Does COVID-19 affect mental health and substance use in young adults?

BACKGROUND: Mental health has been impacted by COVID-19 throughout the United States and beyond. The mental health and well-being were further affected with excessive substance use during the pandemic. The aim of this research was to explore how the COVID-19 affects the mental health of the young adults (18-24 years) in the South Jersey area. We also examined the association between mental health symptoms in young adults and substance use during the first and second year of the pandemic. METHODS AND MATERIAL: A cross-sectional survey was conducted with (n = 711) 527 participants that included young adults (18-24 years old) across university campus in south jersey and in the community cohorts. Multinomial regression analysis and Chi-squared test were used to explore the association between mental symptoms and substance use. Data were analyzed using Microsoft Excel Spreadsheet for descriptive statistics and Python 3.0 scikit-learn package. RESULTS: The study showed that "Lonely" and "Hopeless" were the top two mental health symptoms. It was observed that the symptoms of "Lonely" and "Hopeless" increased for both males and females. In general, males seemed to be affected more than females in this study for mental health symptoms. For substance use, "Nervous" and "Smoking" showed positive correlation in 2020 and "Hopeless" and "Alcohol" were positively correlated in 2021. CONCLUSIONS: Young adults' mental health symptoms and substance use has been proven to be affected through the pandemic and this research results even though localized will assist the community and educational institutions to plan better support to assist young adults with better health and wellness initiatives.

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.

COVID-19 and tinnitus-a tertiary care Centre experience

Background: COVID-19 outbreak was declared a global pandemic in March 2020 by WHO. Due to person-to-person transmission of this infection, majority of countries of world introduced lockdown to ensure people stay at home. A complex bidirectional interaction exists between tinnitus and emotional distress, as they can exacerbate one another. Also, COVID-19 infection can cause damage to outer hair cells. The aim of this study is to find out relationship between COVID-19 and initiation or exacerbation of tinnitus. Method(s): The present retrospective study, after approval by Institutional Ethics Committee, was conducted in Department of ENT, GMC Jammu, from June 2020 to March 2021 on 90 patients with primary complaint of tinnitus. All 90 patients were asked to complete the Tinnitus Handicap Inventory. Also, all patients were asked COVID-19-related questions (history of contracting virus/history of grief/anxiety/depression/stress/nervousness/financial status/ physical exercise/sleep routine/ social interactions). Result(s): Out of 90 patients, 72 patients (80%) had chronic longstanding tinnitus and 18 patients (20%) experienced tinnitus during pandemic. Out of 72 patients who gave history of longstanding tinnitus, 41 patients (56.9%) reported tinnitus to be stable during COVID-19 pandemic, 26 patients (36.1%) reported it to become more bothersome and 5 patients (6.9%) reported that tinnitus was improved. Out of 90 patients, 21 patients (23.3%) were diagnosed as COVID-19 positive. Of these 21 patients experiencing COVID-19 symptoms, 16 patients (76.2%) gave history of exacerbation of tinnitus, 4 patients (19%) gave history of tinnitus remaining stable and 1 patient (4.7%) said that tinnitus was improved. Out of 90 patients, history of negative psychological impact due to COVID-19 restrictions was seen in 65 patients (72.2%). Conclusion(s): With our study, we concluded that ENT specialists should be fully aware that not only pre-existing tinnitus may be exaggerated due to COVID-19 infection, but also, there can be development of new-onset tinnitus due to COVID-19 infection and the negative psychological impact due to COVID-19 pandemic.Copyright © 2022, The Author(s).

The Drivers of Stress in Women Employees Caused by the Pandemic COVID-2019

The rationale of this article is to study and evaluate the stress faced by individuals, especially Indian working women within their families, during the outbreak of the COVID-19 pandemic. Through this study, the authors aim to highlight the impact of the pandemic on Indian women grappling with mental and emotional distress. For this study, primary research techniques have been used. A survey instrument was constructed and circulated among women working from home or employees of any firm. Based on the survey, focused group interviews were conducted with randomly selected females. The total responses for this study were 203. The study results were collated and a statistical analysis of multivariate regression was used to conclude the findings. From this study, three factors contributed to the overall stress levels faced by working women induced by the COVID-19 pandemic: depression, nervousness and anxiety. Many studies have examined healthcare workers and their stress levels during the global pandemic. However, there is little literature on Indian working women, especially those working in I.T. and manufacturing companies. This article aims to identify the factors that can lead to stress and burnout in Indian working women specifically during the COVID-19 pandemic. © 2023 XLRI Jamshedpur, School of Business Management & Human Resources.

