ABSTRACT
Introduction: University professors present several mental health-related symptoms, such as sleep disorders, anxiety and depression. During the COVID-19 pandemic, health practitioners and researchers observed a surge in depressive and anxious symptoms and worse sleep quality. Objective: To analyze factors associated with poor sleep quality among university professors during the beginning of the COVID-19 pandemic. Methods: A virtual questionnaire via Google Forms® platform was sent to professors via university working groups and e-mail lists. The instrument comprised questions about gender, age, self-isolation and specific questionnaires: Pittsburgh Sleep Quality Index (PSQI);State-Trait Anxiety Inventory (STAI);Mental Health Index (MHI-5);Morningness-Eveningness Questionnaire (MEQ) and International Physical Activity Questionnaire (IPAQ). All of the participants signed an Informed Consent Term, and the research was approved by the Ethics Committee in Research (no. 4.036.797). The data were analyzed using IBM Statistical Packages for the Social Sciences® version 26.0 and a descriptive level criterion of 5% (p<0.05) was adopted. Results: A total of 96 participants participated in the study. Half of the participants (n=48) had poor sleep quality in the study. Using bivariate analysis, state-anxiety (p=0.014) and depressive symptoms (p=0.038) were the only factors associated with poor sleep quality. 52.1% of the sample had medium to high anxiety risk (STAI-S), and among them, 62.0% had poor sleep quality. 41.7% of the university professors had depressive symptoms, and from those, 62.5% were not sleeping well. In a binary logistic regression model, professors with depressive symptoms had a 2.39 times higher risk of poor sleep quality (p=0.040/ 95% CI: 1.04-5.50);and those with state-anxiety had a 2.78 times higher risk of poor sleep quality (p=0.015/ 95% CI: 1.22-6.37). Conclusion: In this study, the presence of state-anxiety or depressive symptoms were risk factors associated with the higher incidence of poor sleep quality among university professors.
ABSTRACT
Objective: To describe demographics, clinical, and respiratory mechanics (including ventilatory management details) of patients admitted to the Intensive Care Unit (ICU) with severe COVID-19 and to evaluate the effectiveness of gas exchange variables, ventilatory parameters, and ICU illness severity scores in predicting 28-day mortality. Design: Single-center retrospective cohort study. Setting: Portuguese medical-surgical ICU. Patients: Adults sequentially admitted to the ICU, from March 18 to May 12, 2020, with critical COVID-19 requiring invasive mechanical ventilation (IMV) for over 48 hours. Interventions: None, due to study design. Measurements and results: Data regarding positioning, positive end-expiratory pressure (PEEP), driving pressure, static lung compliance, and lowest daily arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) ratio throughout the first 5 days of . ICU admission were collected from daily ventilatory assessment charts. The median ICU length of stay was 11.3 days and median IMV duration was 9.5 days. The 28-day mortality was 12.1%. When comparing non-survivors and survivors, significant differences were found regarding Simplified Acute Physiology Score (SAPS) II (48.5, IQR 14.0 vs. 32.0, IQR 11.0, p=0.004), PaO2/FiO2 ratio before endotracheal intubation (101.3, IQR 22.5 vs. 174.1, IQR 9.5, p=0.01) and throughout ICU stay. Over 90% of patients were submitted to prone positioning. Use of low PEEP levels and maintenance of low driving pressures in patients whose overall compliance was low as possible. Conclusions: Significant differences were found regarding SAPS II and PaO2/FiO2 ratios between survivors and non-survivors, eliciting further investigation as potential mortality predictors. With the second wave of the pandemic taking shape, sharing previous experience is crucial to further coordinate efforts internationally.