Quality of life in Brazilian medical students: a systematic review and meta-analysis

Abstract Objectives Medical training negatively impacts the quality of life of students. Assessing the well-being of medical students could guide academic policies and future research for improving the mental and physical health status of the population at risk. This study aimed to identify the influence of medical training on the quality of life of Brazilian medical students. Methods A systematic review and meta-analysis was conducted according to the Cochrane criteria and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol (PRISMA). The search was performed by two independent investigators using a predefined protocol registered on the PROSPERO database (CRD42021237926). Data were extracted from PubMed, Embase, and Biblioteca Virtual de Saúde (BVS). For quantitative synthesis, a meta-analysis was conducted to assess the mean difference in the quality of life between medical students at different stages in the academic cycle, stratified by sex. All data were analyzed using the random-effects model, with a confidence interval of 95% (95%CI). Results After evaluating the eligibility criteria, five studies were included in the meta-analysis. The data revealed that students in the pre-clinical cycle of the course exhibited higher quality of life scores in the physical (3.05 [1.48-4.62], p < 0.0001) and psychological (3.05 [0.80-5.30], p < 0.0001) domains than students in the clerkship cycle. No statistically significant differences were observed in the environmental (0.78 [-2.92-4.49], p = 0.68) or social domains (1.41 [-0.52-3.34], p = 0.15). Conclusion Our analysis revealed that the medical course is associated with decreased quality of life of medical students in the physical and psychological domains. This finding was observed in both men and women. However, these findings should be interpreted with caution given the study limitations. Registration number PROSPERO, CRD42021237926.

Age, gender, and 11 comorbidities as risk factors associated with COVID-19 mortality: A retrospective cohort including 1.8 million individuals.

The aim of this study was to investigate the risk factors age, gender, and 11 comorbidities for mortality attributed to COVID-19 among Brazilians. An observational, retrospective cohort study with 1,804,151 individuals was performed using the São Paulo State Statistics Portal database for COVID-19 monitoring. Multivariate binary logistic regression was conducted to estimate the influence of odds ratio (OR) for asthma, diabetes, obesity, Down's syndrome, puerperal, hematological, hepatic, neurological, pulmonary, immunological, kidney, and other diseases contributing to mortality attributed to COVID-19. An additional analysis was undertaken using age-stratified data including children, adults, and seniors. Our findings demonstrated that cardiac diseases (9.37%) and diabetes (6.26%) were the most prevalent disorders in therapeutically managed and deceased patients. Multivariate regression model found that male individuals (OR = 1.819, CI 1.783 to 1.856, p < 0.001), older age (OR per year = 1.081, CI 1.081 to 1.082, p < 0.001) and presenting comorbidities (OR varying from 1.84-5.47) were at a higher risk of death. The age-stratified analysis also indicates disparities in the impact of the comorbidities between children, adults, and seniors. Our comprehensive findings indicate the primary risk factors for mortality attributed to COVID-19 in the entire population examined, provide a broader perspective than investigations focused solely on hospitalized patients. This study may be utilized as a valuable tool for decision-making during the COVID-19 outbreak.

Quality of life in Brazilian medical students: A systematic review and meta-analysis.

INTRODUCTION: Medical training negatively impacts the quality of life of students. Assessing the well-being of medical students might guide academic policies and future research for improving mental and physical health status of the population at risk. OBJECTIVES: This study aimed to identify the influence of medical training on the quality of life of Brazilian medical students. METHOD: A systematic review and meta-analysis was conducted according to the Cochrane criteria and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. The search was performed by two independent investigators using a predefined protocol registered in PROSPERO (CRD42021237926). Data were extracted from PubMed, EMBASE, and Biblioteca Virtual de Saúde. For quantitative synthesis, a meta-analysis was conducted to assess the mean difference in the quality of life between medical students of different academic cycles stratified by sex. All data were analyzed using the random-effects model, with a confidence interval of 95%. RESULTS: After evaluating the eligibility criteria, five studies were included in the meta-analysis. The data revealed that students in the pre-clinical cyclee of the course exhibited higher quality of life scores in the physical (3.05 [1.48, 4.62], p< 0.0001) and psychological (3.05 [0.80, 5.30], p< 0.0001) domains than students in the clerkship cycle. No statistically significant difference was observed in the environmental (0.78 [-2.92, 4.49], p= 0.68]) and social domains (1.41 [-0.52, 3.34], p= 0.15). CONCLUSION: Our analysis revealed that the medical course is associated with a decreased quality of life in the physical and psychological domains of medical students. This finding was observed in both men and women. However, these findings should be interpreted with caution given the limitations of this study.