Validation of the Spanish Version of Fear of COVID-19 Scale: its Association with Acute Stress and Coping its Association with Acute Stress and Coping.

The COVID-19 is a "unique" stressor, which can produce physical and psychological trauma. Coping styles can buffer this psychological impact. Consequently, this paper aims to psychometrically adapt the Fear of COVID-19 scale (FCV-19S) to Spanish and examines the relationships between FCV-19S, stress response, and coping strategies. The sample comprised a convenience sample of 1146 participants (12-83 years), 880 from Spain (76.8%), and 266 from Dominican Republic (23.2%). Overall, the findings support a one-factor structure for FCV-19S, consisting of 7-items, and was invariant across age, sex, occupational status, and cross-national. Therefore, indicating evidences of construct validity. Evidences of reliability were also observed (Cronbach's α = .86, McDonald's ω = .86, Guttmann's λ6 = .86, greatest lower bound = .91, composite reliability = .85, and average variance extracted = .44). Moreover, as regards criterion-related validity, the mediation analysis indicated that the relationship between FCV-19S and acute stress was positive and high, with maladaptive coping styles mediating the relationship, and with a stronger mediation for men. The findings give evidences of the reliability and validity of the Spanish version of FCV-19S among Spanish-speaker participants, which provides the chance of cross-cultural studies.

Clinical Attributes and Risk Factors for In- Hospital Mortality among Covid-19 Patients in a Community Hospital Setting: A Propensity Matched Analysis

Background. New York City emerged as the Epicenter for Covid-19 due to novel Coronavirus SARS-CoV-2 soon after it was declared a Global Pandemic in early 2020 by the WHO. Covid-19 presents with a wide spectrum of illness from asymptomatic to severe respiratory failure, shock, multiorgan failure and death. Although the overall fatality rate is low, there is significant mortality among hospitalized patients. There is limited information exploring the impact of Covid-19 in community hospital settings in ethnically diverse populations. We aimed to identify risk factors for Covid-19 mortality in our institution. Methods. We conducted a retrospective cohort study of hospitalized in our institution for Covid 19 from March 1st to June 21st 2020. It comprised of 425 discharged patients and 245 expired patients. Information was extracted from our EMR which included demographics, presenting symptoms, and laboratory data. We propensity matched 245 expired patients with a concurrent cohort of discharged patients. Statistically significant covariates were applied in matching, which included age, gender, race, body mass index (BMI), diabetes mellitus, and hypertension. The admission clinical attributes and laboratory parameters and outcomes were analyzed. Results. The mean age of the matched cohort was 66.9 years. Expired patients had a higher incidence of dyspnea (P < 0.001) and headache (0.031). In addition, expired patients had elevated CRP- hs (mg/dl) ≥ 123 (< .0001), SGOT or AST (IU/L) ≥ 54 (p < 0.001), SGPT or ALT (IU/L) ≥ 41 (p < 0.001), and creatinine (mg/dl) ≥ 1.135 (0.001), lower WBC counts (k/ul) ≥ 8.42 (0.009). Furthermore, on multivariate logistic regression, dyspnea (OR = 2.56, P < 0.001), creatinine ≥ 1.135 (OR = 1.79, P = 0.007), LDH(U/L) > 465 (OR = 2.18, P = 0.001), systolic blood pressure < 90 mm Hg (OR = 4.28, p = .02), respiratory rate > 24 (OR = 2.88, p = .001), absolute lymphocyte percent (≤ 12%) (OR = 1.68, p = .001) and procalcitonin (ng/ml) ≥ 0.305 (OR = 1.71, P = .027) predicted in- hospital mortality in all matched patients. Conclusion. Our case series provides admission clinical characteristics and laboratory parameters that predict in- hospital mortality in propensity Covid 19 matched patients with a large Hispanic population. These risk factors will require further validation.

Correction to: Validation of the Spanish Version of Fear of COVID-19 Scale: its Association with Acute Stress and Coping.

[This corrects the article DOI: 10.1007/s11469-021-00615-x.].

