Smoking habits during the COVID pandemic: data from Greek healthcare professionals' population

Background: Although smoking is associated with more severe outcomes of COVID-19, little is known about smoking habits during the COVID pandemic. Healthcare professionals (HCPs) are significant role models for the society and their smoking habits are critical concerning the general public attitudes. Aim(s): to determine the smoking levels of HCPs, to assess the effect of the pandemic on their smoking attitude and to evaluate possible associations with their psychological status. Method(s): An anonymous online survey was conducted among HCPs of Northern Greece in 2020 by emails delivered from the local medical and nursing stuff associations including basic information (age, gender, marriage, education level, etc.), smoking status (Heaviness of Smoking Index (HSI)) contact with COVID-19 patients, quarantine status, current physical condition, Sleep Condition Indicator (SCI), DAR-5 (anger), PHQ-4(depression and anxiety), Loneliness scale (LS). Result(s): 1057 HCPs answered (males 45.3%) 79% doctors with mean age 45.2+/- 11.7years and HIS 2.4+/-1.7. 32% of HCPs smoked: 24.9% smoked more cigarettes during the pandemic, 14.2% smoked less, 7% stopped smoking and 54% did not change their smoking habits. There was an association between alcohol use and smoking (p=0.002). A weak but significant correlation was found between LS and HIS (r=0.22, p=0.02) and especially with 'how soon after you wake up do you have your first cigarette' (r=0.28, p=0.001). SCI, LS and PHQ-4 of HCPs that smoked more were significantly higher compared with the other groups. Conclusion(s): During the pandemic, most of the HCPs that smoked continued their smoking habits as before, 25% increased their cigarettes and only 7% stopped.

OSA patients' opinions concerning their disease and treatment during the pandemic

The COVID-19 pandemic has changed the operation of healthcare systems worldwide reducing hospital based services, and increasing telemedicine solutions for the diagnosis and treatment of obstructive sleep apnoea (OSA). Aim(s): to evaluate the opinion of OSA patients concerning their disease during the COVID pandemic,their treatment and follow up. Method(s): A telephone questionnaire based survey was conducted on OSA patients treated with CPAP including basic information (age, gender, marriage, education level, etc.), opinion towards the changes of medical practice during the pandemic, history of OSA, Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS), DAR-5 (anger), PHQ-4(depression and anxiety), Heaviness of Smoking Index (HSI) and Loneliness scale (LS). Adherence on CPAP was assessed objectively by telemonitoring. Result(s): 100 OSA patients 54.3+/-12.5 years (72% males) were evaluated presenting with ESS: 4.3+/-2.95, AIS: 3.14+/-3.3, PHQ-4: 2.29+/-1.72, DAR-5: 6.7+/-1.95 and HSI 3.5+/-.1.7. Mean CPAP use was 5.8+/-1.65 with 2.9+/-2.5years OSA history (96% used CPAP the same as before the pandemic). 41% considered themselves as high risk group for severe disease due to COVID because they suffered from OSA, and 25% believed CPAP could be protective from COVID. Patients infected with COVID (31%) did not change their CPAP use. 30% believed they received worse healthcare facilities than before and 16% presented worse sleep quality. Conclusion(s): During the pandemic, OSA patients continued to use their CPAP as before;however they believed that they should have better healthcare facilities. They considered themselves as a high risk group for COVID infection.

Evaluation of sleep quality among post-COVID patients: findings from a 6- month follow-up study

Background: The current literature concerning sleep quality among post-COVID patients is limited. The aim of this observational cohort study was to evaluate if there is significant and persistent sleep disturbance in patients after recovery from COVID-19. The patients were followed up 1, 3, and 6 months after hospital discharge (in-person visits). Sleep quality was evaluated in each visit with the aid of multiple structured questionnaires: Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS), Fatigue Severity Scale (FSS), Stop-BANG (S-B) questionnaire. Result(s): 131 patients (59.5% males) aged 56.1+/- 11.2 with prior hospitalization due to SARS-CoV-2 infection were enrolled. The most common comorbidities were arterial hypertension (30.6% of patients), cardiovascular disease other than arterial hypertension (17.4%) and chronic obstructive lung disease (11.6%), while 38% of patients had no comorbid conditions. The mean values of the global PSQI were 8.28 +/-3.8, 7.43+/-3.7, and 7.46+/-3.5 in the first, second and third follow up respectively. Statistically significant differences were found for sleep quality (PSQI) between the first and second (p=0.001) and between the first and third visit (p=0.046). During the first visit, the ESS was 6.3+/-4.2, AIS: 7.1+/-4.9, S-B: 2.9+/-1.5 and FSS : 3.65+/-1.8. Statistically significant differences were found for FSS between the first and second (p=0.003) and for FSS (p=0.001) and AIS (p=0.048) between the first and third visit. Conclusion(s): Our findings reveal significant and persistent sleep disturbance up to 6 months after hospital discharge, although there was notable amelioration over time.

Healthcare professionals' sleep and mental stress during the two first consecutive waves of COVID-19 in northern greece

Objectives/Introduction: In December 2019, a novel corona virus was identified (COVID-19). Healthcare Professionals (HCPs) experience high levels of stress and irregular work schedule, with frequent work shifts leading to increased sleep disturbances especially during the pandemic. This study aimed to assess the impact of COVID-19 on the healthcare workers' sleep and mental stress during two consecutive epidemic waves in northern Greece. Method(s): An online cross-sectional, anonymized, self-reported questionnaire survey was conducted in May 2020 (first epidemic wave) and then was repeated in December 2020 (second epidemic wave), including basic information (age, gender, marriage, education level, etc.), contact with COVID-19 patients, quarantine status, current physical condition, Sleep Condition Indicator (SCI), DAR-5 (anger), PHQ-4(depression and anxiety), Heaviness of Smoking Index (HSI) and Loneliness scale (LS). Statistical analysis was performed using the SPSS (version-20 IBM, NY, USA). Continuous variables were presented as mean+/-SD and categorical variables as number (%). p < 0.05 was accepted as statistically significant. To separate parametric from non-parametric variables normality tests using the Kolmogorov- Smirnov test were performed. For the detection of statistically significant differences when comparing the results of a continuous variable between the two waves, the independent-samples-T-test and the Mann-Whitney-U-test were used for parametric and non-parametric variables respectively. Result(s): 1044 HCPs answered (males/females 47%/53%) 79% doctors with mean age 45.2 +/- 11.1 years. During the second wave HCPs presented worse sleep quality (SCI 23.7 +/- 6.7 vs.26.4 +/- 5.7, p < 0.001), worse PHQ-4 (4.4 +/- 2.9 vs. 2.8 +/- 2.3, p < 0.001), increased anger (DAR-5 9.2 +/- 3.8 vs.7.7 +/- 2.6, p < 0.001) and loneliness (LS 5.8 +/- 1.9 vs. 5 +/- 1.6, p < 0.001). The smoking status and HIS did not change during the two waves. A negative correlation was found between SCI - PHQ-4, SCI-DAR-5 and SCI- LS, especially during the second wave. Conclusion(s): Changes in sleep quality were observed in health professionals, especially during the second wave. Sleep quality, anger, depression, anxiety and loneliness were negatively affected during the progression of the pandemic.