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This case study draws attention on mental health sequelae that emerged in the context of the COVID-19 outbreak after recovery from hospitalization, even in subjects without personal psychiatric history. The case involves a 65-year-old male shift nurse who took SARS-COV-2 infection through a co-worker and that had been hospitalized for interstitial pneumonia from April 6 to April 17. After recovery, he developed psychiatric symptoms overlapping between different dimensions of psychiatric disorders and started to be followed by the Occupational Health Department of a Major University Hospital in central Italy. He reported a score of 28 at the Peritraumatic Distress Inventory and of 39 at the Self-Rating Anxiety State. He was treated with a combination therapy of SSRI and NaSSA antidepressants with clinical remission. In this case study, authors discuss the possible overlapping role of post-traumatic stress and anxiety symptoms in patients discharged after COVID-19 hospitalization that may deserve appropriate classification, treatment and follow up with the future goal to refine clinical management of post and long COVID syndromes of subjects who present low abnormalities in other specialty investigations.Copyright © 2022 EDIZIONI MINERVA MEDICA.
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Objective: To investigate the blood glucose control of diabetic patients during the Coronavirus disease 2019 (COVID-19) epidemic, and to explore the factors affecting blood glucose. Method(s): Three hundred and fifty patients with diabetes mellitus hospitalized in the Endocrinology Department of the Second Affiliated Hospital of Air Force Military Medical University from 2017 to 2019 were selected, and we send questionnaires (a self-made questionnaire containing 39 questions, Zung anxiety self-assessment scale, Zung depression self-assessment scale) to the patients through WeChat group. After the effective questionnaires were collected, the patients were divided into good blood glucose control group (fasting blood glucose <=7 mmol/L and 2 h postprandial blood glucose <=10 mmol/L) and poor blood glucose control group (fasting blood glucose>7 mmol/L and/or 2 hours postprandial blood glucose>10 mmol/L). Chi square test or Fisher exact probability method and t test were used to compare the differences between the two groups. In Multi-factor logistic regression, the backward regression method was performed. Result(s): A total of 310 questionnaires were collected, 4 of which did not meet the requirements were eliminated, and a total of 306 valid questionnaires were analyzed. There were 108 cases (35.3%) in the well-controlled group and 198 cases (64.7%) in the poorly controlled group. Compared with well-controlled group, there was a higher percentage of patients with aged >=45 years, diabetes course >=5 years, combined with chronic complications of diabetes, weekly exercise time during the epidemic period<150 min,weekly monitoring of blood glucose frequency <=1 to 2 times and sleep disorders during the epidemic, anxiety, and depression in poorly controlled group, and there were statistically significant differences (P<0.05).The above 8 factors with P<0.05 were included in the logistic regression model. Diabetes course >=5 years, weekly exercise time during the epidemic<150 min, sleep disturbance during the epidemic, weekly monitoring of blood glucose frequency <= 1 to 2 times, depression were risk factors for poor blood glucose control (P<0.05). Conclusion(s): During the epidemic period, the blood glucose level of diabetes patients was generally high. The factors that affected blood glucose control included a long course of diabetes, short exercise time, low monitoring frequency of blood glucose, sleep disorders, and depression.Copyright © 2020 by the Chinese Medical Association.
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Objective: To investigate the blood glucose control of diabetic patients during the Coronavirus disease 2019 (COVID-19) epidemic, and to explore the factors affecting blood glucose. Method(s): Three hundred and fifty patients with diabetes mellitus hospitalized in the Endocrinology Department of the Second Affiliated Hospital of Air Force Military Medical University from 2017 to 2019 were selected, and we send questionnaires (a self-made questionnaire containing 39 questions, Zung anxiety self-assessment scale, Zung depression self-assessment scale) to the patients through WeChat group. After the effective questionnaires were collected, the patients were divided into good blood glucose control group (fasting blood glucose <=7 mmol/L and 2 h postprandial blood glucose <=10 mmol/L) and poor blood glucose control group (fasting blood glucose>7 mmol/L and/or 2 hours postprandial blood glucose>10 mmol/L). Chi square test or Fisher exact probability method and t test were used to compare the differences between the two groups. In Multi-factor logistic regression, the backward regression method was performed. Result(s): A total of 310 questionnaires were collected, 4 of which did not meet the requirements were eliminated, and a total of 306 valid questionnaires were analyzed. There were 108 cases (35.3%) in the well-controlled group and 198 cases (64.7%) in the poorly controlled group. Compared with well-controlled group, there was a higher percentage of patients with aged >=45 years, diabetes course >=5 years, combined with chronic complications of diabetes, weekly exercise time during the epidemic period<150 min,weekly monitoring of blood glucose frequency <=1 to 2 times and sleep disorders during the epidemic, anxiety, and depression in poorly controlled group, and there were statistically significant differences (P<0.05).The above 8 factors with P<0.05 were included in the logistic regression model. Diabetes course >=5 years, weekly exercise time during the epidemic<150 min, sleep disturbance during the epidemic, weekly monitoring of blood glucose frequency <= 1 to 2 times, depression were risk factors for poor blood glucose control (P<0.05). Conclusion(s): During the epidemic period, the blood glucose level of diabetes patients was generally high. The factors that affected blood glucose control included a long course of diabetes, short exercise time, low monitoring frequency of blood glucose, sleep disorders, and depression.Copyright © 2020 by the Chinese Medical Association.