Validation of the Spanish Version of Fear of COVID-19 Scale: its Association with Acute Stress and Coping its Association with Acute Stress and Coping

The COVID-19 is a “unique” stressor, which can produce physical and psychological trauma. Coping styles can buffer this psychological impact. Consequently, this paper aims to psychometrically adapt the Fear of COVID-19 scale (FCV-19S) to Spanish and examines the relationships between FCV-19S, stress response, and coping strategies. The sample comprised a convenience sample of 1146 participants (12–83 years), 880 from Spain (76.8%), and 266 from Dominican Republic (23.2%). Overall, the findings support a one-factor structure for FCV-19S, consisting of 7-items, and was invariant across age, sex, occupational status, and cross-national. Therefore, indicating evidences of construct validity. Evidences of reliability were also observed (Cronbach’s α = .86, McDonald’s ω = .86, Guttmann’s λ6 = .86, greatest lower bound = .91, composite reliability = .85, and average variance extracted = .44). Moreover, as regards criterion-related validity, the mediation analysis indicated that the relationship between FCV-19S and acute stress was positive and high, with maladaptive coping styles mediating the relationship, and with a stronger mediation for men. The findings give evidences of the reliability and validity of the Spanish version of FCV-19S among Spanish-speaker participants, which provides the chance of cross-cultural studies.

CLINICAL ATTRIBUTES AND RISK FACTORS FOR MECHANICAL VENTILATION AMONG PATIENTS WITH COVID-19 IN A COMMUNITY HOSPITAL SETTING: A PROPENSITY-MATCHED ANALYSIS

TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: Covid-19 caused by the novel SARS-CoV-2 has emerged as a global health crisis with various clinical complications. Covid-19 related respiratory manifestations have been reported as mild, moderate to severe including acute lung injury and acute respiratory distress syndrome necessitating non-invasive forms of oxygenation to mechanical ventilation (MV). MV patients frequently undergo prolonged hospitalizations with substantial morbidity and mortality. We sought to evaluate risk factors for MV in our cohort. METHODS: We conducted a retrospective cohort study of patients admitted in our institution from March 1st to June 21st2020, to assess risk factors for Covid-19 related respiratory failure requiring MV. The original cohort encompassed 166 MV and 503 non MV patients. Information from our hospital medical records was extracted, which included demographics, presenting symptoms, past medical history, vital signals, and laboratory data and need for MV. We propensity matched 166 MV with a concurrent cohort of non MV patients in our institution. Covariates applied in matching included age, gender, race, and body mass index (BMI). The admission clinical attributes and laboratory parameters were analyzed, along with outcomes. RESULTS: The mean age of our matched cohort was 63.8 years. Mechanically Ventilated patients had a higher incidence of tachycardia (heart rate > 125) (p <.001), elevated respiratory rate > 24 cycles per minute (p <.001), fever > 97.8 F (Temperature > (p =.037), shortness of breath (p =.001), and headaches (p =.005). In addition, mechanically ventilated patients had a lower serum albumin (g/dl) ≤ 3 units (p <. 001), elevated serum creatinine (mg/dl) ≥ 1.135 units (p =.02), elevated serum CRP-HS ≥ 123 units (p =.005), HbA1C (%) > 6.6 units (p =.004), serum lactic acid (mmol/L) > 1.7 units (p =.003), serum LDH U/L > 465 U/L (p <.001), Procalcitonin (ng/ml) >.305 units (p <0.001), SGOT IU/L or AST IU/L ≥ 54 units (p < 0.001), SGPT or ALT IU/L ≥ 41 units (p =.021), and WBC count > 8.4 k/ul (p <.001). Furthermore, tachycardia (OR = 3.98, p =.001), HbA1C (OR = 2.36, p =.008), serum LDH (OR = 1.9, p =.041), and absolute lymphocyte percent ≤ 12 (OR = 1.98, p =.022) predicted mechanical ventilation in all matched patients in our institutional cohort. CONCLUSIONS: Our case series provides clinical characteristics, laboratory parameters, and predictors for mechanical ventilation in matched patients with Covid-19. Elevated heart rate, HbA1C, serum LDH and decreased lymphocyte percentage were predictors for mechanical ventilation. Tachycardia had the highest odds of 3.98. CLINICAL IMPLICATIONS: Several clinical and laboratory parameters can be utilized for evaluating and stratifying Covid-19 patients’ risk for mechanical ventilation. These risk factors will need further validation in other similar cohorts. DISCLOSURES: No relevant relationships by Olawale Akande, source=Web Response No relevant relationships by Olga Badem, source=Web Response No relevant relationships by Premila Bhat, source=Web Response No relevant relationships by Utpal Bhatt, source=Web Response No relevant relationships by Diego Castellon, source=Web Response No relevant relationships by Bhargav Desai, source=Web Response No relevant relationships by Basilides Fermin, source=Web Response No relevant relationships by Shurovi Jafar, source=Web Response No relevant relationships by KELASH KUMAR, source=Web Response No relevant relationships by Juan Martinez Zegarra, source=Web Response No relevant relationships by Tanveer Mir, source=Web Response No relevant relationships by Parvez Mir, source=Web Response No relevant relationships by Luis Morón Mercado, source=Web Response No relevant relationships by Beatriz Omeragic, source=Web Response No relevant relationships by Maxine Orris, source=Web Response No relevant relationships by Priyank Patel, source=Web Response No relevant relationships by Giovanna Ramirez-Barbieri, source=Web Response No relevant relationships by Luis Santana Alcantara, source=Web Response No relevant relationships by Karthik Seetharam, source=Web Response No relevant relationships by Jilan Shah, source=Web Response No relevant relationships by Phanthira Tamsukhin, source=Web Response No relevant relationships by Zeyar Thet, source=Web Response No relevant relationships by Elbia Toribio, source=Web Response No relevant relationships by Thinzar Wai, source=Web Response No relevant relationships by Vamsi Yenugadhati, source=Web Response

