Posttraumatic-stress disorder, and others psychological impairment in COVID-19 surviving patients

Background: The post-COVID syndrome generates physical and respiratory complications that can be accompanied by psychological impairments, which can affect long-term mental and physical health. Objective(s): Know the prevalence and severity of PTSD, anxiety, and depression in surviving COVID-19 patients in a follow-up evaluation. Method(s): A cross-sectional descriptive study was conducted. 227 survivors COVID-19 patients participated, were assessed three months following discharge hospital. The following questionnaires were used: The Brief Davidson Trauma Scale, the General Anxiety Disorder Questionnaire, and the Patient Health Questionnaire. A descriptive and statically analysis was performed using the statistical software SPSS version 26. Result(s): The 64.5% of the patients were men, 60.9% required of invasive mechanical ventilation (IMV) during the hospitalization, the average age was about 48.23+/-14.33 years old. The 40% of the patients showed symptoms associated with PTSD, 38.4% anxiety symptoms, 36.6% depression symptoms. There were statistically significant differences between the type of treatment during hospitalization (IMV vs without IMV), in PTSD (t=2.482, df=223, p=.014, XIMV = 5.21, XWIMV = 6.08) and anxiety (t= -2.006, df=223, p=.046, XIMV = 4.05, XWIMV =5.44). Conclusion(s): Survivors of COVID-19 experience a high prevalence of PTSD, anxiety, and depression even three months after discharge from hospital. Patients who did not require IMV during hospitalization experienced a high prevalence and severity of PTSD and anxiety symptoms. Screening for PTSD and other emotional disturbances should be considered in follow-up evaluations in patients discharged from the hospital.

Sleep disturbances in post-Covid patients as a function of sex

Introduction: Within the post-Covid syndrome, sleep disturbances are one of the most persistent symptoms, in which women are more 50% vulnerable than men to insomnia. Objective(s): To compare the prevalence of sleep disorders in post-Covid patients according to sex. Method(s): A cross-sectional observational study was carried out. The participants were 264 post-Covid patients evaluated 3 months after hospital discharge, divided into men (n=156, G1) and women (n=108, G2). A general sleep habits survey and the Berlin SAOS questionnaire were used for sleep assessment. Statistical analyses were performed using SPSS v25. Result(s): Mean age was G1: 54.16 +/-11.751 and G2: 54.23 +/- 13.319. There were differences (p<0.05) between both sexes in the following disorders (G1 vs G2): snoring (73.1% vs 58.3%), primary snoring (45.6% vs 28.6%), unrefreshing sleep more than 3 times a week (28.2% vs 43.5%), tiredness or fatigue during the day at least 3 times a week (30.1% vs 51.9%), sudden movements in extremities: (37.2% vs 22.2%), onset insomnia: (34.0% vs 53.7%), intermediate insomnia (36.5% vs 58.3%), final insomnia: (39.7% vs 55.6%). No differences (p>0.05) were found in pauses in breathing, teeth grinding, feeling of paralysis and feeling of choking, with a prevalence greater than 20% in all cases. Conclusion(s): In our study, the affectation of most sleep disorders are more frequent in the female sex, with the predominance of different types of insomnia (onset, intermediate and final);which could be related to affective disorders. In men, the most prevalent disorders were snoring and sudden movements, mostly linked to respiratory disorders.

Cognitive alterations in COVID-19 survivors with and without invasive mechanical ventilation during hospital stay

Introduction: Cognitive impairment is observed in patients for Covid-19;derived from both multiple organic dysfunctions due to the disease and its management during hospital stay. Existing literature reports greater cognitive impairment (60-80%) in patients with invasive mechanical ventilation (IMV), compared to those who did not require it (50-70%). Objective(s): To compare cognitive impairment among COVID-19 survivors with and without IMV during hospital stay. Method(s): A cross-sectional observational study was conducted. A total of 211 COVID-19 survivors participated, 64.9% required IMV (G1) and 35.1% did not (G2). The Montreal Cognitive Assessment (MOCA) was used to assess cognitive functions at a 9 month follow-up after hospital discharge. Statistical analyses were performed in SPSS V25. Result(s): Patients presented the following characteristics: male sex (G1: 61.8%, G2: 54.1%), and average age G1: 54.05+/-11.89, G2: 57.21+/-11.90 years. In both groups (G1 vs. G2) no significant differences (p<0.05) were found in the prevalence of probable mild cognitive impairment (72.3% vs. 82.4%), neither in the mean of principal affections reports: attention (4. 70+/-1.23 vs. 4.80+/-1.03) and memory (2.69+/-1.53 vs. 2.86+/-1.59). Orientation (5.60+/-.71 vs. 5.82+/-.41), was the only value that reached statistically significant differences (p=.013), but without clinical significance. Conclusion(s): Both groups have high prevalence of patients with probable mild cognitive impairment yet nine months after discharge, contrasting with the prevalence reported to patients with IMV and to the recovery time (3-6 months). Cognitive sequelae have a greater impact than reported in all patients regardless of treatment.

