Prevalence of Distress and Depression and Related Health and Behavioural Factors in the Student Population of Latvia during the COVID-19 Outbreak

The COVID-19 pandemic, which has spread across the world, has made an impact on every student's ordinary life and mental health, from studying conditions, internship, employment to freedom of movement. This was a cross-sectional study where Latvian university and college students were asked to fill the self-report online questionnaire developed as part of an international study. The objective of the study was to investigate the effects of COVID-19 pandemic and investigate clinical depression, distress and identify the predicting factors. Depression and distress were determined using the Center for Epidemiologic Studies Depression Scale (CES-D) with a previously developed algorithm and cut-off scores. The statistical analysis included the Pearson's chi-square test and binomial logistic regression. The study included 1047 students. The prevalence of distress was 18% (n =188) and prevalence of depression was 33.8% (n = 354). Depression was more common among women-35.9 % (n = 298). Risk factors for depression were poor quality of sleep (OR = 8.31), unemployment (OR = 1.42), excessive internet usage (OR = 7.17), thoughts about death (OR = 12.14), and suicidal behaviour (OR = 4.99). Physical activities operated as a protective measure to prevent depression. This study potentially could help to develop a plan in the future for dealing with psychological support for the student population. © 2023 Julija Vorobjova et al., published by Sciendo.

[Comparative study of Wuhan-like and omicron-like variants of SARS-CoV-2 in experimental animal models].

INTRODUCTION: The variability of SARS-CoV-2 appeared to be higher than expected, the emergence of new variants raises concerns. The aim of the work was to compare the pathogenicity of the Wuhan and BA.1.1/Omicron variants in BALB/c mice and Syrian hamsters. MATERIALS AND METHODS: The study used strains of SARS-CoV-2: Dubrovka phylogenetically close to Wuhan-Hu-1, and LIA phylogenetically close to Omicron, BALB/c mice, transgenic mice B6.Cg-Tg(K18-ACE2)2Prlmn/HEMI Hemizygous for Tg(K18-ACE2)2Prlmn, Syrian golden hamsters. Animals were infected intranasally, pathogenicity was estimated by a complex of clinical, pathomorphological and virological methods. RESULTS: Comparative studies of SARS-CoV-2 Dubrovka and LIA strains on animal models demonstrated their heterogeneous pathogenicity. In parallel infection of BALB/c mice with Dubrovka and LIA variants, the infection proceeded without serious clinical signs and lung damage. Infection with the LIA strain resulted to a systemic disease with a high concentration of viral RNA in the lungs and brain tissues of animals. The presence of viral RNA in mice infected with the Dubrovka strain was transient and undetectable in the lungs by day 7 post-infection. Unlike the mouse model, in hamsters, the Dubrovka strain had a greater pathogenicity than the LIA strain. In hamsters infected with the Dubrovka strain lung lesions were more significant, and the virus spread through organs, in particular in brain tissue, was observed. In hamsters infected with the LIA strain virus was not detected in brain tissue. CONCLUSION: The study of various variants of SARS-CoV-2 in species initially unsusceptible to SARS-CoV-2 infection is important for monitoring zoonotic reservoirs that increase the risk of spread of new variants in humans.

Changes in the pattern of eating habit and physical activity during the pandemic of COVID-19 in Malaysia: data from COMET-G international multi-country study

Lockdown during the COVID-19 pandemic had led to lifestyle changes among Malaysians. These changes were due to people being confined to work and study at home and stress due to the risk of COVID-19 transmission. Our study aimed to observe changes in the patterns of eating habits and physical activity during the pandemic of COVID-19 in Malaysia and look for the associations with sociodemographic factors, people living together, living conditions and mental health status. This study was an online cross-sectional survey among 963 participants who completed self-administrated questionnaires on socio-demography, Likert scales on eating habits and physical activity and the Center for Epidemiologic Studies Depression Scale for mental health status. The data were analyzed using descriptive statistics, one-way ANOVA, Pearson correlations and independent t tests. Marital status has a significant association with the frequency and intensity of physical workouts during this pandemic and lockdown, changes in eating amount, and changes in body weight (p<0.001). Employment had a significant association with all components of eating habits and physical activities except the level of physical activity affected by the pandemic (p<0.001). Those with normal mental health status found exercise to be helpful in preventing anxiety, practicing healthy eating, and having more changes in body weight, compared to those who were depressed (p<0.001). There was a significant difference in how the vulnerable group practiced healthy eating compared to the non-vulnerable group (p<0.001). The vulnerable group had significant changes in eating amount and body weight (p<0.001). In conclusion, the COVID-19 pandemic has brought changes in eating habits and body weight which were also influenced by sociodemographic factors and mental health status. © 2023, Mahidol University - ASEAN Institute for Health Development. All rights reserved.

