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1.
PLoS One ; 17(4): e0265284, 2022.
Article in English | MEDLINE | ID: covidwho-1779751

ABSTRACT

As a global threat, the COVID-19 pandemic has been an important factor in increasing death rate worldwide. As the virus spreads across international borders, it causes severe illness, death, and disruptions in our daily lives. Death and dying rituals and customs aid bereaved people in overcoming their grief. In this sense, the purpose of this study was to access thoughts and feelings of Portuguese adults and the impact of the loss in daily life during COVID-19. A structured online questionnaire was applied (snowball sampling) and qualitative data on death and mourning namely the impact of the loss in daily life, was collected. One hundred and sixty-six individuals have lost someone since the beginning of the pandemic and were included. Analysis was inspired by Braun and Clark's content analysis. Most participants were female (66.9%), the median age was of 37.3 years, and 70.5% had a high education degree. Moreover, 30.7% of the participants present anxiety symptoms and 10.2% depression symptoms. The answers of studied participants gave insights on the extent of the loss in day-to-day life and four thematic themes were found: (1) The perceived inadequacy of the funeral rituality, (2) Sadness, fear and loneliness, (3) Changes in sleeping and concentration and increased levels of anxiety and (4) Concerns regarding the pandemic situation. We found a high prevalence of anxiety and depression symptoms in the study sample. Also, the changes in post mortem procedures, have shown to be of great importance in the mourning procedure of the participants.


Subject(s)
Bereavement , COVID-19 , Adult , COVID-19/epidemiology , Female , Grief , Humans , Pandemics , Portugal/epidemiology
4.
Int J Environ Res Public Health ; 19(6)2022 03 15.
Article in English | MEDLINE | ID: covidwho-1742467

ABSTRACT

The COVID-19 pandemic is a stressful long-lasting event with an increasingly negative impact upon individuals. This study aimed at assessing the magnitude of depression, anxiety, and stress among adults living in Portugal during the first mandatory lockdown of 2020, and the psychosocial and health-related factors associated with these symptoms. A sample of 484 adults (73% women) with an average age of 40 years old (Standard Deviation, SD = 14.03) responded to an online survey. The survey included measures of depression, anxiety, stress, social support, COVID-19 interference in daily life, attitudes towards COVID-19, and health perception. The impact of the lockdown on psychological well-being was large, with up to 36% of the participants showing signs of at least mild psychological discomfort (i.e., depression, anxiety, and stress). Social support, COVID-19 interference on daily life, health perception, and age, explained all the dependent variables. Education level, income, attitudes towards COVID-19, and gender explained some of the dependent variables. These results suggest that the COVID-19 pandemic has a serious impact on the psychological health of Portuguese adults. The role of the procedures to control the pandemic on the mental health of Portuguese adults should not be underestimated.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Communicable Disease Control , Depression/epidemiology , Depression/psychology , Female , Humans , Male , Pandemics , Portugal/epidemiology , Quality of Life/psychology
5.
Int J Environ Res Public Health ; 19(5)2022 02 26.
Article in English | MEDLINE | ID: covidwho-1736905

ABSTRACT

Recent studies have documented the high prevalence of burnout among medicine and dentistry students, with potentially catastrophic consequences for both students and patients. Both environmental and personality factors play a part in burnout; perfectionism, a common trait in medicine students' personalities, has been linked to psychological distress and increasing students' vulnerability to burnout. Self-compassion, i.e., treating oneself kindly through hardship, has recently emerged as a buffer between perfectionism and psychological distress. While using a novel three-factor conceptualization of perfectionism (BIG3), this study aims to analyze if self-compassion has a protective role in the relationship between perfectionism and burnout, in a sample of medicine and dentistry students, through mediation analysis. We found that self-compassion significantly mediated the relationship between all three forms of perfectionism and burnout: as a partial mediator in self-critical and rigid perfectionism, as well as a full mediator in narcissistic perfectionism. Our findings underline self-compassion's relevance in burnout prevention and management, supporting its use as an intervention target in burnout reduction programs and strategies.


