Separation and Discrimination: The Lived Experience of COVID-19 Survivors in Philippine Isolation Centers

Social isolation in times of pandemic can affect the well-being of individuals infected with a contagious disease. This study explores the lived experience of the 12 COVID-19 survivors placed in community-based isolation centers in Cebu City, Philippines and whose cases were mild and asymptomatic. In describing their lived experience, we employed Max van Manen's phenomenology of practice. Results show that the COVID-19 survivors have suffered more from the consequences of separation and discrimination than the disease's physiological effects. Educating the whole community about social responsibility and ethical behavior in dealing with COVID-19 survivors is essential to minimize social stigma and discrimination.

Relationship of Stressors and Psychosocial Support with Occurrence of Post-Traumatic Stress Disorder in Patients with Covid-19

Post Traumatic Stress Disorder (PTSD) is common in COVID-19 survivors and can be caused by a variety of stressors, including the duration of infection, severity, and location of isolation when infected with COVID-19. Furthermore, public anxiety caused by the rapid increase in the number of cases and deaths caused by COVID-19 plays a role in the occurrence of PTSD. To reduce the risk of mental disorders, psychosocial support is required. The purpose of this study was to describe the incidence of PTSD in COVID-19 survivors, to describe aspects of psychosocial support for COVID-19 survivors, and to assess the relationship between stressor factors and psychosocial support and the occurrence of PTSD in COVID-19 survivors. This research used an analytical observational research design with a cross sectional approach, involving 149 respondents aged 17-65 years, 52 men and 97 women from the COVID-19 survivor community known as COVID Survivor Indonesia (CSI) in DKI Jakarta. The Medical Outcomes Study-Social Support Survey (MOS-SSS) and The Impact Of Event Scale-Revised (IES-R) questionnaires were distributed via Google Form to collect data. Data was processed and analyzed using the Statistical Package for Social Sciences (SPSS) for Windows version 26.0, and results were analyzed using descriptive univariate and bivariate using Chi Square. There is a significant relationship between stressor factors and the occurrence of PTSD, specifically the duration of infection with COVID-19 (P = 0,026), severity when infected with COVID-19 (P = 0,027), and place of isolation when infected with COVID-19 (P = 0,023). Furthermore, there was a significant relationship between psychosocial support and the occurrence of PTSD (p = 0,001). Management of COVID-19 patients is required to detect stressor factors and provide psychosocial support so that COVID-19 survivors can return physical and psychological health. [ FROM AUTHOR] Copyright of International Journal of Multidisciplinary: Applied Business & Education Research is the property of Future Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Influencing factors associated with quality of life and depression among COVID-19 survivors during convalescence.

This study aims to investigate influencing factors of quality of life (QoL) and depression among COVID-19 survivors during convalescence. A cross-sectional study was conducted in November 2020 in Wuhan, China. Information on social support, physical activity, QoL and depressive symptoms were assessed using self-administered questionnaires. Multivariate linear regression and multivariate logistic regression were used to assess the risk factors of subdomains of QoL (physical component score (PCS) and mental component score (MCS)) and depression, respectively. A total of 151 COVID-19 survivors (68 males) aged 53.21 (SD: 12.70) years participated in the study. Multivariate linear regression showed that age (ß=-0.241), history of chronic disease (ß=-0.4.774), physical activity (ß = 2.47) and social support (ß = 0.147) were significantly associated with PCS, while having a spouse (ß = 9.571), monthly income (ß = 0.043) and social support (ß = 0.337) were significantly associated with MCS. Logistic regression suggested that participants aged 40-60 years (OR = 10.20, 95%CI: 1.41-73.82) or above 60 years (OR = 15.63, 95%CI: 1.87-131.00), with high school or above education (OR = 5.81, 95%CI: 1.24-27.20), with low/moderate physical activity (low, OR = 2.97, 95%CI: 1.14-7.77; moderate, OR = 3.42, 95%CI: 1.07-10.91) and low/medium social support (low, OR = 4.81, 95% CI: 2.02-11.43; medium, OR = 9.70, 95%CI: 1.17-80.10) were more likely to be depressed, while higher monthly income (≥3000 Yuan RMB/month) was associated with lower risk for depression (OR = 0.27, 95%CI: 0.09-0.82). These findings indicate COVID-19 survivors with older age, having chronic conditions, without a spouse, low monthly income, low level of physical activity and social support had significantly increased risks for poor QoL and depression, and more attention should be given to this population.

