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1.
Transplant Direct ; 6(7): e572, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-1794966

ABSTRACT

BACKGROUND: The early effects of coronavirus disease 2019 (COVID-19) on transplantation are dramatic: >75% of kidney and liver programs are either suspended or operating under major restrictions. To resume transplantation, it is important to understand the prevalence of COVID-19 among transplant recipients, donors, and healthcare workers (HCWs) and its associated mortality. METHODS: To investigate this, we studied severe acute respiratory syndrome coronavirus 2 diagnostic test results among patients with end-stage renal disease or kidney transplants from the Johns Hopkins Health System (n = 235), and screening test results from deceased donors from the Southwest Transplant Alliance Organ Procurement Organization (n = 27), and donors, candidates, and HCWs from the National Kidney Registry and Viracor-Eurofins (n = 253) between February 23 and April 15, 2020. RESULTS: We found low rates of COVID-19 among donors and HCWs (0%-1%) who were screened, higher rates of diagnostic tests among patients with end-stage renal disease or kidney transplant (17%-20%), and considerable mortality (7%-13%) among those who tested positive. CONCLUSIONS: These findings suggest the threat of COVID-19 for the transplant population is significant and ongoing data collection and reporting is critical to inform transplant practices during and after the pandemic.

2.
Clin Infect Dis ; 73(9): e2985-e2991, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1501042

ABSTRACT

BACKGROUND: It is currently unclear whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection will remain a rare event, only occurring in individuals who fail to mount an effective immune response, or whether it will occur more frequently when humoral immunity wanes following primary infection. METHODS: A case of reinfection was observed in a Belgian nosocomial outbreak involving 3 patients and 2 healthcare workers. To distinguish reinfection from persistent infection and detect potential transmission clusters, whole genome sequencing was performed on nasopharyngeal swabs of all individuals including the reinfection case's first episode. Immunoglobulin A, immunoglobulin M, and immunoglobulin G (IgG) and neutralizing antibody responses were quantified in serum of all individuals, and viral infectiousness was measured in the swabs of the reinfection case. RESULTS: Reinfection was confirmed in a young, immunocompetent healthcare worker as viral genomes derived from the first and second episode belonged to different SARS-CoV-2 clades. The symptomatic reinfection occurred after an interval of 185 days, despite the development of an effective humoral immune response following symptomatic primary infection. The second episode, however, was milder and characterized by a fast rise in serum IgG and neutralizing antibodies. Although contact tracing and viral culture remained inconclusive, the healthcare worker formed a transmission cluster with 3 patients and showed evidence of virus replication but not of neutralizing antibodies in her nasopharyngeal swabs. CONCLUSIONS: If this case is representative of most patients with coronavirus disease 2019, long-lived protective immunity against SARS-CoV-2 after primary infection might not be likely.


Subject(s)
COVID-19 , Cross Infection , Antibodies, Neutralizing , Belgium/epidemiology , Cross Infection/epidemiology , Disease Outbreaks , Female , Health Personnel , Humans , Reinfection , SARS-CoV-2
3.
JAMA ; 325(24): 2457-2465, 2021 Jun 22.
Article in English | MEDLINE | ID: covidwho-1318647

