Comparison of sleep quality among COVID-19 patients and non-COVID-19 population in Pakistan: A cross sectional study during the COVID-19 pandemic.

Background: Adverse effects on the health and well-being changes may also express as a decreased sleep quality in COVID-19 patients. This study aimed to assess sleep quality among confirmed COVID-19 patients and the non-COVID-19 Pakistani population. Methods: An online cross-sectional survey was conducted between April and September 2020 in Punjab province, Pakistan. Information about demographic characteristics, COVID-19 diseased status, prior knowledge about COVID-19, and sleep quality using the Pittsburgh Sleep Quality Index (PSQI) was collected. Results: A total of 597 participants were included in this study, 296 (49.6%) COVID-19 patients and 301(50.4%) non-COVID-19 population. The PQSI was used to measure seven distinct sleep components; subjective quality, latency, duration, efficiency, disturbances, medication, and daytime dysfunction. Where mean ± standard deviation (SD) were 0.96 ± 0.743, 1.47 ± 1.032, 0.97 ± 1.006, 0.61 ± 0.995, 1.13 ± 0.649, 0.23 ± 0.651, 1.02 ± 0.861 respectively in total population (N = 597). Sleep latency, sleep duration, and sleep efficiency did not show a significant difference in the T-Test. While sleep quality, sleep disturbances, sleep medication, and daytime dysfunction showed a significant difference between both populations. Conclusion: In conclusion, we highlighted the poor sleep quality in COVID-19 patients as compared to the non-COVID-19 population.

Psychological Impact of COVID-19 on Doctors and Medical Students of Punjab, Pakistan: A Logistic Regression Analysis.

Background: This study was carried out to find the awareness level, prevalence of anxiety and depression, and their associated factors among doctors and medical students during the COVID-19 pandemic in Punjab province, Pakistan. Materials and Methods: An online questionnaire-based cross-sectional study was conducted; data were collected regarding the demographic profile, awareness of COVID-19, anxiety symptoms using a self-rating anxiety scale (SAS), and depression symptoms using a self-rating depression scale (SDS). A total of 504 responses were obtained. The Chi-square test was used to compare groups and the logistic regression model for the association of factors with anxiety and depression. Results: A total of 504 medical students and doctors responded to the questionnaire. The mean age of participants was 25.66 ± 6.71 years. The awareness rate of COVID-19 was 97.6%. The prevalence rate of anxiety and depression was 3.4% and 15.1%, respectively. According to the logistic regression model, those with low awareness levels (≤6 points) and spending more time on the news (>3 hours) had higher levels of anxiety, while higher levels of depression symptoms were reported in females, young people, and medical students. Conclusion: Doctors and medical students had a high level of awareness of COVID-19 and a low level of anxiety and depression. However, female gender and younger age group were the most vulnerable groups significantly associated with depression.

Tocilizumab in severe COVID-19 – a randomized, double-blind, placebo-controlled trial

Background The therapeutic effectiveness of interleukin-6 (IL-6) receptor inhibitor in critically ill hospitalized patients with coronavirus disease 2019 (COVID-19) is uncertain. Methods To evaluate the efficacy and safety of the outcome as recovery or death of tocilizumab for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, we conducted a randomized, double-blinded, placebo-controlled phase 2 trial in critically ill COVID-19 adult patients. The patients were randomly assigned in a 4:1 ratio to receive standard medical treatment plus the recommended dose of either tocilizumab or the placebo drug. Randomization was stratified. The primary outcome was the recovery or death after administration of tocilizumab or a placebo drug. The secondary outcomes were clinical recovery or worsening of the patients' symptoms and inflammatory markers and discharge from the hospital. Results Out of 190 patients included in this study, 152 received tocilizumab, and 38 received a placebo. The duration of hospital stay of the interventional group was 12.9±9.2, while the placebo group had a more extended hospital stay (15.6±8.8). The survival ratio in tocilizumab group was 0.82 (95% confidence interval [CI], 10.55 to 12.24;p=0.58 by log-rank test). The survival ratio in the placebo group was 0.23 (95% confidence interval [CI], 10.86 to 16.11;p=0.32 by log-rank test). The inflammatory markers in the tocilizumab group significantly declined by day 16 compared to the placebo group. Conclusions The use of tocilizumab was associated with decreased mortality, earlier improvement of inflammatory markers, and reduced hospital stay in patients with severe COVID-19.

Knowledge, attitude, and practice of artificial intelligence among doctors and medical students in Pakistan: A cross-sectional online survey.

Background: The use of Artificial intelligence (AI) has gained popularity during the last few decades and its use in medicine is increasing globally. Developing countries like Pakistan are lagging in the implementation of AI-based solutions in healthcare. There is a need to incorporate AI in the health system which may help not only in expediting diagnosis and management but also injudicious resource allocation. Objective: To determine the knowledge, attitude, and practice of AI among doctors and medical students in Pakistan. Materials and methods: We conducted a cross-sectional study using an online questionnaire-based survey regarding demographic details, knowledge, perception, and practice of AI. A sample of 470 individuals including doctors and medical students were selected using the convenient sampling technique. The chi-square test was applied for the comparison of variables. Results: Out of 470 individuals, 223(47.45%) were doctors and 247(52.55%) were medical students. Among these, 165(74%) doctors and 170(68.8%) medical students had a basic knowledge of AI but only 61(27.3%) doctors and 48(19.4%) students were aware of its medical applications. Regarding attitude, 237(76.7%) individuals supported AI's inclusion in curriculum, 368(78.3%) and 305(64.9%), 281(59.8%) and 269(57.2%) acknowledged its necessity in radiology, pathology, and COVID-19 pandemic respectively. Conclusion: The majority of doctors and medical students lack knowledge about AI and its applications, but had a positive view of AI in the field of medicine and were willing to adopt it.

