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1.
BMC Med ; 18(1): 160, 2020 05 29.
Article in English | MEDLINE | ID: covidwho-1388759

ABSTRACT

BACKGROUND: Understanding of the role of ethnicity and socioeconomic position in the risk of developing SARS-CoV-2 infection is limited. We investigated this in the UK Biobank study. METHODS: The UK Biobank study recruited 40-70-year-olds in 2006-2010 from the general population, collecting information about self-defined ethnicity and socioeconomic variables (including area-level socioeconomic deprivation and educational attainment). SARS-CoV-2 test results from Public Health England were linked to baseline UK Biobank data. Poisson regression with robust standard errors was used to assess risk ratios (RRs) between the exposures and dichotomous variables for being tested, having a positive test and testing positive in hospital. We also investigated whether ethnicity and socioeconomic position were associated with having a positive test amongst those tested. We adjusted for covariates including age, sex, social variables (including healthcare work and household size), behavioural risk factors and baseline health. RESULTS: Amongst 392,116 participants in England, 2658 had been tested for SARS-CoV-2 and 948 tested positive (726 in hospital) between 16 March and 3 May 2020. Black and south Asian groups were more likely to test positive (RR 3.35 (95% CI 2.48-4.53) and RR 2.42 (95% CI 1.75-3.36) respectively), with Pakistani ethnicity at highest risk within the south Asian group (RR 3.24 (95% CI 1.73-6.07)). These ethnic groups were more likely to be hospital cases compared to the white British. Adjustment for baseline health and behavioural risk factors led to little change, with only modest attenuation when accounting for socioeconomic variables. Socioeconomic deprivation and having no qualifications were consistently associated with a higher risk of confirmed infection (RR 2.19 for most deprived quartile vs least (95% CI 1.80-2.66) and RR 2.00 for no qualifications vs degree (95% CI 1.66-2.42)). CONCLUSIONS: Some minority ethnic groups have a higher risk of confirmed SARS-CoV-2 infection in the UK Biobank study, which was not accounted for by differences in socioeconomic conditions, baseline self-reported health or behavioural risk factors. An urgent response to addressing these elevated risks is required.


Subject(s)
Betacoronavirus , Biological Specimen Banks , Coronavirus Infections/epidemiology , Ethnicity/statistics & numerical data , Health Status Disparities , Pneumonia, Viral/epidemiology , SARS Virus , Severe Acute Respiratory Syndrome/epidemiology , Adult , COVID-19 , Female , Humans , Male , Middle Aged , Pandemics , Residence Characteristics/statistics & numerical data , Risk Factors , SARS-CoV-2 , Self Report , United Kingdom/epidemiology
2.
Am J Obstet Gynecol MFM ; 3(5): 100403, 2021 09.
Article in English | MEDLINE | ID: covidwho-1326902

ABSTRACT

BACKGROUND: Although mass vaccination against COVID-19 may prove to be the most efficacious end to this deadly pandemic, there remain concern and indecision among the public toward vaccination. Because pregnant and reproductive-aged women account for a large proportion of the population with particular concerns regarding vaccination against COVID-19, this survey aimed at investigating their current attitudes and beliefs within our own institution. OBJECTIVE: This study aimed to understand vaccine acceptability among pregnant, nonpregnant, and breastfeeding respondents and elucidate factors associated with COVID-19 vaccine acceptance. STUDY DESIGN: We administered an anonymous online survey to all women (including patients, providers, and staff) at our institution assessing rates of acceptance of COVID-19 vaccination. Respondents were contacted in 1 of 3 ways: by email, advertisement flyers, and distribution of quick response codes at virtual town halls regarding the COVID-19 vaccine. Based on their responses, respondents were divided into 3 mutually exclusive groups: (1) nonpregnant respondents, (2) pregnant respondents, and (3) breastfeeding respondents. The primary outcome was acceptance of vaccination. Prevalence ratios were calculated to ascertain the independent effects of multiple patient-level factors on vaccine acceptability. RESULTS: The survey was administered from January 7, 2021, to January 29, 2021, with 1012 respondents of whom 466 (46.9%) identified as non-Hispanic White, 108 (10.9%) as non-Hispanic Black, 286 (28.8%) as Hispanic, and 82 (8.2%) as non-Hispanic Asian. The median age was 36 years (interquartile range, 25-47 years). Of all the respondents, 656 respondents (64.8%) were nonpregnant, 216 (21.3%) were pregnant, and 122 (12.1%) were breastfeeding. There was no difference in chronic comorbidities when evaluated as a composite variable (Table 1). A total of 390 respondents (39.2%) reported working in healthcare. Nonpregnant respondents were most likely to accept vaccination (457 respondents, 76.2%; P<.001) with breastfeeding respondents the second most likely (55.2%). Pregnant respondents had the lowest rate of vaccine acceptance (44.3%; P<.001). Prevalence ratios revealed all non-White races except for non-Hispanic Asian respondents, and Spanish-speaking respondents were less likely to accept vaccination (Table 3). Working in healthcare was not found to be associated with vaccine acceptance among our cohort. CONCLUSION: In this survey study of only women at a single institution, pregnant respondents of non-White or non-Asian races were more likely to decline vaccination than nonpregnant and breastfeeding respondents. Working in healthcare was not associated with vaccine acceptance.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Breast Feeding , Female , Humans , Pregnancy , SARS-CoV-2 , Vaccination
3.
Aging Dis ; 12(3): 710-717, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1315005

