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The COVID-19 pandemic situation affected population health and lifestyle not only for a short period but also long period. Long COVID symptoms is a long-term illness after COVID condition. Long COVID symptoms greatly affected to quality of life of patients. Massage is a unique treatment form of alternative medicine that can promote health in various dimensions. From the previous studies, massage has affected to Long COVID mechanism via anti-inflammatory process, immune system enhancing process, and hormone level balancing that related to Long COVID symptoms as well as being able to reduce the symptoms of the long COVID symptoms. The study about the efficacy and safety of massage against Long COVID symptoms is the essential approach to increase the value of massage and develop health services in the future.
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Many zoonotic diseases are found in wild animals and present a serious risk to human health, in particularly the virus carried by birds flying freely around the world is hard to control. There are three main bird migration routes which cover the most areas of China. It is important to investigate and fully understand the types of avian transmitted diseases in key areas on the bird migration routines and its impacts on both birds and human health. However, no literature is available in how about the risk of virus carried by migrating birds, and how to predict and reduce this risk of virus spreading to human being so far. In this paper, we first reviewed the main pathogen types carried by birds, including coronaviruses, influenza viruses, parasites, Newcastle disease virus (NDV), etc., and then discussed the spread risk of avian viruses to human being and animals in key areas of biosafety prevention. We also analyzed and discussed the risk of cross-spread of diseases among different bird species in nature reserves located on bird migration routes which provide sufficient food sources for migratory birds and attract numerous birds. Diseases transmitted by wild birds pose a serious threat to poultry farms, where high density of poultry may become avian influenza virus (AIV) reservoirs, cause a risk of avian influenza outbreaks. Airports are mostly built in suburban areas or remote areas with good ecological environment. There are important transit places for bird migration and densely populated areas, which have serious risk of disease transmission. Finally, this paper puts forward the following prevention suggestions from three aspects. First, establish and improve the monitoring and prediction mechanism of migratory birds, and use laser technology to prevent contact between wild birds and poultry. Second, examine and identify virus types carried by birds in their habitats and carry out vaccination. Third, protect the ecological environment of bird habitat, and keep wild birds in their natural habitat, so as to reduce the contact between wild birds and human and poultry, and thus reduce the risk of virus transmission.
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As an important immuneoactive component in eggs, yolk immunoglobulin (IgY) shows great competitiveness in research and production due to its good stability, high safety, low cost, easy availability, strong immune activity, and no drug resistance. This article highlights the significant advantages of IgY as a good antibiotic substitute in the prevention and treatment of viral and bacterial diseases. Also, IgY has great potential in the regulation of nutrient metabolism balance, intestinal microflora and immune homeostasis by affecting key rate-limiting enzymes, and relevant receptors and inflammatory factors specifically. Proper diet and targeted delivery of foodborne IgY may be a new perspective on inflammation regulation, disease control, nutritional balance or homeostasis, and oral microencapsulated IgY is expected to be a new approach against increasing public health emergencies (such as COVID-19 pandemic).
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Introduction: Patients' negligence and difficult access to healthcare have an impact on the worsening of emergency conditions, which require immediate treatment due to the possibility of exacerbation in a short period of time. Untreated intra- and extraoral abscesses can have serious consequences on the patient's health and in many cases are life-threatening conditions increasing risk of respiratory obstruction, thrombophlebitis, meningitis, mediastinitis and septicemia. Background: The aim of this study is to investigate the impact of the pandemic and the resulting impediments to accessing medical care on the incidence and type of emergencies in the Oral Surgery Department. Material and methods: This was a retrospective study of 85375 patients aged 2 months to 90 years old with diagnosed intra- and extraoral abscesses before COVID-19 pandemic (2018,2019), and during pandemic (2020, 2021) in the Department of Oral Surgery of the Medical University in Lublin. The obtained results were statistically analyzed with the use of a computer program. Conclusions: The fewest patients were admitted in 2020, and the most in 2021, where we can already see the effects of the pandemic. Emergencies occurred most frequently in people aged 21-30, then 31-40. In 365 cases, tooth extraction was performed, and only in 28 cases, root canal treatment was attempted. Conclusions. Oral health service provision has been significantly affected by COVID-19. Patients came to their appointments too late, which in most cases resulted in the necessity of tooth extraction without attempting root canal treatment.
