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1.
In Vivo ; 36(1): 325-329, 2022.
Article in English | MEDLINE | ID: covidwho-1594965

ABSTRACT

BACKGROUND/AIM: Many patients with malignant gliomas are scheduled for radiochemotherapy, which may cause emotional distress associated with sleep problems. This study aimed to determine the prevalence of such sleep problems in these patients and identify risk factors. PATIENTS AND METHODS: Fifty-seven patients scheduled for radiochemotherapy for grade II-IV gliomas were retrospectively investigated for pre-treatment sleep problems. Fifteen characteristics were evaluated including temporal relation to COVID-19 pandemic, age, gender, performance status, comorbidity, (family) history of malignancies, distress score, emotional problems, physical problems, practical problems, involved sites, glioma grade, upfront surgery, and corticosteroids. RESULTS: Nineteen patients stated pre-treatment sleep problems (prevalence=66.7%). Significant associations with sleep problems were found for female gender (p=0.023), presence of emotional problems (p=0.006), and ≥4 physical problems (p<0.001). A trend was found for distress scores ≥5 (p=0.077). CONCLUSION: The prevalence of sleep problems was high. Risk factors were determined that can be used to identify patients who likely benefit from psychological support.


Subject(s)
COVID-19 , Glioma , Sleep Wake Disorders , Chemoradiotherapy , Female , Glioma/complications , Glioma/drug therapy , Glioma/epidemiology , Humans , Pandemics , Retrospective Studies , Risk Factors , SARS-CoV-2 , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology
2.
JAMA Netw Open ; 4(11): e2134803, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1516698

ABSTRACT

Importance: Infection with SARS-CoV-2 is associated with fatigue and sleep problems long after the acute phase of COVID-19. In addition, there are concerns of SARS-CoV-2 infection causing psychiatric illness; however, evidence of a direct effect is inconclusive. Objective: To assess risk of risk of incident or repeat psychiatric illness, fatigue, or sleep problems following SARS-CoV-2 infection and to analyze changes according to demographic subgroups. Design, Setting, and Participants: This cohort study assembled matched cohorts using the Clinical Practice Research Datalink Aurum, a UK primary care registry of 11 923 499 individuals aged 16 years or older. Patients were followed-up for up to 10 months, from February 1 to December 9, 2020. Individuals with less than 2 years of historical data or less than 1 week follow-up were excluded. Individuals with positive results on a SARS-CoV-2 test without prior mental illness or with anxiety or depression, psychosis, fatigue, or sleep problems were matched with up to 4 controls based on sex, general practice, and year of birth. Controls were individuals who had negative SARS-CoV-2 test results. Data were analyzed from January to July 2021. Exposure: SARS-CoV-2 infection, determined via polymerase chain reaction testing. Main Outcomes and Measures: Cox proportional hazard models estimated the association between a positive SARS-CoV-2 test result and subsequent psychiatric morbidity (depression, anxiety, psychosis, or self-harm), sleep problems, fatigue, or psychotropic prescribing. Models adjusted for comorbidities, ethnicity, smoking, and body mass index. Results: Of 11 923 105 eligible individuals (6 011 020 [50.4%] women and 5 912 085 [49.6%] men; median [IQR] age, 44 [30-61] years), 232 780 individuals (2.0%) had positive result on a SARS-CoV-2 test. After applying selection criteria, 86 922 individuals were in the matched cohort without prior mental illness, 19 020 individuals had prior anxiety or depression, 1036 individuals had psychosis, 4152 individuals had fatigue, and 4539 individuals had sleep problems. After adjusting for observed confounders, there was an association between positive SARS-CoV-2 test results and psychiatric morbidity (adjusted hazard ratio [aHR], 1.83; 95% CI, 1.66-2.02), fatigue (aHR, 5.98; 95% CI, 5.33-6.71), and sleep problems (aHR, 3.16; 95% CI, 2.64-3.78). However, there was a similar risk of incident psychiatric morbidity for those with a negative SARS-CoV-2 test results (aHR, 1.71; 95% CI, 1.65-1.77) and a larger increase associated with influenza (aHR, 2.98; 95% CI, 1.55-5.75). Conclusions and Relevance: In this cohort study of individuals registered at an English primary care practice during the pandemic, there was consistent evidence that SARS-CoV-2 infection was associated with increased risk of fatigue and sleep problems. However, the results from the negative control analysis suggest that unobserved confounding may be responsible for at least some of the positive association between COVID-19 and psychiatric morbidity.


Subject(s)
COVID-19/complications , Fatigue/etiology , Pandemics , Psychological Distress , Psychotropic Drugs/therapeutic use , Sleep Wake Disorders/etiology , Sleep , Adult , Anxiety/drug therapy , Anxiety/epidemiology , Anxiety/etiology , COVID-19/psychology , COVID-19/virology , Cohort Studies , Depression/drug therapy , Depression/epidemiology , Depression/etiology , England/epidemiology , Fatigue/epidemiology , Female , Humans , Male , Middle Aged , Prevalence , Primary Health Care , Psychotic Disorders/drug therapy , Psychotic Disorders/epidemiology , Psychotic Disorders/etiology , Risk Factors , SARS-CoV-2 , Sleep Wake Disorders/epidemiology , Stress, Psychological/etiology
3.
Int J Environ Res Public Health ; 17(9)2020 04 26.
Article in English | MEDLINE | ID: covidwho-1456322

