Cardiometabolic and psychocognitive features of the post-COVID period in patients with atrial fibrillation.

The number of people with long-term consequences of COVID-19 is increasing worldwide. The long-term prognosis for patients remains poorly understood. Objective. To study cardiometabolic and psychocognitive features in comorbid elderly patients with atrial fibrillation (AF), de-pending on the presence of post-COVID syndrome (PCS). Material and methods. The observational analytical cohort study included 223 patients with AF and comorbidity (coronary artery disease, hypertension, obesity, type 2 diabetes mellitus) aged 60-74, who were divided into two groups: group 1 included 123 patients without COVID-19 and group 2 included 110 patients with a history of COVID-19 and the presence of PCS. The study evaluated laboratory and instrumental tests, and a general clinical study assessing psychocognitive disorders using the SPMSQ and HADS questionnaires was conducted. Results and discussion. In COVID-19 survivors, compared with patients of group 1, there were more pronounced atherogenic changes in total cholesterol (TC) (p=0.003), low-density lipoprotein cholesterol (p<0.001), and triglycerides (p=0.011). Lower dia-stolic blood pressure was found in COVID-19 survivors (p<0.001). In addition, patients in group 2 had higher median pulse pressure (p<0.001) and heart rate (p<0.001). In group 2 patients, a larger ascending aorta diameter was observed (p<0.001). The anx-iety-depressive syndrome was more common in COVID-19 survivors with comorbidities, and a statistically significant difference was found in clinical anxiety (24%, p=0.041) and subclinical depression (21%, p=0.015). When assessing cognitive function, mod-erate cognitive impairment was detected in 22% (p=0.005) of patients with PCS and severe cognitive impairment in 2% (p=0.007). Conclusion. In comorbid elderly patients with the post-COVID syndrome, a high prevalence of psychocognitive disorders and adverse cardiometabolic changes were observed, supporting the need for long-term monitoring of the general clinical condition and psychocognitive status of COVID-19 survivors.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

Glucosaminylmuramyl dipeptide efficacy in post-COVID-19 patient rehabilitation treatment.

The COVID-19 pandemic has altered people's lifestyles around the world. Prevention of recurrent episodes of the disease and mitigation of its consequences are especially associated with effective post-COVID-19 rehabilitation in patients. The aim of the study was to evaluate the effects of the drug Likopid (glucosaminylmuramyl dipeptide, GMDP) for post-COVID-19 rehabilitation in patients. Material and methods. Patients who recovered from mild to moderate COVID-19 (n=60, mean age 54+/- 11.7 years) were randomized into the observation group (n=30, 15 men and 15 women) who received 2 courses of Licopid (1 mg twice a day) and the comparison group (n=30, 15 men and 15 women). Analysis of the phenotypic and functional characteristics of the innate immune cellular factors was carried out before the start of immunomodulatory therapy, immediately after the end of the course, and also after 6 months observations. In order to assess the quality of life of all patients, we used the SF-36 Health Status Survey and the Hospital Anxiety and Depression Scale questionnaires. Results. During assessing the effect of immunomodulatory therapy on the parameters of innate immunity of patients at the stage of rehabilitation after COVID-19, an increase in the protective cytolytic activity of CD16+ and CD8+Gr+ cells, as well as a persistent increase in TLR2, TLR4 and TLR9 expression was found, which indicates the antigen recognition recovery and presentation at the level of the monocytic link of the immune system. The use of GMDP as an immunomodulatory agent resulted in an 8-fold reduction in the frequency and severity of respiratory infections due to an increase in the total monocyte count. As a result of assessing patients' quality of life against the background of the therapy, a positive dynamic in role functioning was revealed in patients. In the general assessment of their health status, an increase in physical and mental well-being was noted during 6 months of observation. The comparison group showed no improvement in the psychoemotional state. Discussion. The study demonstrated the effectiveness of GMDP immunomodulatory therapy in correcting immunological parameters for post-COVID-19 rehabilitation in patients. The data obtained are consistent with the previously discovered ability of GMDP to restore impaired functions of phagocytic cells and induce the expression of their surface activation markers, which in turn contributes to an adequate response to pathogens. Conclusion. The study revealed that the correction of immunological parameters with the use of GMDP in COVID-19 convalescents contributed not only to a decrease in the frequency and severity of respiratory infections, but also to an improvement in the psycho-emotional state of patients, and a decrease in anxiety and depression.Copyright © Eco-Vector, 2023. All rights reserved.

Mental distress among healthcare workers due to COVID-19 during second wave in a tertiary care center of South Karnataka: A cross-sectional study

