ABSTRACT
BACKGROUND: COVID-19 pandemic causes major impact on economic, physical, mental well-being of people all over the world. Doctors are working in stressful, unprepared, limited resource setting, and they are under the continuous threat of getting infection. Managing mental health of these warriors is great importance. Hence the present study to estimate the psychological impact of COVID-19* and factors associated with it among doctors in tertiary care hospital, Madurai. METHODS: A Cross-sectional study was conducted during October-November 2020 using a pre-designed semi structured questionnaire and DASS-21 scale which were sent through Google form to doctors who were in their quarantine period after the COVID duty. Totally 292 responses were received. Descriptive statistics done to find frequencies and percentages. Correlation for continuous variables; Univariate and multivariate regression for categorical variables were used to predict the factors influencing the psychological impact. RESULTS: In our study, 42.1% doctors were depressed, 43.8% were stressed and 50.7% had anxiety. Depression*, anxiety*, stress* scores were positively correlated with number of COVID duties(r2 0.163,0.138,0.133), number of elderly persons(r2 0.188,0.169,0.188) in their family and negatively correlated with sleep duration(r 2-0.219,-0.281,-0.239), attitude of study participants(r2-0.319,-0.274,-0.291). Multiple logistic regression showed that disturbed sleep(odd'sratioâ¯=â¯3.931,2.734,3.420) and poor quality of sleep which affect the next day function(odd'sratioâ¯=â¯3.470,2.968,3.122) were significant predictors for all three psychological impacts. CONCLUSION: High prevalence of psychological impact estimated, ensures the requirement of early screening with timely psychological intervention and establishment of guideline policies to support mental health of healthcare workers* for maintaining the functionality of healthcare system.
ABSTRACT
Background: Acute kidney injury (AKI) is a common complication of patients hospitalized with coronavirus disease 2019 (COVID-19), however, the epidemiological studies are limited by single or few centers and short duration. How the incidence of COVID-19-associated AKI has changed over the last 18 months since start of the pandemic is not known. Methods: We used the N3C enclave to collect data from 42 centers from all geographical regions of the United States of patients hospitalized with COVID-19 from December 2019 to May 2021. Unique patient visit occurrence ID data across various hospitalizations for each center was harmonized to uniformly collect information on serum creatinine (SCr), acute dialysis, end-stage kidney disease (ESKD) and transplantation. From a total of 127,223 patients hospitalized with COVID-19, 3,662 patients with preexisting ESKD and 20,090 with < 2 measures of SCr were excluded. AKI and AKI stages were defined by KDIGO criteria. Baseline SCr was defined from the outpatient values before hospitalization when available or lowest inpatient value if not available. We analyzed how the incidence of in-hospital AKI changed over time (every 4-month period). Mann-Kendall Test was used to test for monotonic trends of the AKI incidence. Results: Of the 103,471 patients hospitalized with COVID-19, 31,634 (30.6%) were diagnosed with AKI (mean age 63.3 years, 43.7% female, 32.4% non-white, and 19.5% Hispanic). 14,129 (13.7%) patients were diagnosed with AKI-1, 7,996 (7.7%) had AKI-2 and 9,509 (9.2%) patients had AKI-3 (6,285 [6.1%] without dialysis and 3,224 [3.1%] with dialysis). The incidence of 'all AKI' decreased from 38.8% in Dec 2019-March 2020 to 26.2% in March-May 2021 (p-value for trend = 0.086) and the incidence of AKI-3 declined from 15.5% to 6.5% (p = 0.086). Conclusions: This is the largest and most nationally representative cohort of patients hospitalized with COVID-19 with the highest number of cases of AKI and of AKI-3 reported thus far. The incidence of COVID-19-associated AKI has shown a nonstatistically significant decline during the past 18 months of the pandemic.
ABSTRACT
The spread of the COVID-19 pandemic has led to widespread concerns internationally and among the members of the public health community including dental health professionals. The dental health care professionals are at higher than usual risk due to the proximity to the patient’s face, direct contact with the body fluids such as saliva and blood. The objective of this article is to provide an overview of the symptoms, modes of transmission of the COVID-19 infection, triaging of the dental patients, specific recommendations for the management of the dental patient, infection control modalities with an emphasis on dental specialties, global outlook on the pandemic by dentists, and implications on the patients and dentists. A literature search was performed and articles about the symptoms and modes of transmission of the COVID-19 infection, management of COVID-19 diffusion in dental practice were retrieved. The articles were then reviewed and infection control measures for various dental specialties as well as patient management strategies were also outlined in the results. The dental team has to implement measures to provide care and treatment to the patient as well as prevent the spread of the infection.