Impact of sars-COV-2 on the attitudes of patients with prosthodontic needs

Aim: SARS-CoV-2 has caused a global pandemic that has negative consequences for many parts of life. To our knowledge, no study has assessed the effect of the SARS-CoV-2 pandemic on a possible delay in prosthodontic treatments because of a potential concern of contamination in individuals. Therefore, the purpose of this study was to assess this potential impact of fear, as well as oral health-related quality of life, in partially edentulous patients using questionnaires during the SARS-CoV-2 pandemic. Material(s) and Method(s): A total of 135 partially edentulous patients (74 females and 61 males aged 18-70 years) participated in this study. A complete questionnaire consisting of general knowledge questions on SARS-CoV-2 and the OIDP scale, which evaluates the effect of oral status on daily activities were used in participants. Result(s): Statistical analyzes showed that participants with a history of SARS-CoV-2 and/or who are aware of a member of their social circle with a history of the virus, and/or who is deceased, were unwilling to receive dental care during the pandemic. Most of the participants between the ages of 31 and 60 were more worried about the transmission of SARS-CoV-2 during dental treatment. Discussion(s): Concerns about SARS-CoV-2 contamination of patients over 30 years of age may have a negative impact on oral health due to delayed prosthodontic treatments.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Long-term functional outcome of severe COVID19 pneumonia treated with venovenous extracorporeal membrane oxygenation support - learnings from a single centre

Objectives: Implementation of venovenous extracorporeal membrane oxygenation (VVECMO) allowed survival of patients with severe respiratory failure associated with SARS-CoV-2 infection. However, VVECMO treatment is usually associated with long ICU stays, prolonged sedation, and neuromuscular blockage days. Functional disability, due to delirium and acquired muscle weakness, is frequently an inevitable burden causing long term disability. This study aims to analyse main characteristics of patients under ECMO due to COVID-19 pneumonia, their outcomes and functional status six months after ICU discharge. Method(s): Retrospective review of a prospectively collected database in an ECMO referral centre. All patients receiving VVECMO for SARS-CoV-2 infection were included. Epidemiological and clinical data were reviewed. Functional status at 6 months after ICU discharge was assessed with modified Rankin Scale (mRS). Result(s): Ninety-three patients were included (29% female). Median age was 54+/-12 years, mean SOFA was 5.7+/-2.9, mean SAPS II was 35.6+/-13.6. Mean time from intubation to cannulation was 5+/-5.6 days in 91 patients;awake-ECMO was performed in 2 patients. Mean ECMO run duration was 33.1+/-30 days (longest ECMO run was 194 days). A period of awake-ECMO was performed on 36.5% of patients, during 16.4+/-21.2 days. ICU-acquired weakness was diagnosed on 64.5% of patients and delirium on 63.4%. Mortality was 24.7% (23 patients) with only 1 patient deceased in hospital after ICU discharge. At 6 months follow-up, all patients were still alive and most of them (65.1%) were independent on all daily activities (mRS <= 2). Conclusion(s): Patients with severe COVID-19 treated with VVECMO support had very good functional outcomes at six-month follow-up. Despite long ICU length-of-stay, high incidence of delirium and acquired muscle weakness, full recovery at six-month post-ICU discharge was achievable in most patients.

Arbovirus and its potential to lead the next global pandemic from sub-Saharan Africa: What lessons have we learned from COVID-19?

Risk and predisposing factors for viral zoonoses abound in the sub-Saharan Africa (SSA) region with significant public health implications. For several decades, there have been several reports on the emergence and re-emergence of arbovirus infections. The lifetime burden of arboviral diseases in developing countries is still poorly understood. Studies indicate significant healthcare disruptions and economic losses attributed to the viruses in resource-poor communities marked by impairment in the performance of daily activities. Arboviruses have reportedly evolved survival strategies to aid their proliferation in favorable niches, further magnifying their public health relevance. However, there is poor knowledge about the viruses in the region. Thus, this review presents a survey of zoonotic arboviruses in SSA, the burden associated with their diseases, management of diseases as well as their prevention and control, mobility and determinants of infections, their vectors, and co-infection with various microorganisms. Lessons learned from the ongoing coronavirus disease 2019 (COVID-19) pandemic coupled with routine surveillance of zoonotic hosts for these viruses will improve our understanding of their evolution, their potential to cause a pandemic, control and prevention measures, and vaccine development.Copyright © GERMS 2022.