ABSTRACT

IMPORTANCE: Randomized clinical trials have provided estimates of the effectiveness of the BNT162b2 vaccine against symptomatic SARS-CoV-2 infection, but its effect on asymptomatic infections remains unclear. OBJECTIVE: To estimate the association of vaccination with the Pfizer-BioNTech BNT162b2 vaccine with symptomatic and asymptomatic SARS-CoV-2 infections among health care workers. DESIGN, SETTING, AND PARTICIPANTS: This was a single-center, retrospective cohort study conducted at a tertiary medical center in Tel Aviv, Israel. Data were collected on symptomatic and asymptomatic SARS-CoV-2 infections confirmed via polymerase chain reaction (PCR) tests in health care workers undergoing regular screening with nasopharyngeal swabs between December 20, 2020, and February 25, 2021. Logistic regression was used to calculate incidence rate ratios (IRRs) comparing the incidence of infection between fully vaccinated and unvaccinated participants, controlling for demographics and the number of PCR tests performed. EXPOSURES: Vaccination with the BNT162b2 vaccine vs unvaccinated status was ascertained from the employee health database. Full vaccination was defined as more than 7 days after receipt of the second vaccine dose. MAIN OUTCOMES AND MEASURES: The primary outcome was the regression-adjusted IRR for symptomatic and asymptomatic SARS-CoV-2 infection of fully vaccinated vs unvaccinated health care workers. The secondary outcomes included IRRs for partially vaccinated health care workers (days 7-28 after first dose) and for those considered as late fully vaccinated (>21 days after second dose). RESULTS: A total of 6710 health care workers (mean [SD] age, 44.3 [12.5] years; 4465 [66.5%] women) were followed up for a median period of 63 days; 5953 health care workers (88.7%) received at least 1 dose of the BNT162b2 vaccine, 5517 (82.2%) received 2 doses, and 757 (11.3%) were not vaccinated. Vaccination was associated with older age compared with those who were not vaccinated (mean age, 44.8 vs 40.7 years, respectively) and male sex (31.4% vs 17.7%). Symptomatic SARS-CoV-2 infection occurred in 8 fully vaccinated health care workers and 38 unvaccinated health care workers (incidence rate, 4.7 vs 149.8 per 100 000 person-days, respectively, adjusted IRR, 0.03 [95% CI, 0.01-0.06]). Asymptomatic SARS-CoV-2 infection occurred in 19 fully vaccinated health care workers and 17 unvaccinated health care workers (incidence rate, 11.3 vs 67.0 per 100 000 person-days, respectively, adjusted IRR, 0.14 [95% CI, 0.07-0.31]). The results were qualitatively unchanged by the propensity score sensitivity analysis. CONCLUSIONS AND RELEVANCE: Among health care workers at a single center in Tel Aviv, Israel, receipt of the BNT162b2 vaccine compared with no vaccine was associated with a significantly lower incidence of symptomatic and asymptomatic SARS-CoV-2 infection more than 7 days after the second dose. Findings are limited by the observational design.


Subject(s)
COVID-19 Vaccines , COVID-19/epidemiology , Health Personnel , Adult , Asymptomatic Infections/epidemiology , COVID-19/diagnosis , COVID-19/prevention & control , Female , Humans , Incidence , Israel , Male , Middle Aged , Polymerase Chain Reaction , Propensity Score , Retrospective Studies , SARS-CoV-2/isolation & purification , Tertiary Care Centers
4.
J Occup Environ Med ; 63(6): 528-531, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1288155

ABSTRACT

BACKGROUND: Health care workers (HCWs) experience increased occupational risk of contracting COVID-19, with temporal trends that might inform surveillance. METHODS: We analyzed data from a Veterans Affairs hospital-based COVID-19 worker telephone hotline collected over 40 weeks (2020). We calculated the proportion of COVID-19+ cases among persons-under-investigation (PUIs) for illness compared to rates from a nearby large university-based health care institution. RESULTS: We observed 740 PUIs, 65 (8.8%) COVID-19+. Time trends were similar at the study and comparison hospitals; only for the first of 10 four-week observation periods was the ratio for observed to expected COVID-19+ significant (P < 0.001). DISCUSSION: These data suggest that employee health COVID-19+ to PUI ratios could be utilized as a barometer of community trends. Pooling experience among heath care facilities may yield insights into occupational infectious disease outbreaks.


Subject(s)
COVID-19/epidemiology , Health Personnel/statistics & numerical data , Occupational Exposure/statistics & numerical data , COVID-19/diagnosis , Cohort Studies , Hospitals, University , Hospitals, Veterans , Humans , Incidence , Occupational Health/statistics & numerical data , SARS-CoV-2/isolation & purification , San Francisco/epidemiology , Sentinel Surveillance
5.
Front Psychiatry ; 12: 658846, 2021.
Article in English | MEDLINE | ID: covidwho-1278459

ABSTRACT

Introduction: Health care workers, due to be involved in caring for COVID-19 patients may experience various psychological problems including anxiety disorders. This study aimed to investigate the prevalence of Generalized Anxiety Disorder (GAD) among health care workers during the COVID-19 pandemic by systematic review and meta-analysis. Methods: The PRISMA guideline was used for conducting this study. Related keywords were searched in credited resources including ISC, Magiran, PubMed, Scopus, Web of Science, Cochrane, ProQuest, Science Direct, Google Scholar, and Embase to find the articles published on the prevalence of GAD among health care workers during the COVID-19 pandemic from the first of January to the end of June 2020. Meta-analysis was conducted by the random effects model. Results: In this study, 553 articles were initially identified, from which 19 studies were finally included in the meta-analysis. The results showed that the prevalence of GAD in health care workers based on the GAD-7 and GAD-2 instruments were 32.04% (95% CI: 26.89-37.19, I 2 = 98.2%, p < 0.001) and 22.62% (95% CI: 9.01-36.24, I 2 = 97.7%, p < 0.001). The overall prevalence of GAD was obtained 30.5% (95% CI: 25.58-35.42, I 2 = 98.4%, p < 0.001). Conclusion: This study showed a relatively high GAD prevalence, as one of the fundamental psychological problems, among health care workers during the COVID-19 pandemic. Therefore, health system managers should implement preventive strategies to protect health staff from contracting the virus and monitor them for psychological problems and provide them with supportive measures if necessary.

