Perceived stigma among discharged patients of COVID-19 in Wuhan, China: A latent profile analysis.

Background: Perceived stigma has greatly influenced the life quality of the COVID-19 patients who recovered and were discharged (RD hereafter). It is essential to understand COVID-19 stigma of RD and its related risk factors. The current study aims to identify the characteristics of perceived COVID-19 stigma in RD using latent profile analysis (LPA), to explore its psycho-social influencing factors, and to determine the cut-off point of the stigma scale using receiver operating characteristic (ROC) analysis. Methods: A cross-sectional study was conducted among COVID-19 RD in 13 communities in Jianghan District, Wuhan City, Hubei Province, China from June 10 to July 25, 2021, enrolling total 1,297 participants. Data were collected on demographic characteristics, COVID-19 perceived stigma, post-traumatic stress disorder (PTSD), anxiety, depression, sleep disorder, fatigue, resilience, social support, and peace of mind. LPA was performed to identify different profiles of perceived COVID-19 stigma level. Univariate analysis and multinominal logistic regression analysis were conducted to explore the influencing factors in different profiles. ROC analyses was carried out to identify the cut-off value of perceived stigma. Results: Among the participants, three profiles of perceived stigma were identified: "low perceived COVID-19 stigma" (12.8%), "moderate perceived COVID-19 stigma" (51.1%), and "severe perceived COVID-19 stigma" (36.1%). Multinominal logistic regression analysis revealed that older age, living with other people, anxiety, and sleep disorder were positively associated with moderate perceived COVID-19 stigma, while higher educational level was negatively associated with moderate perceived COVID-19 stigma. Female, older age, living with other people, anxiety, and sleep disorder were positively associated with severe perceived COVID-19 stigma, while higher educational level, social support, and peace of mind were negatively associated with severe perceived COVID-19 stigma. ROC curve of the Short Version of COVID-19 Stigma Scale (CSS-S) for screening perceived COVID-19 stigma showed that the optimal cut-off value was ≥ 20. Conclusion: The study focuses on the issue of perceived COVID-19 stigma and its psycho-socio influencing factors. It provides evidence for implementing relevant psychological interventions to COVID-19 RD.

Psycho-social support based intervention for patients and caregivers stranded during the lock-down during COVID-19 pandemic: A case study report from India

This research report is based upon experience in psychosocial intervention conducted during COVID-19 pandemic at a large National Mental Health Institute. The aim of this intervention was to relieve from distress the patients and caregivers stranded at the campus of National Institute of Mental Health and Neurosciences (NIMHANS), India due to imposition of lockdown. As the institute is a tertiary care center, patients from everywhere regularly seek treatment at the institute. Three hundred discharged patients and their caregivers who had come for treatment from different states were stranded due to lockdown. They were distressed due to multiple challenges related to lack logistics, adequate shelter, uncertainty about food and medicines. A team from the Centre for Psychosocial Support in Disaster Management (CPSSDM) of NIMHANS proactively initiated a gross assessment of needs and challenges faced by this distressed group. The team delivered psychosocial intervention to this group in mobilizing various Non-Governmental Organizations (NGOs) support. We followed the CARE case report guidelines while preparing this report. The report provides practical insights into nature of psychosocial needs and interventions relevant to a specific group of people in transit during a pandemic. © 2023 DMICS.

Early Mental Health and Quality of Life in Discharged Patients With COVID-19.

Aim: This study aimed to analyze the early mental health (MH) and quality of life (QoL) of discharged patients with coronavirus disease 2019 (COVID-19), which can provide a scientific basis for the further development of intervention programs. Methods: In total, 108 subjects participated in this study, including an experimental group (90 patients diagnosed with COVID-19 from March to April 2020 and hospitalized in Wuhan China Resources & WISCO General Hospital, Wuhan, China, 83.3%) and a control group (18 healthy participants, 16.7%). Their MH and QoL were measured through the 12-item Short Form Health Survey version 2 (SF-12v2), the Self-rating anxiety scale (SAS), the Self-rating depression scale (SDS), and the International Physical Activity Questionnaire (IPAQ). The results of questionnaires were compared between these two groups. Results: (1) Comparison of anxiety status: among 90 discharged patients with COVID-19, 30 patients (33.3%) had a state of anxiety. Compared with healthy participants and the general population, patients with COVID-19 in the early stages of discharge had a higher incidence of anxiety and more severe anxiety symptoms (P < 0.05). (2) Comparison of depression status: among 90 discharged patients with COVID-19, 29 patients (32.2%) had a state of depression. Compared with healthy participants and the general population, patients with COVID-19 in the early stages of discharge had a higher incidence of depression and more severe depression symptoms (P < 0.05). (3) Comparison of QoL: 78 patients (86.7%) presented a decrease in physical health-related quality of life (HRQoL) and 73 patients (81.1%) presented a decrease in psychology-related QoL. The SF-12v2 physical component summary (PCS) and the SF-12v2 mental component summary (MCS) of patients were significantly lower than those of healthy people, especially in physical function (PF), vitality (VT), social function (SF), and mental health (MH) (all P < 0.05). (4) Gender differences in mental health and the QoL among patients with COVID-19: women had more severe anxiety/depression symptoms than men (P < 0.05). The scores of women in all dimensions of SF-12V2 were lower than those of men, and there were statistically significant differences between the two groups in PCS, PF, general health (GH), VT, and role-emotional (RE) (P < 0.05). Conclusion: During the early phase after being discharged, patients with COVID-19 might experience negative emotions, such as anxiety or depression, and also problems with reduced QoL, especially among female patients. Therefore, an intervention plan should focus on strengthening psychological condition and improving physical function, and gender-specific rehabilitation programmes should be adapted to improve psychological status and QoL.

