Anxiety, Depression, Insomnia and Stress during the COVID-19 Pandemic: Prevalence and risk according to associated experiences in the general population

Introduction: COVID-19 mortality in Peru is high and its impact on the mental health of the adult population is a significant problem. This study aims to identify the prevalence of and risk for anxiety, depression, insomnia, and stress in the general population in terms of associated experiences during the COVID-19-pandemic. Methods: An observational and cross-sectional study was conducted through an online survey completed by 880 people from two Peruvian cities (Lima and Huaraz). The Depression, Anxiety and Stress Scale 21 (DASS-21) and the Athens Insomnia Scale were used. Results: Prevalence rates of 34.4% for anxiety, 20.7% for depression, 36.8% for insomnia and 12.8% for stress were found. In terms of associated experiences: fear of COVID-19 infection was a risk factor for insomnia, depression, anxiety, and stress;contact with COVID-19 cases was a risk factor for insomnia, anxiety, and stress;death of households from COVID-19 was the highest risk factor for insomnia (OR=12.26) and stress (OR=7). Households testing positive for COVID-19 was a risk factor for anxiety and stress and testing positive for COVID-19 was a risk factor for anxiety. There is a significant relationship among the mental health variables under study. Conclusions: The prevalence and identification of pandemic-associated experiences as risk factors for anxiety, depression, insomnia, and stress in the COVID-19 pandemic allows for the designing of mental health intervention and prevention programs aimed at the general population. There is a direct relationship among anxiety, depression, insomnia, and stress during the COVID-19 pandemic. © 2022 ACM.

Territories and COVID-19 in Ecuador: Functional regions in response to the health crisis

The spread of COVID-19 has altered the structure and functioning of spatial systems, giving rise to multiple dynamics. The spatial and temporal concentration of cases requiring medical care has led to the collapse of healthcare systems around the world, particularly in territories with already limited resilience potential and provision of medical services, as was the case of Ecuador. In this South American country, a reform of the healthcare system was launched as part of the 2008 Constitution that involved a strengthened investment in healthcare services;however © 2022 Instituto de Geografia. All rights reserved.

Relationship between Anti-Spike Protein Antibody Titers and SARS-CoV-2 In Vitro Virus Neutralization in Convalescent Plasma

Newly emerged pathogens such as SARS-CoV-2 highlight the urgent need for assays that detect levels of neutralizing antibodies that may be protective. We studied the relationship between anti-spike ectodomain (ECD) and anti-receptor binding domain (RBD) IgG titers, andSARS-CoV-2 virus neutralization (VN) titers generated by two different in vitro assays using convalescent plasma samples obtained from 68 COVID-19 patients, including 13 who donated plasma multiple times. Only 23% (16/68) of donors had been hospitalized. We also studied 16samples from subjects found to have anti-spike protein IgG during surveillance screening of asymptomatic individuals. We report a strong positive correlation between both plasma anti-RBD and anti-ECD IgG titers, and in vitro VN titer. Anti-RBD plasma IgG correlated slightly better than anti-ECD IgG titer with VN titer. The probability of a VN titer 160 was 80% or greater with anti-RBD or anti-ECD titers of 1:1350. Thirty-seven percent (25/68) of convalescent plasma donors lacked VN titers 160, the FDA-recommended level for convalescent plasma used for COVID-19 treatment. Dyspnea, hospitalization, and disease severity were significantly associated with higher VN titer. Frequent donation of convalescent plasma did not significantly decrease either VN or IgG titers. Analysis of 2,814 asymptomatic adults found 27 individuals with anti-RBD or anti-ECD IgG titers of 1:1350, and evidence of VN1:160. Taken together, we conclude that anti-RBD or anti-ECD IgG titers can serve as a surrogate for VN titers to identify suitable plasma donors. Plasma anti-RBD or anti-ECD titer of1:1350 may provide critical information about protection against COVID-19 disease.

The dispute over wastewater in Mexico as a paradoxical ecological-distributive confl ict

This article addresses the category of ecological-distributive confl ict from The Global Environmental Justice Atlas project to explain the emergence of environmental justice movements as a response to a certain distribution of pollution burdens or access to environmental resources. The theoretical approach addresses environmentalism of the poor and adds a historical review to understand such an existing paradox. The empirical work was carried out in the Valle del Mezquital, where the discharge of wastewater generated in the Metropolitan Area of the Valle de Mexico presents a paradoxical situation: some farmers perceive the reception of contaminated water as positive. The analysis includes a refl ection on the criteria for evaluating confl ict since the emergence of COVID-19 © The Author(s)

Black fungus in India, is it really pathophysiological related to COVID-19?