The Impact of Covid-19 Pandemic on Affective Concussion Symptoms in Adolescents

Purpose of Study: Affective symptoms, such as depression, nervousness, anxiety, and irritability, are common yet complicating aspects for concussion patients, therefore addressing exasperations of these symptoms is essential for injury management. This is an especially important consideration for patient populations increasingly susceptible to affective disorders, such as those in rural regions and adolescents. Increases in adolescent mental health problems during the time of the COVID-19 pandemic pose an additional challenge for clinicians managing affective concussion symptoms in rural adolescents. The aim of this study is to quantify the mental health effects of the pandemic by comparing affective concussion symptoms in groups of adolescents with concussion and without concussion in the Central Oregon region. Methods Used: The study is a secondary data analysis of ImPACT Concussion Test symptom scores from a cohort of non-concussed (Baseline) and concussed (Post-Injury) adolescents between the ages of 12-18, pre-pandemic (January 1, 2015 - March 20, 2020) and pandemic (March 21, 2020 - April 1, 2022). Subjects were excluded from the study if they received special education, had a diagnosis of learning disabilities, ADD, dyslexia, autism, or received treatment for headaches, migraines, epilepsy, brain surgery, meningitis, substance use or psychiatric conditions. Prevalence of symptoms of 'headache', 'trouble falling asleep', 'irritability', 'nervousness', 'sadness', and 'feeling more emotional' were noted for each group during each time period. Summary of Results: A total of pre-pandemic non-concussed (n =2667), pre-pandemic concussed (n=643), pandemic non-concussed (n = 593) and pandemic concussed (n=87) were included in the final analysis. There was a statistically significant increase in the proportions of 'nervousness' (p=0.0209) and 'sadness' (p=0.0117) in pre-pandemic and pandemic non-concussed groups. Furthermore, there were statistically significant increases in the proportions of 'headache' (p=0.0331), 'irritability' (p=0.0006), 'nervousness' (p=0.0135), 'sadness' (p=0.0357) and 'feeling more emotional' (p=0.0039) between pre-pandemic and pandemic concussed adolescents. Conclusion(s): This study demonstrates a significant increase in affective symptoms in both concussed and non-concussed groups during the COVID-19 pandemic consistent with other studies. However, those with concussion during the COVID-19 pandemic showed greater number of affective symptoms as well as somatic symptoms (headache) compared to concussed pre-pandemic adolescents. The results of this study support the broader body of research examining the mental health burden of the COVID-19 pandemic on adolescents, and further encourages a biopsychosocial approach to injury management, in which social and emotional components of a patient's life are considered.

Basic needs of the first batch of medical staff in the fever clinic of Peking union medical college hospital during Coronavirus disease 2019 outbreak: A qualitative study.

Objective The objective of this study was to investigate the basic needs of medical staff during the coronavirus disease 2019 pandemic in a fever clinic, so as to provide a reference for the global epidemic medical teams. Methods A semi-structured qualitative interview outline was designed, including: (1) work level: Working hours, working intensity, and safety guarantee in a fever clinic;(2)life level: Diet, sleep, and physical comfort;(3)psychological level: Emotion, pressure, coping style, and interpersonal resources. The basic needs of the first batch of the fever clinic in Peking Union Medical College Hospital was studied by open telephone interviews. Results A total of 37 medical staff were interviewed, including 8 males (21.6%) and 29 females (78.4%). Among them, there were 16 doctors (43.2%), 19 nurses (51.4%), and 2 medical technicians (5.4%). In terms of work settings, the ideal continuous working time was 4-6 hours per shift. There should be pro re nata positions during extremely high workload, and sufficient personal protective equipment was the key to safety. In terms of living conditions, providing meals according to different shifts was important for dietary needs, and sleeping pills were temporarily needed for sleep. In terms of psychological reactions, nervousness and worrying were relatively common. Family and colleagues were important resources of support. Sport could help relieve physical and psychological stress, and psychological support from psychologists was helpful in reducing their negative emotions. Conclusions The basic needs of medical staff should be respected so as to keep the efficacy of their work. We suggest that medical staff can rest after each 4-6 h working shift. Personal protective equipment should be sufficient. Psychological support should be noted in all of them and provided when necessary.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.

