Exploring the Impact of Bereavement During the COVID-19 Pandemic on Children and Young People: A Scoping Review.

Experiencing bereavement as a child or young person (CYP) can have long-lasting effects. The societal and environmental burdens of the SARS-CoV-2 pandemic exacerbated the experience of loss and grief for many CYP, who were unable to access their usual the support networks. However, it is still unclear what is currently known and not known about the experiences of CYP bereaved during the SARS-CoV-2 pandemic. This review used the framework of Arksey and O'Malley and included five stages: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarizing, and reporting the results. The methodological quality of the included studies was also assessed using the Critical Appraisal Skills Programme tool. The PRISMA framework was used for reporting the results. The electronic databases Medline, PsychINFO, CINAHL, and PubMed were searched for relevant articles. A total of three papers meeting the inclusion criteria were included in this review and two main themes identified: (1) support (which included sub-themes; social isolation and the impact on support; support from family and friends; wider support networks); (2) Emotional impact of bereavement during a pandemic. Access to support networks is crucial for CYP to understand and process their emotions relating to their bereavement experience. The pandemic meant that many usual support networks such as family and friends were inaccessible to CYP, who struggled to deal with their experience of grief during this time. Schools are a valuable support mechanism and can help CYP understand their emotions through open discussions about their bereavement. The limited empirical evidence currently available in this area of research demonstrates an important need to further understanding of the long-term impacts of dealing with pandemic-related loss in childhood.

La pandemia de COVID-19 y el cumplimiento de las guías alimentarias en una comunidad universitaria de Chile / COVID-19 pandemic and adherence to food- based dietary guidelines in a Chilean university community

Introducción. La pandemia de SARS-CoV-2/COVID-19 y las restricciones sanitarias afectaron la disponibilidad, acceso y consumo de alimentos, impactando la alimentación y el estado nutricional. Objetivo. Determinar el efecto de la pandemia SARS-CoV-2/COVID-19 sobre el cumplimiento de las Guías Alimentarias Basadas en Alimentos de Chile, en una comunidad universitaria, antes y durante la pandemia. Materiales y métodos. Estudio de cohorte retrospectiva con 427 participantes. Se aplicó una encuesta online con preguntas basadas en los mensajes de las GABA. La encuesta se validó por juicio de expertos y análisis psicométrico, evaluando la concordancia con el estadístico de Kappa (K=89,95) y la confiabilidad con el coeficiente Alfa de Cronbach (=0,97). Se fijó como período antes de la pandemia al tiempo anterior a marzo del año 2020, y durante la pandemia, entre marzo del 2020 y octubre del 2021. Para medir los cambios antes y durante la pandemia se aplicó el test de simetría considerando un p <0,05 con un intervalo de confianza del 95%, mediante el software estadístico STATA versión 16. Resultados. Se observaron cambios estadísticamente significativos antes y durante la pandemia en los mensajes relacionados con el estado nutricional (p=0,000), consumo semanal de: productos de pastelería (p=0,0040), cecinas y embutidos (p=0,0034), frituras (p=0,0070), legumbres (p=0,0000), aguas (p=0,0000) y lectura e información nutricional de los productos (p=0,0000). Conclusiones. La pandemia de SARS-CoV-2/COVID-19 generó cambios en la alimentación y estado nutricional respecto a los mensajes de las guías. Se precisan políticas alimentarias y estrategias educativas en alimentación y en nutrición para emergencias sanitarias(AU)

Introduction. The SARS-CoV-2/COVID-19 pandemic, as well as health restrictions, impacted food availability, access and consumption, affecting dietary habits and nutritional status. Objective. To determine the effect of the SARS-CoV-2/ COVID-19 pandemic on the adherence to Chilean Food-Based Dietary Guidelines, within a university community, both before and during the pandemic. Materials and methods. A retrospective cohort study involving 427 participants was conducted. An online survey was administered, with questions based on the FBDGs' messages. The survey was validated through expert judgment and psychometric analysis, and agreement was assessed using the Kappa statistic (K = 89.95) while reliability was determined using the Cronbach's Alpha coefficient ( = 0.97). The period before the pandemic was defined as the time prior to March 2020, and the pandemic period was set between March 2020 and October 2021. Changes before and during the pandemic were measured using the symmetry test, considering a p value of <0.05 and a 95% confidence level, using the STATA 16 statistical software. Results. Statistically significant changes were observed before and during the pandemic in messages related to nutritional status (p = 0.000), weekly consumption of bakery products (p = 0.0040), cold meats (p = 0.0034), fried foods (p = 0.0070), legumes (p = 0.0000), water (p = 0.0000), and messages related to reading and nutrition information of products (p = 0.0000). Conclusions. The pandemic led to dietary changes in relation to FBDGs messages. Food policies and food and nutrition education strategies are required to address health emergency contexts(AU)

