Anxiety and depression among healthcare workers infected by COVID-19: A cross-sectional study

Background: The impact of COVID-19 on mental health has been continuously reported, especially among healthcare workers. In the literature, anxiety and depressive symptoms are not uncommon in infected individuals. However, there is little data on these psychological events in healthcare professionals. Objective(s): To determine the prevalence and associated factors of anxiety and depressive symptoms in healthcare workers infected by COVID-19. Method(s): This is a cross-sectional study conducted among healthcare workers at Farhat Hached University Hospital infected by COVID 19. A self-administered questionnaire was used to collect data on the socio-professional and medical characteristics of the participants. Anxiety and depressive symptoms were assessed by the Hospital Anxiety and Depression Scale (HAD-S). Result(s): A total of 477 confirmed COVID-19 in healthcare workers were included in this study (85.9%). The mean age of the participants was 39.9 +/-10.8 years. Women represented 78.2%. The majority of the infected participants were nurses (32.1%). The paucisymptomatic form of the disease was the most frequent (73.8%). After returning to work, 62.7% of the participants retained residual symptoms and 15.5% experienced stigma reactions from their colleagues. The overall prevalence of anxiety and depressive symptoms were 25.4% and 19.1%, respectively. These identified problems were significantly interrelated. Furthermore, residual symptoms and duration of confinement predicted anxiety symptomatology, while female gender and symptomatic clinical form of COVID-19 were significantly associated with depressive symptomatology. Conclusion(s): The psychological events of COVID-19 are frequent among healthcare workers. Thus, systematic screening and early management of psychological disorders are necessary to preserve the human resources of the health sector.

Anosmia in healthcare workers affected with COVID-19: Prevalence and associated factors

Background: COVID-19 is the most important health problem in the world nowadays. Since the publication of the first cases, the symptoms have become more numerous. Anosmia has been recently recognized as a frequent and relevant symptom for the detection of COVID-19, especially in pauci-symptomatic forms. Objective(s): To determine the prevalence of anosmia in health care workers affected by SARS-COV2 and to identify its associated factors. Method(s): This is a cross-sectional analytical study, carried out over a six-month period, which included all healthcare workers of Farhat Hached Academic Hospital of Sousse, Tunisia, affected by SARS-COV2 and confirmed by polymerase chain reaction or antigen rapid test. Result(s): A total of 474 healthcare workers were enrolled with a mean age of 41.02+/-10.67 years and a sex ratio of 0.2. The gynecology department was the most represented one (13.9%). Nurses were the most affected (31.4%). Hospitalization was required for 16 patients (3.4%). The average time of work was 17.04 +/- 11.6 days. Anosmia persisted for more than 90 days in 35 patients (7.4%). After multiple binary logistic regression, anosmia was statistically associated with female gender (p = 0.001;ORIC95%:2.46 [1.4-4.2]) and blue-collar occupational category (p = 0.002;ORIC95%:3.1 [1.5-6.5]). A significant association was also noted between the presence of anosmia and professional seniority (p = 0.019;OR IC95%: 0.97 [0.95-0.99]) and the duration of work (p = 0.03;OR IC95%: 0.97 [0.95-0.99]). Conclusion(s): Although anosmia seems to be frequent in COVID-19 patients, there is still not enough evidence to affirm that it is a strong predictor of the diagnosis of COVID-19.

Work productivity among healthcare workers with post COVID-19 syndrome

IntroductionOver time, the phenomenon of persistent symptoms after COVID-19 infection has evolved from non-specific symptoms to a clinical entity known as post-covid-19 syndrome, which can lead to disabilities. The aim of this study is assess the impact of post-Covid-19 syndrome on health professionals and its implications on professional activity.MethodsThis is a cross-sectional, analytical study conducted over a two-month period and including all health care staff at the Nabeul University Hospital. The evaluation of work productivity was carried out by the questionnaire‘Work Productivity and Activity Impairment Questionnaire'.ResultsOur study involved 89 health workers. The average age of the population was 41.2±10.6 years with a sex ratio of 0.63. Nurses were the most represented occupational group (59.6%). The majority of participants were infected once and in February 2021 (55.1% of cases). General signs were the most reported and were dominated by fever (51.6%). Post-covid-19 syndrome was reported in 44 patients (49.4% of cases). The main persistent symptoms were headache (61.3%), asthenia (59%), and dyspnea (31.8%).The drop in productivity and daily activities were significantly higher in patients who developed post-covid-19 syndrome;p=0,015 and p=0,002 respectively. However, there was no significant difference between the two groups in terms of absenteeism and presenteeism (p=0.42 and p=0.2 respectively).ConclusionGuidelines for the management of post-COVID syndrome based on established criteria are needed to enhance its outcome.

