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3.
Eur J Gen Pract ; 29(2): 2155135, 2023 Dec.
Article in English | MEDLINE | ID: covidwho-20232531

ABSTRACT

BACKGROUND: The Covid-19 pandemic has increased stress levels in GPs, who have resorted to different coping strategies to deal with this crisis. Gender differences in coping styles may be contributing factors in the development of psychological distress. OBJECTIVES: To identify differences by gender and by stress level in coping strategies of GPs during the Covid-19 pandemic. METHODS: A cross-sectional, web-based survey conducted with GPs in Catalonia (Spain), in June-July 2021. via the institution's email distribution list, all GPs members of the Catalan Society of Family and Community Medicine were invited to complete a survey assessing sociodemographic, health and work-related characteristics, experienced stress (Stress scale of the Depression, Anxiety and Stress Scales-DASS 21) and the frequency of use of a range of coping strategies (Brief-COPE) classified as problem-focused, emotion-focused and avoidant strategies, some of which are adaptive and others maladaptive. We compared the scores of each strategy by gender and stress level using Student's t-test. RESULTS: Of 4739 members, 522 GPs participated in the study (response rate 11%; 79.1% women; mean age = 46.9 years, SD = 10.5). Of these, 41.9% reported moderate-severe stress levels. The most common coping strategies were acceptance, active coping, planning, positive reframing and venting. More frequently than men, women resorted to emotional and instrumental support, venting, distraction and self-blame, whereas men used acceptance and humour more commonly than women. Moderate-severe stress levels were associated with non-adaptive coping, with increased use of avoidance strategies, self-blame, religion and venting, and decreased use of positive reframing and acceptance. CONCLUSION: The most common coping strategies were adaptive and differed by gender. However, highly stressful situations caused maladaptive strategies to emerge.


Subject(s)
COVID-19 , Male , Humans , Female , Middle Aged , Cross-Sectional Studies , Spain/epidemiology , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Pandemics , Sex Factors , Adaptation, Psychological
4.
Health Promot Int ; 38(3)2023 Jun 01.
Article in English | MEDLINE | ID: covidwho-20237738

ABSTRACT

Non-pharmaceutical interventions (NPIs) implemented to mitigate the COVID-19 pandemic halted everyday life in higher education along with social and psychological impacts. The objective of our study was to explore the factors related to sense of coherence (SoC) from a gender perspective among university students in Turkey. This is a cross-sectional survey conducted online with a convenience sampling method as part of the international COVID-Health Literacy (COVID-HL) Consortium. SoC was measured by a nine-item questionnaire that was adapted to the Turkish language, including socio-demographic information and health status, including psychological well-being, psychosomatic complaints, and future anxiety (FA). 1595 students from four universities, of whom 72% were female, participated in the study. Cronbach's alpha for the SoC scale was 0.75. Based on the median split of the individual scores, levels of SoC showed no statistically significant difference according to gender. Logistic regression analysis indicated that higher SoC was associated with medium and high subjective social status, studying in private universities, high psychological well-being, low FA, and none/one psychosomatic complaint. While results were similar among female students, type of university and psychological well-being showed no statistically significant association with SoC among males. Our results indicate that structural (subjective social status) and contextual (type of university) factors, along with gender-based variations, are associated with SoC among university students in Turkey.


Subject(s)
COVID-19 , Sense of Coherence , Male , Humans , Female , COVID-19/epidemiology , Universities , Cross-Sectional Studies , Turkey/epidemiology , Pandemics , Sex Factors , Students/psychology
5.
Int J Public Health ; 68: 1605826, 2023.
Article in English | MEDLINE | ID: covidwho-20236770

ABSTRACT

Objectives: The COVID-19 pandemic and its protective measures have changed the daily lives of families and may have affected quality of life (QoL). The aim of this study was to analyze gender differences in QoL and to examine individuals living in different partnership and family constellations. Methods: Data from the Gutenberg COVID-19 cohort study (N = 10,250) with two measurement time points during the pandemic (2020 and 2021) were used. QoL was assessed using the EUROHIS-QOL questionnaire. Descriptive analyses and autoregressive regressions were performed. Results: Women reported lower QoL than men, and QoL was significantly lower at the second measurement time point in both men and women. Older age, male gender, no migration background, and higher socioeconomic status, as well as partnership and children (especially in men), were protective factors for QoL. Women living with children under 14 and single mothers reported significantly lower QoL. Conclusion: Partnership and family were protective factors for QoL. However, women with young children and single mothers are vulnerable groups for lower QoL. Support is especially needed for women with young children.