Background: Healthcare workers (HCWs) in India are facing physical and psychological pressure. The pandemic has significant psychological impacts. Hence, we wanted to assess the mental stress and social stress among HCWs during the second wave of COVID-19. Aim and Objectives: Assessment of the mental distress among HCWs of tertiary care level institution during second wave of COVID-19 with the following objectives: (1) To know the sociodemographic characteristics of the HCWs of tertiary care center and (2) to assess the psychological stress among healthcare workers of a tertiary health center. Material(s) and Method(s): It is a cross-sectional and observational study conducted in hospital setting, in a tertiary care setting. Data were collected from 196 HCWs of the institute. Institutional ethical clearance was taken before the study. Structured questionnaire included sociodemographic variables, work-related variables, and variables to assess social stress. We used hospital anxiety and depression scoring questionnaire to assess anxiety and depression. Data were collected through personal interviews and online through Google forms after taking informed consent. Descriptive statistics and Chi-square tests are used analyzed using Statistical Package for the Social Sciences Version 21 for Statistical analysis. Result(s): A total of 196 HCWs, 121 doctors, 74 nursing staff, and one ward staff participated in the study. Nursing staff were at higher risk for anxiety and depression, that is, 29% and 25% than others. Females were slightly more anxious (29%) and depressed (17%) than males. HCWs who are Muslim by religion were at more mental distress. Media exposure of more than 3 h had increased risk of mental distress. HCWs with other frontline COVID warrior as a partner were both anxious (40%) and depressed (20%). Anxiety (35%) was more among those who's family members got COVID positive. About 25% of them faced social stigma, 55% of them faced issue of isolation with in the community, and 14% of them faced acts of violence which is unacceptable. Conclusion(s): Although its second wave HCWs are still having psychological distress which needs to be addressed. Social stress that they are facing is significant and is associated with higher anxiety and depression, which has to be taken seriously.Copyright © 2023, Mr Bhawani Singh. All rights reserved.

Clinical features of epilepsy course during COVID-19.

Background. Currently, a great body of data regarding the link between epilepsy and novel coronavirus infection (NCI) has been accumulated. Numerous studies have paid a great attention to rise in frequency and severity of epileptic seizures as well as failure of remission in individuals suffering from epilepsy. Objective(s): to study clinical and mental changes during NCI in patients with epilepsy. Material and methods. Fifty patients with epilepsy were examined, who were divided into two groups depending on the NCI history: Group 1 (main) - 25 patients undergone COVID-19 in the period from 2020 to 2022;Group 2 (control) - 25 patients not undergone COVID-19 during the same period. Slinical-anamnestic and psychometric methods were used as well as the following scales and questionnaires: National Hospital Seizure Severity Scale (NHS-3), Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Medical Outcomes Study Sleep Scale (MOS-SS), Multidimensional Fatigue Inventory (MFI-20). Results. In patients with epilepsy who had undergone COVID-19, there was a tendency for more frequent epileptic seizures and increased severity of seizure course. Among such patients, mild depression and more severe asthenia, cognitive impairment, moderate sleep disturbances were more common than in the control group. Conclusion. The NCI pandemic has had a pronounced negative impact on the severity of epilepsy (the underlying disease).Copyright © 2023 IRBIS LLC. All Rights Reserved.

Evusheld prophylaxis increases social interactions and improves anxiety, depression, agoraphobia and quality of life scores

Evusheld is a combination injection of tixagevimab/cilgavimab for pre-exposure COVID-19 prophylaxis and was made available to UK private clinics from October 2022. NICE review is ongoing. Whilst efficacy analysis of Evusheld has focused on the risk-reduction of contracting COVID-19, anecdotal reports suggest additional psychological benefits from Evusheld, although supportive objective data are lacking. In this study, we used 4 well-established psychological health questionnaires to assess different psychological parameters (EQ5D-3 L quality of life (QoL) score, DSM5 Agoraphobia score, Duke's Social Support Index (DSSI) and the hospital anxiety and depression score (HADS)) in blood cancer patients treated with Evusheld at the Genesis Care (GC) Clinic, Cambridge. Patient data (pre-and post-Evusheld) were compared with a control group of GC blood cancer patients who had not received Evusheld. The study was approved by GC and all patients had consented to email contact. Questionnaire replies were anonymised and free-text comments were invited. Questionnaires were completed by 29/40 Evusheld and 54/100 control patients. With EQ5D, Evusheld did not impact mobility, self-care and pain/discomfort scores and patient/ control groups scored at similar levels. EQ5D scores for 'usual activities' and 'anxiety/depression' improved post-Evusheld (patients reporting 'normal activities' increased from 52% to 76% (control = 78%);patients reporting 'no anxiety/ depression' increased from 45% to 66% (control = 65%)). The mean global EQ5D QoL score improved post-Evusheld [69.4% to 72.9% (control = 75.7%)]. With the DSM5 agoraphobia score, Evusheld treatment improved agoraphobia parameters, reducing the mean score from 15.7 to 5.1 (control = 3.7;max = 40) with certain striking changes;72% of pretreatment patients avoided crowded situations all of/most of the time, reducing to 14% post-Evusheld (control = 11%). The DSSI score assessed social/work interactions with external household contacts and post-Evusheld the mean number of interactions over 3 weeks increased from 1.48 to 3.37 (control = 3.77). Pre-Evusheld, 52% of patients had no interactions outside their household, dropping to 20% in the 3 weeks post-Evusheld (control = 17%). Using the HADS 14-point analysis of depression and anxiety revealed on average that each parameter was 25.3% 'significantly improved' and 25.4% 'a little improved' post-Evusheld. Accepting limitations of a small study and potential biases associated with a self-funding patient cohort, Evusheld treatment broadly improved all psychological scores assessed. Free-text comments clearly indicate that Evusheld had a major positive impact on QoL/social mobility for specific patients. The Evusheld patients had higher baseline scores for social isolation, anxiety, depression and agoraphobia compared with control patients, yet Evusheld treatment appeared to improve these parameters to a level similar to control patients.