ABSTRACT

In December 2019, the People's Republic of China and the World Health Organization first reported on a cluster of pneumonia with an unknown cause. Nine months later more than 1.4 million people have died from COVID 19. In this work, the effects of the COVID 19 pandemic on five nursing homes in Austria, which cared for 889 residents in the first half of 2020, were examined. The research question was whether the measures taken were appropriate to prevent an outbreak within the individual facilities. To detect previously unrecognized infections, the present study evaluated the prevalence of neutralizing antibodies against the SARS-CoV-2 virus in residents and employees of the nursing homes. Following the analysis of blood samples, the prospectively collected data was connected to data from screening examinations and data from contact tracing. The present study demonstrated an overall prevalence of neutralizing antibodies against the SARS-CoV-2 virus in nursing homes of 3.7%. Whereas the prevalence in those facilities that have never been hit by an outbreak is 0%, the prevalence in those facilities with an outbreak is up to 4.9%. Neutralizing antibodies against SARS-CoV-2 were detected in 35 persons. A retrospective analysis of all 5 included nursing homes demonstrated that upon regular clinical screening in combination with PCRs an infection with SARS-COV-2 was detected in 66 residents and 24 employees from different professional groups. In only 25 of the 35 persons with neutralizing antibodies against SARS-CoV-2 an infection was proven in advance. This study suggests that specific measures can prevent transmission within a health care facility. Nevertheless, the results also show that a risk reduction to 0% cannot be achieved. In preparation for further pandemic waves there is still the need to reduce the probability of a transmission in nursing homes with specific test strategies.

4.
Salud Colect ; 17: e3356, 2021 05 15.
Article in Spanish | MEDLINE | ID: covidwho-1262711

ABSTRACT

This article presents a critical analysis of the relationship between work and subjectivity, based on reflections regarding experiences of dealing with the SARS-CoV-2 (COVID-19) epidemic in the Unified Health System (SUS) in Sao Paulo, Brazil. In order to do so, context is first provided regarding Brazilian policy and the SUS, drawing attention to different modes of health policy formulation. The ways in which the challenges of the pandemic were dealt with in the SUS are then presented, through an examination of material from panel discussions held with healthcare workers - which are publicly available on Youtube - regarding what they have lived through during the pandemic and the political conflicts they have encountered, as well as their lived experiences with the primary level of care, with mental health, and with social movements. This material is analyzed vis-à-vis conceptual elements that seek to expand upon notions of healthcare work, policies and practices in health care, and subjectification processes, shedding light on lessons that have emerged and on future challenges.


Este artículo busca problematizar la relación trabajo y subjetividad a partir de una reflexión sobre experiencias y modos de enfrentar la epidemia de SARS-Cov 2 (COVID-19) en el Sistema Único de Salud (SUS) de San Pablo, Brasil. Para eso se realiza una contextualización de la política brasileña y del SUS, rescatando los modos de hacer política en salud. Luego, se presentan los modos de enfrentar la pandemia en el SUS sobre la base de diversas rondas de conversaciones con las y los trabajadores de la salud acerca de lo vivido en la pandemia y su enfrentamiento político, sobre vivencias en el primer nivel de atención, en salud mental, y con los movimientos sociales, cuyo registro está disponible en Youtube. Sobre estos registros, se analizan elementos conceptuales que procuran ampliar las nociones en torno al trabajo en salud, las políticas, las prácticas en salud y los procesos de subjetivación, destacando aprendizajes y retos hacia el futuro.


