Assessment of depressive symptoms in patients with COVID-19 during the second wave of epidemic in Myanmar: A cross-sectional single-center study

The Impact of Stress from Social Isolation during the COVID-19 Pandemic on Psychiatric Disorders: An Analysis from the Scientific Literature

The COVID-19 pandemic generated, in addition to severe symptoms, hospitalizations and deaths worldwide, as well as stress from the fear of the disease and social uncertainties, from restriction measures and social isolation. Stress from social isolation impacts mental health, aggravating existing conditions and triggering neuropsychiatric symptoms in individuals with biopsychosocial vulnerability. During and immediately after the period of social restriction imposed by the pandemic, the scientific community carried out several research protocols. These revealed results that relevantly demonstrate the harmful effect of the stress induced by the pandemic situation. This narrative review reports and discusses research results demonstrating impairments in psychiatric disorders such as autism spectrum disorder, dementia, eating disorders, schizophrenia, anxiety, and depression. In this sense, the community has identified a significant negative influence of social isolation on the mental health of individuals through the modification of individual routines and the absence of social interactions. Moreover, the community identified perceived differences related to the impacts on men and women. In addition to studies showing the effect of social isolation on disorders, an evaluation of protocols with some possible therapeutic intervention strategies during times of social restriction was developed.

Prevalence and Associated Factors of Depressive Symptoms Among Mizan-Tepi University Students During the COVID-19 Pandemic

BACKGROUND

Depression is an extremely common and widespread problem among university students. A better understanding of the magnitude and determinants of depressive symptoms is required to create appropriate interventions for those groups. This study aimed to assess the prevalence and predictors of depressive symptoms among Mizan-Tepi University students during the pandemic lockdown.

METHODS

From September 11th to September 25th, 2020, 779 Mizan-Tepi University students participated in this web-based cross-sectional study. The link was created with a Google Form, and the questionnaire was distributed to participants via e-mail, WhatsApp, Telegram, and other social media accounts. To determine the prevalence and determinants of depressive symptoms, both descriptive and inferential analyses were used. The chi-squared test of association and logistic regression were used to identify predictors of depressive symptoms among university students. We used (IBM) SPSS version 20 for all statistical analyses.

RESULTS

The prevalence of depressive symptoms among university students was 39.5%. According to results of multivariable binary logistic regression, being female (AOR = 0.339, 95%CI: 0.220-0.522), being an alcoholic (AOR = 2.101, 95%CI: 1.452-3.041), smoking (AOR = 2.088, 95%CI: 1.460-2.986), being quarantined for 14 days (AOR = 1.775, 95%CI: 1.231-2.560), frequently using social media (AOR = 1.510, 95%CI: 1.063-2.145), fearing COVID-19 (AOR = 5.058, 95%CI: 3.508-7.292), having sleeping problems (AOR = 1.703, 95%CI: 1.051-2.760), having a family member infected with COVID-19 (AOR = 1.829, 95%CI: 1.211-2.763), being exposed to COVID-19 (AOR = 1.748, 95%CI: 1.114-2.743), monthly disposable income ≥ 501 ETB (AOR = 0.531, 95%CI: 0.359-0.784), having a higher level of hope (AOR = 0.158, 95%CI:0.056-0.447), and having high social support (AOR = 0.546, 95%CI: 0.374-0.797) were significantly associated with depressive symptoms among students.

CONCLUSION

In this study, the prevalence of depressive symptoms was found to be high among university students. Being an alcoholic, smoking, quarantined for 14 days, frequently using social media, fearing COVID-19, having sleep problems, having a family member infected with COVID-19, and being exposed to COVID-19 were all associated with an increased risk of developing depressive symptoms, while being a female, having a high level of disposable monthly income, hope, and social support decreased the risk of depressive symptoms among university students. Interventions should be put in place to promote mental health among university students.

Experiences of COVID-19 survivors: A qualitative study based on Watson's Theory of Human Caring

This study aims to investigate the experiences of survivors of COVID‐19 in Turkey. The research questions and results are structured according to Watson’s Theory of Human Caring. The study was conducted using a descriptive qualitative research design. The phenomenological method was used to explore the experiences of survivors of COVID‐19. A total of 34 survivors of COVID‐19 were included in the study. Data were collected using semi‐structured and open‐ended questions online and via telephone interviews between February and March 2020. Data were evaluated using thematic analysis and descriptive analysis. Six main themes and twenty‐five sub‐themes were defined that describe the experiences of survivors of COVID‐19 regarding the illness: (a) Denial and adaptation, (b) Fear, (c) Feeling of hopelessness, (d) Preventions (e) Meaning attribution, and (f) Metaphors about COVID‐19. Information from this research may be used by healthcare professionals to develop new strategies for the care of survivors of COVID‐19. Moreover, it can be said that Watson’s Theory of Human Caring is suitable for monitoring the psychosocial development of patients with COVID‐19.

