Sleep quality of first-line medical workers fighting against COVID-19 in Wuhan

[Background] Sleep is closely related to immune function and human health, and adequate sleep is an important foundation for human health. [Objective] This study investigates the sleep status of the first-line medical staff in Wuhan in a fight against the coronavirus disease 2019 (COVID-19) outbreak, provides reference for improving the sleep quality of the first-line medical staff in public health emergencies. [Methods] Through convenience sampling, 112 medical workers (first-line group) who aided the COVID-19 fight in Wuhan and 134 medical staff (non-first-line group) who did not participate in the fight were selected. The Pittsburgh Sleep Quality Index (PSQI) was employed to collect data on the incidence of sleep disorders, time to fall asleep, duration of sleep, sleep efficiency, sleep disorders, use of sleep aid, and daytime functions. In addition, a self-made questionnaire was used to investigate the common concerns and time allocation characteristics of the first-line medical workers in the context of major infectious disease outbreaks. [Results] There were no significant differences between the two groups in demographic variables such as gender, age, job title, educational background, marriage status, number of children, and working years (P > 0.05). In the first-line group, 62 medical workers (55.36%) reported sleep disorders, while in the non-first-line group, 54 medical workers (40.30%) did;the difference was statistically significant (P=0.008). Among the seven components of the PSQI, the median sleep time (component 3) score of the first-line group was 1.5, which was higher than that of the non-first-line group (median 1.0) (P < 0.001);the median sleep efficiency (component 4) score of the first-line group was 1.0, which was higher than that of the non-first-line group (median 0) (P < 0.001). The actual sleep duration of the first-line group [(5.65+/-1.15) h] was lower than that of the non-first-line group [(7.00+/-1.40) h] (P < 0.001). The distributions of common concerns were different between the two group. The top three concerns were being infected (76.79%), exhausted (37.50%), and overloaded (27.68%) in the first-line group, and family members being infected (53.73%), being infected (45.52%), and child care (33.58%) in the non-first-line group. [Conclusion] The first-line medical team members report poor sleep quality, short sleep time, low sleep efficiency, sleep disorders, and many psychological concerns. It is necessary to take appropriate measures to improve their sleep quality.Copyright © 2021, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.

ATTENTION INDICATORS AS MARKERS OF FATIGUE IN AMBULANCE WORKERS

Medical care at the pre-hospital stage requires concentration of attention from ambulance workers and induces stress on the functional systems of their bodies. The spread of COVID-19 has increased the workload on mobile ambulance teams and worsened functional state of the team members' central nervous systems. This study aimed to investigate the impact of professional activity on changes in the indicators reflecting attention capacity, allocation and switching in mobile ambulance healthcare workers in the context of the COVID-19 pandemic. We used the Number Square method to assess these indicators. The participants were divided into groups with the help of standard tens, through standardization of the number of digital symbols, correct answers, mistakes made and time spent. The clear signs of fatigue by the end of the work shift are the decreased attention capacity, registered in 40.48% (p < 0.0001) of participants, and deteriorating attention allocation, registered in 64.29% (p < 0.05). The dynamics of the indicators were revealed to be associated (negative trends) with length of service and age. The registered values did not decrease at each subsequent shift, which proves the rest period between the shifts ensures a sufficient recovery. Decreased attention capacity and allocation by the end of the shift, as objective signs of fatigue, depend on age and length of service. Lack of negative dynamics shift-to-shift shows that the functional resources of the body are restored during the prescribed rest period even in the intense conditions of mobile ambulance teams' work during the COVID-19 pandemic. © Modern Pediatrics. Ukraine. All rights reserved.

Observational study of antibody levels after second and third SARS-CoV-2 vaccinations in medical workers.

BACKGROUND: Countries around the world are actively promoting vaccination against COVID-19. We observed the changes in serum neutralizing antibody titers in medical workers vaccinated with inactivated COVID-19 vaccine, in order to explore the necessity of a third dose of vaccination. METHODS: A total of 62 medical workers in our hospital were observed. Novel coronavirus neutralizing antibody titers in serum were detected by ELISA (enzyme-linked immunoassay). Neutralizing antibody tests followed in four batches according to the different time periods after three vaccinations. Sixty-two observers participated in the first batch of testing for neutralizing antibody, and 18 of them participated in all four batches. Fasting venous blood was taken from all the participants in the morning to detect serum neutralizing antibody titers. RESULTS: Sixty-two medical workers were divided into age groups of 21-30, 31-40, and >40 years, and the antibody titer in the oldest group was significantly lower than that in youngest group (p = 0.0137). There was a gradual decrease in antibody titers over time at around 1, 3, and 6 months after the second dose of vaccine (p < 0.0001). The antibody positive rate also decreased gradually (p = 0.0003). The neutralizing antibody titer around 1 month after the third dose was significantly increased (p < 0.0001). Unexpectedly, three participants with negative neutralizing antibody after the first and second dose produced neutralizing antibody with a measurable titer after the third dose. CONCLUSIONS: The neutralizing antibody titer in serum increased significantly after the third dose of vaccine. A third immunization even produced neutralizing antibody in previously negative individuals.