7-year outcomes of the first successful pediatric bilateral hand transplantation

Introduction: The purpose of this case report is to describe the 7-year functional outcomes and health-related quality of life (HRQOL) of the first successful pediatric bilateral hand transplantation. The report focuses on activity and participation. The authors suggest assessment methods that can be applied to future cases. Method(s): The child underwent quadrimembral amputation at age two years and received bilateral hand allografts at age eight. Rehabilitation included biomechanical, neurorehabilitation, and occupational approaches in acute and outpatient settings. Therapist observed outcomes assessments, patientreported and parent-reported outcome questionnaires were repeated over a 7-year period. Result(s): At 7-years post transplantation, the adolescent and his mother reported a high level of satisfaction with the outcomes. Therapist observed assessments showed the adolescent achieved functional gross motor dexterity with each upper extremity. Although left gross and fine dexterity was superior to the right at all timepoints observed, the adolescent used his right upper extremity as dominant and incorporated both extremities as appropriate for bimanual tasks. The adolescent achieved modified independence to full independence with self-care activities. The adolescent participated in diverse activities with a high level of enjoyment. Participation was more diverse, social, and communitybased prior to and after the initial COVID-19 pandemic restrictions. At 7-years post transplantation when the adolescent was 15-years of age, the parent rated more instrumental activities of daily living as somewhat difficult. Discussion and Conclusion(s): Therapist observed outcomes assessments, patient-reported and parent-reported outcome questionnaires, showed the child had incorporated his hands into various activities, was completing daily activities independently, and HRQOL outcomes in social, emotional, cognitive, and physical domains were favorable. Most results were stable over time. The decrease in right hand dexterity scores might reflect small kinesiological changes in the right hand. Difficulty with some instrumental activities of daily living were likely due to new activities typical of child development for this now 15-year-old patient.

The effect of COVID-19 pandemic on depression and suicidal ideation in Korean community dwelling elderly

Aims: The impacts of the coronavirus disease of 2019 (COVID-19) pandemic on mental health have been relatively severe. This study examined the influence of the COVID-19 especially on depression and suicidal ideation in community-dwelling elderly in Korea. Method(s): Data were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea). A total of 2423 elderlies were recruited from 22 counties in Jeollanam-do between April and October 2021. We used self-reported questionnaires, including sociodemographic factors, COVID-19 related stress, suicidal ideation, Geriatric Depression Scale-Short Form Korean Version (GDS-SF). Logistic regression was performed to examine the factors on depression and suicidal ideation. Result(s): Of the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, the worry of COVID-19 infection and restriction of daily activity due to COVID-19 pandemic were significantly associated with depression. Male sex, poor perceived health status, disability in house chores and depressive symptom are risk factors for suicidal ideation. Conclusion(s): These findings showed that increased risk factor for depression and suicidal ideation in community dwelling elderly during COVID-19 pandemic. We confirmed that feelings of isolation and negative perception of health were risk factors on depression in community dwelling elderly in the context of the COVID -19 pandemic. Also male, poor self-perceived health status, difficulty of independent living and worry and depression are increased the risk of suicidal ideation among the elderly.

