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Rittmannsberger H, Barth M, Lamprecht B, Malik P, Yazdi-Zorn K. [Interaction of somatic findings and psychiatric symptoms in COVID-19. A scoping review]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024; 38:1-23. [PMID: 38055146 DOI: 10.1007/s40211-023-00487-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/24/2023] [Indexed: 12/07/2023]
Abstract
An infection with SARS-CoV‑2 can affect the central nervous system, leading to neurological as well as psychiatric symptoms. In this respect, mechanisms of inflammation seem to be of much greater importance than the virus itself. This paper deals with the possible contributions of organic changes to psychiatric symptomatology and deals especially with delirium, cognitive symptoms, depression, anxiety, posttraumatic stress disorder and psychosis. Processes of neuroinflammation with infection of capillary endothelial cells and activation of microglia and astrocytes releasing high amounts of cytokines seem to be of key importance in all kinds of disturbances. They can lead to damage in grey and white matter, impairment of cerebral metabolism and loss of connectivity. Such neuroimmunological processes have been described as a organic basis for many psychiatric disorders, as affective disorders, psychoses and dementia. As the activation of the glia cells can persist for a long time after the offending agent has been cleared, this can contribute to long term sequalae of the infection.
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Affiliation(s)
- Hans Rittmannsberger
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich.
| | - Martin Barth
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich
| | - Bernd Lamprecht
- Med Campus III, Universitätsklinik für Innere Medizin mit Schwerpunkt Pneumologie, Kepler Universitätsklinikum GmbH, Linz, Österreich
- Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Österreich
| | - Peter Malik
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich
| | - Kurosch Yazdi-Zorn
- Neuromed Campus, Klinik für Psychiatrie mit Schwerpunkt Suchtmedizin, Kepler Universitätsklinikum GmbH, Linz, Österreich
- Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Österreich
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2
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Malik S, Opara I, Lardier DT, Younger J, Greene RN. Young Adults at the National Epicenter of the COVID-19 Outbreak: Understanding the Impact and Future Challenges of Social Distancing on Mental Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:33. [PMID: 38248498 PMCID: PMC10815492 DOI: 10.3390/ijerph21010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/30/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVES To understand the role and future implications of social distancing on mental health and substance use in young adults between the ages of 18 and 35 living in high-disease-prevalent areas of New York. METHODS Participants completed a self-administered online survey through Qualtrics. RESULTS 43.9% of the sample met criteria for moderate or severe anxiety, and 53.1% of the sample met criteria for moderate to severe depression. 76.1% of the sample experienced both anxiety and depressive symptoms. Despite this, the rates of lifetime mental health diagnoses, treatment, and access to mental health services were low. Rates of depression and anxiety differed across socio-demographic variables (gender, income, sexuality, education, and insurance status). Experiencing severe symptoms of the COVID-19 virus, poor coping skills, loneliness, increased alcohol use, and sleep disturbances were linked to higher rates of depression, anxiety, or both. CONCLUSION As the first epicenter of COVID-19 in the United States, New York represents an important location for prevention researchers to learn about how COVID-19 affected a diverse population of young adults. It is essential that researchers and practitioners proactively develop early and appropriate interventions to address the ongoing mental health crisis and also plan for future crises.
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Affiliation(s)
- Sana Malik
- School of Social Welfare, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Ijeoma Opara
- Department of Social & Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT 06520, USA;
| | - David T. Lardier
- Department of Psychiatry and Behavioral Sciences, School of Medicine, The University of New Mexico, Albuquerque, NM 87131, USA;
| | - Jessica Younger
- School of Social Welfare, Stony Brook University, Stony Brook, NY 11794, USA;
| | - R. Neil Greene
- Center on Alcohol, Substance Use And Addiction (CASAA), University of New Mexico, Albuquerque, NM 87131, USA;
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Ferretti A, Parisi P, Striano P, Spalice A, Iannetti P. Editorial: Stress neurobiology in COVID-19: diagnosis, neuroimaging and therapeutic tools. Front Neurol 2023; 14:1309043. [PMID: 38020589 PMCID: PMC10643119 DOI: 10.3389/fneur.2023.1309043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Alessandro Ferretti
- Pediatrics Unit, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Pasquale Parisi
- Pediatrics Unit, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Alberto Spalice
- Department of Maternal, Infantile, and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Paola Iannetti
- Department of Maternal, Infantile, and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
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Cecchini E, Schino S, Gambadoro N, Ricciardi L, Trio O, Biondi-Zoccai G, Sangiorgi G. Facing the pandemic with a smile: the case of Memedical and its impact on cardiovascular professionals. Minerva Cardiol Angiol 2023; 71:475-484. [PMID: 36305775 DOI: 10.23736/s2724-5683.22.06079-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Since its outbreak, the Coronavirus disease 2019 (COVID-19) has profoundly changed the world we were acquainted with. After the first known contact with humankind in Wuhan, China, in December 2019, the reckless spread of such pathogen put the healthcare system to the test, leading to harmful consequences affecting human lives in every aspect. As of February 2022, the death toll amounts to almost 6 million deaths, but the pathogenic profile of SARS-CoV-2 goes way beyond the mere biological interaction between the viral particle and our organism. People had to deal with the severe psychological impact caused by the only available weapon to fight this infection, i.e., social distancing. The human psychological profile has been strained with repercussions we still are unaware of nowadays. Healthcare professionals were among the most hit categories, not only because of the quarantine but above all for the situations they had to bear every day, constantly facing desperation, death, isolation, and rage. In such circumstances, social media represented a powerful shelter, giving people the ability to keep in contact and to feel connected even if miles apart. In our country, the power of communication was strongly emphasized by launching an Italian Facebook group called "Memedical," where members can share ironic memes to feel closer and give a glimmer of happiness in such a challenging moment. Our review highlights the severity of this pandemic's impact, deteriorating the global population's physical and mental health, and shows how wise use of social media can benefit the quality of life.
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Affiliation(s)
| | - Sofia Schino
- Division of Cardiology, Tor Vergata University, Rome, Italy
| | - Nicola Gambadoro
- Division of Cardiology, G. Fogliani Hospital, Milazzo, Messina, Italy
| | - Luca Ricciardi
- Division of Neurosurgery, Department of NESMOS, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Olimpia Trio
- Division of Cardiology, University Hospital Gaetano Martino, Messina, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
- Mediterranea Cardiocentro, Naples, Italy
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Berg SK, Palm P, Nielsen SD, Nygaard U, Bundgaard H, Rosenkilde S, Thorsted AB, Ersbøll AK, Thygesen LC, Petersen MNS, Christensen AV. Symptoms in the acute phase of SARS-CoV-2 infection among Danish children aged 0-14 years. IJID REGIONS 2023; 7:262-267. [PMID: 37200560 PMCID: PMC10133019 DOI: 10.1016/j.ijregi.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/20/2023]
Abstract
Objectives To investigate the prevalence and burden of proxy-reported acute symptoms in children in the first 4 weeks after detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, and factors associated with symptom burden. Methods Nationwide cross-sectional survey using parental proxy reporting of symptoms associated with SARS-CoV-2 infection. In July 2021, a survey was sent to the mothers of all Danish children aged 0-14 years with a positive SARS-CoV-2 polymerase chain reaction (PCR) test between January 2020 and July 2021. The survey included 17 symptoms associated with acute SARS-CoV-2 infection and questions about comorbidities. Results Of 38,152 children with a positive SARS-CoV-2 PCR test, 10,994 (28.8%) mothers responded. The median age was 10.2 (range 0.2-16.0) years and 51.8% were male. Among participants, 54.2% (n=5957) reported no symptoms, 43.7% (n=4807) reported mild symptoms, and 2.1% (n=230) reported severe symptoms. The most common symptoms were fever (25.0%), headache (22.5%) and sore throat (18.4%). Asthma {odds ratio (OR) 1.91 [95% confidence interval (CI) 1.57-2.32) and OR 2.11 (95% CI 1.36-3.28)}, allergy [OR 1.31 (95% CI 1.14-1.52) and OR 1.70 (95% CI 1.18-2.46], eczema [OR 1.43 (95% CI 1.20-1.71) and OR 2.03 (95% CI 1.38-2.97)] and OCD/anxiety/depression [OR 2.06 (95% CI 1.39-3.06) and OR 3.79 (95% CI 1.80-7.97)] were associated with reporting a higher symptom burden [values indicate outcomes reporting three or more acute symptoms (upper quartile) and reporting a severe symptom burden, respectively]. The highest prevalence of symptoms was found among children aged 0-2 and 12-14 years. Conclusions Among SARS-CoV-2-positive children aged 0-14 years, approximately half reported no acute symptoms within the first 4 weeks after a positive PCR test. Most symptomatic children reported mild symptoms. Several comorbidities were associated with reporting a higher symptom burden.
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Affiliation(s)
- Selina Kikkenborg Berg
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Palm
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Susanne Dam Nielsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatric and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulrikka Nygaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Siri Rosenkilde
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anne Bonde Thorsted
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lau Casper Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Perilli L, Fetta M, Capponi M, Guido CA, Grosso S, Iannetti P, Spalice A. Peripheral nervous system involvement in SARS-CoV-2 infection: a review of the current pediatric literature. Front Neurol 2023; 14:1134507. [PMID: 37305745 PMCID: PMC10249431 DOI: 10.3389/fneur.2023.1134507] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/19/2023] [Indexed: 06/13/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the pathogen responsible for the pandemic health emergency declared by the World Health Organization in March 2020. During the first part of the pandemic, adults showed mild to severe respiratory symptoms. Children seemed initially exempt, both from acute and subsequent complications. Hyposmia or anosmia were promptly identified as the main symptoms of acute infection, so neurotropism of SARS-CoV-2 was immediately suspected. (1, 2). As the emergency progressed, post infectious neurological complications were described also in pediatric population (3). Cases of cranial neuropathy in connection with acute SARS-CoV-2 infection have been reported in pediatric patients, as an isolate post infectious complication or in the context of the multisystem inflammatory syndrome in children (MIS-C) (4-6). Neuroinflammation is thought to be caused by several mechanisms, among which immune/autoimmune reactions (7), but so far, no specific autoantibody has been identified. SARS-CoV-2 can enter the central nervous system (CNS) directly and/or infect it retrogradely, through the peripheral nervous system (PNS), after replicating peripherally; several factors regulate invasion and subsequent neuroinflammation. Indeed, direct/secondary entry and replication can activate CNS-resident immune cells that, together with peripheral leukocytes, induce an immune response and promote neuroinflammation. In addition, as we will discuss in the following review, many cases of peripheral neuropathy (cranial and non-cranial) have been reported during or after SARS-CoV-2 infection. However, some authors have pointed out that the increase of cranial roots and ganglia in neurological imaging is not always observed in children with cranial neuropathy. (8). Even if a variety of case reports were published, opinions about an increased incidence of such neurologic diseases, linked to SARS-CoV-2 infection, are still controversial (9-11). Facial nerve palsy, ocular movements abnormalities and vestibular alterations are among the most reported issues in pediatric population (3-5). Moreover, an increased screen exposure imposed by social distancing led to acute oculomotion's disturbance in children, not primarily caused by neuritis (12, 13). The aim of this review is to suggest food for thought on the role of SARS-CoV-2 in neurological conditions, affecting the peripheral nervous system to optimize the management and care of pediatric patients.
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Affiliation(s)
- Lorenzo Perilli
- Department of Molecular Medicine and Development, University of Siena, Siena, Italy
| | - Marina Fetta
- Department of Maternal, Infantile, and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Lazio, Italy
| | - Martina Capponi
- Department of Maternal, Infantile, and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Lazio, Italy
| | - Cristiana Alessia Guido
- Department of Maternal, Infantile, and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Lazio, Italy
| | - Salvatore Grosso
- Department of Molecular Medicine and Development, University of Siena, Siena, Italy
| | - Paola Iannetti
- Department of Maternal, Infantile, and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Lazio, Italy
| | - Alberto Spalice
- Department of Maternal, Infantile, and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Lazio, Italy
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7
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Mendoza S. Adapting patient treatment of neurological diseases during the COVID-19 pandemic. AIMS Neurosci 2023; 10:75-86. [PMID: 37426782 PMCID: PMC10323254 DOI: 10.3934/neuroscience.2023006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 07/11/2023] Open
Abstract
Treating neurological patients during the pandemic period has become extremely challenging. At the same time, responding properly to these challenges has been diverse around the world, with varying levels of readiness, discipline, and approach. Additionally, there are significant differences in healthcare resources and processes between nations, and even within a nation, and these have significantly influenced the treatment procedure throughout the pandemic. However, neurologists have been called to care for patients with neurological symptoms who have COVID-19, and to continue managing COVID-19-affected neurological comorbidities in patients as before. This study highlights how the treatment procedures for neurological diseases are rapidly changing due to the spread of the SARS-CoV-2 virus. It also focuses on the challenges healthcare professionals are facing while providing proper treatment to neurological patients during the pandemic situation. Lastly, it offers some useful recommendations regarding the effective management of neurological diseases during the COVID-19 pandemic period.