Sociodemographic Factors of Depression During the COVID-19 Pandemic in Malaysia: the COVID-19 Mental Health International Study.

OBJECTIVES: To determine the prevalence of depression and the sociodemographic factors associated with depression in Malaysia during the COVID-19 pandemic METHODS. This study is part of the COVID-19 Mental Health International Study to collect data on the impact of the pandemic on mental health through an online survey. People who were aged ≥18 years, able to read Malay or English, had access to the internet, and consented to participate were asked to complete a pro forma questionnaire to collect their sociodemographic data. The presence of distress and depression was assessed using the English or Malay version of the Center for Epidemiologic Studies Depression Scale. RESULTS: Of 963 participants, 451 (46.8%) had depression and 512 (53.2%) had no depression who were either normal (n = 169, 17.5%) or had distress (n = 343, 35.6%). Participants had higher odds of having depression when living with two people (adjusted odds ratio [AOR] = 3.896, p = 0.001), three people (AOR = 2.622, p < 0.001) or four people (AOR = 3.135, p < 0.001). Participants with three children had higher odds of having depression (AOR = 2.084, p = 0.008), whereas having only one child was a protective factor for depression (AOR = 0.481, p = 0.01). Participants had higher odds of having depression when self-employed (AOR = 3.825, p = 0.003), retired (AOR = 4.526, p = 0.001), being housekeeper (AOR = 7.478, p = 0.004), not working by choice (AOR = 5.511, p < 0.001), or unemployed (AOR = 3.883, p = 0.009). Participants had higher odds of depression when living in a small town (AOR = 3.193, p < 0.001) or rural area (AOR = 3.467, p < 0.001). Participants with no chronic medical illness had lower odds of having depression (AOR = 0.589, p = 0.008). CONCLUSION: In Malaysia during the COVID-19 pandemic, people who are living with two, three, or four people, having three children, living in a small town or rural areas, and having unstable income have higher odds of having depression. Urgent intervention for those at risk of depression is recommended.

Biological characterization of cold-adapted SARS-CoV-2 variants

Introduction. The emergence of new epidemiologically significant variants of SARS-CoV-2 has shifted emphasis to development of a live vaccine, which would be able to provide protection against a wide range of antigenic variants of the virus. The aim of the study was to obtain SARS-CoV-2 variants attenuated through cold adaptation and to provide their biological characterization. Materials and methods. The Dubrovka laboratory strain of SARS-CoV-2 and its variants were cultured on Vero and Calu-3 cells. The virus quantification was performed by virus titration in Vero cells and by real-time reverse transcription-polymerase chain reaction. SARS-CoV-2 virions were analyzed using transmission electron microscopy. Genome sequences of the virus were identified by nanopore sequencing. The attenuation (att) phenotype of SARS-CoV-2 variants was identified using Syrian hamsters as an animal model for COVID-19. Results. Cold-adapted (ca) SARS-CoV-2 variants – Dubrovka-ca-B4 and Dubrovka-ca-D2 were produced by continued passaging of the Dubrovka strain in the Vero cell culture at the temperature being gradually decreased to 23ºC and by subsequent cloning. Up to 20 nucleotide substitutions and 18 amino acid substitutions were detected in genomes of ca-variants. Ca-variants, as distinct from the parent Dubrovka strain, actively replicated at 23ºC, while the Dubrovka-ca-D2 variant had a temperature-sensitive (ts) phenotype (did not replicate at 39ºC). Ca-variants of the virus replicated poorly at 37ºC in the Calu-3 human lung cell culture, which, along with the ts-phenotype, can be a marker of virus attenuation for humans. In the intranasally infected Syrian hamsters, ca-variants of the virus demonstrated an attenuation phenotype: they did not cause loss of appetite, fatigue, drowsiness, did not slow down weight gain, replicating much more slowly in the lungs and brain compared to the virulent Dubrovka strain. Conclusion. The obtained attenuated SARS-CoV-2 ca-variants, Dubrovka-ca-B4 and Dubrovka-ca-D2, should be studied further as candidate vaccine strains for a live attenuated vaccine against COVID-19. © Team of authors, 2022.

Immunogenic properties of SARS-CoV-2 inactivated by ultraviolet light.