Health-related quality of life in long COVID-19 in context of symptom type

Aim: Coronavirus disease 2019 (COVID-19) is complex multisystem disease. After 4 weeks of persistent symptoms, it is termed as Long COVID-19. Long COVID-19 causes a decrease in health-related quality of life (HRQoL). In this study, it was aimed to determine which symptoms were associated with lower HRQoL in Long COVID-19 in this study. Material(s) and Method(s): This cross-sectional study was conducted in a tertiary research hospital. Patients who have positive RT-PCR results at least 28 days and at most 180 days ago were selected for the study. Online survey was applied to 266 patients who had positive PCR test results for COVID-19. The EuroQoL 5D-3L scale was used to measure the HRQoL as a dependent variable. Socio-demographic features and symptoms were assessed by the survey as independent variables. Due to heteroscedasticity, a robust standard error regression analysis was conducted to make inferences on the effects of persistent symptoms on HRQoL. Result(s): Of the total 266 participants, 163 were females (63.3%). The mean age was 41.2 +/- 11.8 years. One hundred forty-two patients (53.3%) did not report any ongoing symptom. Female gender and lower education level as socio-demographic variables, visual problems and myalgia as persistent symptoms were identified as risk factors for reduced HRQoL in Long COVID-19 patients. Discussion(s): Long COVID-19 patients experience lower levels of HRQoL, especially those with visual problems and/or myalgia. Interventions to raise the HRQoL of Long COVID-19 patients should first target visual problems and myalgia.Copyright © 2023, Derman Medical Publishing. All rights reserved.

Scientific rationale of Indian AYUSH Ministry advisory for COVID-19 prevention, prophylaxis, and immunomodulation

The current outbreak of COVID-19 is caused by the SARS-CoV-2 virus that has affected > 210 countries. Various steps are taken by different countries to tackle the current war-like health situation. In India, the Ministry of AYUSH released a self-care advisory for immunomodulation measures during the COVID-19 and this review article discusses the detailed scientific rationale associated with this advisory. Authors have spotted and presented in-depth insight of advisory in terms of immunomodulatory, antiviral, antibacterial, co-morbidity associated actions, and their probable mechanism of action. Immunomodulatory actions of advised herbs with no significant adverse drug reaction/toxicity strongly support the extension of advisory for COVID-19 prevention, prophylaxis, mitigations, and rehabilitation capacities. This advisory also emphasized Dhyana (meditation) and Yogasanas as a holistic approach in enhancing immunity, mental health, and quality of life. The present review may open-up new meadows for research and can provide better conceptual leads for future researches in immunomodulation, antiviral-development, psychoneuroimmunology, especially for COVID-19.Copyright © 2021, Institute of Korean Medicine, Kyung Hee University.

Physical effects of Covid-19 in patients with diabetes 1 year after hospitalisation in the UK: PHOSP-Covid study

Aim: To investigate the impact of Covid-19 on daily activity, maximal physical performance, and clinical frailty of people living with diabetes (any type) 1-year post-hospitalisation for Covid-19 in the UK. Method(s): This study is part of PHOSP-Covid, a multicentre long-term cohort study that recruited adults (>=18 years) who were discharged from one of the 83 NHS hospitals across the four UK nations following a clinical diagnosis of Covid-19 before March 31, 2021. We compared The Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue, Incremental shuttle walk test (ISWT) distance (m), and clinical frailty (Rockwood frailty level), 5-month and 1-year after discharge in patients with and without diabetes. Result(s): Out of 2545 individuals (538 (21%) with diabetes), the proportion of individuals who classified as either 'mildly frail' or 'moderately or higher frail severity' was higher in individuals with diabetes (month 5: diabetes 9.9%, no diabetes 4.7%;month 12: diabetes 8%, no diabetes 4.9%). ISWT distance in patients with diabetes were significantly lower at both follow-ups but this measure improved from 5-months to 1-year (290 [95% CI: 190-440] vs 370 [250-560] for diabetes and 340 [210-450] vs 420 [270-590] for those without, both p < 0.01). At both time points, people with diabetes reported higher levels of fatigue (36 [24-44] vs 39 [25-46] at 5-month (p = 0.03);37 [26-45] vs 40 [28-47] at 1-year visit (p < 0.01)). Conclusion(s): One year after hospitalisation long Covid is more observed in people with diabetes.

The effect of motor learning-based telerehabilitation on quality of life of children with cerebral palsy during the COVID-19 pandemic.