6.
J Obstet Gynaecol Res ; 47(9): 3241-3249, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1276736

ABSTRACT

AIM: To investigate the association between menstrual cycle regularity in healthcare providers and COVID-19 pandemic-related anxiety, depression, stress. METHODS: A cross-sectional study was conducted by administrating online questionnaires to female healthcare workers in Turkey. Women aged 18-40 years with regular menstrual cycles for more than 1 year before the beginning of the pandemic were included in the study and they were divided into two groups according to menstrual cycle regularity during the pandemic. The questionnaires included sociodemographic characteristics, medical and reproductive history, lifestyle information of participants, COVID-19 Stress Scales (CSS), and a short version of the Depression Anxiety Stress Scale (DASS-21). RESULTS: A total of 952 women were included in the study, 679 had regular menstrual cycles, and 273 had irregular menstrual cycles. The prevalence of irregular menses among Turkish women healthcare workers aged 18-40 years was 28.7%. The CSS subdimensions and total scores were significantly higher in the irregular menstruation group than in women with regular menstruation (p < 0.001). The DASS-21 depression, anxiety, and stress subdimensions were likewise significantly higher in women with irregular menstruation (p < 0.001). Besides, both the univariable and the multivariable logistic regression results showed the relationship between irregular menstruation and CSS total score. CONCLUSION: The current study showed the association between the COVID-19 pandemic-induced anxiety, perceived stress, depressive symptoms, and increased prevalence of menstrual cycle irregularity among healthcare providers.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Depression/epidemiology , Female , Health Personnel , Humans , Menstrual Cycle , Menstruation Disturbances/epidemiology , Mental Health , SARS-CoV-2 , Surveys and Questionnaires
7.
Nat Commun ; 12(1): 3698, 2021 06 17.
Article in English | MEDLINE | ID: covidwho-1275915

ABSTRACT

In this single centre cohort study we assessed BNT162B2 vaccine uptake and effectiveness among UK healthcare workers (HCWs) during a time of high community COVID-19 prevalence. Early uptake among HCWs was 62.3% (1409/2260), however there were significant differences in uptake between age groups, ethnic origins, and job roles. Uptake increased to 72.9% after a vaccine hesitancy working group implemented specific measures. In the 42 days after vaccination, 49 new cases of COVID-19 were identified, of which 7 (14.3%) occurred in HCWs who were beyond 10 days of vaccination. Kaplan-Meier curves for partially vaccinated and unvaccinated groups were congruent until day 14 and continued to diverge up to 42 days. Cox regression analysis showed a 70.0% (95%CI 6.0-91.0; p=0.04) risk reduction for COVID-19 infection in partially vaccinated HCWs. Here we report early vaccination rates among HCWs are generally high although uptake is lower in certain groups. It is possible to improve vaccine uptake and efforts should focus on this, however, significant resource is required. The BNT162B2 vaccine is effective from 14 days post-vaccination in a frontline clinical setting and protection continues beyond 21 days post 1st dose without a 2nd dose, being given.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Health Personnel/statistics & numerical data , Vaccination/statistics & numerical data , Adolescent , Adult , COVID-19/epidemiology , Cohort Studies , Female , Health Personnel/ethics , Health Personnel/psychology , Hospitals/statistics & numerical data , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Proportional Hazards Models , Time Factors , United Kingdom/epidemiology , Vaccination/psychology , Vaccination Refusal/psychology , Vaccination Refusal/statistics & numerical data , Young Adult
8.
Rev Psiquiatr Salud Ment (Engl Ed) ; 14(2): 90-105, 2021.
Article in English | MEDLINE | ID: covidwho-1270632

