ABSTRACT
Background: The existing literature on the mental health outcomes of frontline healthcare workers (HCWs) is silent over the psychosocial issues being faced by the housekeeping/hospital attendants (HAs) and sanitary attendants (SAs) who are also actively involved in COVID-19 patient care and in biomedical waste management. This group of HCWs can be considered as the "faceless corona warriors", and their psychosocial issues needs to be focussed upon too. Aim: To evaluate the psychosocial issues and problems related to issues specific to carrying out duties in COVID-19 wards among the HAs and SAs. Materials and methods: An interview-based approach (cross-sectional assessment) conducted by healthcare professionals in the local languages of the HAs and SAs was followed. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess depression and anxiety, respectively. Along with it, a self-designed questionnaire was added to evaluate the different emotional states and problems faced by the HAs and SAs during their COVID-19 duty.
ABSTRACT
Background: Liver function derangements have been reported in coronavirus disease (COVID-19) but reported rates are variable. Methods: We searched Pubmed and Embase with terms COVID and SARS-COV-2 from December 1, 2019 till April 5, 2020. We estimated overall prevalence, stratified prevalence based on severity, estimated risk ratio (RR) and estimated standardized mean difference (SMD) of liver function parameters in severe as compared to nonsevere COVID. Random effect method utilizing inverse variance approach was used for pooling the data. Results: In all, 128 studies were included. The most frequent abnormalities were hypoalbuminemia [61.27% (48.24 - 72.87)], elevations of gamma-glutamyl transferase (GGT) [27.94%(18.22 -40.27)], alanine aminotransferase (ALT) [23.28%(19.92 - 27.01)] and aspartate aminotransferase (AST) [23.41%(18.84 - 28.70)]. Further the relative risk of these abnormalities was higher in the patients with severe COVID-19 when compared to non-severe disease [Hypoalbuminemia - 2.65(1.38 - 5.07); GGT - 2.31(1.6 - 3.33); ALT - 1.76(1.44 - 2.15); AST 2.30(1.82 - 2.90)]. The SMD of hypoalbuminemia, GGT, ALT and AST elevation in severe as compared to nonsevere were -1.05(-1.27 - -0.83), 0.76(0.40 - 1.12), 0.42(0.27 - 0.56) and 0.69 (0.52 - 0.86) respectively. The pooled prevalence and RR of chronic liver disease as a comorbidity was 2.64% (1.73- 4) and 1.69(1.05-2.73) respectively. Conclusion: The most frequent abnormality in liver functions was hypoalbuminemia followed by derangements in gamma-glutamyl transferase and aminotransferases and these abnormalities were more frequent in severe disease. The systematic review was, however, limited by heterogeneity in definitions of severity and liver function derangements.