BACKGROUND: During the pandemic, the access of children with cerebral palsy (CP) to rehabilitation services was adversely affected due to the significant risk of infection. AIMS: We assessed whether the effect of a motor learning-based treatment provided via a telerehabilitation method on the quality of life of children with cerebral palsy during the COVID-19 period was equivalent to face-to-face treatment. METHODS: Distance exercises were explained by a physiotherapist to the patients in the telerehabilitation group, and motor learning-based treatment was applied by their families; the physiotherapist followed the sessions with video conferencing. Motor learning-based treatment was offered to the face-to-face group by a physiotherapist in the clinic. RESULTS: In the comparison between the groups, there was a significant difference in the parameters of play activities, pain-hurt, fatigue, eating activities, and speech communication activities after treatment (p<0.05). However, in the test performed by considering the nonhomogeneous parameters before the treatment, no time-dependent difference was found in the repeated measurements before and after the treatment in all parameters (p>0.05). CONCLUSION: Motor learning-based treatment provided using the telerehabilitation method has a positive effect on the quality of life of children with CP, but the results are similar to face-to-face treatment.

Efficiency of application of sorbed probiotics in the complex therapy of pneumonia caused by SARS-CoV-2. Quality of life in the short term COVID-19

Aim. To determine the clinical efficacy and safety of the immobilized (sorbed) probiotics Bifidobacterium bifidum 1 (5x108 CFU) and B. bifidum 1 (5x107 CFU) in combination with Lactobacillus plantarum 8P-A3 (5x107 CFU) in the complex therapy of pneumonia caused by SARS-CoV-2 in adult patients without severe risk factors and their impact on health-related quality of life (QoL). Material and methods. An open, randomized prospective study included 100 patients (45 males, 55 females), aged from18 to 60 years without risk factors for severe COVID-19, with pneumonia confirmed by computed tomography and an area of lung lesion no more than 75% (moderate forms). SARS-CoV-2 RNA in nasal and oropharyngeal swabs (RT-PCR) was detected in 72% of the participants, in the rest it was highiy probable in terms of the aggregate parameters. The publication presents the results of self-assessment (94 respondents) of working capacity limitations, shortness of breath, intestinal disorders since the end of the probiotic regimen (PR: hospitalization period - B. bifidum 1, 3 capsules 2 times a day for 10 days, then after hospitalization - B. bifidum 1 in combination with L. plantarum 8P-A3 2 powders 3 times a day for 14 days) and QoL (Short Form Medical Outcomes Study: SF-36) 1 month after hospitalization. Results. At the end of PR, the ability to engage in daily activities was higher by 23.1% [95% confidence interval 5.3-37.3, OR 0.08 (0.08-0.77)]. Difficulty of breathing during exercise was less common by 29.7% [15.1-44.5%], OR 0.09 [0.02-0.40], hard stools and no bowel movements were recorded less often by 21.3% [8.5-34, 1] for 1-3 days. One month after hospitalization, the QoL of the patients receiving standard treatment was significantly reduced relative to population indicators in Russia. It was more significantly due to the psychological component of health [total measurement 38.1 (36.2-40.0)] and less significantly due to the physical component [49.5 (48.3-50.8)]. The main reasons limiting daily activities [Role Emotional (RE): 39.4 (37.4-41.4)] were decreased vitality [VT: 40.2 (38.9-041.5)], emotional depression [Mental Health (MH): 41.2 (39.4-43.0)], deficit of social contacts [Social Functioning (SF): 45.1 (43.7-46.6)]. The patients who received PR had a higher ability to carry out daily activities [RE: 57.7 (55.6-59.7)], the severity of psychological problems associated with fatigue, anxiety and depression was lower [MH: 59.8 (58.7-60.9), p<0,001]. The effect of the PR on negative perceptions of social isolation was comparatively less [SF: 53.9 (52.2-55.4)]. The QoL of the patients who additionally suffered from diarrhea in the acute period of SARS-CoV-2 pneumonia was worse in comparison with the patients without diarrhea (due to pain and inability to endure physical activity). The effects of immobilized (sorbed) probiotics to the QoL of the patients with diarrhea during the acute period of COVID-19 were most significant. Conclusion. PR had a significant positive effect on the QoL within a month after hospitalization, increasing working capacity and improving mental health, reducing the severity of psychological problems and fatigue. Additional researches are needed on the possible relationship of organic and functional gastrointestinal diseases with the progression of diarrhea in patients infected with SARS-CoV-2. No side effects of the sorbed probiotics regimen have been identified.Copyright © Eco-Vector, 2022.

