Association between religion, mental health and social distancing during the Covid-19 pandemic / Associação entre religião, saúde mental e distanciamento social na pandemia de Covid-19 / Asociación entre religión, salud mental y distanciamiento social en la pandemia Covid-19

This cross-sectional study aimed to analyze the association of religiosity with behaviors and perceptions in the context of social distancing measures during the COVID-19 pandemic, as well as mental health outcomes, in a university community in Central-West Brazil. A sample of 1,796 subjects responded to an online form with socio-demographic questions and the DASS-21 and PWBS scales. Religion was associated with the frequency of interactions, perceptions of the duration of the social distancing measures, changes in emotional state and history of psychological illness. The prevalence of symptoms of depression, anxiety and stress was lower among people with religion and their scores in psychological well-being were higher. (AU)

Trata-se de um estudo transversal com o objetivo de analisar a associação entre religiosidade e comportamentos e percepções frente ao distanciamento social decorrente da pandemia de Covid-19 e estado de saúde mental em uma comunidade universitária do Centro-Oeste brasileiro. Participaram do estudo 1796 sujeitos, os quais responderam a um formulário online com questões sociodemográficas e às escalas DASS-21 e EBEP. Observou-se associação entre religião e frequência de interações, percepção sobre a duração do distanciamento social e mudanças no estado emocional e histórico de alterações psicológicas. Constatou-se menor prevalência de sintomas relacionados à depressão, à ansiedade e ao estresse e maiores escores de bem-estar psicológico entre aqueles com religião. (AU)

Se trata de un estudio transversal con el objetivo de analizar la asociación entre religiosidad, comportamientos y percepciones frente al distanciamiento social resultante de la pandemia Covid-19 y el estado de salud mental en una comunidad universitaria de la región Centro-Oeste de Brasil. Participaron en el estudio 1796 sujetos, que respondieron un formulario en línea con preguntas sociodemográficas y las escalas DASS-21 y EBEP. Se observó asociación entre religión y frecuencia de interacciones, la percepción de la duración del aislamiento social y los cambios en el estado emocional y el historial de cambios psicológicos. Se observó una menor prevalencia de síntomas relacionados con la depresión, la ansiedad y el estrés, y puntuaciones más altas de bienestar psicológico entre quienes profesaban una religión. (AU)

Differences in Early Childhood Caries Status on Parental Stress Levels and Socioeconomic Status in Makassar City, Indonesia, During the COVID-19 Pandemic

Abstract Objective: To analyze the differences in early childhood caries status on parental stress levels and socioeconomic status in Makassar City, Indonesia, during the COVID-19 pandemic. Material and Methods: This type of analytical observational study with a cross-sectional design was conducted in North Rantepao, Toraja City, South Sulawesi Province, Indonesia. The research subjects of this study were parents who met the criteria, were willing to participate in the study, and had children aged 6-17 years. The questionnaire instrument with the criteria for assessing children's dental and oral health was assessed based on parents' perceptions. Each item is rated on a scale from 1 (never) to 5 (always). Then the total score was divided into three categories, namely low (score 3-6), moderate (score 7-10), and high (score 11-15). Comparative test analysis using Chi-Square test. Results: Parents with high-stress levels had more children with poor oral health. There is a significant difference according to the level of stress and socioeconomic status of the parents. Conclusion: There is a significant difference between caries status in early childhood based on socioeconomic status and parental stress level (AU).

Clinical outcomes of SARS-CoV-2 infected people with diabetes who developed Severe Acute Respiratory Syndrome in Brazil / Desfecho clínico de pessoas com diabetes infectadas pelo SARS-CoV-2 que desenvolveram Síndrome Respiratória Aguda Grave, Brasil

