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1.
Ghana Med J ; 54(4 Suppl): 46-51, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1436194

ABSTRACT

Introduction: The novel corona virus disease 2019 (COVID-19) was diagnosed in Wuhan, China in December 2019 and, in Ghana, in March 2020. As of 30th July 2020, Ghana had recorded 35,142 cases. COVID-19 which can be transmitted by both symptomatic and asymptomatic individuals usually manifest as pneumonia with symptoms like fever, cough, dyspnoea and fatigue. The current non-availability of a vaccine or drug for COVID-19 management calls for early detection and isolation of affected individuals. Chest imaging has become an integral part of patient management with chest radiography serving as a primary imaging modality in many centres. Methods: The study was a retrospective study conducted at Ga East Municipal Hospital (GEMH). Chest radiographs of patients with mild to moderate disease managed at GEMH were evaluated. The age, gender, symptom status, comorbidities and chest x-ray findings of the patients were documented. Results: 11.4 % of the patients had some form of respiratory abnormality on chest radiography with 88.9% showing COVID-19 pneumonia features. 93.8% showed ground glass opacities (GGO), with 3.1% each showing consolidation (CN) only and CN with GGO. There was a significant association between COVID-19 radiographic features and patient's age, symptom status and comorbidities but not with gender. Conclusion: Most radiographs were normal with only 11% showing COVID-19-like abnormality. There was a significant association between age, symptom status and comorbidities with the presence of COVID-19 like features but not for gender. There was no association between the extent of the lung changes and patient characteristics. Funding: None declared.


Subject(s)
COVID-19/diagnostic imaging , Radiography, Thoracic/statistics & numerical data , SARS-CoV-2 , Adolescent , Adult , Age Factors , Aged , COVID-19/epidemiology , Comorbidity , Female , Ghana/epidemiology , Hospitals, Urban , Humans , Lung/diagnostic imaging , Lung/virology , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , Symptom Assessment/methods , Young Adult
2.
Int J Infect Dis ; 99: 19-22, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1385695

ABSTRACT

This study investigated, using cycle threshold (Ct) qPCR values, the association between symptoms and viral clearance in 57 patients with asymptomatic/mild SARS-CoV-2 infection. Patients with olfactory/taste disorders (OTDs) exhibited lower qPCR Ct values and longer time to negative qPCR than those without OTDs, suggesting an association between OTDs and high viral burden.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Coronavirus Infections/virology , Olfaction Disorders/etiology , Pneumonia, Viral/complications , Pneumonia, Viral/virology , Taste Disorders/etiology , Viral Load , COVID-19 , Female , Humans , Male , Middle Aged , Pandemics , Real-Time Polymerase Chain Reaction , SARS-CoV-2
3.
Cytometry A ; 97(9): 887-890, 2020 09.
Article in English | MEDLINE | ID: covidwho-1384155

ABSTRACT

In patients with severe SARS-CoV-2 infection, the development of cytokine storm induces extensive lung damage, and monocytes play a role in this pathological process. Non-classical (NC) and intermediate (INT) monocytes are known to be involved during viral and bacterial infections. In this study, 30 patients with different manifestations of acute SARS-CoV-2 infection were investigated with a flow cytometric study of NC, INT, and classical (CL) monocytes. Significantly reduced NC and INT monocytes and a downregulated HLA-DR were found in acute patients with severe SARS-CoV-2 symptoms. Conversely in patients with moderate symptoms NC and INT monocytes and CD11b expression were increased. © 2020 International Society for Advancement of Cytometry.


