The Impact of COVID-19 on Depression Among Service Industry Workers: A Comprehensive Analysis Based on the 2021 Korea Community Health Survey (preprint)

Background This study aims to comprehensively explore the factors associated with depression among service industry workers during the COVID-19 pandemic, utilizing data from the 2021 Korea Community Health Survey. A total of 16,553 participants were included in the analysis.Methods The research employed a composite sample logistic regression analysis, with depression as the dependent variable and various general characteristics as independent variables.Results The study's findings highlight a notable prevalence of depression within the service industry (3.3%). Women exhibited a 2.22 times higher risk of depression compared to men (95% Confidence Interval (CI): 1.62–3.05). Service workers aged 40–49, 50–59, and ≥ 60 demonstrated lower odds of depression in comparison to those aged 19–29. Higher income levels were associated with reduced odds of depression. Service workers experiencing job loss (Odds Ratio(OR) = 5.42, 95% CI: 3.07–9.55) and deteriorated job conditions (OR = 1.97, 95% CI: 1.60–2.43) exhibited higher odds of depression than those with stable employment.Conclusion In conclusion, this study pinpoints depression risks in service workers, stressing gender, age, income, and job changes. Urgent action is needed, including targeted interventions and enhanced workplace support during the ongoing pandemic. Valuable insights contribute to understanding mental health disparities in this population.

Assessing Sociodemographic Factors Associated with Household Hardships during the COVID-19 Pandemic in Manhica, Mozambique using Data Collected between April 2021 and February 2022 (preprint)

BackgroundCOVID-19 resulted in vast disruption to life in the 21st century. To quell the disease spread, national governments implemented several containment measures like state of emergency, curfews, and lockdowns that likely created hardships for households. To improve knowledge of the negative consequences of these lockdowns, we examine the extent to which the pandemic period was associated with hardships at the household level and assess factors associated with household vulnerability to these hardships. MethodsWe conducted a cross-sectional survey between April 2021 and February 2022 among households residing in the district of Manhica through a survey questionnaire fielded in the Health and Demographic Surveillance System (HDSS) operating in Manhica, Mozambique. Logistic regression was used to analyze associations between the head of household and household characteristics with specific household hardships (business closure, food price increase, household member detained, input inflation, job loss). ResultsHouseholds headed by individuals with lower education and employed in non-agricultural occupations as well as households that were larger in size or poorer in asset ownership compared to other households were generally at greater risk of experiencing a larger variety of hardships. Conversely, households that owned "distance demolishing technologies" such as motorcycles were less likely to experience these hardships, presumably as they were able to transcend local conditions. ConclusionsThese results identify at-risk groups according to a social determinants of vulnerability framework and will help inform future policies and practices that aim to mitigate the negative consequences of COVID-19 as well as future disease outbreaks.

Bayesian Unit-level Models for Longitudinal Survey Data under Informative Sampling: An Analysis of Expected Job Loss Using the Household Pulse Survey (preprint)

The Household Pulse Survey (HPS), recently released by the U.S. Census Bureau, gathers timely information about the societal and economic impacts of coronavirus. The first phase of the survey was quickly launched one month after the beginning of the coronavirus pandemic and ran for 12 weeks. To track the immediate impact of the pandemic, individual respondents during this phase were re-sampled for up to three consecutive weeks. Motivated by expected job loss during the pandemic, using public-use microdata, this work proposes unit-level, model-based estimators that incorporate longitudinal dependence at both the response and domain level. In particular, using a pseudo-likelihood, we consider a Bayesian hierarchical unit-level, model-based approach for both Gaussian and binary response data under informative sampling. To facilitate construction of these model-based estimates, we develop an efficient Gibbs sampler. An empirical simulation study is conducted to compare the proposed approach to models that do not account for unit-level longitudinal correlation. Finally, using public-use HPS micro-data, we provide an analysis of "expected job loss" that compares both design-based and model-based estimators and demonstrates superior performance for the proposed model-based approaches.