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BACKGROUND: The disease caused by coronavirus-19 (COVID-19) has been stated as a global epidemic by the WHO. The COVID-19 pandemic adds many risk factors to maternal mental health during the perinatal period. The impact of anxiety during pregnancy is adverse obstetric consequences such as premature birth, inadequate antenatal care, requests for elective cesarean delivery, low APGAR scores of infants, and postpartum depression. Nursing interventions to overcome anxiety can be done through spiritual and religious intervention approaches. One of the spiritual interventions for the Muslim population to improve religious coping is Qur’anic Bibliotherapy (QB) as Islamic bibliotherapy. AIM: This study aimed to explore the use of QB interventions for pregnant women experiencing anxiety during the COVID-19 pandemic. METHODS: A qualitative exploratory study was conducted to explore the experience of the intervention given to the informant. The qualitative samples were ten respondents with moderate-to-severe anxiety levels. The anxiety instrument used was the Zung Anxiety Scale. RESULTS: The themes obtained from in-depth interviews with semi-structured interviews were recognizing COVID-19 and its perceived impact, the impetus for changing resilience to the COVID-19 pandemic, parents’ role, and the benefits of QB for pregnant women in the COVID-19 pandemic. CONCLUSIONS: QB encourages informants’ positive thinking, feeling, spiritual, and attitude patterns. QB can be used as a complementary Islamic intervention for health workers, especially nurses, in providing nursing care to Muslim patients.
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Background: Since the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 2019 (COVID-19) (1), our understanding of the underlying pathophysiology is constantly evolving in order to explain the wide range of heterogenic clinical manifestations (2). Nevertheless, limited data are available for the severity and multifactorial causality of musculoskeletal pain in COVID-19 patients (3). Objectives: This study aimed to evaluate the prevalence and intensity of rheumatic pain symptoms-arthralgia and myalgia and their association with anxiety and depression in a cohort of COVID-19 patients, hospitalized at the COVID-19 rheumatology department of the University Hospital St. Marina, Varna, Bulgaria. Methods: In the present single-center cohort study, a prospective analysis was performed among COVID-19 patients who were hospitalized from 1 Oct 2021 to 20 Jan 2022 and self-reported for new-onset of musculoskeletal pain. All 226 patients (age 26-91 years) were treated for moderate or severe SARS-CoV-2 infection confrmed by laboratory tests, including positive antigen test or polymer-ase chain reaction (PCR) test, and imaging modality. Detailed disease history and clinical examination were carried out by a fully certifed rheumatologist. All patients who reported new-onset of musculoskeletal pain during the acute phase of the infection, participated on a voluntary basis in a questionnaire survey, by completed Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS) and visual analogue scale (VAS) for arthralgia and myalgia. The questionnaire form also elicited information on sociodemographic characteristics of the patients. In all patients, infammation and thrombotic biomarkers were assessed. The level of signifcance was set to 0.05. Results: Among all 226 COVID-19 patients with musculoskeletal pain, 46.5% (n =105) were women and 53.5% (n = 121), were men. Mean age was 65.6 years. We found a signifcant correlation of depression and anxiety scales scores with pain intensity (both arthralgia and myalgia), all < 0.001. A multiple regression analysis found that SDS and SAS accounted for signifcant variance in the prediction of muscle pain (β = 0.441, p < 0.001;β = 0.293, p = 0.003, respectively) while SDS signifcantly predicted joint pain (β = 0.341, p = 0.043). On the other hand, musculoskeletal pain does not correlate with any of infammation and thrombotic biomarkers assessed in SARS-CoV-2 patients (p > 0.05). Conclusion: Rheumatic pain manifestations are part of the heterogeneous spectrum of COVID-19 disease. The pain intensity is signifcantly associated with anxiety and depression symptoms and does not correlate with infammation and thrombotic biomarkers.