Subject(s)
COVID-19 , Quality of Life , Humans , Male , Child , Female , Child, Preschool , Sex Factors , Pandemics , COVID-19/epidemiology , Cohort Studies , Surveys and Questionnaires
6.
Int J Environ Res Public Health ; 20(10)2023 05 16.
Article in English | MEDLINE | ID: covidwho-20235715

ABSTRACT

This paper explores the structural and group-specific factors explaining the excess death rates experienced by the Hispanic population in New York City during the peak years of the coronavirus pandemic. Neighborhood-level analysis of Census data allows an exploration of the relation between Hispanic COVID-19 deaths and spatial concentration, conceived in this study as a proxy for structural racism. This analysis also provides a more detailed exploration of the role of gender in understanding the effects of spatial segregation among different Hispanic subgroups, as gender has emerged as a significant variable in explaining the structural and social effects of COVID-19. Our results show a positive correlation between COVID-19 death rates and the share of Hispanic neighborhood residents. However, for men, this correlation cannot be explained by the characteristics of the neighborhood, as it is for women. In sum, we find: (a) differences in mortality risks between Hispanic men and women; (b) that weathering effects increase mortality risks the longer Hispanic immigrant groups reside in the U.S.; (c) that Hispanic males experience greater contagion and mortality risks associated with the workplace; and (d) we find evidence corroborating the importance of access to health insurance and citizenship status in reducing mortality risks. The findings propose revisiting the Hispanic health paradox with the use of structural racism and gendered frameworks.


Subject(s)
COVID-19 , Emigrants and Immigrants , Systemic Racism , Female , Humans , Male , COVID-19/mortality , Hispanic or Latino , New York City/epidemiology , Vulnerable Populations , Sex Factors
7.
J Womens Health (Larchmt) ; 32(7): 801-807, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-2322180

ABSTRACT

Objective: The gendered impact of the COVID-19 on scientific productivity has been primarily studied in nonclinical academic fields. We investigated the gendered effect of the pandemic on diverse measures of research participation among physician faculty, who experienced an increase in clinical duties concomitant with pandemic-era challenges to research. Materials and Methods: Physician faculty employed in both 2019 (prepandemic) and 2021 (pandemic era) were identified at one U.S. medical school. Annual outcomes included scientific publications, Institutional Review Board (IRB)-approved protocols, and extramural funding submissions (funding data were unavailable for 2019). Mixed-effects Poisson regression models compared the pandemic impact by gender. Results: The study included 105 women and 116 men, contributing to 122 publications, 214 IRB protocols, and 99 extramural funding applications. Controlling for potential confounders such as faculty rank and track (tenure vs. nontenure), women's publication count increased by 140% during the pandemic (95% confidence interval [CI]: +40% to +310%, p = 0.001) but was unchanged among men (95% CI: -30% to +50%; p > 0.999). The number of IRB protocols decreased from 2019 to 2021, but to a greater extent among men than women. In 2021, there was no gender difference in the number of extramural funding submissions. Conclusions: Among physician faculty at our medical school, women achieved parity with men on multiple measures of scholarly activity, and women's research productivity outpaced that of men in the same faculty track and rank. Targeted initiatives to support research among women faculty, junior investigators, and clinical investigators may have helped avert exacerbation of prepandemic gender disparities in research participation.