ABSTRACT

Poor sleep quality is a common concern and a troublesome symptom among patients suffering from fibromyalgia. The purpose of this review was to identify and describe the available patient reported outcome measures (PROMs) of sleep quality validated in adult people diagnosed with fibromyalgia. The COSMIN and PRISMA recommendations were followed. An electronic systematized search in the electronic databases PubMed, Scopus, CINAHL Plus, PsycINFO, and ISI Web of Science was carried out. Validation studies of PROMs of sleep quality in fibromyalgia published in English or Spanish were included. The selection of the studies was developed through a peer review process through the online software "COVIDENCE". The quality of the studies was assessed using the COSMIN Risk of Bias checklist. A total of 5 PROMs were found validated in patients with fibromyalgia: (1) Pittsburgh Sleep Quality Index (PSQI), (2) Jenkins Sleep Scale (JSS), (3) Sleep Quality Numeric Rating Scale (SQ-NRS), (4) Medical Outcomes Study-Sleep Scale (MOS-SS), and (5) Fibromyalgia Sleep Diary (FSD). The quality of the evidence was very good and the quality of the results ranged from moderate to high. All the included PROMs, except for the FSD, showed adequate psychometric properties and, therefore, are valid and reliable tools for assessing sleep quality in the context of FM. However, none of the studies analyzed all the psychometric properties of the included PROMs as established in the COSMIN guidelines, highlighting that this is a potential field of research for future investigations.


Subject(s)
Depressive Disorder, Major , Fibromyalgia , Patient Reported Outcome Measures , Sleep Wake Disorders , Adult , Female , Fibromyalgia/complications , Fibromyalgia/therapy , Humans , Male , Psychometrics , Quality of Life , Reproducibility of Results , Sleep , Sleep Wake Disorders/etiology , Sleep Wake Disorders/therapy , Surveys and Questionnaires
4.
Anticancer Res ; 41(9): 4439-4442, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1395531

ABSTRACT

BACKGROUND/AIM: Radiotherapy and radiochemotherapy are common treatments for rectal and anal cancer. Anticipation of treatment may cause distress and sleep disorders. This study aimed to identify risk factors for sleep disorders. PATIENTS AND METHODS: In 42 patients with rectal or anal cancer scheduled for radiotherapy, 16 characteristics were analyzed for associations with pre-radiotherapy sleep disorders including age, gender, performance score, comorbidity, patient's or family history of additional cancer/melanoma, distress score, emotional/physical/practical problems, tumor site and stage, surgery and relation to COVID-19 pandemic. RESULTS: Overall prevalence of pre-radiotherapy sleep disorders was 42.9%. Sleep disorders were significantly associated with Karnofsky performance score 60-80 (p=0.044), Charlson comorbidity index ≥3 (p=0.0012), distress score 6-10 (p=0.00012), and more emotional (p=0.0012), physical (p=0.0004) or practical (p=0.033) problems. A trend was found for female gender (p=0.061). CONCLUSION: Sleep disorders were common in patients with rectal or anal cancer scheduled for radiotherapy. Risk factors can help identify patients requiring psychooncological support already prior to the start of radiotherapy.


Subject(s)
Anus Neoplasms/radiotherapy , Anus Neoplasms/surgery , Rectal Neoplasms/radiotherapy , Rectal Neoplasms/surgery , Sleep Wake Disorders/epidemiology , Aged , Anus Neoplasms/pathology , Anus Neoplasms/psychology , COVID-19/epidemiology , Dose Fractionation, Radiation , Female , Humans , Male , Middle Aged , Neoplasm Staging , Prevalence , Rectal Neoplasms/pathology , Rectal Neoplasms/psychology , Sex Characteristics , Sleep Wake Disorders/etiology , Treatment Outcome
5.
Anticancer Res ; 41(9): 4407-4410, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1395530

ABSTRACT

BACKGROUND/AIM: Many patients with gynecological malignancies receive postoperative radiotherapy, which can lead to fear and sleep disorders. We aimed to identify the prevalence of and risk factors for sleep disorders. PATIENTS AND METHODS: Sixty-two patients assigned to radiotherapy for gynecological malignancies were retrospectively evaluated. Seventeen characteristics were analyzed for associations with pre-radiotherapy sleep disorders including age, Karnofsky performance score, Charlson comorbidity index, history of additional malignancy, family history of gynecological cancer, distress score, emotional, physical or practical problems, tumor site/stage; chemotherapy, treatment volume, brachytherapy, and the COVID-19 pandemic. RESULTS: The prevalence of pre-radiotherapy sleep disorders was 46.8%. Sleep disorders were significantly associated with Charlson comorbidity index ≥3 (p=0.012), greater number of physical problems (p<0.0001), and advanced primary tumor stage (p=0.005). A trend was found for greater number of emotional problems (p=0.075). CONCLUSION: Pre-radiotherapy sleep disorders are common in patients with gynecological malignancies, particularly in those with specific risk factors. Patients should be offered early psychological support.