Repercussions of the COVID-19 pandemic on Latin American anesthesiologists. Observational study / Repercusiones de la pandemia por COVID-19 en anestesiólogos latinoamericanos. Estudio observacional

Abstract Introduction: The SARS-CoV-2, COVID-19 pandemic changed the world, causing a global impact on economic, social and public health aspects. This public health situation alerted the international community of anesthesiologists because of the high occupational hazards due to the frequent exposure to patients with COVID-19. Objective: To identify the impact of this pandemic on Latin American anesthesiologists - in a setting with shortage of vaccines - identifying the professionals infected with SARS-CoV-2 and demises, and their geographical distribution. Methods: An observational study was conducted in Latin American anesthesiologists infected SARS-CoV-2 between March and December 2020. The data was collected from the societies, associations and federations members of the Latin American Confederation of Anesthesia Societies in March 2021. Results: 2,170 anesthesiologists infected with SARS-CoV-2 were identified. Of these, 1,550 were from South America and 620 cases were from Central America, Mexico and the Caribbean. Among the 2,170 anesthesiologists infected with SARS-CoV-2, 165 deaths were reported in Latin America, with a mean age of 58 years; 79% were males and the mortality rate was 7.6%. Conclusions: COVID-19 is an emerging disease with significant impact on the population of anesthesiologists. The reports from the societies, associations and federations members of the Latin American Confederation of Anesthesia Societies show the impact in terms of infection and number of deaths associated with the pandemic.

Resumen Introducción: La pandemia por el SARS-CoV-2, COVID-19, cambió el mundo generando un impacto global en aspectos económicos, sociales y sanitarios. Esta situación sanitaria generó alerta en la comunidad anestesiológica internacional por el alto riesgo ocupacional, debido a la exposición más frecuente a pacientes afectados por COVID-19. Objetivo: Conocer las repercusiones de esta pandemia en los anestesiólogos en Latinoamérica -en un escenario con escasez de vacunas- identificando los profesionales infectados por SARS-CoV-2 y fallecidos y su distribución geográfica. Métodos: Se realizó un estudio observacional en anestesiólogos latinoamericanos infectados por SARS-CoV-2 entre marzo y diciembre de 2020. Los datos se obtuvieron en las sociedades, asociaciones y federaciones vinculadas a la Confederación Latinoamericana de Sociedades de Anestesia en marzo de 2021. Resultados: Se identificaron 2.170 anestesiólogos infectados por SARS-CoV-2. De estos, 1.550 correspondieron a Suramérica y 620 casos a Centroamérica, México y el Caribe. Entre los 2.170 anestesiólogos infectados por SARS-CoV-2, se informaron 165 muertes en Latinoamérica, con una edad media de 58 años, 79 % de género masculino y con una tasa de letalidad de 7,6 %. Conclusiones: El COVID-19 es una patología emergente, que causa una gran afectación a la población de médicos anestesiólogos. Los reportes de las sociedades, asociaciones y federaciones vinculadas a la Confederación Latinoamericana de Sociedades de Anestesia demuestran el impacto en términos de infección y muertes relacionadas con la pandemia.

[Innovative SARS-CoV-2 crisis management in the public health sector: Corona dashboard and wastewater surveillance using the example of Berchtesgadener Land, Germany]. / Innovatives SARS-CoV-2-Krisenmanagement im öffentlichen Gesundheitswesen: Corona-Dashboard und Abwasserfrühwarnsystem am Beispiel Berchtesgadener Land.