A Noncontact Ballistocardiography-Based IoMT System for Cardiopulmonary Health Monitoring of Discharged COVID-19 Patients.

We developed a ballistocardiography (BCG)-based Internet-of-Medical-Things (IoMT) system for remote monitoring of cardiopulmonary health. The system composes of BCG sensor, edge node, and cloud platform. To improve computational efficiency and system stability, the system adopted collaborative computing between edge nodes and cloud platforms. Edge nodes undertake signal processing tasks, namely approximate entropy for signal quality assessment, a lifting wavelet scheme for separating the BCG and respiration signal, and the lightweight BCG and respiration signal peaks detection. Heart rate variability (HRV), respiratory rate variability (RRV) analysis and other intelligent computing are performed on cloud platform. In experiments with 25 participants, the proposed method achieved a mean absolute error (MAE)±standard deviation of absolute error (SDAE) of 9.6±8.2 ms for heartbeat intervals detection, and a MAE±SDAE of 22.4±31.1 ms for respiration intervals detection. To study the recovery of cardiopulmonary function in patients with coronavirus disease 2019 (COVID-19), this study recruited 186 discharged patients with COVID-19 and 186 control volunteers. The results indicate that the recovery performance of the respiratory rhythm is better than the heart rhythm among discharged patients with COVID-19. This reminds the patients to be aware of the risk of cardiovascular disease after recovering from COVID-19. Therefore, our remote monitoring system has the ability to play a major role in the follow up and management of discharged patients with COVID-19.

Probable Causes and Risk Factors for Positive SARS-CoV-2 Testing in Recovered Patients: Evidence From Guangzhou, China.

Some patients retested positive for SARS-CoV-2 following negative testing results and discharge. However, the potential risk factors associated with redetectable positive testing results in a large sample of patients who recovered from COVID-19 have not been well-estimated. A total of 745 discharged patients were enrolled between January 30, 2020, and September 9, 2020, in Guangzhou, China. Data on the clinical characteristics, comorbidities, drug therapy, RT-PCR testing, and contact modes to close contacts were collected. Patients who tested positive for SARS-CoV-2 after discharge were confirmed by guidelines issued by China. The repositive rate in different settings was calculated. Among 745 discharged patients, 157 (21.1%; 95% CI, 18.2-24.0%) tested repositive and the repositive rate was 16.8% (95% CI, 14.1-24.0%) for nasopharyngeal swabs and 9.7% (95% CI, 7.0-12.5%) for anal swabs. Among them, 55 (35.0%) were asymptomatic, 15 (9.6%) had mild symptoms, 83 (52.9%) had moderate symptoms, and 4 (2.6%) had severe symptoms at the first admission. The days from discharge to repositivity was 8.0 (IQR, 8.0-14.0). Most repositive patients were without clinical symptoms, and lymphocyte cell counts were higher than before being discharged. The likelihood of repositive testing for SARS-CoV-2 RNA was significantly higher among patients who were of younger age (OR, 3.88; 95% CI, 1.74-8.66, 0-17 years old), had asymptomatic severity (OR, 4.36; 95% CI, 1.47-12.95), and did not have clinical symptoms (OR, 1.89; 95% CI, 1.32-2.70, without fever). No other positive patients emerged within the families or close contacts of repositive patients. Our findings support prolonged but intermittent viral shedding as the probable cause for this phenomenon; we need to familiarize with the possibility that the virus will remain endemic.

Polymerase Chain Reaction Assays Reverted to Positive in 25 Discharged Patients With COVID-19.

We report the observation that 14.5% of COVID-19 patients had positive RT-PCR testing again after discharge. We describe correlations between laboratory parameters and treatment duration (P = .002) and time to virus recrudescence (P = .008), suggesting the need for additional measures to confirm illness resolution in COVID-19 patients.

Duration of Viral Shedding of Discharged Patients With Severe COVID-19.