Subject(s)
Burnout, Professional , Perfectionism , Students, Medical , Burnout, Professional/epidemiology , Burnout, Psychological , Dentistry , Humans , Portugal/epidemiology , Students, Medical/psychology
6.
Am J Trop Med Hyg ; 106(1): 342-344, 2021 10 25.
Article in English | MEDLINE | ID: covidwho-1726464

ABSTRACT

Although rare in Portugal, snakebite envenoming entails severe morbidity and mortality. We present the case of a 65-year-old woman bitten on her leg in a northern coastal region in Portugal, on a walk during the COVID-19 pandemic lockdown. Despite first looking for help at the nearest pharmacy, she developed anaphylactoid shock and was promptly driven to a tertiary hospital, where antivenom was administered in a timely manner under close monitoring. Prophylactic antibiotics were started and maintained based on elevated inflammatory markers and signs of wound inflammation. She evolved favorably, with rapid weaning of vasopressors and resolution of end-organ dysfunction. This case highlights the importance of prompt recognition and describes crucial steps in envenomation management in a country where snakebite is infrequent, but potentially fatal.


Subject(s)
Anaphylaxis/epidemiology , Anaphylaxis/etiology , Snake Bites/complications , Snake Bites/epidemiology , Aged , Anaphylaxis/therapy , Anti-Bacterial Agents/administration & dosage , Antivenins/administration & dosage , Ceftriaxone/administration & dosage , Clindamycin/administration & dosage , Female , Humans , Portugal/epidemiology , Snake Bites/therapy , Tetanus Toxoid/administration & dosage , Treatment Outcome
7.
Int J Environ Res Public Health ; 19(4)2022 02 16.
Article in English | MEDLINE | ID: covidwho-1707657

ABSTRACT

During the first COVID-19 related confinement in Portugal, there was a decrease in the levels of psychological symptoms measured by the Depression, Anxiety and Stress Scale 21 (March to April 2020). Upon experiencing a new period of restraints in 2021, the psychological impact of this sample was assessed again (N = 322, two more time points). It was expected that the psychological symptoms evidenced in February 2021 would be at similar levels to those found in April 2020, leading to a transfer of adaptation. Contrary to our hypothesis, in the second confinement in Portugal there were higher levels of depression and stress symptoms than at the beginning of the pandemic. On the other hand, the maximum level of anxiety was observed in March 2020. It seems that our perception of the threats in 2021 was not the same as at the onset of COVID-19, or that knowledge was not disseminated to the general population to increase their mental health literacy and help them cope with the imposed challenges.


Subject(s)
COVID-19 , Depression , Anxiety/epidemiology , Anxiety/psychology , COVID-19/epidemiology , Depression/epidemiology , Depression/psychology , Humans , Portugal/epidemiology , SARS-CoV-2 , Stress, Psychological/epidemiology , Stress, Psychological/psychology
8.
Arch Sex Behav ; 51(1): 169-181, 2022 01.
Article in English | MEDLINE | ID: covidwho-1702955

ABSTRACT

Recent findings suggest that the current COVID-19 pandemic has a potential negative impact in several areas of life, including sexual health. However, less is known about the psychological dimensions that may work as vulnerability/protective factors for the development of sexual problems in the current pandemic. The current study used a longitudinal design to examine the role played by personality trait factors (neuroticism, extraversion) as well as psychosexual factors (sexual beliefs) in predicting sexual functioning and sexual distress across time during the current pandemic crisis. A total of 528 individuals (337 women) completed a web survey assessing sexual health indicators and psychological factors. The first wave was conducted during the confinement period in Portugal (N = 528) between May and June 2020 and the second four months later (N = 146), when strict confinement rules were over. Generalized estimating equations (GEE) were used to examine the ability of psychological factors to predict sexual functioning and distress across time, while controlling for age and gender. Results indicated that sexual distress at time point 2 was lower than during confinement, and men had lower levels of sexual functioning post-confinement while no significant difference was observed for women. Moreover, higher levels of neuroticism and age-related beliefs significantly predicted lower sexual functioning as well as higher sexual distress, whereas lower levels of extraversion predicted lower sexual functioning after controlling for age and gender effects. Findings support the role of psychological vulnerability factors to predict sexual problems across time and may have important implications in the prevention and treatment of sexual dysfunctions.