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8
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Costagliola G, Vallario MP, Santangelo A, Foiadelli T, Ragone MC, Battini R, Tinelli F, Di Cicco ME, Bonuccelli A, Gaeta G, Iozzi C, Peroni DG, Operto FF, Consolini R, Orsini A. Neurovisual Manifestations in Children with Mild COVID-19: An Association to Remember. Neuroophthalmology 2023; 47:75-78. [PMID: 36891409 PMCID: PMC9988337 DOI: 10.1080/01658107.2023.2174560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 01/11/2023] [Accepted: 01/19/2023] [Indexed: 02/18/2023] Open
Abstract
Neurovisual involvement has been reported in a number of patients with severe SARS-CoV-2 disease (COVID-19), mainly among adult patients. In children, such involvement has been reported in rare cases, often in those presenting with severe forms of COVID-19. The aim of this work is to explore the association between mild COVID-19 and neurovisual manifestations. We report the cases of three previously healthy children who developed neurovisual manifestations following mild acute COVID-19, analysing the clinical phenotype, the latency between the onset of acute COVID-19 and neurovisual involvement, and the kinetic of resolution. Our patients developed different clinical patterns, including visual impairment and ophthalmoplegia. In two cases, these clinical features occurred during acute COVID-19, while in the third patient their development was delayed after 10 days from disease onset. Furthermore, the dynamics of resolution were different, with one patient showing remission after 24 hours, the second after 30 days, and the third showing persistence of the strabismus after 2 months of follow-up. The spreading of COVID-19 among the paediatric population will probably lead to an increase of atypical disease forms, including those presenting with neurovisual involvement. Therefore, a better knowledge of the pathogenic and clinical features of these manifestations is warranted.
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Affiliation(s)
- Giorgio Costagliola
- Pediatric Immunology, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Michele Pio Vallario
- Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Andrea Santangelo
- Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Thomas Foiadelli
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Maria Cristina Ragone
- Ophthalmology Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Roberta Battini
- Department of Neuroscience, IRCSS Fondazione StellaMaris, Calambrone, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Tinelli
- Department of Neuroscience, IRCSS Fondazione StellaMaris, Calambrone, Italy
| | - Maria Elisa Di Cicco
- Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Alice Bonuccelli
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Giovanni Gaeta
- Department of Pediatrics, Pediatric Department, Cecina Hospital, Cecina, Italy
| | - Chiara Iozzi
- Department of Pediatrics, Pediatric Department, Cecina Hospital, Cecina, Italy
| | - Diego Giampiero Peroni
- Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Francesca Felicia Operto
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Fisciano, Italy
| | - Rita Consolini
- Pediatric Immunology, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Alessandro Orsini
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
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Evaluating the Practice of Pediatric Nurse Practitioners: Is It Time for Dual Primary and Acute Care Preparation? J Pediatr Health Care 2023; 37:74-84. [PMID: 36117073 DOI: 10.1016/j.pedhc.2022.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 01/31/2023]
Abstract
This survey aimed to evaluate contemporary pediatric nurse practitioner (PNP) practice as it relates to the competencies of both the primary and acute care population focus and settings of practice to guide curriculum revisions. The design of the study was a cross-sectional survey of PNPs certified by the Pediatric Nursing Certification Board. There were 2,265 surveys completed. Regardless of the certification type, PNPs report providing care across settings and integrating the competencies of both the primary and acute care PNP into practice. This warrants further consideration by programs to prepare future PNPs for dual primary and acute care certification.
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Sheikh A, Huang H, Parvin S, Badruzzaman M, Ahamed T, Hossain E, Baran IS, Saud ZA. A multi-population-based genomic analysis uncovers unique haplotype variants and crucial mutant genes in SARS-CoV-2. J Genet Eng Biotechnol 2022; 20:149. [PMID: 36318347 PMCID: PMC9626712 DOI: 10.1186/s43141-022-00431-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 10/12/2022] [Indexed: 11/05/2022]
Abstract
Background COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Rigorous detection and treatment strategies against SARS-CoV-2 have become very challenging due to continuous evolutions to the viral genome. Therefore, careful genomic analysis is sorely needed to understand transmission, the cellular mechanism of pathogenicity, and the development of vaccines or drugs. Objective In this study, we intended to identify SARS-CoV-2 genome variants that may help understand the cellular and molecular foundation of coronavirus infections required to develop effective intervention strategies. Methods SARS-CoV-2 genome sequences were downloaded from an open-source public database, processed, and analyzed for variants in target detection sites and genes. Results We have identified six unique variants, G---AAC, T---AAC---T, AAC---T, AAC--------T, C----------T, and C--------C, at the nucleocapsid region and eleven major hotspot mutant genes: nsp3, surface glycoprotein, nucleocapsid phosphoprotein, ORF8, nsp6, nsp2, nsp4, helicase, membrane glycoprotein, 3′-5′ exonuclease, and 2′-O-ribose methyltransferases. In addition, we have identified eleven major mutant genes that may have a crucial role in SARS-CoV-2 pathogenesis. Conclusion Studying haplotype variants and 11 major mutant genes to understand the mechanism of action of fatal pathogenicity and inter-individual variations in immune responses is inevitable for managing target patient groups with identified variants and developing effective anti-viral drugs and vaccines. Supplementary Information The online version contains supplementary material available at 10.1186/s43141-022-00431-3.
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Affiliation(s)
- Afzal Sheikh
- grid.443108.a0000 0000 8550 5526Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur, Dhaka 1706 Bangladesh
| | - He Huang
- Research and Development Department, Bioengineering Lab. Co., Ltd, 657 Nagatake Midori-ku, Sagamihara-shi, Kanagawa-ken 252-0154 Japan
| | - Sultana Parvin
- grid.263023.60000 0001 0703 3735Department of Biology, Faculty of Science and Engineering, Saitama University, Saitama, Japan
| | - Mohammad Badruzzaman
- grid.443108.a0000 0000 8550 5526Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur, Dhaka 1706 Bangladesh
| | - Tofayel Ahamed
- grid.443108.a0000 0000 8550 5526Department of Agroforestry and Environment, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur, Dhaka 1706 Bangladesh
| | - Ekhtear Hossain
- grid.263880.70000 0004 0386 0655Department of Biological Sciences and Chemistry, Southern University and A&M College, 244 William James Hall, Baton Rouge, LA 70813 USA
| | - Iri Sato Baran
- Genesis Institute of Genetic Research, Genesis Healthcare Corporation, Yebisu Garden Place Tower 15F/26F 4-20-3 Ebisu, Shibuya-ku, Tokyo, Japan
| | - Zahangir Alam Saud
- grid.412656.20000 0004 0451 7306Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, 6205 Bangladesh
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11
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Shaaban SS, Bhullar R, Mohammad I, Hashmi A. A Patient With Schizophrenia in Remission Relapses Following COVID-19: A Case Report. Cureus 2022; 14:e29845. [PMID: 36348867 PMCID: PMC9630057 DOI: 10.7759/cureus.29845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 11/06/2022] Open
Abstract
As managing COVID-19 complications has become more prevalent in psychiatry, its effects can range from provoking new illnesses in previously healthy individuals to inducing relapses in patients in remission. However, an aspect of COVID-19’s influence that is not well documented is its effect on medication responsiveness. In this case, we present a 28-year-old male diagnosed with treatment-resistant schizophrenia for eight years. While in remission on a maintenance dose of clozapine, he was admitted to the hospital with signs of severe psychosis after testing positive for COVID-19. On admission, he did not have any other major stressors and no prior comorbidities that could have induced the relapse. Despite being on a higher dose of clozapine for four weeks while hospitalized, the patient’s psychosis did not improve. This raises the question if his infection had altered his response to medication that previously brought on remission.
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Chavda VP, Patel AB, Pandya A, Vora LK, Patravale V, Tambuwala ZM, Aljabali AAA, Serrano-Aroca Á, Mishra V, Tambuwala MM. Co-infection associated with SARS-CoV-2 and their management. Future Sci OA 2022; 8:FSO819. [PMID: 36788985 PMCID: PMC9912272 DOI: 10.2144/fsoa-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 10/18/2022] [Indexed: 02/05/2023] Open
Abstract
SARS-CoV-2 was discovered in Wuhan, China and quickly spread throughout the world. This deadly virus moved from person to person, resulting in severe pneumonia, fever, chills and hypoxia. Patients are still experiencing problems after recovering from COVID-19. This review covers COVID-19 and associated issues following recovery from COVID-19, as well as multiorgan damage risk factors and treatment techniques. Several unusual illnesses, including mucormycosis, white fungus infection, happy hypoxia and other systemic abnormalities, have been reported in recovered individuals. In children, multisystem inflammatory syndrome with COVID-19 (MIS-C) is identified. The reasons for this might include uncontrollable steroid usage, reduced immunity, uncontrollable diabetes mellitus and inadequate care following COVID-19 recovery.
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Affiliation(s)
- Vivek P Chavda
- Department of Pharmaceutics & Pharmaceutical Technology, L M College of Pharmacy, Ahmedabad, Gujarat, 380009, India
| | - Aayushi B Patel
- Pharmacy Section, LM College of Pharmacy, Ahmedabad, Gujarat, 380058, India
| | - Anjali Pandya
- Department of Pharmaceutical Sciences & Technology, Institute of Chemical Technology, Mumbai, 400 019, India
| | - Lalitkumar K Vora
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, BT9 7BL, UK
| | - Vandana Patravale
- Department of Pharmaceutical Sciences & Technology, Institute of Chemical Technology, Mumbai, 400 019, India
| | - Zara M Tambuwala
- College of Science, University of Lincoln, Brayford Campus, Lincoln, LN6 7TS, UK
| | - Alaa AA Aljabali
- Department of Pharmaceutics & Pharmaceutical Technology, Yarmouk University, Faculty of Pharmacy, Irbid, 566, Jordan
| | - Ángel Serrano-Aroca
- Biomaterials & Bioengineering Lab, Centro de Investigación Traslacional San Alberto Magno, Universidad Católica de Valencia San Vicente Mártir, c/Guillem de Castro 94, Valencia, 46001, Spain
| | - Vijay Mishra
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, India
| | - Murtaza M Tambuwala
- Lincoln Medical School University of Lincoln, Brayford Campus, Lincoln, LN6 7TS, UK
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13
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Olfactory impairment in psychiatric disorders: Does nasal inflammation impact disease psychophysiology? Transl Psychiatry 2022; 12:314. [PMID: 35927242 PMCID: PMC9352903 DOI: 10.1038/s41398-022-02081-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 12/04/2022] Open
Abstract
Olfactory impairments contribute to the psychopathology of mental illnesses such as schizophrenia and depression. Recent neuroscience research has shed light on the previously underappreciated olfactory neural circuits involved in regulation of higher brain functions. Although environmental factors such as air pollutants and respiratory viral infections are known to contribute to the risk for psychiatric disorders, the role of nasal inflammation in neurobehavioral outcomes and disease pathophysiology remains poorly understood. Here, we will first provide an overview of published findings on the impact of nasal inflammation in the olfactory system. We will then summarize clinical studies on olfactory impairments in schizophrenia and depression, followed by preclinical evidence on the neurobehavioral outcomes produced by olfactory dysfunction. Lastly, we will discuss the potential impact of nasal inflammation on brain development and function, as well as how we can address the role of nasal inflammation in the pathophysiological mechanisms underlying psychiatric disorders. Considering the current outbreak of Coronavirus Disease 2019 (COVID-19), which often causes nasal inflammation and serious adverse effects for olfactory function that might result in long-lasting neuropsychiatric sequelae, this line of research is particularly critical to understanding of the potential significance of nasal inflammation in the pathophysiology of psychiatric disorders.
