assessment was done in December 2019; the second assessment was done in August 2020 (5 months after the lockdown). RESULTS: Getting updates about the coronavirus minimally, some and most of the times were significantly associated with a decrease in positive psychotic and psychopathologic symptoms 5 months after quarantine compared to before it. Practicing religiosity some and all the time versus not was significantly associated with a decrease in negative, psychopathology symptoms and total PANSS score after 5 months of quarantine compared to before it. Finally, female gender (B = 1.77) was significantly associated with an increase in the WHO Domain 3 score (better social relations) after 5 months of quarantine compared to before it. CONCLUSION: Patients with schizophrenia fare better symptomatically after 5 months of quarantine if they receive constant updates about COVID-19 and if they tended to practice religiosity.

Factors related to autonomy among Lebanese women: a web-based cross-sectional study.

BACKGROUND: Autonomy involves making independent decisions and creating lasting and equitable power relationships within families. Many factors, dependent on both the woman and her partner, can influence self-dependence, and subsequent decision-making, exerting a protective or triggering effect on its development. Therefore, the primary objective of the study was to assess autonomy in a sample of Lebanese women. The secondary objective was to evaluate the association between socioeconomic status, psychological factors, and autonomy. METHODS: A web based cross-sectional online study was conducted between June 8 and August 1, 2020. The questionnaire developed on Google Forms was distributed through social media and WhatsApp groups, using the snowball technique. The Women's Autonomy Index (WAI) was created using three items adapted from a previous study. In addition, the Composite Abuse Scale Revised-Short Form (CASR-SF) was used to assess three domains of abuse: physical, sexual, and psychological. The Perceived stress scale short version to measure stress perception, the Lebanese Anxiety Scale to measure anxiety and the Patient Health Questionnaire (PHQ-9) to assess depression. The Statistical Package for the Social Sciences (SPSS) software version 25 was used for data analysis. Linear regressions were performed, taking the Women's Autonomy Index as the dependent variable. RESULTS: The sample consisted of 369 Lebanese women. University education level (beta = 1.263), alcohol consumption (beta = 0.586), intermediate income level (beta = 0.702), high income (beta = 0.911), employment (beta = 0.559), and older age (beta = 0.033) were significantly associated with higher WAI. Living in South Lebanon (beta = - 0.668) and being Druze (beta = - 323) were associated with lower WAI. Significantly higher mean scores of anxiety and perceived stress were found among women with low autonomy. CONCLUSION: In Lebanon, the autonomy of women depends on several personal and partner-related characteristics (education, socioeconomic status, age), in addition to the cultural (geographic and religious) environment. Furthermore, low autonomy is associated with higher perceived stress and anxiety and probable depression and domestic abuse.

Stigma toward people with COVID-19 among the Lebanese population: a cross-sectional study of correlates and mediating effects.

INTRODUCTION: Stigma develops during outbreaks such as the COVID-19 pandemic due to the human fear that arises from the anxiety about a disease of an unknown etiology, with the associated detrimental consequences on both the individual and society. This study was conducted to assess if knowledge about COVID-19, attitude, practice and behavior regarding preventive measures against COVID-19, fear, and anxiety towards COVID-19 will affect the level of stigma and evaluate the mediating effect of fear, anxiety, and diagnosis of COVID-19 on stigma. METHODS: A cross-sectional online survey conducted between December 20, 2020, and January 05, 2021, enrolled 405 participants recruited from the Lebanese population. Two scales were created and adapted to the Lebanese context to measure the current stigma (stigma discrimination scale, self-stigma scale) toward COVID-19. RESULTS: More than half of the sample had moderate to severe stigma discrimination (62%) and self-stigma (65.9%). The multivariable analysis showed that higher fear of COVID-19 scale (Beta = .143) was significantly associated with a higher stigma discrimination scale. Whereas, higher knowledge score (Beta = -.153) was significantly associated with a lower stigma discrimination scale. Fear of COVID-19, anxiety from COVID-19, being diagnosed with COVID-19, and having a family member with COVID-19 partially mediated the association between knowledge and stigma discrimination scale. No mediation effect of fear and anxiety scale was found between the knowledge and self-stigma score. CONCLUSION: Our main findings indicate that a considerable proportion of the Lebanese population has stigma discrimination behaviors toward COVID-19 patients and that those who were infected with the virus experienced COVID-19-related stigmatization.

