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1.
Int J Ment Health Addict ; : 1-16, 2021 Nov 29.
Article in English | MEDLINE | ID: covidwho-2284840

ABSTRACT

The Fear of COVID-19 Scale (FCV-19S) assesses the fear of the novel coronavirus disease 2019 (COVID-19) and has been translated and validated into over 20 languages. The present study conducted confirmatory factor analysis (CFA) and item response theory (IRT) analyses on the FCV-19S among a sample of 937 Pakistani adults (mean [SD] age of 25.83 [11.80] years; 537 [57.3%] females). The CFA and IRT confirmed the unidimensionality of the FCV-19S. The Likert-type scale used in the FCV-19S was supported by the proper threshold orderings. Additionally, no DIF contrast had an absolute value larger than 0.5 regarding the participants' characteristics of gender, age, living status, and education in the IRT findings. The FCV-19S was found to be valid and reliable with strong psychometric properties among the Pakistani adult population.

2.
Cureus ; 14(7): e27021, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2072152

ABSTRACT

Introduction Diabetes and coronavirus disease 2019 (COVID-19) are interrelated. The presence of hyperglycemia per se during COVID-19 infection regardless of diabetes status has been associated with poor prognosis and increased risk of mortality. Objectives The main aim of the current study was to assess the association between admission hyperglycemia and COVID-19 outcomes. Methods This is a retrospective cohort study including 315 patients, mainly employed in the facility, who presented to the emergency department or were admitted with confirmed COVID-19 infection from April 2020 to August 2021. Results The mean age of the studied cohort was 40.2±12.5 years, where 59.68% were males and 37.7% were symptomatic. Older age, male gender, history of diabetes and hypertension, and elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels were associated with a significantly increased risk of developing cytokine release syndrome (CRS). Admission hyperglycemia was significantly associated with poor outcomes. The time to negativity was 9.30±0.1 days for asymptomatic patients; however, it increased significantly according to clinical presentation, presence of comorbidities, and severe outcomes, in patients with cytokine release syndrome. Conclusions Admission hyperglycemia was associated with an increased risk of progression to critical condition in patients hospitalized with COVID-19 independent of the history of diabetes. Therefore, it should not be overlooked but instead should be detected and appropriately treated to improve outcomes. In addition, post-COVID-19 care should be individualized, where severe cases require almost double the time needed by mild cases to convert to negative.

3.
J Pak Med Assoc ; 72(7): 1384-1390, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2057184

ABSTRACT

OBJECTIVE: To identify various emerging diagnostics parameters of coronavirus disease 2019 related to disease progression and fatality. METHODS: The cross-sectional study was conducted at Mardan Medical Complex, Khyber Pakhtunkhwah, Pakistan, from February 9, 2021, to April 21, 2021, and comprised patients of either gender aged >18 years diagnosed with coronavirus disease 2019 on the basis of polymerase chain reaction testing and who were admitted to the hospital using the World Health Organisation interim guidelines. Disease progression was categorised as mild, moderate, severe and critical, and they were monitored closely till the final outcome. Data was analysed using SPSS 26. RESULTS: Of the 408 patients, 215(52.69%) were male and 193(47.30%) were female. The overall median age of the sample was 55 years (interquartile range: 18-84 years). Symptoms included cough 92(22.54%), fever 80(19.60%), shortness of breath 78(19.60%), fatigue 60(14.70%) and loss of smell and test 52(12.74%), while 46(11.27%) were asymptomatic. Azithromycin was the most used drug 304(74.50%), while antiviral Remdesivir was given to 279(68.38%) patients and hydrocortisone to 143(35.04%). Plasma treatment was given to 55(13.48%) patients and mechanical ventilation to 87(21.32%). Compared to baseline, disease progression was mild in 72(17.64%) patients, moderate 96(23.52%), severe 98(24.01%) and critical in 89(21.81%), while no change was seen 53(12.99%) cases. Severity level was significantly associated with liver and renal function parameters (p<0.05). Overall, 47(11.51%) patients died. CONCLUSIONS: Different severity levels during hospitalisation among patients of coronavirus disease 2019 were noted, and severity level was significantly associated with liver and renal function parameters.