Heart rate variability in post-COVID-19 patients with different anxiety levels

Introduction: More than 12% of COVID-19 hospitalized patients develop Generalized Anxiety Disorder (GAD) after discharged. High frequency band percentage of heart rate variability (hfHRV) is a reliable indicator of efficient functional coupling between autonomic branches across high-demanding adaptive situations. Objective(s): To compare hfHRV among post-hospitalized COVID-19 survivors by level of GAD. Method(s): We conducted an observational study with 211 post-COVID-19 participants (63.7% males;47.6y +/-14.3), 3 months after discharged. We registered their hfHRV with a computerized biofeedback equipment throughout four conditions: open-eyes (C1);closed-eyes (C2);closed-eyes+natural-relaxation (C3);and closed-eyes+deep-breathing (C4) (2.5 minutes per condition). Participants were classified into 3 categories using General Anxiety Disorder Scale (GAD-7): low anxiety (n=174, 67.5%, 47.2 yo +/-13.4;G1);moderate anxiety (n=24, 66.5%, 47.3 yo +/-15.3;G2) and severe anxiety (n=13, 60.5%, 46.1 yo +/-9;G3). Statistical analysis were performed with SPSS v28. Result(s): hfHRV percentage is higher at C3 in G1 (G1: 29.5 +/-21.1, G2: 21.1 +/-17.1, G3: 20.0 +/-20.4;p = 0.01). G3 display a 30% decrease in hfHRV during this condition in contrast with G1 (p = 0.006). Percentage of hfHRV in G1 (C1: 31 +/-22.6, C2: 29.2 +/-23.6, C4: 24.3 +/-20.7), and G3 (C1: 29.7 +/-22.8;C2: 27.9 +/-17.6;C4: 20 +/-20) didn't show any significant differences. Conclusion(s): C3 involve an adaptive challenge that demands an effective sympathetic-parasympathetic regulation. An increase in hfHRV during C3 in G1, indicates that the group with low anxiety exhibit a more effective psychophysiological adaptive feature than G2 and G3: a potential protective factor from GAD.

Cognitive impairment as a sequel to SARS-CoV-2 infection

Introduction: COVID-19 survivor patients report a complaint subjectively related to memory and attentionconcentration problems when carry out their daily activities. Objective(s): To investigate the presence of cognitive sequelae associated with COVID-19. Method(s): An observational cross-sectional study was conducted. Participated 229 COVID-19 survivor patients, who were evaluated with Montreal Cognitive Assessment (MoCA) and classified into three groups: a) severe cognitive impairment (G1, <13points, n=11), b) mild cognitive impairment (G2, 13-21 points, n=34), and c) without cognitive alterations (G3, 22-30 points, n=184). Statistical analyses were performed in SPSS V25. Result(s): Average age and male sex: G1: 67.36+/-10.71, 63.6%;G2: 58.76+/-11.55, 61.8%;G3: 53.32+/-11.39, 58.7%. G1 presented statistically differences (p <0.001) in all cognitive functions with the other groups (G1, G2, G3): visuospatial/executive ability (0.09+/-0.30, 0.53+/-0.50, 0.83+/-0.38), identification (2.00+/-0.89, 2.82+/-0.38, 2.92+/-0.32), attention (2.45+/-0.82, 3.97+/-1.16, 5.02+/-0.97), repetition (0.18+/-0.40, 0.29+/-0.46, 1.02+/-0.79), fluency (0.18+/-0.40, 0.68+/-0.47, 0.93+/-0.24), abstraction (0.18+/-0.40, 0.68+/-0.72, 1.41+/-0.77), deferred remembering (0.73+/-1.10, 1.44+/-1.37, 3.13+/-1.36) and orientation (4.64+/-0.92, 5.35+/-0.73, 5.79+/-0.49);except in executive ability, identification, repetition, abstraction and deferred remembering with respect to G2 (p<0.05). Conclusion(s): Cognitive alterations were found in patients post- COVID, especially in attention and deferred remembering, which could be related to errors of execution in other areas. In the case of the severe cognitive impairment, age may be a related variable. Necessary integrate this variable in the rehabilitation plan for a better prognosis and quality of life of patients.