Objetivo: Comparar os desfechos clínicos de pessoas com e sem Diabetes Mellitus tipo 2 (DM 2), infectadas pelo SARS-CoV-2, que desenvolveram Síndrome Respiratória Aguda Grave (SRAG) no Brasil. Métodos: Trata-se de um estudo transversal realizado a partir de análise da ficha de notificação compulsória de Síndrome Respiratória Aguda Grave Hospitalizado, obtidas no DATASUS. Foram analisados homens e mulheres com e sem DM2, infectados pelo SARS-CoV-2 e notificados como SRAG no período de fevereiro de 2020 a maio de 2021. Foram identificados os desfechos: hospitalização, admissão em Unidade de Terapia Intensiva (UTI) e óbito. Em seguida, a porcentagem de cada desfecho entre pessoas com DM2 foi comparada com a de pessoas não-diabéticas infectadas no mesmo período, utilizando o teste de Qui-Quadrado, com intervalo de confiança de 95%. Resultados: De um total de 384.805 pacientes, 111.046 eram diabéticos e 273.759 não diabéticos. Entre os diabéticos, 98.2% foram hospitalizados, 43.7% admitidos em UTI e 44.6% evoluíram a óbito. Enquanto entre os não-diabéticos, 97.3% necessitaram de hospitalização, 37.2% foram admitidos em UTI e 35.7% evoluíram a óbito. Após a análise com o teste de Qui-Quadrado, nos desfechos analisados foi encontrada uma diferença estatística significante (p<0.001) entre os grupos. Conclusão: A presença de DM 2 esteve associada a um pior prognóstico da COVID-19, quando comparada a pessoas sem DM2 na população brasileira. Entretanto, são necessários mais estudos para estabelecer a causalidade e elucidar a fisiopatologia dessa associação (AU)

Objective: Compare the clinical outcomes of people with and without Type 2 Diabetes Mellitus (DM2), infected by SARS-CoV-2, who developed Severe Acute Respiratory Syndrome (SARS) in Brazil. Methodology: This is a cross-sectional study. The research was carried out by analyzing the compulsory notification form Severe Acute Respiratory Syndrome of hospitalized patients, obtained from DATASUS. Type 2 diabetic and non-diabetic men and women infected with SARS-CoV-2 and notified as SARS in the period February 2020 to May 2021 were analyzed. The outcomes were identified as: hospitalization, Intensive Care Unit (ICU) admission, and death. The percentage of each outcome among diabetic patients was compared with that of the infected non-diabetic patients in the same period using the Chi-square test, with a 95% confidence interval. Results: From a total of 384,805 patients, 111,046 were diabetic and 273,759 non-diabetic. Among the diabetic patients, 98.2% were hospitalized, 43.7% were admitted to the ICU, and 44.6% died. While among non-diabetics, 97.3% required hospitalization, 37.2% were admitted to the ICU, and 35.7% died. After the analysis with the Chi-square test, a statistically significant difference was found between the groups (p<0.001). Conclusion: The presence of DM2 was associated with a worse prognosis for COVID-19 compared to people without DM2, in the Brazilian population. However, further studies are needed to establish causality and elucidate the pathophysiology of this association (AU)

Clinical outcomes of SARS-CoV-2 infected people with diabetes who developed Severe Acute Respiratory Syndrome in Brazil / Desfecho clínico de pessoas com diabetes infectadas pelo SARS-CoV-2 que desenvolveram Síndrome Respiratória Aguda Grave, Brasil

Objetivo: Comparar os desfechos clínicos de pessoas com e sem Diabetes Mellitus tipo 2 (DM 2), infectadas pelo SARS-CoV-2, que desenvolveram Síndrome Respiratória Aguda Grave (SRAG) no Brasil. Métodos: Trata-se de um estudo transversal realizado a partir de análise da ficha de notificação compulsória de Síndrome Respiratória Aguda Grave Hospitalizado, obtidas no DATASUS. Foram analisados homens e mulheres com e sem DM2, infectados pelo SARS-CoV-2 e notificados como SRAG no período de fevereiro de 2020 a maio de 2021. Foram identificados os desfechos: hospitalização, admissão em Unidade de Terapia Intensiva (UTI) e óbito. Em seguida, a porcentagem de cada desfecho entre pessoas com DM2 foi comparada com a de pessoas não-diabéticas infectadas no mesmo período, utilizando o teste de Qui-Quadrado, com intervalo de confiança de 95%. Resultados: De um total de 384.805 pacientes, 111.046 eram diabéticos e 273.759 não diabéticos. Entre os diabéticos, 98.2% foram hospitalizados, 43.7% admitidos em UTI e 44.6% evoluíram a óbito. Enquanto entre os não-diabéticos, 97.3% necessitaram de hospitalização, 37.2% foram admitidos em UTI e 35.7% evoluíram a óbito. Após a análise com o teste de Qui-Quadrado, nos desfechos analisados foi encontrada uma diferença estatística significante (p<0.001) entre os grupos. Conclusão: A presença de DM 2 esteve associada a um pior prognóstico da COVID-19, quando comparada a pessoas sem DM2 na população brasileira. Entretanto, são necessários mais estudos para estabelecer a causalidade e elucidar a fisiopatologia dessa associação (AU)

