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East Asian Archives of Psychiatry :... Mar 2024COVID-19 infection is associated with significant depressive and anxiety symptoms and stress. We examined the prevalences of depressive and anxiety symptoms and...
BACKGROUND
COVID-19 infection is associated with significant depressive and anxiety symptoms and stress. We examined the prevalences of depressive and anxiety symptoms and perceived stress among patients with COVID-19.
METHODS
Clinically stable patients with COVID-19 aged 18 to 60 years who were admitted between April 2021 and September 2021 to the MES Medical College in Kerala, India were prospectively recruited. They were assessed using the Montgomery-Asberg Depression Rating Scale, the Hamilton Anxiety Scale, and the Perceived Stress Scale.
RESULTS
Of 112 patients screened, 103 were included in the analysis. Depression scores were higher in patients of lower socio-economic status (p = 0.04), of unemployed (p = 0.01), and with longer hospital stays (p < 0.001). Anxiety scores were higher in patients aged 31 to 40 years (p = 0.04), of lower socio-economic status (p = 0.01), with a history of psychiatric illness (p = 0.006), and with a history of self-harm (p = 0.019). Perceived stress scores were higher in patients of lower socio-economic status (p = 0.02), with a history of psychiatric illness (p = 0.001), and with a history of self-harm (p = 0.022).
CONCLUSION
Socio-economic status, employment status, a history of psychiatric illness, and duration of hospital stay are associated with depression, anxiety, and stress among patients with COVID-19.
Topics: Humans; COVID-19; Adult; Male; Female; Prevalence; India; Middle Aged; Stress, Psychological; Depression; Anxiety; Young Adult; Adolescent; Hospitalization; Psychiatric Status Rating Scales; Prospective Studies; Length of Stay; SARS-CoV-2
PubMed: 38955778
DOI: 10.12809/eaap2346 -
East Asian Archives of Psychiatry :... Mar 2024During the COVID-19 pandemic, social-distancing and confinement measures were implemented. These may affect the mental health of patients with mental disorders such as... (Observational Study)
Observational Study
BACKGROUND
During the COVID-19 pandemic, social-distancing and confinement measures were implemented. These may affect the mental health of patients with mental disorders such as schizophrenia. This study examined the clinical course of patients with schizophrenia at a public hospital in Morocco during the COVID-19 pandemic.
METHODS
This longitudinal observational study was conducted across three periods in 15 months: 1 April 2020 (start of strict home confinement) to 30 June 2020 (T1), 1 July 2020 to 31 January 2021 (corresponding to the Delta wave) [T2], and 1 February 2021 to 30 June 2021 (corresponding to the Omicron wave) [T3]. Patients aged 18 to 65 years with a diagnosis of schizophrenia or schizoaffective disorder (based on DSM 5) made before the pandemic who presented to the Faculty of Medicine and Pharmacy of Rabat were invited to participate. Psychotic symptomatology was evaluated using the Positive and Negative Syndrome Scale (PANSS). Severity and improvement of mental disorder were evaluated using the Clinical Global Impression (CGI)-Severity and -Improvement subscales. Depressive symptoms were assessed using the Calgary Depression Scale (CDS). Adherence to treatments was assessed using the Medication Adherence Rating Scale (MARS). All assessments were made by psychiatrists or residents face-to-face (for T1) or via telephone (for T2 and T3).
RESULTS
Of 146 patients recruited, 83 men and 19 women (mean age, 39 years) completed all three assessments. The CGI-Severity score was higher at T2 than T1 and T3 (3.24 vs 3.04 vs 3.08, p = 0.041), and the MARS score was higher at T1 and T2 than T3 (6.80 vs 6.83 vs 6.35, p = 0.033). Patient age was negatively correlated with CDS scores for depressive symptoms at T1 (Spearman's = -0.239, p = 0.016) and at T2 (Spearman's = -0.231, p = 0.019). The MARS score for adherence was higher in female than male patients at T1 (p = 0.809), T2 (p = 0.353), and T3 (p = 0.004). Daily tobacco consumption was associated with the PANSS total score at T3 (p = 0.005), the CGI-Severity score at T3 (p = 0.021), and the MARS score at T3 (p = 0.002). Patients with a history of attempted suicide had higher CDS scores than those without such a history at T1 (p = 0.015) and T3 (p = 0.018) but not at T2 (p = 0.346).
CONCLUSION
Home confinement during the COVID-19 pandemic had limited negative impact on the mental health of patients with schizophrenia in Morocco.