Subject(s)
Betacoronavirus/immunology , Coronavirus Infections/immunology , Monocytes/immunology , Pneumonia, Viral/immunology , Aged , Betacoronavirus/pathogenicity , Biomarkers/analysis , CD11b Antigen/analysis , COVID-19 , Cell Separation , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Female , Flow Cytometry , Host Microbial Interactions , Humans , Leukocytes , Male , Middle Aged , Monocytes/virology , Pandemics , Phenotype , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , SARS-CoV-2 , Severity of Illness Index
4.
Heart Views ; 21(3): 220-224, 2020.
Article in English | MEDLINE | ID: covidwho-1389617

ABSTRACT

Review of the literature and reported case series has not reported an increased risk of SARS-CoV-2 infection in heart transplant recipients. However, this population is at increased risk of a more severe infection with increased mortality because of age and the presence of multiple comorbid conditions There is no significant difference in presenting symptoms in transplant recipients as compared to nontransplant patients, although diarrhea has been reported to be more frequent in transplant patients, a common side effect of immunosuppressive medications. Standard preventive measures have been shown to be equally protective in heart transplant recipients. Risk factors for severe disease and mortality are similar in both transplant recipients and nontransplant patients and include older age and the presence of comorbidities hypertension being the most common. The SARS-CoV-2 infection did not increase the risk of transplant allograft rejection. Currently, there are no specific treatment recommendations for SARS-CoV-2 infection in transplant recipients. However, the International Society of Heart and Lung and Transplant has issued guidance on how to modulate immunosuppressive therapy during SARS-CoV-2 infection.

5.
Pharmacol Res ; 157: 104849, 2020 07.
Article in English | MEDLINE | ID: covidwho-1318926

ABSTRACT

Taking anti-inflammatory drugs, including non-steroidal (NSAIDs), during Covid-19 infection, how much is risky? The French Minister of Health, who has raised an alarm on a possible risk deriving from the use of ibuprofen for the control of fever and other symptoms during the disease, opened the debate a few days ago. In this paper we examine available evidence from preclinical and clinical studies that had analysed the role of COX in the inflammatory process and the effects of NSAIDs in patients with infections. Most of the published studies that suggested not protective effects of NSAIDs were mainly performed in vitro or on animals. Therefore, their meaning in humans is to be considered with great caution. Based also on data suggesting protective effects of NSAIDs, we concluded that currently there is no evidence suggesting a correlation between NSAIDs and a worsening of infections. Further studies will be certainly needed to better define the role of NSAIDs and particularly COX2 inhibitors in patients with infections. In the meantime, we must wait for results of the revision started by the PRAC on May 2019 on the association ibuprofen/ketoprofen​​​​​​ and worsening of infections. Since nowadays no scientific evidence establishes a correlation between NSAIDS and worsening of COVID-19, patients should be advice against any NSAIDs self-medication when COVID-19 like symptoms are present.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Anti-Inflammatory Agents/adverse effects , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , Virus Diseases/drug therapy , Animals , Anti-Inflammatory Agents/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Betacoronavirus/drug effects , COVID-19 , Humans , Pandemics , SARS-CoV-2
6.
Stroke Vasc Neurol ; 5(4): 331-336, 2020 12.
Article in English | MEDLINE | ID: covidwho-1318206

ABSTRACT

BACKGROUND: COVID-19, caused by SARS-CoV-2, is a global pandemic that has been an immense burden on healthcare systems all over the world. These patients may be at higher risk for acute ischaemic stroke (AIS). We present our experience with AIS in patients with COVID-19. METHODS: We reviewed all patients admitted to our hospital during a 6-week period with a positive nasopharyngeal swab test for SARS-CoV-2. Among these patients, we identified AIS. We reviewed the demographics, clinical, laboratory, imaging characteristics, treatments received and outcomes of AIS in patients with COVID-19. RESULTS: We identified 683 patients admitted with COVID-19 during the study period, of which 20 patients had AIS. Large-vessel occlusion (LVO) was noted in 11 patients (55%). Intravenous alteplase was administered in four patients (20%) and mechanical thrombectomy was performed in five patients (25%). Respiratory symptoms preceded the onset of AIS in most of the patients (70%) by 1 to 21 days. Mortality in patients with AIS was 50% compared with 26% of all COVID-19 admissions. Most of these patients died due to non-neurological causes (70%). Three patients with AIS had clinical and imaging findings consistent with COVID-19, but were negative for multiple nasopharyngeal swab tests. INTERPRETATION: LVO was more common in patients with AIS and COVID-19. They had more severe disease and higher mortality rates. Most of the patients had respiratory symptoms preceding AIS by days to weeks. This could explain certain patients with clinical picture of COVID-19 but negative nasopharyngeal swab tests.