Subject(s)
COVID-19 , Sexual Health , Female , Humans , Male , Pandemics , Portugal/epidemiology , Protective Factors , SARS-CoV-2 , Surveys and Questionnaires
9.
Sleep Med ; 90: 44-52, 2022 02.
Article in English | MEDLINE | ID: covidwho-1683601

ABSTRACT

OBJECTIVE/BACKGROUND: To describe and characterize insomnia symptoms and nightmare profiles in Portugal during the first six weeks of a national lockdown due to COVID-19. PATIENTS/METHODS: An open cohort study was conducted to collect information of the general population during the first wave of SARS-CoV-2/COVID-19 pandemic in Portugal. We analyzed data from 5011 participants (≥16 years) who answered a weekly questionnaire about their well-being. Two questions about the frequency of insomnia and nightmares about COVID-19 were consecutively applied during six weeks (March-May 2020). Latent class analysis was conducted and different insomnia and nightmare profiles were identified. Associations between individual characteristics and both profiles were estimated using odds ratios (ORs) and 95% confidence intervals (CI). RESULTS: Five insomnia (No insomnia, Stable-mild, Decreasing-moderate, Stable-severe, Increasing-severe) and three nightmares profiles (Stable-mild, Stable-moderate, Stable-severe) were identified. Being female, younger, perceiving their income as insufficient and feelings of fear towards COVID-19 were associated with higher odds of insomnia (Women: OR = 6.98 95%CI: 4.18-11.64; ≥60 years: OR = 0.30 95%CI: 0.18-0.53; Insufficient income: adjusted OR (aOR) = 8.413 95%CI: 3.93-16.84; Often presenting fear of being infected with SARS-CoV-2 infection: aOR = 9.13 95%CI: 6.36-13.11), and nightmares (Women: OR = 2.60 95%CI: 1.74-3.86; ≥60 years: OR = 0.45 95%CI: 0.28-0.74; Insufficient income: aOR = 2.60 95%CI: 1.20-5.20; Often/almost always presenting fear of being infected with SARS-CoV-2 infection: aOR = 6.62 95%CI: 5.01-8.74). Having a diagnosis of SARS-CoV-2 virus infection was associated with worse patterns of nightmares about the pandemic. CONCLUSIONS: Social and psychological individual factors are important characteristics to consider in the development of therapeutic strategies to support people with sleep problems during the COVID-19 pandemic.


Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , COVID-19/epidemiology , Cohort Studies , Communicable Disease Control , Dreams , Female , Humans , Pandemics , Portugal/epidemiology , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/epidemiology
10.
Int J Environ Res Public Health ; 19(3)2022 02 04.
Article in English | MEDLINE | ID: covidwho-1674625

ABSTRACT

Increasing evidence on the effects of the COVID-19 pandemic suggests that its social and health impacts are being disproportionately shouldered by socioeconomically disadvantaged populations, including migrants. Knowledge of how these populations are experiencing the COVID-19 crisis is scarce. We examined the effects of the pandemic on the perceived individual financial situation and health condition of migrants in Lisbon, Portugal, and described the most affected subgroups. A cross-sectional survey was conducted with a diverse community-based sample of 1126 migrants. A worsening of their financial situation since the pandemic was reported by 55.6% of the participants and a worsening of their health condition by 19.9%. A worsened financial situation was most often reported by those ≥45 years old and with a lower income (