Psychological affectation in surviving patients of COVID19, consideration of the use of invasive mechanical ventilation

Introduction: The presence of anxious, depressive and post-traumatic stress (PTSD) symptoms are the most reported psychological sequelae in post-COVID patients. The use of invasive mechanical ventilation (IMV) may contribute to the appearance of these symptoms. Objective(s): To know the differences in anxious, depressive, PTSD and fear of COVID symptoms among surviving COVID-19 patients with or without IMV, 3 months after hospital discharge. Method(s): An observational cross-sectional study was conducted. 239 surviving COVID-19 patients participated: 146 with IMV at hospitalization (67.80% men and 32.20% women) (G1) and 93 without IMV (61.29% men 38.70% women) (G2), who were evaluated with: GAD-7 for anxious symptomatology, PHQ-9 for depressive symptomatology, EMACOVID scale to measure fear of COVID-19, and the brief Davidson scale as screening for EPT. Statistical analyzes were performed in the statistical package SPSS V25. Result(s): Average age: G1= 48.62+/-13.62, G2= 48.49+/-15.43. There was a statistically significant difference in the EPT scores (G1: Md=4 [4.00-6.00];G2: Md=5 [4.00-7.00]). No statistically significant differences were found (P<0.05, G1 vs G2) in depression (Md=3 [0.00-6.00] vs Md=3 [0.00-8.50], anxiety (Md=2 [0.00-6.00] vs Md=3 [1:00-7:50]), nor fear of COVID (Md= 9 [7:00-15:00] vs Md=11.80 [7:00-14:00]), although there were clinical differences. Conclusion(s): Patients without IMV have a conscious experience of their hospitalization, which may lead to a higher level of PTSD compared to sedated patients with IMV.

Prevalence of post-traumatic stress disorder, emotional impairments, and fear in COVID-19 surviving patients

Introduction: Among the different psychological sequelae of post-COVID syndrome are symptoms related to emotional impairment, mostly depression, anxiety, and post-traumatic stress disorder (PTSD). Objective: To describe and compare the prevalence and severity of PTSD, anxiety, depression, and fear of COVID-19 in survivors 3 months after discharge from the hospital. Methods: A cross-sectional descriptive study was conducted, a total of 227 survivors of COVID-19 participated;they were assessed 3 months after being discharged from the hospital. A psychological evaluation focused on anxiety, depression, PTSD, and fear was conducted. Statistical analysis through the t-test for independent samples was performed. Results: Of the patients, 64.5% were men, 60.9% required invasive mechanical ventilation (IMV) during hospitalization, and the average age was about 48.23 ± 14.33 years. Also, 40% showed symptoms associated with PTSD, 38.4% exhibited anxiety, 36.6% depression, and 36.12% exhibited fear of COVID-19. There were statistically significant differences between men and women, in PTSD (t = -3.414, df = 224, p = 0.001, x̅m = 5.10, x̅w = 6.32), depression (t = -4.680, df = 225, p = 0.000, x̅m = 3.64, x̅w = 7.18), anxiety (t = -3.427, df = 152.53, p = 0.001, x̅m = 3.78, x̅w = 6.20), and fear of COVID-19 (t = -3.400, df = 224, p = 0.001, x̅m = 11.88, x̅w = 15.19). Furthermore, there were also statistically significant differences between the type of treatment during hospitalization (IMV vs. without IMV), in PTSD (t = 2.482, df = 223, p = 0.014, x̅IMV = 5.21, x̅WIMV = 6.08) and anxiety (t = -2.006, df = 223, p = 0.046, x̅IMV = 4.05, x̅WIMV = 5.44). Conclusion: Survivors of COVID-19 experience a high prevalence of PTSD, anxiety, depression, and fear, even 3 months after discharge from the hospital. Females and patients who did not require IMV during hospitalization are the most affected population, presenting more severe symptoms of these psychological alterations. More research is required to know and observe the long-term evolution of these psychological alterations in this population. Copyright © 2022 Luna-Rodríguez, Peláez-Hernández, Orea-Tejeda, Ledesma-Ruíz, Casarín-López, Rosas-Trujillo, Domínguez-Trejo and Tepepa-Flores.

