Impact of a subcutaneous casirivimab and imdevimab clinic in outpatients with symptomatic COVID-19: A single-center, propensity-matched cohort study.

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: To evaluate the success of a clinic for subcutaneous administration of casirivmab and imdevimab (REGEN-COV; Regeneron) for treatment of patients with symptomatic mild to moderate coronavirus disease 2019 (COVID-19) in terms of preventing disease progression and healthcare utilization. METHODS: This retrospective single-center, propensity-matched cohort study examined healthcare utilization outcomes for patients who received subcutaneous casirivimab and imdevimab at a pharmacist-led clinic of an academic health system. Eligible patients were treated between August 1, 2021, and January 5, 2022, and were at high risk for COVID-19 disease progression. Treatment patients were propensity matched with high-risk control patients with a diagnosis of COVID-19 in the same timeframe who did not receive casirivimab and imdevimab. Patients were followed for 30 days for collection of data on inpatient admissions, emergency department visits, and mortality. Risk of a 30-day healthcare utilization event was assessed and tested for statistical significance utilizing McNemar's test. RESULTS: A total of 585 patients who received treatment with subcutaneous casirivimab and imdevimab were matched with 585 patients who did not receive casirivimab and imdevimab therapy. Patients who received casirivimab and imdevimab had significantly lower risk of a 30-day all-cause inpatient admission event than untreated patients (relative risk reduction, 61.2%; P < 0.0001). Treated patients also had a significantly lower risk of 30-day all-cause emergency department visit than untreated subjects (relative risk reduction, 36.6%; P = 0.0021). There were 6 mortality events in the untreated group and no mortality events in the treatment group. CONCLUSION: This study provides evidence for the effectiveness of a subcutaneous casirivimab and imdevimab clinic in preventing progression of symptomatic mild to moderate COVID-19.

Cognitive vulnerability and depressive symptoms among Emirati college students before and after the enactment of COVID-19 curfew and home-learning measures

The COVID-19 pandemic has meant that college students in many nations, the United Arab Emirates (UAE) included, have had to switch to home-learning. Additionally, infection control measures in the UAE have also led to the enactment of population-wide curfews. The present study represents an exploration of cognitive vulnerability to depression and depressive symptomatology, both before and after the UAE enacted measures to curb the spread of COVID-19. The study relied upon a quasi-experimental design, where two groups of college students from the same population completed measures of depressive symptoms and cognitive vulnerabilities before (N = 34) and after (N = 85) the UAE implemented home learning and curfew measures. The posited cognitive vulnerability's (ruminative response styles and dysfunctional attitudes) were both retained as predictors of depressive symptoms. Furthermore, depressive symptom scores were significantly higher after the enactment of the UAE's curfew and home learning measures. It may be particularly important to provide mental health support for college students during extended periods of enforced home learning and curfew. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Outdoor Activity in the Daytime, but Not the Nighttime, Predicts Better Mental Health Status During the COVID-19 Curfew in the United Arab Emirates.

Background: The COVID-19 pandemic and the associated infection prevention and control measures had a negative impact on the mental health of many people. In the United Arab Emirates (UAE), infection control measures implemented after March 24th, 2020, placed necessary restrictions on people's freedom of movement. Aim: This study aimed to assess the association between levels of daytime vs. nighttime outdoor activity and mental health among a sample of UAE residents during the lockdown period. Method: An opportunity sample of 245 participants completed an online survey assessing levels of depression, somatic symptoms, daytime and nighttime activity levels. Results: Multivariate logistic regression revealed that daytime activity, but not nighttime activity, was associated with a lower risk of clinically significant depressive and somatic symptomatology. Conclusion: The association of better mental health with daytime not nighttime outdoor activity could be possibly attributed to vitamin D, but further studies are needed to confirm this speculation.

Containing COVID-19 risk in the UAE: Mass quarantine, mental health, and implications for crisis management.

The COVID-19 pandemic is the first global "NASECH disaster," owing to its natural hazard (NH) origin and unprecedented subsequent repercussions for global society (S), economy (EC), and health (H). Emergency health control measures required the implementation of compulsory mass quarantine (CMQ) or so-called periods of "lockdown." Yet, CMQ is an instrument with iatrogenic consequences, associated with a rise in societal levels of depression, anxiety, and posttraumatic stress. With a view to informing future crisis management, the study investigated sociodemographic factors associated with mental wellbeing during the March-April 2020 lockdown in the United Arab Emirates. Respondents (n = 1585) completed self-report measures of depression (PHQ8) and generalized anxiety (GAD7). Rates of symptomatology were notably higher than those observed in similar UAE-based studies before the pandemic. Younger age, urban-dwelling, female-gender, and a history of mental health problems were significant factors linked to elevated levels of depression and anxiety. Findings emphasize (1) the crucial need for psychological intervention after disasters and (2) the importance of strengthening the nexus at the intersection of public health and disaster risk reduction (DRR). Implications are that future pandemic containment would benefit from adopting new Health-DRR paradigms and ensuring these are effectively translated into disaster policy.