Introduction: The development of secondarymucormycosis in patients with COVID-19 inIndia could be related to steroid intake, uncontrolled DM and/or traditional medicine beliefs.Mucormycosis is an opportunistic infection inpatients with risk factors. The main agents,Rhizopus spp. and Mucor spp., are ubiquitous saprophytic fungi. For diagnosis, histopathology,direct microscopy and culture are essential tools.Warning criteria for rhino-orbito-cerebral mucormycosis in patients with diabetes mellitus are cranial nerve palsy, diplopia, sinus pain, proptosis,periorbital swelling and palatal ulcer.Case presentation: Man with DM andCOVID-19. In treatment with steroids. He presents with mild proptosis, chemosis and ocularmovement restriction. MRI shows importantfindings in the paranasal sinuses. Rhizopus spp.was found on sampling, the patient was treatedwith amphotericin B without debridement. Herecovered at 4 weeks and was discharged on oralposaconazole.Management: Successful treatment depends ontimely diagnosis, reversal of predisposing factors(hyperglycemia, ketoacidosis, rapid reduction ofglucocorticoid therapy), early surgical debridement of infected tissue and prompt initiation ofhigh-dose systemic antifungal medication.Liposomal amphotericin B is the primary drug.Discussion: Mucormycosis is not directly relatedto COVID-19 infection, but to risk factors for thedisease, such as steroid intake, high prevalence ofdiabetes mellitus in India, and traditional medicine practices. Epidemiological studies are stillneeded to determine the exact cause of theincrease in the number of cases in patients withCOVID-19 in India.

Clinical characteristics and evolution of pediatric patients with acute leukemia and SARS-COV2 virus infection in a third level hospital in Mexico

Introduction: Reports have revealed that people susceptible to severe forms of COVID-19 are older adults with comorbidities;However, the pediatric population has also been affected, considering children with underlying conditions such as onco-hematological conditions to be high risk. We present a cases series in a third level hospital. Material and methods: We conducted a retrospective study in children under the age of 16 years with a diagnosis of acute leukemia and infection with the SARS-CoV2 virus. Descriptive statistics with means and percentages were used. To show differences between the groups, Chi-square test, Student t test and Mann-Whitney U test were used depending on the type of variable and its distribution. Results: SARS-CoV2 virus infection was confirmed in 15 children diagnosed with acute leukemia, at different stages of treatment. The mean age was 7.5 years, 8 male and 7 female, 11 of them diagnosed with acute B-cell lymphoblastic leukemia, one with acute T-cell lymphoblastic leukemia and 3 with acute myeloid leukemia. The mean days of hospital stay at the diagnosis of COVID-19 was 22. Thirteen of the children had fever and neutropenia. 7 patients died. There was a statistically significant correlation with the outcome in patients who presented a prolongation of aPTT, an increase in D-dimer, an increase in liver enzymes and severe respiratory distress with the need for mechanical ventilation. Conclusion: The risk of death in children with leukemia and COVID-19 was associated with prolonged aPTT, increased D-dimer, increased liver enzymes, respiratory distress, and the need for mechanical ventilation.

Chaotic model for COVID-19 growth-factor (preprint)

The new COVID-19 Pandemic caused by SARS-CoV-2 initiated in the world a largest quarantine, due to is exponential capacity of the virus in spreading from human contact. In the present work, it was evaluated the dynamics of such spreading by the indicator of growth-factor, and applied to it the space phase of the time series, the detrended fluctuation analysis (DFA) of the series, and the fractal dimension of the space phase. It was possible to notice a strange attractor in the space phase of the growth-factor, indicating that the process is chaotic deterministic. The value of the alpha coefficient by DFA showed to be less than 0.5, characteristic of long-range memory of the series, in which large events precedes small events. The fractal dimension of the phase space was a fractal number, between 1 and 2, another indicator that the exponential growth-rate of the virus spreading among humans is fractal. These results, even with small number of data, is pointing that the spread of COVID-19 is fractal.