The utility of remdesivir in SARS-CoV-2: A single tertiary care center experience from a developing country.

BACKGROUND: Remdesivir is a monophosphoramidate prodrug of an adenosine analog, and it has a broad-spectrum antiviral activity against paramyxoviruses, flaviviruses, and coronaviruses. Remdesivir is associated with decreased hospital stay and improved outcomes in coronavirus- disease 2019 (COVID-19). METHODOLOGY: Of 846 suspected COVID-19 patients admitted to the hospital, 612 SARS-CoV-2 nasopharyngeal RT-PCR positive patients were evaluated for enrollment in this prospective cohort study. 159 RT-PCR positive patients were given remdesivir. Their clinical, biochemical parameters, hospital stay, and outcomes related to morbidity and mortality were followed. RESULTS: Out of the 159 patients, 141 recovered after remdesivir use. The Chi-square test for independence examined the relation between the day of the first dose, dose of remdesivir, and clinical outcome. The standardized case fatality ratio (CFR) in the 453 hospitalized patients who did not receive remdesivir was 32.89% (N = 149) as compared to 11.32% (N = 18) in the patients who received remdesivir. These findings are in keeping with the therapeutic value of remdesivir in symptomatic SARS-CoV-2 infection of varying severity. CONCLUSION: The use of remdesivir is associated with a decrease in the severity of the SARS-CoV-2 infection. Its use is also associated with a decreased length of hospital stay and lower mortality than the patients who did not receive remdesivir.

Awareness, anxiety, and depression in healthcare professionals, medical students, and general population of Pakistan during COVID-19 Pandemic: A cross sectional online survey.

Background: COVID-19 (coronavirus disease 2019) pandemic has seriously affected the entire world. This study was aimed to assess prevalence and influencing factors of anxiety and depression during the pandemic in our Pakistani population, including healthcare professionals, undergraduate medical students, and general public. Methods: An online cross sectional survey was conducted; with a questionnaire having demographic profile, COVID-19-related knowledge/awareness, self-rating anxiety scale (SAS), and self-rating depression scale (SDS). A total of 1014 people responded to the survey. Chi square test was used to compare different groups, and logistic regression models were used to explore influencing factors for anxiety and depression symptoms. Results: Of the 1014 respondents, 92.6% were aware of COVID-19, and the prevalence rate of anxiety and depression symptoms was 4.6% and 14.3%, respectively. Healthcare professionals had more awareness about COVID-19 as compared to medical students and general public (p<0.001). Logistic regression models showed females, and people who were not aware of COVID-19 (≤ 6 points score) were more likely to have both anxiety and depression symptoms (p<0.05), the general public had more anxiety than healthcare professionals (p<0.05), while undergraduate medical students and young people had only depression (p<0.05). Conclusion: Although major mental health burden is not present in Pakistan, but there is a dire need to pay more attention to vulnerable groups like young people, undergraduate medical students, and women. Psychological interventions are required to reduce the psychological impact of COVID-19 pandemic.

How COVID-19 is Changing Behaviors of Population - A Study from Punjab?

Background and Objectives: Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by a novel Coronavirus. The World Health Organization (WHO) officially declared it a health emergency on January 30, 2020. WHO also called for collaborative efforts from all countries to prevent its further spread. The success of the world's battle against COVID-19 depends upon people's adherence to the control measures which is affected by their Knowledge, Attitudes and Practices (KAP) towards the disease as suggested by KAP theory. In this study, the KAP of population from Punjab towards COVID-19 during the rapid rise period of the COVID-19 outbreak is investigated. Methods: This was a cross-sectional study based on Google forms-based survey regarding the Knowledge, Attitudes and Practices of participants towards COVID-19. A total of n = 500 participants completing their questionnaires were included. Online data was extracted and cross-checked for any discrepancy. Statistical analysis was done by using SPSS ver.22. Results: Participants with = 22 years of age significantly practicing more social distancing (P0.05). Knowledge of hand hygiene and proper discarding of mask were significantly more associated with the practices of social distancing. Knowledge of cough and sneezing etiquettes was significantly related to practice social distancing (P0.01). Attitude of hand hygiene protocols was significantly related to practicing hand washing, minimizing touching environment (P0.01) and disinfecting house and workplace (P0.05). Conclusion: The present study showed a good knowledge, positive attitudes and suitable practices in population of Punjab. The health awareness programs designed after pandemic declaration by WHO, played a vital role in improving all these things. [ABSTRACT FROM AUTHOR] Copyright of Biomedica is the property of Knowledge Bylanes and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)