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Background and objective: The novel coronavirus disease (COVID-19) pandemic has caused a traumatic impact on the whole world in all aspects including physical health, economic condition, and mental health. Psychological problems are commonly neglected for their inconspicuous symptoms. Little is known about the medical students' psychological status during the COVID-19 pandemic. Our study aimed to investigate the prevalence and influencing factors of anxiety among medical students during the COVID-19 pandemic. Methods: Two thousand and two medical students were investigated in this cross-sectional study. Zung's self-rating anxiety scale was used to evaluate their anxiety symptoms. A total of 1917 questionnaires were collected, and the response rate was 95.8%. Results: There were 1735 (90.5%) complete and valid questionnaires. The average SAS standard score was 42.8 ± 11.0. The results indicated that the prevalence of anxiety in medical students was 25.9%. Less social support (OR = 1.4, 95%CI 1.2-1.7) is an independent risk factor of anxiety syndrome, while the female (OR = 0.6, 95%CI 0.5-0.8) is less likely to have anxiety syndrome. Conclusion: The prevalence of anxiety in medical students is higher during the COVID-19 pandemic. Male students and students with less social support are more likely to have anxiety syndrome. Medical educators and students themselves should take serious steps to prevent, recognize and deal with the anxiety prevalence.
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BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic had an impact on people globally, including mothers living in coastal regions. Therefore, this study aims at identifying the psychological status of single mothers living in the coastal regions of Indonesia. METHODS: A descriptive quantitative cross-sectional design was used with non-probability sampling in coastal regions of West Java, Indonesia. Furthermore, the Zung Self Rating Anxiety Scale was used to assess the anxiety level of single mothers. RESULTS: The anxiety of single mothers during the COVID-19 pandemic was generally moderate (n = 45.77.59%), with 44.83% attributing it to health and the economy. Furthermore, previous results showed that this condition was observed in the elderly (n = 38.65.52%), though it lasted <5 years in the majority of cases (n = 33.56.90%). Symptoms associated with the anxiety of single mothers during the pandemic include an increase in restlessness, nervousness, and anxiety. CONCLUSION: The economy and health of single mothers were the primary sources of anxiety during the COVID-19 pandemic. A high percentage of these women suffer from mild anxiety and require immediate care to prevent the development of other health problems. Therefore, health cadres and community nurses are expected to take action to achieve optimal psychological welfare among single mothers during the pandemic. Further study can be conducted by focusing on the theme of defense mechanisms or resilience.
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INTRODUCTION: The outbreak of coronavirus posits deleterious consequences on global healthcare system while affecting human life in every aspect. Despite several measures undertaken to limit the socio-economic effect of coronavirus, various challenges remain pervasive, and one such challenge is mental health, particularly depression and anxiety. Therefore, this study examines the prevalence and determinants of depression and anxiety in Malaysian population during third wave of COVID-19. METHODS: A cross-sectional online survey was carried out via social media platforms and 1544 Malaysians were selected. The level of depression was assessed by Patient Health Questionnaires (PHQ-9) and scored accordingly for categorization. Zung's Self-Rating Anxiety Scale (SAS) was used as a self-assessment survey to quantify the level of anxiety of persons experiencing anxiety-related symptoms. Percentage distribution and logistic regression analysis were used in the data analysis. RESULTS: Results showed that one-fourth (25.1%) of the participants had severe depressive symptoms. Almost one-sixth (18.7%) had mild depressive symptoms and one-third (34.1%) had mild to moderate anxiety symptoms. Age, gender, and friends infected with virus were the three important predictors of depression and anxiety. The odds of having depression (OR = 1.44; C·I. = 1.32-1.62) and anxiety (OR = 1.36; C·I. = 1.27-1.47) were significantly higher among females than in males. CONCLUSION: A significant proportion of the study participants were facing mild to severe depression and anxiety symptoms which is very alarming as the pandemic is still now increasing across the country. Immediate interventions including community counselling programmes, TV and social media campaigns are urgently needed to reduce the psychological stress among the Malaysian population.
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The COVID-19 pandemic and the lockdown has taken the world by storm. This study examines its impact on the anxiety level of university students in Malaysia during the peak of the crisis and the pertinent characteristics affecting their anxiety. A cross-sectional online survey, using Zung's self-rating anxiety questionnaire was conducted during the COVID-19 pandemic and lockdown. Out of the 983 respondents, 20.4%, 6.6%, and 2.8% experienced minimal to moderate, marked to severe, and most extreme levels of anxiety. Female gender (OR = 21.456, 95% CI = 1.061, 1.998, p = 0.020), age below 18 years (OR = 4.147, 95% CI = 1.331, 12.918, p = 0.014), age 19 to 25 (OR = 3.398, 95% CI = 1.431, 8.066, p = 0.006), pre-university level of education (OR = 2.882, 95% CI = 1.212, 6.854, p = 0.017), management studies (OR = 2.278, 95% CI = 1.526, 3.399, p < 0.001), and staying alone (OR = 2.208, 95% CI = 1.127, 4.325, p = 0.021) were significantly associated with higher levels of anxiety. The main stressors include financial constraints, remote online teaching and uncertainty about the future with regard to academics and career. Stressors are predominantly financial constraints, remote online learning, and uncertainty related to their academic performance, and future career prospects.