The Effects of COVID-19 Pandemic on Women’s Access to Reproductive Health and Family Planning Services in Egypt: An exploratory study (preprint)

Background The COVID-19 pandemic has been noted to decrease access to reproductive health / family planning (RH/FP) services globally. We qualitatively explored women’s experiences in accessing RH/FP services during the COVID-19 lockdown months in Egypt. Methods Using semi-structured interviews, a total of 40 women in the Port Said and Souhag governorates were asked about (1) the initial provider they sought services from before COVID-19 lockdown, (2) challenges in accessing that provider as a result of COVID-19, (3) adaptations that women or their families made as a result of those challenges, and (4) the impact of challenges or adaptations on women and their families. Results Many women were unable to access SRH/FP services during COVID-19 lockdown. Main challenges were fear of contracting the virus, closure of health facilities, changing service hours, FP method or drug stock-outs, and/or financial constraints due to job losses or increased costs of services. Women and their families used several coping strategies to overcome the above challenges such as seeking services at private facilities or skipping doctor’s visits. Coping strategies that some women used to address these challenges exposed them to additional health risks, including unintended pregnancies, and posed several social, emotional, and financial burdens to many. Conclusions COVID-19 pandemic and associated lockdown measures undermined women’s access to RH / FP services and interfered with their ability to achieve their reproductive goals. This paper highlights a number of recommendations that can be utilized in times of crisis in order to ensure proper access and utilization of RH/FP services.

The UK COVID-19 furlough scheme and associations with smoking, alcohol consumption and vaping: evidence from 8 UK longitudinal population surveys. (preprint)

BackgroundDisruptions to employment status can impact smoking and alcohol consumption. During the COVID-19 pandemic, the UK implemented a furlough scheme to prevent job loss. We examine how furlough was associated with participants smoking, vaping and alcohol consumption behaviours in the early stages of the pandemic. MethodsData were from 27,841 participants in eight UK adult longitudinal surveys. Participants self-reported employment status and current smoking, current vaping and drinking alcohol (>4 days/week or 5+ drinks per typical occasion) both before and during the pandemic (April-July 2020). Risk ratios were estimated within each study using modified Poisson regression, adjusting for a range of potential confounders, including pre-pandemic behaviour. Findings were synthesised using random effects meta-analysis. Sub-group analyses were used to identify whether associations differed by gender, age or education. ResultsCompared to stable employment, neither furlough, no longer being employed, nor stable unemployment were associated with smoking, vaping or drinking, following adjustment for pre-pandemic characteristics. However, some sex differences in these associations were observed, with stable unemployment associated with smoking for women (ARR=1.35; 95% CI: 1.00-1.82; I2: 47%) but not men (0.84; 95% CI: 0.67-1.05; I2: 0%). No longer being employed was associated with vaping among women (ARR=2.74; 95% CI: 1.59-4.72; I2: 0%) but not men (ARR=1.25; 95% CI: 0.83-1.87; I2: 0%). There was little indication of associations with drinking differing by age, gender or education. ConclusionsWe found no clear evidence of furlough or unemployment having adverse impacts on smoking, vaping or drinking behaviours during the early stages of the COVID-19 pandemic in the UK, with differences in risk compared to those who remained employed largely explained by pre-pandemic characteristics.

Social and mental health risks faced by undocumented migrants during the COVID-19 pandemic: Evidence from three surveys in France (preprint)