Treatment satisfaction and its association with anxiety, depression and fear of COVID-19 among Lebanese inpatients with schizophrenia.

BACKGROUND: The patient's evaluation of treatment and its associated outcomes define the treatment satisfaction. The quality of treatment satisfaction and healthcare service has been affected by depression, anxiety and fear of the current coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: Therefore, this study aimed to assess factors associated with treatment satisfaction among Lebanese inpatients with schizophrenia, namely depression, anxiety and fear of COVID-19. METHODS: A cross-sectional study was conducted between September and November 2020, enrolled 118 patients with chronic schizophrenia consecutively admitted to Psychiatric Hospital of the Cross, Lebanon. The Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction Scale (FACIT-TS-PS) was used to assess treatment satisfaction, the Lebanese Anxiety Scale -10 (LAS-10) was used to assess anxiety, Montgomery-Asberg Depression Rating Scale (MADRS) to assess depression and the Fear of COVID-19 Scale to assess the level of fear of the COVID-19 pandemic. RESULTS: The mean scores of the scales were as follows: treatment satisfaction (65.20; SD 16.11; median=71), LAS-10 (13.65; SD 6.02), MADRS (9.09; SD 6.69) and fear of COVID-19 (18.59; SD 6.78). Higher depression (r= -0.46, p<0.001) was significantly associated with lower treatment satisfaction. Female gender (beta=7.51, p=0.029) was significantly associated with higher treatment satisfaction score. Fear of COVID-19 did not show any significant association with the treatment satisfaction score. CONCLUSIONS: Results of this study found that depression and gender were associated with treatment satisfaction among inpatients with schizophrenia. No association has been found between fear of COVID-19 and treatment satisfaction among those patients. More research is warranted to evaluate treatment satisfaction and associated factors among chronic inpatients with schizophrenia, specifically during the COVID-19 pandemic, in order to improve treatment satisfaction and subjective well-being of patients.

A cross-sectional study of COVID-19-related bullying in a sample of Lebanese adults: scale validation, correlates, and mediating effect of fear and anxiety.

BACKGROUND: The COVID-19 pandemic has led to prolonged exposure to stress and anxiety, raising concerns about a large spectrum of psychological side effects. The primary objective of the study was to validate the COVID-19 Bullying Scale (CBS-11). The second objective was to explore factors associated with COVID-19-related bullying and evaluate the mediating effect of fear and anxiety between knowledge and COVID-19-related bullying. METHODS: A cross-sectional online survey conducted between December 20, 2020, and January 5, 2021, recruited 405 Lebanese adults using a snowball sampling technique. The CBS-11, an 11-item tool specifically created for this study, was used to measure bullying behaviors towards COVID-19 patients. RESULTS: All items of the CBS-11 converged over a 1-factor solution with an eigenvalue over 1, accounting for a variance of 75.16%. The scale has a high Cronbach's alpha (.974), indicating excellent reliability. A positive correlation was found between the COVID-19 bullying scale and fear, anxiety, and stigma discrimination. The logistic regression showed that higher fear of COVID-19 (ORa = 1.04), a positive attitude toward COVID-19 preventive measures and hygiene recommendations (ORa = 1.18), higher stigma discrimination scores (ORa = 1.09), and having a health professional family member (ORa = 2.42) were significantly associated with bullying. CONCLUSION: Our main findings showed that the CBS-11 could be an efficient tool to measure bullying behaviors toward COVID-19 patients. Stigma discrimination and fear from COVID-19 were associated with higher bullying attitudes. Future prospective studies are needed to understand better the factors related to bullying among adults during a pandemic, such as COVID-19.

Coronavirus disease 2019 outbreak: does confinement have any impact on weight change perception?