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14
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Kumar A, Chattopadhyay A, Gupta S. Neuropsychiatric manifestation of the drugs used in the treatment of SARS-2-CoV-2019 (COVID-19) infection and their management: An overview and practice implications. Asian J Psychiatr 2022; 73:103101. [PMID: 35461033 PMCID: PMC8986230 DOI: 10.1016/j.ajp.2022.103101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/16/2022] [Accepted: 04/02/2022] [Indexed: 12/15/2022]
Abstract
Treatment guidelines for the COVID-19 treatment are still evolving, moreover, the changing variants of the virus with varying virulence, pose challenges for the healthcare professionals (HCP) not only in managing the primary infection but also a myriad of physical and neuropsychiatric complications. The neuropsychiatric adverse consequences associated with the COVID-19 are attributable to the direct effect of the virus, secondary complications, drug-drug interaction, and neuropsychiatric manifestations of drugs used in its treatment. These neuropsychiatric manifestations not only complicate the ongoing treatment but also adversely affect the prognosis. As the treatment guidelines for the management of the COVID are still evolving, the use of non-evidence-based medications, including their off-label use, are rampant that often extend to their non-judicious or irrational use (more than the recommended dose, multiple medications, etc.). Despite the significance of the topic, literature is sparse. Knowing about the risk factors and the potential neuropsychiatric adverse effects with various anti-COVID-19 medications would help HCPs in effectively preventing, early identifying, and promptly managing these neuropsychiatric symptoms. Therefore, this narrative review is aimed to highlight the neuropsychiatric symptoms associated with medications/interventions used in the management of COVID-19 and how to manage them, especially in view of the world facing the third wave of COVID-19.
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Affiliation(s)
- Akash Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, 462020, India.
| | - Ankita Chattopadhyay
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Snehil Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, 462020, India.
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15
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Loss of Continuity of Care in Pediatric Neurology Services during COVID-19 Lockdown: An Additional Stressor for Parents. CHILDREN 2022; 9:children9060867. [PMID: 35740804 PMCID: PMC9222060 DOI: 10.3390/children9060867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022]
Abstract
Background. This study aimed to investigate the consequence of the COVID 19-related lockdown on the well-being of children with neurological and neurodevelopmental disorders and the repercussion on parental stress during the period 9 March 2020–3 May 2020. Methods. A web-based survey was shared via mail with the parents of children affected by chronic neurologic disorders and neurodevelopmental disorders in the continuity of care in two Italian tertiary centers, independently by the severity of the diseases and the required frequency of controls. For each patient, they were asked to identify a single main caregiver, among the two parents, to fill in the questionnaire. Parental stress was measured via the Perceived Stress Scale (PSS). Statistical analysis was performed with IBM SPSS Statistics version 25. The differences between the clinical groups were performed with one way ANOVA. The dimensional effect of the clinical variables on outcome was evaluated by multiple linear regression analysis. Results. The survey was completed by 250 parents (response rate = 48.9 %). Sars-Cov2 infection was reported in two patients only. A total of 44.2% of the patients had completely interrupted school activities while 70% of parents underwent changes in their job modalities. Health care services were disrupted in 77% of patients. Higher PSS scores were detected in the parents of children with neurodevelopmental disorders (p = 0.035). Conclusions. The loss of continuity of care during the lockdown must be considered as a risk factor for parents caring for children with chronic neurologic diseases and neurodevelopmental disorders in further phases of the current pandemic.
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16
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Abstract
PURPOSE OF REVIEW As of January 8, 2022, a global pandemic caused by infection with severe acute respiratory syndrome coronavirus (SARS-CoV)-2, a new RNA virus, has resulted in 304,896,785 cases in over 222 countries and regions, with over 5,500,683 deaths (www.worldometers.info/coronavirus/). Reports of neurological and psychiatric symptoms in the context of coronavirus infectious disease 2019 (COVID-19) range from headache, anosmia, and dysgeusia, to depression, fatigue, psychosis, seizures, delirium, suicide, meningitis, encephalitis, inflammatory demyelination, infarction, and acute hemorrhagic necrotizing encephalopathy. Moreover, 30-50% of COVID-19 survivors develop long-lasting neurologic symptoms, including a dysexecutive syndrome, with inattention and disorientation, and/or poor movement coordination. Detection of SARS-CoV-2 RNA within the central nervous system (CNS) of patients is rare, and mechanisms of neurological damage and ongoing neurologic diseases in COVID-19 patients are unknown. However, studies demonstrating viral glycoprotein effects on coagulation and cerebral vasculature, and hypoxia- and cytokine-mediated coagulopathy and CNS immunopathology suggest both virus-specific and neuroimmune responses may be involved. This review explores potential mechanistic insights that could contribute to COVID-19-related neurologic disease. RECENT FINDINGS While the development of neurologic diseases during acute COVID-19 is rarely associated with evidence of viral neuroinvasion, new evidence suggests SARS-CoV-2 Spike (S) protein exhibits direct inflammatory and pro-coagulation effects. This, in conjunction with immune dysregulation resulting in cytokine release syndrome (CRS) may result in acute cerebrovascular or neuroinflammatory diseases. Additionally, CRS-mediated loss of blood-brain barrier integrity in specific brain regions may contribute to the expression of proinflammatory mediators by neural cells that may impact brain function long after resolution of acute infection. Importantly, host co-morbid diseases that affect vascular, pulmonary, or CNS function may contribute to the type of neurologic disease triggered by SARS-COV-2 infection. SUMMARY Distinct effects of SARS-CoV-2 S protein and CNS compartment- and region-specific responses to CRS may underlie acute and chronic neuroinflammatory diseases associated with COVID-19.
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Affiliation(s)
- Robyn S Klein
- Center for Neuroimmunology & Neuroinfectious Diseases, Departments of Medicine, Pathology & Immunology, and Neuroscience, Washington University School of Medicine, St. Louis, Missouri, USA
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17
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Latsou D, Bolosi FM, Androutsou L, Geitona M. Professional Quality of Life and Occupational Stress in Healthcare Professionals During the COVID-19 Pandemic in Greece. Health Serv Insights 2022; 15:11786329221096042. [PMID: 35651953 PMCID: PMC9149609 DOI: 10.1177/11786329221096042] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/04/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Health professionals (HPs) coping with the coronavirus pandemic are at risk of working under stressful conditions impacting their professional well-being. The aim of this paper was to explore HP’s professional quality of life and occupational stress during the COVID-19 pandemic in Greece. Method: A cross-sectional study was conducted (from October to December 2020) in a COVID-19 reference hospital, one of the biggest in Attica. The method of convenience sampling has been used. Data collection was carried out through an anonymous, self-administered questionnaire including, apart from HPs’ demographic and occupational characteristics, Professional Quality of Life Scale (ProQoL) and Job Stress Measure. A total of 250 questionnaires were distributed to physicians and nurses. One hundred eighty-six questionnaires were fully completed (response rate = 78.8%). The analysis was based on descriptive and inductive statistics, using SPSS v25. Results: Participants’ mean age was 41.5 ± 10.4 years; 75.3% were women and 62.4% was nursing staff. ProQoL analysis showed that the majority had moderate compassion satisfaction (74.2%) and burnout (78.5%), while 48.8% had moderate level of secondary post-traumatic stress. The mean value of occupational stress was estimated at 2.76, showing a moderate level of stress. HPs’ demographic and occupational characteristics seemed to affect both work stress and ProQoL ( P ⩽ .05). Occupational stress was positively correlated with both burnout ( r = 0.461, P = .001) and secondary post-traumatic stress ( r = 0.596, P = .001), indicating that an increase in health professionals’ stress at work corresponds to a simultaneous increase in ProQoL. Conclusions: HPs’ professional quality of life and occupational stress seemed to be moderate during the COVID-19 pandemic in Greece. In order to achieve an improvement in HPs’ overall professional well-being, priority should be given to the strengthening of the capacity of the healthcare system as well as to supporting HPs in both stress management and psychological resilience.
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Affiliation(s)
- Dimitra Latsou
- Department of Public Administration, University of Neapolis, Pafos, Cyprus
| | - Fevronia-Maria Bolosi
- Department of Public Administration, University of Neapolis, Pafos, Cyprus
- General Hospital of Athens “Evangelismos,” Athens, Greece
| | - Lorena Androutsou
- Department of Public Administration, University of Neapolis, Pafos, Cyprus
| | - Mary Geitona
- Department of Public Administration, University of Neapolis, Pafos, Cyprus
- Department of Social & Educational Policy, School of Social Sciences, University of Peloponnese, Corinth, Greece
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18
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Suárez-Sánchez D, Vega-Cabrera NV, Fernández-Moya M, Mendoza-Navarro M, Bahena-Hernández Á, Rojas-Hernández JF, Baños-Peña L, López-Méndez FV, Jaramillo-Morales OA. Post-Coronavirus Disease 2019 Triggers the Appearance of Mixed Polyneuropathy and Brain Fog: A Case Report. Clin Pract 2022; 12:261-267. [PMID: 35645308 PMCID: PMC9149881 DOI: 10.3390/clinpract12030031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 12/10/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) can directly or indirectly affect the central and peripheral nervous systems, resulting in cognitive impairment, memory problems, and a wide range of neuromuscular involvement, including neuropathies. However, the long-term neurological complications of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection are not clear. The aim this study was to analyze a case report the presence of neurological sequelae due to post-Coronavirus disease 19 in a patient without apparent previous neurological symptoms. Clinical case: A 46-year-old patient, with no relevant history for the described condition, who, after severe COVID-19 infection, started a mixed neuropathy and mental fog syndrome as the main sequel. Multiple laboratory and imaging studies were performed during and after his hospital stay, and it was corroborated by an electromyography that it occurred from a neuropathy triggered by COVID-19 infection. Conclusions: This case provides additional evidence that mixed neuropathy and brain fog syndrome are potential complications of post-coronavirus disease 2019 syndrome. The neurological sequelae that manifest after a COVID-19 episode can be rapidly enhanced as a consequence of another alteration in some systems of the organism. However, future studies are necessary to elucidate the incidence of these neurological complications, their pathophysiological mechanisms and their therapeutic options.
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Affiliation(s)
- Donají Suárez-Sánchez
- Department of Medical Education and Research, Mexican Social Security Institute, Family Medicine Unit 46, Coyoacan, Mexico City 04610, Mexico; (D.S.-S.); (M.M.-N.); (Á.B.-H.); (J.F.R.-H.); (L.B.-P.); (F.V.L.-M.)
| | - Nereida Violeta Vega-Cabrera
- Department of Medical Education and Research, Mexican Social Security Institute, Family Medicine Unit 46, Coyoacan, Mexico City 04610, Mexico; (D.S.-S.); (M.M.-N.); (Á.B.-H.); (J.F.R.-H.); (L.B.-P.); (F.V.L.-M.)
- Correspondence: (N.V.V.-C.); (O.A.J.-M.)
| | - Monserrat Fernández-Moya
- Life Sciences Division, Nursing and Obstetrics Department, Campus Irapuato-Salamanca, University of Guanajuato, Ex Hacienda el Copal, km. 9 Carretera Irapuato- Silao, A.P. 311, Irapuato, Guanajuato 36500, Mexico;
| | - Maribel Mendoza-Navarro
- Department of Medical Education and Research, Mexican Social Security Institute, Family Medicine Unit 46, Coyoacan, Mexico City 04610, Mexico; (D.S.-S.); (M.M.-N.); (Á.B.-H.); (J.F.R.-H.); (L.B.-P.); (F.V.L.-M.)
| | - Ángel Bahena-Hernández
- Department of Medical Education and Research, Mexican Social Security Institute, Family Medicine Unit 46, Coyoacan, Mexico City 04610, Mexico; (D.S.-S.); (M.M.-N.); (Á.B.-H.); (J.F.R.-H.); (L.B.-P.); (F.V.L.-M.)
| | - Jesús Fabian Rojas-Hernández
- Department of Medical Education and Research, Mexican Social Security Institute, Family Medicine Unit 46, Coyoacan, Mexico City 04610, Mexico; (D.S.-S.); (M.M.-N.); (Á.B.-H.); (J.F.R.-H.); (L.B.-P.); (F.V.L.-M.)
| | - Librado Baños-Peña
- Department of Medical Education and Research, Mexican Social Security Institute, Family Medicine Unit 46, Coyoacan, Mexico City 04610, Mexico; (D.S.-S.); (M.M.-N.); (Á.B.-H.); (J.F.R.-H.); (L.B.-P.); (F.V.L.-M.)
| | - Francisco Vladimir López-Méndez
- Department of Medical Education and Research, Mexican Social Security Institute, Family Medicine Unit 46, Coyoacan, Mexico City 04610, Mexico; (D.S.-S.); (M.M.-N.); (Á.B.-H.); (J.F.R.-H.); (L.B.-P.); (F.V.L.-M.)
| | - Osmar Antonio Jaramillo-Morales
- Life Sciences Division, Nursing and Obstetrics Department, Campus Irapuato-Salamanca, University of Guanajuato, Ex Hacienda el Copal, km. 9 Carretera Irapuato- Silao, A.P. 311, Irapuato, Guanajuato 36500, Mexico;
- Correspondence: (N.V.V.-C.); (O.A.J.-M.)