ABSTRACT

INTRODUCTION: Healthcare workers are vulnerable to adverse mental health impacts of the COVID-19 pandemic. We assessed prevalence of mental disorders and associated factors during the first wave of the pandemic among healthcare professionals in Spain. METHODS: All workers in 18 healthcare institutions (6 AACC) in Spain were invited to web-based surveys assessing individual characteristics, COVID-19 infection status and exposure, and mental health status (May 5 - September 7, 2020). We report: probable current mental disorders (Major Depressive Disorder-MDD- [PHQ-8≥10], Generalized Anxiety Disorder-GAD- [GAD-7≥10], Panic attacks, Posttraumatic Stress Disorder -PTSD- [PCL-5≥7]; and Substance Use Disorder -SUD-[CAGE-AID≥2]. Severe disability assessed by the Sheehan Disability Scale was used to identify probable "disabling" current mental disorders. RESULTS: 9,138 healthcare workers participated. Prevalence of screen-positive disorder: 28.1% MDD; 22.5% GAD, 24.0% Panic; 22.2% PTSD; and 6.2% SUD. Overall 45.7% presented any current and 14.5% any disabling current mental disorder. Workers with pre-pandemic lifetime mental disorders had almost twice the prevalence than those without. Adjusting for all other variables, odds of any disabling mental disorder were: prior lifetime disorders (TUS: OR=5.74; 95%CI 2.53-13.03; Mood: OR=3.23; 95%CI:2.27-4.60; Anxiety: OR=3.03; 95%CI:2.53-3.62); age category 18-29 years (OR=1.36; 95%CI:1.02-1.82), caring "all of the time" for COVID-19 patients (OR=5.19; 95%CI: 3.61-7.46), female gender (OR=1.58; 95%CI: 1.27-1.96) and having being in quarantine or isolated (OR= 1.60; 95CI:1.31-1.95). CONCLUSIONS: One in seven Spanish healthcare workers screened positive for a disabling mental disorder during the first wave of the COVID-19 pandemic. Workers reporting pre-pandemic lifetime mental disorders, those frequently exposed to COVID-19 patients, infected or quarantined/isolated, female workers, and auxiliary nurses should be considered groups in need of mental health monitoring and support.


Subject(s)
COVID-19 , Health Personnel , Mental Disorders/epidemiology , Mental Health , Occupational Diseases/epidemiology , Adolescent , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Female , Health Personnel/psychology , Humans , Male , Mental Disorders/etiology , Middle Aged , Occupational Diseases/etiology , Prevalence , Spain/epidemiology , Young Adult
10.
Curr Pain Headache Rep ; 25(8): 53, 2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1269179

ABSTRACT

PURPOSE OF REVIEW: Personal protection equipment (PPE)-associated headache is an unusual secondary headache disorder that predominantly occurs in healthcare workers as a consequence of the donning of protective respirators, face masks and/or eyewear. The appreciation of this entity is important given the significant ramifications upon the occupational health of healthcare workers and could additionally have an impact on persons living with pre-existing headache disorder(s). RECENT FINDINGS: There has been a renewed interest and recognition of PPE-associated headaches amongst healthcare professionals, largely brought about by the ongoing COVID-19 pandemic which has besieged healthcare systems worldwide. De novo PPE-associated headaches may present with migrainous or tension-type features and can be viewed as a subtype of external compression headache. The prognosis of the disorder is generally favourable, given that most headaches are short-lived without long-term sequalae. Several aetiologies have been postulated to account for the development of these headaches. Notably, these headaches can affect the occupational health and work performance of healthcare workers. In this review, we discuss the epidemiology, clinical characteristics, probable etiopathogenesis, management and prognosis of PPE-associated headaches in the context of the COVID-19 pandemic. Future directions for research and PPE development are proposed.


Subject(s)
COVID-19/prevention & control , Headache/epidemiology , Headache/therapy , Personal Protective Equipment/adverse effects , COVID-19/epidemiology , COVID-19/transmission , Headache/diagnosis , Health Personnel , Humans
11.
PLoS One ; 16(6): e0252664, 2021.
Article in English | MEDLINE | ID: covidwho-1261296