Topics: Humans; COVID-19; Morocco; Male; Female; Adult; Longitudinal Studies; Middle Aged; Schizophrenia; Young Adult; Adolescent; Psychotic Disorders; Antipsychotic Agents; Aged; Medication Adherence; Psychiatric Status Rating Scales; Depression; SARS-CoV-2
PubMed: 38955777
DOI: 10.12809/eaap2255 -
BMJ Health & Care Informatics Jul 2024The detrimental repercussions of the COVID-19 pandemic on the quality of care and clinical outcomes for patients with acute coronary syndrome (ACS) necessitate a...
BACKGROUND
The detrimental repercussions of the COVID-19 pandemic on the quality of care and clinical outcomes for patients with acute coronary syndrome (ACS) necessitate a rigorous re-evaluation of prognostic prediction models in the context of the pandemic environment. This study aimed to elucidate the adaptability of prediction models for 30-day mortality in patients with ACS during the pandemic periods.
METHODS
A total of 2041 consecutive patients with ACS were included from 32 institutions between December 2020 and April 2023. The dataset comprised patients who were admitted for ACS and underwent coronary angiography for the diagnosis during hospitalisation. The prediction accuracy of the Global Registry of Acute Coronary Events (GRACE) and a machine learning model, KOTOMI, was evaluated for 30-day mortality in patients with ST-elevation acute myocardial infarction (STEMI) and non-ST-elevation acute coronary syndrome (NSTE-ACS).
RESULTS
The area under the receiver operating characteristics curve (AUROC) was 0.85 (95% CI 0.81 to 0.89) in the GRACE and 0.87 (95% CI 0.82 to 0.91) in the KOTOMI for STEMI. The difference of 0.020 (95% CI -0.098-0.13) was not significant. For NSTE-ACS, the respective AUROCs were 0.82 (95% CI 0.73 to 0.91) in the GRACE and 0.83 (95% CI 0.74 to 0.91) in the KOTOMI, also demonstrating insignificant difference of 0.010 (95% CI -0.023 to 0.25). The prediction accuracy of both models had consistency in patients with STEMI and insignificant variation in patients with NSTE-ACS between the pandemic periods.
CONCLUSIONS
The prediction models maintained high accuracy for 30-day mortality of patients with ACS even in the pandemic periods, despite marginal variation observed.
Topics: Humans; Acute Coronary Syndrome; COVID-19; Female; Male; Prognosis; Aged; Middle Aged; Machine Learning; SARS-CoV-2; ST Elevation Myocardial Infarction; Coronary Angiography; ROC Curve; Registries; Pandemics
PubMed: 38955390
DOI: 10.1136/bmjhci-2024-101074 -
BMJ Open Jul 2024This study compared the infant vaccination trends a year before and a year after the onset of the COVID-19 pandemic in selected urban and rural communities in Ibadan,...
OBJECTIVES
This study compared the infant vaccination trends a year before and a year after the onset of the COVID-19 pandemic in selected urban and rural communities in Ibadan, Nigeria.
DESIGN
This was a cross-sectional study in which data were extracted from infant vaccination records.
SETTING
Two rural and three urban vaccination centres in primary health clinics at Ibadan Southeast and Olúyòlé local government areas, respectively.
PARTICIPANTS
Infant vaccination records 1 year before and 1 year after the onset of the COVID-19 pandemic (March 2019-February 2020 and March 2020-February 2021, respectively).
OUTCOME MEASURES
Timeliness of vaccination (vaccination taken within 2 weeks of appointment) and vaccination completion according to the Nigerian routine infant vaccination schedule.
RESULTS
2000 vaccination records were included in the study (1013 (50.6%) for male infants). 840 (42.0%) of the records were from the rural immunisation clinics. There were 1194 (59.7%) and 806 (40.3%) records from before and after the onset of the COVID-19 pandemic, respectively. Before the pandemic, birth dose vaccines were timelier among infants from urban communities, while vaccines given at 6 weeks were timelier in the rural areas. Following the onset of the pandemic, the rural communities had a higher proportion of infants with timelier and complete vaccination except for the birth dose vaccines. Overall, there was higher vaccination completion before the pandemic, and this was higher in the rural compared with the urban communities both before (54.8% vs 11.7%) and after (23.6% vs 1.0%) the onset of the pandemic.
CONCLUSIONS
A decline in infant vaccination uptake, timeliness and completion persisted 1 year after the COVID-19 pandemic onset, and urban communities were more affected. More efforts are required to ensure optimal infant vaccination, especially in urban communities, to forestall outbreaks of vaccine-preventable diseases.