COVID-19 has drawn global intensive attention. We analyzed the duration of viral shedding and the total time from illness onset to discharge in groups. This has important implications for making decisions for isolation of discharged patients and to provide guidance for the duration of hospitalization of patients with severe COVID-19.

The characteristics of 527 discharged COVID-19 patients undergoing long-term follow-up in China.

BACKGROUND: Almost a year after the outbreak of coronavirus disease 2019 (COVID-19), many hospitalized COVID-19 patients have recovered. However, little is known about the long-term follow-up (> 2 months) of discharged patients. METHODS: This study enrolled 527 discharged COVID-19 patients from 05 February to 11 March 2020. Basic characteristics, imaging features, nucleic acid detection results, and antibody levels of these patients were retrospectively reviewed. RESULTS: Of the 527 discharged patients, 32 (6.1%) had re-detectable positive (RP) nucleic acid results for SARS-CoV-2 during follow-up examinations, with 11 and four detections entailing stool samples and anal swabs, respectively, rather than respiratory samples. Juveniles were more susceptible to "infection recurrence" than other age groups, with shorter time spans for re-detectable positive (RP) RNA tests (an average of 8.8 days [6.0-9.0 days]), while the reverse was true for the middle-aged group (17.5 days on average [14.0-17.5 days]). Similar improvements in the imaging features of both RP and no RP (NRP) groups were observed. Negative antibody detections in patients at 3 and 6 months after discharge were 14.2% and 25.0%, respectively. Cases evidencing negative antibodies were more common among juvenile patients (40% vs. 15.6%, P=0.03) 6 months post-discharge. CONCLUSIONS: A total of 6.1% of 527 discharged patients showed RP status, which may be easier to be identified from stool samples than from other samples. Given the dropping rate of SARS-CoV-2 antibodies, reinfection may happen, especially in juvenile patients (aged<18 years). These findings have implications for the long-term management of recovered COVID-19 patients.

Clinical characteristics and impacts of traditional Chinese medicine treatment on the convalescents of COVID-19.

Objectives: A significant proportion of discharged COVID-19 patients still have some symptoms. Traditional Chinese medicine (TCM) has played an important role in the treatment of COVID-19, but whether it is helpful for discharged patients is still unknown. The aim of this study was to retrospectively analyze the impacts of TCM treatment on the convalescents of COVID-19. Methods: A total of 372 COVID-19 convalescents from February 21 to May 3 in Shenzhen, China were retrospectively analyzed, 291 of them accepted clinically examined at least once and 191 convalescents accepted TCM. Results: After retrospective analysis of the clinical data of convalescents accepted TCM treatment or not, we found that the white blood cell count, as well as serum interleukin-6 and procalcitonin decreased in TCM group. Serum γ-glutamyl transpeptidase was significantly decreased, while prealbumin and albumin increased in TCM group. Red blood cell, hemoglobin, and platelet count increased in TCM group. The mechanisms of TCM treatment might be the overall regulations, including balanced immune response, improved hematopoiesis and coagulation systems, enhanced functions of liver and heart, increased nutrient intake and lipid metabolism. Conclusions: This study suggested that TCM treatment would be beneficial for discharged COVID-19 patients. However, long-term medical observation and further study with randomized trial should be done to confirm this result. Besides, the potential molecular mechanisms of TCM treatment should be further revealed.

Clinical and imaging findings of discharged patients with SARS-CoV-2 positive anal swab samples: a descriptive study.

BACKGROUND: To explore the clinical features and CT findings of clinically cured coronavirus disease 2019 (COVID-19) patients with viral RNA positive anal swab results after discharge. METHODS: Forty-two patients with COVID-19 who were admitted to Yongzhou Central Hospital, Hunan, China, between January 20, 2020, and March 2, 2020, were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using anal swab viral RT-PCR. In this report, we present the clinical characteristics and chest CT features of six patients with positive anal swab results and compare the clinical, laboratory, and CT findings between the positive and negative groups. RESULTS: The anal swab positivity rate for SARS-CoV-2 RNA in discharged patients was 14.3% (6/42). All six patients were male. In the positive group, 40% of the patients (2/5) had a positive stool occult blood test (OBT), but none had diarrhea. The median duration of fever and major symptoms (except fever) in the positive patients was shorter than that of the negative patients (1 day vs. 6 days, 4.5 days vs. 10.5 days, respectively). The incidence of asymptomatic cases in the positive group (33.3%) was also higher than that of the negative group (5.6%). There were no significant differences in the CT manifestation or evolution of the pulmonary lesions between the two groups. CONCLUSION: In our case series, patients with viral RNA positive anal swabs did not exhibit gastrointestinal symptoms, and their main symptoms disappeared early. They had similar CT features to the negative patients, which may be easier to be ignored. A positive OBT may indicate gastrointestinal damage caused by SARS-CoV-2 infection.