COVID-19 Vaccine Hesitancy Among Patients Recovered From COVID-19 Infection in Wuhan, China: Cross-Sectional Questionnaire Study.

BACKGROUND: Although patients recovered from COVID-19 already have immunity gained from natural infection, they are still at risk of reinfection due to the emergence of new variants of COVID-19 and the diminishing of naturally acquired immunity over time. Vaccination is associated with efficacious protection against COVID-19 infection and could boost infection-acquired immunity; however, various COVID-19 survivors have not been vaccinated due to vaccine hesitancy. OBJECTIVE: The aim of this study was to investigate COVID-19 vaccine hesitancy and related factors among COVID-19 survivors. METHODS: A cross-sectional questionnaire survey was conducted among patients who recovered from COVID-19 infection in Wuhan, China, between June 10 and July 25, 2021. The questionnaire included sociodemographic information, items on COVID-19 infection, the COVID-19 vaccine hesitancy scale based on the 3Cs (complacency, convenience, and confidence) model, trust in vaccine manufacturers and health facilities, and reasons for the decision to accept COVID-19 vaccination. Multivariate logistic regression analysis was used to assess the factors influencing COVID-19 vaccine hesitancy. RESULTS: Among the 1422 participants, 538 (37.8%) were not vaccinated against COVID-19. The COVID-19-recovered patients who self-reported having a current unhealthy status expressed more hesitancy about the COVID-19 vaccine than those who perceived themselves to be healthy (odds ratio [OR] 0.45, 95% CI 0.28-0.71). Compared to the asymptomatic patients, patients with mild symptoms were more likely to receive a COVID-19 vaccine (OR 1.67, 95% CI 1.02-2.82). Regarding the 3Cs model, high complacency (P=.005) and low convenience (P=.004) were significant negative factors for COVID-19 vaccination. Trust in vaccine manufacturers and health facilities was a significant positive factor for COVID-19 vaccination (OR 1.14, 95% CI 1.09-1.19). "Self-needs" was the main reason for patients to receive the COVID-19 vaccine, whereas "already have antibodies and do not need vaccination" was the main reason for patients to not receive the COVID-19 vaccine. CONCLUSIONS: Among the three major factors of vaccine hesitancy, complacency proved to be the most notable among COVID-19-recovered patients. Therefore, educational campaigns can focus on raising the awareness of risk of infection and the benefits of vaccination to reduce complacency toward vaccination among this population. In particular, for individuals who have recovered from COVID-19, improving factors related to convenience such as transportation, the environment of vaccination, and providing door-to-door service was also deemed necessary to facilitate their vaccination. In addition, addressing the concerns about vaccination of COVID-19-recovered patients could foster trust and promote their uptake of vaccination.

The effectiveness of incentive spirometry exercise on pulmonary function in COVID-19 survivors: a randomized controlled trial study

Background: COVID-19 survivors often result in persistent symptoms, even months after being discharged, that lead to decreased lung function. Incentive spirometry is commonly used in pulmonary rehabilitation as it encourages the patient to take slow and deep inspiration through visual feedback. This study aimed to analyze the effects of incentive spirometry exercise on pulmonary function in COVID-19 survivors. Method: Twenty COVID-19 survivors aged 18-59 were enrolled in the study and divided randomly into two groups;ten survivors in the experimental group that received incentive spirometry exercise and ten survivors in the control group that received diaphragmatic breathing exercise. Both exercises were performed five times daily, with ten repetitions each for four weeks. Peak expiratory flow (PEF) was measured by a peak flow meter before and after the treatment in both groups. The data were analyzed statistically. Result: There was a significant increase in pulmonary function in the experimental group (p=0.001) and control group (p=0.001). However, the two groups had no significant difference in pulmonary function (p=0.198). The incentive spirometry exercise shows a more significant effect on pulmonary function rather than diaphragmatic breathing. Conclusion: Incentive spirometry exercise could be an alternative therapy to improve the pulmonary function of COVID-19 survivors. © 2023, Sanglah General Hospital. All rights reserved.