Managing perceived distress to COVID-19 infection on post-COVID-19 condition

Aims: COVID-19 leaves diverse sequalae beyond the acute illness, referred to as 'long COVID'. However, the aetiology, characteristics and risk factors of Long-COVID is still lacking. COVID-19 patients experience various stressful events and suffer emotional distress which causes post-traumatic stress disorders. This study aimed to investigate association between of perceived distress to COVID-19 infection and long COVID. Method(s): Data from 56 patients who visited the psychiatric department of our post-COVID clinic between March and June 2022 were analysed. All patients completed a subjective symptom checklist [32 symptoms in eight categories], selected cognitive function tests [digit span test, trail making test (TMT), and Stroop word colour interference test], and validated neuropsychological scales [Hospital Anxiety and Depression Scale (HAS and HDS), Pittsburgh sleep quality index (PSQI) and Impact of event scale-revised (IES-R)]. We classified patients into two groups, 'High distress group'(N = 37) and 'Low distress group (N = 19) through IES-R score (cut-off = 25). The frequency and severity of long COVID-symptoms between the two groups were compared with Mann-whitney and chi-square test. Result(s): The average age of the patients was 53.34 years, and 70.53 days had passed from the SARS-CoV-2 confirmation using RTPCR. 'High distress group' showed higher HAS (284 vs. 455, p = .01), HDS (197 vs. 387, p = .032), and PSQI (238 vs. 428, p = .05) scores and suffered shortness of breath, palpitation, tingling, subjective memory deficit more frequently. Regarding neurocognitive functioning, there was no difference between two groups. Conclusion(s): Managing perceived distress due to COVID-19 could alleviate the long-covid sequalae especially in neuropsychiatric area.

Can eye movement desensitisation and reprocessing improve psychological recovery following COVID-19 related critical illness? the CovEMERALD feasibility trial

Introduction: Over 200,000 patients survive an intensive care admission each year in the United Kingdom (UK). For patients, survival is frequently beset by a range of chronic disabilities. Approximately 50% must navigate an often complex convalescence, while suffering serious and persistent symptoms of post-traumatic stress disorder (PTSD), anxiety and/or depression.1 Eye-movement desensitisation and reprocessing (EMDR) is a trauma-focussed psychological therapy, recommended for treating PTSD by the International Society for Traumatic Stress Studies2 and NICE.3 However, EMDR has never been systematically investigated for patient benefit following intensive care admission. Objective(s): CovEMERALD4 evaluated the feasibility of delivering a randomised controlled trial (RCT), testing the effect of EMDR on the psychological health of intensive care survivors, following COVID-19 related critical illness. We also provide preliminary evidence of the effect on clinically relevant outcomes. Findings will inform the design of a subsequent fully-powered RCT. Method(s): This feasibility RCT was conducted at a single-centre, teaching hospital in the UK (University Hospital Southampton). Patients were eligible if they were admitted to intensive care for over 24-hours with confirmed COVID-19, were above 18 years of age, were recruited within 3-months of hospital discharge, and had no cognitive impairment or pre-existing psychotic diagnosis. Participants were randomised (1:1) to receive either up to 8 sessions of remotely-delivered EMDR (Recent traumatic events protocol) or standard care alone as the control group (CG). Psychometric evaluation was undertaken at Baseline and 6-months after hospital discharge. Result(s): Seventy-five consecutive patients were screened at hospital discharge, from October 2020 to April 2021. 51 eligible patients approached. 26 (51%) provided consent. Reasons for declining participation were;no psychological distress (n=16), no internet access (n=7) and being physically unready (n=2). Demographic variables were balanced between groups. Of the 13 patients randomised to EMDR, one withdrew prior to intervention: the remaining attended all sessions recommended by the psychological therapists (mean of 3-4 sessions per patient), giving an overall adherence of 93%. One patient from each group declined the 6-month follow-up evaluation, so trial completion was possible in 23 of 26 (88%) participants. No reasons for trial withdrawal were given. There were no attributable adverse events. Mean change in PTSD score (PTSD Checklist-Civilian) from Baseline to 6-months, was -8 (SD=10.49) in the EMDR group vs. +0.75 (SD=15.17) in CG (p=0.126). Mean change in anxiety (Hospital Anxiety and Depression Scale-Anxiety) was -0.45 (SD=2.3) following EMDR vs. -0.83 (SD=4.0) in the CG (p=0.787), and median change in depression (HADS-D) was -2(IQR:-3.0,1.0) following EMDR vs. +1(IQR-1.5,2.0) in the CG (p=0.263). Figure 1. Box-plot of change in PTSD symptoms (PCL-C) from baseline to 6-months post-hospital discharge for control group and EMDR intervention group. Conclusion(s): EMDR can improve psychological recovery following an intensive care admission for COVID-19, and appeared feasible and safe. Although not powered to determine clinical effectiveness, this single-centre feasibility study returned a positive signal, in reducing PTSD and depressive symptoms. A full results manuscript will be submitted prior to congress. CovEMERALD has supported a successful NIHR doctoral fellowship application, during which protocol refinements will be tested, within existing, and recommended rehabilitation pathways. Trial activity and progression will be consistent with the Medical Research Council framework for developing and evaluating complex healthcare interventions.5.