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19
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Neuropsychiatric Disorders in Pediatric Long COVID-19: A Case Series. Brain Sci 2022; 12:brainsci12050514. [PMID: 35624901 PMCID: PMC9138973 DOI: 10.3390/brainsci12050514] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/10/2022] [Accepted: 04/14/2022] [Indexed: 01/13/2023] Open
Abstract
Few data are available regarding the incidence and the evolution of neuropsychiatric manifestations in children with a history of COVID-19. We herein report five consequent cases of pediatric patients with psychiatric and neurological symptoms of long COVID-19. All patients, mainly males, reported asymptomatic-to-mild COVID-19 and underwent home self-isolation. Abnormal movements, anxiety, and emotional dysregulation were the most recurrent symptoms observed from a few weeks to months after the resolution of the acute infection. A later onset was observed in younger patients. Blood tests and brain imaging resulted in negative results in all subjects; pharmacological and cognitive behavioral therapy was set. A multifactorial etiology could be hypothesized in these cases, as a result of a complex interplay between systemic and brain inflammation and environmental stress in vulnerable individuals. Longer follow-up is required to observe the evolution of neuropsychiatric manifestation in the present cohort and other young patients with previous SARS-CoV-2 infection.
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20
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Batterham PJ, Calear AL, Shou Y, Farrer LM, Gulliver A, McCallum SM, Dawel A. Effects of the COVID-19 pandemic on suicidal ideation in a representative Australian population sample-Longitudinal cohort study. J Affect Disord 2022; 300:385-391. [PMID: 34995704 PMCID: PMC8735855 DOI: 10.1016/j.jad.2022.01.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/22/2021] [Accepted: 01/02/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The direct and indirect mental health impacts of the COVID-19 pandemic are considerable. However, it is unclear how suicidal ideation was affected in communities during the acute lockdown phase of the pandemic, and over the longer-term. This study provides longitudinal data on the prevalence of, and risk factors for, suicidal ideation in the Australian national population, during the pandemic. METHOD The Australian National COVID-19 Mental Health and Risk Communication Survey assessed a nationally representative sample of Australian adults (N = 1296) fortnightly for 12 weeks from late-March to June 2020 (7 waves), and again in March 2021 (wave 8). Cox proportional hazards models examined demographic and pandemic-related risk factors for suicidal ideation over time. RESULTS Prevalence of suicidal ideation was high but steady at ∼18% across the acute lockdown phase of the pandemic, and 16.2% in March 2021. People who had direct experience with COVID-19 (tested, diagnosed, or contact with someone who was diagnosed) had increased risk for suicidal ideation. Higher pandemic-related work and social impairment, recent adversity, loneliness, and being younger were also associated with increased risk of suicidal ideation over time. CONCLUSION Both the direct and indirect impacts of COVID-19 were associated with increased risk for suicidal ideation over time, although prevalence did not vary over time. The high prevalence of suicidal ideation in our sample flags a critical need for accessible mental health support, and findings provide insights into the factors placing people at risk during the pandemic.
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Affiliation(s)
- Philip J. Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra Australia,Corresponding author
| | - Alison L. Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra Australia
| | - Yiyun Shou
- Research School of Psychology, The Australian National University, Canberra Australia
| | - Louise M. Farrer
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra Australia
| | - Sonia M. McCallum
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra Australia
| | - Amy Dawel
- Research School of Psychology, The Australian National University, Canberra Australia
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21
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Liu A, Raja xavier J, Singh Y, Brucker SY, Salker MS. Molecular and Physiological Aspects of SARS-CoV-2 Infection in Women and Pregnancy. Front Glob Womens Health 2022; 3:756362. [PMID: 35284910 PMCID: PMC8908006 DOI: 10.3389/fgwh.2022.756362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/01/2022] [Indexed: 01/08/2023] Open
Abstract
Whilst scientific knowledge about SARS-CoV-2 and COVID-19 is rapidly increasing, much of the effects on pregnant women is still unknown. To accommodate pregnancy, the human endometrium must undergo a physiological transformation called decidualization. These changes encompass the remodeling of endometrial immune cells leading to immunotolerance of the semi-allogenic conceptus as well as defense against pathogens. The angiotensin converting enzyme 2 (ACE2) plays an important regulatory role in the renin-angiotensin-system (RAS) and has been shown to be protective against comorbidities known to worsen COVID-19 outcomes. Furthermore, ACE2 is also crucial for decidualization and thus for early gestation. An astounding gender difference has been found in COVID-19 with male patients presenting with more severe cases and higher mortality rates. This could be attributed to differences in sex chromosomes, hormone levels and behavior patterns. Despite profound changes in the female body during pregnancy, expectant mothers do not face worse outcomes compared with non-pregnant women. Whereas mother-to-child transmission through respiratory droplets during labor or in the postnatal period is known, another question of in utero transmission remains unanswered. Evidence of placental SARS-CoV-2 infection and expression of viral entry receptors at the maternal-fetal interface suggests the possibility of in utero transmission. SARS-CoV-2 can cause further harm through placental damage, maternal systemic inflammation, and hindered access to health care during the pandemic. More research on the effects of COVID-19 during early pregnancy as well as vaccination and treatment options for gravid patients is urgently needed.
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Affiliation(s)
- Anna Liu
- Research Institute of Women's Health, Eberhard Karls University, Tübingen, Germany
| | - Janet Raja xavier
- Research Institute of Women's Health, Eberhard Karls University, Tübingen, Germany
| | - Yogesh Singh
- Research Institute of Women's Health, Eberhard Karls University, Tübingen, Germany
- Institute of Medical Genetics and Applied Genomics, Eberhard Karls University, Tübingen, Germany
| | - Sara Y. Brucker
- Research Institute of Women's Health, Eberhard Karls University, Tübingen, Germany
| | - Madhuri S. Salker
- Research Institute of Women's Health, Eberhard Karls University, Tübingen, Germany
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22
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Buselli R, Corsi M, Veltri A, Baldanzi S, Chiumiento M, Del Lupo E, Marino R, Necciari G, Caldi F, Perretta S, Foddis R, Guglielmi G, Cristaudo A. Quarantine and Mental Health Challenges for Occupational Medicine: The Case Report of a Nurse Infected With SARS-CoV-2. Workplace Health Saf 2022; 70:43-49. [PMID: 35037513 DOI: 10.1177/21650799211045715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This case study draws attention to the psychosocial difficulties that emerged in the context of the coronavirus disease 2019 (COVID-19) outbreak in relation to the remote management of subjects with psychiatric vulnerabilities following exposure to prolonged quarantine. The case involves a 56-year-old hospital nurse, followed by the Occupational Health Department of a major university hospital in central Italy for mood instability in the context of a cyclothymic temperament. She was quarantined for occupationally acquired COVID-19 and remained positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via swab test for more than 2 months between March and May 2020. In this case study, we discuss the challenges presented by the risk of a prolonged quarantine in a psychologically vulnerable employee, the need for occupational medicine to provide adequate health surveillance of all health care workers during the COVID-19 pandemic, the effectiveness of telepsychiatry, and the difficulties in formulating a proper treatment strategy.
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Affiliation(s)
- R Buselli
- Azienda Ospedaliero-Universitaria Pisana
| | - M Corsi
- Azienda Ospedaliero-Universitaria Pisana
| | - A Veltri
- Azienda Ospedaliero-Universitaria Pisana
| | - S Baldanzi
- Azienda Ospedaliero-Universitaria Pisana
| | | | - E Del Lupo
- Azienda Ospedaliero-Universitaria Pisana
| | - R Marino
- Azienda Ospedaliero-Universitaria Pisana
| | - G Necciari
- Azienda Ospedaliero-Universitaria Pisana
| | - F Caldi
- Azienda Ospedaliero-Universitaria Pisana
| | - S Perretta
- Azienda Ospedaliero-Universitaria Pisana
| | - R Foddis
- Azienda Ospedaliero-Universitaria Pisana
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23
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Kandula UR, Wake AD. Assessment of Quality of Life Among Health Professionals During COVID-19: Review. J Multidiscip Healthc 2022; 14:3571-3585. [PMID: 35002247 PMCID: PMC8722681 DOI: 10.2147/jmdh.s344055] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/16/2021] [Indexed: 12/18/2022] Open
Abstract
In 2019, coronavirus disease pandemic (COVID-19) influences the quality of life of health personnel who are on the front lines in dealing with COVID-19 patients. The purpose of this study is to assess the quality of life of health professionals during the COVID-19 epidemic. The novel coronavirus disease-19 (COVID-19) has spread across the globe with the direct causal viral agent of severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2) and infected many people. All health professionals (HPs) such as physicians, nurses, and other allied health staff members are primary caregivers in hospitals and other health care settings, specifically under pandemic situations such as COVID-19. The emergence of the COVID-19 pandemic has caused numerous diversions in the preservation of the quality of life (QoL) of health professionals by deviations from normal physical, mental, and social wellbeing aspects. HPs are the most vulnerable population to COVID-19 viral transmission while delivering emergency medical services to persons infected with the virus in various health care sectors, such as direct engagement in lifesaving management. In this perspective, some recent literature on QoL of health professionals was examined, uncovering that they frequently experience fear and anxiety due to viral transmissions in the place of work and probable cross-contamination among family members, tend to experience insomnia caused by sudden increased work pressure, struggle to balance professional and personal life, suffering from mental health disturbances such as depressive episodes, mood disturbances, and suicidal tendencies due to the unpredictability of the disease outbreak. The current review is looking to determine and address the degree of QoL maintained by specific types of health professionals during critical moments of COVID-19 pandemics. This study may assist health organization stakeholders in enhancing QoL among health professionals by introducing required provisions, measures, or initiatives for the welfare of health professionals, notably in resolving pandemic demands in all health organizations.
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Affiliation(s)
- Usha Rani Kandula
- Nursing Department, College of Health Sciences, Arsi University, Asella, Oromia Regional State, Ethiopia
| | - Addisu Dabi Wake
- Nursing Department, College of Health Sciences, Arsi University, Asella, Oromia Regional State, Ethiopia
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Renson T, Hamiwka L, Benseler S. Central nervous system manifestations of monogenic autoinflammatory disorders and the neurotropic features of SARS-CoV-2: Drawing the parallels. Front Pediatr 2022; 10:931179. [PMID: 36034552 PMCID: PMC9399631 DOI: 10.3389/fped.2022.931179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022] Open
Abstract
Central nervous system (CNS) involvement in monogenic autoinflammatory disorders (AID) is increasingly recognized and can be life threatening. Therefore, a low threshold to consider CNS disease should be maintained in patients with systemic inflammation. Hyperinflammation is also a key feature of severe acute COVID-19 and post COVID-19 entities such as multisystem inflammatory syndrome in children. Like AID, COVID-19 patients can present with severe CNS involvement. The impact of COVID-19 on AID and CNS involvement in particular is still obscure, nevertheless dreaded. In the current review, we synthesize the spectrum of CNS manifestations in monogenic AID. We explore common pathophysiological and clinical features of AID and COVID-19. Moreover, we assess the impact of immune dysregulation associated with SARS-CoV-2 infections and post COVID-19 hyperinflammation in AID. The striking commonalities found between both disease entities warrant caution in the management of AID patients during the current pandemic.