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Respiratory mucosal immune system is the body's first line of defense against infection. Since the outbreak of novel coronavirus disease 2019 (COVID-19) in 2019, nasal mucosal immune vaccine, with its ability to induce cellular, humoral and mucosal triple immune responses, has become a research hotspot. This article focuses on novel coronavirus, with an understanding of its structure and pathogenesis, a brief introduction to the immune mechanism of nasal mucosa, a summary of the different types of nasal mucosal immune vaccines and their clinical research, aiming to provide some theoretical reference for the development of new vaccines, and exploration of the best methods and strategies to combat COVID-19.
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Background. Since the start of the COVID-19 pandemic, Chad has had 7,417 confirmed cases and 193 deaths, one of the lowest in Africa. Objective. This study assessed SARS-CoV-2 immunity in N'Djamena. Methods. In August-October 2021, eleven N'Djamena hospitals collected outpatient data and samples. IgG antibodies against SARSCoV- 2 nucleocapsid protein were identified using ELISA. "Bambino Gesu" Laboratory, Rome, Italy, performed external quality control with chemiluminescence assay. Results. 25-34-year-old (35.2%) made up the largest age group at 31.9 12.6 years. 56.4% were women, 1.3 women/men. The 7th district had 22.5% and the 1st 22.3%. Housewives and students dominated. Overall seroprevalence was 69.5% (95% CI: 67.7-71.3), females 68.2% (65.8-70.5) and males 71.2% (68.6-73.8). >44-year-old had 73.9% seroprevalence. Under-15s were 57.4% positive. Housewives (70.9%), civil servants (71.5%), and health workers (9.7%) had the highest antibody positivity. N'Djamena's 9th district had 73.1% optimism and the 3rd district had 52.5%. Seroprevalences were highest at Good Samaritan Hospital (75.4%) and National General Referral Hospital (74.7%). Conclusion. Our findings indicate a high circulation of SARS-CoV- 2 in N'Djamena, despite low mortality and morbidity after the first two COVID-19 pandemic waves. This high seroprevalence must be considered in Chad's vaccine policy.
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Background: The outbreak of coronavirus disease 2019 (COVID-19) was declared by the World Health Organization (WHO) as a COVID-19 pandemic on March 11, 2020. Therefore, the availability of vaccines will help develop immunity and protect people from this pandemic. The present systematic study examined knowledge, attitudes, and willingness of adolescents towards COVID-19 vaccine in Bangkok, Thailand. Objectives: The objective of the study was to evaluate the knowledge, attitudes, and willingness toward COVID-19 vaccine of key stage 4A-5 students at Satit Prasarnmit International Programme in Bangkok towards COVID-19 vaccine. Materials and Methods: The study was conducted using an online questionnaire. A total of 136 students participated. Knowledge, attitudes, and willingness of adolescents toward the COVID-19 vaccine were assessed. Differences between outcomes and socio-demographic characteristics of participants were analyzed through independent t-tests and the ANOVA. The level of willingness to vaccinate against COVID-19 was analyzed by a generalized linear model. Results: Students revealed moderate knowledge about COVID-19, correctly answering 11.08 out of 15 points (SD = 1.74), a low level of attitudes toward COVID-19 vaccine 8.49 out of 15 points (SD = 2.51), and low level of willingness to vaccinate against COVID-19 vaccine 2.29 out of 5 points (SD = 1.26), in total of 35 points (28 questions). There are statistically significant positive correlations shown between attitude towards COVID-19 vaccine and the level of willingness to vaccinate against COVID-19 vaccine (I2 = 0.384, P < 0.01%). Conclusion: This study revealed students in Satit Prasarnmit International Programme had moderate knowledge towards COVID-19, negative attitudes toward COVID-19 vaccine and low willingness to vaccinate against COVID-19. Furthermore, it indicates that there is a casual relationship between attitudes toward COVID-19 vaccine and the willingness of individuals to be vaccinated against COVID-19 vaccine. Thus, attitude toward COVID-19 vaccine acts as a major predictive factor toward the willingness to vaccinate against COVID-19 vaccine. Therefore, to increase peopleA's willingness to be vaccinated against COVID-19 vaccine, it is necessary to increase peopleA's attitude toward COVID-19 vaccine.