Lessons from the stigma of COVID-19 survivors: A Marxist criticism appraisal.

Stigma refers to devalued stereotypes that create barriers for stigmatized individuals. During the COVID-19 pandemic, the stigmatization of survivors worsened existing inequalities and triggered mass hysteria. The paper delves into the stigmatization experienced by COVID-19 survivors and the role of Marxist criticism in analyzing this issue. The main findings from the empiricist tradition approach suggest that the perception of COVID-19 stigma is higher among those who are older, belong to ethnic minorities, lack social support, have manual occupations, and possess lower levels of education. The proposed destigmatization pathways include psychological counseling services, social support, and health education. Employing a Marxist perspective can aid in illuminating how economic practices and material conditions influence prevalent ideologies related to stigma. The stigmatization of COVID-19 survivors may be perceived as a consequence of social power inequality, although the current emphasis on individual characteristics as triggers for stigma may neglect the wider systemic forces in operation. Thus, it's crucial to establish improved social care policies to combat exploitation and oppression due to power imbalances. The ultimate objective of such an examination is to identify effective approaches to tackle and eradicate stigma regarding health-related concerns. An interdisciplinary approach integrating a pluralistic perspective would benefit investigating how social systems and individual attributes contribute to the exacerbation of social inequality and stigmatization.

Poster Presentation: AB No: 62: Comparison of Functional Capacity and Peak Expiratory Flow Rate in Covid-19 survivors with Healthy Individuals – A Pilot Study

Purpose: To compare functional capacity and peak expiratory flow rate in COVID-19 survivors and healthy individuals.Relevance of study: COVID 19 has shown to affect the lung parenchyma. For physiotherapists, as they deal with maximising functional potential of patients, knowing status of functional capacity and lung function of COVID-19 survivors may help in understanding patients' problem more effectively and also in making appropriate clinical decisions. Participants: Fifty participants from community of Ahmedabad, males and females of age group 50–65 years, with (group A) & without (group B) history of COVID-19 in the past 12 months, will be included in the study by convenience sampling. Patients with severe musculoskeletal, neurological & cardiac problems, recent injury, fever, cough & cold are excluded. Method: Observational analytical study was conducted. 6minute walk distance for functional capacity and peak expiratory flow rate with a peak flow meter, was obtained. Analysis: Data analysis for 14 participants was done using SPSS version 16 and Microsoft excel 2019. Data was screened for normality using Levene's test. Between group comparison for 6MWD and PEFR was done using Mann-Whitney U test. Level of significance kept at 5%. Results: Mean age in group A was (58.0 + 4.47) years, and in group B was (59.2 + 5.49)years. Difference in mean+SD for PEFR in L/min for group A (414.29 + 186.44) and Group B (344.29 + 66.29) was not significant (U=20, p=0.562). Difference in mean + SD for 6MWD group A (414.76 + 101.99), Group B (481.69 + 90.24) was not significant (U= 13.5, p=0.15). Conclusion: Study is still going. Implications: If the peak expiratory flow rate and functional capacity are reduced post COVID, there will be a need to manage the same.

One year health-related quality of life after discharge: a prospective cohort study among COVID-19 ICU survivors