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Affiliation(s)
- Thomas Renson
- Division of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Division of Nephrology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium
| | - Lorraine Hamiwka
- Division of Nephrology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Susanne Benseler
- Division of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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25
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Epidemiology, transmission and pathogenesis of SARS-CoV-2. COMPUTATIONAL APPROACHES FOR NOVEL THERAPEUTIC AND DIAGNOSTIC DESIGNING TO MITIGATE SARS-COV-2 INFECTION 2022. [PMCID: PMC9300483 DOI: 10.1016/b978-0-323-91172-6.00015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) has caused Coronavirus disease-2019 (COVID-19), the worst pandemic of the 21st century. Globally, millions of lives have been lost due to COVID-19. Transmission of SARS-CoV-2 occurs human-to-human through air droplets. SARS-CoV-2 is thought to originate from a bat Coronavirus, which might have reached human beings through intermediate hosts. SARS-CoV-2 causes a variable degree of illness in human beings, including patients being an asymptomatic, mild, moderate, and severe disease, which requires hospitalization. The common symptoms of COVID-19 include fever, cough, myalgia, dyspnea, sore throat, anosmia, ageusia, and diarrhea. The pathogenesis of COVID-19 involves the attachment, entry, and replication of the virus in the host cells. The gains entry into human cells through engagement of angiotensin-converting enzyme 2 receptor with its spike proteins. The overproduction of highly inflammatory cytokines results in a cytokine storm, leading to an increased risk of acute respiratory distress syndrome, coagulopathy, and multiorgan failure. This chapter provides insight into the epidemiology, transmission, and pulmonary and extrapulmonary pathogenesis of COVID-19.
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26
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Aydın A, Kulakaç N, Aydın Sayılan A. The effect of COVID-19 anxiety levels of healthcare professionals on the quality of working life and related factors. Int J Clin Pract 2021; 75:e14889. [PMID: 34541747 PMCID: PMC8646894 DOI: 10.1111/ijcp.14889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022] Open
Abstract
AIM This study aims to determine the effect of COVID-19 anxiety levels of healthcare professionals on their working life quality. METHOD The sample of the descriptive, cross-sectional and correlational study consisted of healthcare professionals working in two university hospitals in western Turkey between May and July 2021. We used the "Personal Information Form, Coronavirus Anxiety Scale, and Working Life Quality Scale" as data collection tools. We used numbers and percentage calculations, arithmetic mean, median (25th-75th percentile), Mann-Whitney U test, Spearmen correlation analysis and Linear Regression analysis to analyse the data. RESULTS The mean score on the Quality of Life Scale of healthcare professionals was 3.74 ± 0.28, and the mean score on the Coronavirus Anxiety Scale (CAS) was 9.66 ± 6.06 (min. 0; max. 20). We found a negative and weakly significant relationship between the mean score of the CAS of healthcare professionals and the mean score of the employee quality of life scale. According to the results of the multiple linear regression analysis, we found the factors significantly affecting the anxiety states of healthcare professionals related to the Coronavirus are the quality of working life, age, sex and the state of caring for a patient with COVID-19. CONCLUSION As a conclusion of this study, it was determined that healthcare professionals experienced anxiety, and anxiety decreased as ages, working years and the number of children they have increased. In addition, it was determined that as the anxiety of healthcare professionals increased, the quality of working life decreased.
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Affiliation(s)
- Aykut Aydın
- Department of Labor Economics and Industrial RelationsFaculty of Economics and Administrative SciencesKırklareli UniversityKırklareliTurkey
| | - Nurşen Kulakaç
- Department of NursingFaculty of Health SciencesGümüşhane UniversityGümüşhaneTurkey
| | - Aylin Aydın Sayılan
- Department of NursingHealth Sciences FacultyKırklareli UniversityKırklareliTurkey
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Rossi V, Tammaro S, Santambrogio M, Retucci M, Gallo F, Crotti S, Mantero M, Nosotti M, Privitera E, Palleschi A. Physiotherapy approach after lung transplantation in a critically ill COVID-19 patient: a case report. Monaldi Arch Chest Dis 2021; 92. [PMID: 34818884 DOI: 10.4081/monaldi.2021.2004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/16/2021] [Indexed: 11/22/2022] Open
Abstract
This study describes the case of an 18-years-old male affected by severe COVID-19, who was receiving bilateral lung transplantation (LT), after 71 days of mechanical ventilation and 55 days of veno-venous extracorporeal membrane oxygenation. From post-operative day 2, early mobilization and physiotherapy treatments were performed. Weaning from mechanical ventilation, the use of non-invasive ventilation and tracheostomy management were included in the treatment. Forty-five days after LT the patient was discharged at home, showing improvements in terms of functional and respiratory parameters, quality of life and mood. While evidences about physiotherapy treatments in lung transplantation post severe COVID-19 remain limited, early approach and a multidisciplinary team may be considered key elements for functional recovery of these subjects.
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Affiliation(s)
- Veronica Rossi
- Health Professions Department Unit; Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan.
| | - Serena Tammaro
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan.
| | - Martina Santambrogio
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan.
| | - Mariangela Retucci
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan.
| | - Francesca Gallo
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan.
| | - Stefania Crotti
- Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan .
| | - Marco Mantero
- Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Department of Pathophysiology and Transplantation, University of Milan .
| | - Mario Nosotti
- Department of Pathophysiology and Transplantation, University of Milan; Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan.
| | - Emilia Privitera
- Health Professions Department Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan.
| | - Alessandro Palleschi
- Department of Pathophysiology and Transplantation, University of Milan; Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan.
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Abstract
The COVID-19 pandemic has spread rapidly across the world in 2020, affecting both adults and, to a lesser extent, children. In this article, the authors describe the neurologic manifestations of COVID-19 in children, including the epidemiology, pathogenesis, clinical features, laboratory and imaging findings, and treatment options. The management of patients with concomitant neuroimmunologic disorders and drug interactions between medications used to treat COVID-19 and other neurologic disorders (especially immune-modifying drugs) is also discussed.
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Affiliation(s)
- Tuhina Govil-Dalela
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, MI, USA; Department of Neurology, Children's Hospital of Michigan, Wayne State University, Detroit, MI, USA; Department of Pediatric Neurology, Children's Hospital of Michigan Specialty Center, 2nd Floor, 3950 Beaubien Street, Detroit, MI 48202, USA
| | - Lalitha Sivaswamy
- Department of Pediatric Neurology, Children's Hospital of Michigan Specialty Center, 2nd Floor, 3950 Beaubien Street, Detroit, MI 48202, USA; Department of Pediatrics, Central Michigan University, Pleasant, MI, USA; Department of Neurology, Central Michigan University, Pleasant, MI, USA.
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29
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Giannopoulou I, Galinaki S, Kollintza E, Adamaki M, Kympouropoulos S, Alevyzakis E, Tsamakis K, Tsangaris I, Spandidos DA, Siafakas N, Zoumpourlis V, Rizos E. COVID-19 and post-traumatic stress disorder: The perfect 'storm' for mental health (Review). Exp Ther Med 2021; 22:1162. [PMID: 34504607 PMCID: PMC8392877 DOI: 10.3892/etm.2021.10596] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/10/2021] [Indexed: 12/28/2022] Open
Abstract
Since its outbreak, in December, 2019, in the Chinese city of Wuhan, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into an ongoing global pandemic. Due to the novel antigenic properties of this virus, the world population could not develop immunity effectively and this led to the subsequent spread of COVID-19. This caused an unprecedented emergency situation with significant negative effects on health and well-being both on an individual and societal level. Apart from health, economic and social consequences, the impact of this pandemic on mental health is increasingly being reported in the scientific literature. The present review aimed to provide a comprehensive discussion of the possible neurological and neuropsychiatric manifestations of SARS-CoV-2, together with the related underlying molecular pathways. In addition, the present review focused on populations which are at a higher risk of developing psychiatric disturbances due to the COVID-19 pandemic and discussed possible routes of clinical management and therapeutics to minimize the burden associated with psychiatric disorders. Moreover, research findings exploring the prevalence of COVID-19-related post-traumatic stress disorder (PTSD) symptoms across vulnerable groups, including children, adolescents and COVID-19 survivors are presented, with particular emphasis on those with severe disease who required hospitalization and/or intensive care unit admission. Based on the available literature, the identification of potential determinants associated with PTSD across the different populations is underlined. Lessons learnt from the pandemics across the globe together with the ongoing research on COVID-19 and its impact on mental health, highlight the utmost importance for evidence-based, proactive and targeted interventions in high-risk groups aiming to mitigate the risks and manage vulnerabilities.
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Affiliation(s)
- Ioanna Giannopoulou
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Sofia Galinaki
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Evangelia Kollintza
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Maria Adamaki
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation (NHRF), Athens 11635, Greece
| | - Stylianos Kympouropoulos
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Evangelos Alevyzakis
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Konstantinos Tsamakis
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Iraklis Tsangaris
- Second Department of Critical Care Medicine, Attikon University Hospital, Athens 12462, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece
| | - Nikolaos Siafakas
- Clinical Microbiology Laboratory, School of Medicine, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Vassilios Zoumpourlis
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation (NHRF), Athens 11635, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
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30
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Rittmannsberger H, Barth M, Malik P, Yazdi K. [Neuropsychiatric Aspects of COVID-19 - A Narrative Overview]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 90:108-120. [PMID: 34341978 DOI: 10.1055/a-1523-3850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The SARS-CoV-2 virus (Severe Acute Respiratory Syndrome Coronavirus Type 2) and COVID-19 (Coronavirus Disease 2019) can affect numerous organ systems. In the present paper we offer an overview of the current state of knowledge about the psychiatric aspects of SARS-CoV-2 infection.Medline, Embase und LIVIVO were searched for relevant literature, the last query dating from March 2nd, 2021. Different stress factors in the context of the pandemic can lead to manifest mental illnesses. In addition, there is a risk of neuropsychological changes due to the biological effects of the virus itself.Our work describes the psychological symptoms of COVID-19 sufferers themselves and the psychological effects of the epidemic and the associated socio-economic and psychosocial stress factors on those who are not sick.The most common psychiatric complication among people with COVID-19 is delirium, while hospitalized patients seem to have an increased incidence of symptoms of anxiety, depression and PTSD. There are many case reports on psychotic disorders. In general, an existing psychiatric illness (especially dementia and psychotic disorders) also increases the risk of infection and of a more severe course of the disease. After recovery from COVID-19 infection, there is also a higher incidence of mental illnesses, in particular "Chronic Post-SARS Syndrome" with its manifestations such as fatigue, anxiety, depression and PTSD. In addition, the course of dementia seems to be negatively influenced by an infection with SARS-CoV-2.The second part deals with the effects of the epidemic as a stressor and the established socio-political measures on the mental health of people with and without previous mental illnesses. The literature currently available shows high symptom values for anxiety and depressive disorders as well as post-traumatic stress disorders, stress, suicidality, sleep disorders etc. Risk factors seem to include female gender, younger age and fewer resources, as well as previous psychiatric or physical illnesses. Extrinsic factors such as high infection rates, large numbers of deaths, long curfews/lockdowns, low trust in the government and ineffective measures against economic and social consequences increase the burden.
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Affiliation(s)
- Hans Rittmannsberger
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Austria
| | - Martin Barth
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Austria
| | - Peter Malik
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Austria
| | - Kurosch Yazdi
- Klinik für Psychiatrie mit Schwerpunkt Suchtmedizin, Kepler Universitatsklinikum GmbH, Linz, Austria.,Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Austria
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31
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Pavlovic JM, Pesut DP, Stosic MB. Influence of the COVID-19 pandemic on the incidence of tuberculosis and influenza. Rev Inst Med Trop Sao Paulo 2021; 63:e53. [PMID: 34190955 PMCID: PMC8231979 DOI: 10.1590/s1678-9946202163053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 12/30/2022] Open
Abstract
We examined whether the COVID-19 pandemic has affected the incidence of
tuberculosis (TB) and influenza in Serbia, a Southeast European country with a
low TB incidence rate and a mandatory BCG vaccination at birth. The first case
of COVID-19 was registered on March 6, 2020. Despite the need for a sudden
adaptation of the health care system, routines of mycobacterial laboratories
have never stopped. In 2020, the number of newly diagnosed TB patients was
significantly lower than expected (p = 0.04), but the number of patients with
influenza increased when compared to 2019. Although many patients with influenza
A H1N1 were observed before the beginning of the COVID-19 pandemic, the
increment of cases could also be a consequence of cases of influenza with
COVID-like symptoms detected thereafter. It may also be attributed to
misclassification of clinical cases that were negative for SARS-CoV-2 and
reported as influenza. Difficulties to seek medical attention because of the
COVID-19 pandemic and possible underreporting are considered as reasons for the
decline in the incidence rate of TB. On the other hand, individual and social
measures to prevent the spread of SARS-CoV-2 such as wearing face masks, social
distancing, lockdown, which were strictly applied to COVID-19 patients, health
care staffs and most of the population, could have hindered TB infections more
than the two viral diseases, which appear to be more contagious. The increased
motivation of the population to protect their health during the COVID-19
pandemic provided an opportunity for their effective education. This is crucial
in further combating TB as a preventable disease.
