[Stress, anxiety, and depression in health workers during the COVID-19 pandemic]

Background: Mental health is an integral part of health. Having some psychiatric condition without treatment predisposes to a poor quality of life. These alterations have been found with an incidence of up to 50% in the general population. There are very few studies in Mexico on these conditions in health workers during the COVID-19 pandemic. Objective: To determine the prevalence of stress, anxiety, and depression during the COVID-19 pandemic in health workers. Material and methods: A descriptive, cross-sectional observational study was conducted on health workers in a tertiary hospital, through the application of randomized and self-completed surveys, in search of levels of stress, anxiety, and depression during the COVID-19 pandemic. Results: 44.7% of those surveyed showed depression, 83.1% anxiety, and 66.3% stress. The main groups affected were female staff, singles, and medical residents. Those with type 2 diabetes mellitus had higher anxiety and depression. Conclusion: The prevalence of stress, anxiety, and depression in health workers is similar to that of the general population in our study. Depression was the alteration most found. The scrutiny of alterations in mental health in health workers is of the utmost importance, with greater emphasis in the context of the aforementioned pandemic.

Risk factors and outcomes of autoimmune/inflammatory diseases during covid-19 infection: A comparative study

Objectives: To determine the risk factors, impact and outcomes of COVID-19 in autoimmune / inflammatory diseases (AID). Methods: Case (patients with AID) and controls (patients without AID) study. Both groups with SARS-CoV-2 by PCR. Clinical, biochemical, treatment and outcome characteristics were determined. Spearman correlation, X2 and multivariate analysis were performed. Results: AID, 90 (49.49 ± 14.2 years) vs controls, 90 (52.58 ± 13.5 years). AID: systemic lupus erythematosus (SLE) (n = 20, 22.2%), systemic sclerosis (n = 16, 17.8%), rheumatoid arthritis (n = 14, 15.6%), primary antiphospholipid syndrome (n = 12, 13.3%), autoimmune encephalitis (AIE) (n = 6, 6.7%), granulomatosis with polyangiitis (GPA) (n = 5, 5.6%) and multiple sclerosis (n = 3, 3.3%) were the most frequent. Treatment: anticoagulant 73.3%, glucocorticoid 53.3% and antimalarials 35.6%. The AID patients had less invasive mechanical ventilation (IMV) (p = 0.004), lower death (p = 0.006) and lower discharge with O2 (p = 0.001) (Table 1). AID: creatinine correlate positively with days with IMV (rho = 539, p 0.024). In AID, AIE and O2 saturation ≤ 88% provided risk for IMV (OR 88.42, CI 3.9-196.7, p = 0.005 and OR 10.05, CI 1.2-83.7, p = 0.033, respectively) while antimalarials were protective for IMV (OR 0.08, CI 0.0-0.9, p = 0.042). Regarding death in AID, oxygen saturation ≤ 88% and CO-RADS ≥4 were risk factors (OR 5.12, CI 1.5-16.4, p = 0.006 and OR 8.84, CI 1.2-64.0, p = 0.031, respectively) and anticoagulant use was protective (OR 0.26, CI 0.0-0.8, p = 0.019) (Table 2). Conclusion: Our study suggests that patients with AID have a better outcome than the control group. Multiple factors are involved in this outcome such as surveillance, chronic use of antimalarials, steroid and anticoagulation.We propose that at the molecular level high levels of IFN may be a protective factor for complications from SARS-CoV-2 infection. New longitudinal and molecular level studies in patients with mild/moderate, severe and critical COVID-19 will be necessary to know the impact of COVID-19 in AID.