Subject(s)
Brain Ischemia , COVID-19 , Stroke , Humans , Pandemics , SARS-CoV-2 , Stroke/diagnosis , Thrombectomy
7.
BMJ Case Rep ; 13(10)2020 Oct 29.
Article in English | MEDLINE | ID: covidwho-1304206

ABSTRACT

We report the first case of Guillain-Barré syndrome (GBS) associated with SARS-CoV-2 infection in Japan. A 54-year-old woman developed neurological symptoms after SARS-CoV-2 infection. We tested for various antiganglioside antibodies, that had not been investigated in previous cases. The patient was diagnosed with GBS based on neurological and electrophysiological findings; no antiganglioside antibodies were detected. In previous reports, most patients with SARS-CoV-2-infection-related GBS had lower limb predominant symptoms, and antiganglioside antibody tests were negative. Our findings support the notion that non-immune abnormalities such as hyperinflammation following cytokine storms and microvascular disorders due to vascular endothelial damage may lead to neurological symptoms in patients with SARS-CoV-2 infection. Our case further highlights the need for careful diagnosis in suspected cases of GBS associated with SARS-CoV-2 infection.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/etiology , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , COVID-19 , Electromyography/methods , Female , Guillain-Barre Syndrome/therapy , Humans , Hypesthesia/diagnosis , Hypesthesia/etiology , Japan , Middle Aged , Muscle Weakness/diagnosis , Muscle Weakness/etiology , Pandemics/prevention & control , Pandemics/statistics & numerical data , Rare Diseases , Risk Assessment , Severity of Illness Index , Treatment Outcome
8.
BMJ Case Rep ; 13(9)2020 Sep 21.
Article in English | MEDLINE | ID: covidwho-1304172

ABSTRACT

Clinical manifestations of COVID-19 are known to be variable with growing evidence of nervous system involvement. In this case report, we describe the symptoms of a patient infected with SARS-CoV-2 whose clinical course was complicated with Guillain-Barré syndrome (GBS). We present a case of a 58-year-old woman who was initially diagnosed with COVID-19 pneumonia due to symptoms of fever and cough. Two weeks later, after the resolution of upper respiratory tract symptoms, she developed symmetric ascending quadriparesis and paresthesias. The diagnosis of GBS was made through cerebrospinal fluid analysis and she was successfully treated with intravenous immunoglobulin administration.


Subject(s)
Coronavirus Infections/complications , Guillain-Barre Syndrome/physiopathology , Low Back Pain/physiopathology , Muscle Weakness/physiopathology , Paresthesia/physiopathology , Pneumonia, Viral/complications , Analgesics/therapeutic use , Betacoronavirus , Brain/diagnostic imaging , COVID-19 , Coronavirus Infections/diagnosis , Diagnosis, Differential , Female , Gabapentin/therapeutic use , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/etiology , Guillain-Barre Syndrome/therapy , Humans , Immunoglobulins, Intravenous/therapeutic use , Immunologic Factors/therapeutic use , Lumbar Vertebrae/diagnostic imaging , Magnetic Resonance Imaging , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Radiculopathy/diagnosis , SARS-CoV-2 , Spinal Cord/diagnostic imaging
9.
J Integr Med ; 18(5): 395-400, 2020 09.
Article in English | MEDLINE | ID: covidwho-1263333