Subject(s)
COVID-19 , Adolescent , Adult , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , Azithromycin/therapeutic use , COVID-19/diagnosis , COVID-19 Testing , Cross-Sectional Studies , Disease Progression , Female , Humans , Hydrocortisone , Male , Middle Aged , SARS-CoV-2 , Young Adult
4.
Einstein (Sao Paulo) ; 18: eCE6032, 2020.
Article in English, Portuguese | MEDLINE | ID: covidwho-2026528
5.
Cureus ; 14(7), 2022.
Article in English | EuropePMC | ID: covidwho-1998306

ABSTRACT

Introduction Diabetes and coronavirus disease 2019 (COVID-19) are interrelated. The presence of hyperglycemia per se during COVID-19 infection regardless of diabetes status has been associated with poor prognosis and increased risk of mortality. Objectives The main aim of the current study was to assess the association between admission hyperglycemia and COVID-19 outcomes. Methods This is a retrospective cohort study including 315 patients, mainly employed in the facility, who presented to the emergency department or were admitted with confirmed COVID-19 infection from April 2020 to August 2021. Results The mean age of the studied cohort was 40.2±12.5 years, where 59.68% were males and 37.7% were symptomatic. Older age, male gender, history of diabetes and hypertension, and elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels were associated with a significantly increased risk of developing cytokine release syndrome (CRS). Admission hyperglycemia was significantly associated with poor outcomes. The time to negativity was 9.30±0.1 days for asymptomatic patients;however, it increased significantly according to clinical presentation, presence of comorbidities, and severe outcomes, in patients with cytokine release syndrome. Conclusions Admission hyperglycemia was associated with an increased risk of progression to critical condition in patients hospitalized with COVID-19 independent of the history of diabetes. Therefore, it should not be overlooked but instead should be detected and appropriately treated to improve outcomes. In addition, post-COVID-19 care should be individualized, where severe cases require almost double the time needed by mild cases to convert to negative.

6.
Front Neurol ; 13: 937989, 2022.
Article in English | MEDLINE | ID: covidwho-1957190

ABSTRACT

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease- 2019 (COVID-19), has been a global epidemic in our healthcare system. SARS-CoV-2 primarily affects the respiratory system, but neurological involvement has also been reported, including Guillain-Barré syndrome (GBS) development. Case Presentation: A 58-year-old male with known co-morbid hypertension and type 2 diabetes mellitus presented to the emergency room with complaints of worsening shortness of breath, dry cough, and fever for the past 10 days. On day 20 of hospitalization, he developed neurological symptoms after being tested positive for COVID-19. A neuroelectrophysiology study was conducted to evaluate neurological symptoms and suggested that the patient suffers from acute motor-sensory axonal polyneuropathy (AMSAN). CSF analysis showed elevated protein levels that confirmed the diagnosis of GBS. He was subsequently treated with oral prednisolone and IVIG, which improved neurological symptoms. Conclusion: Ever since the emergence of COVID-19, GBS has surfaced as to its potentially dangerous outcome. Healthcare professionals should be mindful of GBS and should rule it out in anyone having sensory symptoms or weakness during or after a COVID-19 infection. Its early detection and treatment can result in improved clinical outcomes.

7.
Vacunas ; 23: S125-S126, 2022.
Article in English | MEDLINE | ID: covidwho-1946805
8.
PLoS One ; 17(3): e0265328, 2022.
Article in English | MEDLINE | ID: covidwho-1938431