Vaccination against COVID-19 is the most effective method of controlling the spread of SARS-CoV-2 and reducing mortality from this disease. The development of vaccines with high protective activity against a wide range of SARS-CoV-2 antigenic variants remains relevant. In this regard, evaluation of the effectiveness of physical methods of virus inactivation, such as ultraviolet irradiation (UV) of the virus stock, remains relevant. This study demonstrates that the UV treatment of SARS-CoV-2 completely inactivates its infectivity while preserving its morphology, antigenic properties, and ability to induce the production of virus-neutralizing antibodies in mice through immunization. Thus, the UV inactivation of SARS-CoV-2 makes it possible to obtain viral material similar in its antigenic and immunogenic properties to the native antigen, which can be used both for the development of diagnostic test systems and for the development of an inactivated vaccine against COVID-19.

P.0640 Factors influencing changes in anxiety during the COVID-19 related lockdown: modifiable targets for prevention and intervention

Introduction Besides neuropsychiatric effects of the SARS-CoV-2 virus, the pandemic has a severe negative psychological impact, with a high risk of development or worsening of mental disorders due to stress associated with public health measures, lockdown, and isolation, which significantly contribute to anxiety. Thus, identification of risk and protective factors is of key importance to prevent development of disorders, decrease suffering and burden on the healthcare system. Our aim was to analyze factors contributing to self-reported changes in anxiety during the COVID-lockdown. Methods: As part of a 42-country international collaboration effort to assess changes in subjective mental well-being during the pandemic-related lockdown, our present analysis included data from 763 Hungarian adults recruited using a snowball method, who provided demographic and health-related data including psychiatric and medical history and presence of chronic somatic problems, and completed self-report questionnaires evaluating depression (CES-D), anxiety (STAI), suicidal behavior, subjective changes in psychological symptoms, maintenance of daily routine, lifestyle changes including physical activity, sleep, eating and nutrition, degree of lock-up, changes in the frequency and quality of family relationships, being a caretaker of someone from a vulnerable group, fear of contracting the virus or of family member contracting the virus, belief in the effectiveness of precautions, beliefs in conspiracy theories related to the pandemic, financial state, and several work and profession-related variables. Analyses included binary logistic regression models and χ2-square tests. Results: History of anxiety disorders (χ2 (2) = 8.091, p = 0.017) but not of depression (χ2 (2) = 0.762 p = 0.683) increased likelihood of experiencing subjective increase in anxiety during the pandemic-related lockdown. Protective factors predicting no change or improvement of subjective anxiety vs worsening included good general health (OR: 1.241, Wald's χ2=5.294, p=0.021), a higher degree of maintained daily routine (OR: 1.377, Wald's χ2=11.321, p=0.001), and no history of anxiety disorders (OR: 1.757, Wald's χ2=3.895, p=0.048), while risk factors included a higher degree of lock-up (OR: 0.766, Wald's χ2=5.049, p=0.025), decline in the quality of family relationships (OR: 0.245, Wald's χ2=7.794, p=0.005), increased fear of contracting the coronavirus (OR: 0.525, Wald's χ2=35.544, p <0.0001) or of a family member contracting the virus (OR: 0.781, Wald's χ2=7.491, p=0.006), as well as a disbelief in the effectiveness of precautions (OR: 0.698, Wald's χ2=4.001, p=0.045). Our model explained 26.3% of the variance observed in subjective changes of anxiety level with a 68.3% model accuracy (χ2 (19) = 167.002;p < 0.0001;R2: 0.263). Conclusions: Besides the acute and post-infection neuropsychiatric effects of SARS-CoV-2, the pandemic-related lockdown may also cause severe psychological distress and symptoms. Our study identified multiple factors influencing lockdown-related subjective changes in anxiety acting either as risk or protective factors, the majority of which are modifiable and can be targeted with information, psychoeducation or low-threshold intervention or preventive efforts. Identifying and modifying such factors and their impact, besides decreasing subjective suffering and the risk of development of worsening of psychiatric disorders, also decreases burden on the healthcare system. No conflict of interest

P.0413 Modifiable risk and protective factors influencing changes in subjective depression during the COVID-19-lockdown: identifying targets for prevention and intervention