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Background: Coronavirus disease 2019 (COVID-19) has affected all aspects of life globally and becomes a major threat to public health around the world. One of the most important actions that need to be taken to stop the pandemic is vaccinations. Managing the COVID-19 pandemic in the long-term, vaccine hesitancy and negative attitudes toward vaccines are major barriers. Objectives: This study aimed to investigate undergraduate students' knowledge, risk perceptions, and attitudes toward COVID-19 vaccinations among undergraduate students in Chiang Mai University, Thailand. Materials and Methods: The study was conducted using a questionnaire. A total of 280 students participated. COVID-19 related knowledge, risk perception, and attitude toward COVID-19 vaccines were assessed. Statistical test using SPSS statistics to analyze differences between intention to be vaccinated and socio-demographic was done using exact P-value, Pearson's Chi-square test, and Binary Logistic Regression. Results: Students revealed a moderate level of COVID-19 related knowledge. A moderate level of risk perception of getting COVID-19 has the highest number of students who want to get vaccinated (n = 76, 51.0%). Intention to get vaccinated was 53% (n = 148). The analysis of a binary logistic regression indicated that the monthly household income of students had a statistically significant effect on the intention to get vaccinated. Level of monthly household income predicted the deposition of intention to get vaccinated of students (Exp [B] = 0.773, P < 0.001). Most students had no intention to be vaccinated against COVID-19 due to concerns on side effects and efficacy of the current availability of COVID-19 vaccine in Thailand. Therefore, to increase more acceptance of COVID-19 vaccination among students, more choices of COVID-19 vaccine with high efficacy should be provided. Conclusion: Government should take firm and faster action for the unavailability of vaccines in Thailand to decrease vaccine hesitancy rate and give Thai citizens more choices of vaccine brands with higher levels of vaccine efficacy. Side effects from vaccines are one of the reasons for increase in vaccine hesitancy. Therefore, if Thai people can choose a higher efficacy vaccine, the news about vaccine side effects will be lower. Government should start educating and letting people know about side effects and whether the side effects are life threatening or not.
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OBJECTIVE: To investigate the expressions of peripheral blood microRNA-21(miR-21) and transforming growth factor-beta(TNF-beta)/Smad signaling transduction pathway in patients with bronchial asthma complicated with respiratory virus infection. METHODS: Totally 109 patients with asthma complicated with respiratory virus infection(study group) and 104 patients without virus infection(control group) in the Third People's Hospital of Gansu Province between Feb.2019 and Feb.2021 were selected for the cross-sectional study. The basic data of the two groups were collected, and parameters including vital signs, lung function, peripheral blood miR-21 and TGF-beta/Smad signaling pathway proteins were measured. According to the guidelines, the patients of the two groups were divided into acute exacerbation phase and stable phase. The examination results of each group were compared and the levels of peripheral blood miR-21 and TGF-beta/Smad signaling pathway proteins expression of patients with asthma complicated with respiratory virus infection were analyzed. RESULTS: In study group, the proportion of respiratory virus infection among 109 patients was 33.94% for influenza virus, 23.85% for human rhinovirus, 19.27% for respiratory syncytial virus, 10.09% for parainfluenza virus, 6.42% for adenovirus, 4.59% for human coronavirus and 1.83% for human metapneumovirus respectively. The proportion of patients with acute exacerbation phase in the study group was higher than that in the control group, and the levels of peripheral blood miR-21, TGF-beta1, Smad7, pSmad2 and pSmad3 were higher than those in control group(P<0.05). The levels of miR-21, TGF-beta1, Smad2, Smad3, Smad7, pSmad2 and pSmad3 in peripheral blood of patients with acute exacerbation phase of asthma were higher than those of patients with stable phase of asthma(P<0.05). There were no statistical differences in peripheral blood miR-21, TGF-beta1, Smad2, Smad3, Smad7, pSmad2 and pSmad3 levels in asthma patients with different virus infections. CONCLUSION: Early respiratory virus infections might lead to increased expression of peripheral blood miR-21 and increased activation of TGF-beta/Smad signaling pathway in patients with asthma, which played an important role in acute attack of asthma.
