Delivering asthma reviews during the Covid-19 pandemic

The Covid-19 pandemic meant that the delivery of asthma management in primary care changed virtually overnight, requiring the introduction of alternatives to face-to-face care. This study examines the experiences of nurses who were performing asthma reviews during the pandemic, identifying the key themes that emerged, as well as providing recommendations for future practice.

COVID-19 Anxiety in Children and Its Relationship with Self-Related Skills of Executive Fun

Objective: Some children experience a significant deal of anxiety during the outbreak of COVID-19. Behavioral dimensions of the executive function appear to link to situational anxiety experience. Therefore, the primary aim of the present study is to investigate the relationship between self-related skills of executive functions and the level of anxiety in children (8-12-years-old) during the outbreak of COVID-19. Also, the secondary goal of this study is to predict the level of anxiety based on self-related skills of executive functions. Method: Parents of 300 children filled out the Barkley Deficits in Executive Functioning Scale (BDEFS) and the COVID- 19 anxiety scale. Data were analyzed using correlation and path analysis. A significance level of less than 0.05 was set for all tests. Data were analyzed using SPSS 22 software. Results: Results demonstrated that self-related skills of executive functions can predict 28% of COVID-19 anxiety. The subscales of self-management (P < 0.015, t = 5.56), self-regulation (P < 0.011, t = 6.37), self-restraint (P < 0.035, t = 4.29) and emotional self-organization (P < 0.042, P = 0.222) predicted coronavirus anxiety, but self-motivation (P < 0.05, P = 0.894) did not. Conclusion: Given that most subscales of executive function predict anxiety tied to critical situations such as the prevalence of the corona virus, it seems that greater attention should be allocated to the fostering and development of children's executive functions by teaching such skills at home by families.

The Potential Barriers and Benefits of an Online Physical Activity Program during the COVID-19 Restrictions: Latrobe Virtual Streetgames. A Qualitative Study

COVID-19 saw the global reduction of many physical activity programs. To maintain engagement, many programs adjusted their delivery to online formats. To explore the impact that a youth targeted virtual community exercise program had on its participants during the COVID-19 pandemic. Seven participants of Virtual Streetgames took part in a semi-structured one-on-one interview, with questions around the impact of COVID-19, in addition to their view on the virtual program. Three major themes were identified. "Dawning of a new world" described the changes that occurred due to the pandemic. "Traveling together" identified the difficultly to maintain regular wellbeing activities. "Making a difference" contextualized how the virtual delivery was able to influence participants. The COVID-19 pandemic had a significant impact on the participants physical, mental and social health. The use of an online physical activity program had some positive impacts on health, however it did not seem to warrant the same level of engagement when compared to face-to-face. The study helped identify those who are at risk of both short and long-term health impacts due to the COVID-19 pandemic. Additionally, it provided information on how virtual innovative interventions can influence wellbeing outcomes. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI)

Utility of lung ultrasound score for severity categorization and CLUE protocol for disposition of COVID-19 patients presenting to emergency department

Objective: Lung ultrasound is a point-of-care diagnostic work-up tool used extensively in emergency departments. The COVID-19 Lung Ultrasound in Emergency Department (CLUE) protocol has shown initial promise in aiding emergency clinicians to make rapid and appropriate bedside clinical decisions. Its primary objective is to assess the performance of the lung ultrasound scoring system (LUSS) in determining SARS-CoV-2 pneumonia severity so that the patients can be moved to their designated ICUs, wards, or facility quarantine center from the emergency department. Methods: A cross-sectional study was undertaken among adult patients with a confirmed diagnosis of SARS-CoV-2 infection who were admitted/referred to the All India Institute of Medical Sciences, Rishikesh, Uttarakhand. The data were descriptively analyzed using Graphpad Prism (vs. 9.2.0). Results: Out of 197 patients included in this study, 74.6% were men with a mean age of 45.3 ± 15.5 years. The men to women ratio was 2.9:1. The most frequent symptoms on presentation were fever (59.9% of cases), cough (54.3%), dyspnea (36%), and 16.2% of the patients were asymptomatic. The mean LUSS score of the patients with invasive support was 24.3 ± 4.5, as compared to 15.7 ± 5.9 in the non-invasive group. Overall, 64.4% patients did not require any respiratory support with a mean LUSS score of 2.3 ± 3.5. Out of 197 patients, 5 (2.5%) died during hospital stay. The mean LUSS score of survivors was 7.1 ± 8.2, as compared to 22.2 ± 4.3 of the deceased. Conclusion: The CLUE protocol can help in triaging the patients in the mild and moderate severity group and discharging them directly from the emergency department itself to either a facility quarantine center or to home isolation. It ultimately helps in avoiding unnecessary referrals, eliminating contamination, and optimum utilization of health resources.