The impact of the COVID-19 pandemic on Portuguese adults' psychopathological symptoms: a cross-sectional study

BACKGROUND: The impact of the pandemic on mental health has been demonstrated in several reports. The aim of the present study was to evaluate the impact of the COVID-19 pandemic on multiple dimensions of psychopathology in Portuguese adults. We compare a pandemic sample assessed during the second lockdown in Portugal with a prepandemic sample. METHOD(S): Participants provided socio-demographic and clinical information and responded to the Brief Symptom Inventory. RESULT(S): The pandemic group relative to the prepandemic group demonstrated significantly higher levels for BSI scales of depression, anxiety, and phobic anxiety, and lower scores for paranoid ideation. At the level of the 53 BSI items, significant difference between pandemic and prepandemic groups occurred for 20 of the items. CONCLUSION(S): Results describe the multidimensional influence of the pandemic on psychological functioning and are relevant to guiding the implementation of intervention strategies.Copyright © 2021 EDIZIONI MINERVA MEDICA.

COVID-related delays in care and illness anxiety for patients with cutaneous T-cell lymphoma

It is well known that the COVID-19 pandemic caused significant treatment delays for dermatology patients, and recent studies demonstrate poor outcomes for patients with cutaneous T-cell lymphoma (CTCL) during this time. However, not much is known about patient reported delays in management of this condition following the pandemic. This study sought to evaluate patient-reported illness anxiety and delays in management of CTCL. Fifty-two CTCL patients were recruited from clinic from October 2020 to October 2021. Patients were asked to complete a 22-question survey adapted from the United States Census Household Pulse Survey. Control data was extrapolated from published national data from the Household Pulse Survey. Of 52 patients surveyed, 28 were male (59.6%). 25 identified as white (54.3%), 18 as Black (39.1%), 8 as Asian (15.3%) and 1 as Native American (2.2%). Average age was 57 years, age range 24-89 years. Results demonstrate that 32.6% (n=15) of respondents had a household member experience loss of employment since March 2020 compared to 39.6% of the US population. 46.8% of respondents vs. 32.3% US population noted some level of difficulty in paying for household expenses including medical care. Only 4.3% of respondents noted that they delayed receiving medical care due to the coronavirus pandemic. When compared to the US population (59.8%), a lower proportion of respondents (48.9%) noted symptoms of nervousness or anxiety over the past week. 27.7% of respondents vs. 46.1% of US population reported feelings of hopelessness or depression over the past week. These results demonstrate a low number of patients reporting care delays, possible due to the interval when data was collected, several months after COVID-19 onset. It is also possible that telehealth contributed to lessening delays in care. Overall, the results of this study reinforce the significant physical, financial, and emotional impact of CTCL on the daily lives of patients, and the heightened impact of COVID-19 on this population.Copyright © 2023

Psychological Concerns of Children Undergoing Kidney Transplantation and Their Families during the Covid-19 Pandemic