BACKGROUND: The rise of an infectious disease crisis such as the SARS-CoV­2 pandemic posed significant challenges for the administrative structures of the public health service, which resulted in varying levels of efficiency in outbreak management as a function of staffing and digital resources. This substantially impeded the integration of innovative pandemic outbreak management tools. Innovative crisis management, such as cluster tracking, risk group testing, georeferencing, or the integration of wastewater surveillance recommended by the EU Commission, was made significantly more difficult. AIM: In this case study in Berchtesgadener Land, we present the integration of an area-wide georeferenced wastewater surveillance system that captured 95% of the entire population since November 2020. METHODOLOGY: Sampling occurred twice a week at nine municipal wastewater treatment plants and directly from the main sewer at three locations. Samples were pre-treated by centrifugation and subsequently analyzed by digital droplet polymerase chain reaction (PCR) targeting four specific genes of SARS-CoV­2. RESULTS: The integration of an area-wide georeferenced wastewater surveillance system was successful. Wastewater occurrences are plotted for each municipality against cumulative infections over seven days per 100,000 inhabitants. Changes in the infection pattern in individual communities are noticeable ten days ahead of the official case numbers with a sensitivity of approximately 20 in 100,000 inhabitants. DISCUSSION: The integration of this innovative approach to provide a comprehensive overview of the situation by employing a digital dashboard and the use of an early warning system via quantitative wastewater surveillance resulted in very efficient, proactive management, which might serve as a blueprint for other municipalities in Germany.

The SARS-COV2 (COVID-19) Pandemic: What Clinicians should Know

In late 2019, a novel coronavirus, now designated SARS-CoV-2, emerged and was identified as the cause of an outbreak of acute respiratory illness in Wuhan, a city in China, named as COVID-19. Since then the waves of the virus exponentially hit many countries around the globe with high rates of spread associated with variable degrees of morbidity and mortality. The WHO announced the pandemic state of the infection in March 2020 and by June 1st 2020 more than 6 million individuals and more than 370 thousands case fatalities were documented worldwide. In this article, we discussed many aspects regarding this emerged infection based on the available evidence aiming to help clinician to improve not only their knowledge but also their practices toward this infection.

The SARS-COV2 (COVID-19) Pandemic: What Clinicians should Know

In late 2019, a novel coronavirus, now designated SARS-CoV-2, emerged and was identified as the cause of an outbreak of acute respiratory illness in Wuhan, a city in China, named as COVID-19. Since then the waves of the virus exponentially hit many countries around the globe with high rates of spread associated with variable degrees of morbidity and mortality. The WHO announced the pandemic state of the infection in March 2020 and by June 1st 2020 more than 6 million individuals and more than 370 thousands case fatalities were documented worldwide. In this article, we discussed many aspects regarding this emerged infection based on the available evidence aiming to help clinician to improve not only their knowledge but also their practices toward this infection.

Impact of the SARS-CoV-2 (COVID19) pandemic on the morbidity and mortality of high risk patients undergoing surgery: a non-inferiority retrospective observational study.

BACKGROUND: During the COVID-19 crisis it was necessary to generate a specific care network and reconvert operating rooms to attend emergency and high-acuity patients undergoing complex surgery. The aim of this study is to classify postoperative complications and mortality and to assess the impact that the COVID-19 pandemic may have had on the results. METHODS: this is a non-inferiority retrospective observational study. Two different groups of surgical patients were created: Pre-pandemic COVID and Pandemic COVID. Severity of illness was rated according to the Diagnosis-related Groups (DRG) score. Comparisons were made between groups and between DRG severity score-matched samples. Non-inferiority was set at up to 10 % difference for grade III to V complications according to the Clavien-Dindo classification, and up to 2 % difference in mortality. RESULTS: A total of 1649 patients in the PreCOVID group and 763 patients in the COVID group were analysed; 371 patients were matched for DRG severity score 3-4 (236 preCOVID and 135 COVID). No differences were found in relation to re-operation (22.5 % vs. 21.5 %) or late admission to critical care unit (5.1 % vs. 4.5 %). Clavien grade III to V complications occurred in 107 patients (45.3 %) in the PreCOVID group and in 56 patients (41.5 %) in the COVID group, and mortality was 12.7 % and 12.6 %, respectively. During the pandemic, 3 % of patients tested positive for Covid-19 on PCR: 12 patients undergoing elective surgery and 11 emergency surgery; there were 5 deaths, 3 of which were due to respiratory failure following Covid-19-induced pneumonia. CONCLUSIONS: Although this study has some limitations, it has shown the non-inferiority of surgical outcomes during the COVID pandemic, and indicates that resuming elective surgery is safe. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT04780594 .