Subject(s)
Attitude of Health Personnel , COVID-19 , Health Policy , National Health Programs , Occupational Health , Brazil/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/psychology , COVID-19/therapy , Health Personnel/psychology , Humans , Mental Health , Pandemics , Politics
6.
Phys Ther ; 101(8)2021 08 01.
Article in English | MEDLINE | ID: covidwho-1221482

ABSTRACT

OBJECTIVES: The purpose of this study was to explore the prevalence, personal- and work-related exposures, and signs and symptoms among physical therapists during the first wave of coronavirus disease 2019 (COVID-19) in Italy. METHODS: This cross-sectional, survey-based study collected demographic and exposure data from physical therapists from April to May 2020. All physical therapists working in inpatient and outpatient care in Italy were eligible. A self-administered questionnaire was distributed among all eligible physical therapists to collect (1) demographic characteristics, (2-3) personal- and work-related exposures, and (4) signs and symptoms of COVID-19. Factors associated with a COVID-19-positive nasopharyngeal swab (NPS) were explored through logistic regression models and multivariate methods. RESULTS: A total of 15,566 respondents completed the survey, with a response rate of 43.3%, achieving high statistical precision (99% CI, 1% type I error). Among physical therapists who received NPS testing, 13.1% (95% CI = 12.1-14.1%) had a positive result, with a peak reached in March 2020 (36%). The top 5 symptoms were fatigue and tiredness (69.1%), loss of smell (64.5%), aches and pains (60.8%), loss of taste (58.3%), and headache (51.1%). No symptoms were reported by 8.9%. Working in a health care institution (odds ratio [OR] = 12.0; 95% CI = 7.8-18.4), being reallocated to a different unit (OR = 1.9; 95% CI = 1.3-2.7), and changing job tasks (OR = 1.6; 95% CI = 1.2-2.3) increased the risk of being COVID-19 positive. In therapists with a confirmed diagnosis of COVID-19, comorbidities were associated with male sex and age older than 51 years. CONCLUSION: During the first wave in Italy, almost 1 out of 7 physical therapists tested positive on the COVID-19 NPS test. Considering personal- and work-related exposures, health care organizations should adopt prevention measures and adequate preparedness to prevent high rate of infections during future pandemics. IMPACT: This is the largest investigation about the spread of and main risk factors for COVID-19 in the physical therapy field.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Occupational Exposure/statistics & numerical data , Physical Therapists , Adult , Aged , Cross-Sectional Studies , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Prevalence , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
7.
Front Psychol ; 12: 638985, 2021.
Article in English | MEDLINE | ID: covidwho-1178032

ABSTRACT

Background: We described the prevalence of anxiety and depression related to COVID-19 pandemic among different types of population and examined their potential risk factors. Methods: A cross-sectional survey was conducted to collect demographic characteristics, exposure histories, and many other concerns about COVID-19. The Zung's self-rating anxiety scale (SAS) and self-rating depression scale (SDS), followed by a four-step multiple logistic regression analysis was performed to identify factors associated with mental health outcomes. Results: Out of 3,303 participants, the quarantined people (40.9%), community workstation staffs-policemen-volunteers (CPV) (36.4%) and general public (30.7%) reported higher percentages of depression than the general medical staff (18.4%). Moreover, the quarantined people (19.1%) also showed higher prevalence of anxiety than the general public (9.1%) and the general medical staff (7.8%). The quarantined people had the highest risk of anxiety and depression, whereas the self-rated health was negatively associated with the risks of anxiety and depression. Younger age group (18 to 30 years) showed higher risks of anxiety (OR = 6.22, 95% CI = 2.89-13.38, p < 0.001) and depression (OR = 3.69, 95% CI = 2.40-5.69, p < 0.001). People who had exposure history or contact from Hubei province after December 1, 2019 (OR = 1.57, 95% CI = 1.07-2.30, p < 0.001), had family or friends engaged in front-line health care work (OR = 1.47, 95% CI = 1.02-2.14, p < 0.001), had confirmed case nearby (OR = 2.44, 95% CI = 1.43-4.18, p < 0.001) were all more likely to suffer from anxiety. Moreover, the negligence (OR = 1.85, 95% CI = 1.37-2.51, p < 0.001) or overindulgence (OR = 1.45, 95% CI = 1.03-2.04, p < 0.001) toward the epidemic information was associated with a higher risk of depression and anxiety. Conclusions: Our findings show that the CPV and quarantined people were most at-risk population. We have identified that the young people, people with exposure histories and negligence or overindulgence toward epidemic information are in grave need of attention.