Educational strategy I Learn at Home and virtual mediation in learning of schoolchildren in the Ancash region of Peru

The objective was to analyze the educational strategy I learn at home and virtual mediation, as an adequate and efficient response to face the educational problem generated by the COVID-19 pandemic in the Ancash region of Peru. The research was applied, at a quasi-experimental level. The universe of the population includes the parents of seven public institutions. The study sample was all 320 parents, with the application of the census method. It was evidenced that teachers and students have made use of the official platform of the Ministry of Education, for teaching-learning, using radio, television, mobile devices, which has facilitated asynchronous work. The virtual strategy has allowed teacher-student interaction, facilitating the use of classes recorded in videos and audios, allowing the subjects to be developed and better controlled, which has allowed knowing the relationship between the I learn at home strategy and virtual mediation. to complete the school year.

Face Authentication from Masked Face Images Using Deep Learning on Periocular Biometrics

Nowadays, identity theft is an alarming issue with the growth of e-commerce and online services. Moreover, due to the Covid-19 pandemic, society has been pushed towards the usage of masks for people to safely interact with one another. It is hard to recognize a person if the face is mostly covered, even more so to artificial intelligence who have more difficulty identifying a masked individual. To further protect personal information and to develop a secure information system, more comprehensive bio-metric approaches are required. The currently used facial recognition systems are using biometrics such as periocular regions, iris, face, skin tone and racial information etc. In this paper, we apply a deep learning-based authentication approach using periocular biometric information to enhance the performance of the facial recognition system. We used the Real-World Masked Face Dataset (RMFD) and other datasets to develop our system. We implemented some experiments using CNN model on the periocular region information of the images. Hence, we developed a system that can recognize a person from only using a small region of face, which in this case is the periocular information including both eyes and eyebrows region. There is only a focus on the periocular region with our model in the view of the fact that the periocular region of the face is the main reliable source of information we can get while a person is wearing a face mask. © 2022, Springer Nature Switzerland AG.

EMERGING APPLIED MATHEMATICS VIRTUAL SPACE FOR THE BACHELOR'S DEGREE IN HEALTH INFORMATION SYSTEMS

The COVID-19 pandemic has led to the abrupt assumption in the university context, of the distance education to guarantee the continuity of the teaching-learning process (PEA), in which virtuality plays a decisive role. There is evidence of a growing introduction of this modality;however, shortcomings related to its use were revealed in the PEA of the Applied Mathematics curriculum on Health Information Systems career, at the University of Medical Sciences of Santiago de Cuba. In correspondence with ministerial methodological guidelines, the curriculum was virtualized, in the course-by-meeting mode, taking into account technological, organizational and pedagogical aspects;under the guidance of theoretical methods such as analysis and synthesis, historical-logical, and systemic-structural;and empirical methods such as scientific observation and documentary review. The space created in the Virtual Health University of Santiago de Cuba, allows the continuity of the PEA in the midst of the restrictive measures established. Greater independence, self-preparation and protagonism of the actors involved, and an adequate level of essentials are guaranteed, and the rational use of Information and Communication Technologies is encouraged.

Severity of COVID-19 infection in prostate cancer patients and effect of ADT on disease presentation