ID: 218293 Real World Outcome Data in Pandemic: A Tertiary Care Neuromodulation Centre UK- 12 Months Data

Introduction: Covid-19 was classed as a global pandemic by the World Health Organization (WHO) in March 2020. This had an overwhelming effect on the National Health Services (NHS) in the United Kingdom resulting in the disruption and subsequent prioritization of the elective recovery services. Despite the various limitations of delivering services during a pandemic, Barts Neuromodulation Centre maintained the importance of multidisciplinary assessment in the selection of patients suitable for this form of therapy. We present the data on our continued activity through pandemic, dependent on the performance feasibility. The aim of this effectiveness project was to evaluate the post SCS outcome data during covid-19 pandemic. Method(s): This was a telephone and in person data collection of patient responses to standardized and validated pain outcome questionnaires following SCS implant performed at St Bartholomew's Hospital, London during January-December 2021. Data was collated from a tertiary Neuromodulation center at Barts Health NHS Trust, UK. Patients completed the questionnaires prior to SCS implant and post implant 1, 3, 6, and 12 month follow- up appointments with our neuromodulation specialists Results: Two hundred and fifteen patients underwent face to face or telephonic consultation during January to December 2021 for the follow ups. Total 178 patients registered their responses with F:M being 63%:37% and the average age 55 years. At each time point, the following number of patients completed: baseline n= 52;1 month n= 27;3 months n=28;6-month n= 21 and 12 months, n= 26. We demonstrate that NRS pain scores reduced by 43%, ODI disability improved by 35%, HADS anxiety reduced by 45%, depression reduced by 46%, PSQ sleep improved by 77% and EQ5D quality of life improved by 66% at 12 months when compared to baseline. There were no serious adverse events reported through this time. Conclusion(s): To our knowledge, this is one of the first reported real-world post SCS outcome data of prospective follow ups. We demonstrate safe delivery of services and data collection feasibility through pandemic. Moreover, our patient cohort showed improvement in the all dimensions of chronic refractory pain following SCS therapy despite clinical burden of COVID-19. Disclosure: Alia Ahmad: None, Angie Alamgir, PHD: None, Sanskriti Sharma: None, Joanne Lascelles, Clinical nurse specialist: None, Amin Elyas, FRCS: None, Helen Bonar: None, Serge Nikolic, MD: None, Habib Ellamushi: None, Vivek Mehta: None, Kavita Poply, PHD: NoneCopyright © 2023

The psychological consequences of long COVID. The effect of uncertainties, coping strategies, social support systems and quality of life on the onset of depression

Objectives: Many people were infected by COVID-19 and for a minority of them, symptoms persisted beyond twenty days. These symptoms are multi-systemic, fluctuating, and impact the quality of life. Long COVID was first defined by patients themselves in the spring of 2020 to describe their recovery problems. Specifically, long COVID is defined as "a constellation of physical and mental symptoms which can persist or emerge afterwards, generating a multi-systemic and disabling syndrome, which varies from patient to patient and fluctuates over time". The persistence of COVID symptoms, the decrease in the quality of life, the uncertainly about the future sometimes accompanied by a low level of social support perceived in the medical and personal entourage may have triggered the occurrence of a depressive disorder in patients with long COVID. The objective of this research was to study the effect of long COVID symptoms, of uncertainty and the impairment of quality of life on the development of depressive symptoms, while identifying the impact of moderating variables such as coping strategies and social support. Material(s) and Method(s): Two hundred and fourteen participants with long COVID (aged 18-68, M = 44, SD = 11), including 93 % females (n = 200) and 7% males (n = 14), participated in this cross-sectional quantitative study between the months of April and June 2022. They described their symptoms and responded to five scales: the Evaluation of Intolerance of Uncertainty Scale (EII), the Coping Strategies Checklist (WCC), the Medical Outcome Study Short Form 36-item health survey (MOS SF-36), the Perceived Social Support Questionnaire (QSSP), and the Hospital Anxiety and Depression Scale (HADS). Result(s): 91% of the participants reported symptoms of fatigue (n = 171), 52% a loss of concentration (n = 111), 51% pain (n = 110), 49 % trouble sleeping (n = 104), and 41% memory problems (n = 88). Compared with the general population, they presented a poorer quality of life, as well as high scores for anxiety, depression, and intolerance of uncertainty. Scores on coping strategies were also higher than the norms for the general population, and scores on satisfaction with social support were generally good. It was also found that the variables of intolerance of uncertainty, quality of life, and depression all correlated with each other. Furthermore, the regression analysis revealed predictors of depression. The areas of quality of life and emotional well-being (beta = -0.41, t(199) = -6.23, P < 0.01) and fatigue/energy (beta = -0.16, t(199) = -2.83, P < 0.01) were negative predictors of depression, as was the problem-focused coping score (beta = -0.14, t(199) = -2.84, P < 0.05). Symptoms of the disorder related to concentration difficulties (beta = 0.27, t(199) = 5.16, P < 0.01) and those impacting projects (beta = 0.18, t(199) = 3.31, P < 0.01) were positive predictors of depression. The second finding of this study is that people treated specifically for their long COVID had significantly lower scores for anxiety and intolerance of uncertainty despite lower scores for certain dimensions of quality of life. The individuals who took part in our study also developed more problem-based coping strategies and reported more availability of and satisfaction with social support. Lastly, in terms of quality of life, the treated population expressed better mental health. Conclusion(s): The study showed that, in addition to the effects of long COVID symptoms, quality of life, and coping strategies on the onset of symptoms of depression, the specific treatment of patients with long COVID seemed to constitute in itself a protective factor against depression and anxiety. It therefore would seem essential that any patient suffering from long COVID should receive multidisciplinary care specific to this pathology.Copyright © 2023 Elsevier Masson SAS