Twenty-year follow-up of children with obstructive sleep apnea

STUDY OBJECTIVES

Obstructive sleep apnea (OSA) in children is associated with acute metabolic, cardiovascular, and neuro-cognitive abnormalities. The long-term outcomes of childhood OSA into adulthood has not been established. We performed a 20-year follow-up of patients with polysomnographically documented OSA in childhood compared to a healthy control group to evaluate the long-term anthropometric, sleep, cognitive, and cardiovascular outcomes.

METHODS

Children diagnosed to have severe OSA between the ages of 1 - 17 years (4.87 ± 2.77) were prospectively contacted by telephone as young adults after approximately 20 years. Data collected included reported anthropometric, educational level, health history, and the Berlin questionnaire.

RESULTS

Young adults with confirmed severe OSA in childhood had significantly higher adulthood BMI (p=0.038), lower academic degrees (p<0.001), and more snoring (p=0.045) compared to controls. The AHI during childhood trended towards predicting cardiovascular outcomes and the Berlin questionnaire in adulthood.

CONCLUSIONS

Adults with history of severe childhood OSA have a high risk of having snoring, elevated BMI, and lower academic achievement in adulthood. Thus, children with severe OSA may be at increased risk of chronic diseases later in life. The intervening COVID-19 pandemic has introduced considerable additional neurobehavioral morbidity complicating the identification of the full long-term consequences of childhood OSA.

Lipid Nanoparticle Delivery Systems to Enable mRNA-Based Therapeutics

The world raced to develop vaccines to protect against the rapid spread of SARS-CoV-2 infection upon the recognition of COVID-19 as a global pandemic. A broad spectrum of candidates was evaluated, with mRNA-based vaccines emerging as leaders due to how quickly they were available for emergency use while providing a high level of efficacy. As a modular technology, the mRNA-based vaccines benefitted from decades of advancements in both mRNA and delivery technology prior to the current global pandemic. The fundamental lessons of the utility of mRNA as a therapeutic were pioneered by Dr. Katalin Kariko and her colleagues, perhaps most notably in collaboration with Drew Weissman at University of Pennsylvania, and this foundational work paved the way for the development of the first ever mRNA-based therapeutic authorized for human use, COMIRNATY^®. In this Special Issue of Pharmaceutics, we will be honoring Dr. Kariko for her great contributions to the mRNA technology to treat diseases with unmet needs. In this review article, we will focus on the delivery platform, the lipid nanoparticle (LNP) carrier, which allowed the potential of mRNA therapeutics to be realized. Similar to the mRNA technology, the development of LNP systems has been ongoing for decades before culminating in the success of the first clinically approved siRNA-LNP product, ONPATTRO^®, a treatment for an otherwise fatal genetic disease called transthyretin amyloidosis. Lessons learned from the siRNA-LNP experience enabled the translation into the mRNA platform with the eventual authorization and approval of the mRNA-LNP vaccines against COVID-19. This marks the beginning of mRNA-LNP as a pharmaceutical option to treat genetic diseases.

Predicting Anxiety and Depression Among Patients With COVID-19 in Concentrated Isolation at Medical Camps in Vietnam: A Descriptive Cross-Sectional Study

INTRODUCTION

This study aims to assess the requirement for anxiety and depression treatment for patients with coronavirus disease 2019 (COVID-19) in medical camps in Bac Giang province, Vietnam. This information can help improve the government policy to reduce anxiety and depression in patients with COVID-19.

METHODS

A total of patients with 427 COVID-19 participated in the survey conducted from 5 to 15 June 2021 in Bac Giang province. The survey included 17 questions about the general characteristics of the patients, 15 questions to assess common COVID-19 symptoms, the Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder-7 (GAD-7) scores, and four questions to assess hospital reviews, including facilities, food, medical staff, and living conditions. Logistics regression analyses were conducted to assess the association between COVID-19 symptoms and high anxiety and depression (HAD) status.