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has raised concern around the world as an epidemic or pandemic. As data on COVID-19 has grown, it has become clear that older adults have a disproportionately high rate of death from COVID-19. This study describes the early clinical characteristics of COVID-19 in patients with more than 80 years of age. METHODS: Epidemiological, clinical, laboratory, radiological, and treatment data from 17 patients diagnosed with COVID-19 between January 20 and February 20, 2020 were collected and analyzed retrospectively. Treatment outcomes among subgroups of patients with non-severe and severe symptoms of COVID-19 were compared. RESULTS: Of the 17 hospitalized patients with COVID-19, the median age was 88.0 years (interquartile range, 86.6-90.0 years; range, 80.0-100.0 years) and 12 (70.6%) were men. The age distribution of patients was not significantly different between non-severe group and severe group. All patients had chronic pre-existing conditions. Hypertension and cardiovascular diseases were the most common chronic conditions in both subgroups. The most common symptoms at the onset of COVID-19 were fever (n = 13; 76.5%), fatigue (n = 11; 64.7%), and cough (n = 5; 29.4%). Lymphopenia was observed in all patients, and lymphopenia was significantly more severe in the severe group than that in non-severe group (0.4 × 109/L vs 1.2 × 109/L, P = 0.014). The level of serum creatinine was higher in the severe group than in the non-severe group (99.0 µmol/L vs 62.5 µmol/L, P = 0.038). The most common features of chest computed tomography images were nodular foci in 10 (58.8%) patients and pleural thickening in 7 (41.2%) patients. All patients received antiviral therapy, while some patients also received intravenous antibiotics therapy (76.5%), Chinese medicinal preparation therapy (Lianhuaqingwen capsule, 64.7%), corticosteroids (35.3%) or immunoglobin (29.4%). Eight patients (47.1%) were transferred to the intensive care unit because of complications. Ten patients (58.8%) received intranasal oxygen, while 3 (17.6%) received non-invasive mechanical ventilation, and 4 (23.5%) received high-flow oxygen. As of June 20, 7 (41.2%) patients had been discharged and 10 (58.8% of this cohort, 77.8% of severe patients) had died. CONCLUSION: The mortality of patients aged 80 years and older with severe COVID-19 symptoms was high. Lymphopenia was a characteristic laboratory result in these patients, and the severity of lymphopenia was indicative of the severity of COVID-19. However, the majority of patients with COVID-19 in this age cohort had atypical symptoms, and early diagnosis depends on prompt use of a viral nucleic acid test.


Subject(s)
Coronavirus Infections/pathology , Pneumonia, Viral/pathology , Age Factors , Aged, 80 and over , Antiviral Agents/therapeutic use , COVID-19 , COVID-19 Testing , China/epidemiology , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Female , Humans , Lung/diagnostic imaging , Lung/pathology , Male , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Retrospective Studies , Tomography, X-Ray Computed , Treatment Outcome
10.
J Indian Inst Sci ; : 1-22, 2020 Oct 23.
Article in English | MEDLINE | ID: covidwho-1235813

ABSTRACT

The number of confirmed cases of COVID-19 is often used as a proxy for the actual number of ground truth COVID-19-infected cases in both public discourse and policy making. However, the number of confirmed cases depends on the testing policy, and it is important to understand how the number of positive cases obtained using different testing policies reveals the unknown ground truth. We develop an agent-based simulation framework in Python that can simulate various testing policies as well as interventions such as lockdown based on them. The interaction between the agents can take into account various communities and mobility patterns. A distinguishing feature of our framework is the presence of another 'flu'-like illness with symptoms similar to COVID-19, that allows us to model the noise in selecting the pool of patients to be tested. We instantiate our model for the city of Bengaluru in India, using census data to distribute agents geographically, and traffic flow mobility data to model long-distance interactions and mixing. We use the simulation framework to compare the performance of three testing policies: Random Symptomatic Testing (RST), Contact Tracing (CT), and a new Location-Based Testing policy (LBT). We observe that if a sufficient fraction of symptomatic patients come out for testing, then RST can capture the ground truth quite closely even with very few daily tests. However, CT consistently captures more positive cases. Interestingly, our new LBT, which is operationally less intensive than CT, gives performance that is comparable with CT. In another direction, we compare the efficacy of these three testing policies in enabling lockdown, and observe that CT flattens the ground truth curve maximally, followed closely by LBT, and significantly better than RST.