Subject(s)
COVID-19 , Physicians , Male , Humans , Female , United States/epidemiology , Pandemics , Faculty, Medical , Sex Factors
9.
Eur J Public Health ; 33(3): 490-495, 2023 06 01.
Article in English | MEDLINE | ID: covidwho-2319942

ABSTRACT

BACKGROUND: Women have been significantly more likely than men to express hesitancy toward COVID-19 vaccination and, to a lesser extent, to refuse vaccination altogether. This gender gap is puzzling because women have been more likely to perceive higher risks from COVID-19, to approve more restrictive measures to fight the pandemic and to be more compliant with such measures. METHODS: This article studies the gender gap in COVID-19 vaccination attitudes using two nationally representative surveys of public opinion fielded in February 2021 and May 2021 in 27 European countries. The data are analyzed using generalized additive models and multivariate logistic regression. RESULTS: The data analyses show that hypotheses about (i) pregnancy, fertility and breastfeeding concerns, (ii) higher trust in Internet and social networks as sources of medical information, (iii) lower trust in health authorities and (iv) lower perceived risks of getting infected with COVID-19 cannot account for the gender gap in vaccine hesitancy. One explanation that receives support from the data is that women are more likely to believe that COVID-19 vaccines are unsafe and ineffective and this leads them to perceive the net benefits of vaccination as lower than the associated risks. CONCLUSIONS: The gender gap in COVID-19 vaccine hesitancy results to a large extent from women perceiving higher risks than benefits of the vaccines. While accounting for this and other factors decreases the gap in vaccine hesitancy, it does not eliminate it completely, which suggests further research is needed.


Subject(s)
COVID-19 Vaccines , COVID-19 , Male , Pregnancy , Female , Humans , COVID-19 Vaccines/therapeutic use , Sex Factors , COVID-19/epidemiology , COVID-19/prevention & control , Vaccination , Attitude
10.
Nat Aging ; 2(7): 563, 2022 07.
Article in English | MEDLINE | ID: covidwho-2312553
11.
Eur Eat Disord Rev ; 31(3): 413-424, 2023 05.
Article in English | MEDLINE | ID: covidwho-2292562

ABSTRACT

OBJECTIVE: Phenotypical comparisons between individuals with obesity without binge eating disorder (OB) and individuals with obesity and comorbid binge eating disorder (OB + BED) are subject to ongoing investigations. At the same time, gender-related differences have rarely been explored, raising the question whether men and women with OB and OB + BED may require differently tailored treatments. METHOD: We retrospectively compared pre- versus post-treatment data in a matched sample of n = 180 men and n = 180 women with OB or OB + BED who received inpatient treatment. RESULTS: We found that men displayed higher weight loss than women independent of diagnostic group. In addition, men with OB + BED showed higher weight loss than men with OB after 7 weeks of treatment. CONCLUSIONS: The present findings add to an emerging yet overall still sparse body of studies comparing phenotypical features and treatment outcomes in men and women with OB and OB + BED; implications for further research are discussed. CLINICAL TRIAL REGISTRATION: The study was prospectively registered with the German Clinical Trial Register as part of application DRKS00028441.


Subject(s)
Binge-Eating Disorder , Bulimia , Female , Humans , Male , Binge-Eating Disorder/epidemiology , Binge-Eating Disorder/therapy , Binge-Eating Disorder/diagnosis , Obesity/epidemiology , Obesity/therapy , Overweight , Retrospective Studies , Sex Factors , Treatment Outcome , Weight Loss
12.
Neurol Clin ; 41(2): 359-369, 2023 05.
Article in English | MEDLINE | ID: covidwho-2291235

ABSTRACT

This article explores sex-specific neurocognitive impairment. It first defines relevant terms such as gender and sex. Next, it describes the nature of the problem including under-representation of women and other gender and sexual minorities in neuroscience research, including cognitive studies. A biopsychosocial framework is employed to account for structural and social determinants of health in sex/gender-specific neurocognitive impairment. Issues in assessment including the use of gender/sex-specific normative data are also discussed. Lastly, the article covers the current state of research as it relates to sex/gender-specific neurocognitive impairment across a range of medical conditions including neurodegenerative diseases and coronavirus disease-2019.


