A Pilot Study of Application of the Stroke Riskometer Mobile App for Assessment of the Course and Clinical Outcomes of COVID-19 among Hospitalized Patients

Introduction: Early determination of COVID-19 severity and health outcomes could facilitate better treatment of patients. Different methods and tools have been developed for predicting outcomes of COVID-19, but they are difficult to use in routine clinical practice. Methods: We conducted a prospective cohort study of inpatients aged 20–92 years, diagnosed with COVID-19 to determine whether their individual 5-year absolute risk of stroke at the time of hospital admission predicts the course of COVID-19 severity and mortality. The risk of stroke was determined by the Stroke Riskometer mobile application. Results: We examined 385 patients hospitalized with COVID-19 (median age 61 years). The participants were categorized based on COVID-19 severity: 271 (70.4%) to the "not severe” and 114 (29.6%) to the "severe” groups. The median risk of stroke the next day after hospitalization was significantly higher among patients in the severe group (2.83, 95% CI: 2.35–4.68) versus the not severe group (1.11, 95% CI: 1.00–1.29). The median risk of stroke and median systolic blood pressure (SBP) were significantly higher among non-survivors (12.04, 95% CI: 2.73–21.19) and (150, 95% CI: 140–170) versus survivors (1.31, 95% CI: 1.14–1.52) and (134, 95% CI: 130–135), respectively. Those who spent more than 2.5 h a week on physical activity were 3.1 times more likely to survive from COVID-19. Those who consumed more than one standard alcohol drink a day, or suffered with atrial fibrillation, or had poor memory were 2.5, 2.3, and 2.6 times more likely not to survive from COVID-19, respectively. Conclusions: High risk of stroke, physical inactivity, alcohol intake, high SBP, and atrial fibrillation are associated with severity and mortality of COVID-19. Our findings suggest that the Stroke Riskometer app could be used as a simple predictive tool of COVID-19 severity and mortality.

Evaluating depression anxiety and stress assessment before and during the COVID-19 pandemic using generalisability theory.

The current study investigated the assessment of depression, anxiety, and stress during normal and COVID-19 pandemic conditions. Generalisability theory (G-theory) was applied to examine stable and dynamic aspects of psychological distress and the overall reliability of the Depression, Anxiety and Stress Scales (DASS-21), using data from two independent samples collected on three occasions with 2- to 4-week intervals. The US data (n = 115) was collected before the COVID-19 pandemic, and the New Zealand (NZ) data (n = 114) was obtained during the pandemic. The total DASS-21 demonstrated excellent reliability in measuring enduring symptoms of psychological distress (G = .94-.96) across both samples. While all DASS-21 subscales demonstrated good reliability with the pre-pandemic US sample, the subscales' reliability was below an acceptable level for the NZ sample. Findings from this study indicate that the overall psychological distress is enduring and can be reliably measured by the DASS-21 across different conditions and populations, while shifts across depression, anxiety and stress levels are likely during emergency and uncertainty, as seen in the COVID-19 pandemic.

Implications for COVID-19 vaccine uptake: A systematic review.

BACKGROUND: Globally, increasing coronavirus disease (COVID-19) vaccination coverage remains a major public health concern in the face of high rates of COVID-19 hesitancy among the general population. We must understand the impact of the determinants of COVID-19 vaccine uptake when designing national vaccination programmes. We aimed to synthesise nationwide evidence regarding COVID-19 infodemics and the demographic, psychological, and social predictors of COVID-19 vaccination uptake. METHODS: We systematically searched seven databases between July 2021 and March 2022 to retrieve relevant articles published since COVID-19 was first reported on 31 December 2019 in Wuhan, China. Of the 12,502 peer-reviewed articles retrieved from the databases, 57 met the selection criteria and were included in this systematic review. We explored COVID-19 vaccine uptake determinants before and after the first COVID-19 vaccine roll-out by the Food and Drug Authority (FDA). RESULTS: Increased COVID-19 vaccine uptake rates were associated with decreased hesitancy. Concerns about COVID-19 vaccine safety, negative side effects, rapid development of the COVID-19 vaccine, and uncertainty about vaccine effectiveness were associated with reluctance to be vaccinated. After the US FDA approval of COVID-19 vaccines, phobia of medical procedures such as vaccine injection and inadequate information about vaccines were the main determinants of COVID-19 vaccine hesitancy. CONCLUSION: Addressing effectiveness and safety concerns regarding COVID-19 vaccines, as well as providing adequate information about vaccines and the impacts of pandemics, should be considered before implementation of any vaccination programme. Reassuring people about the safety of medical vaccination and using alternative procedures such as needle-free vaccination may help further increase vaccination uptake.