Objective: Compare the clinical outcomes of people with and without Type 2 Diabetes Mellitus (DM2), infected by SARS-CoV-2, who developed Severe Acute Respiratory Syndrome (SARS) in Brazil. Methodology: This is a cross-sectional study. The research was carried out by analyzing the compulsory notification form Severe Acute Respiratory Syndrome of hospitalized patients, obtained from DATASUS. Type 2 diabetic and non-diabetic men and women infected with SARS-CoV-2 and notified as SARS in the period February 2020 to May 2021 were analyzed. The outcomes were identified as: hospitalization, Intensive Care Unit (ICU) admission, and death. The percentage of each outcome among diabetic patients was compared with that of the infected non-diabetic patients in the same period using the Chi-square test, with a 95% confidence interval. Results: From a total of 384,805 patients, 111,046 were diabetic and 273,759 non-diabetic. Among the diabetic patients, 98.2% were hospitalized, 43.7% were admitted to the ICU, and 44.6% died. While among non-diabetics, 97.3% required hospitalization, 37.2% were admitted to the ICU, and 35.7% died. After the analysis with the Chi-square test, a statistically significant difference was found between the groups (p<0.001). Conclusion: The presence of DM2 was associated with a worse prognosis for COVID-19 compared to people without DM2, in the Brazilian population. However, further studies are needed to establish causality and elucidate the pathophysiology of this association (AU)

Modifications of behavior management strategies pre- and post-covid-19 scenario: A survey among pediatric dentists.

Background: COVID-19 presented a unique scenario among children, specifically all over the world. The children had decrease outdoors activities and learning times, increased use of electronic gadgets and changes in sleep patterns. These altered behavior patterns of children directly influenced their behavior in the dental operatory. This coupled with the stringent protocols of COVID-19, made the behavior management of children a tedious task. However, as they say that necessity is the mother of all inventions, the pediatric dentist took this time to evaluate newer methods of behavior management and modified old strategies with newer modifications. Aim: The main aim of this study was to observe the modifications in behavior management strategies among pediatric dentists in the post-COVID-19 era while managing the child in dental operatory. Materials and Methods: Four hundred pediatric dentists were mailed a questionnaire consisting of 24 open and closed-ended questions consisting of personal data, professional information, and questions regarding various behavior management techniques used by them in pre- and post-COVID-19 era. Data obtained were subjected to statistical analysis using SPSS version 26.0, IBM, and a comparison of frequencies of categories of variables with groups was made using Chi-Square test and McNemar test. Results: The results showed that there were statistically highly significant changes in behavior management strategies pre- and post-COVID-19 scenario with P < 0.01. Conclusion: Conventional techniques like Tell-Show-Do were popular in both pre- and post-COVID-19 times with minor modifications in approach, but conscious sedation and distraction techniques were evaluated to have gained more popularity in the post-COVID-19 times along with exploration of new novel techniques.

Policies for expanding access to higher education and changing the profile of medical graduates in Brazil: a cross-sectional study. / Políticas de ampliação do acesso ao ensino superior e mudança no perfil de egressos de medicina no Brasil: um estudo transversal.

This study assesses the effectiveness of policies to expand access to higher education in reducing inequities in the profile of graduates from medical courses in Brazil. This work consists of a cross-sectional study using data from the 2018 Higher Education Census. Analyses were carried out to identify the association between being a beneficiary of the Quota Law, the University for All Program, or the Student Financing Fund and three markers: born in a small-sized municipality, being non-white, or having attended high school in a public school. Analyses were performed using Pearson's chi-square test, and multivariate analysis was conducted using Poisson regression. A significant association was found between being a beneficiary of these policies and being a non-white graduate, who was born in a small town and who had studied in a public high school. All policies presented adjusted Prevalence Ratio (PR), which demonstrated an association with statistical significance. The Quota Law was the most effective policy, with RP=1.92 for non-white graduates, RP=6.66 for having studied in a public high school, and RP=1.08 for being born in a small town. Despite these results, these groups remain underrepresented in medical courses and in the workforce.