SARS-CoV-2 Disease through Viral Genomic and Receptor Implications: An Overview of Diagnostic and Immunology Breakthroughs.

The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which is believed to have originated in China towards the end of November 2019, has now spread across the globe, causing a pandemic in 192 countries. The World Health Organization has called it the SARS-CoV-2 pandemic. Rapid dissemination of the virus occurs mainly through the saliva (Flügge's droplets) and aerosol, together with nasal and lachrymal passages. The literature associated with the recent advancement in terms of rapid diagnostics and SARS-CoV-2 vaccines has thoroughly studied the role of ACE2 receptors and Furin, as well as viral agent access into the host cell and its significant persistence at the level of the oral mucosa, which represents the main access to the virus. The purpose of this review was to underline the processes of SARS-CoV-2 infection mechanisms and novel breakthroughs in diagnostics and vaccines. Different technologies, such as the RT-PCR molecular test and the antigenic test, have been developed to identify subjects affected by the SARS-CoV-2 in order to improve the tracking of infection geographical diffusion. Novel rapid and highly sensitive diagnostic tests has been proposed for the detection of SARS-CoV-2 to improve the screening capability of suspected contagions. The strengthening of the vaccination campaign represents the most effective means to combat the SARS-CoV-2 infection and prevent severe manifestations of the virus-different classes of vaccines have been developed for this purpose. Further attention on the novel SARS-CoV-2 variant is necessary in order to verify the protection efficacy and virulence reduction of the infective agent in the recent vaccine campaign.

Analysis of Covid-19 Data for Eight European Countries and the United Kingdom Using a Simplified SIR Model.

Background: As the SARS-Cov-2/Covid-19 pandemic continues to ravage the world, it is important to understanding the characteristics of its spread and possible correlates for control to develop strategies of response. Methods: Here we show how a simple Susceptible-Infective-Recovered (SIR) model applied to data for eight European countries and the United Kingdom (UK) can be used to forecast the descending limb (post-peak) of confirmed cases and deaths as a function of time, and predict the duration of the pandemic once it has peaked, by estimating and fixing parameters using only characteristics of the ascending limb and the magnitude of the first peak. Results: The predicted and actual case fatality ratio, or number of deaths per million population from the start of the pandemic to when daily deaths number less than five for the first time, was lowest in Norway (predicted: 44 ± 5 deaths/million; actual: 36 deaths/million) and highest for the United Kingdom (predicted: 578 +/- 65 deaths/million; actual 621 deaths/million). The inferred pandemic characteristics separated into two distinct groups: those that are largely invariant across countries, and those that are highly variable. Among the former is the infective period, TL = 16.3 ± 2.7 days, the average time between contacts, TR = 3.8+/- 0.5 days and the average number of contacts while infective R = 4.4 +/- 0.5. In contrast, there is a highly variable time lag TD between the peak in the daily number of confirmed cases and the peak in the daily number of deaths, ranging from lows of TD = 2,4 days for Denmark and Italy respectively, to highs of TD = 12, 15 for Germany and Norway respectively. The mortality fraction, or ratio of deaths to confirmed cases, was also highly variable, ranging from low values 3%, 5% and 5% for Norway, Denmark and Germany respectively, to high values of 18%, 20% and 21% for Sweden, France, and the UK respectively. The probability of mortality rather than recovery was a significant correlate of the duration of the pandemic, defined as the time from 12/31/2019 to when the number of daily deaths fell below 5. Finally, we observed a small but detectable effect of average temperature on the probability α of infection per contact, with higher temperatures associated with lower infectivity. Conclusions: Our simple model captures the dynamics of the initial stages of the pandemic, from its exponential beginning to the first peak and beyond, with remarkable precision. As with all epidemiological analyses, unanticipated behavioral changes will result in deviations between projection and observation. This is abundantly clear for the current pandemic. Nonetheless, accurate short-term projections are possible, and the methodology we present is a useful addition to the epidemiologist's armamentarium. Our predictions assume that control measures such as lockdown, social distancing, use of masks etc. remain the same post-peak as before peak. Consequently, deviations from our predictions are a measure of the extent to which loosening of control measures have impacted case-loads and deaths since the first peak and initial decline in daily cases and deaths. Our findings suggest that the two key parameters to control and reduce the impact of a developing pandemic are the infective period and the mortality fraction, which are achievable by early case identification, contact tracing and quarantine (which would reduce the former) and improving quality of care for identified cases (which would reduce the latter).

