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Pouradeli S, Khadir E, Rezaeian M, Meimand HAE. Exploring suicidal ideation prevalence in multiple sclerosis patients during the COVID-19 pandemic: A study on the relationship between drug use and suicidal ideation. Mult Scler Relat Disord 2024; 87:105676. [PMID: 38776600 DOI: 10.1016/j.msard.2024.105676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/03/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The COVID-19 pandemic has exacerbated psychological challenges, leading to increased rates of clinically significant depression and suicidal ideation among MS patients. Despite advancements in MS treatments, there remains a need to investigate the impact of different drugs on the prevalence of suicidal ideation, particularly in the context of the pandemic. METHOD This cross-sectional study, conducted in 2021, received ethics approval from the Ethics Committee of Kerman University of Medical Science. The study involved 234 MS patients selected from the MS Association in Kerman Province. Questionnaires were prepared and distributed via Google Drive and WhatsApp, with participants providing informed consent. The collected data were analyzed using SPSS software. Inclusion criteria encompassed adults diagnosed with MS according to specific criteria and willing to complete the questionnaires, while exclusion criteria included unclear diagnostic criteria and lack of cooperation. The instruments included a demographic questionnaire, medication checklist, and the Beck Suicidal Thought Scale questionnaire, which has been validated in Iran. RESULTS 202 MS patients completed the questionnaires, most of whom were women and married. The prevalence of Suicidal Ideation was 46.5 %, with 8.9 % at high risk. Factors such as gender, marital status, education, occupation, and city did not show statistically significant differences in SI. Patients with SI had a longer duration of illness and were more likely to have seen a psychiatrist. The COVID-19 pandemic affected the necessary care for 44.6 % of patients and worsened symptoms in 28.7 %. Additionally, 30.2 % of patients had seen a psychiatrist, and the prevalence of SI was significantly higher in this group. The study also explored the prevalence of SI with comorbidities and types of drugs used, finding no statistically significant differences. CONCLUSION The study revealed a high prevalence of suicide ideation among MS patients, emphasizing the need for tailored comprehensive support. Factors contributing to SI included limited healthcare access, fear of COVID-19 complications, social isolation, and heightened anxiety. Recommendations for healthcare providers stress early diagnosis, personalized treatment plans, and collaborative efforts to enhance the well-being of individuals with MS in Iran post-COVID-19.
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Affiliation(s)
- Shiva Pouradeli
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Khadir
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Rezaeian
- Department of Epidemiology and Biostatistics, School of Health, Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Choi W, Lim Y, Heo T, Lee S, Kim W, Kim SC, Kim Y, Kim J, Kim H, Kim H, Lee T, Kim C. Characteristics and Effectiveness of Mobile- and Web-Based Tele-Emergency Consultation System between Rural and Urban Hospitals in South Korea: A National-Wide Observation Study. J Clin Med 2023; 12:6252. [PMID: 37834896 PMCID: PMC10573876 DOI: 10.3390/jcm12196252] [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: 08/28/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: The government of South Korea has established a nationwide web- and mobile-based emergency teleconsultation network by designating urban and rural hospitals. The purpose of this study is to analyze the characteristics and effectiveness of the tele-emergency system in South Korea. (2) Methods: Tele-emergency consultation cases from May 2015 to December 2018 were analyzed in the present study. The definition of a tele-emergency in the present study is an emergency consultation between doctors in rural and urban hospitals via a web- and mobile-based remote emergency consultation system (RECS). Consultations through an RECS are grouped into three categories: medical procedure or treatment guidance, image interpretation, and transportation requests. The present study analyzed the characteristics of the tele-emergency system and the reduction in unnecessary transportation (RUT). (3) Results: A total of 2604 cases were analyzed in the present study from 2985 tele-emergency consultation cases. A total of 381 cases were excluded for missing data. Consultations for image interpretation were the most common in trauma cases (71.3%), while transfer requests were the most common in non-trauma cases (50.3%). Trauma patients were more frequently admitted to rural hospitals or discharged and followed up with at rural hospitals (20.3% vs. 40.5%) after consultations. In terms of disease severity, non-severe cases were statistically higher in trauma cases (80.6% vs. 59.4%; p < 0.001). The RUT was statistically highly associated with trauma cases (60.8% vs. 42.8%; p < 0.001). In an analysis that categorized cases by region, a statistically higher proportion of transportation was used in island regions (69.9% vs. 49.5%; p < 0.003). More RUT was associated with non-island regions (30.1% vs. 50.5%; p = 0.001). (4) Conclusions: The tele-emergency system had a great role in reducing unnecessary patient transportation in non-severe trauma cases and non-island rural area emergency cases. Further research is needed for a cost/benefit analysis and clinical outcomes.