8.
BMC Health Serv Res ; 20(1): 1094, 2020 Nov 27.
Article in English | MEDLINE | ID: covidwho-948419

ABSTRACT

BACKGROUND: Healthcare professionals are experiencing unprecedented levels of occupational stress and burnout. Higher stress and burnout in health professionals is linked with the delivery of poorer quality, less safe patient care across healthcare settings. In order to understand how we can better support healthcare professionals in the workplace, this study evaluated a tailored resilience coaching intervention comprising a workshop and one-to-one coaching session addressing the intrinsic challenges of healthcare work in health professionals and students. METHODS: The evaluation used an uncontrolled before-and-after design with four data-collection time points: baseline (T1); after the workshop (T2); after the coaching session (T3) and four-to-six weeks post-baseline (T4). Quantitative outcome measures were Confidence in Coping with Adverse Events ('Confidence'), a Knowledge assessment ('Knowledge') and Resilience. At T4, qualitative interviews were also conducted with a subset of participants exploring participant experiences and perceptions of the intervention. RESULTS: We recruited 66 participants, retaining 62 (93.9%) at T2, 47 (71.2%) at T3, and 33 (50%) at T4. Compared with baseline, Confidence was significantly higher post-intervention: T2 (unadj. ß = 2.43, 95% CI 2.08-2.79, d = 1.55, p < .001), T3 (unadj. ß = 2.81, 95% CI 2.42-3.21, d = 1.71, p < .001) and T4 (unadj. ß = 2.75, 95% CI 2.31-3.19, d = 1.52, p < .001). Knowledge increased significantly post-intervention (T2 unadj. ß = 1.14, 95% CI 0.82-1.46, d = 0.86, p < .001). Compared with baseline, resilience was also higher post-intervention (T3 unadj. ß = 2.77, 95% CI 1.82-3.73, d = 0.90, p < .001 and T4 unadj. ß = 2.54, 95% CI 1.45-3.62, d = 0.65, p < .001). The qualitative findings identified four themes. The first addressed the 'tension between mandatory and voluntary delivery', suggesting that resilience is a mandatory skillset but it may not be effective to make the training a mandatory requirement. The second, the 'importance of experience and reference points for learning', suggested the intervention was more appropriate for qualified staff than students. The third suggested participants valued the 'peer learning and engagement' they gained in the interactive group workshop. The fourth, 'opportunities to tailor learning', suggested the coaching session was an opportunity to personalise the workshop material. CONCLUSIONS: We found preliminary evidence that the intervention was well received and effective, but further research using a randomised controlled design will be necessary to confirm this.


Subject(s)
Education , Health Personnel , Resilience, Psychological , Students , Delivery of Health Care , Education/standards , Health Personnel/education , Humans , Occupational Stress , Students/psychology
9.
BMJ Open ; 11(4): e049996, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1166516

ABSTRACT

OBJECTIVES: To examine whether engagement in COVID-19-related work was associated with an increased prevalence of depressive symptoms among the staff members working in a designated medical institution for COVID-19 in Tokyo, Japan. DESIGN: A cross-sectional study. SETTING: Data were obtained from a health survey conducted in July 2020 among the staff members of a designated medical institution for COVID-19 in Tokyo, Japan. PARTICIPANTS: A total of 1228 hospital workers. EXPOSURE OF INTEREST: Engagement in COVID-19-related work (qualitatively (ie, the risk of SARS-CoV-2 infection at work or affiliation to related departments) as well as quantitatively (ie, working hours)) and job categories. OUTCOME MEASURES: Depressive symptoms. RESULTS: There was no significant association between depressive symptoms and engagement in work with potential exposure to SARS-CoV-2 or affiliation to COVID-19-related departments. However, working for longer hours in March/April, when Japan witnessed a large number of infected cases, was significantly associated with depressive symptoms (≥11 hours/day: prevalence ratio (PR)=1.45, 95% CI=1.06 to 1.99, compared with ≤8 hours/day). Nurses were more likely to exhibit depressive symptoms than did doctors (PR=1.70, 95% CI=1.14 to 2.54). CONCLUSIONS: This study suggests that the risk of SARS-CoV-2 infection at work or having an affiliation to related departments might not be linked with a higher prevalence of depressive symptoms among Japanese hospital workers; contrarily, long working hours appeared to increase the prevalence of depressive symptoms.