Don't forget ototoxicity during the SARS-CoV-2 (Covid-19) pandemic!

Aim of this communication is to remind clinical professionals to be aware of ototoxic side effects of several specific drugs proposed for the treatment of the new virus SARS-CoV-2 (Covid-19). In particular, chloroquine and hydroxychloroquine, azithromycin, as well as antiviral drugs such as remdesivir, favipiravir and lopinavir can all present potential ototoxic side effects. The data in the literature do not offer specific information on their potential synergetic effects nor on their interactions.

Novel coronavirus disease pandemic and ophthalmologist's perspectives.

Ophthalmologists are among those healers facing a higher risk of acquiring novel coronavirus disease 2019, called COVID-19, during their professional duties since they have close physical contact with their patients. Some patients with COVID-19 may present with or may develop conjunctivitis during the course of the illness. The ocular secretions and tears have been identified to have positive results to COVID-19 tests and as such could be a source of spread. This review aims at providing the useful guidelines to ophthalmic professionals for their own safety, and safety of their patients based on the available current literature, and also based on personal experience and observations. Literature search was made on PubMed for COVID-19 in relation to ophthalmology in the limited period of the last quarter of 2019 and first quarter of 2020. Research also included access to current guidelines published by various ophthalmic societies. Accordingly, present and future ophthalmic practice patterns need to be modified.

Analysis of Covid-19 Data for Eight European Countries and the United Kingdom Using a Simplified SIR Model.

Understanding the characteristics of the SARS-Cov-2/Covid-19 pandemic is central to developing control strategies. Here we show how a simple Susceptible-Infective-Recovered (SIR) model applied to data for eight European countries and the United Kingdom (UK) can be used to forecast the descending limb (post-peak) of confirmed cases and deaths as a function of time, and predict the duration of the pandemic once it has peaked, by estimating and fixing parameters using only characteristics of the ascending limb and the magnitude of the first peak. As with all epidemiological analyses, unanticipated behavioral changes will result in deviations between projection and observation. This is abundantly clear for the current pandemic. Nonetheless, accurate short-term projections are possible, and the methodology we present is a useful addition to the epidemiologist's armamentarium. Since our predictions assume that control measures such as lockdown, social distancing, use of masks etc. remain the same post-peak as before peak, deviations from our predictions are a measure of the extent to which loosening of control measures have impacted case-loads and deaths since the first peak and initial decline in daily cases and deaths. The predicted and actual case fatality ratio, or number of deaths per million population from the start of the pandemic to when daily deaths number less than five for the first time, was lowest in Norway (pred: 44 ± 5 deaths/million; actual: 36 deaths/million) and highest for the United Kingdom (pred: 578 +/- 65 deaths/million; actual 621 deaths/million). The inferred pandemic characteristics separated into two distinct groups: those that are largely invariant across countries, and those that are highly variable. Among the former is the infective period, T L ( T L ¯ = 16.3 ± 2.7  days ) ; the average time between contacts, T R ( T R ¯ = 3.8 ± 0.5 ) days and the average number of contacts while infective, R ( R ¯ = 4.4 ± 0.5 ) . In contrast, there is a highly variable time lag T D between the peak in the daily number of confirmed cases and the peak in the daily number of deaths, ranging from a low of T D = 2,4 days for Denmark and Italy respectively, to highs of T D = 12, 15 for Germany and Norway respectively. The mortality fraction, or ratio of deaths to confirmed cases, was also highly variable, ranging from low values 3%, 5% and 5% for Norway, Denmark and Germany respectively, to high values of 18%, 20% and 21% for Sweden, France, and the UK respectively. The probability of mortality rather than recovery was a significant correlate of the duration of the pandemic, defined as the time from 12/31/2019 to when the number of daily deaths fell below 5. Finally, we observed a small but detectable effect of average temperature on the probability α of infection per contact, with higher temperatures associated with lower infectivity. Policy implications of our findings are also briefly discussed.