Background The often-precarious life circumstances of undocumented migrants are likely to heighten the detrimental impact of the COVID-19 pandemic on their lives. Given the paucity of research exploring how undocumented migrants are affected by the COVID-19 pandemic, we set out to explore the association between being an undocumented migrant and a range of social and mental health measures. Methods Our study draws on three complementary surveys conducted among migrants in France between April 1st and June 7th 2020 (APART TOGETHER, MAKASI, ECHO; n = 716). We tested associations between eight outcome measures, covering health literacy, prevention behaviours, perceptions of government responses, livelihoods and mental health (PHQ-9 score), and the participants' legal status as either undocumented or documented. We modelled the probability of food insecurity increase, job loss, depression, and responses to SARS-COV-2 symptoms with logistic regression models, adjusted for age, gender and legal status. Results Undocumented migrants had a higher probability of experiencing food insecurity increase (aORs=10.40 [3.59, 30.16], and 2.19 [1.39, 3.50] in APART TOGETHER and ECHO), a higher probability of depression (aOR=2.65 [1.01, 6.97] in MAKASI). In all three surveys, undocumented migrants were more likely to lose their job (aORs=6.51 [1.18, 36.00], 8.36 [1.08, 64.70] and 3.96 [1.79, 9.16] in APART TOGETHER, MAKASI and ECHO respectively). Conclusion Our results suggest that the lives of undocumented migrants have been dramatically worsened by the COVID-19 pandemic, exposing and amplifying the inequalities facing this group. There is an urgent need for action to address these inequalities.

Covid19 Pandemic Policy Monitor (COV-PPM): European level tracking of non-pharmaceutical interventions (preprint)

The Covid-19 Pandemic Policy Monitor (COV-PPM) prospectively documents the measures taken to contain SARS-Cov-2 transmission across countries in EU27, EEA and UK. In Germany, measures have also been documented at the federal state and, partially, at the district levels. Non-pharmaceutical interventions (NPIs) implemented since March 2020 have been retrieved and updated weekly from official governments webpages, Ministries of Health, National (Public) Health Institutes or Administrations. NPI categories refer to restrictions, closures or changes in functioning implemented in thirteen domains: public events (gatherings in indoor or outdoor spaces); public institutions (kindergartens, schools, universities); public transport (trains, buses, trams, metro); citizens movement/mobility (e.g. pedestrians, cars, ships); border closures (air, land or sea, all incoming travels, from high-risk regions, only non-nationals); measures to improve the healthcare system (e.g. human resources or technical reinforcement, redistribution, material or infrastructural); measures for risk/vulnerable groups (e.g. elderly, chronically ill, pregnant); economic measures (e.g. lay-off rules establishment, actions to avoid job-loss, tax relaxation); testing policies (e.g. testing criteria changes); nose and mouth protection rules, vaccination and others/miscellaneous measures.

Knowledge and Impact of COVID-19 on Middle-Aged and Older People living with HIV in Lima, Peru (preprint)

COVID-19 has had an unprecedented worldwide impact, and Peru has had one of the highest COVID-19 case rates despite implementation of an early strict nationwide quarantine. Repercussions on Peru healthcare system may impact vulnerable populations, particularly people with HIV (PWH). We explored the knowledge of COVID-19 and the socioeconomic and health impact of the pandemic among middle-aged and older PWH. A cross-sectional telephone survey was administered to 156 PWH age >=40 years receiving care in one of two large HIV clinics in Lima, Peru. The majority of PWH (age 52+/-7.7 years, 41% female, 65% completed secondary school or less) were knowledgeable regarding COVID-19 symptoms and prevention methods. Nearly half of those employed prior to the pandemic reported job loss. Female sex (unadjusted prevalence ratio [PR] 1.85 [95%CI 1.27-2.69]), low educational level (PR 1.62 [1.06-2.48]) and informal work (PR 1.58 [1.06-2.36]) were risk factors for unemployment but not in adjusted models. Increased anxiety was reported in 64% and stress in 77%. COVID-19 has had a substantial socioeconomic and mental health impact on PWH living in Lima, Peru, particularly those with lower educational levels and informal workers. Efforts are needed to ensure continued medical care and socioeconomic support of PWH in Peru.