Background The current COVID-19 pandemic has been an anxious time for children and young people (CYP) with end stage kidney disease and their families particularly as they were identified as a vulnerable group. Many transplant programmes closed and reopening brought new concerns for patients and professionals. We report patient experience on being transplanted during the pandemic. Objectives To obtain a better understanding of the concerns and experiences that CYP and families have about receiving a kidney transplant during the pandemic. Methods A questionnaire was sent to patients and families of 10 paediatric patients transplanted in the first six months of reopening our transplant programme. One patient refused transplant and one lacked social support to proceed with the transplant. Results All participants felt that their questions were answered before transplantation and 75% felt well informed about the SARS-CoV-2 effects on transplantation. 62.5% reported feeling nervous 37.5% were anxious 25% scared and 12.5% relaxed about transplantation during the pandemic. The majority of participants reported surgical complications being their biggest fear;two participants were worried about catching SARS-CoV- 2. 87.5% felt that care was delivered safely in inpatient and outpatient setting. 75% of participants found shielding easy. Overall 87.5% of patients were glad to have received a kidney transplant during the pandemic with one patient struggling with feeling isolated. Conclusions Receiving a kidney transplant can be a stressful experience particularly during a pandemic. Our results show that a significant number of patients felt scared that detailed counselling of CYP and families about risks and addressing their concerns related to SARS-CoV-2 contributed to a good patient and family experience on transplantation during the pandemic. Further studies are needed to look into the longterm effects of the pandemic on this vulnerable group of patients and strategies to mitigate them.

Depression, Anxiety And Stress Among The Undergraduate Students In Punjab

Parents and students want their experiences to be life-changing. The years spent in college are often a period of learning and development for many students. But obstacles like sorrow, despair, anxiety, sadness depression, though, can stand in the way. The prevalence of anxiety and depression among college students has significantly grown since the beginning of the COVID-19 pandemic. According to a recent survey, severe depression and anxiety affect one in three college students. The early detection and treatment of depression can be aided by parents and students being aware of the risk factors and symptoms. In the present study, the validated DASS-21 scale was used as the evaluation tool. It was discovered that college students exhibit mild levels of stress, moderate levels of depression, and severe levels of anxiety. It was shown that female students were more likely than their male counterparts to experience psychological distress. Given the high prevalence of depression, anxiety, and stress among students, support services and preventive measures must be put in place to assist all students, but especially those who are more prone to experiencing greater levels of these psychological illnesses. The present article is based on the study conducted among undergraduate students in Punjab. Copyright © 2022, Anka Publishers. All rights reserved.

Knowledge, Attitude, Practices and Risk of Psychological Distress among Frontline Healthcare Workers Towards COVID-19 in Second Wave

Introduction: Frontline Healthcare Workers (F-HCWs) are at the front position for medical care against Coronavirus Disease 2019 (COVID-19) pandemic which has life-threatening potentials. Poor level of knowledge, practices and negative attitudes as well as high-risk of psychological distress among F-HCWs can directly lead to delayed diagnosis, treatment and poor infection control practices. Aim: To assess the level of Knowledge, Attitude and Practices (KAP) as well as risk of psychological distress among F-HCWs for COVID-19 pandemic. Materials and Methods: This descriptive, hospital-based, cross-sectional study was conducted at Government Medical College, Azamgarh, Uttar Pradesh, India, located in tertiary care centre in rural area) from October 2021 to December 2021 among 223 F-HCWs using convenient sampling technique. To assess the level of KAP as well as risk of psychological distress among F-HCWs a prevalidated structured questionnaire was used consisting 15 knowledge questions, six attitude questions, 15 practices questions and six questions on risk of psychological distress. Chi-square test was performed to examine the association between risk of psychological distress and level of KAP as well as with demographic characteristics of F-HCWs. Results: Out of total 223 participants more than half of physicians (52.9%) and one-third of staff nurses (35.9%) were from age group of 25-35 years, respectively. Majority of both physicians (57.1%) and staff nurses (87.6%) were married and had nuclear type of family as of 64.3% and 74.5%, respectively. Most of the physicians (92.9%) had good level of knowledge but they had less positive attitude (84.3%) compare to staff nurses (92.8%). Majority of both physicians (64.3%) and staff nurses (58.2%) had no or low risk of psychological distress while only few of them had its high level. Conclusion: In this study majority of F-HCWs reported overall 'good' level of knowledge, attitude and practices for prevention of COVID-19. As for as risk of psychological distress was concerned, majority of F-HCWs had its no or low risk.

