Prevalence and determinants of depression, anxiety, and burnout among Egyptian house officers during the COVID-19 pandemic

Background: The COVID-19 pandemic is an unprecedented international health crisis, which has invoked massive consequence on healthcare workers' mental health and wellbeing. This study aimed to detect the prevalence of anxiety, depression, and burnout among house officers amid the COVID-19 pandemic in Egypt to assess the effect of this pandemic on their mental health. Results: A total of 254 house officers were included in this study, and their responses were analyzed. Anxiety, burnout, and depression were reported among 35%, 32%, and 22% of participants, respectively. Multivariate regression analysis found that higher levels of overall worry were associated with anxiety, but not depression or burnout. Having a good personal protective equipment attitude was a significant predictor of both anxiety and burnout. Participants with depression had a higher likelihood of also having a burnout, but a lower likelihood of having anxiety. Overall worry related to the pandemic, depression, and clinical burnout status were all significantly associated with anxiety. Conclusions: The study found that anxiety, depression, and burnout are highly prevalent among house officers, who are newly graduated medical professionals. These findings suggest the need for specific programs to address the wellbeing of these individuals during the COVID-19 pandemic. © 2023, The Author(s).

Effect of COVID-19 infection on psychological aspects of pre-schooler children: a cross-sectional study

Background Coronavirus disease 2019 (COVID-19) had a tremendous effect on individual's lives worldwide. The pandemic's significant socioecological impact is one of the many burdens children confront in the current crises. As a result, this study was designed to determine the psychological impacts of the COVID-19 pandemic on preschoolers, particularly the consequences of COVID-19 infection. This study involved 138 children aged 2-5.11 years old who were classified into two groups based on their COVID-19 infection history, which was documented via a PCR test. All participants were assessed by the Socioeconomic Scale and The Children's Behavior Checklist (CBCL). Results COVID-19 infection was found in 21.7% of the children who participated in this study. Furthermore, children with COVID-19 had a higher percentage of clinical rating on the CBCL Profile of DSM-5 scales for affective problems (13.3 vs. 7.4%), anxiety problems (13.3 vs. 9.3%), pervasive developmental problems (20 vs. 13%), and oppositional defiant problems (6.7 vs. 5.6%) than children without COVID-19. Anxiety and somatic problems had a positive correlation with the impact of the COVID-19 pandemic on the lives of children. Conclusions Children infected with COVID-19 were more likely to have psychological issues, such as affective disorders, anxiety problems, pervasive developmental problems, and oppositional defiant problems. These psychological issues had a relationship with the impact of the COVID-19 pandemic on the lives of children.

KNOWLEDGE IS POWER: OUTREACH EFFORTS TO PROTECT PEOPLE EXPERIENCING HOMELESSNESS DURING THE COVID19 PANDEMIC

STATEMENT OF PROBLEM/QUESTION: People who are experiencing homelessness in Los Angeles do not have access to reliable clean water to practice hand hygiene, have limited ability to socially distance due to shelter space limitations, and may not have the finances to obtain a protective mask or keep one clean if they have one in their possession, which compromises their ability to protect themselves during the COVID-19 pandemic. DESCRIPTION OF PROGRAM/INTERVENTION: Internal MedicinePediatrics residents of Los Angeles County + University of Southern California Medical Center (LAC+USC) created a health education program within interim housing and shelter sites affiliated with the Department of Health Services (DHS) Housing for Health organization to help decrease the risk for covid-19 outbreaks within the population of people experiencing homelessness. The primary intervention consisted of evidence-based health education sessions using powerpoint presentations, informed by an initial survey of common questions fielded by community stakeholders, then followed by open discussion between the resident physicians, shelter staff, and shelter clientele. MEASURES OF SUCCESS: Measuring the efficacy of the intervention included immediate verbal feedback from clients and staff after the health education, as well as pre- and post-surveys. Pre-surveys assessed staff's perception of their client population's understanding of COVID-19 and their adherence to public health recommendations (wearing masks, practicing frequent hand washing, practicing social distancing). After a minimum of one month, post-surveys were sent to staff to evaluate if there was an improvement in client understanding and adherence to public health recommendations. FINDINGS TO DATE: 10 total educational sessions were completed for clients and staff at DHS sites. Staff noted that 4 to 5 clients were: wearing masks 87.5% of the time prior to the intervention and 100% after, practicing good hand hygiene 62.5% of the time prior and 83.3% after, and practicing social distancing 62.5% of the time prior and 100% after. KEY LESSONS FOR DISSEMINATION: Health education interventions within shelter and interim-housing populations can be effective in behavioral modification for disease prevention of covid-19 infection.