Importance of Career Development and Satisfaction of Job Contract Employees Amidst Pandemic (COVID-19) at the Central Luzon State University (preprint)

The study is conducted involving 58 randomly selected Job Order/ Contractual Employees at the Central Luzon State University. The study focused on the importance of career development and satisfaction of job contract employees amidst pandemic (COVID-19) at the Central Luzon State University. The survey respondents were picked accordingly to availability and no further stratification was employed in a bid to generate unbiased findings. The respondents were comprised of 31 (53.4%) females, a majority (58.6%) belonging to the age bracket of 15-24 years old. Most respondents are single (79%) while education-wise, the majority are college graduates (89.70). Classified accordingly to their assigned jobs, namely: Academic, Technical/ Research, Administrative/ Clerical, Creative/ Consultancy, Support/ Janitorial/ Utility/ Messenger, majority are assigned to administrative/ clerical job (43.90%).The common salary rate most are receiving is about PhP 10,972.00 for the exact amount while the highest at PHP 24, 940.00. Most of the respondents have no eligibilities (62.10%). On the importance of Career Development enumerated aspects, the respondents give premium to Job-Specific Training, Career Development Opportunities with the Opportunities for Merits and Promotions and Opportunities to Use Skills and Abilities only at the third spot. Likewise, no association on the Importance of the Career Development Aspects surfaced as it was correlated with Sex of the Respondents; therefore none of the said aspects were influenced by gender or sex. Measurement of the respondent's Current Job Satisfaction using the same career development parameters, responses mostly corresponded to "Slightly Satisfied" only of which the aspect Opportunities to Use Skills/Abilities was on the lead seconded by Organization's Commitment to Professional Development and tied at rank 3 are Agency-paid General Training and Career Development Opportunities. Regardless of gender, job satisfaction has no difference at all.

Pandemic and Progressivity (preprint)

Based on a survey of about 2,500 US resident adults, we show that people who have experienced serious illness or job loss caused by the COVID-19 pandemic, or who personally know someone who has, favor a temporary progressive levy or structural progressive tax reform to a greater extent than others in the sample, controlling for income, demographic characteristics, and other factors. People who reveal preferences for spending items (more on police, military, border protection; less on education, health, environment) that are associated with communitarian (rather than universalist) moral perspectives generally show weaker support for progressive reforms, but more communitarians change their views as a result of personal experience. The results are consistent with previous findings that economic upheavals can mold individuals' views on policy matters.

Theory of Transformational Leadership towards Employee Performance as Sequence of Supply Chain Model: The Mediating Effect of Job Autonomy in Palestine Banks during COVID-19 Pandemic (preprint)

This research aims to establish the relationship between transformation leadership and employeeperformance among staff in Palestine banks similar to any Supply Chain Management model, literature to describe the transformational leadership with the relationship with employee performance and job autonomy. The study tool-type quantitative research via questionnaire method was utilized to collect the data from respondents, structural equation modelling using SPSS V20 run to test the research hypothesis. The result indicates that the positive relationship between transformational leadership and employee performance among employees in the bank sector, Job autonomy also has a partial meditate on the relationship between transformational leadership and employee performance. This study's greatest drawback is its low sample size. This enabled the authors to bring Supply Chain model. Despite this, the results cannot be generalized to the entire high-bank population; the size of the data set used also restricted the study's scope. The sample (N=311) was made up. The main findings were related to confirming the two main hypotheses of the research that were related to testing if there were relationships between transformational leadership and employee performance via job autonomy as a mediator, the study may help the management of banks to develop an understanding of the value of transformational leadership that would enhance employee performance. The study explores the important issue and calls for more research in this domain. The paper adds value between transition leadership, employee productivity, and work flexibility to the organization's small knowledge base. The results presented in this paper would aid Palestinian academics, leadership experts, supply chain management professionals and organizational scientists in improving the efficiency of employees there through transformative leadership. Mediation research was carried out using special statistical methods

20 Years of Academic Job Market in History (preprint)

This paper (draft) is a first attempt of analysing the dataset of academic job market in History using the posts from H-Net website. We can see a significant decline in available professor positions for the last 10 years, and a sharp fall in available jobs due to COVID-19.

