ABSTRACT
In December 2019, a novel coronavirus outbreak spread rapidly all over the world. The virus is known to be neuroinvasive, but much is still unknown. In this study, we aimed to pres-ent the main neurologic symptoms in patients who were diagnosed with coronavirus disease 2019 (COVID-19). The study was conducted retrospectively by phoning 156 patients in Turkey diagnosed with COVID-19 through real-time polymerase chain reaction;only 100 patients could be reached. Data about their demographics, initial symptoms, neurological symptoms, and sleeping habits were collected. During the disease process, 66% had at least one neurological symptom, 55% had central nervous system symptoms, 42% had peripheral nervous system symptoms, and 64% had sleep disturbances and myalgia. Impaired consciousness, smell and taste impairments, and sleep disturbances were significantly higher in patients with positive chest computed tomography imaging (p < 0.05). Neurological symptoms were observed in COVID-19, as in other coronaviruses. Headache in particular was the most common symptom in our population. In patients with respiratory system findings, the detec-tion of certain neurological symptoms such as smell-taste impairments, impaired consciousness, and sleep disorders were more common. We concluded that COVID-19 patients should be approached in a more holistic way, taking the nervous system into account.Copyright © 2022, Dr. Mladen Stojanovic University Hospital. All rights reserved.
ABSTRACT
Background: COVID shelters and many emergency centers were established as a countermeasure to control this pandemic that hit the word by the end of 2019. Due to unavailability of medical care, along with physical health is-sues, these patients suffer with mental health related issues. Aims: This study aimed to explore the both, physical and psychological impacts upon the patients diagnosed with COVID-19 and admitted in intensive care units of hospitals of Pakistan during the third wave. Methods: This cross-sectional survey was performed during the peak time of COVID-19 for the duration of two months i.e. April & May 2021. After getting ethical approval from Shifa International Hopsital (Ref# 070-021), permission was sorted from public and private hospitals of Pakistan. 183 conscious patients diagnosed with COVID and currently admitted in intensive care units were randomly selected from hospitals of Islamabad and Rawal-pindi. Written consent was taken from patients and their caregivers after they were briefed regarding the importance of the study. PHQ-15 was used to assess somatic symptoms related to COVID-19 whereas DASS-21 was used to assess level of depression, anxiety and stress among patients. Results: Of 183 hospitalized patients of COVID-19 in intensive care units, 170 (92.9%) participants showed mild to severe level of somatic symptoms on PHQ-15. Shortness of breath, feeling hearth race, back pain, stomach pain, low energy and sleeping difficulties were the most common somatic complaints reported by patients. The statistics of DASS-21 showed that 51 (27.86%) participants had mild to severe level of depres-sion, 74 (40.4%) had mild to profound level of anxiety and 96 (52.45%) reported mild to profound level of stress. Conclu-sion: This study portrayed a better understanding and confirms the physical and psychological impacts upon hospitalized COVID-19 patients, therefore highlighting the need of both physical and mental health interventions to minimize these impacts.
ABSTRACT
Objective: The systemic anti-cancer therapy (SACT) work stream of the East of England Cancer alliance identified variation in SACT administration times as a potential area to counter the impact of Covid-19 capacity restrictions within chemotherapy day units. The aim is to assess the impact of reducing post infusion observation time of pertuzumab-trastuzumab on efficiency and safety. Methods: The recommendation from East of England Cancer Alliance was to adopt one hour observation post pertuzumab and one hour post trastuzumab for cycle 1, 30 min after each infusion for cycle 2 and 3 and a zero observation time thereafter for patients who have had no reaction. All patients administered IV pertuzumab-trastuzumab between October 2020 and May 2021 were identified. The number of patients experiencing hypersensitivity reactions with the original and reduced observation time was compared. The impact of reduced observation time on chair capacity was also calculated. Results: Of the 26 patients treated with the original observation time between October 2020 to January 2021, two patients reacted and received Hydrocortisone IV 100 mg and Chorphenamine IV 10 mg. Patients continued treatmnet at a slower rate. No patients discontinued treatment due to the reaction. Reactions included flushing, stomach pain, uncontrolled bladder and face swelling. Between February and May 2021,18 patients were treated with reduced observation times and 3 patients reacted. Reactions included hypertension, chills, vomiting and shivering. The total number of patients between the cohorts differs due to the conversion of some patients to Phesgo from April 2021. These patients were managed similarly to the previous cohort with added IV ondansetron and IV metoclopramide. No patient discontinued treatment following the reaction. Chair times savings were 5 h for cycle 1, 2 h for cycle 2 and 3, and 3 h from cycle 4 onwards. In total, 53 chair hours in the chemotherapy day unit were released between February to May 2021. Conclusion: The pressure on chemotherapy units has been exacerbated by staff absence, reduced capacity due to social distancing and use of PPE. Whilst the SPC for trastuzumab states patients should be observed for 6 h post first infusion and for 2 h post subsequent infusions, the implementation of reduced observation times post infusion of pertuzumab-trastuzumab did not impact on patient safety and encouragingly increased the capacity of the day unit by 53 h in four months.