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Affiliation(s)
- WooSung Choi
- Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea;
| | - YongSu Lim
- Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea;
- Department of Emergency Medicine, Gachon University College of Medicine, Incheon 21565, Republic of Korea
| | - Tag Heo
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea; (T.H.); (S.L.)
| | - SungMin Lee
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea; (T.H.); (S.L.)
| | - Won Kim
- Department of Emergency Medicine, Cheju Halla General Hospital, Jeju 63127, Republic of Korea;
| | - Sang-Chul Kim
- Department of Emergency Medicine, Chungbuk National University College of Medicine, Cheongju 28644, Republic of Korea;
| | - YeonWoo Kim
- Department of Emergency Medicine, Andong Medical Center, Andong 36743, Republic of Korea;
| | - JaeHyuk Kim
- Department of Emergency Medicine, Mokpo Hangook Hospital, Mokpo 58643, Republic of Korea;
| | - Hyun Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea;
| | - HyungIl Kim
- Department of Emergency Medicine, Dankook University College of Medicine, Cheonan 31116, Republic of Korea;
| | - TaeHun Lee
- Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Republic of Korea;
| | - Chol Kim
- Department of Emergency Medicine, Saint Carollo General Hospital, Suncheon 57931, Republic of Korea;
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Chen R, Charpignon ML, Raquib RV, Wang J, Meza E, Aschmann HE, DeVost MA, Mooney A, Bibbins-Domingo K, Riley AR, Kiang MV, Chen YH, Stokes AC, Glymour MM. Excess Mortality With Alzheimer Disease and Related Dementias as an Underlying or Contributing Cause During the COVID-19 Pandemic in the US. JAMA Neurol 2023; 80:919-928. [PMID: 37459088 PMCID: PMC10352932 DOI: 10.1001/jamaneurol.2023.2226] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/27/2023] [Indexed: 07/20/2023]
Abstract
Importance Adults with Alzheimer disease and related dementias (ADRD) are particularly vulnerable to the direct and indirect effects of the COVID-19 pandemic. Deaths associated with ADRD increased substantially in pandemic year 1. It is unclear whether mortality associated with ADRD declined when better prevention strategies, testing, and vaccines became widely available in year 2. Objective To compare pandemic-era excess deaths associated with ADRD between year 1 and year 2 overall and by age, sex, race and ethnicity, and place of death. Design, Setting, and Participants This time series analysis used all death certificates of US decedents 65 years and older with ADRD as an underlying or contributing cause of death from January 2014 through February 2022. Exposure COVID-19 pandemic era. Main Outcomes and Measures Pandemic-era excess deaths associated with ADRD were defined as the difference between deaths with ADRD as an underlying or contributing cause observed from March 2020 to February 2021 (year 1) and March 2021 to February 2022 (year 2) compared with expected deaths during this period. Expected deaths were estimated using data from January 2014 to February 2020 fitted with autoregressive integrated moving average models. Results Overall, 2 334 101 death certificates were analyzed. A total of 94 688 (95% prediction interval [PI], 84 192-104 890) pandemic-era excess deaths with ADRD were estimated in year 1 and 21 586 (95% PI, 10 631-32 450) in year 2. Declines in ADRD-related deaths in year 2 were substantial for every age, sex, and racial and ethnic group evaluated. Pandemic-era ADRD-related excess deaths declined among nursing home/long-term care residents (from 34 259 [95% PI, 25 819-42 677] in year 1 to -22 050 [95% PI, -30 765 to -13 273] in year 2), but excess deaths at home remained high (from 34 487 [95% PI, 32 815-36 142] in year 1 to 28 804 [95% PI, 27 067-30 571] in year 2). Conclusions and Relevance This study found that large increases in mortality with ADRD as an underlying or contributing cause of death occurred in COVID-19 pandemic year 1 but were largely mitigated in pandemic year 2. The most pronounced declines were observed for deaths in nursing home/long-term care settings. Conversely, excess deaths at home and in medical facilities remained high in year 2.
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Affiliation(s)
- Ruijia Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Marie-Laure Charpignon
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge
| | - Rafeya V. Raquib
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Jingxuan Wang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Erika Meza
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Hélène E. Aschmann
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Michelle A. DeVost
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Alyssa Mooney
- Institute for Health Policy Studies, University of California, San Francisco, San Francisco
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
- Department of Medicine, University of California, San Francisco, San Francisco
- Editor in Chief, JAMA
| | - Alicia R. Riley
- Department of Sociology, University of California, Santa Cruz, Santa Cruz
| | - Mathew V. Kiang
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
| | - Yea-Hung Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Andrew C. Stokes
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - M. Maria Glymour
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
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Gierek M, Kitala D, Łabuś W, Glik J, Szyluk K, Pietrauszka K, Bergler-Czop B, Niemiec P. The Impact of Telemedicine on Patients with Hidradenitis Suppurativa in the COVID-19 Era. Healthcare (Basel) 2023; 11:healthcare11101453. [PMID: 37239740 DOI: 10.3390/healthcare11101453] [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: 04/04/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: Hidradenitis suppurativa is a chronic, inflammatory skin disease. It is characterized by the transformation of normal skin into skin with abscesses, nodules, tunnels, and scars. The most commonly affected areas are the armpits, groins, buttocks, and subscapular area. Patients with HS require constant care under the supervision of the outpatient clinic. Due to the COVID-19 pandemic, consultations have been introduced in the form of telemedicine. The aim of this study was to evaluate the availability of HS treatment during the COVID-19 pandemic and to assess patient satisfaction, problems with access to medical care, and the impact of the pandemic on the course of the disease. (2) Methods: An internet survey with an anonymous questionnaire was used to assess the effectiveness of telemedicine consultations. The survey consisted of 25 closed questions, and responses were kept fully anonymous. (3) Results: Most respondents reported minor problems with accessing specialized HS medical care during the COVID-19 pandemic (n = 25, 35.71%). However, 35.71% (n = 25) of them reported major problems with appointments for specialized ambulatory treatment during the last few months of the pandemic, mainly due to delayed appointments. Almost half of the respondents had been diagnosed with COVID-19 (n = 34, 48.57%), and 58.57% (n = 41) of respondents did not see a correlation between COVID-19 infection and HS progression. (4) Conclusions: Our study showed that the pandemic significantly limited access to medical advice, and patients with hidradenitis suppurativa prefer standard consultations.