Topics: Humans; Nigeria; Infant; COVID-19; Cross-Sectional Studies; Male; Female; Rural Population; Urban Population; Vaccination; SARS-CoV-2; Immunization Schedule; Infant, Newborn; Pandemics
PubMed: 38955367
DOI: 10.1136/bmjopen-2023-073272 -
PloS One 2024A number of seroprevalence studies in Zambia document the extent of spread of acute SARS-CoV-2 infection, yet knowledge gaps still exist on symptoms and conditions that...
Clinical characteristics and factors associated with long COVID among post-acute COVID-19 clinic patients in Zambia, August 2020 to January 2023: A cross-sectional and longitudinal study design.
INTRODUCTION
A number of seroprevalence studies in Zambia document the extent of spread of acute SARS-CoV-2 infection, yet knowledge gaps still exist on symptoms and conditions that continue or develop after acute COVID-19 (long COVID). This is an important gap given the estimated prevalence of long COVID in other African countries. We assessed factors associated with long COVID at the initial visit to a post-acute COVID-19 (PAC-19) clinic and longitudinally among a cohort of patients with ≥2 review visits.
METHODS
We implemented a cross-sectional and longitudinal analysis of PAC-19 clinic patients from Aug-2020 to Jan-2023. The study outcome was long COVID; defined as the presence of new, relapsing, or persistent COVID-19 symptoms that interfere with the ability to function at home or work. Explanatory variables were demographic and clinical characteristics of patients which included sex, age group, presence of new onset medical conditions, presence of pre-existing comorbidities, vaccination status and acute COVID-19 episode details. We fitted logistic and mixed effects regression models to assess for associated factors and considered statistical significance at p<0.05.
RESULTS
Out of a total 1,359 PAC-19 clinic patients in the cross-sectional analysis, 548 (40.3%) patients with ≥2 PAC-19 clinic visits were in the longitudinal analysis. Patients' median age was 53 (interquartile range [IQR]: 41-63) years, 919 (67.6%) were hospitalized for acute COVID-19, and of whom 686 (74.6%) had severe acute COVID-19. Overall, 377 (27.7%) PAC-19 clinic patients had long COVID. Patients with hospital length of stay ≥15 days (adjusted odds ratio [aOR]: 5.37; 95% confidence interval [95% CI]: 2.99-10.0), severe acute COVID-19 (aOR: 3.22; 95% CI: 1.68-6.73), and comorbidities (aOR:1.50; 95% CI: 1.02-2.21) had significantly higher chance of long COVID. Longitudinally, long COVID prevalence significantly (p<0.001) declined from 75.4% at the initial PAC-19 visit to 26.0% by the final visit. The median follow-up time was 7 (IQR: 4-12) weeks.
CONCLUSION
Factors associated with long COVID in Zambia were consistent both cross-sectionally at the initial visit to PAC-19 clinics and longitudinally across subsequent review visits. This highlights the importance of ongoing monitoring and tailored interventions for patients with comorbidities and severe COVID-19 to mitigate the long-term impacts of COVID-19.
Topics: Humans; Zambia; COVID-19; Male; Female; Cross-Sectional Studies; Longitudinal Studies; Adult; Middle Aged; SARS-CoV-2; Post-Acute COVID-19 Syndrome; Aged; Young Adult; Adolescent; Comorbidity; Risk Factors; Prevalence
PubMed: 38954717
DOI: 10.1371/journal.pone.0306131 -
A mathematical model of COVID-19 with multiple variants of the virus under optimal control in Ghana.PloS One 2024In this paper, we suggest a mathematical model of COVID-19 with multiple variants of the virus under optimal control. Mathematical modeling has been used to gain deeper...
In this paper, we suggest a mathematical model of COVID-19 with multiple variants of the virus under optimal control. Mathematical modeling has been used to gain deeper insights into the transmission of COVID-19, and various prevention and control strategies have been implemented to mitigate its spread. Our model is a SEIR-based model for multi-strains of COVID-19 with 7 compartments. We also consider the circulatory structure to account for the termination of immunity for COVID-19. The model is established in terms of the positivity and boundedness of the solution and the existence of equilibrium points, and the local stability of the solution. As a result of fitting data of COVID-19 in Ghana to the model, the basic reproduction number of the original virus and Delta variant was estimated to be 1.9396, and the basic reproduction number of the Omicron variant was estimated to be 3.4905, which is 1.8 times larger than that. We observe that even small differences in the incubation and recovery periods of two strains with the same initial transmission rate resulted in large differences in the number of infected individuals. In the case of COVID-19, infections caused by the Omicron variant occur 1.5 to 10 times more than those caused by the original virus. In terms of the optimal control strategy, we formulate three control strategies focusing on social distancing, vaccination, and testing-treatment. We have developed an optimal control model for the three strategies outlined above for the multi-strain model using the Pontryagin's Maximum Principle. Through numerical simulations, we analyze three optimal control strategies for each strain and also consider combinations of the two control strategies. As a result of the simulation, all control strategies are effective in reducing disease spread, in particular, vaccination strategies are more effective than the other two control strategies. In addition the combination of the two strategies also reduces the number of infected individuals by 1/10 compared to implementing one strategy, even when mild levels are implemented. Finally, we show that if the testing-treatment strategy is not properly implemented, the number of asymptomatic and unidentified infections may surge. These results could help guide the level of government intervention and prevention strategy formulation.