Introduction The COVID-19 pandemic and the consequential public health measures exert an enormous psychosocial impact, leading to the precipitation or worsening of psychological symptoms and psychiatric disorders. Given the numbers affected, and also the psychiatric consequences of the virus and infection including post-covid symptoms, alleviating the psychological consequences of the lockdown would significantly decrease subjective suffering and healthcare burden. Our aim was to investigate protective and risk factors of pandemic lockdown-related subjective changes in depression in a general population sample as part of a large international 42-country collaboration. Methods: As part of a large international study in 42 countries, 763 Hungarian adults recruited using a snowball method provided demographic and health data and completed online questionnaires evaluating depression (CES-D) anxiety (STAI) as well as their self-reported changes, impact on lifestyle (including physical activity, sleep, eating, daily routines), changes in subjective experiences, use of alcohol, tobacco and psychotropic agents, internet and social media, religion and spirituality, and beliefs related to the pandemic and its origin as well as pandemic-related conspiracy theories during the lockdown. In the present analyses we focused on factors influencing self-reported changes in depression using a binary logistic regression model and χ2-square tests, including age, sex, history of anxiety/mood disorders, presence of chronic somatic problems, health, degree of lock-up, maintenance of daily routine, change in the characteristics of family relationships and contacts, fears related to the virus, beliefs related to the precautions and their effectiveness, financial state, and work and profession-related factors. Results: Proportion of those reporting a subjective worsening of depression did not differ between those with or without history of depression (χ2 (2) = 4.586, p= 0.101), or with or without history of anxiety disorders (χ2 (2) = 4.527, p = 0.104). Several factors significantly influenced likelihood of no change/improvement vs worsening of subjective depression. Protective factors included preserved or improved general health (OR: 1.389, Wald's χ2=11.357), and maintaining daily routine (OR: 1.625, Wald's χ2=25.295, p=0.001), while risk factors included a negative change in family relationships (OR: 0.221, Wald's χ2=12.508, p<0.0001), increased fear of contracting the coronavirus (OR: 0.743B, Wald's χ2=7.176, p=0.007,) and decline in one's financial status (OR: 0.592, Wald's χ2=8.579, p=0.003). Our model explained 19.9 % of the variance in subjective changes of mood with a 74% model accuracy for case classification (χ2 (19) = 115.744;p < 0.0001;R2: 0.199). Conclusion: We identified several factors impacting subjective mood changes as a consequence of the pandemic-related lockdown, including general health, maintaining daily routine, quality of family relationships;fear of contracting the virus and a stable financial state, with history of depression or anxiety having no effect. It is noteworthy that the majority of factors which increased risk of or protect against subjective worsening of depression are modifiable factors and can be addressed by psychoeducation, information, or low threshold interventions, thus decreasing not only subjective suffering and the risk of emergence of more severe psychological symptoms, but also the burden on healthcare. No conflict of interest

Interactions between Anxiety Levels and Life Habits Changes in General Population during the Pandemic Lockdown: Decreased Physical Activity, Falling Asleep Late and Internet Browsing about COVID-19 Are Risk Factors for Anxiety, whereas Social Media Use Is not

BACKGROUND: The COVID-19 pandemic has substantially contributed to increased anxiety rates among the general population worldwide. Pandemic-related health anxiety and worries about getting COVID-19 can lead to generalized anxiety and anxiety somatization, which, together with insalubrious daily life habits, are risk factors of worsening somatic health in people with SARS-Cov-2 infection. SUBJECTS AND METHODS: The current study is a part of the COMET-G project (40 countries, n=55589;approved by the Ethics Committee of the Aristotle University of Thessaloniki), which represents an intermediate analysis of data collected anonymously via online links from a national sample of the Russian general population (n=9936, 31.09+/-12.16 y.o., 58.7% females) to estimate anxiety using STAI-S and self-reported changes in anxiety and life habits (physical activity, nutrition and weight, internet use, sleep) during the lockdown. All statistical calculations (descriptive statistics, between group comparisons using chi-square test, MANOVA, ANOVA, significant at p<0.05) were performed with IBM SPSS 27. RESULTS: Overall STAI-S scores were 29+/-5.4, a subjective feeling of anxiety increase was reported in 40.3% of respondents (43.9% significantly > in females), worsening to clinical anxiety in 2.1% (2.4% > in females). 54.2% of respondents reported decreased physical activity, 33.1% gained weight, 72% used internet more often, 52.6% experienced worries related to the information about COVID-19 (56.8% > in females). 88% experienced worsened sleep quality, 69.2% stayed up until late, 23.2% took sleeping pills, and 31% had nightmares in which they felt trapped. To ANOVA, such life habits as reduced physical activity during the lockdown, increased time spent online, internet browsing about COVID-19, tendency to stay up late, use of sleeping pills and disturbing dreams with scenario of being trapped were significantly related to worsening of clinical anxiety. However, eating behaviour, weight changes, and social media use did not contribute to the clinical anxiety increase. CONCLUSIONS: Factors of decreased physical activity and sleep disturbances related to the lockdown, as well as excessive internet browsing for information about COVID-19, emerged as risk factors for increased anxiety, more notably in women than in men. Preventive measures should be targeted against relevant factors imparting anxiety in the vulnerable population.