11.
J Neurol Res ; 10(5): 164-172, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1227227

ABSTRACT

Coronavirus disease 2019 (COVID-19) disease caused by a new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been associated with many neurological symptoms. The purpose of this article is to describe the neurological manifestations so far reported and their probable pathogenesis. We conducted a literature review on EMBASE, MEDLINE and SCIELO databases using the terms "COVID-19", "COVID", "neurological", "neurologic", "manifestations", "implications", "Guillain-Barre syndrome", "encephalopathy". A total of 33 articles including clinical series, retrospective studies, and case reports were selected and thoroughly reviewed to describe neurological manifestations of COVID-19. There are several neurological manifestations of SARS-CoV-2 infection with different clinical presentations, severity, and prevalence. The most critical ones, such as cerebrovascular disease, encephalopathy, and Guillain-Barre syndrome, were less common and usually associated with previous medical history, known risk factors for cerebrovascular disease or advanced age. The main hypotheses for the spread of the virus are through the hematogenous route or the cribriform plate of the ethmoid bone or a disseminated severe immune response by a cytokine storm. The presence of neurological disturbances associated with laboratory tests alterations is an important clue for the physicians to promptly recognize neurological manifestations of SARS-CoV-2.

12.
J Neurol Res ; 10(4): 113-121, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-1227221

ABSTRACT

Coronavirus (CoV) is a virus infectious disease with a considerable spectrum of clinical presentations. Symptoms ranged from asymptomatic infection to severe pneumonia that may lead to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and several clinical complications. Neurologic symptoms related to CoV have been described recently in the literature. The relationship between SARS-CoV-2 and the central nervous system (CNS) is still not clear. This review aimed to reveal the current knowledge regarding CNS manifestation in SARS-CoV-2. A systematic literature review was carried out to identify the particularities of coronavirus disease 2019 (COVID-19) in patients with CNS involvement, using the PubMed database between January 1, 2020 and April 30, 2020. Conference papers, reviews, published letters, editorials, studies in pregnant women and children, and studies only reporting on a specific factor were excluded. An initial search included as many as 83 articles. Out of the 83 screened articles, 32 were selected for full-text review. Sixteen studies were excluded because they did not analyze nervous system involvement in SARS-CoV-2 infection. Thus, 16 papers were included in this review. There were three retrospective studies and 13 case reports/series of cases. Data from the current literature reveal that patients who suffer from a severe illness have more CNS involvement, neurological symptoms (i.e., dizziness, headache) and an association with strokes. The severe patients had higher D-dimer and C-reactive protein levels than non-severe patients and presented multiple organ involvement, such as serious liver, kidney and muscle damage.

13.
Disaster Med Public Health Prep ; : 1-4, 2020 Nov 19.
Article in English | MEDLINE | ID: covidwho-1147328

ABSTRACT

OBJECTIVE: Personal protective equipment (PPE) use is frequently construed as inconvenient and disturbing by health care professionals (HCPs). We hypothesized that new-onset symptoms among HCPs may be associated with extended use of PPE and aimed to investigate risk factors related with new-onset symptoms. In addition, the effects of new-onset symptoms on working performance were evaluated. METHODS: In this cross-sectional study, 315 participants filled out a questionnaire that contains 4 main parts: (1) demographics, (2) new-onset symptoms with PPE use, (3) PPE usage hours, and (4) personal opinion about the effect of sensed symptoms on working performance. RESULTS: The mean age was 31.58 ± 4.6 years, and 50.5% (n = 159) were female. New-onset symptom rate was 66% (n = 208). The most common new-onset symptom was headache (n = 115, 36.5%) followed by breathing difficulty-palpitation (n = 79, 25.1%), and dermatitis (n = 64, 20.3%). Extended use of PPE, smoking, and overweight were independently associated with developing new-onset symptoms. A clear majority of symptomatic participants pointed out the impact on working performance (193/208, 92.7%). CONCLUSION: Hospitals should take the necessary precautions (eg, shorter shifts and more frequent breaks) to prevent symptoms associated with PPE and ensure that HCPs comply with these precautions.