Autonomic Dysfunction after Covid-19 Immunization - Case Report

Background: The infection caused by the SARS-CoV-2 continues affecting millions of people worldwide and vaccines to prevent the coronavirus disease (COVID-19) are considered the most promising approach for curbing the pandemic. Otherwise, cardiovascular and neurological complications associated with the vaccines were speculated and some few case reports were published. Objective(s): We describe a case of postural orthostatic tachycardia syndrome (POTS) after viral vector COVID-19 vaccination and the possible autoimmune process of the syndrome. Method(s): A 35-year-old female, without previous symptoms or comorbidities, developed intermittent palpitation, intense fatigue and dyspnea, compromising her daily activities, triggered by upright position, seven days following the second dose of the Oxford vaccine. Physical examination was normal, except for a heart rate (HR) increase of 33 beats/min from supine to standing position, with no significant change in blood pressure and reproduction of symptoms. Result(s): A 24-hour Holter monitoring revealed episodes of spontaneous sinus tachycardia correlated with palpitation and fatigue. Extensive diagnostic investigations excluded primary cardiac, endocrine, infectious and rheumatologic etiologies. The patient underwent an autonomic function test which demonstrated normal baroreflex sensitivity, as well as normal cardiovagal and adrenergic scores. Head-up tilt test showed persistent orthostatic tachycardia (HR increase from a medium of 84 beats/min in supine position to 126 beats/min during upright tilt), without hypotension, consistent with the diagnostic criteria for POTS. According to the current guidelines, general behavior recommendations, pharmacotherapy with low dose of propranolol associated with the autonomic rehabilitation were oriented. Along three months of follow-up, the patient reported a gradually improvement in her symptoms. Conclusion(s): POTS is a heterogeneous disorder of the autonomic nervous system characterized by orthostatic tachycardia associated with symptoms of orthostatic intolerance. Although the physiopathology of COVID-19 vaccine and autonomic disorders remains speculative, autoimmune response is one of the possible mechanisms. Based on clinic presentation, the time frame of symptom onset is consistent with other well-known post-vaccination syndromes, which may be an indicator of an autoimmune process induced by immunization. Further studies are needed to assess causal relationship between immunization and autonomic dysfunction.Copyright © 2023

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.

Functional and Psychosocial Outcomes on Patients with Moderate-to-Severe Covid-19 Diseases: A Post-Hospitalization Follow-up Study

Intro: COVID-19 survivors suffer from variable limitations affecting their quality of life. We examined the functional and psychosocial outcomes among COVID-19 patients with moderate-to-severe diseases by three months post-hospitalization. Method(s): This retrospective cohort study included 510 COVID-19 patients admitted to Kepala Batas Hospital with moderate-to-severe diseases, requiring oxygen therapy during hospitalization (Malaysia COVID-19 severity category >=5;WHO scale >=5), between January and August 2021. We followed up with telephone surveillances by 90 days post-discharge from the hospital, assessing their performance in activities of daily living and psychosocial implications. Relevant clinical data were extracted from medical records. We compared patients with low (<10L/ min) versus higher (>=10L/min) oxygen requirements on the patient-reported outcome variables. Finding(s): Among 441 survivors (86.5%), half (n=223, 50.6%) were male, with a relatively young population with a mean age of 50.2 (13.73) years. Only 17.9% were partially vaccinated and 5.7% had complete vaccination before hospitalization. Nearly 70% were supplemented with nasal prong or face mask oxygenation (<10L/ min), 26.1% received high flow oxygenation and 4.1% were mechanically ventilated. By 90-day follow-up, >90% had their functionality returned to baseline before hospitalization. Only 1.6% required home oxygen supplementation. Compared with their baseline functionality, 4.8% were unable to perform basic household chores, 4.1% required assistance in mobilization and 2.5% became fully dependent on caretakers. Among 254 patients returning to work, 98% worked in the same institution but 18.9% required job scope adjustments. About 7.7% experienced post-covid stigma at home and/or work, 3,9% suffered from depression 5.7% became self-isolated and 0.9% had suicidal ideation or attempts. Functional and psychosocial outcomes were similar between patients with low and higher oxygen requirements (all p>0.05). Conclusion(s): Despite fair recovery outcomes reported by survivors with moderate-to-severe disease, a small proportion suffered from significant functional limitations and psychosocial adversity. Post-hospitalization care is essential to screen-detect post-COVID complications and provide timely interventions.Copyright © 2023