Subject(s)
Genital Neoplasms, Female/radiotherapy , Genital Neoplasms, Female/surgery , Radiotherapy, Adjuvant/methods , Sleep Wake Disorders/epidemiology , Adult , Brachytherapy , COVID-19/epidemiology , Female , Genital Neoplasms, Female/pathology , Genital Neoplasms, Female/psychology , Humans , Middle Aged , Neoplasm Staging , Prevalence , Retrospective Studies , Risk Factors , Sleep Wake Disorders/etiology , Treatment Outcome
6.
J Korean Med Sci ; 36(25): e184, 2021 Jun 28.
Article in English | MEDLINE | ID: covidwho-1286919

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is different from previous disasters in that it continues to the present and has affected all aspects of family life. During epidemics, psychosocial support is not less important than infection control. During COVID-19-related school closures, prolonged partial closures of schools could have detrimental social and health consequences for children and may increase the burden on the family. Based on a community sample in Korea, this study identified parental concerns, children's media usage, other various factors and examined whether parental stress level or depression were positively associated with problem behaviors, media exposure, and sleep problems of the primary school children during school closure under COVID-19. METHODS: Participants were 217 parents residing in Suwon, South Korea, who had primary school children and responded to a web-based questionnaire on parental concerns from school closure under COVID-19, subjective stress, depression, whether having received mental health services, and family characteristics; children's sleep patterns, problem behaviors, media usage during the online-only class period, and changes in activity level following the pandemic. RESULTS: During school closure, children gained body weight, spent less time in physical activities and more in media usage. Besides online learning content (97.2%), YouTube was highly used content (87.6%), and games followed (78.3%). Parental subjective stress index was highly associated with parental depression (Pearson correlation 0.439, P < 0.001), children's sleep problems (0.283, P < 0.001), tablet time (0.171, P = 0.012) and behavior problems (0.413, P < 0.001). Parental depression was associated with children's sleep problems (0.355, P < 0.001), TV time (0.153, P = 0.024), tablet time (0.159, P = 0.019), and behavior problems (0.524, P < 0.001). Parents who previously received mental services seemed to be more concerned about the problems their children already have getting worse because of COVID-19 than the disease itself. Children's sleep problem was associated with tablet (0.172, P = 0.011) and smartphone time (0.298, P < 0.001), but not its frequency. CONCLUSION: During COVID-19-related school closures, many parents and children had various difficulties relating to mental health. Ongoing monitoring of mental health of high-risk groups and multiple support systems may need to be expanded to cover those parents having difficulty in caring for their children.


Subject(s)
COVID-19/epidemiology , Mass Media , Pandemics , Parents/psychology , Psychology, Child , SARS-CoV-2 , Schools , Social Isolation , Adult , Body Mass Index , Child , Child Behavior Disorders/epidemiology , Child Behavior Disorders/etiology , Child Care , Depression/epidemiology , Depression/etiology , Education, Distance , Exercise , Female , Humans , Income , Leisure Activities , Male , Mental Health Services/statistics & numerical data , Parent-Child Relations , Procedures and Techniques Utilization , Quarantine , Republic of Korea/epidemiology , Sedentary Behavior , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Social Support , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Surveys and Questionnaires
7.
In Vivo ; 35(4): 2253-2260, 2021.
Article in English | MEDLINE | ID: covidwho-1285628

ABSTRACT

BACKGROUND/AIM: The anticipation of radiotherapy can cause distress and sleep disorders, which may be aggravated by the COVID-19 pandemic. This study investigated sleep disorders in a large cohort of patients with breast cancer before and during the pandemic. PATIENTS AND METHODS: Twenty-three characteristics were retrospectively analyzed for associations with pre-radiotherapy sleep disorders in 338 patients. Moreover, 163 patients presenting before and 175 patients presenting during the COVID-19 pandemic were compared for sleep disorders. RESULTS: Sleep disorders were significantly associated with age ≤60 years (p=0.006); high distress score (p<0.0001); more emotional (p<0.0001), physical (p<0.0001) or practical (p<0.0001) problems; psycho-oncological need (p<0.0001); invasive cancer (p=0.003); chemotherapy (p<0.001); and hormonal therapy (p=0.006). Sleep disorders were similarly common in both groups (prior to vs. during the pandemic: 40% vs. 45%, p=0.38). CONCLUSION: Although additional significant risk factors for sleep disorders were identified, the COVID-19 pandemic appeared to have no significant impact on sleep disorders in patients scheduled for irradiation of breast cancer.


Subject(s)
Breast Neoplasms , COVID-19 , Sleep Wake Disorders , Breast Neoplasms/complications , Breast Neoplasms/epidemiology , Breast Neoplasms/radiotherapy , Female , Humans , Middle Aged , Pandemics , Radiotherapy, Adjuvant/adverse effects , Retrospective Studies , SARS-CoV-2 , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology
8.
Med Sci Monit ; 27: e929454, 2021 Jun 30.
Article in English | MEDLINE | ID: covidwho-1278721

ABSTRACT

BACKGROUND COVID-19 (coronavirus disease 2019) broke out in China. This study was to investigate the situation of mental health status among medical staff following COVID-19. MATERIAL AND METHODS A cross-sectional study was conducted through structured questionnaires to collect the demographical information of the participating medical staff via WeChat following COVID-19 crisis. The Center for Epidemiologic Studies-Depression Scale (CES-D), impact of events scale revised (IES-R), and Pittsburgh Sleep Quality Index (PSQI) scale were used to evaluate depression, post-traumatic stress disorder (PTSD) symptoms, and sleep quality, respectively. 95% confidence intervals (CI) were calculated. RESULTS A total of 597 medical staff's information was included for the statistical analysis, and found 45.23% of subjects had PTSD symptoms, the mean PSQI score was 6.320±3.587. The results of multivariable analysis implied that medical workers who did not participate in the Hubei aid program (ß=4.128; 95% CI, 0.983-7.272; P=0.010) and PTSD symptoms (ß=7.212; 95% CI, 4.807-9.616; P<0.001) were associated with a higher tendency to depression. The PSQI score was linearly related to the CES-D score (ß=1.125; 95% CI, 0.804-1.445; P<0.001). Subgroup analysis showed that medical workers who did not participate in the Hubei aid program, no traumatic experience before COVID-19 outbreaks, and PTSD symptoms may affect the tendency to depression in females, but not in males. PSQI score was linearly related to the CES-D score both in males and females. CONCLUSIONS The medical staff with PTSD symptoms and higher PSQI score may have a higher tendency to depression following COVID-19 outbreaks.