14.
Front Cell Infect Microbiol ; 10: 586054, 2020.
Article in English | MEDLINE | ID: covidwho-1145559

ABSTRACT

Background: The outbreak of coronavirus disease 2019 (COVID-19) has become a global public health concern. Many inpatients with COVID-19 have shown clinical symptoms related to sepsis, which will aggravate the deterioration of patients' condition. We aim to diagnose Viral Sepsis Caused by SARS-CoV-2 by analyzing laboratory test data of patients with COVID-19 and establish an early predictive model for sepsis risk among patients with COVID-19. Methods: This study retrospectively investigated laboratory test data of 2,453 patients with COVID-19 from electronic health records. Extreme gradient boosting (XGBoost) was employed to build four models with different feature subsets of a total of 69 collected indicators. Meanwhile, the explainable Shapley Additive ePlanation (SHAP) method was adopted to interpret predictive results and to analyze the feature importance of risk factors. Findings: The model for classifying COVID-19 viral sepsis with seven coagulation function indicators achieved the area under the receiver operating characteristic curve (AUC) 0.9213 (95% CI, 89.94-94.31%), sensitivity 97.17% (95% CI, 94.97-98.46%), and specificity 82.05% (95% CI, 77.24-86.06%). The model for identifying COVID-19 coagulation disorders with eight features provided an average of 3.68 (±) 4.60 days in advance for early warning prediction with 0.9298 AUC (95% CI, 86.91-99.04%), 82.22% sensitivity (95% CI, 67.41-91.49%), and 84.00% specificity (95% CI, 63.08-94.75%). Interpretation: We found that an abnormality of the coagulation function was related to the occurrence of sepsis and the other routine laboratory test represented by inflammatory factors had a moderate predictive value on coagulopathy, which indicated that early warning of sepsis in COVID-19 patients could be achieved by our established model to improve the patient's prognosis and to reduce mortality.


Subject(s)
COVID-19/blood , Sepsis/virology , Adult , Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing , China/epidemiology , Female , Humans , Logistic Models , Machine Learning , Male , Middle Aged , Prognosis , ROC Curve , Retrospective Studies , Risk Factors , SARS-CoV-2/isolation & purification , Sepsis/blood , Sepsis/diagnosis
15.
Front Physiol ; 11: 622466, 2020.
Article in English | MEDLINE | ID: covidwho-1120618

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide since the end of year 2019 and is currently responsive for coronavirus infectious disease 2019 (COVID-19). The first reports considered COVID-19 as a respiratory tract disease responsible for pneumonia, but numerous studies rapidly emerged to warn the medical community of COVID-19-associated neurological manifestations, including encephalopathy at the acute phase and other postinfectious manifestations. Using standard visual analysis or spectral analysis, recent studies reported electroencephalographic (EEG) findings of COVID-19 patients with various neurological symptoms. Most EEG recordings were normal or revealed non-specific abnormalities, such as focal or generalized slowing, interictal epileptic figures, seizures, or status epilepticus. Interestingly, novel EEG abnormalities over frontal areas were also described at the acute phase. Underlying mechanisms leading to brain injury in COVID-19 are still unknown and matters of debate. These frontal EEG abnormalities could emphasize the hypothesis whereby SARS-CoV-2 enters the central nervous system (CNS) through olfactory structures and then spreads in CNS via frontal lobes. This hypothesis is reinforced by the presence of anosmia in a significant proportion of COVID-19 patients and by neuroimaging studies confirming orbitofrontal abnormalities. COVID-19 represents a new viral disease characterized by not only respiratory symptoms but also a systemic invasion associated with extra-respiratory signs. Neurological symptoms must be the focus of our attention, and functional brain evaluation with EEG is crucial, in combination with anatomical and functional brain imaging, to better understand its pathophysiology. Evolution of symptoms together with EEG patterns at the distance of the acute episode should also be scrutinized.