Features of life activity and the incidence rate of anxiety and depressive disorders among medical students studying remotely during the epidemic of a new coronavirus infection (Covid 19)

Aims. The aim is to study the features of life and the incidence rate of anxiety and depressive disorders among medical faculty students studying remotely during the epidemic of a new coronavirus infection (Covid 19) at the Kabardino-Balkarian State University named after H.M. Berbekov. Materials and methods. We examined 335 students (34% males, 66% females) at the Faculty of Medicine in November- December 2020. The average age of the students examined was 20.3+/-2.3 years. The study included an anonymous mail survey to examine educational conditions, lifestyle, levels of anxiety and depression. Results. 43.8% of the students had insufficient sleep duration, 58.5% had low physical activity, in 24.8% of them we recorded high levels of situational anxiety and in 82.1% of them personal anxiety, in 7.1% of the students we recorded clinically expressed anxiety and 1.8% had clinically expressed depression. During the transition to remote learning, students increased the time use to prepare for classes (51.2%) and the duration of sleep (61.5%), while their physical activity decreased (76.5%). Statistically significant linear correlations were identified between the level of anxiety and depression and the duration of sleep, low physical activity, preparation time for classes, academic performance, and academic debt. Conclusions. The results obtained by us can be used to optimize the educational process, as well as to preserve the mental health of students during the transition to distance learning.Copyright © 2020 Novyi Russkii Universitet. All rights reserved.

Cardiometabolic and psychocognitive features of the post-COVID period in patients with atrial fibrillation

The number of people with long-term consequences of COVID-19 is increasing worldwide. The long-term prognosis for patients remains poorly understood. Objective. To study cardiometabolic and psychocognitive features in comorbid elderly patients with atrial fibrillation (AF), de-pending on the presence of post-COVID syndrome (PCS). Material and methods. The observational analytical cohort study included 223 patients with AF and comorbidity (coronary artery disease, hypertension, obesity, type 2 diabetes mellitus) aged 60-74, who were divided into two groups: group 1 included 123 patients without COVID-19 and group 2 included 110 patients with a history of COVID-19 and the presence of PCS. The study evaluated laboratory and instrumental tests, and a general clinical study assessing psychocognitive disorders using the SPMSQ and HADS questionnaires was conducted. Results and discussion. In COVID-19 survivors, compared with patients of group 1, there were more pronounced atherogenic changes in total cholesterol (TC) (p=0.003), low-density lipoprotein cholesterol (p<0.001), and triglycerides (p=0.011). Lower dia-stolic blood pressure was found in COVID-19 survivors (p<0.001). In addition, patients in group 2 had higher median pulse pressure (p<0.001) and heart rate (p<0.001). In group 2 patients, a larger ascending aorta diameter was observed (p<0.001). The anx-iety-depressive syndrome was more common in COVID-19 survivors with comorbidities, and a statistically significant difference was found in clinical anxiety (24%, p=0.041) and subclinical depression (21%, p=0.015). When assessing cognitive function, mod-erate cognitive impairment was detected in 22% (p=0.005) of patients with PCS and severe cognitive impairment in 2% (p=0.007). Conclusion. In comorbid elderly patients with the post-COVID syndrome, a high prevalence of psychocognitive disorders and adverse cardiometabolic changes were observed, supporting the need for long-term monitoring of the general clinical condition and psychocognitive status of COVID-19 survivors.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

Clinical manifestations and emotional disorders in patients with new coronavirus infection (COVID-19)

The Novel Coronavirus Disease (COVID-19) is characterized by a variety of clinical manifestations, including a predominant lesion of the respiratory system with the possible development of distress syndrome, the development of multiple organ failure. COVID-19 can cause depression, anxiety, and other emotional disorders, which may interfere with subsequent physical recovery. The aim - clinical analysis of emotional disorders in patients with the Novel Coronavirus Infection (COVID-19). Material and methods. A retrospective analysis of electronic medical records of 124 patients admitted to the infectious diseases department of Chelyabinsk City Clinical Hospital No. 8 in 2020-2021 was carried out. The methods of clinical and psychological research (including clinical conversation, observation and testing using the "Hospital Scale of Anxiety and Depression" HADS and the "Symptom Check List" SCL-90-R) were used to identify the features of the emotional states of patients with COVID-19. Statistical analysis was performed using the statistical package <<Statistica 6.0>>. The Spearman rank correlation coefficient was used. Results. Typical complaints upon admission to the hospital are fever, cough, general weakness, loss of smell and taste, runny nose. The majority of patients showed elevated levels of C-reactive protein and protein of the acute phase of inflammation - ferritin, an increase in the D-dimer by more than 2.5 times compared with the average standard values, a decrease in the value of the prothrombin index (mean value 88.7+/-6.4%) indicate coagulopathy as a manifestation of hyperinflammation that develops in COVID-19. More than half of patients (52.08+/-9.42%) experienced psychological distress of moderate and high severity: an increased level of distress was recorded in 42.78+/-9.33% of the examined patients, a high level of distress was found in 9.30+/-5.48% of patients. Direct correlations of varying degrees of strength between general somatic distress and indicators of anxiety, depression, psychopathological manifestations (obsessive-compulsiveness and interpersonal sensitivity) and mental distress were identified. Revealed negative emotional experiences in patients with COVID-19 can cause adverse effects on the course and prognosis of the disease, reduce adherence to treatment, negatively affect the social functioning and quality of life of patients.Copyright © Infectious Diseases: News, Opinions, Training 2022.