SUBOPTIMAL UPTAKE OF OUTPATIENT PULMONARY REHABILITATION FOLLOWING DISCHARGE FOR A COPD EXACERBATION: ONE HOSPITAL'S EXPERIENCE

SESSION TITLE: Practice Management Beyond Coding and Staffing SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: Despite reduced health care utilization and mortality for COPD patients participating in pulmonary rehabilitation (PR) after hospitalization, few enroll in this intervention. Reasons were explored in a post-discharge survey to inform new ways to market or restructure PR. METHODS: IRB-approved, telephone survey and record review of patients with COPD discharged from one hospital over 1-year period. Inclusion criteria for analysis: 1) Principal diagnosis of COPD or respiratory failure;2) Discharge home;3) PR indicated or not contraindicated. Inclusion criteria for survey: 1) Telephone consent;2) Fluency in English. RESULTS: 191 were studied. Of these, 51 (27%) were not in a home setting (26 died, 25 not discharged home), 32 (16%) had no indication for PR (11 had an incorrect diagnosis, 21 not medically indicated). Of the remaining, 62 could not be surveyed (38 not reachable, 8 language barrier, 16 refused consent), leaving 46 (24% of total group) surveyed at 132 ± 89 days following discharge. Of those surveyed, 89% had a primary care provider, 72% had a pulmonologist, 43% had heard of PR, but only 24% ever participated in this intervention. 28% were ever referred to PR. Pulmonologists were the most common referrers. Desirable outcomes and factors that might influence the patient’s decision to participate in PR are in the Table. Table. Survey Results, n = 46 Mean rankings of Importance to Patients: 1 = least important, 5= most important Potential Outcomes of Importance to Patient Reduced Hospitalization Risk 4.80 Improvement in Dyspnea 4.54 Learn More About Lung Disease 4.34 Increase in Ability to do Things 4.26 Fewer Flare-ups of Lung Disease 4.26 Decrease in Tiredness or Fatigue 4.09 Reduced anxiety or nervousness 3.94 Opportunity to Interact with Others 3.49 Factors that Might Positively Influence Decision for PR Likelihood of Beneficial Outcome 4.34 Low Cost 4.23 Short Travel Distance to PR 4.00 Less Concern over Excessive Dyspnea during Exercise 3.54 Convenient Transportation to PR 3.37 Fewer Weather-Related Issues 2.89 Not Having to Get Up in the AM to Go to PR 2.66 No Family Responsibility Conflicts in Attending PR 1.97 Not Too Soon After Hospitalization 1.60 No Employment Conflicts in Attending PR 1.37 CONCLUSIONS: Despite reasonably good access to medical care, uptake of PR was poor. Important factors in under-utilization include non-indication or contraindication or non-referral to PR. CLINICAL IMPLICATIONS: A major limitation of this survey is that it was conducted during the COVID-19 pandemic when PR facilities were closed. Those never participating in PR nevertheless listed desirability of outcomes typically attributed to PR. Although repeating the survey post-pandemic may yield more accurate results, current data indicates the need for improved patient education and referral to PR. This is a potential target for future interventions to increase PR usage. DISCLOSURES: No relevant relationships by Osama Elsankary No relevant relationships by Antarpreet Kaur No relevant relationships by Hnin Hnin Oo No relevant relationships by Jane Reardon No relevant relationships by Ryan Talbert No relevant relationships by Richard ZuWallack

Emotion and sleep quality of adolescents and youth groups in the period of work and school resumption after COVID-19

