Mental Health, Substance Use, and the Importance of Religion during the COVID-19 Pandemic (preprint)

COVID-19 impacted multiple facets of life, with implications on physical, mental, and societal health. Specifically, long COVID and related losses have exacerbated complex and prolonged grief responses and mental disorders including depression and anxiety. These mental health concerns are in turn associated with increased detrimental coping strategies including substance use disorders (SUD). The social and interpersonal implications of SUD are varied. Secondary data analyses from the National Survey on Drug Use and Health (NSDUH) collected during the COVID-19 pandemic revealed an increase in substance use behaviors and mental health problems. Self-reported religious activities had a positive meditating effect on reducing substance use behaviors. Accordingly, we explored the importance of one's religion and faith in coping with stress, grief, and mental health challenges during the COVID-19 pandemic, highlighting the impact of religion and faith in bringing hope and purpose during periods of loss, grief, mental health challenges, and SUD.

Clinical scoring system to predict viable viral shedding in patients with COVID-19

Background : The Centers for Disease Control and Prevention (CDC) recommends 5–10 days of isolation for patients with COVID-19, depending on symptom duration and severity. However, in clinical practice, an individualized approach is required. We thus developed a clinical scoring system to predict viable viral shedding. Methods : We prospectively enrolled adult patients with SARS-CoV-2 infection admitted to a hospital or community isolation facility between February 2020 and January 2022. Daily dense respiratory samples were obtained, and genomic RNA viral load assessment and viral culture were performed. Clinical predictors of negative viral culture results were identified using survival analysis and multivariable analysis. Results : Among 612 samples from 121 patients including 11 immunocompromised patients (5 organ transplant recipients, 5 with hematologic malignancy, and 1 receiving immunosuppressive agents) with varying severity, 154 (25%) revealed positive viral culture results. Multivariable analysis identified symptom onset day, viral copy number, disease severity, organ transplant recipient, and vaccination status as independent predictors of culture-negative rate. We developed a 4-factor predictive model based on viral copy number (-3 to 3 points), disease severity (1 point for moderate to critical disease), organ transplant recipient (2 points), and vaccination status (-2 points for fully vaccinated). Predicted culture-negative rates were calculated through the symptom onset day and the score of the day the sample was collected. Conclusions : Our clinical scoring system can provide the objective probability of a culture-negative state in a patient with COVID-19 and is potentially useful for implementing personalized de-isolation policies beyond the simple symptom-based isolation strategy.