ABSTRACT

BACKGROUND: In the era of COVID-19 where there is emphasis on the importance of wearing a mask, wearing it rightly is equally important. Therefore, the purpose of this study was to assess the knowledge, attitude and practice of wearing a mask in the general population of a developing country at three major tertiary care hospital. MATERIALS AND METHODS: Participants of this cross-sectional study were patients and attendants at three major tertiary care hospital of Karachi Pakistan. Selected participants, through non-probability convenient sampling technique, were interviewed regarding knowledge, attitude, and practice of wearing mask using an Urdu translated version of a questionnaire used in an earlier study. Three summary scores (0 to 100) were computed to indicate participants' mask wearing practice, technique of putting it on, and technique of taking if off. Collected data were analyzed with the help of IBM SPSS version 19. RESULTS: A total of 370 selected individuals were interviewed, out of which 51.9% were male and mean age was 37.65±11.94 years. For more than 90% of the participants, wearing a face mask was a routine practicing during the pandemic. The mean practice score was 65.69±25.51, score for technique of putting on a face mask was 67.77±23.03, and score of technique of taking off a face mask was 51.01±29.23. Education level of participant tends to have positive relationship with all three scores, while presence of asthma or chronic obstructive pulmonary disease (COPD) as co-morbid had negative impact on mask wearing practice. CONCLUSION: We have observed suboptimal knowledge, attitude and practice of wearing mask among the selected individuals. There is a continued need to spread awareness and educate general population about the importance of using a face mask, as well as the proper technique of wearing and taking off a face mask.


Subject(s)
COVID-19/prevention & control , Masks/trends , Adult , Cross-Sectional Studies , Developing Countries/statistics & numerical data , Female , Health Knowledge, Attitudes, Practice , Humans , Knowledge , Male , Masks/statistics & numerical data , Middle Aged , Pakistan/epidemiology , Pandemics , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , Tertiary Care Centers
9.
Journal of Global Health ; 12, 2022.
Article in English | EuropePMC | ID: covidwho-1801608

ABSTRACT

Background The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs. Methods The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability;2) potential for burden reduction;3) potential for a paradigm shift;4) potential for translation and implementation;and 5) impact on equity. Results Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients’ needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts. Interpretation Health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.

10.
Ann Med Surg (Lond) ; 78: 103653, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1800212

ABSTRACT

Introduction: Mixed connective tissue disease (MCTD) is a rare autoimmune condition characterized by Scleroderma, Polymyositis, and Systemic Lupus Erythematous (SLE). Though a possible relationship between COVID-19 and autoimmune diseases has been recently reported, its pathophysiological mechanism behind flares in Lupus Nephritis (LN), a complication of SLE, remains unknown. Case presentation: A 22-year-old COVID-19 positive female presented with anemia, bilateral pitting edema, periorbital swelling, and posterior cervical lymphadenitis. Further inspection revealed lower abdominal striae, hepatosplenomegaly, and hyperpigmented skin nodules. Complete blood counts showed elevated inflammatory markers and excessively high protein creatinine ratio. Antinuclear antibody titers were elevated (anti-smith and U1 small nuclear ribonucleoprotein) and Rheumatoid Factor was positive. She was diagnosed with MCTD associated with a flare of LN. To control her lupus flare, a lower dose of steroids was initially administered, in addition to oral hydroxychloroquine and intravenous cyclophosphamide. Her condition steadily improved and was discharged on oral steroid maintenance medication. Discussion: We present a rare phenomenon of newly diagnosed LN, a complication of SLE, with MCTD in a PCR-confirmed COVID-19 patient. The diagnostic conundrum and treatment hurdles should be carefully addressed when patients present with lupus and COVID-19 pneumonia, with further exploration of the immuno-pathophysiology of COVID-19 infection in multi-systemic organ dysfunction in autoimmune disorders. Conclusion: In COVID-19 patients with LN and acute renal injury, it is critical to promptly and cautiously treat symptomatic flares associated with autoimmune disorders such as SLE and MCTD that may have gone unnoticed to prevent morbidity from an additional respiratory infection.

11.
Curr Psychol ; : 1-8, 2022 Feb 08.
Article in English | MEDLINE | ID: covidwho-1700210

ABSTRACT

The present study's aim is to find the prevalence of two of the common indicators of mental health - depression and anxiety - and any correlation with socio-demographic indicators in the Pakistani population during the lockdown from 5 May to 25 July 2020. A cross-sectional survey was conducted using an online questionnaire sent to volunteer participants. A total of 1047 participants over 18 were recruited through convenience sampling. The survey targeted depression and anxiety levels, which were measured using a 14 item self-reporting Hospital Anxiety and Depression Scale (HADS). Out of the total sample population (N=354), 39.9% suffered from depression and 57.7% from anxiety. Binary logistical regressions indicated significant predictive associations of gender (OR=1.410), education (OR=9.311), residence (OR=0.370), household income (OR=0.579), previous psychiatric problems (OR=1.671), and previous psychiatric medication (OR=2.641). These were the key factors e associated with a significant increase in depression. Increases in anxiety levels were significantly linked to gender (OR=2.427), residence (OR=0.619), previous psychiatric problems (OR=1.166), and previous psychiatric medication (OR=7.330). These results suggest depression and anxiety were prevalent among the Pakistani population during the lockdown. Along with other measures to contain the spread of COVID-19, citizens' mental health needs the Pakistani government's urgent attention as well as that of mental health experts. Further large-scale, such as healthcare practitioners, should be undertaken to identify other mental health indicators that need to be monitored.