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The global pandemic coronavirus pneumonia (COVID-19), the disease infected by the new coronavirus (SARS-CoV-2), is extremely contagious. It is mainly spread among people through respiratory droplets, aerosols, direct or indirect contact, fecal-oral transmission, and cold chain transportation. Especially, patients who are in the incubation period or have no obvious symptoms already have the ability to infect others. SARS-C0V-2 is a positive-sense single-stranded RNA virus, with a single linear RNA segment. Each SARS-CoV-2 virion is 60-140 mm in diameter. Like other coronaviruses, SARS-CoV-2 has four structural proteins, known as the spike (S), envelope(E), membrane (M), and nucleocapsid (N) proteins. To date, a variety of detection methods for the SARS-CoV-2 have been developed based on the virus structural basis and 'etiological characteristics, which would provide an effective guarantee for the diagnosis of COVID-19 patients and the control of the epidemic. In order to help for the early diagnosis and prevention of COVID-19, the pathogenic characteristics and recent progresses of detection base on nucleic acid, immunology and biosensors of the SARS-CoV-2 are reviewed in this paper.
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Supply chain managers are forced to develop crisis-induced strategies due to the complexity of crises, as opposed to the more traditional strategies that prioritize competitive priorities. The increasing frequency and severity of recent crises, such as the coronavirus outbreaks, widespread product recalls, and financial crises, highlight the need for introspective and retrospective socio-economic insights on the contexts, priorities, and themes of supply chain management in times of crisis. This article's goal is to review the literature on supply chain management during times of crisis, organizing the relevant body of scholarly work in a systematic way, outlining current research methodologies, capturing strategic priorities and themes of complexity in research studies, and highlighting opportunities for additional research. Four factors for restorative priorities are identified by the review, which is based on a systematic analysis of 250 academic publications from 1996 to 2021 and reflects operations strategy in times of crisis: Critical supplies with important services, prompt action with restoration, safety with security, and traceability with transparency are just a few examples. The analysis also reveals that network configurations and business cycle complexity, optimal choices and provisioning system complexity, complicated learning processes and demand forecast are all sources of operational complexity during crises. The build-to-cycle, organic capabilities, and operational mindfulness framings for supply chain management in emergency situations are suggested with the use of review insights. The article ends with suggestions for future research on supply chain improvements, diagnosis, solidarity, mapping, temporariness, and thresholds, as well as optimal selection issues on connecting crisis network allocations with cross-functionalities and connecting crisis systems investments with liabilities.
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Patients on maintenance hemodialysis (MHD) are highly susceptible to SARS-CoV-2 and with high mortality rates due to Coronavirus disease 2019, mainly because of the older age in this group of patients, comorbidities, compromised immune status due to uremia, as well as inability to keep social isolation because of the necessity for regular physical presence in dialysis facility. Several retrospective studies of patients on MHD in Europe, America and Asia, show high susceptibility to SARS-CoV-2 in this group of patients with very high rates of critical course of the disease and high mortality rates, reaching more than 40% The aim of this retrospective observational study was to identify risk factors among patients on intermittent hemodialysis for infection with SARS-CoV-2 as well as predictors of severe COVID-19 and fatal outcome. Materials and methods. We analyzed 69 patients receiving intermittent dialysis in Aleksandrovska University Hospital - Hemodialysis Unit. 34 of them have been tested positive for SARS-CoV-2 in the period from September 2020 (when the first case of the disease was registered for our dialysis center) up to March 2022, and are compared with a control group of 35 dialysis-dependent patients without COVID-19. Data about comorbidities, main laboratory and radiologic findings, need of hospitalization and treatment in ICU, as well as data for conducted treatment, are collected from electronic medical records. To identify predictors of severe COVID and poor outcome we compared the group of survivors with the one of non-survivors. Results. There are no significant differences between patients on MHD with and without COVID-19 except higher frequency of COPD and hypoproteinemia in the positive group. Older age, female gender, history of smoking, lymphopenia with neutrophilia, treatment in ICU and need of mechanical ventilation, signs of malnutrition - hypoproteinemia and lower levels of serum creatinine, are risk factors for severe disease and fatal outcomes. Conclusions. The course of COVID infection in dialysis-dependent patients is severe and with high mortality rate, in line with other studies worldwide. Malnutrition is the main risk factor for COVID and also main predictor for poor outcomes.
