Population well-being and the COVID-19 vaccination program in Chile: evidence from Google Trends.

OBJECTIVE: We analyze the dynamics of the mental well-being of the Chilean population in response to the progress of the vaccination strategy implemented by the government. STUDY DESIGN: This study aims at investigating the possibility of using Google Trends as an instrument for tracking mental well-being of the Chilean population. METHODS: We use the volume of searches for keywords in Google Trends (GT) related to Anguish, Anxiety, Depression, and Stress as a proxy for population well-being. Using event study methods, we analyze social attention reactions to news about the vaccination program. We implement a Difference-in-Difference-in-Differences estimation to estimate changes in population welfare by socio-economic status induced by the progress of inoculation. RESULTS: We show that social attention to mental health problems is sensitive to news about the vaccination program. Moreover, and most importantly, we find that mental well-being responds positively to the percentage of inoculated people. This phenomenon appear to be permanent and affected by socio-economic status, with the wealthier population experiencing greater improvements than the less wealthy. CONCLUSIONS: During the COVID-19 vaccination program in Chile, social attention to mental health problems appears to be sensitive to news about the vaccination program. There is also strong evidence of socio-economic status-induced heterogeneity in population responses to program implementation. The above phenomena appears to be permanent and cannot be attributed to either socio-economic segregation in access to vaccines or to the highly stratified schedule of the vaccination program.

Psychological repercussions on nursing staff due to the COVID-19 pandemic: A cross-sectional study.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has caused a high demand for health services, especially nursing. This workload can lead to emotional distress affecting their daily lives on a personal and professional basis. OBJECTIVE: To examine the prevalence of depression, anxiety, and stress in nurses and to analyze the factors associated with their presence during the COVID-19 pandemic. METHODS: An observational cross-sectional descriptive study was carried out in a second-level hospital in Mexico between September and October 2020. Within a population of 150 nurses invited to the study, 116 participated by answering a questionnaire regarding emotional aspects during their time caring for COVID-19 patients, as well as using the depression, anxiety, and stress scale (DASS-21). RESULTS: Among de 116 participants, 77.6% were females, and 22.4% were males. The 91.4% reported fear of spreading the disease to their families, and 59.5% reported that the death of their patients infected with COVID-19 affected them deeply. The factors associated with moderate to extremely severe levels of depression were the attitude of indifference from the community to their work during the pandemic (OR:2.66) and the increase consumption of addictive substances (OR:9.80). In the stress subscale, the variables that conferred a significant association was working inside the COVID-19 area (OR:17.05), being severely affected by the death of patients infected (OR:4.23), and fear of entering the red zone (OR:19.47). The need for psychological care was associated with moderate to severe depression and anxiety (OR:7.38, OR:9.50, respectively). For the anxiety subscale, no association with the studied variables was found. CONCLUSIONS: The study indicates a high prevalence of emotional distress among nurses, and that there were working, psychological and social factors associated with symptoms of depression and stress. Future research should focus on prevention measures and strategies to reduce psychological impact, as this could affect the quality of care provided to their patients.

