The Relationship between Gender Role, Job Role, and Risk and Protective Factors for Posttraumatic Stress Symptomatology among Healthcare Workers during the First Wave of COVID-19

Background: The emotional experiences of healthcare workers during the first wave of COVID-19 warrant further investigation especially regarding gender differences. The purpose of this study was to determine the relationship between gender role, job role and risk and protective factors for the development of Post Traumatic Stress Disorder (PTSD). Methods: A total of 521 healthcare workers completed the survey during the first pandemic wave. Psychosocial Index (PSI) was used to assess stress, well-being, distress, illness behaviour, and quality of life;the distress caused by stressful events was evaluated with the Impact of Event Scale – Revised (IES-R) and resilience was measured with the Connor-Davidson resilience scale (CD RISC). Results: Associations were found between female gender and distress with and without sleep disturbance (p<0.0001). Assessment of PTSD symptoms showed significance on symptoms of avoidance (p=0.0006), intrusiveness of thought (p=0.0016), and hyperarousal (p=0.003) to the disadvantage of female compared to male. Nurses emerged as the most vulnerable professional role about distress (p<0.0001), sleep disturbance (p<0.0001), and abnormal illness behaviors (p<0.0001). Finally, the study of post-traumatic symptomatology showed significance for avoidance (p=0.0072), intrusive thinking (p=0.0071), and hyperarousal (p=0.0019) to the disadvantage of the medical and nursing role in the female gender compared to the medical and nursing role in the male gender and other professional role in the female gender. Conclusions: Such findings suggest, there are differences in gender, rather than professional role and resilience factor, in emotional management in a particularly stressful condition, such as that of the first pandemic wave © 2022. by the Author(s);licensee Mediterranean Journal of Clinical Psychology, Messina, Italy. This article is an open access article, licensed under a Creative Commons Attribution 4.0 Unported License

Insomnia and nightmare profiles during the COVID-19 pandemic in Portugal: characterization and associated factors.

OBJECTIVE/BACKGROUND: To describe and characterize insomnia symptoms and nightmare profiles in Portugal during the first six weeks of a national lockdown due to COVID-19. PATIENTS/METHODS: An open cohort study was conducted to collect information of the general population during the first wave of SARS-CoV-2/COVID-19 pandemic in Portugal. We analyzed data from 5011 participants (≥16 years) who answered a weekly questionnaire about their well-being. Two questions about the frequency of insomnia and nightmares about COVID-19 were consecutively applied during six weeks (March-May 2020). Latent class analysis was conducted and different insomnia and nightmare profiles were identified. Associations between individual characteristics and both profiles were estimated using odds ratios (ORs) and 95% confidence intervals (CI). RESULTS: Five insomnia (No insomnia, Stable-mild, Decreasing-moderate, Stable-severe, Increasing-severe) and three nightmares profiles (Stable-mild, Stable-moderate, Stable-severe) were identified. Being female, younger, perceiving their income as insufficient and feelings of fear towards COVID-19 were associated with higher odds of insomnia (Women: OR = 6.98 95%CI: 4.18-11.64; ≥60 years: OR = 0.30 95%CI: 0.18-0.53; Insufficient income: adjusted OR (aOR) = 8.413 95%CI: 3.93-16.84; Often presenting fear of being infected with SARS-CoV-2 infection: aOR = 9.13 95%CI: 6.36-13.11), and nightmares (Women: OR = 2.60 95%CI: 1.74-3.86; ≥60 years: OR = 0.45 95%CI: 0.28-0.74; Insufficient income: aOR = 2.60 95%CI: 1.20-5.20; Often/almost always presenting fear of being infected with SARS-CoV-2 infection: aOR = 6.62 95%CI: 5.01-8.74). Having a diagnosis of SARS-CoV-2 virus infection was associated with worse patterns of nightmares about the pandemic. CONCLUSIONS: Social and psychological individual factors are important characteristics to consider in the development of therapeutic strategies to support people with sleep problems during the COVID-19 pandemic.