Ocular Manifestations in Patients with Coronavirus Disease 2019 (COVID-19): A Real World Multicenter Observational Study in Egypt

Background: The aim of the work was to evaluate the ocular manifestations in the patients with COVID-19 and its role in the prediction of the course and the outcome of the disease. Methods: This retrospective study was conducted at two tertiary referral COVID-19 isolation hospitals in two major university hospitals in Egypt. Two hundred and twenty-eight patients were enrolled in the study. The medical records of patients who had clinically confirmed COVID-19 between 1/5/2020 to 15/7/2020 were retrospectively reviewed. Data were collected from patient charts, including age, sex, accommodation, ocular manifestations, fever, headache, cough, dyspnea, anosmia, cyanosis, abdominal pain, anorexia, liver, kidney, cardiac manifestations, CT, X-ray finding, blood tests, and outcome of the disease. Results: Thirty-four patients with ocular manifestation were finally enrolled in the study with a mean age of 42.1 years;20 patients (58.8%) were men. The incidence of ocular manifestation was 14.9% (34/228). All patients with ocular manifestations had conjunctivitis (redness, epiphora, foreign body sensation), which had been treated and resolved completely within 10 days in all patients without any permanent ocular damage. There was a trend between the presence of ocular manifestations and the associated milder disease course, although this trend was not statistically significant. Conclusion: dOphthalmic manifestation is common in patients with COVID-19 and it occurs more frequently in patients with mild to moderate form COVID-19, but it could not predict the patient's mortality.

An Inverted Virtual Faculty Development Program for Remote Teaching: Pilot for Replication

Background: Due to the COVID 19 pandemic, all the universities worldwide are experiencing a paradigm shift to online learning. Baby boomers and Generation X need to cope with the challenging transformation, so an emerging need for a faculty development program was needed towards achieving the goal of that transformation. Objectives: To describe and assess an inverted virtual faculty development program (VFDP) that was designed and implemented for the first time in the school to equip educators with the necessary technology competencies for remote online learning. Methods: An interventional prospective study held in a university setting post need analysis conduction to prioritize the required technological skills for faculty members. The program was designed to integrate five essential skills needed to by faculty members to teach remotely. The intervention comprised attending five virtual sessions after watching a pre-distributed material, then evaluated using the Kirkpatrick model. Results: Almost 81% of faculty members completed the program and 80 % of participants were satisfied with the content of the program. There was a statistically significant difference between the perceived ability of the participants to share and record video lectures before and after the VFDP (p value <0.001). The percentage of the departments that applied the program components showed that 96% of them were able to record lectures. In addition, 80% of them were able to develop online quizzes. Conclusion: The inverted virtual faculty development program (VFDP) has supported the participating faculty in developing their needed technological competencies required to bridge the gap of remote teaching/learning. © 2022, Ain Shams University Faculty of Medicine. All rights reserved.

