Health-related and socio-economic burden of the COVID-19 pandemic in Vienna

Comprehensive examination of support needs and mental well-being: a mixed-method study of the Austrian general population in times of crisis

Introduction

In the recent years, the Austrian general population has faced a confluence of multiple crises. This study investigates the support wishes and mental health parameters of the Austrian general population aiming to comprehending the unmet needs and providing guidance for future psychosocial interventions and research endeavors.

Methods

1,031 participants attended the online survey and one third (n = 332) wished for further support to improve mental well-being in April 2022. A total of 280 participants accompanied their support wish with written accounts. Participants' mental health status was evaluated using the PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), PSS-10 (perceived stress), CAGE (alcohol abuse), WHO-5 (well-being), and the SCOFF (eating disorder) questionnaires. Data analysis employed a mixed-methods approach.

Results

The preeminent support wish identified was the need for professional mental support (29.3%), followed by communication (21.6%), other professional support except mental and medical support (13.9%). In line with these findings, participants expressing a support wish experienced increased mental health distress across all assessed parameters.

Conclusion

The findings indicate the presence of a vulnerable population within the Austrian general population, which may benefit from targeted support interventions. Consequently, this study contributes to the identification of unmet support needs among the Austrian populace during times of crisis, facilitating the development and enhancement of precisely tailored intervention strategies.

Psychosocial and economic impact of COVID-19 pandemic by sex among migrant populations compared with general Finnish population: a population-based study

AIMS

To study sex differences in the psychosocial and economic impact of the restrictive measures during the COVID-19 pandemic in 2020 among the migrant origin and the general population in Finland.

METHODS

Cross-sectional MigCOVID Survey data (10/2020-2/2021; n=3668) were used. FinHealth 2017 Follow-up Study participants constituted the general population reference group (n=3490). Sex differences in self-perceived impact of the restrictive measures during the COVID-19 pandemic in 2020 on the psychosocial and economic situation were examined with multivariate logistic regression, adjusting for sociodemographics and self-rated health.

RESULTS

The migrant origin population had higher odds for reporting weakened economic situation (odds ratio (OR) 5.41; 95% confidence interval (CI) 3.96-7.39), increased loneliness (OR 1.75; 95% CI 1.35-2.28), decrease in feelings of hope for the future (OR 1.70; 95% CI 1.33-2.19) and increased sleeping difficulties and nightmares (OR 1.98; 95% CI 1.34-2.92) than the general population. While the psychosocial and economic impact of COVID-19 was higher in women compared with men in the general population, findings were not fully replicated in the migrant origin population.

CONCLUSIONS

Individuals of migrant origin faced a higher likelihood of experiencing adverse changes in both psychosocial and economic aspects during the pandemic, suggesting increased vulnerability linked to migrant origin. Additional research is required to delve into the intricate connections among gender, migrant origin, and the impact of COVID-19, aiming to enhance comprehensive understanding of the contributing factors. Vulnerabilities of different population groups should be identified and addressed when planning measures to reduce adverse societal impact in future crises.

The association between enteral nutrition with survival of critical patients with COVID-19

BACKGROUND

Coronavirus disease 2019 (COVID-19) results in several complications and mortality in intensive care unit (ICU) patients. Limited studies have investigated the effect of enteral nutrition (EN) on the survival of COVID-19 patients in the ICU. The aim of this study was to investigate the association of EN with biochemical and pathological indices associated with mortality in ICU patients with COVID-19.

METHODS

This case-control study was conducted on 240 patients with COVID-19 hospitalized in the ICU including 120 eventual nonsurvived as the cases and 120 survived patients as the controls. All of the patients received EN as a high protein high volume or standard formula. Data on general information, anthropometric measurements, and the results of lab tests were collected.

RESULTS

The recovered patients received significantly more high protein (60.8% vs. 39.6%, p = .004) and high volume (61.6% vs. 42.3%, p = .005) formula compared to the nonsurvived group. Mortality was inversely associated with high volume (odds ratio [OR]: 0.45 confidence interval [CI]95%, p = .008) and high protein (OR: 0.42 CI95%, p = .003) formula. The results remained significant after adjusting for age and sex. Further adjustment for underlying diseases, smoking, body mass index, and the acute physiology and chronic health evaluation II (APACHE II) score did not change the results.

CONCLUSION

The findings of the study showed that there was a significant inverse association between mortality and high volume and high protein formula in patients with COVID-19. Further investigation is warranted.