Objective: To understand the emotion and sleep state of youths and adolescents who returned to school during the mild period of COVID-19. Methods: A total of 1621 subjects were investigated using the self-made information questionnaire, SAS, SDS and Pittsburgh Sleep Quality Index (PSQI). Nvivo12.0 and SPSS23.0 were used to analyze the data. Results: The subjects reported boredom, worry, nervousness. There were significant differences in sleep quality index in terms of gender, residence status, time of reading news of COVID-19, and time of communicating with parents (P<0.01). The sleep quality index (4.67±3.12) of college students was lower than the norm (5.8±2.4) (P<0.001), the SAS score (42.87±9.94) of teenagers was higher than the norm (29.78±10.07) (P<0.001), and the SDS score (47.64±11.34) of youths and teenagers was higher than the norm (33.46±8.55) (P<0.001). During this period, PSQI was significantly positively correlated with SAS score and SDS score, and effectively predicted SAS score and SDS score. Conclusion: During the stage of work and school resumption, the emotional state of youths and teenagers was still affected, but presented positive characteristics, with a variety of positive emotions. Compared with the general state, youths and teenagers showed higher depression and anxiety, but sleep quality of college students was better than that in the general state.

Impact of COVID-19 on medical education and anxiety levels of medical students

Objective: To study the impact of covid-19 on medical education and anxiety level of medical students. Methodology: This prospective cross sectional study was done at Shifa College of mMedicine, Islamabad, Pakistan from 1st October 2020 to 15th November 2020. Medical students were randomly selected and a preformed questionnaire was circulated among them via Online Google forums. We used GAD-7 scale. Data were analyzed using SPSS version 23. Results: Out of 122 respondents, 69 (56.5%) were female. Mean age was 22.1 ± 1.7 years. Almost all students had online education during COVID-19, however, 64 (52.4%) of them faced communication problems during online education. Only 32 (26.2%) were satisfied with this method. In this study, 46 (37.7%) respondents had anxiety;38.0% had moderate to severe and 27.0% had mild anxiety. Most of the anxious respondents were significantly younger (21.6 vs. 22.5 years, p = 0.01). Females were significantly more anxious (69.6% vs. 30.4%) than males (p < 0.03). Conclusion: During Covid-19 pandemic, anxiety and stress levels have increased among medical student.

PSYCHOLOGICAL IMPACT OF COVID-19 IN HEMODIALYSIS PATIENTS

BACKGROUND AND AIMS: The COVID-19 pandemic has required containment measures in Morocco, as well as practice changes in haemodialysis centres. Haemodialysis patients are at risk of aggressive symptoms of COVID-19, which significantly increases mortality. This particular situation creates psychological disorders in those patients, such as anxiety, sleep disorders and irritability. The objective of our study is to assess the mental health status of haemodialysis patients during the pandemic and the psychological impact of confinement. This assessment will allow the adaptation of a supportive relationship with the patient through adequate psychological management. METHOD: This is a mono-centric, non-interventional study that included all haemodialysis patients at the haemodialysis centre of the nephrology department at Ibn Rochd University Hospital during the confinement period (March 2020- June 2020).This study is based on a pseudonymized paper questionnaire, during confinement, based on two psychiatric scores (GAD-7, PHQ-9) that assess anxiety, depression as well as sleep disorders, which allowed us to collect socio-demographic data, anxiety depressive symptomatology and an assessment of sleep disorders. RESULTS: The average age of our population is 47.4 years old, 54% of whom are men. Almost 34.54% have a primary level of education The higher level of education was 14.45%, while 14.54% are illiterate. Regarding family status, 45% are married. Those who are living alone accounted for 55%. Before confinement, 57.15% patients were daily workers;10 others had no work, among 3 of them were students;the 5 others were managers. After starting haemodialysis, 65.7% patients stopped their work. We noted that 38% of patients had a feeling of nervousness and anxiety for several days, while 9% had the same symptoms for more than half of the day. Concerning excessive anxiety, it was noted in 34% of patients for several days, while 16% showed excessive anxiety for more than half of the days. Concentration difficulties were noted in 41% of the patients for over several days and 5% more than half of days, while 58% of patients never had difficulties of concentration. The irritability feeling over several days was noted in 43% of patients, while 5.4% presented a feeling of irritability more than half of the days. Difficulty falling asleep is noted in 49% of patients, while 51% of patients have no difficulty falling asleep. The feelings of sadness, depression and despair are noted in 49% of patients for several days and 5% for more than half of the days. Sleep disorders were noted in 60% of patients on several days, while 40% had sleep disorders on more than half of the days. Loss of appetite was noted in 65% of patients. A lack of self-confidence was noted for several days in 43% of patients. 29% of patients lost the pleasure of having fun for several days. A total of 36% were slow or restless for several days. None of our patients expressed a desire to end their life, and 49% did not lose the pleasure of doing their daily activity. CONCLUSION: The mental health of dialysis patients assessed appears to be unaffected during this first wave of the pandemic. This could be due to high resilience, higher unemployment among dialysis patients, a reduced impact of social distancing on the haemodialysis population, strict precautionary measures and perceived support from health workers, who can all contribute to addressing this pandemic.