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Affiliation(s)
- Marcin Gierek
- Dr Sakiel Center for Burns Treatment, Jana Pawła II Street 2, 41-100 Siemianowice Śląskie, Poland
| | - Diana Kitala
- Dr Sakiel Center for Burns Treatment, Jana Pawła II Street 2, 41-100 Siemianowice Śląskie, Poland
| | - Wojciech Łabuś
- Dr Sakiel Center for Burns Treatment, Jana Pawła II Street 2, 41-100 Siemianowice Śląskie, Poland
| | - Justyna Glik
- Dr Sakiel Center for Burns Treatment, Jana Pawła II Street 2, 41-100 Siemianowice Śląskie, Poland
- Department of Organisation of Chronic Wound Healing, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
| | - Karol Szyluk
- Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
- District Hospital of Orthopaedics and Trauma Surgery, Bytomska 62 Street, 41-940 Piekary Slaskie, Poland
| | - Kornelia Pietrauszka
- Department of Dermatology, Medical University of Silesia in Katowice, Francuska Street, 40-027 Katowice, Poland
| | - Beata Bergler-Czop
- Department of Dermatology, Medical University of Silesia in Katowice, Francuska Street, 40-027 Katowice, Poland
| | - Paweł Niemiec
- Department of Biochemistry and Medical Genetics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medykow Street 18, 40-752 Katowice, Poland
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Jokubaitis M, Bakutis J, Ryliškienė K. COVID-19 pandemic: Impact of quarantine on migraine and patients' care in Lithuania. Clin Neurol Neurosurg 2023; 226:107615. [PMID: 36791587 PMCID: PMC9899160 DOI: 10.1016/j.clineuro.2023.107615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVE there is a scarcity of data regarding the long-term (one year or more) impact of COVID-19 related quarantine on migraine burden. The aim of this cross-sectional study was to assess the impact of quarantine on migraine course, and the implications of a shift in migraine patients' care. METHODS An anonymous online survey of 206 migraine patients in Lithuania was undertaken in April 2021. RESULTS During quarantine, 42.2% of respondents reported migraine worsening, 17.0% - migraine improvement, and 40.8% reported no change. The most common causes of improvement specified by respondents were improved sleep, increased physical activity, and better eating habits. The most common reasons for migraine worsening were decreased physical activity, use of masks and respirators, and anxiety about own health. Logistic regression revealed that the changes in migraine course were associated not only with the migraine severity and educational level, but also with lifestyle alterations such as changes in sleep, the use of personal protective equipment, and increased home workload. A quarter of respondents were unable to consult a doctor. Patients who failed this started using more analgesics (65.0% and 55.0%, p = 0.004). Almost one-third of consultations were conducted over the telephone. Treatment changes were more common during face-to-face than remote consultations (63.6% and 18.2%, p = 0.009), however, the efficacy of treatment changes did not differ significantly (61.9% and 50.0%, p = 0.741). CONCLUSION we found an overall rise in migraine burden because of lifestyle changes during the COVID-19 related quarantine. Inability to visit a doctor led to the emergence of remote consultations.
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Affiliation(s)
| | - Justas Bakutis
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Mathkor DM, Faidah H, Jalal NA, Qashqari FSI, Haque S, Bantun F. In silico identification of microRNAs targeting the PPARα/γ: promising therapeutics for SARS-CoV‑2 infection. Biotechnol Genet Eng Rev 2023:1-12. [PMID: 36708330 DOI: 10.1080/02648725.2022.2163867] [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: 08/06/2022] [Accepted: 12/26/2022] [Indexed: 01/29/2023]
Abstract
The SARS-CoV-2 lifecycle is dependent on the host metabolism machinery. It upregulates the PPARα and PPARγ genes in lipid metabolism, which supports the essential viral replication complex including lipid rafts and palmitoylation of viral protein. The use of PPAR ligands in SARS-CoV-2 infection may have positive effects by preventing cytokine storm and the ensuing inflammatory cascade. The inhibition of PPARα and PPARγ genes may alter the metabolism and may disrupt the lifecycle of SARS-CoV-2 and COVID-19 progression. In the present work, we have identified possible miRNAs targeting PPARα and PPARγ in search of modulators of PPARα and PPARγ genes expression. The identified miRNAs could possibly be viewed as new therapeutic targets against COVID-19 infection.