Subject(s)
Cognitive Dysfunction , Sex Factors , Female , Humans , Male , COVID-19 , Cognitive Dysfunction/epidemiology
13.
BMJ ; 381: 845, 2023 04 21.
Article in English | MEDLINE | ID: covidwho-2296951
14.
J Psychiatr Res ; 162: 88-94, 2023 06.
Article in English | MEDLINE | ID: covidwho-2296377

ABSTRACT

Women are at heightened risk for chronic stress-related psychological sequelae (SRPS), including major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) in response to potentially traumatic events, including the COVID-19 pandemic. However, few studies have examined pre- and peri-event stressors that could account for gender differences in chronic SRPS. To address this gap, we conducted a prospective cohort study of healthcare providers (HCPs) caring for patients with COVID-19 at a large tertiary care hospital in New York City, and measured mental health risk factors and symptoms of MDD, GAD, and PTSD at baseline (April 2020) and at a 7-month follow-up (December 2020). We defined chronic SRPS as the presence of probable MDD, GAD, and/or PTSD at both timepoints. We conducted a mediation analysis to evaluate whether pre- and peri-event stressors explained women's increased risk for chronic SRPS. Among our sample of 786 HCPs, 571 (72.6%) were women. Compared with men, women were twice as likely to have chronic SRPS (18.7% vs. 8.8%, χ2[1] = 11.38, p < 0.001). However, after accounting for pre- and peri-event stressors, being a woman was no longer associated with chronic SRPS (p = 0.58). The pre- and peri-event stressors that accounted for this heightened risk among women included being in a woman-prevalent profession (specifically nursing; estimate = 0.08, SE = 0.04, p = 0.05), pre-pandemic burnout (estimate = 0.11, SE = 0.05, p = 0.04), greater family-related (estimate = 0.09, SE = 0.03, p = 0.004), infection-related (estimate = 0.06, SE = 0.02, p = 0.007), and work-related concerns (estimate = 0.11, SE = 0.03, p < 0.001), and lower leadership support (estimate = 0.07, SE = 0.03, p = 0.005). These findings can inform institutional interventions to mitigate the risk of chronic SRPS among women HCPs.


Subject(s)
COVID-19 , Depressive Disorder, Major , Stress Disorders, Post-Traumatic , Male , Humans , Female , COVID-19/epidemiology , Prospective Studies , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/complications , Sex Factors , Pandemics , Stress Disorders, Post-Traumatic/psychology , Health Personnel , Disease Progression
15.
J Comp Eff Res ; 11(9): 689-698, 2022 06.
Article in English | MEDLINE | ID: covidwho-2254396

ABSTRACT

Aim: To provide a comprehensive understanding of the varying effects of SARS-CoV-2 infection based on sex. Methods: A PubMed search of 470 primary articles was performed, with inclusion based on relevance (sex differences discussed in the target COVID population) and redundancy. PubMed was queried based on title for the keywords "SEX" and "COVID" or "SARS" between 2020 and 2022. Results: For COVID-19, males have increased risk for infectivity and intensive care unit admission and worse overall outcomes compared with females. Genetic predispositions, sex hormones, immune system responses and non-biological causes all contribute to the disparity in COVID-19 responses between the sexes. COVID-19 sex-related determinants of morbidity and mortality remain unclear. Conclusions: Male sex is a risk factor for several overall worse outcomes related to COVID-19. Investigating the sex impact of COVID-19 is an important part of understanding the behavior of the disease. Future work is needed to further explore these relationships and optimize the management of COVID-19 patients based on sex.