Subject(s)
COVID-19 , Depression , Medical Staff , Sleep Wake Disorders , Stress Disorders, Post-Traumatic , Adult , COVID-19/epidemiology , COVID-19/psychology , China/epidemiology , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Depression/etiology , Female , Humans , Male , Medical Staff/psychology , Medical Staff/statistics & numerical data , Mental Health/statistics & numerical data , Occupational Health/statistics & numerical data , Psychiatric Status Rating Scales , SARS-CoV-2 , Sex Factors , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Surveys and Questionnaires
9.
Ann N Y Acad Sci ; 1486(1): 90-111, 2021 02.
Article in English | MEDLINE | ID: covidwho-1263856

ABSTRACT

Evidence from previous coronavirus outbreaks has shown that infected patients are at risk for developing psychiatric and mental health disorders, such as depression, anxiety, and sleep disturbances. To construct a comprehensive picture of the mental health status in COVID-19 patients, we conducted a systematic review and random-effects meta-analysis to assess the prevalence of depression, anxiety, and sleep disturbances in this population. We searched MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, Wanfang Data, Wangfang Med Online, CNKI, and CQVIP for relevant articles, and we included 31 studies (n = 5153) in our analyses. We found that the pooled prevalence of depression was 45% (95% CI: 37-54%, I2  = 96%), the pooled prevalence of anxiety was 47% (95% CI: 37-57%, I2  = 97%), and the pooled prevalence of sleeping disturbances was 34% (95% CI: 19-50%, I2  = 98%). We did not find any significant differences in the prevalence estimates between different genders; however, the depression and anxiety prevalence estimates varied based on different screening tools. More observational studies assessing the mental wellness of COVID-19 outpatients and COVID-19 patients from countries other than China are needed to further examine the psychological implications of COVID-19 infections.


Subject(s)
Anxiety/etiology , COVID-19/complications , Depression/etiology , Pandemics , SARS-CoV-2 , Sleep Wake Disorders/etiology , Anxiety/epidemiology , COVID-19/psychology , Depression/epidemiology , Female , Humans , Male , Mental Health , Prevalence , Sleep Wake Disorders/epidemiology
10.
Psychoneuroendocrinology ; 131: 105295, 2021 09.
Article in English | MEDLINE | ID: covidwho-1253500

ABSTRACT

The majority of COVID-19 survivors experience long-term neuropsychiatric symptoms such as fatigue, sleeping difficulties, depression and anxiety. We propose that neuroimmune cross-talk via inflammatory cytokines such as interleukin-6 (IL-6) could underpin these long-term COVID-19 symptoms. This hypothesis is supported by several lines of research, including population-based cohort and genetic Mendelian Randomisation studies suggesting that inflammation is associated with fatigue and sleeping difficulties, and that IL-6 could represent a possible causal driver for these symptoms. Immune activation following COVID-19 can disrupt T helper 17 (TH17) and regulatory T (Treg) cell responses, affect central learning and emotional processes, and lead to a vicious cycle of inflammation and mitochondrial dysfunction that amplifies the inflammatory process and results in immuno-metabolic constraints on neuronal energy metabolism, with fatigue being the ultimate result. Increased cytokine activity drives this process and could be targeted to interrupt it. Therefore, whether persistent IL-6 dysregulation contributes to COVID-19-related long-term fatigue, sleeping difficulties, depression, and anxiety, and whether targeting IL-6 pathways could be helpful for treatment and prevention of long COVID are important questions that require investigation. This line of research could inform new approaches for treatment and prevention of long-term neuropsychiatric symptoms of COVID-19. Effective treatment and prevention of this condition could also help to stem the anticipated rise in depression and other mental illnesses ensuing this pandemic.


Subject(s)
COVID-19/complications , Interleukin-6/physiology , Mental Disorders/etiology , Animals , Anxiety/epidemiology , Anxiety/etiology , COVID-19/epidemiology , COVID-19/etiology , COVID-19/psychology , Cohort Studies , Depression/epidemiology , Depression/etiology , Fatigue/epidemiology , Fatigue/etiology , Humans , Interleukin-6/metabolism , Interleukin-6/pharmacology , Mental Disorders/epidemiology , Neuroimmunomodulation/drug effects , Neuroimmunomodulation/physiology , SARS-CoV-2/physiology , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Survivors/statistics & numerical data
11.
JAMA Netw Open ; 4(5): e2111417, 2021 05 03.
Article in English | MEDLINE | ID: covidwho-1242694