Este estudo avalia o impacto de políticas de ampliação do acesso ao ensino superior na redução de iniquidades no perfil dos egressos de cursos médicos no Brasil. Estudo transversal que utiliza dados do Censo da Educação Superior de 2018. Foram realizadas análises para identificar associação entre ser beneficiário da Lei de Cotas, do Programa Universidade para Todos ou do Fundo de Financiamento Estudantil e três marcadores: nascimento em município de pequeno porte, ser não-branco ou ter cursado ensino médio em escola pública. Realizamos análises utilizando teste de qui-quadrado de Pearson e análise multivariada através de regressão de Poisson. Houve associação significativa entre ser beneficiário destas políticas e ser egresso não branco, ter nascido em município de pequeno porte e ser egresso de escola pública no ensino médio. Todas as políticas apresentaram resultados de Razões de Prevalências (RP) ajustadas superiores a um e com significância estatística. A Lei de Cotas foi a política mais efetiva com RP=1,92 para ser egresso não-branco, RP=6,66 para ter estudado ensino médio em escola pública e RP=1,08 para ter nascido em município de pequeno porte. Apesar destes resultados, estes grupos continuam sub-representados nos cursos médicos e na composição da força de trabalho.

The Need for Psychological Support of Health Workers during the COVID-19 Pandemic and the Influence on Their Work.

The aim of this research was to analyze how the need for psychological support of health workers (HCWs) influenced the beliefs, perceptions and attitudes towards their work during the COVID-19 pandemic and to predict the need of psychological assistance. A descriptive transversal study was conducted based on a self-administered questionnaire distributed to health professionals working in the Canary Islands, Spain. The data were analyzed using Pearson's chi-squared test and the linear trend test. The correlation test between ordinal and frequency variables was applied using Kendall's Tau B. Multiple logistic regression was used to predict dichotomous variables. The sample included 783 health professionals: 17.8% (n = 139) of them needed psychological or psychiatric support. Being redeployed to other services influenced the predisposition to request psychological help, and HCWs who required psychological support had more negative attitudes and perceptions towards their work. After five waves of COVID-19, these HCWs reported to be physically, psychologically and emotionally exhausted or even "burned out"; they did not feel supported by their institutions. The commitment of health personnel to fight against the COVID-19 pandemic decreased after the five waves, especially among professionals who required psychological support.

Evaluation of Knowledge Levels of Dentistry Students on the COVID-19 and its Effects on Depression

ABSTRACT Objective To determine the level of knowledge of dentistry students regarding the COVID-19 outbreak and to evaluate whether the risk factors of the outbreak cause depression. Material and Methods This study was conducted with 516 dentistry students (3rd, 4th and 5th grades) who started clinical practice in their education. The first part of the questionnaires applied to the students includes questions about demographic information, while the second part contains questions to determine their knowledge levels on the COVID-19 pandemic and protection against it. In the third section, Beck Depression Inventory (BDI) was used to examine depression symptoms. The data were analyzed by frequency analyses and Chi-squared tests via the IBM SPSS 22.0 software. Results Of the 516 students, 150 (29%) participants were in the 3rd, 212 (41%) were in the 4th and 154 (30%) were in the 5th grade. 355 (69%) students stated that their knowledge level about COVID-19 was high. 30.9% were conscious of the importance of using masks. 29.6% were aware of the importance of using gloves, 30.3% of not shaking hands. According to BDI scores, 37.1% of the participants seemed to experience moderate to severe and very severe depression. Conclusion It was observed that the students didn't have a sufficient level of knowledge about the factors affecting the spread of the pandemic. New stress factors such as COVID-19 may increase the incidence of depression.

Dentistry during COVID-19: patients' knowledge and satisfaction toward health protocols COVID-19 during dental treatment.