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Affiliation(s)
- Darin Mansor Mathkor
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Hani Faidah
- Department of Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Naif A Jalal
- Department of Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Fadi S I Qashqari
- Department of Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Shafiul Haque
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Farkad Bantun
- Department of Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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Bhaskar S, Jovanovic S, Katyal A, Namboodiri NK, Chatzis D, Banach M. Is COVID-19 another case of the obesity paradox? Results from an international ecological study on behalf of the REPROGRAM Consortium Obesity study group. Arch Med Sci 2023; 19:25-34. [PMID: 36817671 PMCID: PMC9897093 DOI: 10.5114/aoms/136447] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 05/06/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Obesity has emerged as one of the major risk factors of severe morbidity and cause-specific mortality among severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infected individuals. Patients with obesity also have overlapping cardiovascular diseases and diabetes, which make them increasingly vulnerable. This novel ecological study examines the impact of obesity and/or body mass index (BMI) on rates of population-adjusted cases and deaths due to coronavirus disease 2019 (COVID-19). MATERIAL AND METHODS Publicly available datasets were used to obtain relevant data on COVID-19, obesity and ecological variables. Group-wise comparisons and multivariate logistic regression analyses were performed. The receiver operating characteristic curve (ROC) was plotted to compute the area under the curve. RESULTS We found that male BMI is an independent predictor of cause-specific (COVID-19) mortality, and not of the caseload per million population. Countries with obesity rates of 20-30% had a significantly higher (approximately double) number of deaths per million population to both those in < 20% and > 30% slabs. We postulate that there may be a U-shaped paradoxical relationship between obesity and COVID-19 with the cause-specific mortality burden more pronounced in the countries with 20-30% obesity rates. These findings are novel along with the methodological approach of doing ecological analyses on country-wide data from publicly available sources. CONCLUSIONS We anticipate, in light of our findings, that appropriate targeted public health approaches or campaigns could be developed to minimize the risk and cause-specific morbidity burden due to COVID-19 in countries with nationwide obesity rates of 20-30%.
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Affiliation(s)
- Sonu Bhaskar
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global Consortium, Obesity REPROGRAM Study Group, Sydney, Australia
- Department of Neurology & Neurophysiology, Liverpool Hospital & South West Sydney Local Health District (SWSLHD), Liverpool, Australia
- NSW Brain Clot Bank, NSW Health Pathology and Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Sanja Jovanovic
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global Consortium, Obesity REPROGRAM Study Group, Sydney, Australia
- Kwantlen Polytechnic University, Office of Research Services, Surrey, British Columbia, Canada
| | - Anubhav Katyal
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global Consortium, Obesity REPROGRAM Study Group, Sydney, Australia
- Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, Australia
- University of New South Wales (UNSW), South Western Sydney Clinical School, Sydney, Australia
| | - Narayanan K. Namboodiri
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global Consortium, Obesity REPROGRAM Study Group, Sydney, Australia
- Sree Chitra Institute for Medical Sciences and Technology (SCTIMST), Department of Cardiology, Trivandrum, Kerala, India
| | - Dimitrios Chatzis
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global Consortium, Obesity REPROGRAM Study Group, Sydney, Australia
- Medical School, European University Cyprus, Nicosia, Cyprus
| | - Maciej Banach
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global Consortium, Obesity REPROGRAM Study Group, Sydney, Australia
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
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Post-COVID Headache: A Literature Review. Curr Pain Headache Rep 2022; 26:835-842. [PMID: 36197571 PMCID: PMC9533267 DOI: 10.1007/s11916-022-01086-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/08/2022]
Abstract
Purpose of Review Post-COVID headache may be unique in presentation and mechanism, often presenting as a new phenotype in patients with a history of a primary headache disorder or resulting in a new headache syndrome in those without history of headache. This review presents a description of the literature published focused on post-COVID headache. Additionally, we discuss potential mechanisms and considerations for treatment of post-COVID headache. Recent Findings Headache is one of the most common symptoms of COVID. Common characteristics are revealed when reviewing the phenotypes of headaches that have been described in patients with COVID-19, with most headache phenotypes resembling migraine and new persistent daily headache. Post-COVID headaches are often described as moderate to severe, persistent, and treatment refractory. Summary This review highlights the diversity of presentation of headaches that present as a complication of COVID-19. Treatment of post-COVID headache is challenging, especially in the setting of a pandemic where resources are limited. Clinical Case A 42-year-old woman with a history of episodic migraine without aura presents over video visit with a new headache type. Her typical headaches are predominantly left sided, throbbing in nature, and associated with photophobia and phonophobia. They are fully relieved by oral sumatriptan 2 h after treatment. She describes this new headache as a constant, pulsating, holocephalic pain with no other migrainous features that have been ongoing for 6 weeks. She notes that the headache has been persistent since that time. She has tried over-the-counter acetaminophen and ibuprofen and her typical migraine abortive therapy without relief. She is debilitated and wonders if there is anything that will take the pain away. She shares that she tested positive for COVID-19 about 2 days prior to headache onset and has associated rhinorrhea, anosmia, and ageusia.