Subject(s)
COVID-19 , Transients and Migrants , Cross-Sectional Studies , Female , Humans , Middle Aged , Pandemics , Portugal/epidemiology , SARS-CoV-2 , Socioeconomic Factors
11.
Infect Dis (Lond) ; 54(6): 441-447, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1672043

ABSTRACT

BACKGROUND: Repeated serosurveys in the same population provide more accurate estimates of the frequency of SARS-CoV-2 infection and more comparable data over time than notified cases. We aimed to estimate the incidence of SARS-CoV-2 infection, identify associated factors, and assess time trends in the ratio of serological/molecular diagnosis in a cohort of university workers. METHODS: Participants had a serological rapid test for SARS-CoV-2 immunoglobulins M and G, and completed a questionnaire, in May-July 2020 (n = 3628) and November 2020-January 2021 (n = 2661); 1960 participated in both evaluations and provided data to compute the incidence proportion and the incidence rate. Crude and adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) were computed using generalized linear models with Poisson regression. RESULTS: The incidence rate was 1.8/100 person-months (95% CI: 1.5-2.0), and the 6 months' cumulative incidence was 10.7%. The serological/molecular diagnosis ratio was 10:1 in the first evaluation and 3:1 in the second. Considering newly identified seropositive cases at the first (n = 69) and second evaluation (n = 202), 29.0% and 9.4% never reported symptoms, respectively, 14.5% and 33.3% reported contact with a confirmed case and 82.6%, and 46.0% never had a molecular test. Males (aIRR: 0.61; 95% CI: 0.44-0.85) and 'high-skilled white-collar' workers (aIRR: 0.74, 95% CI: 0.53-1.04) had lower risk of infection. CONCLUSION: University workers presented a high SARS-CoV-2 incidence while restrictive measures were in place. The time decrease in the proportion of undiagnosed cases reflected the increased access and awareness to testing, but opportunities continued to be missed, even in the presence of COVID-19-like symptoms.


Subject(s)
COVID-19 , Antibodies, Viral , COVID-19/diagnosis , COVID-19/epidemiology , Cohort Studies , Humans , Incidence , Male , Portugal/epidemiology , SARS-CoV-2 , Seroepidemiologic Studies
13.
Arch Virol ; 167(2): 459-470, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1653515

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a major impact on global human health. During the spread of SARS-CoV-2, weakened host immunity and the use of vaccines with low efficacy may result in the development of more-virulent strains or strains with resistance to existing vaccines and antibodies. The prevalence of SARS-CoV-2 mutant strains differs between regions, and this variation may have an impact on the effectiveness of vaccines. In this study, an epidemiological investigation of SARS-CoV-2 in Portugal was performed, and the VSV-ΔG-G* pseudovirus system was used to construct 12 spike protein epidemic mutants, D614G, A222V+D614G, B.1.1.7, S477N+D614G, P1162R+D614G+A222V, D839Y+D614G, L176F+D614G, B.1.1.7+L216F, B.1.1.7+M740V, B.1.258, B.1.258+L1063F, and B.1.258+N751Y. The mutant pseudoviruses were used to infect four susceptible cell lines (Huh7, hACE2-293T-293T, Vero, and LLC-MK2) and 14 cell lines overexpressing ACE2 from different species. Mutant strains did not show increased infectivity or cross-species transmission. Neutralization activity against these pseudoviruses was evaluated using mouse serum and 11 monoclonal antibodies. The neutralizing activity of immunized mouse serum was not significantly reduced with the mutant strains, but the mutant strains from Portugal could evade nine of the 11 monoclonal antibodies tested. Neutralization resistance was mainly caused by the mutations S477N, N439K, and N501Y in the spike-receptor binding domain. These findings emphasize the importance of SARS-CoV-2 mutation tracking in different regions for epidemic prevention and control.