Depression, distress and their association with patterns of psychoactive substance use during the COVID-19 emergency state in latvia

IntroductionThe WHO warned that the COVID-19 pandemic could have psychiatric consequences such as elevated levels depression, increased alcohol and drug use, and other behaviours that exert a strong influence on health. In Latvia a state of emergency was announced on March 12th, was extended twice and lifted on June 10th.ObjectivesTo estimate the prevalence of depression and distress in the general population of Latvia and association with substance use during the state of emergency.MethodsThe nationwide representative online study in the general population of Latvia was conducted in July 2020 during three week period. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to determine the presence of distress/depression. The structured questionnaire to determine psychoactive substance use was applied. Proportions of independent variables across the study groups were compared using Chi-squaretest.ResultsThe study sample included 2608 respondents. The prevalence of depression and distress was estimated at 5.7% (95%CI 4.92 – 6.71) and 13.5% (95%CI 6.85 – 8.91), respectively. Patients with depression (28% vs. 7.4%, p <0.001) and distress (30.9% vs. 7.4% p <0.05) smoked more tobacco compared to respondents without distress/depression. Those with depression or distress were significantly more likely to consume more alcohol during the emergency state than people without depression or distress (14.0% and 17.7% vs. 6.6%, p <0.001). The changes in the use of other psychoactive substances in those who had depression or distress were not statistically significant.ConclusionsPreparing support systems to mitigate mental health consequences is needed urgently.

[Reactivation of Epstein-Barr virus (Herpesviridae: Lymphocryptovirus, HHV-4) infection during COVID-19: epidemiological features].

INTRODUCTION: Immunodeficiency underlying the development of severe forms of new coronavirus infection may be the result of mixed infection with SARS-CoV-2 and other pathogens, including Epstein-Barr virus (EBV).The aim is to study the prevalence and epidemiological features of co-infection with SARS-CoV-2 and EBV. MATERIAL AND METHODS: A cross-sectional randomized study was conducted in Moscow region from March to May 2020. Two groups were examined for EBV-markers: hospital patients (n = 95) treated for SARS-CoV-2 infection and blood donors (n = 92). RESULTS: With equal EBV prevalence the detection of active infection markers in donors (10.9%) was noticeably lower than in SARS-CoV-2 patients (80%). Significant differences in this indicator were also found when patients from subgroups with interstitial pneumonia with the presence (96.6%) and absence (97.2%) of SARS-CoV-2 in the nasopharyngeal smear were compared with the subgroup of patients with mild COVID-19 (43.3%). The average IgG VCA and IgG EBNA positivity coefficients in donor group were higher than in patient group (p < 0.05). Patients with active EBV infection markers were significantly more likely to have pneumonia, exceeding the reference values of ALT and the relative number of monocytes (odds ratio - 23.6; 3.5; 9.7, respectively). DISCUSSION: The present study examined the incidence and analyzed epidemiological features of active EBV infection in patients with COVID-19. CONCLUSION: A significantly higher rate of detection of active EBV infection markers in hospital patients indicates a combined participation SARS-CoV-2 and EBV in the development of interstitial pneumonia. Low levels of specific IgG EBV serve as predictors of EBV reactivation. Exceeding the reference values of ALT and the relative number of monocytes in patients should serve as a reason for examination for active EBV infection markers.

Effects of COVID-19 on psychological well-being, lifestyle and attitudes towards the origins of the pandemic in psychiatric patients and mentally healthy subjects: fi rst Hungarian descriptive results from a large international online study

The COVID-2019 pandemic has presented a new situation affecting not only the somatic but the mental health of people worldwide and exposing the world including healthcare professionals to a challenge never experienced before. Therefore its effects on mental health, although can be estimated, but cannot be predicted, thus we are only halfways prepared for understanding as well as screening, preventing and treating the pandemic-related mental health problems. For this reason, the Mental Health Sector of the Scientific Researches Institute of the Pan-Hellenic Medical Association prepared a large, international online, general population study with participation from over 42 countries, assessing various aspects of general mental function, needs and behaviors that could occur during the COVID-19 outbreak, as a result of either the outbreak itself or the social measures adopted in order to control it. While the study is ongoing, here we present the first descriptive results from the Hungarian study sample including 738 adult participants collected during the first wave of COVID-19-associated lockdown, focusing on differences in the effect of COVID-19 on psychological and lifestyle measures, as well as attitudes towards the pandemic between mentally healthy participants and people with mental disorders.