Topics: COVID-19; Humans; Ghana; SARS-CoV-2; Basic Reproduction Number; Models, Theoretical
PubMed: 38954691
DOI: 10.1371/journal.pone.0303791 -
Journal of Medical Internet Research Jul 2024In the era of the internet, individuals have increasingly accustomed themselves to gathering necessary information and expressing their opinions on public web-based...
BACKGROUND
In the era of the internet, individuals have increasingly accustomed themselves to gathering necessary information and expressing their opinions on public web-based platforms. The health care sector is no exception, as these comments, to a certain extent, influence people's health care decisions. During the onset of the COVID-19 pandemic, how the medical experience of Chinese patients and their evaluations of hospitals have changed remains to be studied. Therefore, we plan to collect patient medical visit data from the internet to reflect the current status of medical relationships under specific circumstances.
OBJECTIVE
This study aims to explore the differences in patient comments across various stages (during, before, and after) of the COVID-19 pandemic, as well as among different types of hospitals (children's hospitals, maternity hospitals, and tumor hospitals). Additionally, by leveraging ChatGPT (OpenAI), the study categorizes the elements of negative hospital evaluations. An analysis is conducted on the acquired data, and potential solutions that could improve patient satisfaction are proposed. This study is intended to assist hospital managers in providing a better experience for patients who are seeking care amid an emergent public health crisis.
METHODS
Selecting the top 50 comprehensive hospitals nationwide and the top specialized hospitals (children's hospitals, tumor hospitals, and maternity hospitals), we collected patient reviews from these hospitals on the Dianping website. Using ChatGPT, we classified the content of negative reviews. Additionally, we conducted statistical analysis using SPSS (IBM Corp) to examine the scoring and composition of negative evaluations.
RESULTS
A total of 30,317 pieces of effective comment information were collected from January 1, 2018, to August 15, 2023, including 7696 pieces of negative comment information. Manual inspection results indicated that ChatGPT had an accuracy rate of 92.05%. The F1-score was 0.914. The analysis of this data revealed a significant correlation between the comments and ratings received by hospitals during the pandemic. Overall, there was a significant increase in average comment scores during the outbreak (P<.001). Furthermore, there were notable differences in the composition of negative comments among different types of hospitals (P<.001). Children's hospitals received sensitive feedback regarding waiting times and treatment effectiveness, while patients at maternity hospitals showed a greater concern for the attitude of health care providers. Patients at tumor hospitals expressed a desire for timely examinations and treatments, especially during the pandemic period.
CONCLUSIONS
The COVID-19 pandemic had some association with patient comment scores. There were variations in the scores and content of comments among different types of specialized hospitals. Using ChatGPT to analyze patient comment content represents an innovative approach for statistically assessing factors contributing to patient dissatisfaction. The findings of this study could provide valuable insights for hospital administrators to foster more harmonious physician-patient relationships and enhance hospital performance during public health emergencies.
Topics: COVID-19; Humans; China; Internet; Pandemics; Hospitals; Patient Satisfaction; SARS-CoV-2; Empirical Research
PubMed: 38954461
DOI: 10.2196/52992 -
JAMA Network Open Jul 2024Older adults who are hospitalized for COVID-19 are at risk of delirium. Little is known about the association of in-hospital delirium with functional and cognitive...
IMPORTANCE
Older adults who are hospitalized for COVID-19 are at risk of delirium. Little is known about the association of in-hospital delirium with functional and cognitive outcomes among older adults who have survived a COVID-19 hospitalization.
OBJECTIVE
To evaluate the association of delirium with functional disability and cognitive impairment over the 6 months after discharge among older adults hospitalized with COVID-19.