How Did Levels of Psychological Distress and Perceptions of Workplace Support amongst Children's Social Work Staff Change during the Covid-19 Pandemic?

Covid-19 brought about drastic changes in day-to-day life and working practices, and had a profound impact on the mental health and well-being of the general population. Certain professional groups have also been particularly affected. This study sought to explore how levels of psychological distress and perceptions of workplace support amongst social work staff changed during the pandemic. We present the results from a series of surveys conducted in four local authorities (LAs) in England, before and during the Covid-19 pandemic. Social workers and other social care staff (n  = 62) were asked about their experiences of psychological distress, using the twelve-item General Health Questionnaire. Overall, we found the proportion of staff reporting elevated levels of psychological distress increased and, in line with previous studies involving social workers, was high relative to the general population. Yet, most staff also said they had high levels of support from managers and colleagues, whilst a small proportion reported an increased perception of workplace support during the pandemic, compared to before. We consider these findings in relation to Organisational Support Theory and reflect on the ability of LAs to provide effective support for social care staff.

Knowledge about, acceptance of and willingness to use over-the-counter COVID-19 self-testing kits

Objectives: Early investments in new diagnostic technologies that allow for rapid and decentralized testing were critical in reducing SARS-CoV-2's detrimental health and economic effects. This study evaluates public knowledge about, acceptance of and willingness to use COVID-19 self-testing kits. Methods: An online descriptive cross-sectional questionnaire was used in this study. The final study population included all contacted national and resident adults, age 18 and over, who were willing to engage in the study. The survey was divided according to participants' demographic information and 11 questions assessed the respondents' understanding of and willingness to use COVID-19 self-testing kits. The statistical analysis was carried out using SPSS version 24. Multivariate linear regression models were used to identify the factors influencing respondents' knowledge of and attitudes toward the acceptability of self-testing kits for COVID-19 and their willingness to use these kits. Key findings: A total of 876 respondents participated in the study and completed the whole questionnaire. The average knowledge score on the acceptability of and willingness to use self-testing kits for COVID-19 was 70.2%, with a 95% confidence interval (CI) [69.1%, 71.4%]. Participants who were postgraduate, female and vaccinated against COVID-19, as well as employees and older participants, were jointly highly associated with higher levels of knowledge about, acceptance of and willingness to use self-testing kits for COVID-19. Moreover, participants who had been infected with COVID-19, were vaccinated against COVID-19 or were female, employees, older, Western or Arabic were jointly highly associated with positive attitudes about the acceptability of and willingness to use self-testing kits for COVID-19. Conclusions: The majority of the respondents have acceptable levels of knowledge about, acceptance of and willingness to use self-testing kits for COVID-19. Nonetheless, future studies should consider the issues of pre- and post-test counselling, false negative results and the sale of unregulated testing kits. Additional information should be communicated so that people can make informed decisions and be protected from possible abuse of COVID-19 self-testing kits when they become available in pharmacies.