Introduction & Objectives: The TMPRSS2 protein has been found to be involved as a critical host cell factor in severe acute respiratory syndrome caused by coronavirus 2(SARS-CoV-2). The production of this protein is regulated by the androgen receptor (AR), also in non-prostatic tissues, including the lung. There is the speculation that androgen deprivation therapy (ADT) may protect patients affected by prostate cancer (PC) from SARS-CoV-2 infection. Our goal is to analyze the severity of COVID-19 in PC patients and the possible influence of ADT on this infection. Materials & Methods: Retrospective study of patients treated for COVID-19 between March 15th and May 15th 2020 in our institution who had previous diagnosis of PC. Patients were divided into two: Those treated with ADT during the infection or the year before, and those who were not treat with ADT on that period. Differences between groups in demographic characteristics, parameters of PC disease, risk factors for SARS-CoV-2 pneumonia, the presence of severe COVID-19 and mortality rates were analyzed. Results: During the study period, a total of 1365 patients were treated in our center for COVID-19 documented with positive PCR. From a total of 1349 subjects registered in our PC database, 156 were on ADT treatment and 1193 were not. Out of the total, 61 (4.52%) PC patients suffered from COVID-19, 11 (18.0%) belonged to the ADT group and 50(82.0%) to the non-ADT group. The mean age of the series was 77.6 years (SD:7.7). The cumulative incidence recorded of COVID-19 in total PC patients was 4.5% (95%CI: 3.5-5.8). Demographic variables, comorbidities and risk factors for infection were quite homogeneous in both groups. Although a worse tendency was observed in the non-ADT group, no statistically significant differences were found in any of the variables analyzed. Regarding the influence of ADT on the course of the disease, no statistically significant differences were found neither in the exitus rate (27.3% vs. 34.0%;p 0.481), nor in the presence of severe COVID-19: need for intubation or ICU admission(0% vs 6.3%;p 0.561) and need for corticoid treatment, interferon beta or tocilizumab (60% vs. 34.7%;p 0.128). In the univariate analysis, treatment with ADT was not found to be a protective factor for worse clinical evolution (RR 1.11;95%CI 0.67-1.85;p=0.68) or exitus (RR 0.8;95%CI 0.28-2.27;p=0.68). We also found no statistically significant differences when multivariate analysis adjusted for clinically relevant comorbidities was performed. Conclusions: In our study, the use of ADT has not been shown to be a protective factor against serious COVID-19. In view of the results published to date, more research in this area is definitely needed to draw firm conclusions.

Placental pathology and perinatal risk during the COVID-19 pandemic

Background: Respiratory and immune changes during pregnancy can lead to viral infections. In coronavirus disease 2019 (COVID-19), clinical characteristics and perinatal risks are difficult to assess and are relatively unknown. Objective: To review placental pathology in asymptomatic women with COVID-19, and to evaluate effects on perinatal outcomes. Material and method: Retrospective, observational, cross-sectional study that included 29 pregnant women in 2020. The women underwent COVID-19 tests and were divided in two groups: 1) control, COVID-19-negative patients, and 2) asymptomatic COVID-19-positive patients;the placentas were studied at the pathology department, and clinical data were retrieved from the electronic medical record;in addition, a literature review was carried out. Results: When the groups were compared, no differences were observed in general data and clinical characteristics. On the day of delivery, patients 2, 4, 5, 6, 8 and 9 of the COVID-19 group were between day 0 and 10.5 after having tested positive;only patients 1, 3 and 7 had overcome the infection. There was a decrease in weeks of gestation in the COVID-19 group (37.8 +/- 1.8 vs. 39 +/- 0.8;p = 0.05). COVID-19-positive patients' placental histopathology showed a higher prevalence of thrombotic alterations in placental villi (55.5 vs. 0 %). Conclusions: COVID-19 asymptomatic infection potentiates preexisting prothrombotic profile, thus increasing the risk of placental thrombosis and, potentially, of thrombosis in pregnant women.

Covid-19 rapid test validation. Isla de la juventud, Cuba

Having diagnostic methods that meet certain attributes is vital to guide health decisions, the current context warrants it. In order to validate the capacity of two rapid tests to detect antibodies due to SARS-CoV-2 infection in Isla de la Juventud, Cuba, from April to May 2020, a descriptive cross-sectional evaluation study was carried out. Rapid tests: Wondfo (SARS-CoV-2 antibody test) and Lungene covid-19 IgG/IgM, were compared to the real-time polymerase chain reaction test. Two homogeneous samples of 250 each were constructed, determining validation indicators. Sensitivity values of 6.6% and 8.3% respectively were obtained for each test, while the specificity was higher for Wondfo (95%). The positive predictive values were very low, the negative ones were adequate, higher in Lungene with 94.8%. Likelihood ratio values were classified as useless. In different scenarios in terms of symptomatic cases, sensitivity of 50% was reached in an interval of 1 to 7 days for Wondfo. The area under the ROC curve for Wondfo was 0.50 (95% CI = 0.46-0.55) and 0.46 for Lungene (95%CI = 0.38-0.55). The kappa index for Wondfo was 0.025 and 0.010 for Lungene. The rapid tests explored showed very low sensitivity, positive predictive value, and inadequate likelihood ratio. The global validity of the tests did not demonstrate a good diagnostic performance, marked by the value of the area under the ROC curve. The degree of agreement was poor. © 2021, Finlay Ediciones. All rights reserved.