Purpose: This study aimed to evaluate the relationship between factors related to COVID-19 confinement (i.e., fear of COVID-19, anxiety, anger, boredom, eating disorders, and duration of confinement) and weight perception in a sample of the Lebanese population. Methods: A cross-sectional web-based survey carried out at a one-time point between April 3 and 18, 2020, enrolled 407 participants. Due to the imposed lockdown, respondents self-reported their weight and height. One dichotomized question (positive/negative) assessed the perception of weight change (yes=change perception, and no=no change perception). The variation in BMI was calculated by subtracting the estimated weight during confinement from the estimated weight before. Results: No significant variation in BMI was detected before and during the confinement (p=0.40), while a perceived weight change was found in 212 (52.1%) participants. The regression analysis showed that higher fear of COVID-19 score (ORa=0.96) and higher self-reported weight change (ORa=0.47) were associated with lower weight change perception. However, longer confinement duration (ORa=1.07), higher anxiety (ORa=1.05), and high eating concerns (ORa=1.81) were associated with higher weight change perception. Conclusion: Our results revealed that both the fear of COVID-19 and self-reported weight change were negatively associated with weight perception, while higher anxiety and a longer duration of confinement correlated with a higher weight change perception. Further studies are necessary to confirm our findings. Résumé Objectif: L’étude visait à évaluer la relation entre les facteurs reliés au confinement dû à l'épidémie de COVID-19 (peur du COVID-19, anxiété, colère, ennui, troubles de l'alimentation et durée du confinement) et la perception du poids dans un échantillon de la population libanaise. Méthodes: Une enquête transversale en ligne a été réalisée entre le 3 et le 18 avril 2020 et a recruté 407 participants. En raison du confinement, les répondants ont déclaré eux-mêmes leur poids et leur taille. Une question dichotomisée (positive / négative) évaluait la perception du changement de poids. La variation de l’indice de masse corporelle (IMC) a été calculée en soustrayant le poids estimé pendant le confinement du poids estimé avant le confinement. Résultats: Aucune variation significative de l'IMC n’a été détectée avant et pendant le confinement (p = 0,40), alors qu'un changement de poids perçu a été trouvé chez 212 (52,1%) participants. En prenant le changement de poids perçu comme variable dépendante, les résultats ont montré qu'une peur plus élevée du COVID-19 (ORa = 0,96) et un changement de poids (ORa = 0,47) étaient associés à une plus faible perception du changement de poids. Cependant, une durée de confinement plus longue (ORa = 1,07), une anxiété plus élevée (ORa = 1,05) et une préoccupation alimentaire plus élevée (ORa = 1,81) étaient associées à une plus grande perception du changement de poids. Conclusion: Nos résultats ont révélé que la peur du COVID-19 et le changement de poids auto-déclaré étaient associés négativement à la perception du poids, tandis qu'une anxiété plus élevée et une durée de confinement plus longue étaient corrélées à une perception plus élevée du changement de poids. D'autres études sont nécessaires pour confirmer nos résultats.

Smoking and COVID-19: A Scoping Review.

Smoking affects a person's overall health and damages nearly every organ of the body. Since smoking tobacco affects and damages the lungs, it increases the risk of respiratory infections and makes it easier for the coronavirus disease (COVID-19) to invade the lung tissue, causing more severe symptoms and increasing the risk of death. However, debates are still ongoing as to the effect of cigarette smoking on vulnerability to COVID-19. Some studies, where active smokers were underrepresented among patients with COVID-19, claimed that a "smoker's paradox" may exist in COVID-19 and that smokers are protected from infection and severe complications of COVID-19. However, other studies reported the opposite trend. The objective of this study is to review the findings of epidemiological and in vitro studies about the association between smoking and the risk of contracting COVID-19, taking into account disease severity. Several epidemiological studies have found a higher smoking prevalence among COVID-19 infected patients. Also, studies had shown that people with respiratory diseases caused by tobacco use are at higher risk of developing severe COVID-19 symptoms. Studies have shown that in vitro, the acute exposure allows for more severe proximal airway epithelial disease from SARS-CoV-2 by reducing the mucosal innate immune response and the proliferation of airway basal stem cells and has implications for disease spread and severity in people exposed to cigarette smoke, with a more severe viral infection and cell death. Smoker patients with different comorbidities are at higher risk of contracting the COVID-19 virus and have a worse prognosis for the virus as well as for their comorbidities. Further investigations of the interaction between smoking and COVID-19 are warranted to accurately assess the risk of contracting COVID-19 among smokers, and the progression to mechanical ventilation or death in patients who suffer from it.

COVID-19 detection by dogs: from physiology to field application-a review article.