DESIGN, SETTING, AND PARTICIPANTS
This prospective cohort study involved patients aged 60 years or older who were hospitalized with COVID-19 between June 18, 2020, and June 30, 2021, at 5 hospitals in a major tertiary care system in the US. Follow-up occurred through January 11, 2022. Data analysis was performed from December 2022 to February 2024.
EXPOSURE
Delirium during the COVID-19 hospitalization was assessed using the Chart-based Delirium Identification Instrument (CHART-DEL) and CHART-DEL-ICU.
MAIN OUTCOMES AND MEASURES
Primary outcomes were disability in 15 functional activities and the presence of cognitive impairment (defined as Montreal Cognitive Assessment score <22) at 1, 3, and 6 months after hospital discharge. The associations of in-hospital delirium with functional disability and cognitive impairment were evaluated using zero-inflated negative binominal and logistic regression models, respectively, with adjustment for age, month of follow-up, and baseline (before COVID-19) measures of the respective outcome.
RESULTS
The cohort included 311 older adults (mean [SD] age, 71.3 [8.5] years; 163 female [52.4%]) who survived COVID-19 hospitalization. In the functional disability sample of 311 participants, 49 participants (15.8%) experienced in-hospital delirium. In the cognition sample of 271 participants, 31 (11.4%) experienced in-hospital delirium. In-hospital delirium was associated with both increased functional disability (rate ratio, 1.32; 95% CI, 1.05-1.66) and increased cognitive impairment (odds ratio, 2.48; 95% CI, 1.38-4.82) over the 6 months after discharge from the COVID-19 hospitalization.
CONCLUSIONS AND RELEVANCE
In this cohort study of 311 hospitalized older adults with COVID-19, in-hospital delirium was associated with increased functional disability and cognitive impairment over the 6 months following discharge. Older survivors of a COVID-19 hospitalization who experience in-hospital delirium should be assessed for disability and cognitive impairment during postdischarge follow-up.
Topics: Humans; COVID-19; Delirium; Female; Male; Aged; Cognitive Dysfunction; Prospective Studies; Hospitalization; SARS-CoV-2; Aged, 80 and over; Middle Aged
PubMed: 38954414
DOI: 10.1001/jamanetworkopen.2024.19640 -
Microbial Biotechnology Jul 2024Porcine epidemic diarrhoea virus (PEDV) infects pigs of all ages by invading small intestine, causing acute diarrhoea, vomiting, and dehydration with high morbidity and...
Porcine epidemic diarrhoea virus (PEDV) infects pigs of all ages by invading small intestine, causing acute diarrhoea, vomiting, and dehydration with high morbidity and mortality among newborn piglets. However, current PEDV vaccines are not effective to protect the pigs from field epidemic strains because of poor mucosal immune response and strain variation. Therefore, it is indispensable to develop a novel oral vaccine based on epidemic strains. Bacillus subtilis spores are attractive delivery vehicles for oral vaccination on account of the safety, high stability, and low cost. In this study, a chimeric gene CotC-Linker-COE (CLE), comprising of the B. subtilis spore coat gene cotC fused to the core neutralizing epitope CO-26 K equivalent (COE) of the epidemic strain PEDV-AJ1102 spike protein gene, was constructed. Then recombinant B. subtilis displaying the CLE on the spore surface was developed by homologous recombination. Mice were immunized by oral route with B. subtilis 168-CLE, B. subtilis 168, or phosphate-buffered saline (PBS) as control. Results showed that the IgG antibodies and cytokine (IL-4, IFN-γ) levels in the B. subtilis 168-CLE group were significantly higher than the control groups. This study demonstrates that B. subtilis 168-CLE can generate specific systemic immune and mucosal immune responses and is a potential vaccine candidate against PEDV infection.
Topics: Porcine epidemic diarrhea virus; Animals; Bacillus subtilis; Spores, Bacterial; Mice; Antibodies, Viral; Swine; Viral Vaccines; Coronavirus Infections; Swine Diseases; Antigens, Viral; Administration, Oral; Cytokines; Immunoglobulin G; Mice, Inbred BALB C; Female; Cell Surface Display Techniques; Spike Glycoprotein, Coronavirus
PubMed: 38953907
DOI: 10.1111/1751-7915.14518 -
Indian Journal of Public Health Apr 2024
Topics: Humans; COVID-19 Vaccines; India; COVID-19; Female; Male; SARS-CoV-2; Adult; Vaccination Hesitancy; Middle Aged; Patient Acceptance of Health Care
PubMed: 38953834
DOI: 10.4103/ijph.ijph_1509_22