Considering the paucity of data on long-term Health-Related Quality of Life (HRQoL) in coronavirus disease 2019 (COVID-19) intensive care unit (ICU) survivors, we present one-year follow-up results on patients' HRQoL and compare them with those of the already reported 6-month follow-up. We conducted a prospective cohort study of patients in COVID-19 ICU between March and June 2020. A HRQoL analysis was performed six months and 1 year after discharge by means of a short-form-36 (SF-36) questionnaire. Hospital mortality in 403 ICU COVID-19 patients was 44.9%;further 4.0% died between hospital discharge and 6-month follow-up and only 0.5% died in the next six months. The median physical component of HRQoL increased from 43.7 (interquartile range (IQR): 31.7-52.7) at 6 months to 46.0 (IQR: 38.0-53.0) 1 year after hospital discharge (p = 0.007). In multivariable regression analysis, age >50 (odds ratio (OR) 0.270) and female sex (OR 0.144) were independently associated with reduced physical HRQoL 1 year after discharge. The median mental component of HRQoL increased from 50.6 (IQR: 42.0-55.8) at 6 months to 53.0 (IQR: 47.0-56.0) 1 year after discharge (p = 0.035), with no significant predictors. Increased HRQoL was associated with an improvement in patients' physical status, role functioning, emotional well-being (all p < 0.001) and social functioning (p = 0.007). ICU COVID-19 patients' HRQoL slightly improved 1 year after discharge, when compared to results of the 6-month follow-up. Medications received during ICU stay had no effect on physical or mental HRQoL.Copyright © 2023 The Author(s). Published by MRE Press.

Where Do We Go After Surviving the Virus? Cross-Country Documentary Analysis of the Social Consequences Faced by COVID-19 Survivors.

In this study, we attempted to move beyond the skewed discussions on stigma to unravel other social consequences that are experienced by persons who have recovered from COVID-19. We conducted a documentary review of published news reports from 14 highly ranked news portals in Ghana and Malaysia (published between 1st January 2020 and 30th August 2020) that contained personal accounts from the recovered patients about their lived experiences with the virus and social consequences encountered after recovery. Narratives from the recovered patients were extracted and analyzed following the narrative thematic analysis procedure. Common themes identified from the narratives included: 1) Stigma impacting mental health, 2) Assault and abuse 3) Experiences of treatment. The findings show the need for interprofessional collaboration between social and health care professionals such as social workers, community health workers, medical practitioners and psychologists to prevent and address issues of abuse and other social consequences experienced by COVID-19 survivors.

Surviving COVID-19: Biopsychosocial Impacts, Death Anxiety, and Coping Strategies.

As the COVID-19 pandemic erupted, attempts to contain the spread of the virus took two concurrent forms, including mobility restrictions (aka lockdowns) and the race to produce a vaccine. However, it is quite striking that, amidst both the lockdown and the race to produce a vaccine, the question of how COVID-19 survivors/patients coped with the disease has not received the degree of attention it deserved. To navigate this issue, we employed a sample consisting of 100 COVID-19 survivors; this paper explores the relationship between the biopsychosocial (BPS) impacts of COVID-19, death anxiety, and coping strategies. In this context, the mediating role of death anxiety is placed in the spotlight. The analysis reveals a significant positive association between the BPS impact of COVID-19 and death anxiety and a significant negative association between death anxiety and coping strategies among COVID-19 survivors. Thus, death anxiety mediates the relationship between the BPS impact and the coping strategies that COVID-19 survivors adopt. Given the general recognition of the validity of the BPS model in contemporary medical science and practice, a thorough examination of COVID-19 survivors and their experiences related to surviving is necessary to match the challenges of today, including the increased probability of pandemics.

Loneliness, internalizing symptoms, and inflammatory markers in adolescent COVID-19 survivors.

BACKGROUND: Concerns about the psychiatric sequelae after COVID-19 infection have increased as the pandemic spreads worldwide. The increase in self-isolation during this pandemic period has also revealed the importance of feelings of loneliness. This study aimed to examine the relationship between baseline inflammation levels, internalizing symptoms, and feelings of loneliness in adolescent COVID-19 survivors in the long term. METHODS: A total of 74 adolescents (41 girls, 55.4%, mean age 14.88) and their parents were included in the study. This cross-sectional study assessed internalizing symptoms via Revised Children's Anxiety and Depression Scale (RCADS) and feelings of loneliness using the UCLA-loneliness scale. Baseline inflammatory markers at COVID-19 diagnosis were collected. Logistic regression analysis was used to determine predictors for depression in adolescents. RESULTS: The most common disorder was Major Depressive Disorder (MDD) (25.7%), and 33.8% of the adolescents were in the clinical range in at least one internalizing domain. Baseline C-Reactive Protein (CRP) levels correlated weakly with MDD scores. Loneliness scores correlated with all internalizing symptoms, strong association with MDD scores. Loneliness, anxiety, and parental anxiety were associated with an increased likelihood of MDD. Baseline CRP positivity did not predict MDD in adolescent COVID-19 survivors. CONCLUSIONS: This study indicates that anxiety, loneliness, and parental anxiety play an important role in adolescents' experience of depressive symptoms after COVID-19 infection. Thus, screening parental psychopathology and loneliness in COVID-19 survivors seems to be preventive for adolescent mental health problems.

