Unequal outcomes: The effects of the COVID-19 pandemic on mental health and wellbeing among Hispanic/Latinos with varying degrees of 'Belonging'.

BACKGROUND: The COVID-19 pandemic has brought disparities in mental and physical health faced by ethnic minorities to the forefront. In the U.S., Hispanic/Latino communities are plagued by elevated rates of psychiatric conditions and trauma. Exacerbating this burden, common discourse often implicates Hispanic/Latino ethnicity as a causal factor, despite clear evidence of systemic causes, including lack of access to resources, and discrimination. AIMS: To parse apart Hispanic/Latino ethnicity from determinants of wellbeing (such as trauma, financial status, and loneliness), we examined mental and physical health during COVID-19 via an online, anonymous survey available in both English and Spanish. METHODS: We examined wellbeing across three participant groups, including two groups of Hispanic/Latino adults with varying degrees of 'belonging' to the dominant culture in their country of residence: Hispanic/Latino individuals living in Spanish-speaking and/or Central or Latin American countries (Group 1), Hispanic/Latino individuals living in the U.S. (Group 2), and non-Hispanic/Latino individuals living in the U.S. (Group 3). RESULTS: Results demonstrated there were significant differences between groups in specific aspects of wellbeing. Most importantly, results showed Hispanic/Latino ethnicity does not significantly predict psychosocial wellbeing or psychosis risk, and identified several predictors of these outcomes, including U.S. residence, trauma, loneliness, and age. CONCLUSION: Our results demonstrate that Hispanic/Latino ethnicity itself is not a causal factor of poor psychosocial wellbeing or elevated psychosis risk and instead identify several social and systemic causal factors commonly faced by Hispanic/Latino Americans. We suggest that language reporting on minority mental health acknowledge systemic factors as contributing to poor outcome rather than referring to ethnicity as if it were a causal factor.

The role of viruses in the inception of sinusitis.

Chronic rhinosinusitis (CRS) is a complex inflammatory disorder that affects between 2 and 16% of adults in the United States with estimated healthcare costs between 4 to 12 million USD. Viruses are a frequent cause of upper respiratory infections and a trigger for CRS exacerbations. There are several cross-sectional studies that have identified types of viruses associated with CRS. Rhinovirus, parainfluenza virus, influenza virus, and respiratory syncytial virus were the main associated viruses found in nasal lavage samples of patients with CRS. Other viruses such as adenovirus or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have weak associations with CRS and were excluded from the review. Rhinovirus and its subtypes utilize glycoproteins like intercellular adhesion molecule 1 (ICAM-1), low density lipoprotein receptor (LDLR) family members, and cadherin-related family member 3 (CDHR3) to invade host cells. Influenza and parainfluenza virus invade through the binding of hemagglutinin (HA) to sialic acid-containing molecules while respiratory syncytial virus has a RSV specific glycoprotein that binds to the cellular receptor human nucleolin (NCL). Viral infection that causes CRS is frequently associated with type 1 and type 2 immune responses. Dysregulated immune response to viral infections can result in the activation of airway remodeling, epithelial-mesenchymal transitions, and epithelial barrier breakdown that are central to the pathogenesis of CRS. Risk factors for viral infections in CRS. Dysfunctional epithelial barrier function and age are strong risk factors for CRS infections. Comorbid respiratory diseases like asthma or allergic rhinitis are highly associated with CRS risk and CRS exacerbations. Children are also more likely to have upper respiratory tract infections than adults and viruses associated with CRS are more prevalent in infants and children. Studying and understanding the role of viruses in CRS is an important step in identifying disease pathogenesis and targeting these pathways early to slow disease progression.

Cross-cultural comparisons of psychosocial distress in the USA, South Korea, France, and Hong Kong during the initial phase of COVID-19.

The COVID-19 crisis has resulted in disruption of everyday life worldwide but the impact and response to the pandemic have not been uniform. Many countries rapidly deployed physical-distancing mandates to curb the spread of the virus; others did not. Social distancing strategies are necessary to reduce the transmission of the virus but there may be unintended consequences. We examined psychological distress in four societies with distinct public health strategies (South Korea, Hong Kong, France and the United States) to identify common and region-specific factors that may contribute to mental health outcome during the pandemic. From March to July of 2020, a survey of demographics, general health, mental health, loneliness and social networks was conducted. Overall, younger age, greater concern for COVID, and more severe loneliness predicted worse psychological outcome but the magnitudes of these effects varied across the four regions. Objective measures of social isolation did not affect mental health. There were also notable differences in psychological outcome; Hong Kong, with very strict social distancing protocols plus ongoing political unrest, suffered the most drastic deterioration of mental health. To prepare for an impending mental health crisis, concerted efforts to reduce loneliness should be integrated into a comprehensive public health strategy.

Deterioration of mental health despite successful control of the COVID-19 pandemic in South Korea.

South Korea was able to successfully control the spread of COVID-19 without nationwide lockdowns or drastic social distancing efforts, but pandemic-related psychological outcome of the general population remains unknown. Between March and June 2020, 400 South Korean residents participated in an online study of depression, anxiety, stress, psychosis-risk and loneliness, as well as indices of social network, physical health and demographics. Clinical levels of depression, anxiety or stress were reported by 45% of the respondents, and psychosis-risk was present in 12.8%; a drastic increase above the base rate reported by previous studies conducted in South Korea prior to the pandemic. Subjective feelings of loneliness, but not the size of the social network accounted for poor mental health. Women were especially at increased risk for mental health problems. Thus, despite effective mitigation of the pandemic, there was a striking deterioration of mental health. As the psychological burden of the continuing pandemic accrues, the probability of an impending mental health crisis is increasing, especially in countries with greater infection and death rates than South Korea. Comprehensive efforts to address the psychological aftermath of the pandemic are urgently needed.