Clinical features of epilepsy course during COVID-19

Background. Currently, a great body of data regarding the link between epilepsy and novel coronavirus infection (NCI) has been accumulated. Numerous studies have paid a great attention to rise in frequency and severity of epileptic seizures as well as failure of remission in individuals suffering from epilepsy. Objective(s): to study clinical and mental changes during NCI in patients with epilepsy. Material and methods. Fifty patients with epilepsy were examined, who were divided into two groups depending on the NCI history: Group 1 (main) - 25 patients undergone COVID-19 in the period from 2020 to 2022;Group 2 (control) - 25 patients not undergone COVID-19 during the same period. Slinical-anamnestic and psychometric methods were used as well as the following scales and questionnaires: National Hospital Seizure Severity Scale (NHS-3), Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Medical Outcomes Study Sleep Scale (MOS-SS), Multidimensional Fatigue Inventory (MFI-20). Results. In patients with epilepsy who had undergone COVID-19, there was a tendency for more frequent epileptic seizures and increased severity of seizure course. Among such patients, mild depression and more severe asthenia, cognitive impairment, moderate sleep disturbances were more common than in the control group. Conclusion. The NCI pandemic has had a pronounced negative impact on the severity of epilepsy (the underlying disease).Copyright © 2023 IRBIS LLC. All Rights Reserved.

Glucosaminylmuramyl dipeptide efficacy in post-COVID-19 patient rehabilitation treatment.

The COVID-19 pandemic has altered people's lifestyles around the world. Prevention of recurrent episodes of the disease and mitigation of its consequences are especially associated with effective post-COVID-19 rehabilitation in patients. The aim of the study was to evaluate the effects of the drug Likopid (glucosaminylmuramyl dipeptide, GMDP) for post-COVID-19 rehabilitation in patients. Material and methods. Patients who recovered from mild to moderate COVID-19 (n=60, mean age 54+/- 11.7 years) were randomized into the observation group (n=30, 15 men and 15 women) who received 2 courses of Licopid (1 mg twice a day) and the comparison group (n=30, 15 men and 15 women). Analysis of the phenotypic and functional characteristics of the innate immune cellular factors was carried out before the start of immunomodulatory therapy, immediately after the end of the course, and also after 6 months observations. In order to assess the quality of life of all patients, we used the SF-36 Health Status Survey and the Hospital Anxiety and Depression Scale questionnaires. Results. During assessing the effect of immunomodulatory therapy on the parameters of innate immunity of patients at the stage of rehabilitation after COVID-19, an increase in the protective cytolytic activity of CD16+ and CD8+Gr+ cells, as well as a persistent increase in TLR2, TLR4 and TLR9 expression was found, which indicates the antigen recognition recovery and presentation at the level of the monocytic link of the immune system. The use of GMDP as an immunomodulatory agent resulted in an 8-fold reduction in the frequency and severity of respiratory infections due to an increase in the total monocyte count. As a result of assessing patients' quality of life against the background of the therapy, a positive dynamic in role functioning was revealed in patients. In the general assessment of their health status, an increase in physical and mental well-being was noted during 6 months of observation. The comparison group showed no improvement in the psychoemotional state. Discussion. The study demonstrated the effectiveness of GMDP immunomodulatory therapy in correcting immunological parameters for post-COVID-19 rehabilitation in patients. The data obtained are consistent with the previously discovered ability of GMDP to restore impaired functions of phagocytic cells and induce the expression of their surface activation markers, which in turn contributes to an adequate response to pathogens. Conclusion. The study revealed that the correction of immunological parameters with the use of GMDP in COVID-19 convalescents contributed not only to a decrease in the frequency and severity of respiratory infections, but also to an improvement in the psycho-emotional state of patients, and a decrease in anxiety and depression.Copyright © Eco-Vector, 2023. All rights reserved.

Analysis of mortality and long-term prognosis in ventilated patients with COVID-19: a multicenter prospective observational study

Introduction: Long-term prognosis, especially for post-intensive care syndrome (PICS) is an emerging problem in critically ill patients. Prevalence and risk factors are unclear in patients with severe coronavirus disease 2019 (COVID-19). We aimed to investigate the prevalence and risks of mortality and PICS in ventilated patients with COVID-19. Method(s): A multicenter prospective study was conducted on ventilated patients with COVID-19 infection. The questionnaire for PICS evaluation was mailed within a median of 6 mo after hospital discharge, concerning Barthel Index, Short-Memory Questionnaire, and Hospital Anxiety and Depression Scale scores. Result(s): 251 patients completed the PICS questionnaires with a prevalence of PICS of 58.6%, along with the highest percentages of cognitive impairment. Delirium (OR 2.34, p = 0.03) and the duration of mechanical ventilation (OR 1.29, p = 0.02) were identified as independent risks for PICS. In 297 patients who received mechanicalventilation for 7 day or longer, protein and energy delivery in day 4-7, especially for protein delivery, were independently and monotonically associated with in-hospital mortality, but not with PICS occurence. Conclusion(s): 60% of the ventilated patients with COVID-19 suffered from PICS. Delirium and longer mechanical ventilation were identified as risks for PICS. In the patents requiring longer mechanical ventilation, nutrition delivery in the late period of the acute phase might be imprtant to survive COVID-19.