Social Workers Response to Domestic Violence and Abuse during the COVID-19 Pandemic

The rapid global spread of COVID-19 has put increased pressure on health and social service providers, including social workers who continued front line practice throughout the pandemic, engaging with some of the most vulnerable in society often experiencing multiple adversities alongside domestic violence and abuse (DVA). Movement restrictions and stay-at-home orders introduced to slow the spread of the virus, paradoxically leave these families at even greater risk from those within the home. Utilising a survey methodology combining both open- and closed-ended questions, this study captured a picture of social work practice in Ireland with families experiencing DVA during the early waves of the COVID-19 pandemic. Findings highlight both the changes and challenges in work practices and procedures that limit social work assessment and quality contact with families, changes to the help-seeking behaviours from victims/survivors, as well as emerging innovative practice responses with enhanced use of technology. Implications for practice include an increased awareness of the risk and prevalence of DVA accelerated by the pandemic. Conclusions assert that social work assessment and intervention with families experiencing DVA must remain adaptive to the changing COVID-19 context and continue to develop innovative practice approaches.

Consulta remota a pessoas com transtornos alimentares durante a pandemia de COVID-19

Objectives: to analyze subjective experiences related to adaptation to remote care by users with eating disorders during the COVID-19 pandemic. Methods: a descriptive study with a qualitative approach conducted with users of an eating disorders outpatient clinic. A semi-structured remote interview was applied using the Google Meet application. The data were submitted to lexical analysis using ALCESTE software and discussed in the light of scientific evidence. Results: the remote appointment is a positive strategy but not a substitute for the face-to-face modality. The research cited financial savings, closer contact with professionals, and flexibility of service schedules as advantages. It pointed out the difficulty in clinical evaluation concerning weight, vital signs, and poor mastery of technology as limitations. Final Considerations: the study induces discussion about the systematization of remote care, which, during the COVID-19 pandemic, were responsible for providing a greater sense of support to people with eating disorders. Objetivos: analizar experiencias subjetivas relacionadas a la adaptación a la atención remota por usuarios con trastornos alimenticios durante la pandemia de COVID-19. Métodos: estudio descriptivo de abordaje cualitativo realizado con usuarios de un ambulatorio especializado en trastornos alimenticios. Fue aplicada una entrevista semiestructurada remota, utilizándose el aplicativo Google Meet. Los datos fueron sometidos al análisis lexical mediante software ALCESTE y discutidos a la luz de las evidencias científicas. Resultados: la consulta remota es una estrategia positiva, pero no substitutiva de la presencial. Ventajas como economía financiera, mayor contacto con los profesionales y flexibilización de horarios de atenciones fueron citadas. Dificultad de evaluación clínica en relación al peso, signos vitales y poco dominio de tecnología fueron apuntados como limitaciones. Consideraciones Finales: el estudio induce la discusión sobre sistematización de atenciones remotas, las cuales, durante la pandemia de COVID-19, fueron responsables por fornecer mayor sensación de soporte a personas con trastornos alimenticios. Objetivos: analisar as experiências subjetivas relacionadas à adaptação ao atendimento remoto por usuários com transtornos alimentares durante a pandemia de COVID-19. Métodos: estudo descritivo de abordagem qualitativa realizado com usuários de um ambulatório especializado em transtornos alimentares. Foi aplicada uma entrevista semiestruturada remota, utilizando-se o aplicativo Google Meet. Os dados foram submetidos à análise lexical por meio do software ALCESTE e discutidos à luz das evidências científicas. Resultados: a consulta remota é uma estratégia positiva, mas não substitutiva da modalidade presencial. Vantagens como economia financeira, maior contato com os profissionais e flexibilização de horários de atendimentos foram citadas. Dificuldade de avaliação clínica em relação ao peso, sinais vitais e pouco domínio da tecnologia foram apontados como limitações. Considerações Finais: o estudo induz a discussão sobre sistematização dos atendimentos remotos, os quais, durante a pandemia de COVID-19, foram responsáveis por fornecer maior sensação de suporte às pessoas com transtornos alimentares.