Subject(s)
COVID-19/psychology , Depression/epidemiology , Personnel, Hospital/psychology , Adult , Cross-Sectional Studies , Female , Hospitals , Humans , Male , Mental Health , Middle Aged , Surveys and Questionnaires , Tokyo/epidemiology
10.
Rev Colomb Psiquiatr (Engl Ed) ; 2021 Mar 11.
Article in English, Spanish | MEDLINE | ID: covidwho-1157696

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has represented an extraordinary challenge for health workers as they care for others while exposing themselves to contagion. Doctors, nurses, therapists and other non-care staff in clinics and hospitals are asked to be prepared to work in particularly complex and stressful situations, which makes them vulnerable to mental health problems. OBJECTIVE: To determine the prevalence and clinical characteristics of anxiety and depression symptoms in staff working at a health institution in Medellin, Colombia. METHODS: Observational, descriptive and cross-sectional study, based on a survey designed for the investigation, which included two scales to screen depression and anxiety symptoms, as well as sociodemographic variables. RESULTS: A total of 1,247 workers from the health institution were included. Of these, 14.6% reported symptoms of depression and 18.5% of clinically significant anxiety. A higher proportion of moderate to severe depression and anxiety symptoms was found in those working face to face. CONCLUSIONS: Anxiety and depression symptoms are highly prevalent among staff at a health institution in Medellin, Colombia, during the COVID-19 pandemic. Given the vital role of the health sector in times of pandemic, the development of mental health programmes that address the problems of this population should be considered a priority.

11.
Int J Environ Res Public Health ; 18(5)2021 03 06.
Article in English | MEDLINE | ID: covidwho-1134143

ABSTRACT

The COVID-19 pandemic had a significant effect on healthcare globally. Additional pressure created by coronavirus adversely affected the mental health and psychological well-being of healthcare workers, leading many to question their desire and willingness to continue working in healthcare. This study aimed to identify predictors for career change ideation among healthcare professionals in two countries; Lithuania and the United Kingdom amid the coronavirus pandemic. In total, 610 healthcare professionals from Lithuania and the UK (285 and 325, respectively) participated in a survey from May to August 2020. Psychological distress and psychological well-being were measured using the self-report scales "DASS-21" and "WHO-5". Almost half of the sample (49.2%), 59.6% and 40.0% in Lithuanian and the UK, respectively, exhibited career change ideation, the country effect was significant (AOR = 2.21, p < 0.001). Stronger ideation to leave healthcare was predicted by higher levels of depression (AOR = 1.10, p = 0.005), stress (AOR = 1.10, p = 0.007), anxiety surrounding inadequate personal protective equipment (AOR = 2.27, p = 0.009), and lower psychological well-being scores (AOR = 1.10, p = 0.007). We conclude that psychosocial support must be provided for healthcare professionals to prevent burnout and loss of staff amid the pandemic.


Subject(s)
COVID-19 , Psychological Distress , Anxiety/epidemiology , Critical Care , Health Personnel , Humans , Lithuania/epidemiology , Pandemics , SARS-CoV-2 , United Kingdom/epidemiology
12.
J Sleep Res ; 30(5): e13313, 2021 10.
Article in English | MEDLINE | ID: covidwho-1123569

ABSTRACT

After the March-April 2020 coronavirus disease 2019 (COVID-19) outbreak, a second contagion wave afflicted Europe in the autumn. The present study aimed to evaluate sleep health/patterns of Italians during this further challenging situation. A total of 2,013 Italians longitudinally participated in a web-based survey during the two contagion peaks of the COVID-19 outbreak. We investigated the risk factors for sleep disturbances during the second wave, and we compared sleep quality and psychological well-being between the two assessments (March-April and November-December 2020). Female gender, low education, evening chronotype, being a high-risk person for COVID-19 infection, reporting negative social or economic impact, and evening smartphone overuse predicted a higher risk of poor sleep and insomnia symptoms during the second wave. Advanced age, living with a high-risk person for COVID-19 infection, and having a relative/friend infected with COVID-19 before the prior 2 weeks were risk categories for poor sleep quality. Living with children, having contracted COVID-19 before the prior 2 weeks, being pessimistic about the vaccine and working in healthcare, were risk factors for insomnia symptoms. The follow-up assessment highlighted reduced insomnia symptoms and anxiety. Nevertheless, we found reduced sleep duration, higher daytime dysfunction, advanced bedtime and wake-up time, and a shift to morningness, confirming the alarming prevalence of poor sleepers (~60%) and severe depression (~20%) in a context of increased perceived stress. The present study showed a persistent impact of the COVID-19 pandemic on sleep and mental health. Large-scale interventions to counteract the chronicity and exacerbation of sleep and psychological disturbances are necessary, especially for the at-risk categories.