ABSTRACT

Importance: Infection with COVID-19 has been associated with long-term symptoms, but the frequency, variety, and severity of these complications are not well understood. Many published commentaries have proposed plans for pandemic control that are primarily based on mortality rates among older individuals without considering long-term morbidity among individuals of all ages. Reliable estimates of such morbidity are important for patient care, prognosis, and development of public health policy. Objective: To conduct a systematic review of studies examining the frequency and variety of persistent symptoms after COVID-19 infection. Evidence Review: A search of PubMed and Web of Science was conducted to identify studies published from January 1, 2020, to March 11, 2021, that examined persistent symptoms after COVID-19 infection. Persistent symptoms were defined as those persisting for at least 60 days after diagnosis, symptom onset, or hospitalization or at least 30 days after recovery from the acute illness or hospital discharge. Search terms included COVID-19, SARS-CoV-2, coronavirus, 2019-nCoV, long-term, after recovery, long-haul, persistent, outcome, symptom, follow-up, and longitudinal. All English-language articles that presented primary data from cohort studies that reported the prevalence of persistent symptoms among individuals with SARS-CoV-2 infection and that had clearly defined and sufficient follow-up were included. Case reports, case series, and studies that described symptoms only at the time of infection and/or hospitalization were excluded. A structured framework was applied to appraise study quality. Findings: A total of 1974 records were identified; of those, 1247 article titles and abstracts were screened. After removal of duplicates and exclusions, 92 full-text articles were assessed for eligibility; 47 studies were deemed eligible, and 45 studies reporting 84 clinical signs or symptoms were included in the systematic review. Of 9751 total participants, 5266 (54.0%) were male; 30 of 45 studies reported mean or median ages younger than 60 years. Among 16 studies, most of which comprised participants who were previously hospitalized, the median proportion of individuals experiencing at least 1 persistent symptom was 72.5% (interquartile range [IQR], 55.0%-80.0%). Individual symptoms occurring most frequently included shortness of breath or dyspnea (26 studies; median frequency, 36.0%; IQR, 27.6%-50.0%), fatigue or exhaustion (25 studies; median frequency, 40.0%; IQR, 31.0%-57.0%), and sleep disorders or insomnia (8 studies; median 29.4%, IQR, 24.4%-33.0%). There were wide variations in the design and quality of the studies, which had implications for interpretation and often limited direct comparability and combinability. Major design differences included patient populations, definitions of time zero (ie, the beginning of the follow-up interval), follow-up lengths, and outcome definitions, including definitions of illness severity. Conclusions and Relevance: This systematic review found that COVID-19 symptoms commonly persisted beyond the acute phase of infection, with implications for health-associated functioning and quality of life. Current studies of symptom persistence are highly heterogeneous, and future studies need longer follow-up, improved quality, and more standardized designs to reliably quantify risks.


Subject(s)
COVID-19/complications , Dyspnea/etiology , Fatigue/etiology , Sleep Wake Disorders/etiology , COVID-19/virology , Hospitalization , Humans , Pandemics , SARS-CoV-2 , Survivors
12.
J Intern Med ; 290(2): 444-450, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1203883

ABSTRACT

OBJECTIVES: To understand the sequelae of COVID-19. METHODS: We followed up 1174 patients with severe coronavirus disease 2019 (COVID-19)who were recovered and discharged for 6 months. RESULTS: There were 175 cases with clear IgG results 6 months after discharge, of which 82 (46.9%) were IgG (+) and 16 (9.1%) were IgG (dim+). Four hundred and forty-one participants (55.4%) had some kind of sequelae. The most common symptoms were fatigue (25.3%), sleep disorder (23.2%) and shortness of breath (20.4%). In those who had sequelae, 262 (59.4%) had more than one symptom. Critical cases were more likely to have cough (20.5% vs 11.6%, p = 0.023) and hypomnesis (15.1% vs 8.0%, p = 0.041) than severe cases. Furthermore, univariate and multivariate logistic regression analyses revealed that women are more likely to have multiple symptoms (p = 0.002), fatigue (p = 0.009) and sleep disorder (p = 0.008), whereas critical illness was found as independent risk factor for hypomnesis (p = 0.045). CONCLUSION: Our study demonstrated the duration of antibody and sequelae of COVID-19 and compared the differences amongst different populations.


Subject(s)
COVID-19/complications , Adult , Aged , Aged, 80 and over , Cough/etiology , Critical Illness , Dyspnea/etiology , Fatigue/etiology , Female , Follow-Up Studies , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Memory Disorders/etiology , Middle Aged , Severity of Illness Index , Sex Factors , Sleep Wake Disorders/etiology , Young Adult
13.
Global Health ; 17(1): 34, 2021 03 29.
Article in English | MEDLINE | ID: covidwho-1158211

ABSTRACT

BACKGROUND: Mental burden due to the SARS-CoV-2 pandemic has been widely reported for the general public and specific risk groups like healthcare workers and different patient populations. We aimed to assess its impact on mental health during the early phase by comparing pandemic with prepandemic data and to identify potential risk and protective factors. METHODS: For this systematic review and meta-analyses, we systematically searched PubMed, PsycINFO, and Web of Science from January 1, 2019 to May 29, 2020, and screened reference lists of included studies. In addition, we searched PubMed and PsycINFO for prepandemic comparative data. Survey studies assessing mental burden by the SARS-CoV-2 pandemic in the general population, healthcare workers, or any patients (eg, COVID-19 patients), with a broad range of eligible mental health outcomes, and matching studies evaluating prepandemic comparative data in the same population (if available) were included. We used multilevel meta-analyses for main, subgroup, and sensitivity analyses, focusing on (perceived) stress, symptoms of anxiety and depression, and sleep-related symptoms as primary outcomes. RESULTS: Of 2429 records retrieved, 104 were included in the review (n = 208,261 participants), 43 in the meta-analysis (n = 71,613 participants). While symptoms of anxiety (standardized mean difference [SMD] 0.40; 95% CI 0.15-0.65) and depression (SMD 0.67; 95% CI 0.07-1.27) were increased in the general population during the early phase of the pandemic compared with prepandemic conditions, mental burden was not increased in patients as well as healthcare workers, irrespective of COVID-19 patient contact. Specific outcome measures (eg, Patient Health Questionnaire) and older comparative data (published ≥5 years ago) were associated with increased mental burden. Across the three population groups, existing mental disorders, female sex, and concerns about getting infected were repeatedly reported as risk factors, while older age, a good economic situation, and education were protective. CONCLUSIONS: This meta-analysis paints a more differentiated picture of the mental health consequences in pandemic situations than previous reviews. High-quality, representative surveys, high granular longitudinal studies, and more research on protective factors are required to better understand the psychological impacts of the SARS-CoV-2 pandemic and to help design effective preventive measures and interventions that are tailored to the needs of specific population groups.