Impact of Covid-19 on tourism-based livelihood of people in Small Island Developing Nation: Case study of A & N Islands, India (preprint)

In the past few decades, the tourism sector has emerged as a significant economic activity in island nations, particularly in tropical regions. However, most of the tropical islands face similar constraints. National and international tourists visit the SIDS including A & N Islands and contribute to the GDP to significant share. The Covid-19 outbreaks in SIDs including A & N islands shows that number of people infected were less as compared to metros or big cities. However, tourism activities completely stopped due to lockdown resulting in decreasing tourist’s arrival, declined GDP and per capita income of SIDs to greater extent. The information gathered from various sources, mass media and net analysed and interpreted in this chapter. Due to Covid-19 tourist’s arrival declined which has serious consequences on the livelihood of islander. Our analysis revealed A&N Islands deficit in energy available at from different sources by 18.26%. However, they are surplus in protein. The burden of high expenditure coupled with poor infrastructure makes them more vulnerable in the circumstance of pandemic outbreaks. This outbreak has created the question of survival due to loss of jobs, halted economic activates, psychological, health unrest and livelihood threats among the depending people of these Island nations. Therefore, government interventions and subsidized package is very much essential to revive the tourism industry.

Digital Landscape of COVID-19 Testing: Challenges and Opportunities (preprint)

The COVID-19 Pandemic has left a devastating trail all over the world, in terms of loss of lives, economic decline, travel restrictions, trade deficit, and collapsing economy including real-estate, job loss, loss of health benefits, the decline in quality of access to care and services and overall quality of life. Immunization from the anticipated vaccines will not be the stand-alone guideline that will help surpass the pandemic and return to normalcy. Four pillars of effective public health intervention include diagnostic testing for both asymptomatic and symptomatic individuals, contact tracing, quarantine of individuals with symptoms or who are exposed to COVID-19, and maintaining strict hygiene standards at the individual and community level. Digital technology, currently being used for COVID-19 testing include certain mobile apps, web dashboards, and online self-assessment tools. Herein, we look into various digital solutions adapted by communities across universities, businesses, and other organizations. We summarize the challenges experienced using these tools in terms of quality of information, privacy, and user-centric issues. Despite numerous digital solutions available and being developed, many vary in terms of information being shared in terms of both quality and quantity, which can be overwhelming to the users. Understanding the testing landscape through a digital lens will give a clear insight into the multiple challenges that we face including data privacy, cost, and miscommunication. It is the destiny of digitalization to navigate testing for COVID-19. Block-chain based systems can be used for privacy preservation and ensuring ownership of the data to remain with the user. Another solution involves having digital health passports with relevant and correct information. In this early draft, we summarize the challenges and propose possible solutions to address the same.

Eviction, Health Inequity, and the Spread of COVID-19: Housing Policy as a Primary Pandemic Mitigation Strategy (preprint)

The COVID-19 pandemic precipitated catastrophic job loss, high unemployment rates, and severe economic hardship in renter households. As a result, housing precarity and the risk of eviction increased and worsened during the pandemic, especially among people of color and low-income populations. This paper considers the implications of this eviction crisis for health and health inequity, and the need for eviction prevention policies during the pandemic. Eviction and housing displacement are particularly threatening to individual and public health during a pandemic. Eviction is likely to increase COVID-19 infection rates because it results in overcrowded living environments, doubling up, transiency, limited access to healthcare, and a decreased ability to comply with pandemic mitigation strategies (e.g. social distancing, self-quarantine, and hygiene practices). Indeed, recent studies suggest that eviction may increase the spread of COVID-19 and that the absence or lifting of eviction moratoria may be associated with an increased rate of COVID-19 infection and death. Eviction is also a driver of health inequity as historic trends and recent data demonstrate that people of color are more likely to face eviction and associated comorbidities. Black people have had less confidence in their ability to pay rent and are dying at 2.1 times the rate of non-Hispanic whites. Indigenous Americans and Hispanic/Latinx people face an infection rate almost 3 times the rate of non-Hispanic whites. Disproportionate rates of both COVID-19 and eviction in communities of color compound negative health effects and make eviction prevention a critical intervention to address racial health inequity. In light of the undisputed connection between eviction and health outcomes, eviction prevention, through moratoria and other supportive measures, is a key component of a pandemic control strategies to mitigate COVID-19 spread and death.