ABSTRACT
Objectives: The aim was to identify relevant patient reported outcome (PRO) instruments used to screen for patients with symptoms of COVID-19 and measure their treatment outcomes in clinical and epidemiological studies. Methods: A literature search was conducted to identify PRO symptom instruments developed to screen patients and/or monitor treatment outcomes of COVID-19. The searches were conducted in early May 2021 using ePROVIDE, PubMed Medline, and grey literature search using a generic search engine. The following key words were used: COVID-19, symptom diary, symptom instrument and results were limited to the past two years. Results from the literature review were combined and compared against a recently published qualitative interview study with patients recovering from COVID-19 (Rofail et al, MAD-ID 2021) to evaluate conceptual overlap among diaries and patient-reported concepts. Results: Seven acute COVID-19 diaries and one post COVID-19 symptom/functioning scale were identified from the targeted literature search. Symptoms present across all diaries and reported in the qualitative study included: cough, diarrhea, dyspnea/difficulty breathing, sore throat, myalgia/muscle pain, fever, loss of smell, fatigue, vomiting, headache, loss of taste, loss of appetite/anorexia,nausea, runny nose/stuffy nose. Somewhat frequently reported symptoms captured by at least three diaries and the qualitative study included: abdominal/stomach pain, chills/feeling cold, chest pain, chest discomfort/pressure/tightness, sneezing, sputum, vision disorders/conjunctivitis, constipation, dizziness, epigastric soreness, head congestion, sinus pressure, skin lesions, sweating, tachycardia/heart palpitations and teary or watery eyes. Symptoms that were only reported in the qualitative study included: body ache, back pain, earache, mental fatigue/sleepiness, skin rash, swollen glands, and not feeling like oneself. Conclusions: There are a number of common symptoms similarities across the diaries that were frequently reported in qualitative research. However, there were several discrepancies across diaries for included and excluded symptom concepts. More research is needed to identify symptoms of COVID-19 that matter most to patients.
ABSTRACT
Background: The COVID-19 pandemic disrupted the lives of children and adolescents by invading their families, peer groups and school, worsening their prospects and causing anxiety about the future. Due to the threat of COVDI-19, restrictions were imposed worldwide, forcing changes in daily life, social interactions, education and work. There is no doubt that these strict restrictions have contributed immensely to reducing the risk of SARS-CoV-2 virus spread, but at the same time had significantly affected the health of young people in all its dimensions. The main aim of this study is to present changes in health and health behaviours between 2018 and 2021. Method: Data from the Youth and COVID-19 survey conducted in the first quarter of 2021 by the Institute of Mother and Child in Warsaw among adolescents aged 11-17 years (n=1571) as well as data from the Health Behaviour in School-aged Children (HBSC) according to the 2018 survey conducted in the same age groups (n=7701) were analysed. So were analysed indicators of physical development, mental health, subjective complaints and health behaviour. The prevalence of the aforementioned indicators was compared between 2018 and 2021, overall, by gender and age using chi2 test. Results: A significant increase was observed in the percentage of overweight and obese adolescents (according to WHO criteria) evident in the older age groups (15 and 17 years) and the percentage of underweight boys;an increase in the percentage of adolescents negatively assessing their health and well-being (according to the WHO5 scale-score indicating depressive symptoms) in each age group and both genders;frequently experiencing physical and mental health problems-in both genders such as headache, stomach ache, backache, feeling depressed, nervousness, difficulty in falling asleep and dizziness;only in girls-tiredness;in older adolescents-headache, stomach ache, backache, feeling depressed, irritability, nervousness, difficulty in falling asleep and dizziness;in each age group-feeling depressed;only in the youngest-tiredness. There was a significant decrease in the percentage of adolescents undertaking moderate-to-intensive physical activity at the recommended level of 60 minutes per day in both genders and each age group. However, there were positive changes in dietary behaviour: an increase in the percentage of adolescents eating daily with family in each age group, eating vegetables daily in both sexes and each age group, and a decrease in the percentage of adolescents frequently drinking sugary drinks in both sexes and each age group. Furthermore, no change was observed in the rate of frequent consumption of fruit and vegetables. Conclusion: The adverse effects of the pandemic on health and well-being are progressing rapidly, so urgent action is needed to help mitigate the severe effects of the pandemic and safeguard the future of young people.