RESULTS

A logistic regression analysis evaluated the risk factors in need of intervention. Our study showed that lower hospital review scores (odd ratio = 0.98; 95% confident interval = 0.97-0.99) were found to be a risk needing intervention. It was also identified that older patients (odd ratio = 1.1; 95% confident interval = 1.03-1.18), women (odd ratio = 1.31; 95% confident interval = 1.09-1.31), patients who were primary income earners in the family (odd ratio = 1.15; 95% confident interval = 1.03-1.28), patients who had headaches (odd ratio = 1.16; 95% confident interval = 1.06-1.21), and patients who had joint pain (odd ratio = 1.17; 95% confident interval = 1.06- 1.3) were risk factors for HAD status.

CONCLUSION

Our research shows that every 10-year age increase was associated with a 10% increase in the likelihood of HAD status. Study subjects being primary income earners were also associated with a 15% increased risk of having HAD status. This study showed that a decrease in family income due to COVID-19 caused an increase in high-level anxiety/depression status.

Liaison Psychiatry During the Peak of the Coronavirus Pandemic: A Description of Referrals and Interventions

Introduction: The novel coronavirus SARS-CoV-2 belongs to the coronavirus family, a group of viruses that can cause upper respiratory infections in humans. Among other symptoms, it can present as an asymptomatic infection or as a more severe disease requiring hospitalization. Neuropsychiatric symptoms have been described in the acute phase of the illness and as long-term repercussions. We describe the characteristics and interventions in those COVID-19 patients referred to our liaison psychiatry service. Materials and Methods: This is a cross-sectional descriptive study. This study was carried out within the Department of Psychiatry of Cruces University Hospital (Basque Country, Spain). Data from each psychiatric consultation within our consultation-liaison service were consecutively obtained for 1 month from March 17 to April 17, 2020. We recruited data regarding clinical and referral characteristics and psychiatric interventions. Results: Of a total of 721 SARS-CoV-2 hospitalizations, 43 (5.6%) patients were referred to our psychiatry liaison service. The median age was 61 years old, and 62.8% were women. The infectious disease department was the most frequent petitioner (37.2%), and the most common reason for referral was patient anxiety (25.6%). A total of 67.4% of patients received psychological counseling and 55.8% received some pharmacological approach, with a median of 3.7 visits/calls per patient. In addition, 20.3% needed a medication switch due to potential interactions between psychotropics and drugs used to treat SARS-CoV-2. Discussion: In our study, up to 5.6% of SARS-CoV-2 hospitalized patients needed a psychiatric evaluation, especially for anxiety and mood symptoms. Psychosocial factors associated with the pandemic, drugs used to treat the infection, or a direct causative effect of the virus may explain our findings.

Clinical features and outcomes of COVID-19 and dengue co-infection: a systematic review

BACKGROUND

Dengue is the most common arboviral disease in the tropical and sub-tropical regions of the world. Like other regions, dengue-endemic areas have faced the additional public health and socio-economic impact of the ongoing coronavirus disease 2019 (COVID-19) pandemic. COVID-19 and dengue co-infections have been reported, with complicated patient management and care requirements. This review aimed to collate and synthesise current knowledge on the clinical features and outcomes of COVID-19 and dengue virus co-infection, a potentially important new dimension to be considered in public health management of the COVID-19 pandemic.

METHODS

A systematic literature review was conducted using PubMed, Web of Science and Scopus databases from 1st January to 21st November 2020. The key search terms used were "dengue" and "coronavirus". Descriptive analysis with graphical illustrations were used to present the clinical and laboratory parameters of the co-infection.

RESULTS

Thirteen published papers and four news articles were included in the review. Most studies were case reports with a detailed description of the clinical and laboratory characteristics of the co-infection. All cases were in adults with the exception of a six-year old child. The common symptoms of co-infection were fever, dyspnea, headache, and cough. Common laboratory results included thrombocytopenia, lymphocytopenia, elevated transaminases, and leukopenia. Serious outcomes of co-infection included septic shock, acute respiratory disease syndrome and multi-organ failure, leading to death in some patients.

CONCLUSIONS

COVID-19 and dengue co-infection was associated with severe disease and fatal outcomes. The correct diagnosis and treatment of co-infection poses a substantial challenge due to the overlapping clinical and laboratory parameters. Therefore, confirmative diagnostic tests are necessary for accurate and timely diagnosis and patient management.