A pilot study of application of the Stroke Riskometer mobile app for assessment of the course and clinical outcomes of COVID-19 among hospitalised patients.

BACKGROUND: Early determination of COVID-19 severity and health outcomes could facilitate better treatment of patients. Different methods and tools have been developed for predicting outcomes of COVID-19, but they are difficult to use in routine clinical practice. METHODS: We conducted a prospective cohort study of inpatients aged 20-92 years, diagnosed with COVID-19 to determine whether their individual 5-year absolute risk of stroke at the time of hospital admission predicts the course of COVID-19 severity and mortality. The risk of stroke was determined by the Stroke Riskometer mobile application. RESULTS: We examined 385 patients hospitalised with COVID-19 (median age 61 years). The participants were categorised based on COVID-19 severity: 271 (70.4%) to the "Not severe" and 114 (29.6%) to the "Severe" groups. The median risk of stroke the next day after hospitalisation was significantly higher among patients in the Severe group (2.83 [95% CI 2.35-4.68]) vs the Not severe group (1.11 [95% CI 1.00-1.29]). The median risk of stroke and median systolic blood pressure (SBP) were significantly higher among non-survivors (12.04 [95% CI 2.73-21.19]) and (150 [95% CI 140-170]) vs survivors (1.31 [95% CI 1.14-1.52]), 134 [95% CI 130-135]), respectively. Those who spent more than 2.5 hours a week on physical activity were 3.1 times more likely to survive from COVID-19. Those who consumed more than one standard alcohol drink a day, or suffered with atrial fibrillation, or had poor memory were 2.5, 2.3, and 2.6 times more likely not to survive from COVID-19, respectively. CONCLUSIONS: High risk of stroke, physical inactivity, alcohol intake, high SBP, and atrial fibrillation are associated with severity and mortality of COVID-19. Our findings suggest that the Stroke Riskometer app could be used as a simple predictive tool of COVID-19 severity and mortality.

Investigating Predictors of Psychological Distress for Healthcare Workers in a Major Saudi COVID-19 Center.

This study investigated the relationship between fear of COVID-19, previous exposure to COVID-19, perceived vulnerability to disease, sleep quality, and psychological distress among healthcare workers (HCWs) in Taif city in Saudi Arabia, which has a population of 702,000 people. A cross-sectional study design was adopted. HCWs (n = 202) completed a survey containing the Fear of COVID-19 Scale (FCV-19S), Perceived Vulnerability to Disease (PVD), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale (DASS-21). FCV-19S and sleep quality were significant predictors for psychological distress. Female gender was a significant predictor for depression and stress. Single, divorced, and widowed marital status were predictive for anxiety. FCV-19S was weakly correlated with PVD but moderately with depression, anxiety, and stress. Of the two PVD subscales, perceived infectability was weakly correlated with psychological distress. PVD and previous experience with COVID-19 were not significant predictors. Sleep quality and FCV-19S were major predictors of psychological distress. Findings indicated that poor sleep quality was strongly associated with psychological distress, while fear of COVID-19 had a moderate association. Such results support the need to design and implement psychological programs to assist HCWs in dealing with the psychological impact of this ongoing pandemic.

The Role of Mindfulness and Life Satisfaction in Psychological Distress During the COVID-19 Lockdown in New Zealand: a Quasi-experimental Study.