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Background: Coronavirus disease 2019 (COVID-19) is an epidemic that has greatly affected the daily life of people around the world. This epidemic, in addition to affecting lives, also affects other matters such as the economy or government administration that need to find ways to reduce the epidemic rate. That is to provide adequate quality vaccines for the people of the country. Finally, the government finds measures to stop the spread of COVID-19. Objectives: This study aimed to assess an acceptance to be vaccinated against COVID-19. Materials and Methods: Intention to be vaccinated against COVID-19 was measured with a question A"When a vaccine for COVID-19 is ready for you, will you get vaccinated?A" Response options were A"yes, A" A"not sureA" and A"no.A" Participants who responded A"not sureA" or A"noA" were asked to provide a reason. Results: A total of 400 responses were received. Overall, 38.5% (n = 154) of participants intended to get vaccinated, 29.5% (n = 117) were unsure, and 32.25% (n = 129) were not planning to get vaccinated. Factors that are independently related to vaccine hesitancy (A"not sureA" or A"yesA" response) include being male, risk perception of getting COVID-19, confidence in the government in handling the pandemic. Conclusion: A total of 400 participants, in the study, 38.5% (n = 154) of participants intended to get vaccinated, 29.5% (n = 117) were unsure, and 32.25% (n = 129) were not planning to get vaccinated. Male participants had a higher chance to refuse to vaccinate more than female 2.69 times. Predictive factors for COVID-19 vaccination were risk perception of contracting COVID-19 and lack of confidence in the government handling the pandemic of COVID-19.
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Objective: To evaluate the influence of coronavirus disease 2019 (COVID-19) prevention and control measures on the transmission and epidemic of influenza in Chongqing, so as to provide references for formulating targeted influenza prevention and control strategies. Methods: The influenza surveillance data, during the year 2018 to 2020, were collected through the "China Influenza Surveillance Information System", and the seasonal characteristics of influenza epidemic were analyzed. The percentage of influenza like cases (ILI%) and influenza virus positive rate between 2020 and 2018-2019 were compared, so as to evaluate the impact of COVID-19 prevention and control measures on influenza epidemic characteristics. Results: The annual proportions of ILI cases in Chongqing were respectively 3.53%, 2.23% and 1.2% from 2018 to 2020, while the positive rates of influenza virus were respectively 13.97%, 23.81% and 2.65%. The distribution trend of ILI% from 2018 to 2019 fluctuated were similar, but it continued to drop and remain at a low level since February 2020. The positive rate of influenza virus showed an epidemic peak from December to March in 2018-2019, also peaked from November 2019 to January 2020, but decreased to 0 in March. ILI% was positively correlated with the positive rate of influenza virus (r=0.404 8, P < 0.05). In 2020, compared with the same period of 2018-2019, the growth rate of ILI% was -66.09% and -46.32%, respectively. The positive rate of influenza virus in 2020 decreased by 81.03% and 88.87% compared with the same period of 2018-2019, respectively. The growth rates of influenza virus positive rate in January 2020 were decreased with a small rate of about 39.87%, and with a significantly decline of more than 93.65% from February. No influenza epidemic was found after March. Conclusions: Since COVID-19 prevention and control measures were implemented in January 2020 in Chongqing, the ILI% and the positive rate of influenza virus in sentinel hospitals decreased significantly. In the season of high incidence of respiratory infectious diseases, personal protection and other measures can effectively reduce influenza virus infection.