Subject(s)
COVID-19/psychology , Mental Disorders/etiology , Mental Health , Pandemics , Adolescent , Adult , Aged , Anxiety/epidemiology , Anxiety/etiology , Depression/epidemiology , Depression/etiology , Female , Humans , Male , Mental Disorders/epidemiology , Middle Aged , Protective Factors , SARS-CoV-2 , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Stress, Psychological/epidemiology , Stress, Psychological/etiology
14.
Med Sci Monit ; 27: e930447, 2021 Apr 15.
Article in English | MEDLINE | ID: covidwho-1134483

ABSTRACT

BACKGROUND The present study was designed to reveal the trajectory of self-reported somatic symptom burden and sleep quality over time in patients with COVID-19 and to identify prognostic factors for greater somatic symptom burden and sleep disturbance. MATERIAL AND METHODS Seventy-four patients with COVID-19 were prospectively followed for longitudinal assessment of somatic symptom burden and sleep quality. We used the 8-item Somatic Symptom Scale (SSS-8) and the modified Medical Research Council (mMRC) scale for somatic symptom burden and the Pittsburgh Sleep Quality Index for sleep quality investigation. Univariate and multivariate analyses were performed to identify independent factors associated with somatic symptom burden and sleep quality. RESULTS Although the degree of physical discomfort and sleep quality issues tended to decline during self-quarantine, patients still experienced these problems to a certain degree. Univariate and multivariate analyses showed that SSS-8 scores at admission (relative risk [RR] 1.234, 95% CI 1.075-1.417, P=0.003) and mMRC scores at discharge (RR 2.420, 95% CI 1.251-4.682, P=0.009) were 2 independent prognostic indicators of somatic symptom burden. In addition, muscle pain as a chief complaint (RR 4.682, 95% CI 1.247-17.580, P<0.022) and history of use of hypnotic drugs (RR 0.148, 95% CI 0.029-0.749, P<0.019) were 2 independent indicators of patient sleep quality during hospitalization. CONCLUSIONS To the best of our knowledge, the present study was the first dynamic assessment of the somatic symptom burden and sleep quality in patients with COVID-19 during hospitalization and quarantine after discharge. Patients with high somatic symptom burden at admission, especially muscle pain as the chief complaint, are prone to having a higher physical burden and more sleep disturbance at discharge.


Subject(s)
COVID-19/complications , Cost of Illness , Medically Unexplained Symptoms , Myalgia/epidemiology , Sleep Wake Disorders/epidemiology , Adult , Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Female , Humans , Longitudinal Studies , Male , Middle Aged , Myalgia/diagnosis , Myalgia/etiology , Myalgia/physiopathology , Patient Admission/statistics & numerical data , Patient Discharge/statistics & numerical data , Prognosis , Prospective Studies , Quarantine/statistics & numerical data , Risk Assessment/statistics & numerical data , SARS-CoV-2/isolation & purification , Self Report/statistics & numerical data , Severity of Illness Index , Sleep/physiology , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/etiology
15.
Recenti Prog Med ; 112(3): 207-215, 2021 03.
Article in Italian | MEDLINE | ID: covidwho-1123709

ABSTRACT

OBJECTIVES: The recent lockdown, resulting from the SARS-CoV-2 pandemic, has had a strong social and psychological impact on the most fragile individuals and family structures. In the present work we investigated the experience of families without specific elements of social or health vulnerability during the quarantine period that occurred in the spring of 2020. MATERIALS AND METHODS: Between May and July 2020, 22 primary care pediatricians belonging to AUSL Romagna administered to a number of families a questionnaire to detect changes that occurred, during the lockdown, in family environment, school attendance and personal attitudes. RESULTS: A total of 721 questionnaires were collected, analyzing the associations between variables relating to home environment, daily rhythms, school and warning signs in relation to the age of children. As a result of the lockdown, family habits changed in 31% of cases, with a greater presence of the reference figure in 68% of these. Three out of four families reported they had sufficient domestic spaces, and nine out of ten had access to an outdoor, private or condominium space. Daily rhythms were preserved in 56.7% of cases; mood disorders appeared in 30% of adolescent children, followed by sleep, appetite and psychosomatic disorders. One in three children has made progress in terms of evolution and behavior, and one in 5 children has seen their relationships improve. The overall resilience of families during the lockdown period was considered good in 66.3%, sufficient in 31.3% and not satisfactory in only 2.4% of cases. CONCLUSIONS: Our data show that, in the interviewed families, the simultaneous presence of adults and children at home has generally intensified. Families refer, on the whole, a positive and resilient behavior in the lockdown period, even if initial emotional problems are reported in one out of three children-adolescents. The ability to maintain a family organized structure seems to be partially compromised. Forced cohabitation leads to competition for the same resources of time and space and affects the entire family unit. The school institution emerges as a protective factor for children, young people and also for the well-being of families themselves.