Long-term health consequences of COVID-19 in survivors hospitalised at a tertiary care hospital and their correlation with acute COVID-19 severity and associated risk factors.

OBJECTIVES: To determine post-COVID syndromes in the Indian population, correlating a wide spectrum of post-COVID manifestations with acute disease severity and associated risk factors. BACKGROUND: Post-COVID Syndrome (PCS) is defined as signs and symptoms that develop during or after acute COVID-19 infection. DESIGN OF STUDY: This is a prospective observational cohort with repetitive measurements. METHODS: The study followed RT-PCR confirmed COVID-19-positive survivors discharged from HAHC Hospital, New Delhi, for a period of 12 weeks. The patients were interviewed over the phone at 4 weeks and 12 weeks from the onset of symptoms for evaluation of clinical symptoms and health-related quality of life parameters. RESULTS: A total of 200 patients completed the study. At the baseline, 50% of the patients were categorised as severe based on their acute infection assessment. At 12 weeks after symptom onset, fatigue (23.5%), hair loss (12.5%) and dyspnea (9%) were the main persistent symptoms. The incidence of hair loss (12.5%), memory loss (4.5%) and brain fog (5%) were found to be increased as compared to the acute infection period. Severity of the acute COVID infection behaved as an independent predictor for the development of PCS, with high odds of experiencing persistent cough (OR = 13.1), memory loss (OR = 5.2) and fatigue (OR = 3.3). Further, 30% of subjects in the severe group experienced statistically significant fatigue at 12 weeks (p < .05). CONCLUSION: From the results of our study, it can be concluded that there is a huge disease burden of post-COVID Syndrome (PCS). The PCS comprised multisystem symptoms ranging from serious complaints of dyspnea, memory loss and brain fog to non-serious complaints of fatigue and hair loss. Severity of the acute COVID infection behaved as an independent predictor for the development of PCS. Our findings strongly recommend vaccination against COVID-19, for protection from disease severity as well as prevention of PCS. RELEVANCE TO CLINICAL PRACTICE: The findings of our study support the multidisciplinary approach required for the management of PCS with a team comprising of physicians, nurses, physiotherapists and psychiatrists working in close coordination for the rehabilitation of these patients. As nurses are considered the most trusted professionals in the community and the class of health workers associated with rehabilitation, focus should be given to educating them on PCS, which would prove to be an important strategy for efficient monitoring and long-term management of COVID-19 survivors.

Stigma, Sociodemographic Factors, and Clinical Factors Associated with Psychological Distress among COVID-19 Survivors during the Convalescence Period: A Multi-Centre Study in Malaysia.