Economic precarity, social isolation, and suicidal ideation during the COVID-19 pandemic (preprint)

The US population faces stressors associated with suicide brought on by the COVID-19 pandemic. Understanding the relationship between stressors and suicidal ideation may inform policies and programs to prevent suicide. We aimed to evaluate the relationship between economic precarity, social isolation, and suicidal ideation during the COVID-19 pandemic. We used data from two, nationally representative surveys of US adults: The 2017-2018 National Health and Nutrition Examination Survey and the 2020 COVID-19 and Life Stressors Impact on Mental Health and Well-being study (conducted March 31 to April 13). We compared suicidal ideation in 2017-2018 to suicidal ideation in 2020. We estimated the association between stressors - job loss, trouble paying rent, and social isolation - and suicidal ideation in 2020 using bivariable and multivariable Poisson regression models with robust variance. Suicidal ideation increased more than fourfold, from 3.4% in the 2017-2018 NHANES to 16.3% in the 2020 CLIMB survey, and from 5.8% to 26.4% among participants in low-income households. Suicidal ideation was more prevalent among people facing difficulty paying rent (31.5%), job loss (24.1%), and loneliness (25.1%), with each stressor associated with suicidal ideation in bivariable models. In the multivariable model, difficulty paying rent was associated with suicidal ideation (aPR: 1.5, 95% CI: 1.2 to 2.1), while losing a job was not (aPR: 0.9, 95% CI: 0.6 to 1.2). Feeling alone was associated with suicidal ideation (aPR: 1.9, 95% CI: 1.5 to 2.4). We conclude that suicidal ideation increased more than fourfold during the COVID-19 pandemic. Difficulty paying rent and loneliness were most associated with suicidal ideation. Policies and programs to support people experiencing economic precarity and loneliness may contribute to suicide prevention.

Work, Care and Gender During the Covid-19 Crisis (preprint)

We explore impacts of the pandemic crisis and associated restrictions to economic activity on paid and unpaid work for men and women in the UK. Using data from the Covid-19 supplement of Understanding Society, we find evidence that labour market outcomes of men and women were roughly equally affected at the extensive margin, as measured by the incidence of job loss or furloughing, but if anything women suffered smaller losses at the intensive margin, experiencing slightly smaller changes in hours and earnings. Within the household, women provided on average a larger share of increased childcare needs, but in an important share of households fathers became the primary childcare providers. These distributional consequences of the pandemic may be important to understand its inequality legacy over the longer term.

Pandemic-related PTSD symptoms and substance use among community-based adults (preprint)

Objectives: To examine: (1) the role of gender and socioeconomic status in pandemic-related post-traumatic stress disorder (PTSD) symptoms and substance use; (2) associations between probable PTSD and substance use, and (3) the supports needed to address these problems.  Methods: Data were collected in June 2020 from 933 community-based adults in Alberta without a previous diagnosis of PTSD. The Primary Care PTSD Screen was adapted to assess pandemic-related PTSD symptoms. Participants were asked if alcohol or cannabis use had increased in the past month. Adjusted logistic regression models examined associations between probable PTSD and substance use. Results: Significantly more women (19%) than men (13%) met criteria for probable pandemic–related PTSD, while a similar percentage (13.5% of women, 13.0% of men) reported increased substance use during the pandemic. Adults with lower income, education, or pandemic-related job loss were more vulnerable to PTSD and substance use increases. Probable pandemic-related PTSD was associated with increased substance use for both women (OR = 2.2) and men (OR = 2.3) in adjusted models. Many adults (50% of women, 40% of men) indicated they needed support to address mental health or substance use during the pandemic, particularly from friends, a physician, and/or a counsellor.  Conclusions: This study examined adults who had just experienced two months of increasing COVID-19 cases and containment measures. Findings suggest women and socioeconomically vulnerable adults may be in greater need of mental health supports, and that pandemic-related PTSD is an important consideration for interventions to reduce substance use among both women and men.