Subject(s)
COVID-19/prevention & control , Community Medicine , Family Relations/psychology , Pandemics , Pediatricians , Psychology, Adolescent , Psychology, Child , Quarantine/psychology , SARS-CoV-2 , Adolescent , Adult , Attitude , COVID-19/epidemiology , Child , Child, Preschool , Crowding/psychology , Emigrants and Immigrants/psychology , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/etiology , Female , Health Care Surveys , Housing , Humans , Infant , Infant, Newborn , Male , Mood Disorders/epidemiology , Mood Disorders/etiology , Parents/psychology , Psychophysiologic Disorders/epidemiology , Psychophysiologic Disorders/etiology , Schools , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology
16.
Prog Neuropsychopharmacol Biol Psychiatry ; 110: 110292, 2021 08 30.
Article in English | MEDLINE | ID: covidwho-1117498

ABSTRACT

BACKGROUND: Emotional wellbeing of healthcare workers is critical to the quality of patient care, and effective function of health services. The corona virus disease-2019 (COVID-19) pandemic exerted unique physical and emotional demands on healthcare workers, however little is known about the emotional wellbeing of healthcare workers during the COVID-19 pandemic in resource-restricted settings. This study investigated the prevalence of psychological distress, and sleep problems in healthcare workers in a COVID-19 referral hospital in Nigeria. METHODS: A total of 303 healthcare workers were interviewed with the 12-item General Health Questionnaire (GHQ-12) to evaluate psychological distress, and the Pittsburgh Sleep Quality Index (PSQI) to assess multidimensional aspects of sleep, including quality, latency, duration, habitual efficiency, disturbances, use of sleeping medications and daytime dysfunction. RESULTS: The participants were mostly males, 183(60.4%) and mean age was 38.8(SD = 8.9) years. Most of the participants were married (70.3%), had spent less than 10 years in service (72.9%), and had no medical comorbidity (92.1%). The prevalence of psychological distress was 23.4%, and six in every ten participants reported sleep problems. The largest proportion of participants reported difficulty in sleep latency (81.5%), duration (71.3%), and daytime dysfunction (69.6%), while approximately one third (32%) each reported using sleep medication, and had difficulty with sleep quality. Psychological distress was inter-related with poor sleep problems (p = 0.001; effect size = 0.2). CONCLUSION: The prevalence rates of psychological distress and sleep problems during the COVID-19 pandemic were several folds the rates previously reported in similar contexts. Preventative psychosocial support services for healthcare workers are indicated. The creation of a culturally-sensitive interdisciplinary blueprint for locally-viable actions model are strongly suggested ahead of future emergency situations.


Subject(s)
COVID-19/psychology , Health Personnel/psychology , Occupational Stress/etiology , Psychological Distress , Sleep Wake Disorders/etiology , Workplace/psychology , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Female , Health Personnel/statistics & numerical data , Humans , Male , Middle Aged , Nigeria/epidemiology , Occupational Stress/epidemiology , Occupational Stress/psychology , Prevalence , Sleep Wake Disorders/epidemiology , Surveys and Questionnaires , Workplace/statistics & numerical data
17.
Psychiatry Res ; 298: 113819, 2021 04.
Article in English | MEDLINE | ID: covidwho-1096207

ABSTRACT

The COVID-19 pandemic and the consequent restrictions imposed by governments worldwide have had profound social and psychological effects, particularly for young adults. This study used longitudinal data to characterise effects on mental health and behaviour in a UK student sample, measuring sleep quality and diurnal preference, depression and anxiety symptoms, wellbeing and loneliness, and alcohol use. Self-report data was collected from 254 undergraduates (219 females) at a UK university at two-time points: autumn 2019 (baseline, pre-pandemic) and April/May 2020 (under 'lockdown' conditions).  Longitudinal analyses showed a significant rise in depression symptoms and a reduction in wellbeing at lockdown. Over a third of the sample could be classed as clinically depressed at lockdown compared to 15% at baseline. Sleep quality was not affected across the sample as a whole. The increase in depression symptoms was highly correlated with worsened sleep quality. A reduction in alcohol use, and a significant shift towards an 'evening' diurnal preference, were also observed. Levels of worry surrounding contracting COVID-19 were high. Results highlight the urgent need for strategies to support young people's mental health: alleviating worries around contracting COVID, and supporting good sleep quality, could benefit young adults' mental health as the COVID-19 crisis unfolds.


Subject(s)
Alcohol Drinking , Anxiety , COVID-19 , Communicable Disease Control , Depression , Loneliness , Sleep Wake Disorders , Students , Adolescent , Adult , Alcohol Drinking/epidemiology , Anxiety/epidemiology , Anxiety/etiology , Depression/epidemiology , Depression/etiology , Female , Humans , Longitudinal Studies , Male , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Students/psychology , Students/statistics & numerical data , United Kingdom/epidemiology , Young Adult
18.
Int J Psychiatry Clin Pract ; 25(2): 164-171, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1091335