ABSTRACT

INTRODUCTION: In late 2019, a new coronavirus disease known as COVID-19 (novel coronavirus disease 2019) was identified. As there is no any drug to treat this pandemic, the healthcare professionals are disproportionately at higher risk. The mental health outcome is expected to be high. Anxiety is expected to have a significant impact on health professionals, especially among those who work without adequate resources for self-protection. OBJECTIVES: The objectives of this research was to assess self-reported anxiety symptoms and associated factors among Ethiopian healthcare professionals in the early stages of the pandemic. METHODS: We have conducted an online cross-sectional study to collect information from healthcare professionals in Ethiopia during the early stage of the outbreak from April 7, 2020 to May 19, 2020. GAD-7 was used for measurement of anxiety. We have used a cut of point of 10 and above to report anxiety symptoms. We have used Google Forms for online data collection and SPSS-22 for analysis. To determine associated factors for anxiety, a binary logistic regression model was used. Variables with p-value < 0.2 during the bivariable binary logistic regression were exported for further analysis in the multivariable binary logistic regression. Finally, variables with p-value <0.05 were considered as significantly associated with the outcomes. RESULTS: Three hundred and eighty-eight healthcare professionals filled the online questionnaire; Majority (71.1%) were males. Significant number of respondents (78.9%) reported lack of adequate personal protective equipment (PPE) at the work place. The prevalence of anxiety was 26.8%. Being female (AOR: 1.88; 95% C.I:1.11, 3.19), visiting/treating 30-150 patients per day (AOR: 3.44; 95% C.I:1.51, 7.84), those employed at private healthcare institutions (AOR: 2.40; 95% C.I:1.17, 4.90), who do not believe that COVID-19 is preventable (AOR: 2.04; 95% C.I:1.04, 4.03) and those who reported lack of PPE (AOR: 1.98; 95% C.I:1.04, 3.79) were more likely to be anxious. CONCLUSIONS: The anxiety prevalence among healthcare professionals in Ethiopia during early stage of COVID-19 pandemic was high. This study shows that lack of preventive equipment, being female, contact with many patients, low self-efficacy and working in private health facilities were risk factors for anxiety. Anxiety prevention among health professionals during COVID-19 pandemic requires a holistic approach including provision of sufficient PPE, improving self-efficacy and addressing problems both at public and private institutions and focusing more on female health professionals.


Subject(s)
Anxiety , COVID-19/psychology , Health Personnel/psychology , Pandemics , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Humans , Male , Middle Aged , Personal Protective Equipment , Prevalence , Self Report , Surveys and Questionnaires , Workplace , Young Adult
12.
BMC Infect Dis ; 21(1): 536, 2021 Jun 07.
Article in English | MEDLINE | ID: covidwho-1261267

ABSTRACT

BACKGROUND: At present, no agents are known to be effective at preventing COVID-19. Based on current knowledge of the pathogenesis of this disease, we suggest that SARS-CoV-2 infection might be attenuated by directly maintaining innate pulmonary redox, metabolic and dilation functions using well-tolerated medications that are known to serve these functions, specifically, a low-dose aerosolized combination of glutathione, inosine and potassium. METHODS: From June 1 to July 10, 2020, we conducted a pilot, prospective, open-label, single-arm, single-center study to evaluate the safety and efficacy of preexposure prophylaxis (PrEP) with aerosolized combination medication (ACM) on the incidence of SARS-CoV-2 positivity in 99 healthcare workers (HCWs) at a hospital designated for treating COVID-19 patients. We compared SARS-CoV-2 positivity in ACM users to retrospective data collected from 268 untreated HCWs at the same hospital. Eligible participants received an aerosolized combination of 21.3 mg/ml glutathione and 8.7 mg/ml inosine in 107 mM potassium solution for 14 days. The main outcome was the frequency of laboratory-confirmed SARS-CoV-2 cases, defined as individuals with positive genetic or immunological tests within 28 days of the study period. RESULTS: SARS-CoV-2 was detected in 2 ACM users (2, 95% CI: 0.3 to 7.1%), which was significantly less than the incidence in nonusers, at 24 (9, 95% CI: 5.8 to 13.0%; P = 0.02). During the PrEP period, solicited adverse events occurred in five participants; all were mild and transient reactions. CONCLUSIONS: Our findings might be used either to prevent SARS-CoV-2 infection or to support ongoing and new research into more effective treatments for COVID-19. TRIAL REGISTRATION: ISRCTN, ISRCTN34160010 . Registered 14 September 2020 - Retrospectively registered.


Subject(s)
COVID-19/drug therapy , COVID-19/prevention & control , Health Personnel , Pre-Exposure Prophylaxis , Adult , Aerosols/pharmacology , Female , Hospitals , Humans , Longitudinal Studies , Male , Middle Aged , Pilot Projects , Prospective Studies , Retrospective Studies , Treatment Outcome
13.
Ann Med Surg (Lond) ; 66: 102403, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1260645