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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a significant health and financial issue in the current century. Despite significant attempts to manage the illness, the transmission routes of the virus and its widespread genomic mutations have led to an increasing number of new infections and mortality rates. In the absence of specific treatment for this new virus, identifying and managing factors affecting the prognosis of the disease is one of the critical strategies to reduce disease mortality. Patients with iron deficiency anemia (IDA), who account for an estimated half a billion people globally, are more prone to infections due to immune system disorders. Since they visit hospitals more frequently for follow-up care and diagnosis, they are more susceptible to becoming infected with SARS-CoV-2. Once infected with SARS-CoV-2, low hemoglobin (Hb) levels and compromised immune systems disrupt the restriction of infection in these individuals, ultimately leading to severe complications of COVID-19.
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COVID-19 is a widespread contagious viral infection that can severely affect the respiratory system. Although many people recover from using the disease without special care or treatment, pregnant women are particularly vulnerable to pulmonary infections due to their hangers systems system and physiology. To investigate the treatment provided to pregnant women who are PCR-positive for COVID-19 in their early three months of pregnancy, a reanalyzed analyzed data from 84 participants who received treatment at Tangerang Regional Hospital in 2 study was the study conducted based on an ases of observational investigation with a cross-sectional approach. It assembled the data for analysis of the chi-square test. The results showed that 92.9% of participants underwent a cesarean section, while the remaining 7.1% were discharged after giving birth typically or recovering. Additionally, the study did not find any correlation between factors such as age, education, work, gravida, ANC visit, and the impact of COVID-19 on the third trimester of pregnancy at Tangerang Hospital in 2022. The study recommends that pregnant women seek information about pregnancy care from healthcare providers, particularly midwives, posyandu officers, and the media, to make well-known decisions about their health and well-being during this critical period, ensuring a safe and healthy pregnancy outcome.
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A pandemic is a complex phenomenon that requires multi-directional corrective actions and, above all, preventive measures. Managing crises such as the COVID-19 pandemic has proven to be the biggest challenge facing healthcare organizations. In the process of ensuring a safe hospital environment for patients and staff, various models and adequate approaches to crisis management were applied. In order to explore the opinion of health care managers on the challenges and practices of providing a safe hospital environment in the management of the COVID-19 pandemic, a qualitative survey - a semi-structured interview - was conducted among 35 health care managers. Based on the results of the interviews with head and senior nurses, the main themes related to "challenges" and "practices" during the pandemic related to the practice of health care professionals were identified. Challenges include: developing and implementing measures to manage safe hospital environment during the COVID-19 pandemic;staff shortages and psychological problems. Practices include changes in nurses' work schedules, nurse rotation, staff training, organizational support. Healthcare managers have provided new and safe practices for managing staff and the environment during the COVID-19 pandemic. The results of this study show that healthcare managers perceive management during the COVID-19 pandemic differently than other crises. In their opinion, managing in these difficult conditions is very complex and requires greater flexibility on the part of managers in accordance with constantly changing circumstances.