Subject(s)
COVID-19 , Female , Hospitalization , Humans , Intensive Care Units , Male , SARS-CoV-2 , Sex Factors
17.
Swiss Med Wkly ; 150: w20446, 2020 12 14.
Article in English | MEDLINE | ID: covidwho-2273782

ABSTRACT

AIMS OF THE STUDY: Hydroxychloroquine and lopinavir/ritonavir have been used as experimental therapies to treat COVID-19 during the first wave of the pandemic. Randomised controlled trials have recently shown that there are no meaningful benefits of these two therapies in hospitalised patients. Uncertainty remains regarding the potential harmful impact of these therapies as very early treatments and their burden to the health care system. The present study investigated the length of hospital stay (LOS), mortality, and costs of hydroxychloroquine, lopinavir/ritonavir or their combination in comparison with standard of care among patients hospitalised for coronavirus disease 2019 (COVID-19). METHODS: This retrospective observational cohort study took place in the Geneva University Hospitals, Geneva, Switzerland (n = 840) between 26 February and 31 May 2020. Demographics, treatment regimens, comorbidities, the modified National Early Warning Score (mNEWS) on admission, and contraindications to COVID-19 treatment options were assessed. Outcomes included LOS, in-hospital mortality, and drug and LOS costs. RESULTS: After successful propensity score matching, patients treated with (1) hydroxychloroquine, (2) lopinavir/ritonavir or (3) their combination had on average 3.75 additional hospitalisation days (95% confidence interval [CI] 1.37–6.12, p = 0.002), 1.23 additional hospitalisation days (95% CI −1.24 – 3.51, p = 0.319), and 4.19 additional hospitalisation days (95% CI 1.52–5.31, p <0.001), respectively, compared with patients treated with the standard of care. Neither experimental therapy was significantly associated with mortality. These additional hospital days amounted to 1010.77 additional days for hydroxychloroquine and hydroxychloroquine combined with lopinavir/ritonavir, resulting in an additional cost of US$ 2,492,214 (95%CI US$ 916,839–3,450,619). CONCLUSIONS: Prescribing experimental therapies for COVID-19 was not associated with a reduced LOS and might have increased the pressure put on healthcare systems.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19 Drug Treatment , COVID-19/epidemiology , Hydroxychloroquine/therapeutic use , Lopinavir/therapeutic use , Ritonavir/therapeutic use , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Antiviral Agents/administration & dosage , Antiviral Agents/adverse effects , COVID-19/mortality , Child , Child, Preschool , Comorbidity , Drug Combinations , Drug Therapy, Combination , Health Expenditures , Hospital Mortality/trends , Humans , Hydroxychloroquine/administration & dosage , Hydroxychloroquine/adverse effects , Infant , Length of Stay/statistics & numerical data , Lopinavir/administration & dosage , Lopinavir/adverse effects , Middle Aged , Pandemics , Retrospective Studies , Ritonavir/administration & dosage , Ritonavir/adverse effects , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Socioeconomic Factors , Therapies, Investigational/methods , Young Adult
18.
PLoS One ; 15(12): e0243027, 2020.
Article in English | MEDLINE | ID: covidwho-2270795

ABSTRACT

BACKGROUND: New York City (NYC) bore the greatest burden of COVID-19 in the United States early in the pandemic. In this case series, we describe characteristics and outcomes of racially and ethnically diverse patients tested for and hospitalized with COVID-19 in New York City's public hospital system. METHODS: We reviewed the electronic health records of all patients who received a SARS-CoV-2 test between March 5 and April 9, 2020, with follow up through April 16, 2020. The primary outcomes were a positive test, hospitalization, and death. Demographics and comorbidities were also assessed. RESULTS: 22254 patients were tested for SARS-CoV-2. 13442 (61%) were positive; among those, the median age was 52.7 years (interquartile range [IQR] 39.5-64.5), 7481 (56%) were male, 3518 (26%) were Black, and 4593 (34%) were Hispanic. Nearly half (4669, 46%) had at least one chronic disease (27% diabetes, 30% hypertension, and 21% cardiovascular disease). Of those testing positive, 6248 (46%) were hospitalized. The median age was 61.6 years (IQR 49.7-72.9); 3851 (62%) were male, 1950 (31%) were Black, and 2102 (34%) were Hispanic. More than half (3269, 53%) had at least one chronic disease (33% diabetes, 37% hypertension, 24% cardiovascular disease, 11% chronic kidney disease). 1724 (28%) hospitalized patients died. The median age was 71.0 years (IQR 60.0, 80.9); 1087 (63%) were male, 506 (29%) were Black, and 528 (31%) were Hispanic. Chronic diseases were common (35% diabetes, 37% hypertension, 28% cardiovascular disease, 15% chronic kidney disease). Male sex, older age, diabetes, cardiac history, and chronic kidney disease were significantly associated with testing positive, hospitalization, and death. Racial/ethnic disparities were observed across all outcomes. CONCLUSIONS AND RELEVANCE: This is the largest and most racially/ethnically diverse case series of patients tested and hospitalized for COVID-19 in New York City to date. Our findings highlight disparities in outcomes that can inform prevention and testing recommendations.