ABSTRACT

INTRODUCTION: The mental health effects of coronavirus is found to be high in health care professionals, patients and communities. Therefore, this review tried to summarize the prevalence and associated factors of the psychological impact of COVID-19 among the health care workers (HCWs), patients and communities in Ethiopia. METHODS: The studies from Medline via PubMed, Science Direct, and Google Scholar were searched from February 17 to March 17, 2021. PRISMA-2020 (Preferred Reporting Items for Systematic Reviews and Meta-analyses) was used to conduct this review. RESULT: Initially, 2190 publications were obtained from three databases (PubMed, Science Direct, and Google Scholar). Finally, 9 articles that fulfilled eligible criteria were included in the review. Among different types of mental health impacts stress was reported that lies in the range from 18% to 100%, anxiety was reported from 27.7% to 100%, depression was from 12.4% to 55.7%. Several factors were associated with negative psychological impacts of COVID-19 among health care workers, patients and communities such as level of education, occupation, gender, age, marital status, presence of co-morbidity, lack of social support, personal/family exposure, their attitude, income level, family size, presence of respiratory symptoms, substance use, area of residence, and lack of protective equipment. CONCLUSION: There was overall high psychological impact of COVID-19 pandemic among healthcare workers, communities, and patients. The most common indicators of psychological impact reported across studies were anxiety and stress. Therefore, online psychotherapy and cognitive behavioral and mindfulness-based therapies should be provided through smartphone applications to minimize psychological impacts of COVID-19.

14.
Front Public Health ; 9: 644008, 2021.
Article in English | MEDLINE | ID: covidwho-1247942

ABSTRACT

On December 31, 2019, an outbreak of lower respiratory infections was documented in Wuhan caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the beginning, SARS-CoV-2 has caused many infections among healthcare workers (HCWs) worldwide. Aims of this study were: a. to compare the distribution among the HCWs and the general population of SARS-CoV-2 infections in Western Sicily and Italy; b. to describe the characteristics of HCWs infected with SARS-CoV-2 in the western Sicilian healthcare context during the first wave of the epidemic diffusion in Italy. Incidence and mean age of HCWs infected with SARS-CoV-2 were comparable in Western Sicily and in the whole Italian country. The 97.6% of infections occurred in HCWs operating in non-coronavirus disease 2019 (COVID-19) working environments, while an equal distribution of cases between hospital and primary care services context was documented. Nurses and healthcare assistants, followed by physicians, were the categories more frequently infected by SARS-CoV-2. The present study suggests that healthcare workers are easily infected compared to the general population but that often infection could equally occur in hospital and non-hospital settings. Safety of HCWs in counteracting the COVID-19 pandemic must be strengthened in hospital [adequate provision of personal protective equipment (PPE), optimization of human resources, implementation of closed and independent groups of HCWs, creation of traffic control building and dedicated areas in every healthcare context] and non-hospital settings (influenza vaccination, adequate psychophysical support, including refreshments during working shifts, adequate rest, and family support).


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Delivery of Health Care , Health Personnel , Humans , SARS-CoV-2 , Sicily/epidemiology
15.
Int J Environ Res Public Health ; 18(11)2021 May 24.
Article in English | MEDLINE | ID: covidwho-1244003

ABSTRACT

Efforts to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among hospital healthcare staff are crucial for controlling the Coronavirus Disease 19 (COVID-19) pandemics. The study aimed to explore the prevalence and clinical presentations of COVID-19 in healthcare workers (HCWs) at the University Clinical Hospital (UCH) in Wroclaw with 1677 beds. The retrospective study was performed in 2020 using a self-derived structured questionnaire in a sample of HCWs who were diagnosed with SARS-CoV-2 infection confirmed using a PCR double gene test and consented to be enrolled into the study. The significance level for all statistical tests was set to 0.05. The study showed that of the 4998 hospital workers, among 356 cases reported as COVID-19 infected, 70 consented to take part in the survey: nurses (48.5%), doctors (17.1%), HCWs with patient contact (10.0%), other HCWs without patient contact (7.1%), and cleaning personnel (5.7%). HCWs reported concurrent diseases such as hypertension (17.1%), bronchial asthma (5.7%), and diabetes (5.7%). Failure to keep 2 m distancing during contact (65.5%) and close contact with the infected person 14 days before the onset of symptoms or collection of biological material (58.6%) were identified as the increased risks of infection. A large part of infections in hospital healthcare staff were symptomatic (42.9%). The first symptoms of COVID-19 were general weakness (42.9%), poor mental condition (41.4%), and muscle pain (32.9%); whereas in the later stages of the illness, general weakness (38.6%), coughing (34.3%), lack of appetite (31.4%), and loss of taste (31.4%) were observed. In about 30% of the infected HCWs, there was no COVID-19 symptoms whatsoever. The vast majority of the patients were treated at home (85.7%). In conclusion, the majority of the SARS-CoV-2 infections in the hospital HCWs were asymptomatic or mildly symptomatic. Therefore, successful limitation of COVID-19 infection spread at hospitals requires a close attention to future cross-infections.