16.
Front Psychiatry ; 11: 566221, 2020.
Article in English | MEDLINE | ID: covidwho-1119558

ABSTRACT

Background and Aims: Malaysia's first Movement Control Order (MCO) or "lockdown" was in place for 6 weeks to curb the spread of coronavirus disease (COVID-19). Consequently, all universities were forced to close temporarily with abrupt changes to teaching and learning activities. However, there has been a lack of consensus regarding students' actual psychological status and mental health during the MCO implementation. This study investigates the link, state, and differences of negative emotional symptoms, happiness, and work-life balance among university students during the COVID-19 pandemic. Methodology: This study recruited 1,005 university students across Malaysia. Data was collected online using Qualtrics to measure negative emotional symptoms (The Depression, Anxiety, and Stress Scale), happiness (The Oxford Happiness Inventory), and work-life balance (Work-Family Conflict Scale). All data was analyzed using SPSS version 25 and AMOS version 26 using T-test, ANOVA, logistic regression analyses, and path analysis method. Findings: Findings indicated that 22, 34.3, and 37.3% of the university students scored moderate to extremely severe levels of stress, anxiety, and depression symptoms, respectively. Half scored rather happy or very happy (50%) for happiness levels. Meanwhile, 50.4 and 39.4% scored high to very high levels of work-to-family and family-to-work conflict. Significant differences in stress, anxiety, depression, happiness, work-family conflict, and family-work conflict were recorded across different demographic factors. Happiness was found to be a protective factor with a lesser likelihood of experiencing severe stress (OR = 0.240, 95% CI: 0.180, 0.321), anxiety (OR = 0.336, 95% CI: 0.273, 0.414), and depression (OR = 0.121, 95% CI: 0.088, 0.165) with higher happiness levels. Higher score of work-to-family conflict contributes to greater odds of having severe levels of anxiety (OR = 1.453, 95% CI: 1.161, 1.818). While greater likelihood of developing severe stress (OR = 1.468, 95% CI: 1.109, 1.943) and severe anxiety (OR = 1.317, 95% CI: 1.059, 1.638) under increasing score of family-to-work conflict. Besides, happiness is found to negatively linked with lower negative emotional symptoms, while work-family conflict and family-work conflict are positively linked with higher negative emotional symptoms. Conclusion: Lockdown implementation during the COVID-19 pandemic appears to have a significant impact on university students' negative emotional symptoms, happiness, and work-life balance. Happiness was found to be a protective factor while the state of work-life balance is a risk factor that can predict students' negative emotional symptoms.

17.
Child Youth Serv Rev ; 116: 105235, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-1118356

ABSTRACT

The present study aims to examine the comorbidity patterns of the symptoms (intrusion and avoidance) for posttraumatic stress disorder (PTSD) and generalized anxiety disorder (GAD) and the role of perceived threat and courtesy stigma in distinguishing specific patterns of the symptoms for PTSD and GAD among children and adolescents who are susceptible to coronavirus disease 2019 (COVID-19) in Hubei, China. A total of 1172 (683 female and 489 male) children and adolescents aged 8-18 years were involved in completing the measurements of PTSD, GAD, perceived threat of COVID-19, and COVID-19-related courtesy stigma. The Latent Profile Analysis identified the three profiles of the symptoms for PTSD and GAD which were labeled as Moderate PTSD, Mild Comorbidity, and Severe Comorbidity. The scores of the symptoms for PTSD, GAD, perceived threat, and stigma were different among the three profiles. The risk factors (i.e., perceived threat and stigma) that are related to comorbidity patterns were examined through a three-step method. The possibility of entry into the Severe Comorbidity Profile increased with increasing perceived threat and stigma. The mental health care interventions for children and adolescents who are susceptible to COVID-19 can be developed to reduce perceived threat and stigma.

18.
Tidsskr Nor Laegeforen ; 140(18)2020 12 15.
Article in Norwegian | MEDLINE | ID: covidwho-1117720

ABSTRACT

BACKGROUND: There is emerging evidence of an increased risk of venous thromboembolism as well as several reports of cerebral venous thrombosis in COVID-19. CASE PRESENTATION: A previously healthy man in his fifties was admitted due to sudden confusion and reduced consciousness. One month earlier the patient had symptoms with headache, fever, dry cough, vomiting and diarrhoea and reduced sense of taste and smell. He was diagnosed with COVID-19 and the symptoms were mainly resolved within three weeks. On admission the patient was disorientated with aphasia. Brain imaging revealed a haemorrhagic infarction in the left temporal lobe due to thrombosis of the left transverse sinus and low-molecular weight heparin was instituted. On follow-up four months later, there was clinical improvement with only slight problems with short term memory and concentration. INTERPRETATION: This case illustrates the risk of serious neurological complications due to cerebral venous thrombosis in COVID-19.