The impact of Covid-19 restrictions in Ireland on symptom severity in mild to moderate Parkinson's disease

Introduction: The COVID pandemic and public health restrictions significantly impacted those living with neurological conditions such as Parkinson's Disease due to the curtailment of therapies. Patients attending a single centre movement disorders clinic reported reduced physical activity and quality of life during the pandemic. This study aimed to assess the impact of pandemic restrictions on Parkinson's Disease symptom severity in people with mild to moderate Parkinson's Disease. Method: A cross-sectional study design with a convenience sample of 20 people living with mild to moderate Parkinson's Disease was adopted. A telephone survey questionnaire was completed to measure changes in symptom severity on the 14 most common Parkinson's Disease symptoms. Data were analysed using descriptive statistics. Results: Nineteen participants completed the survey. Participants frequently reported a decline in nine symptoms of Parkinson's Disease;bradykinesia, rigidity, walking, sleep, mood, memory, quality of life and fatigue. Nil changes in freezing were reported. No change was reported in the nonmotor symptoms of constipation, speech and pain in 75, 65 and 95% of participants, respectively. Conclusion: Findings of this study acknowledge the negative impact of restrictions on the motor and nonmotor symptoms of Parkinson's Disease. Flexibility to access and delivery of service should be considered to mitigate any future potential restrictions.

Comparative Study on the Role of Serum Levels of Interleukin6 and Interleukin-8 in Predicting the Severity of COVID-19 and Prognosis in Patients Admitted to Ghaemshahr Razi Hospital

Background and purpose: The Coronavirus Disease 2019 (COVID-19) pandemic, caused by severe respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in a worldwide emergency. Various studies show conflicting and diverse results on the role of inflammatory cytokines in predicting the severity and prognosis in patients with COVID-19. The aim of this study was to compare the serum levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) in predicting the severity of COVID-19 and prognosis in patients admitted to Qaemshahr Razi Hospital. Materials and methods: In this cross-sectional prospective study, the serum levels of interleukin 8 and 6 were measured in 51 patients with COVID-19 and compared with 25 healthy individuals in Qaemshahr Razi Hospital, 2021. ELISA method was used to measure these cytokines and data analysis was performed in SPSS V25. Results: The serum levels of IL6 and IL8 in the patient group were about 4 times and 6 times higher than those of the control group, respectively. Average levels of IL-6 (P=0.004) and IL-8 (P<0.001) were significantly higher in patients with severe COVID-19 compared to moderate form and control group. There was no correlation between the duration of hospitalization and the level of IL-6 (P=0.1), while there was a significant correlation between the length of hospital stay and the level of IL-8 (P=0.012). Conclusion: IL-6 and IL-8 serum levels in patients with COVID-19 can be helpful in predicting the severity of disease and prognosis of patients.

Resilience and Resistance in the Community Sector: Organisational Challenges and Responses by the Australian DFV Sector in the Time of COVID-19 Pandemic

The COVID-19 pandemic led to increases in family violence in Australia and elsewhere. In response, organisations in the domestic and family violence (DFV) sector, had to adapt to the emerging public health measures and worked collaboratively to protect the most vulnerable in the community. These services, including courts, rapidly transformed their methods of service delivery that are likely to continue for some time. But what have been the implications/impacts of these rapid changes on the DFV service sector in Australia? How have these impacts informed the future needs of the DFV sector? And what is needed to strengthen this community sector of the future? This article reports on the findings of a national research project examining the impacts of COVID-19 on the DFV service sector and the adaptations and innovations that emerged in response. The study highlights that the surge in demand for services put pressure on an already overwhelmed workforce/service sector and provided an opportunity for front line workers to contribute to building a robust sector to respond to future crisis events. These findings have significant implications for future DFV sector service delivery, and for the social work profession as a whole.