Subject(s)
COVID-19 , SARS-CoV-2 , Animals , Antibodies, Neutralizing , Humans , Mice , Mutation , Portugal/epidemiology , Spike Glycoprotein, Coronavirus/genetics
14.
Int J Environ Res Public Health ; 19(3)2022 Jan 20.
Article in English | MEDLINE | ID: covidwho-1643607

ABSTRACT

Concerns, behaviours, and beliefs influence how people deal with COVID-19. Understanding the factors influencing adherence behaviour is of utmost importance to develop tailored interventions to increase adherence within this context. Hence, we aimed to understand how COVID-19 affected adherence behaviour in Portugal. A cross-sectional online survey was conducted between 1 March and 3 April 2021. Descriptive statistics were performed, as well as univariable and multivariable regression models. Of the 1202 participants, 476 who were taking at least one medication prescribed by the doctor were selected. Of these, 78.2% were female, and the mean age was 40.3 ± 17.9 years old. About 74.2% were classified as being highly adherent. During the pandemic, 8.2% of participants reported that their adherence improved, while 5.9% had worsened adherence results. Compared with being single, widowers were 3 times more prone to be less adherent (OR:3.390 [1.106-10.390], p = 0.033). Comorbid patients were 1.8 times (OR:1.824 [1.155-2.881], p = 0.010) more prone to be less adherent. Participants who reported that COVID-19 negatively impacted their adherence were 5.6 times more prone to be less adherent, compared with those who reported no changes (OR:5.576 [2.420-12.847], p < 0.001). None of the other variables showed to be significantly associated with pharmacological adherence.


Subject(s)
COVID-19 , Adult , Cross-Sectional Studies , Female , Humans , Medication Adherence , Middle Aged , Pandemics , Portugal/epidemiology , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
15.
Infect Dis (Lond) ; 54(6): 418-424, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1621501

ABSTRACT

BACKGROUND: Integrated approaches to surveillance of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection are important for public health actions. The 2nd National Serological Survey (ISN2COVID-19) aimed to characterize the extent of SARS-CoV-2 infection and vaccine-induced response in the Portuguese population following the third epidemic wave and the launch of the vaccination campaign. METHODS: A cross-sectional study was performed using data on 8463 Portuguese 1-79 years of age, collected in February and March, 2021. SARS-CoV-2 IgM and IgG (anti-nucleoprotein and anti-spike) antibodies were determined in serum samples using Abbott Architect chemiluminescent microparticle assays. Post-infection and vaccine-induced seroprevalence with 95% confidence intervals (95%CI) were estimated in the overall sample and stratified by population characteristics. RESULTS: The estimated seroprevalence was 15.5% (95%CI:14.6-16.5%), of which 13.5% (95%CI: 12.6-14.4%) was attributable to natural infection and 2.0% (95%CI:1.7-2.4%) to vaccination. The lowest seroprevelence was observed in persons aged 70-79 years (8.9% 95%CI:6.8-11.6), while seroprevalence in children (14.3%; 95%CI:11.5-17.6%) and adolescents (12.9%; 95%CI:10.5-15.7%) was similar to that of persons aged between 20 and 69 years. Of seropositive individuals, 22.6% (95%CI:19.7-25.9%) did not report any symptoms in 6 months prior to interview. Of persons with completed vaccination (2-doses), 98.6% (95%CI: 93.0-99.7%) had specific IgG (anti-S) antibodies. CONCLUSIONS: After the third epidemic wave, the post-infection SARS-CoV-2 seroprevalence was 1.7 times higher than the cumulative incidence based on PCR-testing, but was higher (2.7 times) in children may be due to the high proportion of asymptomatic and mild infections.