Impacts of COVID-19 on the mental health of graduate students in the health area of a university in Ceara, Brazil

Graduate students experience an environment of intense demands. The COVID-19 pandemic caused the suspension of face-to-face academic activities, affecting the daily lives of these people. This study aimed to analyze the impact of COVID-19 on the mental health of stricto sensu graduate students in the health area of a public university in Ceara regardind the use of antidepressant and anxiolytic drugs. This cross-sectional, descriptive study uses a remote questionnaire from August 2021 to February 2022. Socio-demographic, clinical, medication use, and data from the "Self-Report Questionnaire" test were collected. 217 master's and doctoral students participated in the study, most of them female (71%), between 21 and 30 years old (55.3%) and without children (76.5%). The results showed an increase in the number of graduate students with symptoms of anxiety and/or depression after the pandemic (23.4%). Among the main symptoms, there is a strong indication of mental suffering (60.4%), nervousness, tension or concern (77.9%), sadness (55.3%), difficulties in carrying out daily activities with satisfaction (55.4%), and tiredness (65%). These symptoms were most prevalent among women. Regarding medication use (anxiolytics/antidepressants), 38.2% responded positively. Of these, 40.9% increased the dosage, and 79.5% experienced adverse reactions. In this way, the COVID-19 pandemic negatively affected graduate students' mental health, reinforcing the need for universities to develop strategies to mitigate these students' emotional suffering.Copyright © 2023, Conselho Federal de Farmacia. All rights reserved.

National asthma strategy-Monitoring progress using national asthma indicators

Introduction/Aim: Progress in achieving the Goals and Objectives of the National Asthma Strategy was measured using 10 national asthma indicators. The status of asthma in Australia was shown using indicators covering prevalence, mortality, hospital and emergency department (ED) visits and treatment and management. Findings are based on historical data up to the most recent data available so that progress could be assessed. Method(s): Data for each indicator has been sourced from the National Health Survey, Medicare Benefits Schedule, Pharmaceuticals Benefits Scheme, National Hospital Morbidity and Mortality Databases. Relevant analysis has been conducted to show changes over time and variation in progress across priority population groups. Result(s): In 2020-2021, 2.7 million Australians were living with asthma. Hospitalisations due to asthma declined between 2016-2017 and 2020-2021 by over 40%. ED visits also declined between 2018-2019 and 2019-2020 by about 10%. However variation can be seen in the use of these services across the country. These findings are potentially attributable to an indirect impact of the COVID-19 pandemic and the health protection measures put in place. Results also include data on mortality, use of General Practitioner services and the use of medicines to treat and manage asthma, psychological distress experienced by people with asthma, and interference of asthma on daily activities. Conclusion(s): Some favourable outcomes in some indicators show progress towards achieving the Goals and Objectives of the National Asthma Strategy. However, some results were impacted indirectly for the COVID-19 pandemic and variation across Australia can be demonstrated. Improved data is needed to understand the treatment and management of asthma in primary health care.