Adolescence and emerging adulthood facing COVID-19 in Spain and the Dominican Republic

COVID-19 pandemic has had a major impact worldwide. The aim of this study is to analyze the psychological impact during confinement on adolescents and emerging adults. The convenience sample is composed by (n = 399) residents of Spain and the Dominican Republic (DR). The age range is 12 to 29 years old (M = 22.57;SD = 3.67). The assessment was conducted online, with the following instruments: an ad hoc survey to measure socio-demographic variables, Fear of COVID-19 Scale, Impact of Event Scale-Revised, The Brief Coping Orientation to Problems Experience and Strengths and Difficulties Questionnaire. The results show differences by age, sex and residence. Adults reported more fear of COVID-19 (p < .05) and acute stress than adolescents (p < .01), more fear and stress in women than men (p < .01) and more fear to the disease in residents of the DR than in Spain (p < .01). Linear regression analysis showed that fear of COVID-19 was a good predictor of acute stress. In conclusion, it is suggested to expand the study in these populations in situations of stress, specifically the one derived from COVID-19, that allow the prevention of acute stress and training in adaptive coping strategies in the face of crisis situations. Copyright © 2020 RPCNA.

Adolescence and emerging adulthood in the face of COVID-19 in Spain and the Dominican Republic

Adolescence and emerging adulthood facing COVID-19 in Spain and the Dominican Republic. COVID-19 pandemic has had a major impact worldwide. The aim of this study is to analyze the psychological impact during confinement on adolescents and emerging adults. The convenience sample is composed by (n = 399) residents of Spain and the Dominican Republic (DR). The age range is 12 to 29 years old (M = 22.57;SD = 3.67). The assessment was conducted online, with the following instruments: an ad hoc survey to measure socio-demographic variables, Fear of COVID-19 Scale, Impact of Event Scale-Revised, The Brief Coping Orientation to Problems Experience and Strengths and Difficulties Questionnaire. The results show differences by age, sex and residence. Adults reported more fear of COVID-19 (p < .05) and acute stress than adolescents (p < .01). more fear and stress in women than men (p < .01) and more fear to the disease in residents of the DR than in Spain (p < .01). Linear regression analysis showed that fear of COVID-19 was a good predictor of acute stress. In conclusion, it is suggested to expand the study in these populations in situations of stress, specifically the one derived from COVID-19, that allow the prevention of acute stress and training in adaptive coping strategies in the face of crisis situations.

SPONTANEOUS PNEUMOMEDIASTINUM IN PATIENTS WITH SARS-COV-2 VIRUS (COVID-19)