HEALTH RELATED QUALITY OF LIFE IN PATIENTS WITH END-STAGE RENAL DISEASE BEFORE AND AFTER STARTING DIALYSIS DURING PANDEMIC COVID-19

BACKGROUND AND AIMS: Patients with end-stage renal disease (ESRD) have complex functional and social changes that affect their quality of life (QoL), leading to an increased cardiovascular risk, mortality and overall morbidity. Several studies showed that general QoL worsened after dialysis initiation but improved by 12 weeks. The influence of coronavirus (COVID-19) among pre-dialysis CKD patients starting dialysis during pandemic COVID-19 is challenging and still largely unexplored. To evaluate the quality of life in patients with ESRD before and after initiating dialysis during pandemic COVID-19, in Constanta County, a south-eastern Romanian region. METHOD: We assessed 59 patients (mean age = 61.65year ± 11.36, Male : Female = 3:1, 13.79% employee) with ESRD before and after dialysis started (T1-12 weeks and T2-24 weeks), using KDQOL-36TM, in the interval of time of 1 year (May 2020-May 2021). RESULTS: QoL was severely affected in patients with diabetes and hypertension, especially because of diet restrictions (58.6%, P < 0.01), fatigue (67.5%, P < 0.01), concerns about the kidney disease (72.4%, P < 0.05) and permanent need for medical services (48.6%, P = NS). Most of the patients required acute initiation of haemodialysis on CVC (66.1%) due to uraemic manifestations and late referral, 34.4% started planned haemodialysis on AV fistula and 8.47% started planned peritoneal dialysis. An overall improvement of QoL was seen both in patients with urgent and planned dialysis initiation, in women group less than in males (P < 0.05). Among dialysis patients at T2, we have found significantly lower levels for mean Mental Component Summary (MCS), calculated as 45.9 ± 14.1, about 3.1 points less than the majority of other studies. The following mental health-related symptoms were claimed during the COVID-19 pandemic 'second and third waves': feeling sad, worrying, feeling nervous and trouble falling asleep, even though dialysis patients seemed less impacted by social distancing measures. CONCLUSION: The initiation of dialysis was an important factor in improving the QoL in our ESRD patients and the type of dialysis and planned initiation contribute substantially to the patient's perception of the disease and influence the main psychosocial parameters of QoL. COVID-19 pandemic affected the QoL of patients that started dialysis in the established interval of time, especially the mean MCS score, probably associated with the high morbidity and mortality of Romanian ESRD and dialysis patients.

Impact of the COVID-19 outbreak on the level of distress in patients with breast cancer