Modeling COVID-19 with Human Pluripotent Stem Cell-Derived Cells Reveals Synergistic Effects of Anti-inflammatory Macrophages with ACE2 Inhibition Against SARS-CoV-2 (preprint)

Dysfunctional immune responses contribute critically to the progression of Coronavirus Disease-2019 (COVID-19) from mild to severe stages including fatality, with pro-inflammatory macrophages as one of the main mediators of lung hyper-inflammation. Therefore, there is an urgent need to better understand the interactions among SARS-CoV-2 permissive cells, macrophage, and the SARS-CoV-2 virus, thereby offering important insights into new therapeutic strategies.  Here, we used directed differentiation of human pluripotent stem cells (hPSCs) to establish a lung and macrophage co-culture system and model the host-pathogen interaction and immune response caused by SARS-CoV-2 infection. Among the hPSC-derived lung cells, alveolar type II and ciliated cells are the major cell populations expressing the viral receptor ACE2 and co-effector TMPRSS2, and both were highly permissive to viral infection. We found that alternatively polarized macrophages (M2) and classically polarized macrophages (M1) had similar inhibitory effects on SARS-CoV-2 infection. However, only M1 macrophages significantly up-regulated inflammatory factors including IL-6 and IL-18, inhibiting growth and enhancing apoptosis of lung cells. Inhibiting viral entry into target cells using an ACE2 blocking antibody enhanced the activity of M2 macrophages, resulting in nearly complete clearance of virus and protection of lung cells. These results suggest a potential therapeutic strategy, in that by blocking viral entrance to target cells while boosting anti-inflammatory action of macrophages at an early stage of infection, M2 macrophages can eliminate SARS-CoV-2, while sparing lung cells and suppressing the dysfunctional hyper-inflammatory response mediated by M1 macrophages.    

Immediate Effects of COVID-19 Outbreak on Psychiatric Outpatients: Posttraumatic Stress and Influencing Factors (preprint)

We aimed to investigate the effects of COVID-19 outbreak and public health measures on the psychological well-being of patients with psychiatric disorders. This cross-sectional study assessed 436 outpatients recruited from a tertiary psychiatry clinic in Istanbul, Turkey, nearly one month after the government introduced strict measures of lockdown against the ongoing outbreak. Respondents completed a web-based survey on sociodemographic data, subjective sleep quality, and a range of psychiatric symptoms using the Impact of Events Scale-Revised (IES-R), and Hospital Anxiety and Depression Scale (HADS). Respondents reported high frequencies of clinically significant posttraumatic stress disorder (PTSD) (32.6%, IES-R score equal to or above 33), anxiety (36.4%, HADS anxiety score > 10), and depression (51%, HADS depression score > 10). 20.5% of respondents described that their psychological status worsened during the COVID-19 outbreak, and 12.1% of respondents described poor or very poor sleep in the prior month. Positive predictors of increased PTSD symptoms included the chronic medical diseases, knowing someone in the social vicinity diagnosed with the COVID-19 infection, job loss or being on temporary leave after the outbreak, and increased exposure time to TV or social media. In contrast, male gender, older age, higher educational attainment, and the psychiatric diagnoses of schizophrenia and (to a lesser degree) bipolar disorder were the negative predictors. Our results suggest that patients with psychiatric disorders are prone to substantial psychological distress during the COVID-19 outbreak, and various individual, behavioral, and social factors mediate this effect.