Subject(s)
COVID-19 , Pandemics , Sleep Wake Disorders , Sleep , Adult , COVID-19/epidemiology , Female , Humans , Italy/epidemiology , Longitudinal Studies , Male , Middle Aged , Risk Factors , Sleep Wake Disorders/epidemiology
13.
Obstet Gynecol ; 137(5): 894-896, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1122164

ABSTRACT

BACKGROUND: Studies evaluating the safety and efficacy of currently available vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) do not include pregnant participants. No data are available to counsel on vaccine safety and potential for neonatal passive immunity. CASE: A 34-year-old multigravid patient working in health care received the Pfizer-BioNTech (BNT162b2) mRNA vaccine for SARS-CoV-2 in the third trimester of pregnancy. Uncomplicated spontaneous vaginal delivery of a female neonate with Apgar scores of 9 and 9 occurred at term. The patient's blood as well as neonatal cord blood were evaluated for SARS-CoV-2-specific antibodies. Both the patient and the neonate were positive for antibodies at a titer of 1:25,600. CONCLUSION: In this case, passage of transplacental antibodies for SARS-CoV-2 was shown after vaccination in the third trimester of pregnancy.


Subject(s)
Antibodies, Viral/blood , COVID-19 Vaccines , Fetal Blood/immunology , SARS-CoV-2/immunology , COVID-19 Serological Testing , Female , Humans , Infant, Newborn , Pregnancy
14.
PLoS One ; 16(2): e0247422, 2021.
Article in English | MEDLINE | ID: covidwho-1090538

ABSTRACT

AIM: To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). METHODS: Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. RESULTS: As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). CONCLUSIONS: Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality.


Subject(s)
COVID-19/mortality , Health Personnel , Hospitalization , Occupational Exposure/adverse effects , Registries , SARS-CoV-2 , Adult , Aged , COVID-19/therapy , Female , Humans , Male , Middle Aged , Prevalence , Retrospective Studies , Risk Factors , Spain/epidemiology
15.
Cytometry A ; 99(1): 68-80, 2021 01.
Article in English | MEDLINE | ID: covidwho-1086342

ABSTRACT

Biosafety has always been an important aspect of daily work in any research institution, particularly for cytometry Shared Resources Laboratories (SRLs). SRLs are common-use spaces that facilitate the sharing of knowledge, expertise, and ideas. This sharing inescapably involves contact and interaction of all those within this working environment on a daily basis. The current pandemic caused by SARS-CoV-2 has prompted the re-evaluation of many policies governing the operations of SRLs. Here we identify and review the unique challenges SRLs face in maintaining biosafety standards, highlighting the potential risks associated with not only cytometry instrumentation and samples, but also the people working with them. We propose possible solutions to safety issues raised by the COVID-19 pandemic and provide tools for facilities to adapt to evolving guidelines and future challenges.


Subject(s)
COVID-19/epidemiology , Containment of Biohazards/trends , Laboratories/trends , COVID-19/prevention & control , COVID-19/transmission , Containment of Biohazards/standards , Flow Cytometry , Humans , Laboratories/standards , Risk Assessment/standards , Risk Assessment/trends
16.
Nurs Health Sci ; 23(1): 245-254, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1027065

ABSTRACT

The purpose of this study of healthcare workers who cared for COVID-19 patients was to identify factors that affected the duration of wearing personal protective equipment (PPE). The results of this study will provide initial guidance to practicing clinicians and a foundation for further research on this topic. This cross-sectional study examined 139 frontline healthcare professionals who worked at a single hospital in Wuhan, China, from March 16 to April 1, 2020. General and demographic data, physical and mental status, use of personal protective equipment, type of hospital work, and duration of wearing personal protective equipment were recorded. The mean duration of wearing personal protective equipment was 194.17 min (standard deviation: 3.71). Multiple linear regression analysis indicated that the duration of wearing personal protective equipment was significantly associated with the presence of a chronic disease, working hours when feeling discomfort, lack of patient cooperation and subsequent psychological pressure, prolonged continuous wearing of personal protective equipment, feeling anxious about physical strength, and the presence of fatigue when wearing personal protective equipment. These factors should be considered by practicing healthcare professionals and in future studies that examine the optimal duration of wearing personal protective equipment.