Respiratory function and symptoms after acute COVID-19 infection in children and adolescents

Introduction/Aim: Significant long-term effects on both symptomatology and respiratory function have been recognised in adult populations after COVID-19 infection, termed 'Long COVID'. These have caused loss of productivity and increased need for healthcare services. This study aimed to measure symptoms and lung function in children and adolescents after acute COVID-19 infection Methods: Between June 1 and 31 October 2021 there were 144 children admitted to hospital across the Sydney Children's Hospital Network, Australia. Of these, 63 children were referred to the respiratory clinic with symptoms of ongoing cough, shortness of breath and fatigue, 3-6 months post COVID infection. 20 of these children performed reliable lung function. For these children, body plethysmography and double diffusion testing were performed within 3-6 months of their infection. The Liverpool respiratory questionnaire and PROMIS paediatric sleep questionnaires were also administered. Result(s): Of the 20 patients tested, 7 had COVID pneumonitis requiring hospitalisation during the acute illness. 6 of the 20 patients had significant persistent symptoms as measured by the Liverpool respiratory questionnaire, while none of the children had any significant sleep symptoms. All children had preserved spirometry within normal limits. Of note, 2 children with persistent respiratory symptoms had DLNO/DLCO ratio >1.15, suggesting pulmonary vascular disease. The same two children who had elevated DLNO / DLCO had high ventilator equivalents on CPET testing suggesting increased physiological dead space ventilation. Despite this, their peak aerobic capacity was within normal limits. There were no significant differences between the alpha and delta cohorts or between children treated at home vs those requiring hospitalisation during their infection. Conclusion(s): COVID-19 may cause long-lasting effects in children. In this cohort, all children maintained spirometry results within normal limits despite significant symptoms impacting daily activities. Double diffusion testing may shed some light on lung changes leading to persistent symptomatology after COVID infection.

DISABILITY AND COVID-19 TESTING: A CROSS-SECTIONAL RADx-UP STUDY

Background: Nearly 26% of adults in the U.S. live with disability and are more likely to experience chronic health conditions, barriers to healthcare, and severe COVID-19 illness. Therefore, COVID-19 testing of adults living with disability is important to consider. The purpose of this study was to explore relationships between disability and COVID-19 testing, infection, and related challenges. Method(s): A Rapid Acceleration of Diagnostics-Underserved Population (RADx-UP) project in Miami, FL determined disability with a modified version of the Washington Group General Disability Measure. HIV serostatus and COVID-19 vaccination were confirmed with medical records. COVID-19 testing and infection history were self-reported. Statistical analyses included chi-squared tests and multiple binary logistic regression;variance inflation factors were calculated to ensure absence of collinearity. Result(s): A total of 1,689 RADx-UP participants with an average age of 55+/-12.3, 51% male, 49% Black non-Hispanic, 23% living with HIV (86% virally suppressed), and 76% received at least one dose of a COVID-19 vaccine. Nearly 40% were disabled, 37% reported employment disability, and 21% were functionally disabled (disability that interferes with performance of daily activities). Despite recruitment from the same sources, PLWH, compared to those without HIV, were more likely to be disabled (52% vs 36%;p< 0.0001), report employment disability (63% vs 30%;p< 0.0001), and report functional disability (29% vs 18%;p< 0.0001). Those with employment disability were less likely to have ever been tested for COVID-19 compared to those without (81% vs 85%;p=0.026). Employment disability was also associated with lower odds of having ever tested positive for COVID-19 after adjustment for demographics, health insurance, HIV, COVID-19 vaccination, smoking, and lung disease (aOR, 0.62;95% CI, 0.43-0.90;p=0.013). Disability was associated with greater odds of transportation challenges (aOR, 2.33;95% CI, 1.76-3.08;p< 0.0001), illicit drug use (aOR, 1.92;95% CI, 1.49-2.47;p< 0.0001), and smoking (aOR, 1.74;95% CI, 1.39-2.17;p< 0.0001). Compared to those without, those with transportation challenges (14% vs 40%;p< 0.0001) and illicit drug use (18% vs 30%;p=0.001) were more likely to postpone medical care. Conclusion(s): Lower COVID-19 testing rates may contribute to underestimated COVID-19 positivity rates in adults living with disability. Challenges with transportation and substance abuse contribute to less engagement in care.