Genetic predisposition for negative affect predicts mental health burden during the COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) pandemic was accompanied by an increase in mental health challenges including depression, stress, loneliness, and anxiety. Common genetic variants can contribute to the risk for psychiatric disorders and may present a risk factor in times of crises. However, it is unclear to what extent polygenic risk played a role in the mental health response to the COVID-19 pandemic. In this study, we investigate whether polygenic scores (PGSs) for mental health-related traits can distinguish between four resilience-vulnerability trajectories identified during the COVID-19 pandemic and associated lockdowns in 2020/21. We used multinomial regression in a genotyped subsample (n = 1316) of the CovSocial project. The most resilient trajectory characterized by the lowest mental health burden and the highest recovery rates served as the reference group. Compared to this most resilient trajectory, a higher value on the PGS for the well-being spectrum decreased the odds for individuals to be in one of the more vulnerable trajectories (adjusted R-square = 0.3%). Conversely, a higher value on the PGS for neuroticism increased the odds for individuals to be in one of the more vulnerable trajectories (adjusted R-square = 0.2%). Latent change in mental health burden extracted from the resilience-vulnerability trajectories was not associated with any PGS. Although our findings support an influence of PGS on mental health during COVID-19, the small added explained variance suggests limited utility of such genetic markers for the identification of vulnerable individuals in the general population.

Estimation of non-health gross domestic product (NHGDP) loss due to COVID-19 deaths in West Bengal, India

OBJECTIVES

The state of West Bengal witnessed a significant surge of COVID-19 in all three waves. However, there is a gap in understanding the economic loss associated with COVID-19. This study estimates future non-health gross domestic product (NHGDP) losses associated with COVID-19 deaths in West Bengal, India.

SETTING

Various open domains were used to gather data on COVID-19 deaths in West Bengal and the aforementioned estimates.

PRIMARY AND SECONDARY OUTCOME MEASURES

The NHGDP losses were evaluated using the cost-of-illness approach. Future NHGDP losses were discounted at 3%. Excess death estimates by the WHO and Global Burden of Disease (GBD) were used. Sensitivity analysis was carried out by varying discount rates and average age of death (AAD).

RESULTS

21 532 deaths in West Bengal from 17 March 2020 to 31 December 2022 decreased the future NHGDP by $0.92 billion. Nearly 90% of loss was due to deaths occurring in the age group of 30 years and above. Majority of the NHGDP loss was borne by the 46-60 years age group. NHGDP loss/death was $55,171; however, the average loss/death declined with rise in age. Based on the GBD and WHO excess death estimates, the NHGDP loss increased to $9.38 billion and $9.42 billion, respectively. When the lower age interval is considered as AAD, the NHGDP loss increased to $1.3 billion. At 5% and 10% discount rates, the losses reduced to $0.767 billion and $0.549 billion, respectively.

CONCLUSIONS

Results from the study suggest that COVID-19 contributed to a major economic loss in West Bengal. The mortality and morbidity caused by COVID-19, the substantial economic costs at individual and population levels in West Bengal, and probably across India and other countries, is another economic argument for better infection control strategies across the globe to minimise the impact of COVID-19.

Maternal mortality in Colombia during the COVID-19 pandemic: time series and social inequities

OBJECTIVE

The impact of the COVID-19 pandemic goes beyond morbidity and mortality from that disease. Increases in maternal mortality have also been described but have not been extensively studied to date. This study aimed to examine changes in maternal mortality and identify correlates and predictors of excess maternal mortality in Colombia during the pandemic.

SETTING

Analysis of data from the national epidemiological surveillance databases of Colombia (Sivigila).

PARTICIPANTS

Deaths among 6342 Colombian pregnant women who experienced complications associated with pregnancy, childbirth or the perperium during 2008-2020 were included in this study. For inequalities analysis, a subsample of 1055 women from this group who died in 2019 or 2020 years were analysed.

METHODS

We collected data from the national surveillance system (Sivigila) on maternal mortality. Analysis was carried out in two stages, starting with a time series modelling using the Box-Jenkins approach. Data from Sivigila for 2008-2019 were used to establish a baseline of expected mortality levels. Both simple and complex inequality metrics, with the maternal mortality ratios (MMRs), were then calculated using the Multidimensional Poverty Index as a socioeconomic proxy.

RESULTS

Maternal deaths in 2020 were 12.6% (95% CI -21.4% to 95.7%) higher than expected. These excess deaths were statistically significant in elevation for the months of July (97.4%, 95% CI 35.1% to 250.0%) and August (87.8%, 95% CI 30.5% to 220.8%). The MMR was nearly three times higher in the poorest municipalities compared with the most affluent communities in 2020.

CONCLUSIONS

The COVID-19 pandemic had considerable impact on maternal health, not only by leading to increased deaths, but also by increasing social health inequity. Barriers to access and usage of essential health services are a challenge to achieving health-related Sustainable Development Goals.