Goals: In a very short period of time, during the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the coronavirus disease 2019 (COVID-19) became a great threat worldwide in terms of health, as well as social and economic aspects. From the beginning of the outbreak, patients with cancer were considered a high-risk population with regard to the COVID- 19 infection. Epidemiological measures imposed during the pandemic, such as social distancing and lockdowns, additionally burdened patients with cancer. Psychological distress is common in such patients. The prevalence of distress in patients with breast cancer ranges approximately 20–40%. The aim of this study was to examine the impact of the COVID-19 outbreak on the level of distress among patients with breast cancer in Croatia, during extreme epidemiological measures. We also sought to examine whether disease or socio-demographic characteristics were predictors for distress. Methods: A total of 545 patients with breast cancer were approached to participate in the study;201 patients completed the questionnaire with disease and socio-demographic characteristics. All patients were actively receiving systemic oncological treatment (neoadjuvant, adjuvant, or metastatic setting), with disease stages ranging I–IV. The level of distress was measured using the Distress Thermometer with a cut-off value of 4, followed by a problem list. The study was conducted from April 20, 2020 to May 24, 2020, while all extreme epidemiological measures (lockdown and strict social distancing) were ongoing and equally applied to all regions in Croatia. Results: High distress level was reported in 54.2% of patients. The most prominent problems were worry, fatigue, sleep, nervousness, fear, and child care. Highly distressed patients had more practical problems (child care, housing, and work/school) and emotional problems (depression, fear, nervousness, sadness, worry, and loss of interest for usual activities), than those in the low distress group. None of the socio-demographic or disease characteristics of the patients were linked to the level of distress. Conclusion(s): Even in a country with a favorable epidemiological situation, at the beginning of the COVID-19 pandemic, every second patient with breast cancer had a high level of distress. COVID-19- induced distress should be promptly addressed and additional psychological and social support, targeting specific practical and emotional problems, should be provided for those patients. Conflict of Interest: No significant relationships.

Assessment of COVID-19-related new onset of Depression and Anxiety: A Comparative Cross-Sectional Study

Aim: The aim of the present study assessment of new-onset depression and anxiety associated with COVID-19. Methods: This analytical, cross-sectional study was done the Department of Psychiatry Adesh Medical College Hospital Ambala Haryana, India for 10 months. By using Google Form platform contained validated online survey among Indian population which includes all adult males and females during or post COVID-19 infection and compared to the non-COVID-19 population as a control group. Results: 38% of participants were male while 62% are females. 26% of participants were married while 70% were single. 60% of participants are students and 38% are employed while 2% are retired. Regarding the COVID-19-positive and COVID-19-negative participants, 25% of participants reported having been diagnosed with COVID-19. Scores of PHQ-9 ranged from 0 to 27 (the mean is and the standard deviation is 6.12). Depression prevalence in our sample was 40%. Scores of GAD-7 ranged from 0 to 21 (the mean of 8.99 and the standard deviation is 5.33). Anxiety prevalence in our sample was 41%. The model shows a significant overall effect of gender [F(489) = 39.02, p<0.001], a non-significant effect of COVID-19 infection [F(489)=1.88, p=0.177] and a trending effect of the interaction between gender and COVID-19 [F(489) = 3.25, p=0.069]. Since the effect is not significant, we did not run any post hoc analyses. Conclusion: Significant levels of depression and anxiety were observed among the study population. The high levels of depression and anxiety may have masked the differences between those with or without COVID-19.

Mental and physical disorders in graduate university teachers during the COVID 19 pandemic in Mexico City

Introduction: During the confinement period due to the SARS-CoV2 pandemic, in July 2021, a survey was carried out to study the health and working conditions of postgraduate professors at a public university in Mexico City. Material and methods: All postgraduate professors were invited to participate. The protocol was approved by the bioethics committee. By an electronic questionnaire was obtained information about: personal, work, distance teaching, physical and mental health, and symptoms of depression, and anxiety. The Chi2 test was used. Significant associations are reported. Results: Eighty-nine graduate teachers participated, 50.6% women and 49.4% men. Sixty-three percent were full-time, and 44.9% were hourly teachers. During the pandemic, most received some training in distance learning, 74% had adequate equipment and furniture. Cyberbullying was not reported, and 79% allocated part of their free time to work. Fourteen percent had good physical health and 76% moderate. The most-reported complaints were neck, back, and hand/wrist pain, and sleep disturbances, mainly full-time;45% slept 6 hours or less. Thirty-six percent had good mental health and 41.6% moderate;37% indicated feeling nervous, higher in full-time teachers;7% reported feeling depressed, twice higher in women. Due to academic load, 46% felt overwhelmed, and 31% burnout, higher in full-time and women. Conclusions: During confinement, graduate professors reported moderate symptoms of anxiety and depression and musculoskeletal complaints related in part to their teaching activities, with symptoms being higher in full-time staff and women.