Feasibility of a pain informed movement program for people with symptomatic knee osteoarthritis

Purpose: Disability in knee osteoarthritis (KOA) is known to be largely due to pain, the mechanism of which is complex and multidimensional with alterations in nociceptive processing in the peripheral and central nervous system (CNS) leading to persistent pain. Current clinical practice guidelines for KOA provide strong recommendations for education and exercise including land-based or mind-body approaches. However, individually these strategies are only moderately effective. One potential reason for this is a lack of understanding of their underlying mechanisms and how their combination might impact nervous system modulation. Neuromuscular exercise is known to improve lower extremity strength. Mind-body approaches as well as pain neuroscience education (PNE) are uniquely positioned to potentially reverse CNS adaptations by inducing positive neuroplastic changes and improving descending modulation of pain resulting in decreased pain. To our knowledge, neuromuscular exercise, mind-body techniques, and PNE have not been studied in combination. We therefore aimed to establish the feasibility of an intervention consisting of these three elements referred to as Pain Informed Movement (PIM). The results of this study will inform necessary modifications for a two-arm pilot randomized controlled trial (RCT). Method(s): This study was a single-arm feasibility trial with a nested qualitative component and the primary feasibility outcome of complete follow up. Inclusion criteria: age >= 40 years, KOA clinical diagnosis or people fulfilling the NICE diagnostic criteria, and average pain intensity >=3/10 on the numeric pain rating scale. PIM consisted of twice weekly in-person exercise sessions and a third home exercise session for 8 weeks. In addition, PNE, provided as online videos, covered the following topics: purpose of pain, neurophysiological changes associated with pain, movement guidelines when pain persists, mind-body techniques to impact neurophysiology and support moving with ease that included breath awareness and regulation, muscle tension regulation, awareness of pain related thoughts and emotions, and relaxation. The mind-body techniques and the PNE topics were implemented during the group exercise sessions that included evidence-based neuromuscular exercises aimed at improving sensorimotor control and functionality of the knee joint. Participants completed questionnaires and in-person assessments at baseline and at program completion. Assessments included weight and height, chair stands as a measure of functional leg strength, and conditioned pain modulation to assess efficiency of the descending modulatory pathways. Participants also had their blood drawn to monitor changes in brain derived neurotrophic factor (BDNF), a marker of neuroplasticity. Questionnaires included the Pain Catastrophizing Scale, Hospital Anxiety and Depression Scale, the Knee Injury and Osteoarthritis Outcome Score - function and pain subscales, Chronic Pain Self Efficacy scale, pain intensity rated in the past 24 hours, the past week, and worst pain in the past 24 hours. Secondary feasibility outcomes included acceptability of the intervention, burden of assessments, recruitment rate, compliance rate, adherence rate, and self-reported adverse events. Feasibility findings were evaluated against a-priori success criteria. In the qualitative component, participants were invited to an online focus group and were asked about their experience and perceptions of the program. Interview recordings were analyzed using thematic content analysis to identify suggestions for program modification. Result(s): In total, 19 participants (mean age 63.3 years (SD 10.5), 73% female) were enrolled, with a complete follow up rate of 74% (n=14) for our primary objective, indicating that modifications would be needed to proceed. Of the 5 dropouts, only one was study related. We will be adding additional inclusion criteria of: ability to get up and down from the floor independently, and no use of mobility aids. Adherence to in-person treatment sessions was 91%, hich indicates proceeding with the protocol for the next phase (i.e., pilot RCT). Some absences were due to unmodifiable factors (e.g., COVID-19). We will make protocol amendments for the purpose of improving the adherence rate to include 'no planned absences'. All other success criteria were met: recruitment rate, compliance to exercise sessions, program acceptability, duration, frequency, and delivery, likelihood of recommending the program to others and taking the program again, burden, and adverse events (Table 1). Analysis of the focus groups revealed that the video content pertaining to the mind-body techniques would benefit from on screen demonstrations by the instructor to assist with participants' execution of breath and muscle tension regulation. The majority of participants improved in most of the physical assessment outcomes and questionnaires (Table 2). Conclusion(s): The PIM program is feasible, acceptable, not burdensome, does not cause adverse events, and had an excellent compliance rate. Minor modifications are needed to optimize enrolment and adherence rates. Although improvements in pain, function, and psychological measures were observed, the feasibility nature of this study precludes any conclusions regarding efficacy. A pilot two-arm RCT will be conducted to establish the feasibility and explore potential effects of PIM when compared to conventional neuromuscular exercise and standard OA education. [Formula presented] [Formula presented]Copyright © 2023

Clinical features of epilepsy course during COVID-19.

Background. Currently, a great body of data regarding the link between epilepsy and novel coronavirus infection (NCI) has been accumulated. Numerous studies have paid a great attention to rise in frequency and severity of epileptic seizures as well as failure of remission in individuals suffering from epilepsy. Objective(s): to study clinical and mental changes during NCI in patients with epilepsy. Material and methods. Fifty patients with epilepsy were examined, who were divided into two groups depending on the NCI history: Group 1 (main) - 25 patients undergone COVID-19 in the period from 2020 to 2022;Group 2 (control) - 25 patients not undergone COVID-19 during the same period. Slinical-anamnestic and psychometric methods were used as well as the following scales and questionnaires: National Hospital Seizure Severity Scale (NHS-3), Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Medical Outcomes Study Sleep Scale (MOS-SS), Multidimensional Fatigue Inventory (MFI-20). Results. In patients with epilepsy who had undergone COVID-19, there was a tendency for more frequent epileptic seizures and increased severity of seizure course. Among such patients, mild depression and more severe asthenia, cognitive impairment, moderate sleep disturbances were more common than in the control group. Conclusion. The NCI pandemic has had a pronounced negative impact on the severity of epilepsy (the underlying disease).Copyright © 2023 IRBIS LLC. All Rights Reserved.

