Post-Discharge Spirometry Evaluation in Patients Recovering from Moderate-to-Critical COVID-19: A Prospective Cohort Study (preprint)

To determine the prevalence and types of spirometry abnormalities among post-COVID-19 patients in Malaysia, with secondary objective focusing on associated factors. Conducted at the COVID-19 Research Clinic, Faculty of Medicine, University Technology MARA, from March 2021 to December 2022, this study included patients three months post-discharge from hospitals following moderate-to-critical COVID-19. Of 408 patients studied, abnormal spirometry was found in 46.8%, with 28.4% exhibiting a restrictive pattern, 17.4% showing preserved ratio impaired spirometry (PRISm), and 1.0% displaying an obstructive pattern. Factors independently associated with abnormal spirometry included older age (OR: 1.0, 95% CI: 1.01–1.04, p = 0.003), underlying cardiovascular disease (OR: 3.5, 95% CI: 1.19–10.47, p = 0.023), history of acute respiratory distress syndrome (p < 0.001), shorter discharge-to-follow-up interval (OR: 0.9, 95% CI: 1.00–1.02, p = 0.035), oxygen desaturation during 6-minute walk test (OR: 1.9, 95% CI: 1.20–3.06, p = 0.007), and presence of consolidation (OR: 8.1, 95% CI: 1.75–37.42, p = 0.008) or ground-glass opacity (OR: 2.6, 95% CI: 1.52–4.30, p < 0.001) on chest X-ray. This study highlights patients recovering from moderate-to-critical COVID-19 often exhibit abnormal spirometry, notably a restrictive pattern and PRISm. Routine spirometry screening for high-risk patients is recommended.

The Willingness of Malaysian Parents To Vaccinate Their Children Below 12 Years Old Against COVID-19 – A Large Cross-Sectional Study (preprint)

Background: The administration of a new drug such as the COVID-19 vaccine in children could be a major concern for their parents. This study aims to assess the willingness of Malaysian parents to vaccinate their children < 12 years old against COVID-19. Methods: : An online cross-sectional study was conducted nationwide in Malaysia from 29 th August 2021 to 17 th October 2021. Parents with children < 12 years old were recruited by the snowball sampling method. Results: : Of the 4,438 survey responses received, 3,528 (79.5%) parents were included in the analysis. Of these parents, 2,598 (73.6%) were willing, 486 (13.8%) were not willing, and 444 (12.6%) were still undecided to vaccinate their children against COVID-19. Those who were single parent [odds ratio (OR): 2.0, 95% confidence internal (CI): 1.32 – 3.04, p = 0.001], had secondary or lower education (OR: 1.5, 95% CI: 1.21 – 1.96, p < 0.001), worked as healthcare worker (OR: 1.7, 95% CI: 1.34 – 2.26, p < 0.001), had significant contact with COVID-19 (OR: 1.3, 95% CI: 1.09 – 1.63, p = 0.006), and already received COVID-19 vaccine (OR: 15.4, 95% CI: 9.76 – 24.33, p < 0.001) were significantly more willing to vaccinate their children against COVID-19. The common reasons given by parents who were willing to vaccinate their children against COVID-19 include vaccination could protect their children (99.4%), the vaccination could protect other family members (99.3%), and the vaccine was effective (98.2%). The common reasons given by parents who were not willing to vaccinate their children against COVID-19 include the uncertainty towards the new vaccine (96.1%), worry about the vaccine contents (93.2%), limited information about the vaccine from the doctors (82.3%), and believed the vaccine was unsafe (79.8%) Conclusions: : Nearly three-quarters of Malaysian parents were willing to vaccinate their children < 12 years old against COVID-19. The COVID-19 vaccination history of the parents was the strongest independent predictor for their willingness to vaccinate their children. Future health education should target parents at risk of vaccine refusal or hesitation, focus to address the common reasons for refusing the COVID-19 vaccine, and highlight the benefits of the COVID-19 vaccine.

Anxiety, Coping Strategies and Quality of Life of Malaysian Community During the Movement Control Order for COVID-19 Pandemic: A Web-Based Cross-Sectional Study (preprint)

Background: The Coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented series of lockdown worldwide. A nationwide full lockdown called the “Movement Control Order” (MCO) was imposed in Malaysia on 18th March 2020 following the surge in COVID-19 cases. This study aimed to investigate the anxiety, coping strategies and, quality of life (QOL) of the Malaysian community during the MCO for the COVID-19 pandemic. Methods: This web-based cross-sectional study was conducted between April and May 2020. Questionnaires on Depression, Anxiety and Stress Scale – 21 (DASS-21), Brief-Coping Orientation to Problems Experienced (Brief-COPE), and World Health Organization Quality of Life – Brief Version (WHOQOL-BREF) were administered. Respondents were defined as having anxiety if their DASS-21 anxiety domain score was 8 and above.Results: A total of 528 responses were received with an anxiety prevalence of 29.2%. Respondents with anxiety were significantly younger (33.40 ± 9.86 versus 36.73 ±12.61 years, p = 0.001), without a partner (62.3% versus 37.7%, p = 0.006), lived in an area with higher incidence of COVID-19 – red zone (81.2% versus 18.8%, p = 0.041) and had higher avoidant coping score (median, 25 versus 20, p < 0.001). Logistic regression showed that living in the red zone (odd ratio = 1.78, 95% CI = 1.09, 2.91, < 0.001) and used avoidant coping strategies (odd ratio = 1.12, 95% CI = 1.08, 1.16, p < 0.001) were independent predictors of anxiety. Respondents with anxiety had significantly lower mean scores for physical health (13.8 ± 2.59 versus 16.15 ± 2.21), psychological (13.29 ± 2.95 versus 15.84 ± 2.44), social relationships (12.88 ± 3.66 versus 15.03 ± 3.08), and environment (14.63 ± 2.31 versus 16.18 ± 2.20), all p < 0.001.Conclusion: Anxiety was common during the MCO for the COVID-19 pandemic and was associated with poorer QOL. Those who lived in the area with a high incidence of COVID-19 in recent weeks and used avoidant coping strategies were more vulnerable to develop anxiety. Identification and risk stratification of individuals that prone to anxiety enables the initiation of psychological interventions to maintain mental health.