Study protocol: examining the impacts of COVID-19 mitigation measures on pregnancy and birth outcomes in Scotland-a linked administrative data study

INTRODUCTION

This protocol outlines aims to test the wider impacts of the COVID-19 pandemic on pregnancy and birth outcomes and inequalities in Scotland.

METHOD AND ANALYSIS

We will analyse Scottish linked administrative data for pregnancies and births before (March 2010 to March 2020) and during (April 2020 to October 2020) the pandemic. The Community Health Index database will be used to link the National Records of Scotland Births and the Scottish Morbidity Record 02. The data will include about 500 000 mother-child pairs. We will investigate population-level changes in maternal behaviour (smoking at antenatal care booking, infant feeding on discharge), pregnancy and birth outcomes (birth weight, preterm birth, Apgar score, stillbirth, neonatal death, pre-eclampsia) and service use (mode of delivery, mode of anaesthesia, neonatal unit admission) during the COVID-19 pandemic using two analytical approaches. First, we will estimate interrupted times series regression models to describe changes in outcomes comparing prepandemic with pandemic periods. Second, we will analyse the effect of COVID-19 mitigation measures on our outcomes in more detail by creating cumulative exposure variables for each mother-child pair using the Oxford COVID-19 Government Response Tracker. Thus, estimating a potential dose-response relationship between exposure to mitigation measures and our outcomes of interest as well as assessing if timing of exposure during pregnancy matters. Finally, we will assess inequalities in the effect of cumulative exposure to lockdown measures on outcomes using several axes of inequality: ethnicity/mother's country of birth, area deprivation (Scottish Index of Multiple Deprivation), urban-rural classification of residence, number of previous children, maternal social position (National Statistics Socioeconomic Classification) and parental relationship status.

ETHICS AND DISSEMINATION

NHS Scotland Public Benefit and Privacy Panel for Health and Social Care scrutinised and approved the use of these data (1920-0097). Results of this study will be disseminated to the research community, practitioners, policy makers and the wider public.

Comparison of health behaviors of adult women in Korea before and during the COVID-19 pandemic: secondary analysis of the Korea National Health and Nutrition Examination Survey 2019-2020

PURPOSE

This study investigated the changes in the health-related behaviors of adult women in Korea during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

Data from the eighth Korea National Health and Nutrition Examination Survey (2019- 2020) were analyzed. The participants were 4,848 women aged 19 to 64 years in 2019 and 2020. Data analysis using the complex sampling design was performed using SPSS 20.1.

RESULTS

Positive changes during the pandemic compared to before the pandemic in Korean adult women were found for improved subjective oral health perceptions (odds ratio [OR], 1.77; p<.001), increased moderate-intensity exercise in work and leisure activities (OR, 1.75; p<.001 and OR; 1.29, p=.004), and a decrease in secondhand smoke exposure at the workplace and in public places (OR, 0.64; p=.004 and OR, 0.60; p<.001). However, the following negative health behavior changes were found: decreased frequency of walking 5 days a week (OR, 0.81; p=.011) and an increase in unhealthy daytime sleep durations (OR, 1.40; p=006).

CONCLUSION

Compared to before the COVID-19 pandemic, Korean adult women perceived their subjective dental health more positively during the COVID-19 pandemic, decreased their exposure to secondhand smoke at work and in public places, decreased walking, and increased sleep duration during the week. Since this study only compared data between 1 year before and after the start of the pandemic, it is necessary to investigate a longer period of time in the future. A future study should attempt to identify the factors related to changes in health behaviors caused by the pandemic.

Examining the Influence of Housing Conditions and Daily Greenspace Exposure on People's Perceived COVID-19 Risk and Distress

Many people have worried about COVID-19 infection, job loss, income reduction, and family conflict during the COVID-19 pandemic. Some social groups may be particularly vulnerable due to their residential neighborhoods and daily activities. On the other hand, people's daily exposure to greenspace offers promising pathways for reducing these worries associated with COVID-19. Using data collected with a questionnaire and a two-day activity diary from two typical neighborhoods in Hong Kong, this study examines how people's housing conditions and daily greenspace exposure affect their perceived COVID-19 risk and distress (i.e., worries about job loss, income reduction, and family conflict) during the pandemic. First, the study compares people's perceived COVID-19 risk and distress based on their residential neighborhoods. Further, it examines the associations between people's perceived COVID-19 risk and distress with their housing conditions and daily greenspace exposure using ordinal logistic regression models. The results indicate that living in a high-risk neighborhood, being married, renting a residential unit, and living in a large household are significantly associated with a higher neighborhood-based perceived COVID-19 risk and distress during the pandemic. In addition, people also reported lower mobility-based perceived COVID-19 risk when compared to their neighborhood-based perceived COVID-19 risk, while they still have a high perceived COVID-19 risk in their occupational venues if they have to work in a high-risk district (e.g., Kowloon). Lastly, daily greenspace exposure (i.e., woodland) could reduce people's perceived COVID-19 risk and distress. These results have important implications for the public health authority when formulating the measures during the COVID-19 pandemic.