Symptômes respiratoires et anomalies radiologiques dans le COVID long

Introduction La prévalence et les caractéristiques des symptômes respiratoires persistants après COVID-19 sont en grande partie inconnues. Les objectifs étaient de déterminer la prévalence et les caractéristiques de ces symptômes à distance du COVID-19 et les relations entre dyspnée, anomalies radiologiques et troubles fonctionnels. Méthodes Dans l’étude de cohorte COMEBAC (Consultation Multi-Expertise de Bicêtre Après Covid-19), 478 survivants hospitalisés ont été évalués par téléphone 4 mois après la sortie de l’hôpital et 177 qui avaient été hospitalisés en unité de soins intensifs (USI) ou présentant des symptômes persistants ont été évalués en hôpital de jour (HDJ). La présence d’une dyspnée et d’une toux qui n’existaient pas avant la COVID-19, et les résultats des EFR, de la tomodensitométrie à haute résolution du thorax et de l’échocardiographie ont été recueillis. Résultats Parmi les 478 patients, 78 (16,3 %) ont signalé une dyspnée et 23 (4,8 %) une toux, apparues depuis la COVID-19. Les patients présentant une dyspnée d’apparition récente étaient significativement plus jeunes (56,1±12,3 versus 61,9±16,6 ans), avaient eu une COVID-19 plus sévère (admission en USI 56,4 % versus 24,5 %) et un antécédent d’embolie pulmonaire pendant la COVID-19 plus fréquente (18,0 % versus 6,8 %) (tous les p≤0,001) que les patients sans nouvelle dyspnée et parmi eux 23 (29,5 %) avaient un score de Nijmegen>22. Parmi les patients réévalués en HDJ, la prévalence des lésions fibrosantes pulmonaires était de 19,3 %, avec une étendue lésionnelle<25 % dans 97 % des cas. Les patients présentant des lésions fibrosantes étaient plus âgés (61±11 versus 56±14 ans, p=0,03), plus fréquemment pris en charge en USI (87,9 versus 47,4 %, p<0,001) et avaient une capacité pulmonaire totale inférieure (74,1±13,7 versus 84,9±14,8 %, p<0,001) et une DLCO plus basse (73,3±17,9 versus 89,7±22,8 %, p<0,001). L’association d’une nouvelle dyspnée, de lésions fibrosantes et d’une DLCO<70 % était rarement observée (8/478 patients). Conclusion La dyspnée d’apparition récente et les lésions fibrosantes pulmonaire peu étendues sont fréquentes 4 mois après COVID-19 mais l’association d’une dyspnée avec des lésions fibrosantes et des troubles de la diffusion est rarement retrouvée.

Prognostic impact of CT severity score in childhood cancer with SARS-CoV-2

Background: CT chest severity score (CTSS) is a semi-quantitative measure done to correlate the severity of the pulmonary involvement on the CT with the severity of the disease. The objectives of this study are to describe chest CT criteria and CTSS of the COVID-19 infection in pediatric oncology patients, to find a cut-off value of CTSS that can differentiate mild COVID-19 cases that can be managed at home and moderate to severe cases that need hospital care. A retrospective cohort study was conducted on 64 pediatric oncology patients with confirmed COVID-19 infection between 1 April and 30 November 2020. They were classified clinically into mild, moderate, and severe groups. CT findings were evaluated for lung involvement and CTSS was calculated and range from 0 (clear lung) to 20 (all lung lobes were affected). Results: Overall, 89% of patients had hematological malignancies and 92% were under active oncology treatment. The main CT findings were ground-glass opacity (70%) and consolidation patches (62.5%). In total, 85% of patients had bilateral lung involvement, ROC curve showed that the area under the curve of CTSS for diagnosing severe type was 0.842 (95% CI 0.737–0.948). The CTSS cut-off of 6.5 had 90.9% sensitivity and 69% specificity, with 41.7% positive predictive value (PPV) and 96.9% negative predictive value (NPV). According to the Kaplan–Meier analysis, mortality risk was higher in patients with CT score > 7 than in those with CTSS < 7. Conclusion: Pediatric oncology patients, especially those with hematological malignancies, are more vulnerable to COVID-19 infection. Chest CT severity score > 6.5 (about 35% lung involvement) can be used as a predictor of the need for hospitalization.

Does COVID-19 infection have an impact on children’s psychological problems?

Background: Coronavirus disease 2019 (COVID-19) has a significant impact on children, adolescents, and their families. So, the purpose of this study is to investigate the prevalence of children’s psychological problems during the COVID-19 pandemic and their association of COVID-19 infection in children and their risk factors. A cross-sectional study was conducted on 148 children aged 6–12 years old categorized into 2 groups based on COVID-19 infection history. Participants were assessed by the Socioeconomic Scale and the Checklist for Children’s Behavior (CBCL). Results: Children who had COVID-19 had a high percentage of problems regarding family, school, social, financial, and parent problems due to the COVID-19 pandemic. Regarding CBCL, children who had COVID-19 infection had a higher percentage of clinical rating than the other group regarding withdrawal (11.1% vs. 8.9%), anxious/depressed (33.3% vs. 25%), somatic (11.1% vs. 10.7%), internalizing (61.1% vs. 48.2%), externalizing (38.9% vs. 35.7%), and total problems (50% vs. 44.6%). Family history of psychiatric disorder and the presence of three or more offspring were at high risk for internalizing problems, while those with school problems during pandemic were more vulnerable for internalizing and total problems. Conclusion: Children with COVID-19 infection had a higher risk of developing psychological problems, such as withdrawal, anxiety/depression, somatic, internalizing, externalizing, and total problems. © 2021, The Author(s).