A New Look on Long-COVID Effects: The Functional Brain Fog Syndrome.

Epidemiological data and etiopathogenesis of brain fog are very heterogeneous in the literature, preventing adequate diagnosis and treatment. Our study aimed to explore the relationship between brain fog, neuropsychiatric and cognitive symptoms in the general population. A sample of 441 subjects underwent a web-based survey, including the PANAS, the DASS-21, the IES-R, the Beck Cognitive Insight Scale, and a questionnaire investigating demographic information, brain fog, subjective cognitive impairments (Scc) and sleep disorders. ANOVA, ANCOVA, correlation and multiple stepwise regression analyses were performed. In our sample, 33% of participants were defined as Healthy Subjects (HS; no brain fog, no Scc), 27% as Probable Brain Fog (PBF; brain fog or Scc), and 40% as Functional Brain Fog (FBF; brain fog plus Scc). PBF and FBF showed higher levels of neuropsychiatric symptoms than HS, and FBF showed the worst psychological outcome. Moreover, worse cognitive symptoms were related to the female gender, greater neuropsychiatric symptoms, sleep disorders, and rumination/indecision. Being a woman and more severe neuropsychiatric symptoms were predictors of FBF severity. Our data pointed out a high prevalence and various levels of severity and impairments of brain fog, suggesting a classificatory proposal and a multifaceted etiopathogenic model, thus facilitating adequate diagnostic and therapeutic approaches.

COVID-19 and Stressful Adjustment to Work: A Long-Term Prospective Study About Homeworking for Bank Employees in Italy.

The COVID-19 evolution has forced the massive introduction of homeworking (HW) for most employees in the initial stages of the pandemic and then return to work, mainly due to the vaccination campaign. These multiple abrupt adjustment demands in work may be a source of intense stress for office workers with consequences on wellbeing and the quality of life. This long-term prospective study aimed at investigating the effect of adaptation demands on a broad population of employees of a large Italian banking group in the job-related stress framework. We administered a web-based survey to 1,264 participants in Reopening after the first lockdown, from June to October 2020, at 841 subjects in Second Wave, corresponding to the rise of contagions from November 2020 to January 2021, and to 491 individuals in Vaccination Round, which ranged from February to June 2021. We assessed workaholism by using the Dutch Work Addiction Scale (DUWAS-10), work-family conflicting overlap by using the Work and Family Conflict Scale (WAFCS), and concern for back to work (BW) and for HW by specific questions. Higher WAFCS scores characterized Reopening and Vaccination Round while Second Wave had the highest level of concern for HW. Women and younger individuals showed the highest concern for BW, WAFCS, and DUWAS-10 scores regardless of the pandemic stage. HW days per week were related to more heightened concern for BW and lower concern for HW, DUWAS, and WAFCS scores. The number of children was related to lower Concern for BW and higher WAFCS scores in Reopening and Second Wave. Our data showed that massive adjustment demands in work and family routine represented a significant source of stress for employees, regardless of the different pandemic stages. The highest level of fatigue emerged in women and younger subjects. These results shed light on the need for a road map to promote a gradual and structured adjustment for workers and encourage organizations to consider homeworking as a valid stable alternative.

Effects of COVID-19 Infection Control Measures on Appointment Cancelation in an Italian Outpatient Memory Clinic.

Background: In the first wave of the COVID-19 pandemic in 2020, many countries made changes to the routine management of patients with non-communicable diseases, including neurocognitive disorders. Therefore, many "so-called" non-urgent elective procedures and outpatient appointments have been canceled or postponed, possibly impacting negatively on health and well-being of patients in the short- and long-term. Aim: Here, we aimed at describing numbers and types of outpatient appointments canceled as a result of government's restrictive measures in our memory clinic. Methods: The scheduled appointments at the memory clinic of the Santa Lucia Foundation IRCCS, Rome, Italy, are recorded in a comprehensive dataset under strict administrative control. Here, we compared appointments (first-time and follow-up) that were canceled from January to April 2020 with those of the corresponding months in 2019. Results: We observed a substantial decrease in appointments during 2020. The majority of scheduled appointments were follow-up, and about a quarter were first-time appointments. We estimated that 66.7% and 77.4% of patients missed out respectively their first and follow-up appointments in our memory clinic due to government's restrictive measures in March-April 2020. Conclusions: A large number of patients with neurocognitive disorders missed crucial appointments due to government's restrictive measures, and many experienced a delay in initial diagnosis and initiation of treatment. This has relevant impact on their treatment and consequently has (is still having and potentially will have) an increase on the healthcare service burden of clinics. Furthermore, as a second wave of COVID-19 affects Europe, and with winter approaching, it is a compelling priority to ensure easy and rapid access to appropriate assessment, care and treatment in the event of a new outbreak and potential subsequent lockdowns, with particular attention to the development of specific healthcare technologies customized to older persons with cognitive impairment.