High rates of psychological distress among COVID-19 survivors and stigmatisation have been reported in both early and late convalescence. This study aimed to compare the severity of psychological distress and to determine the associations among sociodemographic and clinical characteristics, stigma, and psychological distress among COVID-19 survivors across two different cohorts at two different time points. Data were collected cross-sectionally in two groups at one month and six months post-hospitalisation among COVID-19 patient from three hospitals in Malaysia. This study assessed psychological distress and the level of stigma using the Kessler Screening Scale for Psychological Distress (K6) and the Explanatory Model Interview Catalogue (EMIC) stigma scale, respectively. At one month after discharge, significantly lower psychological distress was found among retirees (B = -2.207, 95% confidence interval [95% CI] = -4.139 to -0.068, p = 0.034), those who received up to primary education (B = -2.474, 95% CI = -4.500 to -0.521, p = 0.014), and those who had an income of more than RM 10,000 per month (B = -1.576, 95% CI = -2.714 to -0.505, p = 0.006). Moreover, those with a history of psychiatric illness [one month: (B = 6.363, 95% CI = 2.599 to 9.676, p = 0.002), six months: (B = 2.887, CI = 0.469-6.437, p = 0.038)] and sought counselling services [one month: (B = 1.737, 95% CI = 0.385 to 3.117, p = 0.016), six months: (B = 1.480, CI = 0.173-2.618, p = 0.032)] had a significantly higher severity of psychological distress at one month and six months after discharge from the hospital. The perceived stigma of being infected with COVID-19 contributed to greater severity of psychological distress. (B = 0.197, CI = 0.089-0.300, p = 0.002). Different factors may affect psychological distress at different periods of convalescence after a COVID-19 infection. A persistent stigma contributed to psychological distress later in the convalescence period.

Stress and mental health of COVID-19 survivors and their families after hospital discharge: relationship with perceived healthcare staff empathy.

Several studies attest to the long-term consequences of COVID-19 infection on survivors' mental illness, especially in terms of high prevalence of post-traumatic stress disorder (PTSD) 1-3 months after hospitalization. Aims of the present study were (1) to jointly evaluate PTSD and positive mental health among COVID-19 survivors and family members after hospital discharge, and (2) to investigate the relationship between perceived healthcare staff's relational empathy during hospitalization and survivors' post-traumatic stress levels. In this cross-sectional study, 60 survivors (Mage = 60.45; 63.3% men) and 40 family members (Mage = 52.33; 60% women) participated in an online survey 3-7 months after hospital discharge. In addition to providing socio-demographic data, they completed PTSD Checklist for DSM-5 and Mental Health Continuum Short Form. Survivors also completed the Consultation and Relational Empathy measure. Percentages of participants meeting a provisional PTSD and mental health diagnosis (flourishing, moderate, languishing) were calculated. A hierarchical regression analysis was performed on survivors' data, with perceived staff's empathy as predictor and post-traumatic stress symptoms (PTSS) as outcome. One-fifth of the participants received a provisional PTSD diagnosis, about half were diagnosed with flourishing or moderate mental health, and only 5% were languishing, with no significant between-group differences. Among survivors, a negative association was detected between perceived healthcare staff's empathy and PTSS, explaining 10.5% of the model variance over and above demographic and clinical variables. Findings highlighted the coexistence of PTSD and positive mental health among survivors and family members, suggesting the usefulness of assessing both negative and positive dimensions of mental health, in order to promote psycho-social adaptation once returning to everyday life. In addition, the role of compassionate care in clinical practice emerged as a potential means to mitigate severe traumatic reactions among survivors.

Functional and Clinical Characteristics of Individuals Attending Pulmonary Rehabilitation After Severe COVID-19.

BACKGROUND: A proportion of patients with COVID-19 need hospitalization due to severe respiratory symptoms. We sought to analyze characteristics of survivors of severe COVID-19 subsequently admitted to in-patient pulmonary rehabilitation and identify their rehabilitation needs. METHODS: From the COVID-19 Registry of Fondazione Don Gnocchi, we extracted 203 subjects admitted for in-patient pulmonary rehabilitation after severe COVID-19 from April 2020-September 2021. Specific information on acute-hospital stay and clinical and functional characteristics on admission to rehabilitation units were collected. RESULTS: During the acute phase of disease, 168 subjects received mechanical ventilation for 26 d; 85 experienced delirium during their stay in ICU. On admission to rehabilitation units, 20 subjects were still on mechanical ventilation; 57 had tracheostomy; 142 were on oxygen therapy; 49 were diagnosed critical illness neuropathy; 162 showed modified Barthel Index < 75; only 51 were able to perform a 6-min walk test; 32 of 90 scored abnormal at Montreal Cognitive Assessment; 43 of 88 scored abnormal at Hospital Anxiety and Depression Scale; 65 scored ≥ 2 at Malnutrition Universal Screening Tool, and 95 showed dysphagia needing logopedic treatment. CONCLUSIONS: Our analysis shows that subjects admitted for in-patient pulmonary rehabilitation after severe COVID-19 represent an extraordinarily multifaceted and clinically complex patient population who need customized, comprehensive rehabilitation programs carried out by teams with different professional skills. The need for step-down facilities, such as sub-intensive rehabilitation units, is also highlighted.