Insomnia and nightmare profiles during the COVID-19 pandemic in Portugal: characterization and associated factors

Objective/Background To describe and characterize insomnia symptoms and nightmare profiles in Portugal during the first six weeks of a national lockdown due to COVID-19. Patients/Methods An open cohort study was conducted to collect information of the general population during the first wave of SARS-CoV-2/COVID-19 pandemic in Portugal. We analyzed data from 5011 participants (≥16 years) who answered a weekly questionnaire about their well-being. Two questions about the frequency of insomnia and nightmares about COVID-19 were consecutively applied during six weeks (March-May 2020). Latent class analysis was conducted and different insomnia and nightmare profiles were identified. Associations between individual characteristics and both profiles were estimated using odds ratios (ORs) and 95% confidence intervals (CI). Results Five insomnia (No insomnia, Stable-mild, Decreasing-moderate, Stable-severe, Increasing-severe) and three nightmares profiles (Stable-mild, Stable-moderate, Stable-severe) were identified, respectively. Being female, younger, perceiving their income as insufficient and feelings of fear towards COVID-19 were associated with higher odds of insomnia (Women: OR=6.98 95%CI:4.18-11.64;≥60 years: OR=0.30 95%CI:0.18-0.53);Insufficient income: aOR=8.413 95%CI:3.93-16.84;Often presenting fear of being infected with SARS-CoV-2 infection: aOR=9.13 95%CI:6.36-13.11), and nightmares (Women: OR=2.60 95%CI:1.74-3.86;≥60 years: OR=0.45 95%CI:0.28-0.74) Insufficient income: aOR=2.60 95%CI:1.20-5.20;Often/almost always presenting fear of being infected with SARS-CoV-2 infection: aOR=6.62 95%CI:5.01-8.74). Having a diagnosis of SARS-CoV-2 virus infection was associated with worse patterns of nightmares about the pandemic. Conclusions Social and psychological individual factors are important characteristics to consider in the development of therapeutic strategies to support people with sleep problems during COVID-19 pandemic.

Early efficacy results of montelukast as add on treatment of hospitalized patient with COVID-19 pneumonia: An investigator-initiated open labelled randomized controlled ongoing clinical trial

Background: Leukotriene receptor antagonists might have a role in viral infections, either by improving lung injury and inflammation, or by acting on 3CL proteinase of the HCoV-19. Thus, we hypothesised that montelukast may be an adjuvant drug in HCoV-19 infection treatment. This study aims to evaluate the efficacy and safety of montelukast in the adjuvant treatment of COVID-19 pneumonia. Method: We are conducting a randomized, controlled, parallel, open-label trial involving hospitalized adult patients with confirmed COVID-19. Patients were randomly assigned in a 1:1 ratio to receive either montelukast 10 mg, once a day for 14 days, in addition to standard of care (SoC), or SoC alone. SoC follows the best practice for treating these patients, according to updated recommendations. The primary outcome is time to recovery. Participants are assessed using diary cards to capture data on treatment-related improvements in an 8-point ordinal scale (COVID-19 scale). Secondary endpoints include changes in NEWS (National Early Warning Score), respiratory and inflammatory parameters. Mann-Whitney U test for continuous variables and Ficher's exact test for categorical variables were used to compare differences between groups. This phase IV clinical trial takes place at the University Hospital of São João, Porto. EudraCT number: 2020-001747-21. Results: Eighteen patients (11 males, mean age 60 years, age range 42-89, table 1) enrolled and completed the trial. The trial is still open for the recruitment of participants. The participants from the active group spent less time hospitalized than control group [median (P25-75): 3.0 (3-6) vs 7.5 (4.75-17.75) days, p = 0.03]. The number of days to achieve 7 (not hospitalized, limitation on activities) or 8 points (not hospitalized, no limitations) in the COVID-19 scale was also statistically significant. The number of patients in need of supplemental high flux oxygen and the NEWS score followed the same trend (table 1). Conclusion: In conclusion, early efficacy results from this ongoing clinical trial suggest montelukast may have a role in treating COVID-19 patients as an adjuvant treatment by diminishing hospitalization days until discharge. Data were presented as median (25th percentile-75th percentile) unless otherwise states. Bpm: beats per minute;cpm: cycles per minute;NEWS: National Early Warning Score);SoC: standard of care. NEWS is based on 7 clinical parameters (respiration rate, oxygen saturation, any supplemental oxygen, temperature, systolic blood pressure, heart rate, level of consciousness), and is being used as an efficacy measure. Higher points represent higher risk of poor outcomes. COVID-19 scale is as follows: (1) Death;(2) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO);(3) Hospitalized, on non-invasive ventilation or high flow oxygen devices;(4) Hospitalized, requiring supplemental oxygen;(5) Hospitalized, not requiring supplemental oxygen-requiring ongoing medical care (COVID-19 related or otherwise);(6) Hospitalized, not requiring supplemental oxygen-no longer requires ongoing medical care;(7) Not hospitalized, limitation on activities and/or requiring home oxygen;(8) Not hospitalized, no limitations on activities. (Figure Presented).