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Based on an online cross-sectional survey, this study aimed to evaluate the role of the coronavirus disease 2019 (COVID-19) pandemic and economy-related factors in post-traumatic stress symptoms (PTSSs) and sleep in a sample of the general Lebanese population using the post-traumatic stress disorder checklist. The online survey was conducted between May 10, and May 20, 2020, and 502 Lebanese adults who have access to the internet were enrolled. Results highlighted that positive correlates of PTSS were fear of COVID-19, female gender, and waterpipe smoking;negative correlates were higher family satisfaction, higher financial wellness, older age, having access to healthcare, and never having to work. When including insomnia as an independent variable to explain PTSS, the model did not substantially change. Positive correlates of insomnia included fear of poverty, fear of COVID-19, violence at home, the number of dependent children, having a job, and having a chronic disease. Conversely, higher family satisfaction and financial wellness were associated with lower likelihood of insomnia. When entering PTSS, insomnia remained positively associated with fear of poverty, PTSS, and violence at home. However, fear of COVID-19 was no longer associated with insomnia. We concluded that both the fear of COVID-19 and the economic crisis are correlated with PTSS and insomnia. © 2023 Author(s).
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Background: Multiple sclerosis (MS) patients have been considered a higher-risk population for COVID-19 due to the high prevalence of disability and disease-modifying therapy use;however, there is little data in our Middle East and North Africa region (MENA) identifying clinical characteristics of MS associated with worse COVID-19 outcomes. Material(s) and Method(s): This a nationwide, multicenter, retrospective cohort study conducted between March 2020 and February 2021 and included MS patients with a suspected or confirmed COVID-19. Using data collected from the MENACTRIMS registry and local COVID-19 registries, the association of patient demographics, MS disease characteristics, and use of disease-modifying therapies with outcomes and severity of COVID-19 illness were evaluated by multivariate logistic models. Result(s): A total of 600 MS patients with suspected (n=58) or confirmed (n=542) COVID-19 (mean age: 36.4 +/- 10.16 years;414 (69%) females;mean disease duration: 8.3+/- 6.6 years) were analyzed. Seventy-three patients (12.2%) had a COVID-19 severity score of 3 or more, and 15 patients (2.5%) died of COVID-19. The median EDSS was 2.0 (range, 0-9.5), and 559 patients (93.2%) were receiving disease-modifying therapy (DMT). There was a higher proportion of patients with a COVID-19 severity score of 3 or more among patients treated with DMTs relative to untreated patients (82.9% vs 17.1%;P < .001), from whom the majority (n=117;19.7%) were maintained on anti-CD20 therapies such as ocrelizumab and rituximab. Comorbidities mainly hypertension and cardiovascular diseases, progressive MS, disease duration, and EDSS were associated with severe or worse COVID-19 disease outcome. Multivariate logistic regression analysis showed that older age (odds ratio per 10 years, 1.5 [95%CI, 1.1-2.0]), male gender (OR, 2.1 [95%CI. 1.2-3.8]), obesity (OR, 2.8 [95%CI, 1.3-5.8]), and treatment ocrelizumab/rituximab (OR for ocrelizumab, 4.6 [95%CI. 1.2-17.7], OR for rituximab, 14.1 [95%CI, 4.8-41.3]) or off-label immunosuppressive medications such as azathioprine or mycophenolate mofetil (OR, 8.8 [95%CI. 1.7-44.0]) were risk factors for moderate to severe COVID-19 requiring hospitalization. Surprisingly, smoking and diabetes were not identified as risk factors for severe COVID-19 disease in our cohort. Conclusion(s): In this registry-based cohort study of patients with MS, age, sex, EDSS, obesity, progressive MS were independent risk factors for severe COVID-19. Moreover, there was an association found between exposure to anti-CD20 DMTs and COVID-19 severity. Knowledge of these risk factors may help improve the clinical management of MS patients with COVID-19 infection.Copyright © 2022
ABSTRACT
Background: COVID-19 is a respiratory disease that results in a prothrombotic state manifesting as thrombotic, microthrombotic and thromboembolic events. As a result, several antithrombotic modalities have been implicated in the treatment of this disease. Purpose(s): Currently, prophylactic dose anticoagulation is considered the standard of care antithrombotic regimen in hospitalised patients with COVID-19. However, high-quality data about the subject is unavailable. This study aimed to identify if therapeutic anticoagulation (TAC) or concurrent use of antiplatelet and anticoagulants was associated with an improved outcome in this patient population. Method(s): A retrospective observational cohort study of adult patients admitted to a single university hospital for COVID-19 infection was performed. The primary outcome was a composite of in-hospital mortality, intensive care unit (ICU) admission or the need for mechanical ventilation. The secondary outcomes were each of the components of the primary outcome, in-hospital mortality, ICU admission, or the need for mechanical ventilation. Result(s): 242 patients were included in the study and divided into four subgroups: Therapeutic anticoagulation (TAC), prophylactic anticoagulation+ antiplatelet (PACAP), TAC+antiplatelet (TACAP) and prophylactic anticoagulation (PAC) which was the reference for comparison. Multivariable Cox regression analysis and propensity matching were done and showed when compared with PAC, TACAP and TAC were associated with less inhospital all-cause mortality with an adjusted HR (aHR) of 0.113 (95% CI 0.028 to 0.449) and 0.126 (95% CI 0.028 to 0.528), respectively. The number needed to treat in both subgroups was 11. Furthermore, PACAP was associated with a reduced risk of invasive mechanical ventilation with an aHR of 0.07 (95% CI 0.014 to 0.351). However, the was no statistically significant difference in the occurrence of major or minor bleeds, ICU admission or the composite outcome of in-hospital mortality, ICU admission or the need for mechanical ventilation. Conclusion(s): The use of combined anticoagulant and antiplatelet agents or TAC alone in hospitalised patients with COVID-19 was associated with a better outcome in comparison to PAC alone without an increase in the risk of major and minor bleeds. Sufficiently powered randomised controlled trials are needed to further evaluate the safety and efficacy of combining antiplatelet and anticoagulants agents or using TAC in the management of patients with COVID-19 infection.