Tapping the Potential of Resilience to Support an Integrated and Person-Centred Approach to Health and Wellbeing-Developing a Simple Assessment Tool for Practice

(1) Background: The push towards population health management and the need for new approaches in health services delivery focusing on the prevention and management of chronic diseases has helped in advocating for more person-centred care, and thus for integration of physical and mental health. Resilience plays a key role in supporting sustainable lifestyle changes and promoting health and wellbeing, but most assessment tools available today are too long for widespread use. The purpose of this paper is to describe the development of a new diagnostic tool to capture a person's resilience and resources. (2) Methods: This paper outlines the interrelatedness of different theories of salutogenesis, social determinants of health and health promotion with resilience and establishes resilience as a key enabler to promote health and wellbeing. (3) Results: A new, short questionnaire is proposed based on the triade of evidence-based medicine, which should be easy to use and give a good assessment of a person's resilience. (4) Conclusions: There are many reasons why the call for a short and easy-to-use assessment tool for resilience is warranted. In view of the international transition towards integrated, person-centred health systems, such a tool would find many usages. It would also support the strategies to tackle multi-morbidity, complex conditions and the social determinants of health in its focus on strengthening an individual's ability to cope with adverse events, and actively engage in health promotion and community involvement programmes. The next step is to test the tool in practice and validate it.

Changes in the mental health status of the general Chinese population during the COVID-19 pandemic: A longitudinal study

The study is based on a longitudinal evaluation of the public, during the initial COVID-19 outbreak in China and 8 months after. It aimed to explore the changes in the mental health of the public at the beginning of the pandemic and during the regular epidemic prevention and control. An online survey questionnaire was used to collect data during the initial COVID-19 outbreak (February 10, 2020-February 18, 2020; T1) and 8 months after the outbreak (October 21, 2020-December 29, 2020; T2). Psychological distress was assessed using the Patient Health Questionnaire-9 (PHQ-9), Self-rating Anxiety Scale (SAS), and Post-traumatic Stress Disorder Checklist (PCL-5). A chi-square test was used to compare the changes in the depression and anxiety scores at T1 and T2, and the correlation between symptoms was analyzed through Spearman's rank correlation. In T1, 1,200 people were recruited, while 168 people responded in T2. Depression (48.2-31.0%; p=0.001) and anxiety (17.9-9.5%; p = 0.026) symptoms decreased over time; two participants developed post-traumatic stress disorder (PTSD) in T2. The scores of the PHQ-9 scale and the SAS scale were both positively correlated with the score of the PCL-5 scale and negatively correlated with sleep time. During the COVID-19 pandemic, part of the general population's anxiety and depression significantly reduced with time, and they rarely developed PTSD. PTSD occurrence was related to severe depression and anxiety.

Opportunities to Increase Financial Well-Being by Investing in Environmental, Social and Governance with Respect to Improving Financial Literacy under COVID-19: The Case of Latvia

The latest studies reveal that the COVID-19 pandemic has pushed investors in developed economies to focus more on the value attached to environmental and social responsibilities. Unfortunately, socially responsible investment and compliance with environmental, social and governance criteria are not given enough priority in Latvia at present. The purpose of the study is to investigate how the COVID-19 pandemic has influenced the willingness of Latvians to invest in assets that meet environmental, social and governance (ESG) criteria and factors influencing investors’ choice based on their financial literacy. Different views on sustainable investments, socially responsible investments and the relevance of environmental, social and governance criteria from private investors’ perspectives were analyzed to identify factors influencing investment decisions in favour of sustainable investments. Quantitative analysis was carried out to reveal the regularities between financial literacy, the willingness to invest to meet the ESG criteria and the level of education and income of the Latvian population, as well as their savings/investment experience. Such statistical methods as descriptive statistics and hypothesis testing were applied to perform an analysis of the results. The authors’ findings include the importance of sustainable investing to Latvian society, changes of attitude towards ESG investing in different private investors’ groups under the COVID-19 crisis, and the effects of these changes on the financial well-being of the population and, on the basis of these findings, have come to the conclusion that the willingness to invest in the assets that follow environmental, social and governance criteria depends on the level of education, savings/investment experience and income level.