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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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Shah U, Rajeshree S, Ravat P, Kalika M, Mehta S, Sapre A, Ravat SH. Challenges for low middle-income people with epilepsy during the COVID-19 pandemic: Lessons learnt, call for action. Epilepsia Open 2022; 7:665-673. [PMID: 36005396 PMCID: PMC9538458 DOI: 10.1002/epi4.12646] [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: 06/15/2022] [Accepted: 08/16/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic impacted the care of people with epilepsy (PWE). Several online surveys were conducted but there is limited data regarding the impact on low-income PWE from lower-middle income countries (LMICs) who have no access or ability to answer online surveys. The purpose of this interview was to understand the challenges faced by low-income PWE during the lockdown phase of the pandemic. METHOD PWE visiting the epilepsy specialty outpatient department of a tertiary referral government hospital to avail of subsidized services were interviewed. In the interview, they discussed challenges in obtaining medical care, the impact on wellbeing, employment, and vaccination status during the lockdown phase of the pandemic. RESULTS Out of the 214 PWE interviewed, 20.6% had increased seizure frequency, 28.9% did not have access to medication mainly due to travel restrictions, 30.5% reported lack of availability of medication and 50% were not able to afford the medication mainly due to loss of income. 51% were unable to have follow-up consultations. 36% reported worsening of mood and some reported impact on other aspects of wellbeing. The impact on wellbeing was significantly associated with an increase in seizure frequency (P < .05). The study revealed hesitation related to vaccines in the majority and expectations of financial support by the government and assistance for procuring medication. There was a lack of awareness about telemedicine services and the same was not adequately offered by government hospitals. SIGNIFICANCE The study underscores the need to learn lessons from the challenging experiences of low-income PWE and create an action plan for the future to address the issues of lack of affordability of medical care and access to telemedicine. It is critical that the care of the marginalized, underrepresented PWE from lower-middle income countries is not neglected during a pandemic.
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Affiliation(s)
- Urvashi Shah
- Department of NeurologySeth GSMC and KEM HospitalMumbaiIndia
| | | | - Parthvi Ravat
- Department of NeurologySeth GSMC and KEM HospitalMumbaiIndia
| | - Mayuri Kalika
- Department of NeurologySeth GSMC and KEM HospitalMumbaiIndia
| | - Saloni Mehta
- Department of NeurologySeth GSMC and KEM HospitalMumbaiIndia
| | - Antara Sapre
- Department of NeurologySeth GSMC and KEM HospitalMumbaiIndia
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11
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Lleixa Sardañons M, Artola Ortiz M, Becerril Ríos N, Cordero Martín G, Hernando Andrés A, Lozano Ladero AM, Sabroso Mellado JR, Sánchez Franco CM, del Río Muñoz B. Nursing care of patients with multiple sclerosis during the COVID-19 pandemic. REVISTA CIENTÍFICA DE LA SOCIEDAD DE ENFERMERÍA NEUROLÓGICA (ENGLISH ED.) 2022. [PMCID: PMC9446056 DOI: 10.1016/j.sedeng.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Introduction Development Conclusions
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12
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Uwishema O, Frederiksen KS, Correia IFS, Mahmoud A, Onyeaka H, Dost B. The impact of COVID-19 on patients with neurological disorders and their access to healthcare in Africa: A review of the literature. Brain Behav 2022; 12:e2742. [PMID: 35951730 PMCID: PMC9480907 DOI: 10.1002/brb3.2742] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/24/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has hampered the progress of neurological healthcare services for patients across Africa. Before the pandemic, access to these services was already limited due to elevated treatment costs among uninsured individuals, shortage of medicines, equipment, and qualified personnel, immense distance between residing areas and neurological facilities, and a limited understanding of neurological diseases and their presentation by both the health workers and the African population. METHODOLOGY The databases PubMed, Google Scholar, Science Direct, and the National Library of Medicine were searched for literature. All articles on neurological disorders in Africa were considered. AIM This review article explores the challenges of providing the best services for patients suffering from neurological disorders in Africa amid the COVID-19 pandemic and provides evidence-based recommendations. RESULTS As Africa's governments made more resources available to support patients affected by COVID-19, neurological care received less priority and the capacity and competency to treat patients with neurological disorders thus suffered substantially. Both short-term and long-term strategies are needed to improve the quality of neurological services after the pandemic in the region. CONCLUSION To strengthen Africa's neurological services capability during and after the COVID-19 pandemic, African governments must ensure appropriate healthcare resource allocation, perform neurology management training, and increase health security measures in medication supply. Long-term strategies include incorporating responsible finance and resource procurement and advancement of tele-neurology. International collaboration is essential to promote the sustainable improvement of neurological services in Africa.