Prevalence and Severity of COVID-19 and Missed Job Opportunities among Healthcare Workers in Mazandaran Province, February-June 2020

Background and purpose: The COVID-19 pandemic resulted in an uncontrolled disease burden on healthcare workers (HCWs) worldwide. We aimed to investigate the prevalence and severity of COVID-19 in HCWs of selected hospitals in Mazandaran province and examine the association between COVID-19 and missed opportunities of HCWs. Materials and methods: In this retrospective descriptive-analytical study, 1105 HCWs in Qaemshahr Razi Hospital and Sari Fatemeh-Zahra Hospital were studied between February 2020 and June 2020. In order to evaluate the frequency and severity of the disease, clinical and paraclinical manifestations were recorded by a trained HCW. Data were analyzed in SPSS V18. Results: The frequency of COVID-19 was 16.19% among HCWs. The patients included 113 (63.13%) nurses, 47(26.26%) service providers and administrative personnel, and 19(10.61%) physicians. Duration of sick leave was found to be significantly associated with severity of COVID-19 (P=0.006). This length was also significantly associated with the job and was longer in nurses (P=0.013). Our findings revealed a significant relationship between the level of adherence to personal protective equipment (PPE) and the severity of COVID-19 (P=0.001). Conclusion: COVID-19 could exert remarkable impact on the quality of work in HCWs, especially among nurses. Effective training of HCWs regarding PPE instructions results in suitable protection against severe forms of the disease.

Effect of loneliness and sociodemographic, health, COVID-19 pandemic-related factors on depression among older adults

The present study aimed to identify the presence of depression in older adults and the affecting factors during the COVID-19 pandemic. This cross-sectional study was conducted online with 1320 deliberately recruited older adults in Turkey between February and May 2021. The variables were depression, loneliness, fear of COVID-19, and other sociodemographic health variables. In the study, we used the Geriatric Depression Scale, Loneliness Scale, and the Fear of COVID-19 Scale and RLa form including items inquiring information about sociodemographic and COVID-19 related characteristics and health conditions of the participants. In this study, we detected probable-definite depression in 73.8% of the participants. According to the results of multiple logistic regression analysis, we concluded that social and emotional loneliness, increased fear of COVID-19, perceived insufficient income, presence of chronic disease, managing activities of daily living only with assistance, irregular sleep and diet patterns, future anxiety, alcohol use, perception of mental health being negatively affected by the pandemic, and living in regions outside the Mediterranean Region affected the state of probable-definite depression in the participants. Depression was high in older adults during the pandemic. Psychosocial and health promotion interventions for depression risk factors determined from multivariate regression analysis, may enable older adults, who have become more vulnerable due to the restriction measures applied during the COVID-19 pandemic, to be less affected by this period.

Empathy of Healthcare Professionals During Covid-19 Crisis

Background: Empathy is one of the most vital parts of medical ethics that is a prerequisite for good clinical practice, yet the level of empathy of the doctors has not been up to the mark. Objective(s): To measure empathy of healthcare professionals during COVID-19 crisis Material(s) and Method(s): This was a cross Sectional Study done in almost all public and private tertiary care hospitals of Peshawar. The study duration was 6 months (10 September 2021-10 Febuary 2022) after the approval of research proposal. The sampling method was non probability convenient sampling. The inclusion criteria were health professionals involved in the care of the COVID 19 patients like pulmonogists, physicians, trainee doctors, nurses and chest physiotherapists. Exclusion criteria were the doctors from other specialties who were not taking in the management of such patients. Empathy scale was used to collect responses of the participants.The data was analyzed using SPSS latest version Results: Significant association was seen between Consultants, Nurses and PGRs with that they were not interested in patient's personal matters as these are not relevant to medical treatment. i.e. p-value <0.001. Significant association was seen between Consultants, Nurses and PGRs they Viewed things from patient' perspectives might confuse me and make me too distracted to take the right clinical decision (cognitive). I.e. p-value=0. 026 Conclusion(s): The level of empathy did get affected to a colossal extent during the COVID-19 pandemic as reflected by the above results. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