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Affiliation(s)
| | - Dragica Petar Pesut
- University of Belgrade, Faculty of Medicine, Internal Medicine Department, Belgrade, Serbia.,University Clinical Center of Serbia, Teaching Hospital of Pulmonology, Belgrade, Serbia
| | - Maja Borivoje Stosic
- Public Health Institute of Serbia "Dr Milan Jovanović Batut", Department of HIV, Hepatitis, STDs and TB, Belgrade, Serbia
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Gramaglia C, Gambaro E, Bellan M, Balbo PE, Baricich A, Sainaghi PP, Pirisi M, Baldon G, Battistini S, Binda V, Feggi A, Gai M, Gattoni E, Jona A, Lorenzini L, Marangon D, Martelli M, Prosperini P, Zeppegno P. Mid-term Psychiatric Outcomes of Patients Recovered From COVID-19 From an Italian Cohort of Hospitalized Patients. Front Psychiatry 2021; 12:667385. [PMID: 34177656 PMCID: PMC8222628 DOI: 10.3389/fpsyt.2021.667385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/05/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Although the usual primary clinical manifestation of Coronavirus disease (COVID-19) is respiratory, several non-respiratory symptoms have been described, including neuropsychiatric ones. The aim of this study was to investigate the mid-term mental health outcomes in patients recovered from COVID-19, 3-4 months after discharge from the University Hospital Maggiore della Carità, Novara, Italy. Furthermore, we investigated the possible association of the mid-term mental health consequences of the COVID-19 infection with patients' clinical current status, persistent physical impairment and severity of acute phase of the disease. Methods: Prospective study involving 238 individuals recovered from COVID-19. In the context of a multi-disciplinary approach, patients' assessment included both a clinical interview performed by an experienced psychiatrist, trained in the use of the Mini-International Neuropsychiatric Interview to assess the presence of anxiety and depressive symptoms and self-administered questionnaires: Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Resilience Scale for Adults (RSA), Impact of Event Scale (IES). Results: At the psychiatric assessment 32.9 and 29.5% of participants showed anxiety and depressive symptoms, respectively. Changes in appetite and sleep patterns emerged for 15.6 and 31.2% of patients. According to the self-administered questionnaires, 7.1% of participants had moderate-severe anxiety levels (BAI), while 10.5% had mild to severe depression (BDI-II). Twenty-six (11%) participants were referred to further psychiatric consultation. Psychiatric symptoms showed no correlation with acute COVID-19 severity; in our sample patients with depressive symptoms at the clinical interview, as well as those with mild to severe levels of depression according to BDI-II scores, had lower forced expiratory volume in the 1st second (FEV1) values than those without and greater odds for persistent, poor tolerance for physical efforts. Conclusions: As could be expected, an approach including both a psychiatric interview and the use of self-administered questionnaires is likely to capture the psychiatric outcome of patients recovered from COVID-19 better than questionnaires alone. Anxiety and depressive symptoms at follow-up had no correlation with the severity of COVID acute manifestations, but rather with ongoing and persistent physical symptoms. Further studies and longer follow-up duration will allow a better understanding of the complex relationship between residual physical symptoms, quality of life and psychological health.
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Affiliation(s)
- Carla Gramaglia
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Eleonora Gambaro
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Mattia Bellan
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | | | - Alessio Baricich
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Pier Paolo Sainaghi
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Mario Pirisi
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Giulia Baldon
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
| | - Sofia Battistini
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
| | - Valeria Binda
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Alessandro Feggi
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Martina Gai
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
| | - Eleonora Gattoni
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Amalia Jona
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Luca Lorenzini
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
| | - Debora Marangon
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Maria Martelli
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
| | | | - Patrizia Zeppegno
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale UPO, Novara, Italy
- Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
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Buselli R, Corsi M, Veltri A, Baldanzi S, Chiumiento M, Lupo ED, Marino R, Necciari G, Caldi F, Foddis R, Guglielmi G, Cristaudo A. Mental health of Health Care Workers (HCWs): a review of organizational interventions put in place by local institutions to cope with new psychosocial challenges resulting from COVID-19. Psychiatry Res 2021; 299:113847. [PMID: 33721785 PMCID: PMC7920813 DOI: 10.1016/j.psychres.2021.113847] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/27/2021] [Indexed: 12/15/2022]
Abstract
The COVID-19 outbreak has been associated with significant occupational stressors and challenges for healthcare workers (HCWs) including the risk of exposure to SARS-CoV-2. Many reports from all over the world have already found that HCWs have significant levels of self-reported anxiety, depression and even symptoms of post-traumatic stress disorder. Therefore, supporting mental health of HCWs is a crucial part of the public health response to the COVID-19 pandemic. The aim of the present review is to ascertain the interventions put in place worldwide in reducing stress in HCWs during the COVID-19 outbreak. We evidenced how only few countries have published specific psychological support intervention protocols for HCWs. All programs were developed in university associated hospitals and highlighted the importance of multidisciplinary collaboration. All of them had as their purpose to manage the psychosocial challenges to HCW's during the pandemic in order to prevent mental health problems.Whether one program offers distinct benefit compared to the others cannot be known given the heterogeneity of the protocols and the lack of a rigorous protocol and clinical outcomes. Further research is crucial to find out the best ways to support the resilience and mental well-being of HCWs.
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Affiliation(s)
| | - Martina Corsi
- Occupational Health Department, U.O. Medicina Preventiva del Lavoro, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa (PI), Italy.
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Fernandes J, Puhlmann P. Opsoclonus myoclonus ataxia syndrome in severe acute respiratory syndrome coronavirus-2. J Neurovirol 2021; 27:501-503. [PMID: 33788141 PMCID: PMC8011042 DOI: 10.1007/s13365-021-00974-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/09/2021] [Accepted: 03/19/2021] [Indexed: 01/30/2023]
Abstract
A patient presented with an opsoclonus-myoclonus-ataxia syndrome after a 2-week period of fever. In her work as an assistant nurse, she had been exposed to patients infected with severe acute respiratory syndrome coronavirus-2. Laboratory investigations showed that the patient had positive IgG antibodies against this pathogen, and a chest CT showed changes compatible with this infection. Other known causes for this syndrome were excluded. Our case shows that the opsoclonus-myoclonus-ataxia syndrome can occur as a post-/para-infectious manifestation in patients infected with severe acute respiratory syndrome coronavirus-2.
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Affiliation(s)
- João Fernandes
- NÄL, Norra Älvsborgs Länssjukhus, Lärketorpsvägen 20, 461 73, Trollhattan, Sweden.
| | - Peter Puhlmann
- NÄL, Norra Älvsborgs Länssjukhus, Lärketorpsvägen 20, 461 73, Trollhattan, Sweden
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Turan Ş, Poyraz BÇ, Aksoy Poyraz C, Demirel ÖF, Tanrıöver Aydın E, Uçar Bostan B, Demirel Ö, Ali RK. Characteristics and outcomes of COVID-19 inpatients who underwent psychiatric consultations. Asian J Psychiatr 2021; 57:102563. [PMID: 33556918 PMCID: PMC7840407 DOI: 10.1016/j.ajp.2021.102563] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 01/08/2023]
Abstract
Patients hospitalized with COVID-19 are at risk of developing many neuropsychiatric disorders, due to the effects of the disease on the brain and the psychosocial pressures of having the disease. The aim of the present study was to evaluate the characteristics and outcomes of patients who were hospitalized with a diagnosis of COVID-19, who underwent psychiatric consultations. The medical records of 892 patients hospitalized due to COVID-19 and the 89 among them who requested psychiatric consultations were analyzed retrospectively. After the psychiatric consultations, patients were most frequently diagnosed with delirium (38.2 %), adjustment disorder (27.0 %), depressive disorder (19.1 %) and anxiety disorder (11.2 %). Patients with delirium had longer hospital stays (p < 0.001), were transferred more frequently to intensive care units (p < 0.001), and had higher mortality rates during their hospital stays (p < 0.001), than all other patients. The need for oxygen (p < 0.001) and mechanical ventilation (p < 0.001) was also significantly higher in delirium patients, as well as in patients who received other psychiatric diagnoses. Neuropsychiatric disorders develop in patients receiving inpatient treatments in COVID-19 wards, and these disorders negatively affect the prognosis of COVID-19. Our findings suggest that the presence of neuropsychiatric disorders in in-patients with COVID-19 might be associated with the negative outcomes of the disease.
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Affiliation(s)
- Şenol Turan
- Department of Psychiatry, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Burç Çağrı Poyraz
- Department of Psychiatry, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Cana Aksoy Poyraz
- Department of Psychiatry, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ömer Faruk Demirel
- Department of Psychiatry, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ezgi Tanrıöver Aydın
- Department of Psychiatry, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Büşra Uçar Bostan
- Department of Psychiatry, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Öznur Demirel
- Department of Psychiatry, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ritvan Kara Ali
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey.
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Post-traumatic stress, anxiety, and depressive symptoms in caregivers of children tested for COVID-19 in the acute phase of the Italian outbreak. J Psychiatr Res 2021; 135:256-263. [PMID: 33508545 PMCID: PMC7825987 DOI: 10.1016/j.jpsychires.2021.01.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/14/2020] [Accepted: 01/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The recent COVID-19 pandemic pointed out new burdens for researchers on mental health and that evidence-based (EB) studies on vulnerable populations are timely needed. The present paper aims at analysing the impact of suspicious of SARS-COV-2 infection in a cohort of parents presented at 3 major hospitals (spread between north and center of Italy) during the Italian COVID-19 pandemic phase 1. METHODS Participants of the present cross-sectional, multicenter study were parental couples of children suspected to have COVID-19 who underwent testing with nasopharyngeal swabbing. All subjects were assessed by means of the: Impact of Event Scale-Revised (IES-R), Generalized Anxiety Disorder 7-Item (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) in order to evaluate Post-traumatic stress (PTSS), anxiety, and depressive symptoms, respectively. OUTCOMES Results evidenced that parents whose children tested positive for COVID-19 were more prone to developing PTSS, anxiety and depressive symptoms. The same results emerged for parents who had quarantined as opposed to those who had not. Moreover, patients who suffered economic damage showed a higher prevalence of anxiety and depressive symptoms, whereas PTSS was more common among unemployed subjects and among mothers. INTERPRETATION This study identified a mental health strain represented by parenting a child who tested positive for SARS-CoV-2 infection. Further EB research is needed to develop evidence-driven strategies to reduce adverse psychological impacts and related psychiatric symptoms in caregivers of COVID-19 infected children during the next phases of the pandemic.
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Stasolla F, Matamala-Gomez M, Bernini S, Caffò AO, Bottiroli S. Virtual Reality as a Technological-Aided Solution to Support Communication in Persons With Neurodegenerative Diseases and Acquired Brain Injury During COVID-19 Pandemic. Front Public Health 2021; 8:635426. [PMID: 33665181 PMCID: PMC7921156 DOI: 10.3389/fpubh.2020.635426] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/24/2020] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 poses an ongoing threat to lives around the world and challenges the existing public health and medical service delivery. The lockdown or quarantine measures adopted to prevent the spread of COVID-19 has caused the interruption in ongoing care and access to medical care including to patients with existing neurological conditions. Besides the passivity, isolation, and withdrawal, patients with neurodegenerative diseases experience difficulties in communication due to a limited access to leisure opportunities and interaction with friends and relatives. The communication difficulties may exacerbate the burden on the caregivers. Therefore, assistive-technologies may be a useful strategy in mitigating challenges associated with remote communication. The current paper presents an overview of the use of assistive technologies using virtual reality and virtual body ownership in providing communication opportunities to isolated patients, during COVID-19, with neurological diseases and moderate-to-severe communication difficulties. We postulate that the assistive technologies-based intervention may improve social interactions in patients with neurodegenerative diseases and acquired brain injury-thereby reducing isolation and improving their quality of life and mental well-being.