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Affiliation(s)
- Olivier Uwishema
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,Department of Projects and Research, Clinton Global Initiative University, New York City, New York, USA.,Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | | | - Inês F Silva Correia
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,School of Medicine, Faculty of Health, Education, Medicine & Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Ashraf Mahmoud
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Helen Onyeaka
- School of Chemical Engineering, University of Birmingham, Edgbaston, UK
| | - Burhan Dost
- Department of Anaesthesiology, School of Medicine, Ondokuz Mayis University, Kurupelit, Turkey
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13
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Sharma R, Singla RK, Banerjee S, Sinha B, Shen B, Sharma R. Role of Shankhpushpi (Convolvulus pluricaulis) in Neurological Disorders: An Umbrella Review Covering Evidence from Ethnopharmacology to Clinical Studies. Neurosci Biobehav Rev 2022; 140:104795. [PMID: 35878793 DOI: 10.1016/j.neubiorev.2022.104795] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 02/05/2023]
Abstract
C. pluricaulis Choisy (C. pluricaulis), a perennial herb aka C. microphyllus Sieb. and C. Prostratus Forsk. is being used as a traditional folk medicine for a variety of ailments. In this article, we collected information about C. pluricaulis through electronic search using PubMed, SciFinder, Google Scholar, and Web of Science as well as network pharmacology is done. This comprehensive review sheds light on the plant profile, phytochemistry, neuropharmacological, and toxicological data of C. pluricaulis. The crude herb and its metabolites have exhibited a wide range of in vitro and in vivo neuropharmacological effects, including memory enhancement, anxiolytic, tranquilizing, anti-depressant, anti-stress, neurodegenerative, anti-inflammatory, anti-oxidant, analgesic, sedative, anti-convulsant, and Alzheimer's disease-reversing effects. Network pharmacology results indicate that compounds from C. pluricaulis interact with various proteins, neuro synapses, signaling pathways, and serotonergic synapse which plays a crucial role in neurotransmission, Alzheimer's disease, long-term depression, addictions to alcohol, cognitive disorders, psychological conditions, and increasing serotonin concentration in synapses.
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Affiliation(s)
- Ruchi Sharma
- Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India.
| | - Rajeev K Singla
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Xinchuan Road, 2222 Chengdu, Sichuan, China; iGlobal Research and Publishing Foundation, New Delhi, India.
| | - Subhadip Banerjee
- School of Natural Product Studies, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, India.
| | - Baivab Sinha
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Xinchuan Road, 2222 Chengdu, Sichuan, China; Changhong AI Labs, Sichuan Changhong Electric Co. Ltd., Sichuan, China.
| | - Bairong Shen
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Xinchuan Road, 2222 Chengdu, Sichuan, China.
| | - Rohit Sharma
- Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India.
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14
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Movement disorders in coronavirus disease 2019 times: impact on care in movement disorders and Parkinson disease. Curr Opin Neurol 2022; 35:494-501. [PMID: 35787539 DOI: 10.1097/wco.0000000000001075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to outline the impact of the COVID-19 pandemic on movement disorder holistic care, particularly in the care of people with Parkinson disease (PWP). RECENT FINDINGS As the pandemic unfolds, a flurry of literature was published regarding the impact of COVID-19 on people with Parkinson disease including the direct impact of infection, availability of ambulatory care, loss of community-based team care, and acceptability of telemedicine. SUMMARY COVID-19 has impacted the care of PWP in numerous ways. Recognizing infection in PWP poses challenges. Specific long-term complications, including emerging reports of long COVID syndrome is a growing concern. Caregivers and PWP have also been impacted by COVID-19 social isolation restrictions, with radical changes to the structure of social networks and support systems globally. In a matter of weeks, the global community saw an incredible uptake in telemedicine, which brought with benefits and pitfalls. As PWP adapted to virtual platforms and the changing architecture of care delivery, the pandemic amplified many preexisting inequities amongst populations and countries, exposing a new 'digital divide'.
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15
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Bianchini E, Onelli C, Morabito C, Alborghetti M, Rinaldi D, Anibaldi P, Marcolongo A, Salvetti M, Pontieri FE. Feasibility, Safety, and Effectiveness of Telerehabilitation in Mild-to-Moderate Parkinson's Disease. Front Neurol 2022; 13:909197. [PMID: 35785358 PMCID: PMC9245570 DOI: 10.3389/fneur.2022.909197] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/06/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Parkinson's disease (PD) patients frequently engage in rehabilitation to ameliorate symptoms. During the Coronavirus disease 2019 (COVID-19) pandemic, access to rehabilitation programs has been markedly limited, consequently, telerehabilitation gained popularity. In this prospective, open-label, and pilot study, we aimed to investigate feasibility, safety, and efficacy of telerehabilitation in mild-to-moderate PD patients. Materials and Methods Twenty-three PD patients, with Hoehn and Yahr stage <3, without gait disturbances or dementia and capable of using the televisit platform, were recruited for a 5-week telerehabilitation program, consisting of 1 remote visit with a therapist and a minimum of two sessions of >30-min of self-conducted exercises per week. Patients received video tutorials of exercises and were asked to keep a diary of sessions. At baseline (T0), at the end of the intervention (T1), and 1 month after the end of treatment (T2), patients were remotely assessed with MDS-UPDRS part I-III, PDQ-39, Functional Independence Measure (FIM), and Frontal Assessment Battery scales, respectively. Acceptable compliance to the program was defined as >60% matching of frequency and duration of sessions, whereas optimal compliance was set at >80% matching. Results The dropout rate was 0%. Over 85% of patients reached acceptable adherence cut-off and around 70% reached optimal one. No adverse events were reported during sessions. The repeated measure analysis of variance (rANOVA) showed a significant effect of factor “time” for MDS-UPDRS-III (p < 0.0001) with a mean reduction of 4.217 points between T0 and T1 and return to baseline at T2. No significant effect was found for other outcome measures. Conclusion Our findings demonstrate that telerehabilitation is safe, feasible, and effective on motor symptoms in mild-to-moderate PD patients.
