SARS-CoV-2 infection is associated with increased odds of insomnia, RLS and dream enactment behavior.

Background: Literature suggests that the COVID-19 pandemic has resulted in poor sleep quality, especially among the infected population. However, literature regarding the effect of COVID-19 pandemic and SARS-CoV-2 infection on occurrence of insomnia, restless legs syndrome and dream enactment behavior is either scarce or unavailable. Methods: This study was planned to assess the effect of SARS-CoV-2 infection on the occurrence of insomnia, restless legs syndrome (RLS) and dream enactment behavior (DEB). For this cross-sectional study, a questionnaire comprising of items related to demographic details, past medical history, and information related to SARS-CoV-2 infection was distributed through social media. Insomnia was diagnosed using clinical criteria. RLS, DEB, sleep quality, depression and anxiety were assessed using a validated questionnaire. Information regarding the use of hypnotic medications was also gathered. Results: Of the 1596 respondents, 37.2% reported disturbed sleep while insomnia was reported by 22.6% respondents. 27.3% of respondents reported RLS and 17.4% suffered DEB. The odds of insomnia were greater among males (OR = 1.27; 95% CI: 1.03-1.58; P < 0.02) and among those who had SARS-CoV-2 infection (OR = 1.76; 95% CI = 1.42-2.19; P < 0.001). Similarly, SARS-CoV-2 infection was also associated with increased odds of RLS (OR = 2.48; 95% CI = 1.98-3.11; P < 0.001) and DEB (OR = 1.58; 95%CI = 1.21-2.06; P < 0.001). Insomnia, RLS and DEB were more frequent among respondents who required oxygen therapy, those who experienced loss of taste and/or smell, depression and anxiety. Prevalence of insomnia, DEB and RLS was higher than said prevalence among respondents with no history of SARS-CoV-2 infection, but lower than that of those with positive history of SARS-CoV-2 infection. 5.3% of respondents reported taking hypnotic medications before infection, 7% during infection and 5.3% after infection. Conclusion: SARS-CoV-2-infection-related factors in association with environmental factors have increased the prevalence of insomnia, DEB and RLS among subjects having infection. SARS-CoV-2-associated immunological changes, hypoxia and neurotropism may play a role in occurrence of insomnia, DEB and RLS.

The Use of Telepsychiatry during Coronavirus Disease 2019: A Cross-sectional Study on Demographic and Clinical Profile of Those who Sought Help by Using this Facility

Aim: We aimed to study the demographic and clinical profile of patients who sought teleconsultation for psychiatric disorders from august 2020 to January 2021. Materials & Methods: In this cross-sectional descriptive study, data was retrieved from the telepsychiatry services and was analyzed to examine the demographic and clinical parameters of patients. Results: Atotal of 3444 teleconsultations were sought with a mean age of 37.78 ± 15.08. About 80% of the patients were in the age group of 20-60 years. Females outnumbered males with 1938 (56.3%) females and 1538 (43.7%) males. Mood disorders were the most frequent diagnosis with Major Depressive Disorder in 1572 (45.6%) and Bipolar Disorder in 636 (18.5%). Co-morbidity was present in 234 (6.8%) of the study group. The mean psychotropics prescribed were 1.95 ± 0.84. One, two, three and four psychotropics were prescribed in 918 (26.7%), 1470 (42.7%), 900 (26.1%) and 42 (1.2%) respectively. Those aged < 20 years or ≥ 60 years prescribed psychotropics at lower rates in comparison to the 20-60 years age group. Female patients had a significantly higher rate of psychotropic prescription than male patients. Three or four psychotropics were prescribed to those with co-morbidity at a significantly higher rate. Conclusion: Demographic and clinical profile of patients seeking treatment through telepsychiatry was found to be comparable with face-to-face outpatient consultations. Clinical Significance: With the development of clinical, operational, legal, and ethical guidelines for telepsychiatry practice, the systematic application of Information and Communication Technologies to the practice of mental healthcare is being rapidly adopted.

The Impact of COVID-19 On Comorbidities: A Review Of Recent Updates For Combating It.