COVID-19 perceived stigma among survivors: A cross-sectional study of prevalence and predictors.

Background and objectives: Perceived stigma related to infectious diseases is of public health importance and can adversely impact patients' physical and mental health. This study aims to identify the level of perceived stigma among COVID-19 survivors in Qatar and investigate its predictors. Methods: An analytical cross-sectional design was employed. Four hundred and four participants who had a positive COVID-19 PCR test were randomly selected from medical records. The selected participants were interviewed to collect sociodemographic and health-related information. Perceived stigma was assessed using the COVID-19 perceived stigma scale-22 (CPSS-22) that was developed by the researchers. A descriptive analysis followed by a bivariate analysis investigated possible associations between the perceived stigma levels and independent variables. A multivariable analysis was performed using logistic regression to identify any significant associations with perceived stigma. The validity and reliability of the developed tool were also tested. Results: The prevalence of COVID-19 perceived stigma was twenty-six percent (n=107, 26.4%) at 95% CI [22.4-30.4]. Factors associated with higher COVID-19 perceived stigma were male gender, being a manual worker, non-Arabic ethnicity, low educational level, living alone, and being isolated outside the home. However, only occupation, ethnicity, and low educational level predicted COVID-19 perceived stigma in multivariable analysis. The CPSS-22 showed excellent reliability (Cronbach's alpha 0.92). Conclusion: Perceived stigma was relatively common among participants. Designing programs and interventions targeting male manual workers and those of low-educational levels may assist policymakers in mitigating the stigma related to COVID-19.

Validation of the Malay Version of the Explanatory Model Interview Catalogue Stigma Scale among Covid-19 Survivors in Malaysia

The Coronavirus disease (COVID-19) imparted unprecedented negative impact worldwide since it was declared as a global pandemic in 2020 due to its high infectivity and mortality rate. Consequently, those who have been infected with COVID-19 experienced significant amount of social stigma which resulting in deterioration of mental well-being. Hence, this study aimed to translate the Explanatory Model Interview Catalogue Stigma Scale (EMIC-SS) into Malay and investigate the reliability and validity of the Malay version (EMIC-SS-M) among COVID-19 survivors in Malaysia. Initially, concurrent translation and back translation of the EMIC-SS was conducted followed by the assessment of its face and content validity. Then, the EMIC-SS-M was administered to 219 COVID-19 survivors recruited from three targeted centers for assessment of its reliability (internal consistency) and validity (convergent and discriminant validity, exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]). The EMIC-SS-M reported an acceptable internal consistency with Cronbach's alpha of 0.727, while its domains reported acceptable Cronbach's alpha ranged from 0.708 to 0.795. EFA and CFA confirmed that the EMIC-SS-M consisted of 15 items in 4 domains. The EMIC-SS-M exhibited good psychometric properties and ready for use to assess stigma among COVID-19 survivors in Malaysia. It can be adapted for use to assess stigma in other disease conditions among the Malaysian population in future studies. Copyright © 2022, Faculty of Medicine, University of Malaya. All rights reserved.

"As if we are branded with the mark of Cain": stigma, guilt, and shame experienced by COVID-19 survivors in Israel - a qualitative study.