La pandemia de COVID­19 es el primer "desastre NASECH" mundial, debido a su origen de peligros naturales (NH) y las repercusiones posteriores sin precedentes para la sociedad (S), la economía (CE) y la salud (H) globales. Las medidas de control de la salud de emergencia requirieron la implementación de cuarentena masiva obligatoria (CMQ), o los llamados períodos de "bloqueo". Sin embargo, CMQ es un instrumento con consecuencias iatrogénicas, asociadas con un aumento en los niveles sociales de depresión, ansiedad y estrés postraumático. Con miras a informar la futura gestión de crisis, el estudio investigó los factores sociodemográficos asociados con el bienestar mental durante el cierre de marzo a abril de 2020 en los Emiratos Árabes Unidos. Los encuestados (n = 1585) completaron medidas de autoinforme de depresión (PHQ8) y ansiedad generalizada (GAD7). Las tasas de sintomatología fueron notablemente más altas que las observadas en estudios similares realizados en los Emiratos Árabes Unidos antes de la pandemia. La edad más joven, la vivienda urbana, el sexo femenino y un historial de problemas de salud mental fueron factores importantes relacionados con niveles elevados de depresión y ansiedad. Los hallazgos enfatizan (1) la necesidad crucial de una intervención psicológica después de los desastres (PIAD) y (2) la importancia de fortalecer el nexo en la intersección de la salud pública y la reducción del riesgo de desastres (RRD). Las implicaciones son que la futura contención de una pandemia se beneficiaría de la adopción de nuevos paradigmas de salud y reducción del riesgo de desastres y de garantizar que estos se traduzcan efectivamente en políticas de desastres.

Levels of Trust in Information Sources as a Predictor of Protective Health Behaviors During COVID-19 Pandemic: A UAE Cross-Sectional Study.

Health information sources and the level of trust in a particular source may influence the subsequent adoption of advocated health behaviors. Information source preference and levels of trust are also likely to be influenced by sociodemographic (culture, age, gender) variables. Understanding these source-trust-behavior relationships across various national and cultural contexts is integral to improved health messaging. The present study identified the sources most frequently consulted to obtain information about COVID-19 during the pandemic's early stages in the United Arab Emirates (UAE). The study quantified levels of trust across an array of information sources, factoring in sociodemographic variables. Finally, the study explored the relationship between sociodemographic variables, levels of trust in information sources, and the adoption of COVID-19 related protective behaviors. Participants (n = 1585) were recruited during the first 2 weeks of April 2020 via announcements in the UAE media and through email networks. All participants completed a web-based survey presented in English or Arabic, as preferred. The most frequently consulted information sources were websites (health information websites), social media, government communications, and family and friends. The sources rated most trustworthy were: personal physicians, health care professionals, and government communications. There were differences in the use of sources and levels of trust according to age, gender, and education. The levels of trust in sources of information were associated with the adoption of protective behaviors, significantly so for citizens of the UAE. These findings may help inform the improvement of pandemic-related health messaging in multicultural contexts.

In this together: Psychological wellbeing of foreign workers in the United Arab Emirates during the COVID-19 pandemic.

The COVID-19 pandemic and the associated infection prevention and control measures (e.g. quarantine, lockdown and isolation), have had an adverse impact on mental health. To date, the mental health status and challenges of foreign workers during the pandemic have been neglected in the literature. This cross-sectional web-based survey assessed levels of post-traumatic stress, depression, anxiety and insomnia among an international sample of foreign workers (n = 319) resident in the United Arab Emirates (UAE). The majority of participants were female (76%), European (69%) and highly educated (83% had a bachelor's or higher degree). Results indicate high rates of post-traumatic stress, depression, anxiety, and insomnia, especially among women, younger individuals, and those with a previous diagnosis of a psychological disorder. Additionally, foreign workers' perceptions of pandemic severity in their home nations (mild, moderate, severe) were positively correlated with their symptom levels of depression, anxiety and insomnia. Overall, these findings may help inform future public mental health strategy and pandemic preparedness plans with reference to safeguarding the psychological wellbeing of foreign workers.