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Affiliation(s)
| | - Marta Matamala-Gomez
- Department of Human Sciences for Education "Riccardo Massa", Center for Studies in Communication Sciences "Luigi Anolli" (CESCOM), University of Milano-Bicocca, Milan, Italy
| | - Sara Bernini
- Scientific Institute for Research, Hospitalization, and Healthcare (IRCCS), Mondino Foundation, Pavia, Italy
| | - Alessandro O Caffò
- Department of Educational Sciences, Psychology and Communication, University of Bari, Bari, Italy
| | - Sara Bottiroli
- "Giustino Fortunato" University of Benevento, Benevento, Italy.,Scientific Institute for Research, Hospitalization, and Healthcare (IRCCS), Mondino Foundation, Pavia, Italy
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[Systemic consequences and clinical aspects of SARS-CoV-2 infection]. DER PATHOLOGE 2021; 42:155-163. [PMID: 33575886 PMCID: PMC7877545 DOI: 10.1007/s00292-021-00913-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND COVID-19 is considered a systemic disease. A severe course with fatal outcome is possible and unpredictable. OBJECTIVES Which organ systems are predominantly involved? Which diseases are predisposed for a fatal course? Which organ changes are found with lethal outcome? MATERIALS AND METHODS Data from published autopsy studies (28 cases by our group) with respect to organ changes and possible cause of death. RESULTS The most severe alterations are found in the lungs by diffuse alveolar damage as a symptom of an acute respiratory distress syndrome (ARDS), in part with fibrosis. Thrombosis of small- to mid-sized pulmonary arteries is associated with hemorrhagic lung infarction. Frequent complications are bacterial pneumonias and less frequently fungal pneumonias by aspergillus. Pulmonary thromboembolism is found in 20-30% of lethal courses, also in the absence of deep venous thrombosis. Intestinal involvement of COVID-19 can be associated with intestinal ischemia, caused by shock or local thrombosis. In most cases, the kidneys display acute tubular injury reflecting acute renal failure, depletion of lymphocytes in the lymph nodes and spleen, and hyperplastic adrenal glands. The liver frequently reveals steatosis, liver cell necrosis, portal inflammation, and proliferation of Kupffer cells. Important preexisting diseases in autopsy studies are arterial hypertension with hypertensive and ischemic cardiomyopathy and diabetes mellitus but large population-based studies reveal increased risk of mortality only for diabetes mellitus not for arterial hypertension. CONCLUSIONS Alterations of the pulmonary circulation with pulmonary arterial thrombosis, infarction, and bacterial pneumonia are important and often lethal complications of COVID-19-associated ARDS. Findings from autopsy studies have influenced therapy and prophylaxis.
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Corsi M, Orsini A, Pedrinelli V, Santangelo A, Bertelloni CA, Carli N, Buselli R, Peroni D, Striano P, Dell'Osso L, Carmassi C. PTSD in parents of children with severe diseases: a systematic review to face Covid-19 impact. Ital J Pediatr 2021; 47:8. [PMID: 33446246 PMCID: PMC7807213 DOI: 10.1186/s13052-021-00957-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 01/04/2021] [Indexed: 11/10/2022] Open
Abstract
CONTEXT The literature agrees on the impact of post-traumatic stress symptoms in parents of seriously ill children but there is less clarity about the real extent and gender differences of this psychopathological risk. The recent Covid-19 outbreak highlighted new burdens for researchers on Post Traumatic Stress Disorder (PTSD) and clear evidence-based knowledge on this issue is timely needed. OBJECTIVE In this review, we present a synthesis of the updated evidence on PTSD rates in parents of children with severe diseases. We also aim to try to understand if research in this field has been refined over time with the long-term intent to better face the new challenges of Covid-19 in the paediatric field. DATA SOURCES The PubMed database was searched. STUDY SELECTION Studies were included if they assessed PTSD in parents of children diagnosed with physical illnesses. DATA EXTRACTION Of 240 studies, 4 were included. RESULTS Analysis of the 4 studies revealed 2 studies with PTSD rates around 20% and in line with previous best-evidence. All 4 studies tried to provide more data on fathers, however, all the studies present the lack of a control group. LIMITATIONS The limited number of studies, which also differ widely in the methodology used. CONCLUSIONS Methodological errors evidenced in all the 4 studies limit their reliability, making the understanding of the paediatric caregiver's concern regarding PTSD still difficult. More sound research is needed.
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Affiliation(s)
- Martina Corsi
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Alessandro Orsini
- Department of Clinical and Experimental Medicine, Pediatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy.
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliero- Universitaria Pisana, University of Pisa, Pisa, Italy.
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Andrea Santangelo
- Department of Clinical and Experimental Medicine, Pediatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Carlo Antonio Bertelloni
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Niccolò Carli
- Department of Clinical and Experimental Medicine, Pediatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Rodolfo Buselli
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Pediatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Pasquale Striano
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
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Shapiro PA, Brahmbhatt K, Caravella R, Erickson J, Everly G, Giles K, Gopalan P, Greenspan H, Huijón RM, Key RG, Kroll D, Prince E, Rabinowitz T, Saad-Pendergrass D, Shalev D. Report of the Academy of Consultation-Liaison Psychiatry Task Force on Lessons Learned From the COVID-19 Pandemic: Executive Summary. J Acad Consult Liaison Psychiatry 2021; 62:377-386. [PMID: 34000470 PMCID: PMC8120806 DOI: 10.1016/j.jaclp.2021.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The COVID-19 pandemic forced consultation-liaison psychiatrists to adapt to unprecedented circumstances. The Academy of Consultation-Liaison Psychiatry (ACLP) recognized the need and opportunity to assess its response and convened a task force in mid-2020 to review the lessons learned from the initial experience of the COVID-19 pandemic. OBJECTIVE The aim of the study was to summarize experience and make recommendations to the ACLP Board of Directors about potential ACLP directions related to current and future pandemic response. METHODS In August-November 2020, the task force reviewed local experiences, ACLP list-serv contributions, and the published literature and generated recommendations for ACLP actions. RESULTS Recommendations addressed telepsychiatry, hospital staff wellness, support for consultation-liaison psychiatrists, the need for additional research on psychiatric and neuropsychiatric aspects of COVID-19, and the ACLP's role in advocacy and dissemination of information. The task force report was submitted to the ACLP Board of Directors in November 2020. CONCLUSIONS As the preeminent organization of consultation-liaison psychiatrists, the ACLP can implement actions related to pandemic awareness and preparedness for the benefit of consultation-liaison psychiatrists, other health care workers, patients, and the general population.
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Affiliation(s)
- Peter A. Shapiro
- Department of Psychiatry, Columbia University, New York, NY,Send correspondence and reprint requests to Peter A. Shapiro, MD, New York-Presbyterian Hospital, Columbia University Irving Medical Center, 622 W. 168 St Box 427, New York NY 10032
| | - Khyati Brahmbhatt
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Rachel Caravella
- Department of Psychiatry, New York University Langone Health, New York, NY
| | | | - George Everly
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD
| | - Karen Giles
- Department of Psychiatry, Emory University, Atlanta, GA
| | - Priya Gopalan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | | | | | - R. Garrett Key
- Department of Psychiatry, University of Texas-Austin, Austin, TX
| | - David Kroll
- Department of Psychiatry, Harvard University, Boston, MA
| | - Elizabeth Prince
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD
| | | | | | - Daniel Shalev
- Department of Psychiatry, Columbia University, New York, NY
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Foiadelli T, Rossi V, Paolucci S, Rovida F, Novazzi F, Orsini A, Brambilla I, Marseglia GL, Baldanti F, Savasta S. Human Herpes Virus 7-related encephalopathy in children. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021415. [PMID: 35441609 PMCID: PMC9179060 DOI: 10.23750/abm.v92is4.12664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/27/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Primary HHV7 infection is almost ubiquitous, and it can present as exanthema subitem. Little is known on the clinical relevance of HHV7 neuroinvasion in immunocompetent children. METHODS We describe 12 patients (median age 9.45 years, 50% males) with acute encephalopathy and active HHV7 infection. In all patients, HHV7-DNA was detected on cerebrospinal fluid (CSF) by RT-PCR. RESULTS 7/12 patients had meningoencephalitis (two with ADEM and one with MOG antibody-associated CIS); 5/12 showed acute neuropsychiatric symptoms. EEG showed anomalies exclusively in patients with meningoencephalitis. Six patients had RMN anomalies. CSF HHV7 copies ranged between 20 and 3,500 copies/mL (median 66 copies/mL) and mean HHV7 CSF/blood ratio was 0.75. Outcome was favorable in all children, although 3/12 had minor neurobehavioral sequelae. Mean follow-up period of 5.2 months. CONCLUSIONS HHV7 can determine neuroinvasion in immunocompetent children, leading to acute encephalopathy. Blood-brain barrier damage and high CSF/blood viral copies ratio correlated with a more severe presentation. We speculate on the importance of immune-mediated mechanisms in provoking clinical features.
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Affiliation(s)
- Thomas Foiadelli
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Virginia Rossi
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Stefania Paolucci
- Molecular Virology Unit, Department of Diagnostic Medicine, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Francesca Rovida
- Molecular Virology Unit, Department of Diagnostic Medicine, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Federica Novazzi
- Molecular Virology Unit, Department of Diagnostic Medicine, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Alessandro Orsini
- Pediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Italy
| | - Ilaria Brambilla
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Gian Luigi Marseglia
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Fausto Baldanti
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy, Molecular Virology Unit, Department of Diagnostic Medicine, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Salvatore Savasta
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
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Cheng YY, Chou W. Response to letter to the editor: Rehabilitation for steroid exposed and psychologically influenced COVID-19 survivors. J Formos Med Assoc 2020; 120:1286-1287. [PMID: 33353793 PMCID: PMC7833835 DOI: 10.1016/j.jfma.2020.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/08/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Yuan-Yang Cheng
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, No.1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan; School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, Taiwan
| | - Willy Chou
- Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Chiali, No. 901, Chung Hwa Rd., Yung Kung District, Tainan City, 710, Taiwan; Department of Physical Medicine and Rehabilitation, Chung Shan Medical University, Taichung, Taiwan.
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Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of the coronavirus 2019 (COVID-19) disease, which has caused a pandemic in 2020. This healthcare crisis has had a significant repercussion on the mental health of people who have had the disease itself, those who have undergone restrictive lockdowns, and healthcare professionals who have been working directly or indirectly in patient care. Although the pathological mechanisms related to neuropsychiatric manifestations in patients with COVID-19 are currently unknown, different methods of action through which the central nervous system could be affected have been proposed, including direct or indirect methods. Among them, inflammatory activation through what is known as a "cytokine storm," which is present in both COVID-19 and some mental disorders, seems to play a fundamental role. We also analyze the effects the pandemic has had on the general population, which has had to be remain in lockdown, as well as on healthcare professionals who have been working.
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Affiliation(s)
- A Rodríguez-Quiroga
- Servicio de Psiquiatría y Salud Mental, Hospital Universitario Infanta Leonor, Madrid, España
- Departamento de Medicina Legal, Psiquiatría y Patología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - C Buiza
- Servicio de Psiquiatría y Salud Mental, Hospital Universitario Infanta Leonor, Madrid, España
- Departamento de Medicina Legal, Psiquiatría y Patología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - M A Álvarez de Mon
- Servicio de Psiquiatría y Salud Mental, Hospital Universitario Infanta Leonor, Madrid, España
- Departamento de Medicina Legal, Psiquiatría y Patología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - J Quintero
- Servicio de Psiquiatría y Salud Mental, Hospital Universitario Infanta Leonor, Madrid, España
- Departamento de Medicina Legal, Psiquiatría y Patología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
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Shaygannejad V, Afshari-Safavi A, Hatef B. Assessment of mental health, knowledge, and attitude of patients with multiple sclerosis and neuromyelitis optica spectrum disorder in response to 2019 novel coronavirus. Neurol Sci 2020; 42:2891-2901. [PMID: 33219424 PMCID: PMC7678583 DOI: 10.1007/s10072-020-04905-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/12/2020] [Indexed: 11/28/2022]
Abstract
Background With the recent pandemic of the novel coronavirus disease (COVID-19), multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) patients for their compromised immune system have been in significant concern. Awareness and attitude about this virus have an important impact on infection prevention and coping with stress and anxiety. So we conducted this study to assess knowledge, attitude, and mental health status in MS and NMOSD patients within the COVID-19 pandemic. Method In this cross-sectional study, the link of Depression Anxiety Stress Scales-21 (DASS-21) and a self-administered structured questionnaire were sent through social media to MS and NMOSD patients and two control groups consisting of healthy and migraine individuals. Results A total of 223 MS patients, 41 NMOSD, 29 migraine, and 245 healthy subjects participated in this study. MS patients had higher total DASS scores compared to healthy participants (p = 0.012). There were no significant differences among the study groups regarding knowledge and attitude. In MS patients, physical comorbidity was associated with a total score of attitude (OR 1.59, 95% CI 0.53, 2.66, p = 0.004). We did not find association between other demographic and clinical variables with DASS scores, attitude, and knowledge in MS patients. Conclusion The current data highlight the necessity of attitude, knowledge, and mental health assessment among MS and NMOSD patients. Further studies in other countries need to be carried to assess these points among MS and NMOSD patients.