Psychosocial skills of ICU healthcare staff providing care to patients with COVID-19

Introduction: The COVID-19 crisis has imposed deep improvements in ICU responsiveness face to unprecedented and uncertain situations. In addition to strengthening logistics resources, this responsiveness required the development of psychosocial skills of healthcare providers, especially in ICU. Objective(s): To assess extrinsic factors interfering with psychosocial skills of the staff working in COVID-19 ICU and to analyze the different dimensions of these skills. Method(s): This is an observational descriptive study conducted at the COVID-19 ICU of an Academic Hospital, during a one-month period. All healthcare providers were enrolled. Data collection was based on a self-administered questionnaire including: sociodemographic factors;the general perception of work in covid-19 ICU and psychosocial skills. Six dimensions were explored separately, then by a standardized scale ranging from 0 to 100.Three levels of satisfaction were considered. Result(s): Fifty-five healthcare providers were enrolled. The average age was 32 years. The sex ratio was 0.25. Mean scales of satisfaction were 53.6 for professional status and occupational security;62.4 for working conditions and 69.8 for relational aspects. The most altered extrinsic factors were satisfaction regarding the salary and satisfaction regarding the administration policy with mean scores of 15 and 10 respectively. Satisfying psychosocial skills were creative and critical thoughts, self-awareness and empathy for others, communication and interpersonal relationships. Whereas the most impaired skills were stress management and problems solving, with mean scales of 49.6 and 68.3 respectively. Conclusion(s): Psychosocial skills were generally acceptable. However, they could be improved by specific actions targeting extrinsic factors.

Depressive disorders among physician parents in times of COVID-19 pandemic

Introduction: Studies have shown that physicians manifest a clear duty to work. For parents, reconciling work with parenthood is not easy and can even lead to depression. Objective(s): To determine the prevalence and the factors for depression in Tunisian physician parents. Method(s): This was a descriptive and analytical cross-sectional study of 93 Tunisian physician parents, conducted on google drive in March 2021, including a questionnaire containing the parents' personal and professional data and the Beck Depression Inventory (BDI). Result(s): In our study, the sex ratio (M/F) was 0.05. The average age was 34.43 years old. Almost three-quarters of doctors (71.3%) were providing on duty services in the hospital while 69% were providing at least one call per month in COVID units. The average BDI score was 6.16. According to the BDI score, 60.9% of participants had depression. The BDI score was correlated with several types of dissatisfaction: dissatisfaction with the relationship with his child (p = 0.002), time devoted to the partner (0.001), time devoted to the child (p = 0.004), child's educational style (p <0.001), time spent on leisure or personal activities (p <0.001), child's academic performance (p = 0.001) and child's behavior (p <0.001). Furthermore, the BDI score was associated with postponing having a child for career reasons (p = 0.038) and thinking that his career is slowed down by parenthood (p <0.001). Conclusion(s): Depression's rate among physician parents appears to be significant. It's associated with a feeling of guilt and dissatisfaction, hence the necessity of an early detection and management.

The support of healthcare workers suffering from COVID 19

Introduction: The COVID-19 pandemic has focused attention on the challenges and risks faced by frontline healthcare workers (HCW). Objective(s): To describe the quality of management of HCW affected by the COVID-19. Method(s): This is a cross-sectional study enrolling all HCW of Farhat Hached Academic hospital who had been affected by COVID-19 during the period from september to December 2020. Result(s): During the study period, 267 HCW were affected with a mean age of 42.3 +/-10 years and a ratio-sex of 0.25. The most represented category was nurses (33.3%) followed by technicians (26.1%). Gynecology department had the highest number of affected HCW (14.4%).The majority of participants (97.4%) reported a medical care. Twelve HCW (4.5%) were hospitalized with an average length of hospital stay of 7.55 +/- 6.12 days. The average length of sick leave was 18.68 +/- 10.99 days. During the lockdown, 38.6% of HCW took care of their children without any external help. All of the HCW were supported by phone calls from colleagues in 88.4% of cases, the hierarchy in 67.4% of cases, occupational medicine in 60.3% of cases. Conclusion(s): The impact of COVID 19 is greater in HCW than in the general population. The affected staff should have a multidimensional management to avoid post covid sequelae in both physical and mental levels.