BACKGROUND: Coronavirus disease 2019 (COVID-19) as an infectious disease primarily spreading through droplet infection in dental treatment. Patient satisfaction is an indicator of healthcare quality service. Quality of healthcare service and patient satisfaction has been affected by the COVID­19 pandemic. This study aims to assess the knowledge and satisfaction toward health protocols COVID-19 during dental treatment among dental patients. METHODS: An institutional-based cross-sectional study was conducted on 270 dental patients using a self­designed questionnaire consisting of knowledge and satisfaction about health protocols COVID-19 during dental treatment through a random sampling technique. Data were imported to SPSS version 21 for analysis. Descriptive and analytical statistics were used to identify the factors associated with their knowledge and satisfaction. A p value < 0.05 was considered statistical significance. RESULTS: Totally, 270 dental patients with mean age of 37.6 ± 6.7 years participated in the study. The mean knowledge score was 36.7 ± 3.5, as considerable number of participants were unaware about the risk associated with dental treatment as well as restrictions imposed on dental procedures. About 18% of participants experienced one or other form of dental complaints during the lockdown period. The overall level of patient satisfaction was 44.6%. CONCLUSION: It can be concluded that, public knowledge is to be improved about risk of virus transmission that can be related with dental treatment and also people should be encouraged to use virtual facilities, such as teledentistry, so that no dental emergencies is left untreated during the pandemic time. In addition, the level of satisfaction was in a medium level for dental patients in the study area. Specifically, we deduced from the results that social/physical distancing measures are one of the mechanisms to decrease the fear of exposure to the COVID-19.

Decreases in out of hospital cardiac arrest (OHCA) outcome metrics persist when known COVID patients are excluded from analysis.

OBJECTIVE: A decline in OHCA performance metrics during the pandemic has been reported in the literature but the cause is still not known. The Montgomery County Fire and Rescue Service (MCFRS) observed a decline in both the rate of return of spontaneous circulation (ROSC) and the proportion of resuscitations that resulted in cerebral performance category (CPC) 1 or 2 discharge of the patient beginning in March of 2020. This study examines whether the decline in these performance metrics persists when known COVID positive patients are excluded from the analysis. METHODS: Two samples of OHCA patients for similar time periods (one year apart) before and after the start of the COVID pandemic were developed. A database of known COVID positive patients among EMS encounters was used to identify and exclude COVID positive patients. OHCA outcomes in these two groups were then compared using a Chi-square test and Fisher's exact test for difference in proportions and Analysis of Variance (ANOVA) for difference in means. A two-stage multivariable logistic regression model was used to develop odds ratios for achieving ROSC and CPC 1 or 2 discharge in each period. RESULTS: After excluding known COVID patients, 32.5% of the patients in the pre-COVID period achieved ROSC compared to 25.1% in the COVID period (p = 0.007). 6% of patients in the pre-COVID period were discharged with CPC 1 or 2 compared to 3.2% from the COVID era (p = 0.026). Controlling for all available patient characteristics, patients undergoing OHCA resuscitation prior to be beginning of the pandemic were 1.2 times more likely to achieve ROSC and 1.6 times more likely to be discharged with CPC 1 or 2 than non-COVID patients in the pandemic era sample. CONCLUSIONS: When known COVID patients are excluded, pre-pandemic OHCA resuscitation patients were more likely to achieve ROSC and CPC 1 or 2 discharge. The prevalence of known COVID positive patients among all OHCA resuscitations during the pandemic was not sufficient to fully account for the marked decrease in both ROSC and CPC 1 or 2 discharges. Other causative factors must be sought.

Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil.

BACKGROUND: There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. METHODS: This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann-Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. RESULTS: From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren's syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03-2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19-6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31-3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46-0.98). CONCLUSION: Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR - 9KTWX6).

The characteristics of and responses to the two COVID-19 outbreak waves in Hebei Province of China, January 2020 to February 2021.

Hebei Province was affected by two coronavirus disease 2019 (COVID-19) outbreak waves during the period 22 January 2020 through 27 February 2020 (wave 1) and 2 January 2021 through 14 February 2021 (wave 2). To evaluate and compare the epidemiological characteristics, containment delay, cluster events and social activity, as well as non-pharmaceutical interventions of the two COVID-19 outbreak waves, we examined real-time update information on all COVID-19-confirmed cases from a publicly available database. Wave 1 was closely linked with the COVID-19 pandemic in Wuhan, whereas wave 2 was triggered, to a certain extent, by the increasing social activities such as weddings, multi-household gatherings and church events during the slack agricultural period. In wave 2, the epidemic spread undetected in the rural areas, and people living in the rural areas had a higher incidence rate than those living in the urban areas (5.3 vs. 22.0 per 1 000 000). Furthermore, Rt was greater than 1 in the early stage of the two outbreak waves, and decreased substantially after massive non-pharmaceutical interventions were implemented. In China's 'new-normal' situation, development of targeted and effective intervention remains key for COVID-19 control in consideration of the potential threat of new coronavirus strains.