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Affiliation(s)
- Vahid Shaygannejad
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Afshari-Safavi
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Biostatistics and Epidemiology, Faculty of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Boshra Hatef
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Vanak, Mollasadra, Tehran, Iran.
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Keyhanian K, Umeton RP, Mohit B, Davoudi V, Hajighasemi F, Ghasemi M. SARS-CoV-2 and nervous system: From pathogenesis to clinical manifestation. J Neuroimmunol 2020; 350:577436. [PMID: 33212316 PMCID: PMC7647896 DOI: 10.1016/j.jneuroim.2020.577436] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/21/2020] [Accepted: 11/02/2020] [Indexed: 01/08/2023]
Abstract
Since the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a growing body of evidence indicates that besides common COVID-19 symptoms, patients may develop various neurological manifestations affecting both the central and peripheral nervous systems as well as skeletal muscles. These manifestations can occur prior, during and even after the onset of COVID-19 general symptoms. In this Review, we discuss the possible neuroimmunological mechanisms underlying the nervous system and skeletal muscle involvement, and viral triggered neuroimmunological conditions associated with SARS-CoV-2, as well as therapeutic approaches that have been considered for these specific complications worldwide.
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Affiliation(s)
- Kiandokht Keyhanian
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Raffaella Pizzolato Umeton
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA 01655, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Babak Mohit
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Vahid Davoudi
- Ann Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Fatemeh Hajighasemi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Mehdi Ghasemi
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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Cagnazzo F, Arquizan C, Derraz I, Dargazanli C, Lefevre PH, Riquelme C, Gaillard N, Mourand I, Gascou G, Bonafe A, Costalat V. Neurological manifestations of patients infected with the SARS-CoV-2: a systematic review of the literature. J Neurol 2020; 268:2656-2665. [PMID: 33125542 PMCID: PMC7597753 DOI: 10.1007/s00415-020-10285-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 01/05/2023]
Abstract
Objective To perform an updated review of the literature on the neurological manifestations of COVID-19-infected patients Methods A PRISMA-guideline-based systematic review was conducted on PubMed, EMBASE, and SCOPUS. Series reporting neurological manifestations of COVID-19 patients were studied. Results 39 studies and 68,361 laboratory-confirmed COVID-19 patients were included. Up to 21.3% of COVID-19 patients presented neurological symptoms. Headache (5.4%), skeletal muscle injury (5.1%), psychiatric disorders (4.6%), impaired consciousness (2.8%), gustatory/olfactory dysfunction (2.3%), acute cerebrovascular events (1.4%), and dizziness (1.3%), were the most frequently reported neurological manifestations. Ischemic stroke occurred among 1.3% of COVID-19 patients. Other less common neurological manifestations were cranial nerve impairment (0.6%), nerve root and plexus disorders (0.4%), epilepsy (0.7%), and hemorrhagic stroke (0.15%). Impaired consciousness and acute cerebrovascular events were reported in 14% and 4% of patients with a severe disease, respectively, and they were significantly higher compared to non-severe patients (p < 0.05). Individual patient data from 129 COVID-19 patients with acute ischemic stroke (AIS) were extracted: mean age was 64.4 (SD ± 6.2), 78.5% had anterior circulation occlusions, the mean NIHSS was 15 (SD ± 7), and the intra-hospital mortality rate was 22.8%. Admission to the intensive care unit (ICU) was required among 63% of patients. Conclusion This updated review of literature, shows that headache, skeletal muscle injury, psychiatric disorders, impaired consciousness, and gustatory/olfactory dysfunction were the most common neurological symptoms of COVID-19 patients. Impaired consciousness and acute cerebrovascular events were significantly higher among patients with a severe infection. AIS patients required ICU admission in 63% of cases, while intra-hospital mortality rate was close to 23%. Electronic supplementary material The online version of this article (10.1007/s00415-020-10285-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Federico Cagnazzo
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, 80, Avenue Augustin Fliche, Montpellier, France.
| | - Caroline Arquizan
- Department of Neurology, Hôpital Gui de Chauliac, Montpellier University Medical Center, Montpellier, France
| | - Imad Derraz
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, 80, Avenue Augustin Fliche, Montpellier, France
| | - Cyril Dargazanli
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, 80, Avenue Augustin Fliche, Montpellier, France
| | - Pierre-Henri Lefevre
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, 80, Avenue Augustin Fliche, Montpellier, France
| | - Carlos Riquelme
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, 80, Avenue Augustin Fliche, Montpellier, France
| | - Nicolas Gaillard
- Department of Neurology, Hôpital Gui de Chauliac, Montpellier University Medical Center, Montpellier, France
| | - Isabelle Mourand
- Department of Neurology, Hôpital Gui de Chauliac, Montpellier University Medical Center, Montpellier, France
| | - Gregory Gascou
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, 80, Avenue Augustin Fliche, Montpellier, France
| | - Alain Bonafe
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, 80, Avenue Augustin Fliche, Montpellier, France
| | - Vincent Costalat
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, 80, Avenue Augustin Fliche, Montpellier, France
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Buselli R, Corsi M, Necciari G, Pistolesi P, Baldanzi S, Chiumiento M, Del Lupo E, Guerra PD, Cristaudo A. Sudden and persistent dysphonia within the framework of COVID-19: The case report of a nurse. Brain Behav Immun Health 2020; 9:100160. [PMID: 33078141 PMCID: PMC7558225 DOI: 10.1016/j.bbih.2020.100160] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/09/2020] [Accepted: 10/10/2020] [Indexed: 12/12/2022] Open
Abstract
In December 2019, clusters of atypical pneumonia with unknown etiology emerged in the city of Wuhan in China. In early January 2020, the Center for Disease Control in China announced that it was identified a new coronavirus, first tentatively named 2019-nCoV and officially named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. On February 11, 2020 the WHO identified the disease caused by SARS-CoV-2 as COVID-19 (COronaVIrus Disease-19 based on the year of appearance). Although only a few months have passed since the beginning of this pandemic, numerous studies, case reports, reviews by leading international scientific and medical journals have been published. However, given the unpredictability of virus behaviour and the still limited knowledge about it, many aspects of the infection are still little known. A recent epidemiological study has shown the presence of dysphonia in some patients with COVID-19, with a minority reporting aphonia during the clinical course of the disease. This case study draws attention on a 50-year-old female nurse presented with a history of fatigue resulting from minor exertion and persistent dysphonia at the Occupational Health Department of a major University Hospital in central Italy. The patient had a history of COVID-19 infection, which lasted about two months with pulmonary and extrapulmonary symptoms. After two RT-PCR negativities for SARS-CoV-2, dysphonia and fatigue due to minor exertionpersisted. The patient, following the persistence of the symptomatology, was subject to numerous specialist examinations, which showed no organic alterations. Based on her clinical and instrumental history, we hypothesized a psychogenetic dysphonia related to COVID-19. This case report highlights the importance of personalized medicine with long-term follow-up and rubustpsychological support in patients who tested positive for COVID-19 and in particular in the categories at greatest risk of both contagion and adverse physical and mental outcomes like health care workers. Despite world updates produced daily, general knowledge of COVID-19 remains unclear. Update answers to clinical questions can be difficult particularly regarding clinical presentations and treatment strategies. Importance of personalized medicine with long-term follow-up and good psychological support in patients who tested positive for COVID-19. Health care workers are at greatest risk of both contagion and adverse physical and mental outcomes.
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Affiliation(s)
- Rodolfo Buselli
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, 56124, Pisa, PI, Italy
| | - Martina Corsi
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, 56124, Pisa, PI, Italy
| | - Gabriele Necciari
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, 56124, Pisa, PI, Italy
| | - Piero Pistolesi
- Department of Public Health, Azienda USL Toscana Centro, 50053, Empol, FI, Italy
| | - Sigrid Baldanzi
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, 56124, Pisa, PI, Italy
| | - Martina Chiumiento
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, 56124, Pisa, PI, Italy
| | - Elena Del Lupo
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, 56124, Pisa, PI, Italy
| | - Paolo Del Guerra
- Department of Public Health, Azienda USL Toscana Centro, 50053, Empol, FI, Italy
| | - Alfonso Cristaudo
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, 56124, Pisa, PI, Italy
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Buselli R, Corsi M, Baldanzi S, Chiumiento M, Del Lupo E, Dell’Oste V, Bertelloni CA, Massimetti G, Dell’Osso L, Cristaudo A, Carmassi C. Professional Quality of Life and Mental Health Outcomes among Health Care Workers Exposed to Sars-Cov-2 (Covid-19). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176180. [PMID: 32858810 PMCID: PMC7504107 DOI: 10.3390/ijerph17176180] [Citation(s) in RCA: 178] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 12/20/2022]
Abstract
The novel coronavirus disease 2019 (COVID-19) is a global pandemic spreading worldwide, and Italy represented the first European country involved. Healthcare workers (HCWs) facing COVID-19 pandemic represented an at-risk population for new psychosocial COVID-19 strain and consequent mental health symptoms. The aim of the present study was to identify the possible impact of working contextual and personal variables (age, gender, working position, years of experience, proximity to infected patients) on professional quality of life, represented by compassion satisfaction (CS), burnout, and secondary traumatization (ST), in HCWs facing COVID-19 emergency. Further, two multivariable linear regression analyses were fitted to explore the association of mental health selected outcomes, anxiety and depression, with some personal and working characteristics that are COVID-19-related. A sample of 265 HCWs of a major university hospital in central Italy was consecutively recruited at the outpatient service of the Occupational Health Department during the acute phase of COVID-19 pandemic. HCWs were assessed by Professional Quality of Life-5 (ProQOL-5), the Nine-Item Patient Health Questionnaire (PHQ-9), and the Seven-Item Generalized Anxiety Disorder scale (GAD-7) to evaluate, respectively, CS, burnout, ST, and symptoms of depression and anxiety. Females showed higher ST than males, while frontline staff and healthcare assistants reported higher CS rather than second-line staff and physicians, respectively. Burnout and ST, besides some work or personal variables, were associated to depressive or anxiety scores. The COVID-19 pandemic represents a new working challenge for HCWs and intervention strategies to prevent burnout and ST to reduce the risk of adverse mental health outcomes are needed.
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Affiliation(s)
- Rodolfo Buselli
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56124 Cisanello (Pisa), Italy; (R.B.); (S.B.); (M.C.); (E.D.L.); (A.C.)
| | - Martina Corsi
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56124 Cisanello (Pisa), Italy; (R.B.); (S.B.); (M.C.); (E.D.L.); (A.C.)
- Correspondence:
| | - Sigrid Baldanzi
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56124 Cisanello (Pisa), Italy; (R.B.); (S.B.); (M.C.); (E.D.L.); (A.C.)
| | - Martina Chiumiento
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56124 Cisanello (Pisa), Italy; (R.B.); (S.B.); (M.C.); (E.D.L.); (A.C.)
| | - Elena Del Lupo
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56124 Cisanello (Pisa), Italy; (R.B.); (S.B.); (M.C.); (E.D.L.); (A.C.)
| | - Valerio Dell’Oste
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Via Roma 67, 56100 Pisa, Italy; (V.D.); (C.A.B.); (G.M.); (L.D.); (C.C.)
| | - Carlo Antonio Bertelloni
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Via Roma 67, 56100 Pisa, Italy; (V.D.); (C.A.B.); (G.M.); (L.D.); (C.C.)
| | - Gabriele Massimetti
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Via Roma 67, 56100 Pisa, Italy; (V.D.); (C.A.B.); (G.M.); (L.D.); (C.C.)
| | - Liliana Dell’Osso
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Via Roma 67, 56100 Pisa, Italy; (V.D.); (C.A.B.); (G.M.); (L.D.); (C.C.)
| | - Alfonso Cristaudo
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56124 Cisanello (Pisa), Italy; (R.B.); (S.B.); (M.C.); (E.D.L.); (A.C.)
| | - Claudia Carmassi
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Via Roma 67, 56100 Pisa, Italy; (V.D.); (C.A.B.); (G.M.); (L.D.); (C.C.)
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