ABSTRACT
BACKGROUND: There has been a significant increase in number of patients seeking neuropsychological rehabilitation months after the acute phase of COVID-19 infection. OBJECTIVE: Identify the cognitive and psychiatric disorders in patients with long COVID or Post-Acute Sequelae of COVID (PASC) and explore the association between disease severity during the acute phase and persistent neuropsychological manifestations. METHODS: 614 adults were assessed an average of eight months post-infection. Participants were, on average, 47.6 y.o., who sought rehabilitation for neuropsychological problems. Patients were evaluated using the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS), Phonemic Verbal Fluency and Clock Drawing tests (NEUPSILIN) for executive functions, and the Hospital Anxiety and Depression Scale (HADS). RESULTS: The BNIS score was significantly below reference values in all subscales, especially affect and memory. Verbal Fluency and Clock Drawing subtest results were also lower. Patients with PASC tested high for anxiety/depression, but there was no statistically significant relationship between HADS and BNIS scores. Neuropsychological evaluations showed no differences in cognitive or psychiatric profiles between hospitalized and non-hospitalized patients. CONCLUSIONS: Neuropsychological results suggest executive function problems and high incidence of anxiety/depression, irrespective of acute-phase severity, underscoring a need for neurorehabilitation programs while providing data for public policy initiatives.
Subject(s)
Anxiety , COVID-19 , Cognition Disorders , Depression , Adult , Anxiety/etiology , Brazil/epidemiology , COVID-19/complications , Cognition Disorders/etiology , Cognition Disorders/psychology , Depression/etiology , Humans , Neuropsychological Tests , Post-Acute COVID-19 SyndromeABSTRACT
Adopting modern methods for delivering teaching has been a great topic area of research in Higher education (HE). With the advancement of information and communication technologies towards accomplishing various contemporary demands such as Industry 4.0, online-based education has been explored to a greater extent, however, they are still limited. More recently, due to the coronavirus disease (COVID-19) pandemic, online teaching and assessment have become unprecedentedly mandatory in many HE settings. However, with online technologies, there arise new issues and concerns that impact educational quality. In this paper, we focus on the challenges associated with electronic examinations or online exams in HE and the strategies to address them. Using a design-based research approach we design, implement, and evaluate an innovative framework for online exams within a context of an Australian HE mixed-sector. We conduct an exploratory study on the quality of the process flow of the proposed Online Exam for Bachelor of Information Technology (OEBIT) framework. A triangulation of both qualitative data from focus groups and quantitative data from student outcomes provides the validity of data and confirms the completeness of the results. The successful deployment of our generalized framework with a smooth transition from pen-paper-based examination to online exam during the COVID-19 pandemic demonstrates its real-life application. © 2021, Southeast Asian Association for Institutional Research. All rights reserved.
ABSTRACT
Background: Coronavirus 2019 disease (COVID-19), caused by SARS-CoV-2, can lead to cardiac impairment. Information on AF and on left atrial (LA) involvement in patients with COVID-19 pneumonia is limited, and we aimed to explore the association with mortality in these patients. Methods: This study was conducted from February 2020 to August 2020, in 4 centers (Umberto I°;M. Scarlato;Cardarelli and Monaldi hospitals). 280 hospitalized patients with COVID-19 TC-confirmed interstitial pneumonia were included in the analysis;mean age was 66.6 years, 112 were female. Results: A total of 70 patients had cardiac injury (defined as blood levels of high sensitivity Troponin I above the 99th-percentile upper reference limit), and these patients were older (mean age 74.5 [38-89] vs 56.3 [20-79] years;P<0.001) with increased body mass index (mean 29.3 [25.8-31.4] vs 26.9 [22.2-28.3];P<0.001);had higher levels of C-reactive protein (mean 99.8 [45.8-130.4] vs 37.9 [22.2-96.3] mg L-1;P<0.001), and of D-Dimer (mean 4.9 [3.2-7.3] vs 2.1 [0.5-3.4];P<0.001);had a higher proportion of multiple ground-glass opacities in computed tomography (CT) findings (49 of 70 patients [71.2%] vs 72 of 210 patients [34.7%];P<0.001) and multiple consolidations by lung ultrasound (52 of 70 patients [75.6%] vs 77 of 210 patients [36.6%];P<0.001). LV mass index and LA volume index were significantly increased in patients with cardiac injury (Table 1). Greater proportion of patients with cardiac injury showed AF occurrence (28 of 70 [40.0%] vs 23 of 210 [10.4%];P<0.0001). The more common complication in patients with cardiac injury was acute respiratory distress syndrome (47 of 70 [67.1%] vs 37 of 210 [17.6%];P<0.001). Patients with cardiac injury had higher mortality than those without cardiac injury (34 of 70 [48.5 %] vs 16 of 210 [7.6%];P<0.0001). In a multivariable Cox proportional hazards model, including clinical data, laboratory and echocardiographic indexes, in the overall population of COVID pneumonia patients, troponin levels (Hazard Ratio, 4.29 [95% CI, 1.85-8.43] P<0.001), LA volume index (HR 3.6 [95% CI, 1.15-7.48;p<0.001], PASP (HR: 3.9;[95% CI, 1.72-6.39] P<0.001) and AF occurrence (HR: 2.5;[95% CI, 1.22-5.4] P<0.001) emerged as independent predictors of in-hospital death. Conclusions: Our survey showed that higher prevalence of AF in patients with severe COVID-19 pneumonia was associated with higher risk of in-hospital mortality.