A retrospective review of the functional status of patients post-severe COVID-19 disease

Introduction: The purpose of this study was to evaluate the functional status and ongoing respiratory symptoms of patients who have been discharged home, who were admitted to the intensive care unit (ICU) with severe COVID-19 disease. Long term complications post critical illness, such as post intensive care syndrome (PICS), are well-recognised [1], however, little data exists specific to COVID-19 ICU survivors. Method(s): Local ethics committee approval was secured. Participants were recruited using the electronic intensive care chart database. All patients, from March 2020 to November 2021, who survived Covid-19 were included. Researchers conducted phone interviews with participants and completed three questionnaires;Katz Index of Independent Living Questionnaire, Karnofsky Performance Status Scale and the American Thoracic Society (ATS) Respiratory Disease Questionnaire. Data was input and analysed using excel and stored on a password encrypted computer. Result(s): Database search revealed 61 patients available, 33 of 61 patients were included. 20 (61%) were male, 13 (39%) were female. Mean age was 58, with a range of 25-81. Mean length of ICU stay was 15 days, with a range of 1-74 days. 15 (45%) patients were intubated. Most common Katz score (range 1-6) was the highest score of 6 in 23 (70%) patients. Most common Karnofsky score (range 10-100) was 60 in 11 (33%) patients, with 31 (94%) scoring < 100. The most frequent ATS shortness of breath (SOB) grade (range 0-4) was 3 in 10 (9%) patients, with 23 (70%) patients scoring > 0. 14 (42%) patients had an ongoing cough, 11 (33%) patients had a wheeze and 0 (0%) patients were on home oxygen therapy. Conclusion(s): This study highlights in the majority of patients who survived severe Covid-19 disease to discharge home, there were serious ongoing limitations to their functional status and exercise tolerance, however, they remained independent of basic activities of daily living.

Impact of Different Exercise Techniques on Menstrual Pain Severity in Postacute Covid-19 Women

Background: The purpose of this investigation was to determine the impact of different exercise techniques on menstrual pain severity in post-acute covid-19 women. Method(s): Thirty post-acute COVID-19 women suffering from primary menstrual pain. Their body mass index ranged from 25 to 35 kg/m2, and their age was between 18 and 25 years old. They were split up into two groups randomly. The control group (n=15) were instructed to avoid regular physical exercise during the study period, and the exercise group (n=15) were requested to perform set of home-based exercise protocol, from the fourth day of the menstrual cycle till the onset of the second menstrual cycle. Both groups were examined for pain intensity Pre-treatment and post-treatment using visual analogue scale (VAS). Result(s): Menstrual pain intensity was significantly reduced in the exercise group (p=0.000) but not statistically different in the control group (p=0.089). Conclusion(s): Different exercise techniques has a positive impact on menstrual pain severity in post-acute covid-19 women. Therefore, it can be recommended for menstrual pain relief in post-acute covid-19 women to promote their daily activities, independent living and quality of life.Copyright © 2021 Muslim OT et al.

The Health Hexagon Model: Postulating a holistic lifestyle approach to mental health for times and places of uncertainty

Professional-driven mental health services are often predicated on westernized beliefs of mental health and distress. This presumptuous view results in treatment solutions that are not suitable to (many) non-western contexts because they are neither culturally valid nor practically sufficient. Instead of promoting imported ideas of mental health, we encourage communities, including Hong Kong, from and for where the authors primarily theorize the current thesis, to turn to and strengthen the resources they employed before the medicalization of distress and suffering. Basic foundational elements in one's everyday life, which we present here as the Health Hexagon Model, should be promoted, especially healthy sleep, healthy diet, regular physical activity, closeness with nature, supportive kinships and friendships, and a sense of purpose, meaning, or sacredness. These elements are not novel;the importance of these basic elements has been recognized, distilled, and transmitted generation after generation. We advocate for communities to identify the missing or hampered fundamental elements in their lives and focus on finding methods that would help them adopt a lifestyle conducive to individual and collective health. This call-to-action is particularly timely as the global community fights for its survival against the coronavirus and ponders ways to cope with the seismic changes in lifestyle it has brought.Copyright © 2022 The Authors