Knowledge and Medical Worker Health Security Management During a Pandemic COVID-19

Successive waves of the pandemic observed in Europe and around the world demonstrate the dramatic working conditions of medical staff. Constant exposure to dangerous SARS-Cov-2 virus undoubtedly affects the medical community's sense of security in terms of functioning in the workplace. The year 2020 demonstrated the unstable condition of information-related conditions that we live in. In an age of near-instant communication in the form of the Internet and other types of communicators, citizens received various, most often contradictory and untrue information concerning the virus, the pandemic conditions, and the principles of safe functioning in them. It seems, however, that medical specialists, due to their education and occupations, are among the best prepared in terms of knowledge, out of all professions. In addition to knowledge concerning the virus itself, these specialists also understand where to look for reliable information concerning the latest scientific reports on the pandemic. The article aims to present the views of medical workers regarding their sense of health security in relation to access to knowledge and information about the COVID-19 pandemic and their functioning in the work environment. The results of the research reveal positive dependencies between the access of knowledge and information and healthcare professionals sense of health security.

Stressful events induce long-term gut microbiota dysbiosis and associated post-traumatic stress symptoms in healthcare workers fighting against COVID-19.

OBJECTIVE: The microbiota-gut-brain axis is a key pathway perturbed by prolonged stressors to produce brain and behavioral disorders. Frontline healthcare workers (FHWs) fighting against COVID-19 typically experience stressful event sequences and manifest some mental symptoms; however, the role of gut microbiota in such stress-induced mental problems remains unclear. We investigated the association between the psychological stress of FHW and gut microbiota. METHODS: We used full-length 16S rRNA gene sequencing to characterize the longitudinal changes in gut microbiota and investigated the impact of microbial changes on FHWs' mental status. RESULTS: Stressful events induced significant depression, anxiety, and stress in FHWs and disrupted the gut microbiome; gut dysbiosis persisted for at least half a year. Different microbes followed discrete trajectories during the half-year of follow-up. Microbes associated with mental health were mainly Faecalibacterium spp. and [Eubacterium] eligens group spp. with anti-inflammatory effects. Of note, the prediction model indicated that low abundance of [Eubacterium] hallii group uncultured bacterium and high abundance of Bacteroides eggerthii at Day 0 (immediately after the two-month frontline work) were significant determinants of the reappearance of post-traumatic stress symptoms in FHWs. LIMITATIONS: The lack of metabolomic evidence and animal experiments result in the unclear mechanism of gut dysbiosis-related stress symptoms. CONCLUSION: The stressful event sequences of fighting against COVID-19 induce characteristic longitudinal changes in gut microbiota, which underlies dynamic mental state changes.

Post-COVID-19 Epidemic: Allostatic Load among Medical and Nonmedical Workers in China.

BACKGROUND: As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. OBJECTIVE: During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. METHODS: An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. RESULTS: There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; p = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18-1.31; p < 0.01), depression (OR = 1.23; 95% CI 1.17-1.29; p < 0.01), somatization (OR = 1.20; 95% CI 1.14-1.25; p < 0.01), hostility (OR = 1.24; 95% CI 1.18-1.30; p < 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34-1.66; p < 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78-0.89; p < 0.01), subjective support (OR = 0.84; 95% CI 0.80-0.88; p < 0.01), utilization of support (OR = 0.80; 95% CI 0.72-0.88; p < 0.01), social support (OR = 0.90; 95% CI 0.87-0.93; p < 0.01), and global well-being (OR = 0.30; 95% CI 0.22-0.41; p < 0.01) were negatively associated. CONCLUSIONS: In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.

Factors Influencing Mental Health of Medical Workers During the COVID-19 Outbreak.

Background: Since the outbreak of COVID-19, physical and psychological harm has been spreading across the global population alongside the spread of the virus. Currently, the novel coronavirus has spread to most countries in the world, and its impact on the public is also increasing. As a high-risk group in direct contact with the virus, medical workers should be monitored, and their mental health deserves extensive attention. The aim of this study was to explore the mental health of medical workers facing the novel coronavirus and the main factors affecting it. Methods: The present cross-sectional study including 2,100 eligible individuals from 1,050 hospitals in China was conducted through the network platform powered by www.wjx.cn, a platform providing functions equivalent to Amazon Mechanical Turk. We used a self-designed questionnaire to collect demographic information and data on mental states, including gender, age (years), educational level, job rank, body and mind reaction, cognition of risk, and the judgment of the epidemic situation. Independent samples t-tests and one-way (ANOVA) analysis were carried out to compare the differences in the mental reactions according to the demographic and psychological states of the participants. Results: There were 502 males (23.9%) and 1,598 females (76.1%). The participants reported feeling calm (39.1%), tense (63.0%), scared (31.4%), angry (18.8%), sad (49.0%), afraid (34.7%), optimistic (5.1%), impressed (65.0%), and confident (31.1%) during the epidemic. At the same time, the psychological stress responses of medical staff were significantly different according to the levels of exposure in their environments, duration and personal experience. Conclusions: Prolonged exposure to the virus and intense work are detrimental to the mental health of medical care personnel. It is necessary to adjust work conditions and intensity according to workers' mental state flexibly and systematically.

Clinical characteristics of 80 hospitalized frontline medical workers infected with COVID-19 in Wuhan, China.

More than 1,000 medical workers have been infected with COVID-19 in China. The 80 hospitalized patients included 57 SARS-CoV-2 confirmed and 23 clinically diagnosed. The median age was 39 years, 49 (61.25%) were women, and one patient died. The most common symptoms at onset were fever (65, 81.25%), cough (47, 58.75%), fatigue (28, 35%), myalgia (19, 23.75%), expectoration (19, 23.75%), and diarrhea (15, 18.75%). Patients of frontline medical workers at a single-center hospital showed some unique clinical and laboratory findings compared with other patients in Wuhan and outside of Wuhan. This study provides our experience for other frontline medical workers.