Coronavirus disease is caused by the SARS-CoV-2 virus. The virus first appeared in Wuhan (China) in December 2019 and has spread globally. Till now, it affected 269 million people with 5.3 million deaths in 224 countries and territories. With the emergence of variants like Omicron, the COVID-19 cases grew exponentially, with thousands of deaths. The general symptoms of COVID-19 include fever, sore throat, cough, lung infections, and, in severe cases, acute respiratory distress syndrome, sepsis, and death. SARS-CoV-2 predominantly affects the lung, but it can also affect other organs such as the brain, heart, and gastrointestinal system. It is observed that 75 % of hospitalized COVID-19 patients have at least one COVID-19 associated comorbidity. The most common reported comorbidities are hypertension, NDs, diabetes, cancer, endothelial dysfunction, and CVDs. Moreover, older and pre-existing polypharmacy patients have worsened COVID-19 associated complications. SARS-CoV-2 also results in the hypercoagulability issues like gangrene, stroke, pulmonary embolism, and other associated complications. This review aims to provide the latest information on the impact of the COVID-19 on pre-existing comorbidities such as CVDs, NDs, COPD, and other complications. This review will help us to understand the current scenario of COVID-19 and comorbidities; thus, it will play an important role in the management and decision-making efforts to tackle such complications.

COVID-19 antibody seroprevalence in residential psychiatric inpatients

Aims While other mental health care outpatient facilities were moved to COVID-centers in March 2020 during the COVID-19 pandemic, the Institute of Mental Health and Neurosciences in Kashmir remained the only functional outpatient facility in the region. It is the only mental health care hospital in the country with a residential facility for psychiatric inpatients catering to the whole population of Jammu and Kashmir, India. The Mental Health Care Act 2017 that neccesitated “halfway homes” is yet to be implemented in the state leaving it's inpatients entirely under the institution's care. This study is to investigate the seroprevalence of antibodies to SARS-COVID-19 virus in the 34 residential inpatients in separate male (23 patients) and female (11 patients) wards. This was done as an audit to strategies and measures taken by the institute in protecting it's inpatients. Method 3 to 5 ml of peripheral venous blood samples were collected and plasma extracted and analysed using the CE-IVD Roche Cobas Elecsys AntiSARS-CoV-2, Electrochemiluminescence Immunoassay (ECLIA) for the qualitative detection of total Immunoglobulins (IgG, IgM and IgA;Pan Ig) generated against SARS-CoV-2 (Roche Diagnostics, Indianapolis, IN, USA). The test was performed according to the manufacturer's instructions. Result Out of the 34 inpatients, 2 male inpatients tested positive for antibodies against SARS-CoV-2 (seroprevalence of 5.88%). In comparison, based on a report conducted by the government's Department of Community Medicine and Biochemistry on the 28th of October 2020, out of 2,361 participants in the community, 959 tested positive (seroprevalence of 40.6%). One of the inpatients that tested positive was re-admitted after testing negative via RT-PCR. The second patient was admitted after being found homeless. He was tested negative on day 1 via RAT and on day 5 via RT-PCR. We believe both of them aquired the infection in the community. Conclusion This audit shows that the strategies implemented by the institute were effective in the prevention of the spread of COVID-19. Practical implementations of what works and improvisations are the proven methods of decreasing the mortality and morbidity in vulnerable populations while continuously providing vital mental health services.

Knowledge, attitudes, and practices about COVID-19 among Kashmiri population: A cross-sectional study.