For years, the dog, man's best friend, was the most widely employed scent-detector tool for civilian and military purposes. Recently, many studies highlighted the role of canine olfactory ability in the medical field, specifically in detecting different infectious, metabolic and neoplastic conditions. The objective of this literature review is to clarify the rationale behind dog's ability to detect diseases, to assess the possible application for COVID-19 detection and to discuss the evidence available on the matter. Available evidence shows that properly trained disease-detector dogs are an efficient tool for identification of specific disease-associated volatile organic compounds marker profiles for a particular disease. And since COVID-19 positive persons have a specific volatilome different from non-infected persons, they can be recognised by the dogs, by sniffing different body fluids consequently aiding in the diagnosis of COVID-19. Possible applications of dogs as COVID-19 detectors will be an easy real-time mobile diagnostic aid with low cost and good performance. More evidence is needed to be able to describe standardised measures concerning the best fluid to test, testing procedure, time of possible detection according to disease evolution, risks associated with the dog exposure and to translate the good results in study setting into the real-life operational one.

COVID-19 pandemic and mental health in Lebanon: a cross-sectional study.

OBJECTIVES: To evaluate depression, stress, anxiety and obsessive-compulsive behaviours in the Lebanese population in response to COVID-19 pandemic. METHODS: This cross-sectional study was conducted between March and April 2020 on 386 participants randomly recruited from Lebanese general population. RESULTS: Following the evolution of the COVID-19 pandemic in Lebanon compared to was not significantly associated with higher stress, higher depression, lower obsessive-compulsive traits, higher anxiety. Moreover, higher compulsion (Beta = 0.092), having a university level of education (Beta = 0.573), intermediate income (Beta = 1.889), following the evolution of the COVID-19 pandemic in Lebanon all of the time (Beta = 7.064), most of the time (Beta = 5.592), sometimes (Beta = 4.235) and little of the time (Beta = 7.676) were significantly associated with a higher hygienic prevention practices score. Higher age (Beta = -0.051), being a male (Beta = -1.432), higher depression (Beta = -0.083) and practicing religion some of the time (Beta = -0.826) were significantly associated with a lower hygienic prevention practices score. CONCLUSION: This study found a strong interrelationship between psychological stress, depression, anxiety and obsessive-compulsive traits during the COVID-19 pandemic and identified the most vulnerable sub-groups in the Lebanese population. Additional measures should be deployed by health authorities in Lebanon and worldwide to face the impact of COVID-19 pandemic on mental health.Key pointsFollowing the evolution of the COVID-19 pandemic in Lebanon compared to not was significantly associated with higher stress, higher depression, lower obsessive-compulsive disorder, higher anxiety.Higher compulsion, having a university level of education, following the evolution of the COVID-19 pandemic in Lebanon were significantly associated with a higher hygienic prevention practices score.Higher depression, male gender, and practicing religion some of the time were significantly associated with a lower hygienic prevention practices score.Additional measures should be deployed by health authorities in Lebanon and worldwide to face the impact of COVID-19 pandemic on mental health.

Association between eating behavior and quarantine/confinement stressors during the coronavirus disease 2019 outbreak.

BACKGROUND: Quarantine/confinement is an effective measure to face the Coronavirus disease 2019 (COVID-19). Consequently, in response to this stressful situation, people confined to their homes may change their everyday eating behavior. Therefore, the primary objective of this study is to evaluate the association between quarantine/confinement stressors and eating behavior during the COVID-19 outbreak. The secondary objective is to compare the association of quarantine/confinement stressors and diet behavior between two groups of participants, those attending diet clinics and those not (general population). METHOD: A cross-sectional web-based online survey carried out between April 3 and 18, 2020, enrolled 407 participants from the Lebanese population. Eating Disorder Examination - Questionnaire (EDE-Q) were used to measure the behavioral features of eating disorders. RESULTS: More than half of the sample (53.0%) abide by the home quarantine/confinement, 95.4% were living with someone in the quarantine/confinement, and 39.6% continued to work from home. Higher fear of COVID-19 was found in 182 (44.8%) participants, higher boredom in 200 (49.2%) participants, higher anger in 187 (46.3%), and higher anxiety in 197 (48.5%) participants. Higher fear of COVID-19 (Beta = 0.02), higher BMI (Beta = 0.05), and physical activity (Beta = 1.04) were significantly associated with a higher restraint score. Higher anxiety, higher fear of COVID-19, higher BMI, practicing physical exercise, and a higher number of adults living in the quarantine/confinement were significantly associated with higher shape and weight concerns. CONCLUSION: Our results showed that the fear of COVID-19 was correlated with more eating restraint, weight, and shape concerns in the whole sample, but more specifically in the dietitian clients group. Public health control measures are needed to reduce the detrimental effects of psychological distress associated with quarantine/confinement on eating behaviors during the COVID-19 outbreak.