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Affiliation(s)
- Edoardo Bianchini
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Sant'Andrea University Hospital, Rome, Italy
| | - Camilla Onelli
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | | | - Marika Alborghetti
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Sant'Andrea University Hospital, Rome, Italy
| | - Domiziana Rinaldi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Sant'Andrea University Hospital, Rome, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Santa Lucia, Rome, Italy
| | | | | | - Marco Salvetti
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Sant'Andrea University Hospital, Rome, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Sant'Andrea University Hospital, Rome, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Santa Lucia, Rome, Italy
- *Correspondence: Francesco E. Pontieri
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Lleixa Sardañons M, Artola Ortiz M, Becerril Ríos N, Cordero Martín G, Hernando Andrés A, Lozano Ladero AM, Sabroso Mellado JR, Sánchez Franco CM, del Río Muñoz B. Atención del personal de enfermería a pacientes con esclerosis múltiple durante la pandemia de la COVID-19. REVISTA CIENTÍFICA DE LA SOCIEDAD ESPAÑOLA DE ENFERMERÍA NEUROLÓGICA 2022. [PMCID: PMC9212886 DOI: 10.1016/j.sedene.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Barbieri MA, Bagnato G, Ioppolo C, Versace AG, Irrera N. Impact of the COVID-19 Pandemic on Chronic Neurological Disorders: Focus on Patients with Dementia. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2022; 21:1017-1026. [PMID: 35021982 DOI: 10.2174/1871527321666220111124928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/13/2021] [Accepted: 10/28/2021] [Indexed: 06/14/2023]
Abstract
The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) represents a public health problem worldwide. COVID-19 triggers a maladaptive cytokine release commonly referred to as cytokine storm syndrome with increased production of proinflammatory cytokines, which also appears to contribute to chronic neuroinflammation and neurodegenerative disorders' appearance, including multiple sclerosis, Parkinson's disease, and Alzheimer's disease. In this context, SARS-CoV-2 might enter the central nervous system through binding with the angiotensin converting enzyme 2 receptors which are highly expressed in glial cells and neurons. For this reason, an association between COVID-19, its dependent cytokine storm, and the development and/or progression of neurodegenerative disorders might be evaluated. Therefore, the aim of this review was to assess the impact of COVID-19 on neurodegenerative disorders, focusing on the possible increased mortality risk and/or deterioration of the clinical course of pre-existing chronic neurological diseases in patients with dementia.
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Affiliation(s)
- Maria Antonietta Barbieri
- Department of Clinical and Experimental Medicine, University of Messina, c/o AOU Policlinico G. Martino, Via C. Valeria, Gazzi, 98125, Messina, Italy
| | - Gianluca Bagnato
- Department of Clinical and Experimental Medicine, University of Messina, c/o AOU Policlinico G. Martino, Via C. Valeria, Gazzi, 98125, Messina, Italy
| | - Carmelo Ioppolo
- Department of Clinical and Experimental Medicine, University of Messina, c/o AOU Policlinico G. Martino, Via C. Valeria, Gazzi, 98125, Messina, Italy
| | - Antonio Giovanni Versace
- Department of Clinical and Experimental Medicine, University of Messina, c/o AOU Policlinico G. Martino, Via C. Valeria, Gazzi, 98125, Messina, Italy
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, c/o AOU Policlinico G. Martino, Via C. Valeria, Gazzi, 98125, Messina, Italy
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18
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Sabetkish N, Rahmani A. The overall impact of COVID-19 on healthcare during the pandemic: A multidisciplinary point of view. Health Sci Rep 2021; 4:e386. [PMID: 34622020 PMCID: PMC8485600 DOI: 10.1002/hsr2.386] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/21/2021] [Accepted: 08/22/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS The Coronavirus disease 2019 (COVID-19) pandemic globally changed the priorities of medical and surgical procedures. It has caused many healthcare systems to stop performing their routine screenings. Altering medical clinics to COVID-19 referral centers, lockdowns, and the public fear to refer to medical centers caused a significant reduction in the referral rate; especially in the elderly. This short review article highlights the transform in clinical practice during the post-COVID era and the need for future medical revolutions. METHODS A comprehensive literature search was separately performed by both authors. The articles published between 2019 and August 2021 were included in this study and selected according to a quality appraisal method. RESULTS We have summarized the possible corresponding changes in the diagnosis and treatment of all fields of medical care including internal medicine, surgical, and minor subcategories after the COVID-19 pandemic. We have also discussed the potential impacts of the pandemic on all these different categories and subcategories of medicine, including the outpatient setting and clinical work. We do believe that the lack of routine check-ups has led to an increase in the stage of disease in patients with a previously diagnosed problem. On the other hand, the dramatic change in the lifestyle of the population including restricted mobility and increased consumption of unhealthy food has caused metabolic syndrome and other new diseases that have not been diagnosed and properly managed. CONCLUSION Our findings revealed the urgent need for public health awareness. It indicated the need to carry out both psychological and screening approaches in the post-COVID era to not miss patients with a chronic disease and new cases who were undiagnosed during the COVID pandemic.