Impact of the COVID-19 pandemic on workplace violence at an academic emergency department.

STUDY OBJECTIVES: COVID-19 brought unique challenges; however, it remains unclear what effect the pandemic had on violence in healthcare. The objective of this study was to identify the impact of the pandemic on workplace violence at an academic emergency department (ED). METHODS: This mixed-methods study involved a prospective descriptive survey study and electronic medical record review. Within our hospital referral region (HRR), the first COVID-19 case was documented on 3/11/2020 and cases peaked in mid-November 2020. We compared the monthly HRR COVID-19 case rate per 100,000 people to the rate of violent incidents per 1000 ED visits. Multidisciplinary ED staff were surveyed both pre/early-pandemic (April 2020) and mid/late-pandemic (December 2020) regarding workplace violence experienced over the prior 6-months. The study was deemed exempt by the Mayo Clinic Institutional Review Board. RESULTS: There was a positive association between the monthly HRR COVID-19 case rate and rate of violent ED incidents (r = 0.24). Violent incidents increased overall during the pandemic (2.53 incidents per 1000 visits) compared to the 3 months prior (1.13 incidents per 1000 visits, p < .001), as well as compared to the previous year (1.24 incidents per 1000 patient visits, p < .001). Survey respondents indicated a higher incidence of assault during the pandemic, compared to before (p = .019). DISCUSSION: Incidents of workplace violence at our ED increased during the pandemic and there was a positive association of these incidents with the COVID-19 case rate. Our findings indicate health systems should prioritize employee safety during future pandemics.

[Description of Influenza B in seasonal epidemic in Cantabria during the beginning of the pandemia due to SARS-CoV-2]. / Descripción de la epidemia estacional por Gripe B en Cantabria durante los inicios de la pandemia por SARS-CoV-2.

OBJECTIVE: Co-circulation of the two Influenza B lineages hinders forecast of strain to include in trivalent vaccine. Autonomous Communities such as Cantabria continue without supplying tetravalent vaccine. The aim of this study was to analyse epidemiological characteristics of influenza type B in Cantabria (2019-2020 season) as well as to establish the predominant lineage and its relation to the recommended vaccine. METHODS: Retrospective study whereby flu diagnosis and lineage analysis were determined by RT-PCR. RESULTS: All samples belonged to the Victoria lineage. Most prevalent viral co-infection was due to SARS-CoV-2. The population affected by influenza B was mainly paediatric and non-vaccinated patients more frequently required hospital admittance. CONCLUSIONS: Influenza type B has a higher incidence in the paediatric population and type A affects more the adult population. Only 28.8% of patients with Influenza B that presented with some underlying condition or risk factor were vaccinated. This shows the need to increase coverage with tetravalent vaccines in order to reduce the burden of disease associated with the Influenza B virus.

Evidence of Stability in Patient-Reported Global Health During the COVID-19 Pandemic.

OBJECTIVES: Measures of health-related quality of life (HRQOL) are collected throughout healthcare systems and used in clinical, economic, and outcomes studies to direct patient-centered care and inform health policy. Studies have demonstrated increases in stressors unique to the COVID-19 pandemic, however, their effect on HRQOL is unknown. Our study aimed to assess the change in self-reported global health during the pandemic for patients receiving care in a large healthcare system compared with 1 year earlier. METHODS: An observational cross-sectional study of 2 periods was conducted including adult patients who had a healthcare appointment and completed the Patient-Reported Outcomes Measurement Information System Global Health (PROMIS GH) as standard care during the COVID-19 pandemic and a year earlier. The effect of time on PROMIS global mental health (GMH) and global physical health (GPH) was evaluated through multiple statistical methods. RESULTS: There were 38 037 patients (mean age 56.1 ± 16.6 years; 61% female; 87% white) who completed the PROMIS GH during the pandemic (August 2020) and 33 080 (age 56.7 ± 16.5 years; 61% female; 86% white) who had completed it 1 year earlier (August 2019). GMH was significantly worse, whereas GPH was similar during the pandemic compared with a year earlier (adjusted estimate [standard error]: -1.21 (0.08) and 0.11 (0.08) T-score points, respectively). CONCLUSIONS: Our study found modest, nonclinically meaningful decreases in GMH and similar GPH during the COVID-19 pandemic compared with a year earlier in patients cared for in a large healthcare system. Nevertheless, healthcare systems are likely seeing a biased sample of patients during these times. Findings from our study have implications for the interpretation of HRQOL during this pandemic.