The Effects of Quarantine or Hospitalisation on Mental Health of Children and Parents with the COVID-19 Suspicion: A Case-Control Study

Background and Objectives: The aim of our study is to compare the children between the ages of 6 and 16 being in quarantine or hospitalised for at least 14 days with suspicion of COVID-19 and their parents and the children without suspicion of COVID-19 and their parents in terms of their mental exposure level. Method(s): A list of questions, investigating post-traumatic stress disorder (PTSD) symptoms in children and parents and prepared by arranging DSM-5 diagnostic criteria, The Revised Child Anxiety and Depression Scale - Parent Form, DSM-5 Level 2 Sleep Disorder Scale 6-17 Age Parents Form and Hospital Anxiety Depression Scale, were answered by parents. Result(s): The mean score of DSM-5 Level 2 Sleep Disorder Scale (respectively 16.72+/-8.31, 14.34+/-6.37) and the rate of confrontation of DSM-5 PTSD diagnostic criteria (respectively 8.5%, 2.9%) were statistically significantly higher in the study group of children compared to the control group (p<0.05). Mean score of the depression scale (respectively 8.37+/-3.70 and 6.97+/-3.63) and the rate of confrontation of DSM-5 PTSD diagnostic criteria (respectively 16.3%, 7.9%) were statistically notably higher in the parents of study group compared to the control group (p<0.05). In addition to this, a statistically important positive correlation was found between anxiety and depression levels of the parents and anxiety, depression and sleep scores of the children for all of them (p<0.05). Conclusion(s): Direct exposure to COVID-19 poses a higher risk for both children and their parents in the emergence of psychiatric symptoms than those without any direct exposure.Copyright © 2023, Medcom Limited. All rights reserved.

Anxiety and depression among healthcare workers infected by COVID-19: A cross-sectional study

Background: The impact of COVID-19 on mental health has been continuously reported, especially among healthcare workers. In the literature, anxiety and depressive symptoms are not uncommon in infected individuals. However, there is little data on these psychological events in healthcare professionals. Objective(s): To determine the prevalence and associated factors of anxiety and depressive symptoms in healthcare workers infected by COVID-19. Method(s): This is a cross-sectional study conducted among healthcare workers at Farhat Hached University Hospital infected by COVID 19. A self-administered questionnaire was used to collect data on the socio-professional and medical characteristics of the participants. Anxiety and depressive symptoms were assessed by the Hospital Anxiety and Depression Scale (HAD-S). Result(s): A total of 477 confirmed COVID-19 in healthcare workers were included in this study (85.9%). The mean age of the participants was 39.9 +/-10.8 years. Women represented 78.2%. The majority of the infected participants were nurses (32.1%). The paucisymptomatic form of the disease was the most frequent (73.8%). After returning to work, 62.7% of the participants retained residual symptoms and 15.5% experienced stigma reactions from their colleagues. The overall prevalence of anxiety and depressive symptoms were 25.4% and 19.1%, respectively. These identified problems were significantly interrelated. Furthermore, residual symptoms and duration of confinement predicted anxiety symptomatology, while female gender and symptomatic clinical form of COVID-19 were significantly associated with depressive symptomatology. Conclusion(s): The psychological events of COVID-19 are frequent among healthcare workers. Thus, systematic screening and early management of psychological disorders are necessary to preserve the human resources of the health sector.

Validity and reliability of the fear of COVID-19 scale (FCV-19) in Turkish pregnant women Turkish version of COVID-19 fear scale (FCV-19) in Turkish pregnant women

Aim: The emergence of coronavirus disease 2019 (COVID-19) has not only create international concern, but also caused panic, fear, and an increase in mental health problems among individuals. Fear of COVID-19 Scale (FCV-19S), developed by Ahorsu, was previously reported as a valid psychometric instrument for the assessment of COVID-19 fear among individuals. Validation of the scale among other high-risk groups like pregnant women may help obstetricians develop better coping skills during the pandemic. Material(s) and Method(s): This cross-sectional methodological study included 277 pregnant women admitted for routine follow-up at the outpatient obstetrics clinic of Liv Ankara Hospital, Turkey. Participants were asked to complete the Turkish version of the Hospital Anxiety and Depression Scale (HADS) and FCV-19S. Statistical analysis was performed using SPSS 25 software. Result(s): The mean FCV-19S score was 19.2+/-5.7 (range: 7-35). Cronbach's alpha for internal consistency evaluating the reliability of FCV-19S, was 0.857, revealing a satisfactory internal consistency. According to the correlation matrix analysis, all items of FCV-19S showed positive and strong correlations with total FCV-19S scores (p<0.001), and positive and moderate correlations with HADS scores (p<0.001). Discussion(s): Turkish version of FCV-19S is a valid and reliable clinical tool to assess the anxiety of pregnant women during the COVID-19 pandemic in Turkey.Copyright © 2023, Derman Medical Publishing. All rights reserved.