Subject(s)
COVID-19/therapy , Disposable Equipment/statistics & numerical data , Health Personnel/psychology , Personal Protective Equipment/statistics & numerical data , Adult , Attitude of Health Personnel , China , Cross-Sectional Studies , Epidemiologic Studies , Female , Health Personnel/statistics & numerical data , Humans , Male , Pandemics , Personal Protective Equipment/adverse effects , Personal Protective Equipment/classification , SARS-CoV-2 , Surveys and Questionnaires , Time Factors
17.
Can Med Educ J ; 11(6): e188-e190, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-995305

ABSTRACT

There is already considerable evidence of how this novel corona virus (COVID-19) has had a major impact on our mental health and wellbeing. We are reminded of the mental health consequences of previous infectious disease outbreaks, not only for the public, but for frontline healthcare workers. Yet the lived experiences of resident physicians are missing from this discussion despite them being essential to the COVID-19 response and continuing to provide care during this time. The author asserts that considering what is known about the mental health effects of frontline healthcare work during previous outbreaks, residents are at risk given their role as physicians. In addition to baseline systemic stressors that put residents at risk of mental distress, they also face COVID-19 related stressors that exacerbate the risk given their role as trainees too. The author acknowledges and welcomes several rapid responses to residents' developing mental health needs from medical leaders across Canadian hospitals, programs, and resident bodies. Ultimately, however, medical leaders need to advocate for and implement changes that will support residents' mental health now and in the long-term well after COVID-19 has left its mark.


À partir d'une recherche sur l'actualité qui a émergé de la Chine et des autres pays qui ont été touchés les premiers par la maladie à coronavirus 2019 (COVID-19), il existait déjà des données relativement à son incidence majeure sur notre santé et notre bien-être. On nous rappelle les conséquences des épidémies antérieures de maladies infectieuses sur la santé mentale, non seulement pour le public, mais également pour les travailleurs de la santé de première ligne. Pourtant, les expériences vécues par des médecins résidents sont absentes de cette discussion, même si elles sont essentielles à la réponse au COVID-19 et à la continuité des soins offerts au cours de cette période. L'auteur affirme qu'en tenant compte de ce qui est connu des effets sur la santé mentale du travail de la santé de première ligne au cours des éclosions antérieures, les résidents sont à risque étant donné leur rôle de médecins. En plus des agents stressants systémiques réguliers qui mettent les résidents à risque de détresse mentale, ils sont également confrontés aux agents stressants liés à la COVID-19 qui aggravent également le risque alors qu'ils sont stagiaires. L'auteur reconnaît de nombreuses initiatives des dirigeants médicaux dans les hôpitaux, les programmes et les organismes de résidence au Canada qui sont accueillies comme des réponses rapides à l'évolution des besoins en matière de santé mentale des résidents. En dépit de ces actions positives l'auteur demande aux responsables médicaux de continuer à promouvoir et à mettre en œuvre des modifications au soutien en matière de santé mentale maintenant et au cours des années à venir, après la COVID-19.