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Background: A significant portion of individuals with SARS-CoV-2 infection have persistent COVID-19 symptoms after recovery. Symptoms may be new or persistent from the initial illness, which could cause both psychological and physical difficulty to the patients. These symptoms are collectively known as "long COVID-19 syndrome". There is limited information about this syndrome in the Thai population. Objectives: We aimed to describe and evaluate the risk for post COVID-19 symptoms among hospitalized COVID-19 patients in a university hospital. Methods: A prospective descriptive study was conducted on symptomatic COVID-19 patients admitted in Ramathibodi Hospital from July 1 to September 10, 2021. All surviving COVID-19 patients received a telephone assessment every month until 3 months after discharge and electronic medical records were reviewed. Information collected included symptoms, severity, treatment, duration of symptom, complication of COVID-19 and treatment. The New York Heart Association (NYHA) functional classification was used to categorized severity of dyspnea. Results: Among 253 evaluable patients, 57.3% were female and the mean age was 59.3 years old. Of these, 66% and 24.1% had moderate (pneumonia and SpO2 90%) and severe COVID-19 (pneumonia with severe respiratory distress and SpO2 90%), respectively. Almost all patients were inadequately vaccinated (unvaccinated 53.3%, partially vaccinated 41.9%). Overall, complete resolution of symptoms before 1 month after onset were noted in 47 patients (18.5%) and 72 (28.5%) patients had at least one persistent symptom at three months. The most common symptom is sleep disturbance (11.9%);29.2% remain in NYHA II and 0.8% in NYHA III and IV each. Female gender (OR 1.94;[95% CI 1.09-3.48], p=0.024), history of receiving dexamethasone (OR 1.04;[95% CI 1.01-1.08], p=0.004) and length of hospitalization (OR 1.04;[95% CI 1.00-1.08], p=0.034) were associated with being in NYHA II. Additionally, 5.9% had bacterial infection, and most were urinary tract infection and pneumonia, respectively. The risk factor associated with post-COVID-19 bacterial infection is bed ridden status (OR 23.3;[95% CI 5.79-93.72], p=<0.001). Conclusions: A significant number of COVID-19 patients had residual COVID-19 symptoms and still not fully functional at least 3 months after recovery. A major limitation of this study is obtaining information by telephone interview since hospital visit were not encouraged to limit mobility of people during pandemic, which may have led to a recall bias.
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Background: Studies show that wearing personal protective equipment (PPE) for long periods of time can lead to discomfort such as headaches, which could affect the performance of healthcare workers. The aim of this study was to determine the prevalence and risk factors of headaches related to PPE in healthcare workers at a COVID-19 referral hospital. Methods: A cross-sectional study was conducted involving 174 healthcare workers in a COVID-19 referral hospital in Bali. We conducted interviews using a questionnaire that consisted of three main parts: characteristics of the subjects, PPE usage, and PPE-associated headaches. A multiple logistic regression was used to analyze the data. Results: The analysis results showed that the PPE-associated headaches had a prevalence of 63.8% and were gradual in onset, pressure-like in quality (46%), and mild in intensity (80.1%). PPE level III-associated headache was the most common type. The majority of the participants had headaches up to 6 hours after using the protective gear, but improving within 15-30 minutes of removal and/or after pharmacotherapy. A Chi-squared analysis showed a statistically significant association between duration of PPE use, working units, and PPE levels (p<0.05). A logistic regression analysis found a significant relationship between PPE level and headache occurrence (OR=4.826;95%CI: 2.433-9.572;p<0.001). Conclusion: The frequency of PPE-associated headache was high and the PPE level was a risk factor of headache among healthcare workers. Better strategies are needed to reduce the duration of PPE exposure so that the work performance and quality of life of healthcare workers are not significantly affected.
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Objective: Coronaviruses are a large family of viruses that cause different types of diseases. This study aims to evaluate the risk factors for mortality based on comorbidity and sociodemographic characteristics among COVID-19 patients. Methods: This cross-sectional study conducted in Herat, Afghanistan, from February 24 to July 5, 2020, used data provided by the public health department, including sociodemographics, symptoms, comorbidities, hospitalization, contact history, and COVID-19 test type. The Chi-square test was used to observe differences between categorical variables. In bivariate analysis, all independent variables with a significant p-value were put into the model. Odds ratios and 95% confidence intervals were calculated, and a p-value less than 0.05 was considered statistically significant. Results: The study analyzed 11,183 COVID-19 cases, with a 53.5% positivity rate. Recovery rates in the city and Herat province districts were 96.2% and 94.7%, respectively. Case-fatality rates varied with age, with 0.4% for those aged 1-29 and 33% for those aged 80-105. Mortality rates were highest for those with COPD and cancer, at 12.5% and 18.2%, respectively. In the logistic regression results, age, gender, and COPD were significant variables for COVID-19 mortality. Conclusion: By providing more health service facilities to people in risk groups, especially in rural areas, the mortality rate of COVID-19 and other diseases can be decreased.