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Background and ObjectiveaaOur aim is to investigate the impact of COVID-19 on screen time among Lebanese high school students (grades 9–12).MethodsaaAn anonymous online questionnaire was distributed among 510 school students fromdifferent governorates in Lebanon;this included questions regarding screen time, food habits, andphysical activity. Psychological symptoms were assessed using the Generalized Anxiety Disorder-7items and Patient Health Questionnaire-9 items. Effects of screen time on sleep was evaluated usingthe Insomnia Severity Index and Bedtime Procrastination Scale.ResultsaaFemale students reported higher depression (p = 0.018) and anxiety (p = 0.023) thanmale students;however, there was no difference in their sleep. Insomnia, depression, and anxietywere highest among phone users. A screen time of more than 7 hours per day was significantly associatedwith higher depression (67.9%), anxiety (61.6%), insomnia (82.1%), and bedtime procrastination.It also indicated a shift toward a less healthy diet and light exercise.ConclusionsaaSeven hours of screen was found to develop depression and anxiety, exercisingless, eating a less healthy diet, and experiencing disturbed sleep among school adolescents
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This study aims to explore the prevalence and correlates of food insecurity among Lebanese households since the ordeals of COVID-19, economic crisis, and Beirut port explosions. At the core of the study, a mobile application entitled Nutrition Assessment System (NAS) that simplified the data collection was used as toolkit and a technical test was carried out in all Lebanese governorates between November 2020 and March 2021. Findings show that food insecurity is an immediate problem for households in Beirut and in many governorates in Lebanon. Nine in every 16 households ate less than 2 meals per day and more than 70% of them skipped their meals to spare food. Even though half the population studied had a low food consumption score, 82.4% of the people were not relying on livelihood coping strategies. However, more than three out of ten of these households relied on at least three food-based coping strategies. In addition, as for the livelihoods, this assessment found that most Lebanese households reported a drop in income along with an expansion in debt incurrence in the last 24 months to be able to buy food. Improving food security in Lebanon requires effort not only on the part of the government, but through regional and international actions. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
ABSTRACT
Background: In 2020, the International Pharmaceutical Federation (FIP) published a set of 21 global development goals (DGs) that bring together workforce/education [W], practice [P], and science [S] in a transformative framework, defining an improved and more advanced pharmacy profession for the next decade. This paper aims to benchmark the context of the Lebanese pharmacy profession with the respective elements of the FIP DGs to optimise the previously suggested strategic plan. Methods: A group of pharmacy researchers with extensive academic, professional, and post-educational experience endeavoured to map the FIP DGs with the work produced in Lebanon, describing the current situation. The documents mapped were sought from published literature and white papers developed by academia and the Order of Pharmacists of Lebanon (OPL), the national pharmacists' association. Results: This study found that efforts are necessary to bridge the gap between the current situation of the pharmacy profession in Lebanon and optimal practice. In the short term, existing projects should be immediately implemented, e.g. pharmacy curricula reforms and accreditation, postgraduate training, recognising pharmacy specialities, organising the profession, and assessing advanced competencies. In parallel, related policies and regulations should be updated. Cultural changes, involving closer ties between education and practice, are required to reform the pharmacy profession. In the medium term, a national research strategy, including earlycareer scientists mentoring and assessment tools validation, is necessary. Digitalising the patient profile and medication safety reporting and updating the pharmacists' database through appropriate platforms are also essential steps toward modernising pharmacy. Conclusion: Authorities and stakeholders should combine and coordinate efforts to implement existing plans and develop necessary strategies for optimizing pharmacy education, workforce, practice, and research, which is expected to bridge the gap between the challenging current situation of the profession in Lebanon and its optimal future development, for the best of the pharmacist and the patient's health.
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Purpose: This study aimed to evaluate the relationship between factors related to COVID-19 confinement (i.e., fear of COVID-19, anxiety, anger, boredom, eating disorders, and duration of confinement) and weight perception in a sample of the Lebanese population. Methods: A cross-sectional web-based survey carried out at a one-time point between April 3 and 18, 2020, enrolled 407 participants. Due to the imposed lockdown, respondents self-reported their weight and height. One dichotomized question (positive/negative) assessed the perception of weight change (yes = change perception, and no = no change perception). The variation in BMI was calculated by subtracting the estimated weight during confinement from the estimated weight before. Results: No significant variation in BMI was detected before and during the confinement (p = 0.40), while a perceived weight change was found in 212 (52.1%) participants. The regression analysis showed that higher fear of COVID-19 score (ORa = 0.96) and higher self-reported weight change (ORa = 0.47) were associated with lower weight change perception. However, longer confinement duration (ORa = 1.07), higher anxiety (ORa = 1.05), and high eating concerns (ORa = 1.81) were associated with higher weight change perception. Conclusion: Our results revealed that both the fear of COVID-19 and self-reported weight change were negatively associated with weight change perception, while higher anxiety and a longer duration of confinement correlated with a higher weight change perception. Further studies are necessary to confirm our findings. © 2021