Perceived stress among physician parents during COVID-19 pandemic

Introduction: Stress among physician parents is still poorly studied, especially during the SARS-COV-2 pandemic. Objective(s): To describe the stress of being both a doctor and a parent during COVID-19 epidemic. Method(s): It was a cross-sectional, descriptive and analytical study, carried out on google drive in March 2021, and relating to 93 Tunisian medical parents. We used a questionnaire containing the parents' personal and professional data as well as the perceived stress scale (PSS10). Result(s): The majority of parents (94.7%) were women. The average age was 34.43 years old. The average age of marriage was 29.6 years for men and 25.4 years for women. The majority of parents (89.4%) had one or two children and 70.2% were satisfied with their relationship with their children. On another side, 71.3% of doctors had to provide on duty services in the hospital, with 44.1% providing 3-4 on-calls per month, while 69% were providing on duty services in the COVID units. The average PSS score was 22.6. The distribution of scores indicated medium and high stress level in respectively 84.9% and 14% of parents. Furthermore, the PSS score was negatively correlated with the marriage age (p=0.046, r=-0.2). On the other hand, no association was observed with the children number nor with the satisfaction of the relationship with his child. Conclusion(s): It follows from our study that stress among physician parents is at a fairlyhighlevel. Managing this stress during a pandemic is not easy and requires the activation of several defense mechanisms.

The support of healthcare workers suffering from COVID 19

Introduction : The COVID-19 pandemic has focused attention on the challenges and risks faced by frontline healthcare workers (HCW). This study aimed to describe the quality of management of HCW affected by the COVID-19. Methods : This is a cross-sectional study enrolling all HCW of Farhat Hached Academic hospital who had been affected by COVID-19 during the period from september to December 2020. Results : During the study period, 27 HCW were affected with a mean age of 42.3 ±10 years and a ratio-sex of 0.25. The most represented category was nurses (33.3%) followed by technicians (26.1%). Gynecology department had the highest number of affected HCW (14.4%) followed by pediatric department and administration in 7.2% and 5.7% respectively. The mean of seniority was 14.5± 11 years. The majority of participants (97.4%) reported a medical care. Twelve HCW (4.5%) were hospitalized with an average length of hospital stay of 7.55 ± 6.12 days. The average length of sick leave was 18.68 ± 10.99 days. During the lockdown, 38.6% of HCW took care of their children without any external help. All of the HCW were supported by phone calls from colleagues in 88.4% of cases, the hierarchy in 67.4% of cases, occupational medicine in 60.3% of cases. Conclusion : The impact of COVID 19 is greater in HCW than in the general population. The affected staff should have a multidimensional management to avoid post covid sequelae in both physical and mental levels.

Impact of the COVID-19 lockdown in Multiple Sclerosis patients

Background and aims: The COVID-19 pandemic persisting crisis showed an upheaval on the whole world. People with multiple sclerosis (MS) are a particularly vulnerable group. We aimed to assess how this pandemic has affected MS patients during the lockdown decreed in Tunisia. Methods: After obtaining the approval of ethics committee, a phone survey was conducted from the 15th of May to the 15th of June in the MS center in Razi hospital in Tunis- Tunisia. The designed questionnaire includedin particular the impact of the lockdown on patients' medical follow-up, MS symptoms, treatment availability and daily lifestyle and professional activities. Results: A total of 213 questionnaires were fulfilled. There was no SARS CoV-2 infected case in our cohort. Patients completely followed quarantine guidelines in 176 cases (82.6%). Professional activities were totally stopped in 80.3% while teleworking was adopted in only 4.9% of active patients. During the lockdown, 46 patients (21.6%) experienced a relapse. Steroids were prescribed in 15 cases. Exacerbation of existing symptoms related to MS was described by 133 patients (mainly mood disorders (87%) and sleep disturbances (62%)). About 58 patients interrupted their MS treatments mainly because of mobility issues (n=24) and treatment unavailability (n=27). This was significatively associated with the exacerbation of neuropathic pain (p=0.01)) but not with relapses (p=0.27). Physical activity interruption was associated to the exacerbation of fatigue (p=0.02). Conclusion: COVID-19 lockdown negatively affected our MS patients especially in work, psychological state and MS treatments availability. As a consequence, worsening of MS related symptoms and psychiatric features were described.