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1.
Front Psychiatry ; 12: 797545, 2021.
Article in English | MEDLINE | ID: covidwho-1603439

ABSTRACT

Objective: The COVID-19 pandemic poses unprecedented challenges to healthcare workers worldwide. This study sought to estimate the prevalence of depression, anxiety, and stress among healthcare workers in Saudi Arabia, and to identify the factors associated with these psychological disorders. Methods: A cross-sectional questionnaire-based study was conducted from January 21 to March 2, 2021. Physicians, pharmacists, nurses, and other healthcare workers from different parts of Saudi Arabia were recruited through snowball sampling. Psychological outcomes were measured using the Depression, Anxiety, and Stress Scale (DASS-21). Pearson's chi-square test was used to explore the bivariate association between diverse characteristics and each outcome. Multiple logistic regression analyses were performed to identify factors associated with depression, anxiety, and stress. Results: A total of 501 healthcare workers completed the survey, of whom 60% were female and nearly half were pharmacists. The majority (76.25%) of respondents reported that a family member, friend, or colleague had contracted COVID-19, and more than one-third (36%) knew someone who died due to COVID-19. Overall, the estimated prevalence rates of depression, anxiety, and stress were 54.69, 60.88, and 41.92%, respectively. The multivariate analysis revealed that healthcare workers with chronic diseases, nurses, and healthcare workers from the southern region were more likely to suffer from depression and stress. Further, individuals with positive COVID-19 test results showed a greater proportion of depressive symptoms compared to others. In addition, knowing someone who died due to COVID-19 and having a chronic illness were predisposing factors for anxiety. Conclusion: After more than a year, the prevalence of depression, anxiety, and stress remains substantial among healthcare workers in Saudi Arabia. The findings can help guide efforts to mitigate the psychological impact of the pandemic.

2.
Front Med (Lausanne) ; 8: 727593, 2021.
Article in English | MEDLINE | ID: covidwho-1555792

ABSTRACT

Novel Severe Acute Respiratory Syndrome-Corona Virus-2 infection (SARS-CoV-2) is an acute respiratory and infectious disease. This perspective aims to provide a basic understanding of the inflammation caused by SARS-CoV-2 and its relation to the trigeminal ganglion (TG). The virus enters through the mucous membranes of the orofacial region and reaches the TG, where it resides and takes control of its peptides including Substance P (SP). SP is the main neuropeptide, neuromodulator, and neuro-hormone of TG, associated with nociception and inflammation under noxious stimulus. SP release is triggered and, consequently, affects the immune cells and blood vessels to release the mediators for inflammation. Hence, cytokine storm is initiated and causes respiratory distress, bronchoconstriction, and death in complicated cases. Neurokinin-1 Receptor (NK-1R) is the receptor for SP and its antagonists, along with glucocorticoids, may be used to alleviate the symptoms and treat this infection by blocking this nociceptive pathway. SP seems to be the main culprit involved in the triggering of inflammatory pathways in SARS-CoV-2 infection. It may have a direct association with cardio-respiratory rhythm, sleep-wake cycle, nociception, and ventilatory responses and regulates many important physiological and pathological functions. Its over-secretion should be blocked by NK-1R antagonist. However, experimental work leading to clinical trials are mandatory for further confirmation. Here, it is further proposed that there is a possibility of latency in SARS-CoV-2 virus infection if it is acting through TG, which is the main site for other viruses that become latent.