Subject(s)
COVID-19 , SARS-CoV-2 , Adolescent , Adult , Aged , Antibodies, Viral , COVID-19/epidemiology , Child , Cross-Sectional Studies , Humans , Immunoglobulin G , Middle Aged , Portugal/epidemiology , Seroepidemiologic Studies , Young Adult
16.
Nat Commun ; 13(1): 140, 2022 01 10.
Article in English | MEDLINE | ID: covidwho-1616985

ABSTRACT

While mRNA vaccines are administrated worldwide in an effort to contain the COVID-19 pandemic, the heterogeneity of the humoral immune response they induce at the population scale remains unclear. Here, in a prospective, longitudinal, cohort-study, including 1245 hospital care workers and 146 nursing home residents scheduled for BNT162b2 vaccination, together covering adult ages from 19 to 99 years, we analyse seroconversion to SARS-CoV-2 spike protein and amount of spike-specific IgG, IgM and IgA before vaccination, and 3-5 weeks after each dose. We show that immunogenicity after a single vaccine dose is biased to IgG, heterogeneous and reduced with increasing age. The second vaccine dose normalizes IgG seroconversion in all age strata. These findings indicate two dose mRNA vaccines is required to reach population scale humoral immunity. The results advocate for the interval between the two doses not to be extended, and for serological monitoring of elderly and immunosuppressed vaccinees.


Subject(s)
Antibodies, Viral/immunology , COVID-19/immunology , Immunization, Secondary , SARS-CoV-2/immunology , Adult , Age Factors , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/prevention & control , Female , Humans , Immunogenicity, Vaccine , Longitudinal Studies , Male , Middle Aged , Portugal/epidemiology , Prospective Studies , Seroconversion , Vaccination , Young Adult
17.
Eur J Neurol ; 28(10): 3360-3368, 2021 10.
Article in English | MEDLINE | ID: covidwho-1606972

ABSTRACT

BACKGROUND AND PURPOSE: COVID-19-related acute neurological phenotypes are being increasingly recognised, with neurological complications reported in more than 30% of hospitalised patients. However, multicentric studies providing a population-based perspective are lacking. METHODS: We conducted a retrospective multicentric study at five hospitals in Northern Portugal, representing 45.1% of all hospitalised patients in this region, between 1 March and 30 June 2020. RESULTS: Among 1261 hospitalised COVID-19 patients, 457 (36.2%) presented neurological manifestations, corresponding to a rate of 357 per 1000 in the North Region. Patients with neurologic manifestations were younger (68.0 vs. 71.2 years, p = 0.002), and the most frequent neurological symptoms were headache (13.4%), delirium (10.1%), and impairment of consciousness (9.7%). Acute well-defined central nervous system (CNS) involvement was found in 19.1% of patients, corresponding to a rate of 217 per 1000 hospitalised patients in the whole region. Assuming that all patients with severe neurological events were hospitalised, we extrapolated our results to all COVID-19 patients in the region, estimating that 116 will have a severe neurological event, corresponding to a rate of nine per 1000 (95% CI = 7-11). Overall case fatality in patients presenting neurological manifestations was 19.8%, increasing to 32.6% among those with acute well-defined CNS involvement. CONCLUSIONS: We characterised the population of hospitalised COVID-19 patients in Northern Portugal and found that neurological symptoms are common and associated with a high degree of disability at discharge. CNS involvement with criteria for in-hospital admission was observed in a significant proportion of patients. This knowledge provides the tools for adequate health planning and for improving COVID-19 multidisciplinary patient care.


Subject(s)
COVID-19 , Nervous System Diseases , Humans , Nervous System Diseases/epidemiology , Portugal/epidemiology , Retrospective Studies , SARS-CoV-2
18.
Enferm Infecc Microbiol Clin (Engl Ed) ; 40(1): 28-31, 2022 01.
Article in English | MEDLINE | ID: covidwho-1587898

ABSTRACT

OBJECTIVE: To assess the characteristics of suspected coronavirus disease 19 (COVID-19) and the rate of confirmed COVID-19 in a pediatric population at the beginning of the pandemic in Portugal. STUDY DESIGN: Suspected COVID-19 pediatric cases that were tested in a Portuguese hospital between March 17 and April 2 2020 were included in this descriptive retrospective study. The analyzed data included socio-demographic parameters, characteristics of the household, underlying medical conditions and symptoms. RESULTS: Ninety-four patients were included and all of them were symptomatic and treated without hospitalization. The most common symptoms were cough (80%;n=75), rhinorrhea (72%;n=68) and fever (60%;n=56). There was only one positive for SARS-CoV-2 in a five-year-old child with mild illness without epidemiologic linkage. CONCLUSION: This study showed a low rate of confirmed COVID-19 in children. The causes for this low rate can be multifactorial and illustrates how differently this virus spreads in the pediatric population.