KIDNEY INVOLVEMENT IN SARS-Co-V-2 INFECTION. A LATIN AMERICAN REGISTRY

Introduction: Acute kidney injury (AKI) and urinary sediment alterations are frequently associated to COVID-19, adding severity and high mortality risk. Knowledge of patient characteristics, risk factors, adverse outcomes, and regional peculiarities are key in the fight against this new disease. In order to describe the clinical characteristics of COVID-19 kidney involvement in Latin America (LA), the Latin American Society of Nephrology and Hypertension presents preliminary results of an ongoing Registry. Method(s): Repository of patients (Pts) by open invitation to nephrologists in LA. We included pts with confirmed SARS-CoV-2 infection by RT-PCR who developed proteinuria and/or, hematuria and/or AKI. Pts with CKD stage 5, on chronic dialysis or transplanted were excluded. Surveymonkey platform was used for data entry, and the SPSS v22 was used for the analysis. The study was approved by the Institutional Review Board of Clinica Los Olivos (Cochabamba, Bolivia) and a waiver of written consent was granted. Demographic variables, comorbidities, lab, characteristics and causes of AKI, need for kidney replacement therapy (KRT), ICU admission, mechanical ventilation (MV), complications and in-hospital mortality were collected Results: N= 632 pts. Brazil, Mexico, Colombia, Argentina, Peru and Bolivia were the main providers of pts. Median age 63 yrs (IQR, 53-73). Most pts were male (67.2%). One or more comorbidities were present in 86.9% of cases, mainly hypertension, diabetes and obesity. AKI was hospital-acquired in 59.7% and non-oliguric in 58.5%. Other causes of kidney involvement associated to COVID-19 were volume depletion (38.6%), nephrotoxicity (26.7%), and sepsis (23.4%). KRT was implemented in 47.2% but 32 pts (5.1%) needing dialysis were not dialyzed. Non-recovery of renal function was observed in 65.3%. Sixty-six percent of pts were in ICU and 67.2% underwent MV. However, 3.3% and 2.5% pts needing ICU and MV respectively did not receive it. Proteinuria (PU) at admission was present in 62.5% of 280 evaluable pts. which had more CKD, severity of AKI and the underlying condition and higher mortality rate. In those pts without PU at admission, onset of PU during hospital stay was observed in 15.4% (29/188) which had more hypertension, COVID-19 MODS as cause of AKI, more severe AKI as well as organ dysfunction. Complications in the general population occurred in 79.7%, mainly sepsis (44.9%). All-cause mortality was 57.4%. Variables independently associated to mortality were age (RR 0.95), COVID-19 DOMS (RR 2.46), nephrotoxicity (RR 2.07), oliguria (RR 2.28), non-recovery of AKI (1.97), ICU admisssion (RR 25.6) and MV (2.51). Conclusion(s): This regional cohort of COVID-19 patients showed that kidney involvement is usually found in elderly males patients with associated comorbidities. AKI was predominantly hospital-acquired and non-oliguric. COVID-19 multi-organ dysfunction syndrome (MODS), volume depletion, nephrotoxicity and sepsis were main causes of AKI. Almost half patients required KRT. Of note, a number of pts needing KRT, ICU admission or MV were not treated for not recorded reasons. PU at admission was frequent and associated to CKD, severe clinical condition, worse renal outcomes and increased mortality. In-hospital onset of PU was linked to hypertension, COVID-19 MODS as cause of AKI, and severity of kidney, respiratory and hemodynamic failure. No conflict of interestCopyright © 2021

Development and validation of a novel patient-reported outcomes (PRO) measure for symptom burden in patients with cancer and COVID-19 infection

Background: The symptom burden experienced by patients with cancer who contract the COVID-19 (C19) infection remains to be fully understood. To accurately assess this symptom burden, we developed a valid, reliable patient-reported outcome (PRO) measure of C19 symptoms combined with a known measure of cancer symptom burden. Methods: Within the institutional initiative on COVID-19 and cancer named Data- Driven Determinants for COVID-19 Oncology Discovery Effort (D3CODE), patients with cancer and PCR-positive C19 tests were invited to participate in this longitudinal study after providing consent. Pts completed the EQ-5D-5L and the 13 symptom severity and 6 interference items of the core MD Anderson Symptom Inventory (MDASI) plus 14 COVID-specific symptom items generated from literature and expert review. Items were measured on a 0-10 scale, 0 = none to 10 = worst imaginable symptom or interference. Demographic and disease information was collected. Psychometric procedures determined validity and reliability of the MDASI-COVID. Results: 600 pts enrolled, mean age 56.5y (range 20 to 91y). 59% female, 80% white. 78% solid tumors, 19% heme cancers. 12.5% required hospitalization for C19. Median number of days between positive C19 test and PRO completion was 17 days. Mean overall health rating on EQ-5D-5L was 78.3 (SD 19.6), best being 100. Highest mean (M) severity symptoms on the MDASI-COVID were fatigue (M 3.45, SD 2.17), drowsiness (M 2.50, SD 2.89), sleep disturbance (M 2.44, SD 2.99), malaise (M 2.37, SD 3.05), and distress (M 2.27, SD 2.90). Most severe (≥ 7) symptoms) reported were fatigue (21.3% of pts), change in taste (14.8%), change in smell (14.4%), malaise (14.3%), sleep disturbance (14.3%), and drowsiness (14%). Internal consistency (Cronbach α) of the 27 symptom items was 0.957, of the 6 interference items was 0.937. Mean severity of the 27 symptom items was significantly correlated with overall EQ-5D-5L health rating (correlation = -0.45, P < 0.0005), demonstrating concurrent validity. Mean symptom severity and interference showed known-group validity between patients who required C19 hospitalization (symptom M 2.32, SD 2.09;interference M 3.29, SD 3.02) and those who did not (symptom M 1.69, SD 1.85;interference M 2.20, SD 2.64) (symptom P 0.007;interference P 0.004). Conclusions: We have validated a novel PRO, the MDASI-COVID, to quantify the combined symptom burden in patients with cancer and COVID-19. This measure allows longitudinal evaluation of COVID-19 on cancer symptom burden and provide clinicians with an accurate tool for ongoing symptom assessment and management. Longitudinal analysis on long-term symptoms related to COVID-19 and cancer are ongoing.