4.
Front Pediatr ; 9: 629549, 2021.
Article in English | MEDLINE | ID: covidwho-1120412

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused overwhelming challenges in healthcare worldwide. During such an outbreak, some needs of high-risk groups who require regular follow-ups and long-term management are not met. The vulnerable populations include patients with Duchenne muscular dystrophy (DMD). Duchenne muscular dystrophy is characterized by respiratory complications caused by muscle weakness. Hence, patients with this condition are at high risk of severe diseases including COVID-19. Methods: To standardize care and provide optimal treatment to DMD patients in Saudi Arabia during the COVID-19 pandemic, a panel of experts including neurologists and pediatricians consolidated recommendations for healthcare professionals and caregivers. Results: During this pandemic, substituting unnecessary clinic visits with virtual clinic services was highly recommended, if possible, without compromising clinical outcomes. Duchenne muscular dystrophy patients with respiratory complications should be closely monitored, and those with cardiovascular complications must continue taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Moreover, individualized home-based rehabilitation management was preferred. Glucocorticoid and new gene correction therapies should be continued. However, new gene correction therapy must be post-poned in newly diagnosed patients. A multidisciplinary decision was required before the initiation of hydroxychloroquine based on the COVID-19 treatment protocol. Conclusion: COVID-19 has caused challenges and transformed access to health care. However, these limitations have provided opportunities for the health care system to adapt. Further, telemedicine has become a reliable platform for follow-up appointments that should be conducted by a multidisciplinary team including physicians, dieticians, and physical therapists.

5.
J Pediatric Infect Dis Soc ; 9(4): 510-513, 2020 Sep 17.
Article in English | MEDLINE | ID: covidwho-1072381

ABSTRACT

Coronavirus disease (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Physicians in China reported what is believed to be the first adult case of a SARS-CoV-2 infection associated with acute Guillain-Barré syndrome (GBS), followed by 5 adult Italian patients and another case in the United States. In the current report, we present one of the first descriptions of an association of GBS and SARS-CoV-2 infection in a child. In our facility, an 11-year-old boy presented with typical features of GBS and, after 5 days, a morbilliform skin rash over the palms of both hands. Three weeks before the start of the neurological symptoms, the boy had experienced an episode of mild febrile illness with mild respiratory manifestations and a persistent cough. The diagnosis of SARS-CoV-2 infection was confirmed by oropharyngeal swab on reverse-transcription polymerase chain reaction assay. The disease course of our patient strongly suggests a possible relationship between the development of GBS and SARS-CoV-2 infection. The case is discussed in view of previous case reports regarding the association of GBS and COVID-19.


Subject(s)
Coronavirus Infections/complications , Guillain-Barre Syndrome/virology , Pneumonia, Viral/complications , Betacoronavirus , COVID-19 , Child , Coronavirus Infections/therapy , Guillain-Barre Syndrome/therapy , Humans , Male , Pandemics , Pneumonia, Viral/therapy , SARS-CoV-2
6.
Cureus ; 12(12): e12200, 2020 Dec 21.
Article in English | MEDLINE | ID: covidwho-1041135

ABSTRACT

Introduction COVID-19 has been a gravitating topic in the past months, yet much information about this new virus is to be unraveled. The uncertainties about the virus and its effects have affected a lot of daily life activities. One of these affected activities is emergency department (ED) visits and how this disease might have changed people's perspective on when to go to an emergency. This study aims to assess the effect of the COVID-19 pandemic on emergency department visits for neurological conditions. Methods A retrospective record review study was conducted at King Abdul-Aziz University Hospital (KAUH) during the month of July 2020. The study included visits of patients with common neurological conditions (headache, seizures, and weakness), during December 2019 - May 2020 at KAUH. Information obtained from the medical records included demographic data, date of visit, the reason for the visit, history of a similar episode, number of ED visits during the past year, priority given at the ED, length of hospitalization, diagnosis of COVID-19 at KAUH, known chronic diseases, and whether brain imaging was performed with which kind of imaging. Descriptive analysis was conducted to assess the impact of the pandemic on ED visits and statistical analysis (chi-square test) was performed on ED visit data to assess for significance. Results There was a 24% reduction in the number of visits for common neurological symptoms (during the pandemic) time period in comparison to (pre-pandemic). However, some other variables have also shown an increase (during the pandemic) time period. Most notably, brain CT scans, which underwent an 11.3% increase during the pandemic time period (p=0.005). Some variables have shown no significant change, for example, the relationship between the time period and the reason for the visit (p=0.305). Conclusion Multiple factors most likely contributed to the decrease in emergency department visits recorded in this study. One of the main reasons is the fear of catching COVID-19 infection by just vising the hospitals. Considering these findings, it is predominant to raise awareness when patients do need to go to the emergency department due to an acute neurological condition regardless of any pandemic.

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