OBJECTIVES: Quantitative research on the psychological effects of lockdown conditions during the COVID-19 pandemic is needed to inform mental health interventions which aim to alleviate potential adverse effects. The goal of this study was to investigate psychological distress during the lockdown in New Zealand. METHODS: We implemented a longitudinal quasi-experimental research design using a sample (n = 81) who completed surveys on mindfulness, satisfaction with life, and mental health indicators at three time-points, separated by at least 2-week intervals. The sample was divided into two parts, the baseline group (n = 44) and the lockdown group (n = 37). The baseline group completed the surveys the first time prior to lockdown, and mostly completed the second and third surveys during lockdown. The lockdown group mostly completed the survey for the first time during lockdown and the second and third surveys during or after lockdown. RESULTS: Mindfulness and satisfaction with life at baseline significantly predicted lower levels of depression, anxiety, and stress during uncertain and emergency conditions before and during lockdown. The baseline group experienced significantly less anxiety and stress during lockdown compared to just prior to the lockdown (baseline condition). CONCLUSIONS: Individuals who have higher levels of mindfulness and those with greater life satisfaction experience significantly less depression, anxiety, and stress over time, during both uncertain and emergency conditions such as during the threat of COVID-19. The finding of anxiety and stress reduction during lockdown may be specific to New Zealand, as conditions differ in many ways from those in other countries. Preventative measures which increase mindfulness and satisfaction with life could help alleviate depression, anxiety, and stress during uncertain and emergency conditions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12671-021-01731-4.

Real-Time Telehealth Treatment Team Consultation for Self-Injury by Individuals with Autism Spectrum Disorder.

OBJECTIVES: Self-injurious behavior (SIB) refers to any repeated self-directed, non-suicidal, behavior that may cause or has the potential to cause physical harm to the person's body. Behavioral interventions provide the standard evidence-based treatments for SIB by people with autism spectrum disorder (ASD) and intellectual disabilities (ID). Translating the proven effectiveness of behavioral interventions to treatment of self-injury in community settings by clinicians and caregivers has not been totally successful. The aim of the present study was to advance translational research by providing real-time telehealth consultation to a treatment team at a community-based mental health agency that provided inpatient and outpatient services to individuals with ASD and ID. METHOD: The participants of this single-case experimental study were three adolescents with ASD who had been referred for services because of their increasingly unmanageable SIB both at home and at school. The telehealth consultant provided real-time assistance to the treatment team within a translational model of care in the development and implementation of a behavior support plan and an informal mindfulness-based Soles of the Feet (SoF) program. RESULTS: Both visual and statistical analyses demonstrated reductions in the frequency of SIB for all three adolescents, with overall clinically significant reductions only with the SoF intervention. CONCLUSION: The results of this translational study suggest that telehealth consultation might be a viable technological alternative in situations which preclude face-to-face consultation. Telehealth consultation could be one method of supporting people with behavioral difficulties during pandemics, such as COVID-19.

Effectiveness of a low-dose mindfulness-based intervention for alleviating distress in young unemployed adults.

While the effectiveness of mindfulness-based interventions (MBIs) with respect to distress has been widely researched, unemployed individuals, who often suffer from high levels of distress, have largely been neglected in MBI research. The present study aimed to investigate the effects of a low-dose MBI on distress in a sample of young unemployed adults. The sample included 239 young unemployed adults enrolled for a 6-week long employability-related training camp. Participants were allocated into an intervention group that received weekly 1-hour mindfulness training over 4 weeks, and a control group. Dispositional mindfulness, distress and well-being were assessed in the entire sample prior to the start and upon completion of the mindfulness training. A mixed model ANCOVA showed that distress was inversely and significantly predicted by baseline levels of mindfulness and well-being. After accounting for the baseline levels of mindfulness and well-being, a significant effect of the mindfulness intervention was evident. This result shows that a low-dose MBI can decrease distress in a sample of young unemployed adults and its effectiveness is positively associated with initial levels of dispositional mindfulness and well-being.