SESSION TITLE: Medical Student/Resident Disorders of the Mediastinum Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: In March, 2020 the World Health Organization (“WHO”) declared SARS-CoV-2 as a global pandemic. SARS-CoV-2 viral infection has been noted to present a variety of symptoms including anosmia (loss of sense of smell), dyspnea, cough, fever, diarrhea and acute respiratory failure. Spontaneous pneumomediastinum is a rare complication with viral pneumonia. We here present one of the two cases with this finding. CASE PRESENTATION: 63-years-old male presented with fever, chills, and progressive shortness of breath over the past week. Patient was previously diagnosed with corona virus disease with reverse transcriptase RNA PCR test. Past medical history was significant for diabetes, hypertension and hyperlipidemia. On presentation, patient was hypoxic (SaO2 84%). Physical examination revealed reduced breath sounds bilaterally and soft-tissue crepitus in bilateral clavicle area. Laboratory test results showed elevated C-reactive protein concentration, leukocytosis, and lymphopenia. Chest Computed Tomography (CT) showed diffuse lower neck/chest wall subcutaneous emphysema with associated diffuse pneumomediastinum and bilateral ground-glass airspace infiltrates (Figure 1,2,3). Patient was started on anti-infective therapy with vancomycin, piperacillin/tazobactam, and azithromycin, and placed on nasal cannula at 4 liter/minute. On day four of admission, patient developed multi-organ failure requiring mechanical ventilation and vasopressor support. Later on day twelve, patient expired due to cardiopulmonary arrest. DISCUSSION: Pneumomediastinum is defined as the presence of free air in the mediastinum with an incidence of 1 in every 25,000 cases in ages between 5-34 years, predominantly found in males. It may be spontaneous from a predisposing factor or due to secondary causes. SARS-CoV-2 is a new addition to secondary pulmonary causes, being reported recently in literature. The pathophysiology of spontaneous pneumomediastinum is explained due to pressure gradient difference between alveoli and lung interstitial tissue. SARS-CoV-2 infects type I and II pneumocytes, disrupting alveolar membrane integrity leading to alveolar rupture and leakage of air into interstitial tissue, as well as severe hypoxemia increasing respiratory effort. Associated clinical symptoms of pneumomediastinum are varying, including dyspnea, although a portion of patient are asymptomatic. Pneumomediastinum is typically identified through chest x-ray with management being primary conservative. CONCLUSIONS: Spontaneous pneumomediastinum in association with SARS-CoV-2 is a serious condition and merits early recognition. Despite early diagnosis and optimal management, the mortality was 100% in our two patients of Covid-19 associated mediastinum. Reference #1: Wang J, Su X, Zhang T, Zheng C. Spontaneous Pneumomediastinum: A Probable Unusual Complication of Coronavirus Disease 2019 (COVID-19) Pneumonia. Korean J Radiol. 2020;21(5):627-628. doi:10.3348/kjr.2020.0281 Reference #2: Dionísio P, Martins L, Moreira S, et al. Spontaneous pneumomediastinum: experience in 18 patients during the last 12 years. J Bras Pneumol. 2017;43(2):101-105. doi:10.1590/S1806-37562016000000052 Reference #3: Kolani S, Nawfal H, Haloua M, et al. Spontaneous pneumomediastinum occurring in the SARS-COV-2 infection [published online ahead of print, 2020 May 11]. IDCases. 2020;21:e00806. doi:10.1016/j.idcr.2020.e00806 DISCLOSURES: No relevant relationships by Darakhshan Ahmad, source=Web Response No relevant relationships by Marium Ghani, source=Web Response No relevant relationships by Parvez Mir, source=Web Response No relevant relationships by Judy Pham, source=Web Response No relevant relationships by Yariana Rodriguez-Ortiz, source=Web Response No relevant relationships by Phanthira Tamsukhin, source=Web Response

Validation of the Spanish version of Fear of COVID-19 Scale: Its association with acute stress and coping (preprint)

Background The COVID-19 is a “unique” stressor, which can produce physical and psychological trauma. Coping styles can buffer this psychological impact. Consequently, this paper aims to psychometrically adapt the Fear of COVID-19 Scale (FCV-19S) to Spanish and examines the relationships between FCV-19S, stress response and coping strategies.Methods The sample comprised a convenience sample of 1146 participants (12-83 years), 880 from Spain (76.8%) and 266 from Dominican Republic (23.2%).Results Overall, the findings support a one-factor structure for FCV-19S, consisting of  7-items, and was invariant across age, sex, occupational status and cross-national. Therefore, indicating evidences of construct validity. Evidences of reliability were also observed (Cronbach’s α = .86, McDonald’s ω = .86, Guttmann’s λ6 = .86, Greatest lower bound = .91, composite reliability = .85, and Average Variance Extracted = .44). Moreover, as regards criterion-related validity, the mediation analysis indicated that the relationship between FCV-19S and acute stress was positive and high, with maladaptive coping styles mediating the relationship, and with a stronger mediation for men.Conclusion The findings give evidences of the reliability and validity of the Spanish version of FCV-19S among Spanish-speaker participants, which provides the chance of cross-cultural studies.