Subject(s)
COVID-19 , Child , Child, Preschool , Humans , Pandemics , Portugal/epidemiology , Retrospective Studies , SARS-CoV-2
19.
Int J Environ Res Public Health ; 19(1)2021 12 29.
Article in English | MEDLINE | ID: covidwho-1580790

ABSTRACT

The COVID-19 pandemic has had significant psychological impact on vulnerable groups, particularly students. The present study aims to investigate the mental and psychological impact of the COVID-19 pandemic and associated factors in a sample of Portuguese higher education students. An online cross-sectional study was conducted among 1522 higher education students selected by convenience sampling. The survey assessed mental health symptoms as well as sociodemographic variables, health-related perceptions, and psychological factors. Results were fitted to binary and multivariable logistic regression models. The overall prevalences of stress, anxiety, and depression were 35.7%, 36.2%, and 28.5%, respectively. Poor mental health outcomes were related with being female, having no children, living with someone with chronic disease, facing hopelessness, and lacking resilient coping. Future studies focusing on better ways to promote mental health and wellbeing among students are warranted. It is necessary to gather more evidence on the post-pandemic mental health using robust study designs and standardized assessment tools.


Subject(s)
COVID-19 , Pandemics , Anxiety/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Mental Health , Portugal/epidemiology , SARS-CoV-2 , Stress, Psychological/epidemiology , Students
20.
Arch Pediatr ; 29(1): 27-29, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1561682

ABSTRACT

AIM: The COVID-19 pandemic has forced governments to impose lockdown policies, thus impacting patients with chronic diseases, such as type 1 diabetes. The aim of this study was to evaluate the impact of lockdown on glycemic control in type 1 diabetes patients. PATIENTS AND METHODS: We retrospectively evaluated patients using a continuous subcutaneous insulin infusion device during the nationwide lockdown. Children and adolescents aged 2-18 years followed up at the Pediatric Endocrinology Unit of Hospitalar São João in Portugal were included in the study. We collected data on the age, weight, insulin doses, and glycemic control of the patients before and after the restrictions. RESULTS: The study included 100 patients, 59 males, with a mean age of 12.5 years. Baseline data showed a suboptimal glycemic control with a median HbA1c of 7.9%. The lockdown was associated with an increase in the body mass index (BMI) of all patients (p = 0.009), particularly girls and older teenagers. Metabolic control deteriorated in the 10-13 age group (p = 0.03), with a 0.4% increase in HbA1c. CONCLUSION: To date, this is the largest study on the impact of lockdown on type 1 diabetes in patients using an insulin pump. The results highlight the importance of physical activity, parental supervision, and continuation of healthcare assistance through telemedicine in young individuals with type 1 diabetes.


Subject(s)
COVID-19/prevention & control , Diabetes Mellitus, Type 1/drug therapy , Glycemic Control/methods , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Pandemics/prevention & control , Quarantine , Adolescent , Blood Glucose , COVID-19/epidemiology , Child , Communicable Disease Control/methods , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/epidemiology , Female , Glycated Hemoglobin A/analysis , Glycated Hemoglobin A/metabolism , Humans , Hypoglycemic Agents/therapeutic use , Infusions, Subcutaneous , Insulin Infusion Systems/adverse effects , Male , Portugal/epidemiology , Retrospective Studies , SARS-CoV-2
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