BACKGROUND: Nations across the globe are investing enormous resources to contain the coronavirus disease 2019 (COVID-19) pandemic. Assessing community knowledge and behavior could help in designing effective health-care policies tailored to the need of target population. AIMS: We aimed to assess the knowledge, attitudes, and practices (KAP) about COVID-19 among Kashmiri population and to determine the association of KAP scores with the sociodemographic variables. SETTINGS AND DESIGN: This was a cross-sectional study conducted via various online platforms. MATERIALS AND METHODS: A structured questionnaire was formulated which was divided into three scoring sections assessing KAP about COVID-19 and a nonscoring section assessing individual reactions. A link to the survey was disseminated through social media platforms. A total of 1051 individuals participated. STATISTICAL ANALYSIS: Descriptive statistics were used for assessing the demographic characteristics of participants. Inferential statistics (Mann-Whitney U-test and Kruskal-Wallis test) were used for comparison. RESULTS: Majority of the participants belonged to the age group of 20-39 years (75.4%), were unmarried (66.6%), were from urban background (54.9%), and had education of above high school (96.3%). In general, scores suggested that participants possessed adequate knowledge (mean ± standard deviation: 10.07 ± 1.134), had good attitudes (11.85 ± 1.42), and followed good practices (12.26 ± 1.42) regarding COVID-19. However, we found the correlations between KAP scores to be weak. CONCLUSIONS: A knowledge-praxis gap was highlighted in the studied population which was especially true for the vulnerable age group of > 60 years. The findings call for attention of health-care policymakers to design need-based, locally adaptable, and practicable interventional strategies for target population.

Effectiveness of Azithromycin as Add-on Therapy in COVID-19 Management.

As winter is approaching us, the possibility of respiratory tract infection is rising in the current scenario due to the lack of Covid-19 prophylaxis. So no one could be safe until everyone is safe. Researchers are looking for the vaccine to remove the need for social distancing, mask-wearing, and social gathering worldwide. We cannot say about the vaccine's effectiveness if the vaccine is available. Several drugs are being tested to save people's life from the pandemic; azithromycin is one of them. This work is a review article with the updated findings of azithromycin in the context of COVID-19. The option of azithromycin regarding COVID-19 is justified by its anti-inflammatory, immunomodulatory, and anti-fibrotic effects and their pharmacokinetic properties, leading to effective concentrations in the target tissue. Azithromycin tends to be an effective candidate for SARS-CoV-2 replication inhibition that blocks the initial stage of the viral life cycle. Clinical trials at a preliminary scale and final stage show the significant results of azithromycin in supportive care therapy. Azithromycin was an early candidate for the medication of Covid-19 with or without hydroxychloroquine. It is exercised mainly as an outpatient antibiotic in COVID-19. In summing up, any primary anti-viral and antibiotic treatment is not the only possibility of fighting COVID-19 pharmacologically. It will be an injustice to those who require broader spectrum antibiotics if we do not use azithromycin. So significant research priority is needed to determine whether azithromycin is useful in the treatment of COVID-19.

Changes in sleep pattern and sleep quality during COVID-19 lockdown.

INTRODUCTION: To mitigate the spread of the pandemic coronavirus infection (COVID-19), governments across the world have adopted "lockdowns" which have confined many individuals to their homes. This disrupts normal life routines, elements of which are important circadian cues. The pandemic is also associated with new stressors, altered roles, and uncertainties about health and economic security, which are also likely to affect sleep. The current study is an online survey of sleep experience, routines, physical activity, and symptoms of anxiety and depression, to study the alterations associated with the lockdown. MATERIALS AND METHODS: The survey was conducted in early May 2020 using a questionnaire circulated through social media platforms. Questions related to demographic characteristics, current and previous sleep schedules, routine, and working patterns. Insomnia (Insomnia Severity Index - 4), Stress (Perceived Stress Scale - 4), anxiety and depressive symptoms (Patient Health Questionnaire - 4) and physical activity (International Physical Activities Questionnaire) were assessed using standardized instruments. RESULTS: A total of 958 valid responses were received. Compared to the prelockdown period, there was a shift to a later bedtime and waking time, with a reduction in night-time sleep and an increase in day-time napping. These effects were visible across occupational groups, but mostly affected working individuals except health professionals. Sleep quality deteriorated across groups. Reductions in sleep duration were associated with depressive symptoms. CONCLUSIONS: The COVID-19 lockdown is associated with changes in sleep schedule and in the quantity and quality of night-time sleep. Although these changes are associated with elevated rates of emotional symptoms, it is unclear from these cross-sectional results, whether sleep deterioration produces psychological distress, or vice versa.