Subject(s)
COVID-19 , Health Personnel , Humans , Poland/epidemiology , Retrospective Studies , SARS-CoV-2 , Universities
16.
Gastroenterology ; 161(3): 1011-1029.e11, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1240783

ABSTRACT

This guideline provides updated recommendations on the role of preprocedure testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in individuals undergoing endoscopy in the post-vaccination period and replaces the prior guideline from the American Gastroenterological Association (AGA) (released July 29, 2020). Since the start of the pandemic, our increased understanding of transmission has facilitated the implementation of practices to promote patient and health care worker (HCW) safety. Simultaneously, there has been increasing recognition of the potential harm associated with delays in patient care, as well as inefficiency of endoscopy units. With widespread vaccination of HCWs and the general population, a re-evaluation of AGA's prior recommendations was warranted. In order to update the role of preprocedure testing for SARS-CoV2, the AGA guideline panel reviewed the evidence on prevalence of asymptomatic SARS-CoV2 infections in individuals undergoing endoscopy; patient and HCW risk of infections that may be acquired immediately before, during, or after endoscopy; effectiveness of COVID-19 vaccine in reducing risk of infections and transmission; patient and HCW anxiety; patient delays in care and potential impact on cancer burden; and endoscopy volumes. The panel considered the certainty of the evidence, weighed the benefits and harms of routine preprocedure testing, and considered burden, equity, and cost using the Grading of Recommendations Assessment, Development and Evaluation framework. Based on very low certainty evidence, the panel made a conditional recommendation against routine preprocedure testing for SARS-CoV2 in patients scheduled to undergo endoscopy. The panel placed a high value on minimizing additional delays in patient care, acknowledging the reduced endoscopy volumes, downstream impact on delayed cancer diagnoses, and burden of testing on patients.


Subject(s)
COVID-19 , Endoscopy , Mass Screening/standards , Pandemics , COVID-19/diagnosis , COVID-19/therapy , COVID-19 Vaccines/therapeutic use , Endoscopy/standards , Gastroenterology/standards , Humans , SARS-CoV-2 , Vaccination
17.
Work ; 69(1): 47-54, 2021.
Article in English | MEDLINE | ID: covidwho-1241161

ABSTRACT

BACKGROUND: COVID-19 increased psychological and physical complaints, including anxiety, depression, and pain. OBJECTIVE: We aimed to examine anxiety, depression, and musculoskeletal complaints that may occur in healthcare workers during the COVID-19 pandemic. METHODS: Data were cross-sectional, collected by the online questionnaire method consisted of demographic questions, Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), Nordic Musculoskeletal System Query (NMQ), and Visual Analogue Scale (VAS). RESULTS: Among the groups, the number of doctors in the frontline group, the fear of being infected, the number of tests performed, and personal protective equipment were higher than the second-line group (p < 0.05). It was found that 73.4% of the participants had anxiety, 83.5% had depression, and 94.9% had musculoskeletal pain. It was observed that there was no statistically significant difference between the applied scale scores between the groups (p > 0.05). About musculoskeletal system complaints of the participants, neck pain presence was determined as 73.4% in the last 12 months, and upper back pain was the highest with 61.4% in the last week. Neck (p < 0.005) and upper back pain (p = 0.04) parameters in the last seven days of the NMQ scale applied to the participants were found to be statistically significantly higher in the contact group. CONCLUSIONS: Anxiety, depression, and musculoskeletal pain of healthcare workers were found to be high. While neck and back pain was the most common in musculoskeletal complaints, it was found that these pains were higher in the frontline group. In this regard, healthcare professionals can be given psychological support and exercise training.


Subject(s)
Anxiety/epidemiology , COVID-19 , Depression/epidemiology , Health Personnel , Musculoskeletal Pain/epidemiology , Cross-Sectional Studies , Humans , Pandemics , Surveys and Questionnaires
18.
Neuropsychiatr Dis Treat ; 17: 1363-1373, 2021.
Article in English | MEDLINE | ID: covidwho-1229112