Subject(s)
COVID-19 , Ethnicity , Hospitals, Public , Pandemics , SARS-CoV-2 , Adolescent , Adult , Age Factors , Aged , COVID-19/ethnology , COVID-19/mortality , COVID-19/therapy , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Middle Aged , New York City/epidemiology , New York City/ethnology , Retrospective Studies , Risk Factors , Sex Factors
19.
Swiss Med Wkly ; 150: w20417, 2020 12 14.
Article in English | MEDLINE | ID: covidwho-2267622

ABSTRACT

Coronavirus disease 2019 (COVID-19) is primarily a pulmonary disease, but also affects the cardiovascular system in multiple ways. In this review, we will summarise and put into perspective findings and debates relating to the diverse aspects of cardiovascular involvement of COVID-19. We will review evidence for the role of the renin-angiotensin-aldosterone system (RAAS), the risk of pre-existing cardiovascular disease in COVID-19 susceptibility and course, and the mechanism of acute and long-term myocardial injury. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) uses membrane-bound angiotensin converting-enzyme-2 (ACE2) as a receptor for cell entry. ACE2 is part of an important counter-regulatory circuit antagonising the harmful effects of angiotensin II on lung and heart. Modulation of ACE2 may therefore affect disease susceptibility and disease course. However, observational clinical studies and one randomised trial have so far not yielded evidence for harmful or beneficial effects of blockers of the RAAS during COVID-19. Age, gender, and multi-morbidity all increase susceptibility to SARS-CoV-2. In contrast, pre-existing cardiovascular diseases do so only minimally, but they may aggravate the disease course. Direct SARS-CoV-2 infection of the heart tissue and myocytes is rare. Nevertheless, COVID-19 may lead to myocarditis-like acute cardiac injury, characterised by myocardial oedema, but lacking extensive myocyte loss and lymphocytic infiltration. Independent of this, increases in cardiac biomarkers (troponin, N-terminal pro-brain natriuretic peptide, D-dimer) are frequent, especially in the phase of severe systemic inflammation and acute respiratory distress syndrome, and quantitatively associated with poor outcome. The pulmonary infection may result initially in right ventricular dysfunction, but in cases with severe systemic infection hypoxia, hyperinflammation and cytokine storm heart failure may eventually ensue. Unlike other infections and inflammatory states, COVID-19 does not appear to trigger acute coronary syndromes. In children, even mild COVID-19 can induce a multisystem inflammatory syndrome with Kawasaki-like symptoms frequently accompanied by cardiogenic shock.


Subject(s)
COVID-19/epidemiology , COVID-19/physiopathology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/physiopathology , Age Factors , Angiotensin-Converting Enzyme 2/metabolism , Angiotensin-Converting Enzyme Inhibitors , Biomarkers , Comorbidity , Humans , Inflammation/physiopathology , Inflammation Mediators/metabolism , Myocardial Infarction/physiopathology , Myocardium/pathology , Renin-Angiotensin System/physiology , Sex Factors , Systemic Inflammatory Response Syndrome/physiopathology , COVID-19 Drug Treatment
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