Changes in Sleep Pattern and Digital Media use During Covid-19 Lockdown

Objective: To find out an association between covid and sleep and how covid lockdown has affected the sleeping habits of the youth in Pakistan compared to pre-lockdown sleeping patterns. Study Design: Cross-sectional study. Place and Duration: Current research was conducted at HITEC (IMS-HITEC) Institute of Medical Sciences, Taxila Cantt Pakistan from 5th may to 15th may 2020). Material(s) and Method(s): It was a quantitative study in which participants filled out an online survey form. The data was collected on Google forms shared through social media focusing on undergraduate individuals from 16 to 24 years of age to acquire a homogenous example of responders, since youth are more liable to digital media use and their routine is more prone to be affected by the lockdown. The participation rate was 98.2%. SPSS was used for the data entry and analysis purpose. The data obtained was compiled, tabulated and analysed statistically. Chi square test was used to check whether the variables yielded significant or insignificant results. Result(s): Out of a total of 100 participants, 60 (60%) were females and 40 (40%) were males. The mean age was 21 years and the participants were mostly university students. A set of questions were also asked to determine which social media apps the participants were increasingly using, most of the participants spent time on Instagram (68%) and YouTube (64%), while modest people spent time on Netflix (41%), Snapchat (30%) and Facebook (33%). Lesser participants spent time on TikTok (11%) and Skype/Zoom (25%). Practical Implications: The use of e-learning and other forms of social interaction are becoming increasingly significant in the education of our young people. The findings of the current research make it possible for us to evaluate the influence of lockdown measures on Pakistani population in light of previously published studies that were carried out during the same time period in other countries and continents. Conclusion(s): Participants in the lockdown reported spending more time in front of screens and suffering delayed sleep habits. It was found that risky behaviours were associated with increased screen screen time.. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

The rate of bleeding during cesarean section in pregnant women with COVID-19 admitted to hospitals in Tabriz, 2021.

Introduction: Intensification of immune system sensitivity after pregnancy with cytokine storm caused by Covid 19 can lead to coagulation disorders and increase the amount of bleeding after delivery. Since bleeding following cesarean section is more likely to occur in women with Covid-19 than in women without the disease, the present study was performed aimed to investigate the amount of bleeding during caesarean section in women with covid-19. Method(s): This descriptive-analytical study was performed on 396 clinical files of women after cesarean section (35 women with Covid 19 and 361 women without Covid 19) in Al-Zahra and Imam Reza hospitals of Tabriz. Demographic information, history of midwifery and bleeding volume, platelets, prothrombin time, and relative thromboblastin time were extracted for each individual. Data were analyzed by SPSS statistical software (version 21) and student's t-test, chi-square and multivariate regression. P< 0.05 was considered statistically significant. Result(s): The rate of bleeding in patients with Covid 19 (1259.59 +/- 127.69 ml) was significantly higher than patients without Covid 19 (351.74 +/- 11.94 ml) (p=0.005). The rate of bleeding during cesarean section for patients with Covid 19 based on the severity of the disease indicated that the higher the severity of the disease, the higher the bleeding during cesarean section (P=0.001). Finally, it was found that severe Covid 19 increases the bleeding of cesarean section by 12.95 times (95% CI: 8.35-15.95). Conclusion(s): Infection to high intensity Covid 19 can increase the risk of bleeding during cesarean section;therefore, measures and planning such as blood preparation and access to appropriate veins for blood transfusion management should be considered. Copyright © 2022, Mashhad University of Medical Sciences. All rights reserved.

Hydroxychloroquine desensitization improves the retention rate for patients with Systemic lupus erythematosus, 356 cases analysis in Japan Impact of the COVID-19 pandemic on patients with rheumatological disorders: A single centre study in Sri Lanka