Fractal signature of coronaviruses related to severe acute respiratory syndrome (preprint)

Coronavirus is the agent which causes the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), emergent infections such as the present Pandemic of COVID-19. Understanding its genome pattern is important for developing new and faster ways of testing for identifying the genome of the virus, and also for better understanding of its origin and evolution. The aim of this work was to investigate the genome of SARS-CoV, MERS-CoV and SARS-CoV-2 by the paradigm of chaos theory and fractal geometry. For that, it was calculated the alpha coefficient by detrended fluctuation analysis (DFA) for the sequences of these genomes converted to binary numbers in order to determine if it is a chaotic or a random series of data. Also, it was applied the random walking for obtaining a fractal map of the whole genome, and calculated the fractal dimension (FD) by box-counting of this map by two different softwares. With this, it was found that the alpha coefficient of the first SARS viruses was > 0.5, indicating that the series is chaotic or fractal, and has a persistent long-range memory or self-similarity along its sequence. This is not the case for MERS virus, which showed to have a completely random sequence (alpha < 0.5). For the fractal dimension, SARS viruses presented a FD around 1.5, and for MERS the fractal dimension decreases (FD < 1.5). The images generated by random walking of the entire RNA genome are by itself a fractal signature of the virus, which may be applied for studying its origin and for faster diagnostic of COVID-19.

Perceptions of general surgeons in training in the initial phase of COVID-19 pandemic

Objective: The aim of this study is to describe the perceptions of surgeons in training during the initial phase of the COVID-19 pandemic. Material and methods: A 51-question survey was conducted among physicians in training from a department of surgery in an Argentine hospital. Five domains were explored: institutional, healthcare, academic, domestic and emotional. Results: The survey was completed by 55 physicians (91.7%): 35 residents and 20 fellows. Among the respondents, 98.1% considered the information provided by the hospital and the department about the measures implemented in the COVID-19 stetting was sufficient. 98.1% considered that the instructions about personal protective equipment were satisfactory, but 38% reported difficulties to use them. 92.5% of the residents agreed with the system implemented for on-call shifts, 94.5% increased the time dedicated to academic activities, 75% considered the virtual class schedule implemented as very useful and 72.72% perceived that they had spaces to express their concerns. The supervision was considered adequate by 60%;81.81% were worried to lose manual dexterity;53% felt frustrated and 54% were afraid of infecting their family/partner. Conclusion: Understanding the perceptions of surgeons in training in the initial phase of the COVID-19 pandemic made it possible to detect opportunities for improvement and incorporate modifications to address the following phases, ensuring learning and prioritizing their physical and psychosocial well-being. © 2018 Department of Spanish Literature and Theory of Literature and Comparative Literature.Universidad de Valladolid. All rights reserved.

Chaotic model for COVID-19 growth factor

Purpose The new COVID-19 pandemic caused by SARS-CoV-2 initiated in the world a large quarantine, due to the exponential capacity of the virus in spreading from human contact. In the present work, the dynamics of such spreading was evaluated by the analysis of the growth factor of the disease. Method It was applied the space phase of the time series, the detrended fluctuation analysis (DFA) of the series, and the fractal dimension of the space phase. Results It was possible to notice a strange attractor in the space phase of the growth factor indicating that the process is a deterministic chaos. The value of the alpha coefficient by DFA showed to be less than 0.5, characteristic of anti-persistent long-range memory, in which large events alternate with small events, and vice-versa. The fractal dimension of the phase space set was a fractal number, between 1 and 2, another indicator that the growth factor of the disease is not random. Conclusion This global analysis is pointing that the spread of COVID-19 is a deterministic chaos, with long-range memory. Understanding such dynamics may help the control of this disease.

Fractal signature of coronaviruses related to severe acute respiratory syndrome

The aim of this work was to investigate the genome of SARS-CoV, MERS-CoV, and SARS-CoV-2 by the paradigm of chaos theory and fractal geometry. Coronavirus is the agent that causes the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) and emergent infections such as the present pandemic of COVID-19. Understanding its genome pattern is important for developing new and faster ways of testing for identifying the genome of the virus and also for better understanding of its origin and evolution. For that, it was calculated the alpha coefficient by detrended fluctuation analysis (DFA) for the sequences of these genomes converted to binary numbers in order to determine if it is a chaotic or a random series of data. Also, it applied the random walking for obtaining a fractal map of the whole genome and calculated the fractal dimension (FD) by box-counting of this map by two different software. With this, it was found that the alpha coefficient of the first SARS viruses was > 0.5, indicating that the series is chaotic or fractal, and has a persistent long-range memory or self-similarity along its sequence. This is not the case for MERS virus, which showed to have a completely random sequence (α < 0.5). For the fractal dimension, SARS viruses presented a FD around 1.5, and for MERS the fractal dimension decreases (FD < 1.5). The images generated by random walking of the entire RNA genome are by itself a fractal signature of the virus, which may be applied for studying its origin and for faster diagnostic of COVID-19.