Sociodemographic determinants and clinical risk factors associated with COVID-19 severity: a cross-sectional analysis of over 200,000 patients in Tehran, Iran.

BACKGROUND: Defining socio-demographic factors, clinical presentations and underlying diseases associated with COVID-19 severity could be helpful in its management. This study aimed to further clarify the determinants and clinical risk factors of the disease severity in patients infected with COVID-19. METHODS: A multi-centre descriptive study on all patients who have been diagnosed with COVID-19 in the province of Tehran from March 2020 up to Dec 2020 was conducted. Data on socio-demographic characteristics, clinical presentations, comorbidities, and the health outcomes of 205,654 patients were examined. Characteristics of the study population were described. To assess the association of study variables with the disease severity, the Chi-Squared test and Multiple Logistic Regression model were applied. RESULTS: The mean age of the study population was 52.8 years and 93,612 (45.5%) were women. About half of the patients have presented with low levels of blood oxygen saturation. The ICU admission rate was 17.8% and the overall mortality rate was 10.0%. Older age, male sex, comorbidities including hypertension, cancer, chronic respiratory diseases other than asthma, chronic liver diseases, chronic kidney diseases, chronic neurological disorders, and HIV/AIDS infection were risk markers of poor health outcome. Clinical presentations related with worse prognosis included fever, difficulty breathing, impaired consciousness, and cutaneous manifestations. CONCLUSION: These results might alert physicians to pay attention to determinants and risk factors associated with poor prognosis in patients with COVID-19. In addition, our findings aid decision makers to emphasise on vulnerable groups in the public health strategies that aim at preventing the spread of the disease and its mortalities.

[Experience of care and daily life during national sanitary confinement in patients followed and treated in Cancer Control Centers: The BaroCov Inquiry]. / Expérience des soins et de la vie quotidienne pendant le confinement sanitaire national chez des patients suivis et traités en centre de lutte contre le cancer : l'enquête BaroCov.

Confinement within the framework of Covid 19 required organizations in cancer centers, in particular with postponing certain treatments. We interviewed 6080 patients who had a scheduled appointment during this period. 2478 patients gave their opinion regarding access and organization of care, teleconsultation, their concerns and their reasons for satisfaction. While 83 % of them say they are satisfied with the organization of care, 25 % of respondents say they have given up care that they consider essential in 1/3 of cases. The concern related to the follow-up of the cancerous disease takes precedence over that of being infected with the Sars-cov-2 virus, unlike the general population, and relationships with their loved ones are spontaneously cited as a reason for satisfaction. This method captures the experience of patients, despite certain limitations. Such an approach could be used to set up a specific system during normal periods.

Emergency department utilization for mental health conditions before and after the COVID-19 outbreak.

INTRODUCTION: The outbreak of COVID-19 disrupted lives across the United States. Evidence shows that such a climate is deleterious to mental health and may increase demand for mental health services in emergency departments. The purpose of this study was to determine the difference in emergency department utilization for mental health diagnoses before and after the COVID-19 surge. METHODS: We conducted a cross-sectional study between January-August 2019 and January-August 2020 with emergency department encounter as the sampling unit. The primary outcome was the proportion of all emergency department encounters attributed to mental health. We performed chi-square analyses to evaluate the differences between 2019 and 2020. RESULTS: We found that overall emergency department volume declined between 2019 and 2020, while the proportion attributable to mental health conditions increased (p < 0.01). Substance abuse, anxiety, and mood disorders accounted for nearly 90% of mental health diagnoses during both periods. When stratified by sex, substance abuse was the leading mental health diagnosis for males and anxiety and substance abuse disorders combined accounted for the largest proportion for females. DISCUSSION: The emergency department is an important community resource for the identification and triage of mental health emergencies. This role is even more important during disasters and extended crises, making it imperative that emergency departments employ experienced mental health staff. This study provides a comparison of emergency department utilization for mental health diagnoses before the pandemic and during the spring 2020 surge and may serve as a useful guide for hospitals, health systems and communities in future planning.