Background: The COVID-19 pandemic has affected patient populations all over the world and majority are being directly or indirectly affected by the virus. Many had to encounter logistical problems related to clinic attendance due to lockdowns, cancellation of clinics, unavailability of safe transport, quarantine process and multiple other factors. Therefore, the morbidity and mortality during the pandemic was also related to the co-morbidities of the patients, including rheumatological disorders. Thus, it is worthwhile investigating the impact of the pandemic on their disease, to guide a more structured approach to their care, particularly if similar situations occur in the future. Method(s): This was a cross sectional observational study done on 325 of Rheumatology clinic follow-up patients at University Hospital, Kothelawala Defence University (UH-KDU), Sri Lanka. After obtaining informed verbal consent, data was collected by the investigator by telephone interviewing and recorded in a questionnaire. The questionnaire included details on the diagnosis, duration of clinic follow-up, the routine medication, disruption of clinic visits with reasons, availability of medication and disease flares during this pandemic. Data was analysed using SPSS version 23. Result(s): The mean age of the study population was 57.1 years and a majority of 42.2% had degenerative arthritis while 20.6% and 24.3% had inflammatory arthritis and soft tissue rheumatism respectively. Sixty six percent of the patients has been followed up in the clinic for more than a year. Out of the study population 23.4% was on disease modifying drugs (DMARDs). Routine clinic follow-up was disrupted in 79.1%. Out of which 42.4% did not attend due to fear of contracting COVID during the clinic visit, 15.2% due to transport difficulties, 21% due to cancellation of clinics by hospital and 21.4% due to other reasons. Forty two percent experienced disease flare during the pandemic, while for 47.7% routine medicine was unavailable. Disease flare was found to be a correlated with disruption of clinic visits (P = 0.000) and availability of medicine. (P = 0.000) Conclusion(s): A significant proportion of regular clinic attendees had their clinic follow-up disrupted due to COVID pandemic. The main reason for clinic absence was fear of contracting COVID during the clinic visit. More than one third of the study population experienced a disease flare related to disruption of clinic attendance and unavailability of medicine. Therefore, it is recommended that telemedicine services be made available to patients with chronic rheumatological disorders, should they fail to attend follow-up visits to ensure the patient wellbeing.

Severity and Mortality of Covid-19 in Patients with Diabetes Mellitus

Background: Covid-19 infection appeared as rapidly spreading cases of acute respiratory disease in Wuhan city of China that became pandemic. It was brought to the notice of WHO on December 31, 2019. Diabetes mellitus is one of the biggest health problems and fast growing emergencies of the 21st century. Diabetic patients with who got infected with Covid-19 have more chance of in hospital treatment need, intensive care unit care requirement, intubation and death. Objective(s): The objective of this study was to know the severity and mortality of covid-19 in patients with diabetes mellitus. Study Design: This was a descriptive case series study. Study Setting: It was done in the Covid-19 isolation and ICU unit of Ayub Teaching Hospital Abbottabad from May 2020 to October 2021. Method(s): Using non-probability consecutive sampling, 189 diabetic patients were enrolled. Sample included all covid-19 patients having diabetes that received indoor treatment during this period. All patients from both genders with age > 18 years were included. Patients with malignancy or on immunosuppressants for more than 1 month were excluded. Patients who were maintaining oxygen saturation at room air/facemask/nasal prongs were labelled as having non-severe disease while patient who needed CPAP or assisted ventilation were labelled as having severe covid-19 disease. All patients who died during admission were documented as covid-19 related mortality. Patients were labelled as diabetic who were known diabetic and taking diabetes treatment. Data was collected on a structured pro forma. Statistical program SPSS version 16.0 was used for the analysis of data. Result(s): In this study, mean age was 61.29 +/- 11.73 years. There were 40.2% male and 59.8% female patients. 86.2% patients were not-vaccinated, 3.7% patients were partially vaccinated and 10.1% patients were fully vaccinated. Hypertension was most common comorbidity (42.3%) and only CKD was significantly associated with increased mortality. 43.92%patients had non-severe illness while 56.08% patients had severe illness. The overall mortality of illness was 48.15% while it was 84.9% in patients with severe illness. Practical implication: These published publications provide a variety of various estimations and impact amounts due to the numerous different study designs and demographics. A comprehensive and methodical study is required because of the unpredictability of the situation. So that we conducted this study to assess the severity and mortality of covid-19 in patients with diabetes mellitus Conclusion(s): Our study concluded that severity and mortality of covid-19 was high in diabetic patients with high fasting & random sugar levels, pack smoking years and low oxygen saturation. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.