12.
Int J Environ Res Public Health ; 18(19)2021 Sep 29.
Article in English | MEDLINE | ID: covidwho-1444198

ABSTRACT

Background: The unprecedented COVID-19 pandemic has resulted in social distancing and isolation which leads to insufficient physical activity and thereby increases sedentary behaviors. Hence, this study aimed to assess the prevalence of insufficient physical activity and sedentary behaviors among medical students during the COVID-19 lockdown in Pakistan, and to determine their associated factors. Methods: A cross-sectional online survey was carried out among 407 medical students from the Punjab and Sindh provinces between May and June 2020. To collect data, an e-questionnaire was sent to obtain informed consent along with questions concerning socio-demographics as well as an International Physical Activity Questionnaires-Short Form (IPAQ-SF). Results: As per the IPAQ, almost five in ten participants were physically inactive (48.2%), and 45.2% reported sedentary behaviors. Participants with insufficient physical activity were more likely to report sedentary behaviors than their counterparts (AOR = 2.53; 95% CI = 1.66-3.85, p < 0.001). The odds of insufficient physical activity were higher among the participants who did not strictly follow the COVID-19 preventive measures (AOR = 2.51; 95% CI = 1.35-4.69, p = 0.004); similarly, there were increased odds of sedentary behaviors observed among participants within a normal weight range compared to those who were underweight (AOR = 2.69; 95% CI = 1.76-4.11, p < 0.001). Conclusions: Insufficient physical activity and sedentary behavior are prevalent among medical students in Pakistan during the COVID-19 pandemic. These findings indicate the importance of establishing tailored policies and programs to encourage young adults to engage in physical activity.


Subject(s)
COVID-19 , Students, Medical , Communicable Disease Control , Cross-Sectional Studies , Exercise , Humans , Pakistan , Pandemics , SARS-CoV-2 , Sedentary Behavior , Surveys and Questionnaires , Young Adult
13.
Einstein (Säo Paulo) ; 18:eCE6032-eCE6032, 2020.
Article in English | LILACS (Americas) | ID: grc-742996
14.
Med Hypotheses ; 145: 110343, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-842726

ABSTRACT

ABO blood groups is a cheap and affordable test that can be immediately retrieved from COVID-19 patients at the diagnosis. There is increasing evidence that non-O blood groups have both higher susceptibility and higher severity of COVID-19 infections. The reason behind such relationship seems elusive. Regarding susceptibility, Non-O individuals have Anti-A antibodies which can prevent viral entry across ACE-2 receptors, moreover, Non-O individuals are at higher risk of autoimmunity, hypercoagulable state, and dysbiosis resulting in an augmented tendency for vascular inflammatory sequelae of COVID-19. We can conclude, on the diagnostic level, that ABO blood groups can be potentially used for risk stratification of affected COVID-19 patients, to anticipate the deterioration of patients at higher risk for complications. On a therapeutic level, plasma from normal O blood group individuals might potentially replace the use of convalescent serum for the treatment of COVID-19.


Subject(s)
ABO Blood-Group System , COVID-19 Serological Testing/methods , COVID-19/blood , COVID-19/diagnosis , Risk Assessment/methods , Antibodies/chemistry , Autoimmunity , COVID-19/immunology , COVID-19/therapy , Disease Progression , Female , Furin/metabolism , Gastrointestinal Microbiome , Humans , Immunization, Passive , Male , Pandemics , Thrombosis , COVID-19 Serotherapy
15.
Asia Pac J Public Health ; 32(8): 525-526, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-814436
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