Stigma is associated with harmful health outcomes, and it fuels social and health inequalities. It can undermine social cohesion and encourage social exclusion of groups, which may contribute to secrecy about disease symptoms, avoidance of disease testing and vaccination, and further spread of a contagious illness. Stigmatization is a social process set to exclude those who are perceived to be a potential source of disease and may pose a threat to effective interpersonal and social relationships. In this qualitative study, we delved into the stigmatization experiences of twenty COVID-19 recovered patients during the COVID-19 first wave, using in-depth semi-structured interviews conducted during November 2020. Using thematic analysis, we found that the process of stigmatization was all-encompassing, from the stage of diagnosis throughout the duration of the disease and the recovery phases. On the basis of the data, we hypothesized that stigma is a significant public health concern, and effective and comprehensive interventions are needed to counteract the damaging and insidious effects during infectious disease pandemics such as COVID-19, and reduce infectious disease-related stigma. Interventions should address provision of emotional support frameworks for the victims of stigmatization and discrimination that accompany the COVID-19 pandemic and future pandemics. This study was conducted in the early days of the COVID-19 pandemic, when uncertainty about the disease was high and fear of contamination fueled high levels of stigmatization against those who became ill with Covid-19.

Determinants of 1-Year Adverse Event Requiring Re-Hospitalization in COVID-19 Oldest Old Survivors.

The incidence of "Long COVID" syndrome appears to be increasing, particularly in the geriatric population. At present, there are few data regarding the relationship between long COVID and the risk of re-hospitalization in the oldest old survivors. Patients older than 80 years consecutively hospitalized for COVID-19 in our tertiary care hospital were enrolled and followed after discharge in a 12-month ambulatory program. A comprehensive geriatric assessment (CGA), including functional capabilities and physical and cognitive performances, was performed at 6-month follow-up. Frailty degree was assessed using a 30-item frailty index. The re-hospitalization rate was assessed at 12-month follow-up through a computerized archive and phone interviews. Out of 100 patients discharged after hospitalization for COVID-19 (mean [SD] age 85 [4.0] years), 24 reported serious adverse events requiring re-hospitalization within 12 months. The most frequent causes of re-hospitalization were acute heart failure (HF), pneumonia and bone fracture (15.3% each). By multivariate logistic analysis, after adjustment for potential confounders, history of chronic HF [aOR: 3.00 (CI 95%: 1.10-8.16), p = 0.031] or chronic renal failure [aOR: 3.83 (CI 95%: 1.09-13.43), p = 0.036], the burden of comorbidity [(CIRSc) aOR: 1.95 (CI 95%: 1.28-2.97), p = 0.002] and frailty [aOR: 7.77 (CI 95%: 2.13-28.27), p = 0.002] resulted as independent predictors of re-hospitalization. One-fourth of the oldest old patients previously hospitalized for COVID-19 suffered from adverse events requiring re-hospitalization, two-thirds of them within three months after discharge. Frailty, the burden of comorbidity, history of chronic HF or chronic renal failure, but not COVID-19 disease severity, independently predicted re-hospitalization.

Predictors of Post Covid Syndrome among Covid Survivors Patients attending Post Covid Out-Patients Clinic

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic remains a constant challenge for healthcare systems and affects the well-being of many individuals. The objective of the current study is to determine the parameters that can predict post COVID-19 sequale and incidence of post Covid sequale among Covid survivor's patients attending post covid outpatient clinic. Patients and methods: This was a case control study carried out on 60 COVID-19 survivors whom were recovered from the acute illness and discharged for follow-up at the post covid out-patient clinic at Zagazig University. The sixty patients included in the study were divided to Group I: (Asymptomatic patients): include 30 patients whom were discharged for follow-up and in whom no significant symptoms or signs were reported during the study. Group II: (Symptomatic patients): include 30 patients whom were discharged for follow-up and in whom there were significant symptoms or signs during the study. Results: There is statistically significantly association between initial parameters high (CRP, D-dimer, ferritin, LDH, IL6) and low Lymphocytes. Post covid degree of lung affection in chest CT scan where Grade ≥5 (severe lung affection) prevailed in 63.3% and 20% in those with and without post covid syndrome, respectively, while Grade <2 (less sever lung affection) was more dominant in those without post covid (30% vs. 6.7%). Conclusion: Persistence of symptoms is common after the acute phase of COVID-19 infection. Post covid syndrome occurs regardless of the disease severity. High CRP, LDH, ferritn, D-dimer, and IL6, low Lymphocytes and degree of lung affection at diagnosis of acute covid19 may be good predictors for the occurrence of post covid syndrome. © 2022, Ain Shams University Faculty of Medicine. All rights reserved.