Subject(s)
COVID-19/complications , Intracranial Thrombosis/virology , Venous Thrombosis/virology , Brain/diagnostic imaging , Humans , Intracranial Thrombosis/diagnostic imaging , Intracranial Thrombosis/drug therapy , Male , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/drug therapy
19.
Front Psychiatry ; 11: 568929, 2020.
Article in English | MEDLINE | ID: covidwho-1106051

ABSTRACT

Objective: The differences between the physical and mental health of people living in a lower-middle-income country (LMIC) and upper-middle-income country (UMIC) during the COVID-19 pandemic was unknown. This study aimed to compare the levels of psychological impact and mental health between people from the Philippines (LMIC) and China (UMIC) and correlate mental health parameters with variables relating to physical symptoms and knowledge about COVID-19. Methods: The survey collected information on demographic data, physical symptoms, contact history, and knowledge about COVID-19. The psychological impact was assessed using the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety, and Stress Scale (DASS-21). Findings: The study population included 849 participants from 71 cities in the Philippines and 861 participants from 159 cities in China. Filipino (LMIC) respondents reported significantly higher levels of depression, anxiety, and stress than Chinese (UMIC) during the COVID-19 (p < 0.01) while only Chinese respondents' IES-R scores were above the cut-off for PTSD symptoms. Filipino respondents were more likely to report physical symptoms resembling COVID-19 infection (p < 0.05), recent use of but with lower confidence on medical services (p < 0.01), recent direct and indirect contact with COVID (p < 0.01), concerns about family members contracting COVID-19 (p < 0.001), dissatisfaction with health information (p < 0.001). In contrast, Chinese respondents requested more health information about COVID-19. For the Philippines, student status, low confidence in doctors, dissatisfaction with health information, long daily duration spent on health information, worries about family members contracting COVID-19, ostracization, and unnecessary worries about COVID-19 were associated with adverse mental health. Physical symptoms and poor self-rated health were associated with adverse mental health in both countries (p < 0.05). Conclusion: The findings of this study suggest the need for widely available COVID-19 testing in MIC to alleviate the adverse mental health in people who present with symptoms. A health education and literacy campaign is required in the Philippines to enhance the satisfaction of health information.

20.
J Occup Environ Med ; 62(9): 686-691, 2020 09.
Article in English | MEDLINE | ID: covidwho-1105010

ABSTRACT

OBJECTIVE: To determine whether job insecurity due to COVID-19 and financial concern were associated with worse mental health during the COVID-19 pandemic. METHOD: Participants (N = 474 employed U.S. individuals) completed an online survey from April 6 to 12, 2020. Linear regressions were used to examine factors associated with mental health. RESULTS: After accounting for demographic characteristics, health status, other COVID-19 experiences, and anxiety symptoms, greater job insecurity due to COVID-19 was related to greater depressive symptoms. Conversely, after accounting for covariates and depressive symptoms, greater financial concern was related to greater anxiety symptoms. Further, greater job insecurity was indirectly related to greater anxiety symptoms due to greater financial concern. CONCLUSIONS: Findings suggest that employers should aim to reduce job insecurity and financial concern among employees during the COVID-19 pandemic to address the associated mental health consequences.


Subject(s)
Anxiety/epidemiology , Betacoronavirus , Coronavirus Infections/psychology , Depression/epidemiology , Employment/psychology , Mental Health/statistics & numerical data , Pneumonia, Viral/psychology , Adult , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/economics , Coronavirus Infections/epidemiology , Female , Humans , Male , Middle Aged , Pandemics/economics , Pneumonia, Viral/economics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , United States , Young Adult
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