Panic buying or preparedness? The effect of information, anxiety and resilience on stockpiling by Muslim consumers during the COVID-19 pandemic

PurposeThe purpose of this study is to examine the causes of consumer stockpiling by Muslim consumers during the coronavirus (COVID-19) pandemic. Specifically, this paper examines exposure to COVID-19 information and its relationship with panic buying directly, indirectly through anxiety and as moderated by resilience.Design/methodology/approachIn the early stages of the COVID-19 pandemic, this study surveys 1,006 Muslims from a sample of 1,392 UAE citizens and residents about their exposure to COVID-19 information, anxiety, resilience and panic buying.FindingsGreater exposure to COVID-19 information had a direct effect on panic buying yet a much weaker indirect effect through increased anxiety. This mediating effect is only significant at moderate to high levels of resilience, suggesting panic buying is a particular coping response of resilient individuals who experience anxiety after greater exposure to COVID-19 information. Anxiety was found to increase panic buying above that directly related to COVID-19 information exposure.Social implicationsFindings provide some guidance for policymakers where a nuanced approach to building and directing resilience and in directing information flows are needed to curtail panic buying within their Muslim populations.Originality/valueWhile the phenomenon of consumer stockpiling is referred to as panic buying, the findings suggest that anxiety plays a smaller role in the process than preparedness prompted by crisis-related information exposure. Furthermore, this is the first study to date to specifically examine COVID-19 related panic buying among a Muslim population.

Portable Magnetic Resonance Imaging for ICU Patients.

OBJECTIVES: Patients in ICUs often require neuroimaging to rule out a wide variety of intracranial problems. CT may be available in the ICU itself, but MRI has greater sensitivity for many conditions that affect the brain. However, transporting patients who are on ventilators and other life-sustaining devices is a labor-intensive process and involves placing the patient at risk for adverse events. This is a report of portable MRI in a clinical setting. DESIGN: This is a prospective, nonrandomized, observational study at one institution, utilizing a 0.064-T, self-shielding, portable MRI in ventilated patients in an ICU setting. SETTING: Academic medical center. PATIENTS: Nineteen patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection. Patients selected for imaging had any of the following: 1) unexplained encephalopathy or coma, 2) seizures, 3) focal neurologic deficit, or 4) abnormal head CT. Imaging was performed in each patient's ICU room with a portable, self-shielding, 0.064-T MRI. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among 19 patients, 20 MRI scans in seven ICUs were acquired between April 13, 2020, and April 23, 2020. No adverse events to patients or staff from MRI acquisition were reported. In 12 patients, abnormal findings were seen, which included increased fluid attenuated inversion recovery signal (n = 12), hemorrhage (n = 3), and diffusion-weighted imaging positivity (n =3). Imaging led to changes in clinical management in five patients. CONCLUSIONS: In this case series of patients, use of portable MRI has been found to be safe, feasible, and led to changes in clinical management based on imaging results. However, future studies comparing results with other imaging modalities are required to understand fully the extent of its clinical utility.

Psychosocial Correlates of Depression and Anxiety in the United Arab Emirates During the COVID-19 Pandemic.

The impact of the COVID-19 pandemic on mental health is likely to be significant. Identifying vulnerable groups during the pandemic is essential for targeting psychological support, and in preparation for any second wave or future pandemic. Vulnerable groups are likely to vary across different societies; therefore, research needs to be conducted at a national and international level. This online survey explored generalized anxiety and depression symptoms in a community sample of adults (N = 1,039) in the United Arab Emirates (UAE) between April 8th and April 22nd, 2020. Respondents completed symptom measures of depression (PHQ8) and generalized anxiety (GAD7), along with psychosocial and demographic variables that might potentially influence such symptoms. Bivariate and multivariate associations were calculated for the main study variables. Levels of anxiety and depression were notably higher than those reported in previous (pre-pandemic) national studies. Similar variables were statistically significantly associated with both depression and anxiety, most notably younger age, being female, having a history of mental health problems, self or loved ones testing positive for COVID-19, and having high levels of COVID-related anxiety and economic threat. Sections of the UAE population experienced relatively high levels of depression and anxiety symptoms during the early stages of the pandemic. Several COVID-related and psychosocial variables were associated with heightened symptomatology. Identifying such vulnerable groups can help inform the public mental health response to the current and future pandemics.

The role of perceived social support on depression and sleep during the COVID-19 pandemic.

The aim of the present study was to examine the role of perceived social support pertaining to a range of psychological health outcomes amongst individuals undergoing social isolation and social distancing during COVID-19. A total of 2,020 participants provided responses to an online cross-sectional survey comprised of validated instruments including the Multidimensional Scale of Perceived Social Support (MSPSS), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-9), the Brief Irritability Test (BITe) and the UCLA Loneliness Scale (UCLA-LS). Individuals experiencing self-isolation had significantly higher rates of depression, irritability and loneliness compared to those who were not. The risk for elevated levels of depression symptoms was 63% lower in individuals who reported higher levels of social support compared to those with low perceived social support. Similarly, those with high social support had a 52% lower risk of poor sleep quality compared to those with low social support. Social support was found to be significantly associated with elevated risk for depression and poorer sleep quality. The results contribute to our understanding of differential psychological outcomes for individuals experiencing anti-pandemic measures.