Global burden of the COVID-19 associated patient-related delay in emergency healthcare: a panel of systematic review and meta-analyses.

BACKGROUND: Apart from infecting a large number of people around the world and causing the death of many people, the COVID-19 pandemic seems to have changed the healthcare processes of other diseases by changing the allocation of health resources and changing people's access or intention to healthcare systems. OBJECTIVE: To compare the incidence of endpoints marking delayed healthcare seeking in medical emergencies, before and during the pandemic. METHODS: Based on a PICO model, medical emergency conditions that need timely intervention was selected to be evaluated as separate panels. In a systematic literature review, PubMed was quarried for each panel for studies comparing the incidence of various medical emergencies before and during the COVID-19 pandemic. Markers of failure/disruption of treatment due to delayed referral were included in the meta-analysis for each panel. RESULT: There was a statistically significant increased pooled median time of symptom onset to admission of the acute coronary syndrome (ACS) patients; an increased rate of vasospasm of aneurismal subarachnoid hemorrhage; and perforation rate in acute appendicitis; diabetic ketoacidosis presentation rate among Type 1 Diabetes Mellitus patients; and rate of orchiectomy among testicular torsion patients in comparison of pre-COVID-19 with COVID-19 cohorts; while there were no significant changes in the event rate of ruptured ectopic pregnancy and median time of symptom onset to admission in the cerebrovascular accident (CVA) patients. CONCLUSIONS: COVID-19 has largely disrupted the referral of patients for emergency medical care and patient-related delayed care should be addressed as a major health threat.

Laboratory Findings of COVID-19 Infection are Conflicting in Different Age Groups and Pregnant Women: A Literature Review.

Coronavirus disease 2019 (COVID-19), a new type and rapidly spread viral pneumonia, is now producing an outbreak of pandemic proportions. The clinical features and laboratory results of different age groups are different due to the general susceptibility of the disease. The laboratory findings of COVID-19 in pregnant women are also conflicting. Para-clinical investigations including laboratory tests and radiologic findings play an important role in early diagnosis and treatment monitoring of COVID-19. The majority of previous reports on the COVID-19 laboratory results were based on data from the general population and limited information is available based on age difference and pregnancy status. This review aimed to describe the COVID-19 laboratory findings in neonates, children, adults, elderly and pregnant women altogether for the first time. The most attracting and reliable markers of COVID-19 in patients were: normal C-reactive protein (CRP) and very different and conflicting laboratory results regardless of clinical symptoms in neonates, normal or temporary elevated CRP, conflicting WBC count results and procalcitonin elevation in children, lymphopenia and elevated lactate dehydrogenase (LDH) in adult patients, lymphopenia and elevated CRP and LDH in the elderly people, leukocytosis and elevated neutrophil ratio in pregnant women.

A Cross-Sectional Study on Cognitive Errors and Obsessive-Compulsive Disorders among Young People During the Outbreak of Coronavirus Disease 2019.

Given that the lockdown measures taken so as to diminish the dissemination of the COVID-19 pandemic are likely to create major mental disorders such as obsessive-compulsive disorder (OCD), the present study was conducted aiming to evaluate the prevalence of OCD and cognitive errors among young people during the outbreak of coronavirus disease 2019. The present study is a descriptive, cross-sectional study in which a total of 150 young people aged 13 to 19 were randomly included. Maudsley Obsessive-Compulsive Inventory Questionnaire (MOCI) and Cognitive Error Questionnaire (CEQ) were completed, and then their results were analyzed by SPSS 22 software. The results revealed that 67.3% of the subjects who were evaluated may have demonstrated OCD symptomatology. The prevalence of obsessive-compulsive disorder symptoms in women was slightly higher than in men (72.1 compared to 60.3%). Likewise, the test results indicated that there was a significant difference between obsessive-compulsive disorder symptom in men and women (p = .001). There was also a significant difference between the two groups with OCD symptoms and without OCD symptoms in all the components of cognitive errors (p = .001). To the authors' best of knowledge, this is the first study that has evaluated OCD symptoms at the time of COVID-19 prevalence. The findings suggest the need to enhance the prevention of relapse during social restrictions as well as to develop other strategies including online consultation and digital psychiatric management.