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency that has affected many world nations, including Ethiopia. Aside from its implications on the community as a whole, COVID-19 has also been associated with a variety of mental health problems among healthcare workers (HCWs). In this study, we aim to assess the prevalence of self-reported symptoms of depression, anxiety, and stress during the COVID-19 pandemic among HCWs in central Ethiopia. METHODS: An institutional-based cross-sectional study was conducted using an online survey from June 25, 2020, to July 25, 2020, in Ethiopia. Data were collected using a self-reported Depression, Anxiety, and Stress Scale (DASS-21). Data were cleaned, coded, and analysed using SPSS Version 23. A multivariable logistic regression analysis was done to identify the associated factors for mental health outcomes at a p-value of less than 0.05. RESULTS: A total of 816 HCWs completed the self-report questionnaire. The percentage of HCWs who had moderate to extremely severe symptoms of depression, anxiety, and stress were 60.3%, 78%, and 33.8%, respectively. Female participants, HCWs in the Oromiya Special Zone, medical laboratory professionals, and HCWs working in the COVID-19 treatment isolation centers were significantly more likely to have symptoms of depression, anxiety, and stress. CONCLUSION: In this study, HCWs reported a high prevalence of depression, anxiety, and stress symptoms. Female participants, HCWs in the Oromiya Special Zone, medical laboratory professionals, and HCWs working in the COVID-19 treatment isolation centers were significantly more likely to have symptoms of depression, anxiety, and stress. It is imperative that the Ethiopian Federal Ministry of Health should develop psychological interventions to address the specific needs of HCWs who have been impacted by the COVID-19 pandemic.

19.
Int J Health Plann Manage ; 36(5): 1561-1574, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1220217

ABSTRACT

BACKGROUND: Reliable and detailed nationwide data on the prevalence and distribution of mental disorders among healthcare workers in China during the coronavirus disease 2019 (COVID-19) outbreak are scarce. METHODS: We did a cross-sectional online survey from March 2 to 2 April 2020 and a total of 19,379 healthcare workers from 25 provinces participated. Depression, anxiety and post-traumatic stress disorder (PTSD) were assessed by the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and PTSD Checklist for DSM-5 (PCL-5), respectively. RESULTS: The age-standardized prevalence of depression, anxiety and PTSD was 15.5%, 12.7% and 5.2%, respectively. Frontline workers had higher prevalence estimates than non-frontline workers (depression: 18.2% vs. 13.9%; anxiety: 14.7% vs. 11.6%; PTSD: 6.1% vs. 4.6%). Subgroups who were nurses, were married or had dependent children reported higher prevalence of depression, anxiety and PTSD. Despite of the large variations, the prevalence of mental disorders was lowest in East China, followed by Middle China, and highest in West China. CONCLUSION: Healthcare workers faced enormous stress not only from the direct risk presented by the COVID-19 outbreak, but also from the profound changes in their professional practice. Prevalence of adverse psychological outcomes has a significant association with geographically distribution of health resources and regional economic level. Sufficient medical resource may be a protective factor to mental health condition of healthcare personnel when such a public health emergency happened.


Subject(s)
COVID-19 , Mental Disorders , Stress Disorders, Post-Traumatic , Anxiety , China/epidemiology , Cross-Sectional Studies , Health Personnel , Humans , Mental Disorders/epidemiology , Prevalence , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
20.
Rev Bras Med Trab ; 19(1): 73-81, 2021 Apr 30.
Article in English | MEDLINE | ID: covidwho-1220027

ABSTRACT

INTRODUCTION: Health professionals who provide clinical care are exposed to patients potentially infected by the severe acute respiratory syndrome coronavirus 2 SARS-CoV-2), namely physicians and nurses; consequently, these professionals face higher risks of infection. OBJECTIVES: This study aimed to describe the prevalence of coronavirus disease 19 (COVID-19) cases among health professionals and the frequencies of risk factors and psychosocial risk. METHODS: This is a cross-sectional study targeted at health professionals working in Portugal during the current COVID-19 pandemic. Data were obtained through a self-administered questionnaire available online at the websites of medical and nursing boards, among other sources. We performed a univariate analysis, calculating absolute and relative frequencies, and a bivariate analysis with a Pearson's chi-squared test. RESULTS: We studied 4,212 health professionals, of which 36.7% (n = 1,514) worked in areas dedicated to the treatment of sick or suspected COVID-19 patients. Of these, 2.11% tested positive for SARS-CoV-2. Among all participants, 76.7% and 79.1% presented moderate to severe levels of fatigue and anxiety, respectively. Fatigue levels were significantly higher in professionals working in areas dedicated to the treatment of patients with COVID-19 (80.5% p = 0.01), but this difference was not observed regarding anxiety (79.5% p = 0.681). CONCLUSIONS: The percentage of health professionals who tested positive for SARS-CoV-2 was 2.11%. The reported high levels of fatigue and anxiety should determine a better protection of the health and safety of those who provide health care in the current pandemic.

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