ABSTRACT

OBJECTIVES: Psychological burdens of the COVID-19 pandemic are likely to impact sleep negatively. We investigate prevalence and correlates of disturbed sleep among subscribers to Text4Hope a daily supportive text message program launched in Alberta to support residents to deal with stress, anxiety, and depression. METHODS: A survey link was sent to Text4Hope subscribers to assess demographic and clinical variables, including disturbed sleep, stress, anxiety, and depression using the third question on the Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale, Generalised Anxiety Disorder 7-item scale, and PHQ-9, respectively. Data were analysed using univariate and logistic regression analyses. RESULTS: Overall, 6041 out of 32,805 Text4Hope subscribers completed the survey (18.4% response rate). Prevalence of disturbed sleep was 77.8%. Subscribers aged 41-60 years were twice as likely to present with sleep disturbance compared to individuals ≤25 years (OR 1.89, 95% CI: 1.27-2.81). Individuals with moderate/high anxiety and stress symptoms and those with passive death wish/suicidal ideation had higher probability for sleep disturbance [(OR 4.05, 95% CI: 3.33-4.93), (OR 2.42, 95% CI: 1.99-2.94), and (OR 2.39, 95% CI: 1.69-3.38)], respectively. CONCLUSION: As the pandemic continues, more Canadians are likely to develop sleep problems, an important consideration for planning mental health services.KEY POINTSThis is the first study to examine the prevalence rates and demographic and clinical correlates of disturbed sleep in a large sample (n = 6041) of Canadians during the COVID-19 pandemic.Prevalence of disturbed sleep was high at 77.8%.Individuals aged 41-60 years were twice as likely to present with sleep disturbance compared to individuals ≤25 years (OR 1.89, 95% CI: 1.27-2.81).Individuals with moderate/high anxiety symptoms, moderate/high stress symptoms, and suicidal ideation/thoughts of self-harm had higher likelihood of developing sleep disturbance, compared to individuals lacking these symptoms [(OR 4.05, 95% CI: 3.33-4.93) and (OR 2.42, 95% CI: 1.98-2.94)], respectively.As the pandemic continues, with fear of multiple waves, more Canadians are likely to develop sleep problems, an important consideration for planning the provision of mental health services.


Subject(s)
COVID-19/epidemiology , Sleep Wake Disorders/epidemiology , Adult , Age Factors , Alberta/epidemiology , Anxiety/epidemiology , Anxiety/etiology , COVID-19/complications , COVID-19/psychology , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Female , Humans , Male , Middle Aged , Prevalence , Psychiatric Status Rating Scales , Risk Factors , Sleep Wake Disorders/etiology , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Suicidal Ideation , Surveys and Questionnaires , Young Adult
19.
Sleep Breath ; 25(4): 2197-2204, 2021 12.
Article in English | MEDLINE | ID: covidwho-1080518

ABSTRACT

PURPOSE: This study aimed to assess the frequency of sleep and mood disturbances, and their association with COVID-like symptoms in healthcare workers (HCWs) with and without positive Coronavirus RT-PCR in a corona referral center. METHODS: This study was a cross-sectional, anonymous survey of adult HCWs. Data collection was performed in May and June 2020, while governmental restrictions were in place. The participants completed the forms including six separate parts: personal and occupational information, Insomnia Severity Index (ISI), Generalized Anxiety Disorder-7 (GAD-7), Patient's Health Questionnaire (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and COVID-like symptoms and Coronavirus RT-PCR status. RESULTS: Among the 372 HCW participants, 245 (66%) were women and  mean age was 34.5 ± 7.1 years (age range 23 to 58). The mean scores of all questionnaires except ISI were significantly higher in the HCWs with positive Coronavirus RT-PCR than another group (PSQI, 9 ± 3.4 vs. 6.9 ± 3.1; GAD-7, 9.8 ± 3.6 vs. 7.9 ± 5.3; PHQ-9, 12.8 ± 6.1 vs. 9.5 ± 6.4, P < 0.05; and ISI, 13.8 ± 5.3 vs. 12.3 ± 6 P = 0.163). Positive association between COVID-like symptoms and sleep and mood disturbances was found in the group without a positive test result. Analysis of questionnaires showed higher scores in the group directly involved except for ISI (P < 0.001 and P = 0.053 respectively). CONCLUSIONS: During the COVID-19 pandemic, the HCWs in this sample experienced a high rate of sleep and mood disturbances. There was also a strong association between sleep and mood disturbances and COVID-like symptoms in the group without a positive RT-PCR result. With all this considered, effective psychological support for HCWs during crisis seems to be necessary.


Subject(s)
Anxiety/physiopathology , COVID-19/physiopathology , Depression/physiopathology , Personnel, Hospital , Sleep Wake Disorders/physiopathology , Adult , Anxiety/epidemiology , Anxiety/etiology , COVID-19/complications , COVID-19/epidemiology , COVID-19/virology , Comorbidity , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Female , Health Surveys , Humans , Iran/epidemiology , Male , Middle Aged , Personnel, Hospital/statistics & numerical data , Referral and Consultation/statistics & numerical data , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Young Adult
20.
Appl Nurs Res ; 59: 151412, 2021 06.
Article in English | MEDLINE | ID: covidwho-1077770

ABSTRACT

BACKGROUND: The profession of nurses involves exposure to harmful agents. Despite numerous international studies on the occurrence of sleep disorders in nurses, most studies lacked an assessment of the dependence on the occurrence of the situation causing fear and anxiety which is a highly contagious. AIM: Determining the relationship between the occurrence of sleep disorders and socio-demographic variables of medical personnel during the COVID-19 epidemic. DESIGN: This is a cross-sectional study conducted online involving 336 health professionals. RESULTS: Insomnia among staff was determined at the level of Subthreshold insomnia and Clinical insomnia (moderate severity). Suspicion or confirmed COVID-19 had an effect on the occurrence of sleep disorders in the study group of medical personnel. CONCLUSION: Taking into account the statistical error of 6%, the sleep disorders concern about 40% of professionally active nurses and midwives in Poland. Worsening of insomnia was observed in people with the possibility of contact with a patient with COVID-19 in the workplace. Insomnia was more common in respondents over 25 years of age. Psychosocial interventions are needed to help healthcare staff better respond to COVID-19 and future epidemics.


Subject(s)
Anxiety/etiology , Anxiety/therapy , COVID-19/psychology , Fear/psychology , Health Personnel/psychology , Sleep Wake Disorders/etiology , Sleep Wake Disorders/therapy , Adult , Age Factors , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Poland , SARS-CoV-2 , Socioeconomic Factors , Young Adult
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