18.
JMIR Public Health Surveill ; 6(4): e22521, 2020 12 14.
Article in English | MEDLINE | ID: covidwho-976110

ABSTRACT

BACKGROUND: As the COVID-19 pandemic continues to spread across the globe, the search for an effective medication to treat the symptoms of COVID-19 continues as well. It would be desirable to identify a medication that is already in use for another condition and whose side effect profile and safety data are already known and approved. OBJECTIVE: The objective of this study was to evaluate the effect of different medications on typical COVID-19 symptoms by using data from an online surveillance survey. METHODS: Between early April and late-July 2020, a total of 3654 individuals in Lower Saxony, Germany, participated in an online symptom-tracking survey conducted through the app covid-nein-danke.de. The questionnaire comprised items on typical COVID-19 symptoms, age range, gender, employment in patient-facing healthcare, housing status, postal code, previous illnesses, permanent medication, vaccination status, results of reverse transcription polymerase chain reaction (RT-PCR) and antibody tests for COVID-19 diagnosis, and consequent COVID-19 treatment if applicable. Odds ratio estimates with corresponding 95% CIs were computed for each medication and symptom by using logistic regression models. RESULTS: Data analysis suggested a statistically significant inverse relationship between typical COVID-19 symptoms self-reported by the participants and self-reported statin therapy and, to a lesser extent, antihypertensive therapy. When COVID-19 diagnosis was based on restrictive symptom criteria (ie, presence of 4 out of 7 symptoms) or a positive RT-PCR test, a statistically significant association was found solely for statins (odds ratio 0.28, 95% CI 0.1-0.78). CONCLUSIONS: Individuals taking statin medication are more likely to have asymptomatic COVID-19, in which case they may be at an increased risk of transmitting the disease unknowingly. We suggest that the results of this study be incorporated into symptoms-based surveillance and decision-making protocols in regard to COVID-19 management. Whether statin therapy has a beneficial effect in combating COVID-19 cannot be deduced based on our findings and should be investigated by further study. TRIAL REGISTRATION: German Clinical Trials Register DRKS00022185; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00022185; World Health Organization International Clinical Trials Registry Platform U1111-1252-6946.


Subject(s)
Antihypertensive Agents/adverse effects , COVID-19/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , SARS-CoV-2/drug effects , Aged , Antihypertensive Agents/therapeutic use , COVID-19/diagnosis , COVID-19/transmission , COVID-19/virology , Cross-Sectional Studies , Epidemiological Monitoring , Female , Germany/epidemiology , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Male , Middle Aged , Mobile Applications/supply & distribution , Prospective Studies , SARS-CoV-2/genetics , Self Report , Surveys and Questionnaires
19.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 63(12): 1483-1490, 2020 Dec.
Article in German | MEDLINE | ID: covidwho-928411

ABSTRACT

BACKGROUND: The COVID-19 pandemic poses particular challenges for people working in the medical sector. Some of the medical students and young medical professionals who are starting their work in healthcare facilities during this time are confronted with extraordinary moral challenges. A portion of them does not yet have sufficient coping skills to adequately deal with these challenges. This can lead to so-called moral distress (MoD). Permanent or intensive exposure to MoD can have serious consequences. Appropriate support services have the potential to improve the handling of MoD. OBJECTIVE: This article aims to provide an overview of the current state of research on MoD among medical students and young medical professionals in order to sensitize lecturers with responsibility for education and training and doctors in leading positions to the problem. MAIN PART: This article presents the scientific concept of MoD, known triggers, and options for prevention and intervention. The topic is presented with reference to the changes in patient care in the context of the COVID-19 pandemic and research needs are presented. CONCLUSION: The article illustrates the necessity of a German-language, interdisciplinary discourse on MoD among medical students and young professionals.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Students, Medical , Betacoronavirus , COVID-19 , Germany , Humans , Morals , Pandemics/prevention & control , SARS-CoV-2
20.
Int J Ment Health Nurs ; 30(2): 440-450, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-887380

ABSTRACT

The purpose of this research is to determine the impact of working during the early stage of the COVID-19 pandemic on the well-being of staff at one 600-bed acute hospital in metropolitan Melbourne, Australia. This exploratory study is part of a larger mixed methods survey project, reporting the qualitative data from an on-line survey of clinical staff working at one acute hospital between April 16th and May 13th, 2020 during the COVID-19 pandemic. Responses to five free-text questions were analysed using inductive content analysis. 321 medical, nursing, allied health and non-clinical staff responded to the survey. Respondents reported anxiety, fear and uncertainty related to the pandemic, from the perspectives of work, home, family and community. They reported feeling confused by inconsistent messages received from government, hospital executive, managers and media. Seven themes were identified: (i) worrying about patient care, (ii) changed working conditions, (iii) working in the changed hospital environment, (iv) impact of the pandemic, (v) personal isolation and uncertainty, (vi) leadership and management and (vii) additional support needed for staff. Despite the pandemic being comparatively well-controlled in Australia, all disciplines reported a high degree of anticipatory anxiety. Staff working in healthcare require both managerial and psychological support to minimise anxiety and promote well-being and resilience in order to deal with the health crisis. Regular unambiguous communication directing the way forward is crucial.


Subject(s)
COVID-19/psychology , Personnel, Hospital/psychology , COVID-19/epidemiology , Humans , Occupational Stress/epidemiology , Surveys and Questionnaires , Victoria/epidemiology , Workplace/psychology
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