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Affiliation(s)
- Nastaran Sabetkish
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical CenterTehran University of Medical SciencesTehranIran
- ImmunologyAsthma and Allergy Research Institute, Tehran University of Medical SciencesTehranIran
| | - Alireza Rahmani
- Research Center for Prevention of Cardiovascular DiseaseInstitute of Endocrinology & Metabolism, Iran University of Medical SciencesTehranIran
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19
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Andraus M, Thorpe J, Tai XY, Ashby S, Hallab A, Ding D, Dugan P, Perucca P, Costello D, French JA, O'Brien TJ, Depondt C, Andrade DM, Sengupta R, Delanty N, Jette N, Newton CR, Brodie MJ, Devinsky O, Helen Cross J, Li LM, Silvado C, Moura L, Cosenza H, Messina JP, Hanna J, Sander JW, Sen A. Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study. Epilepsy Behav 2021; 123:108261. [PMID: 34481281 PMCID: PMC8457887 DOI: 10.1016/j.yebeh.2021.108261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 12/13/2022]
Abstract
UNLABELLED The COVID-19 pandemic has had an unprecedented impact on people and healthcare services. The disruption to chronic illnesses, such as epilepsy, may relate to several factors ranging from direct infection to secondary effects from healthcare reorganization and social distancing measures. OBJECTIVES As part of the COVID-19 and Epilepsy (COV-E) global study, we ascertained the effects of COVID-19 on people with epilepsy in Brazil, based on their perspectives and those of their caregivers. We also evaluated the impact of COVID-19 on the care delivered to people with epilepsy by healthcare workers. METHODS We designed separate online surveys for people with epilepsy and their caregivers. A further survey for healthcare workers contained additional assessments of changes to working patterns, productivity, and concerns for those with epilepsy under their care. The Brazilian arm of COV-E initially collected data from May to November 2020 during the country's first wave. We also examined national data to identify the Brazilian states with the highest COVID-19 incidence and related mortality. Lastly, we applied this geographic grouping to our data to explore whether local disease burden played a direct role in difficulties faced by people with epilepsy. RESULTS Two hundred and forty-one people returned the survey, 20% were individuals with epilepsy (n = 48); 22% were caregivers (n = 53), and 58% were healthcare workers (n = 140). Just under half (43%) of people with epilepsy reported health changes during the pandemic, including worsening seizure control, with specific issues related to stress and impaired mental health. Of respondents prescribed antiseizure medication, 11% reported difficulty taking medication on time due to problems acquiring prescriptions and delayed or canceled medical appointments. Only a small proportion of respondents reported discussing significant epilepsy-related risks in the previous 12 months. Analysis of national COVID-19 data showed a higher disease burden in the states of Sao Paulo and Rio de Janeiro compared to Brazil as a whole. There were, however, no geographic differences observed in survey responses despite variability in the incidence of COVID-19. CONCLUSION Our findings suggest that Brazilians with epilepsy have been adversely affected by COVID-19 by factors beyond infection or mortality. Mental health issues and the importance of optimal communication are critical during these difficult times. Healthcare services need to find nuanced approaches and learn from shared international experiences to provide optimal care for people with epilepsy as the direct burden of COVID-19 improves in some countries. In contrast, others face resurgent waves of the pandemic.
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Affiliation(s)
- Maria Andraus
- Department of Internal Medicine, Faculty of Medicine, Neurology Service, Epilepsy Program, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jennifer Thorpe
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK; SUDEP Action, 18 Newbury Street, Wantage, Oxfordshire OX12 8DA, UK
| | - Xin You Tai
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Samantha Ashby
- SUDEP Action, 18 Newbury Street, Wantage, Oxfordshire OX12 8DA, UK
| | - Asma Hallab
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health. Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - Ding Ding
- Institute of Neurology, Fudan University Huashan Hospital, Shanghai, China
| | - Patricia Dugan
- Department of Neurology, NYU Grossman School of Medicine, USA
| | - Piero Perucca
- Department of Neuroscience, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Australia & Departments of Medicine and Neurology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Daniel Costello
- Epilepsy Service, Cork University Hospital & College of Medicine and Health, University College Cork, Ireland
| | | | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Australia & Departments of Medicine and Neurology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme - Université Libre de Bruxelles, Brussels, Belgium
| | - Danielle M Andrade
- Adult Epilepsy Genetics Program, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | | | - Norman Delanty
- Beaumont Hospital, and School of Pharmacy and Biomolecular Sciences, FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Nathalie Jette
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Charles R Newton
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK; University Department of Psychiatry, University of Oxford, UK
| | - Martin J Brodie
- Epilepsy Unit, West Glasgow Ambulatory Care Hospital-Yorkhill, Glasgow, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, USA
| | - J Helen Cross
- UCL NIHR BRC Great Ormond Street Institute of Child Health, London, UK; Young Epilepsy, St Pier's Lane, Dormansland, Lingfield RH7 6P, UK
| | - Li M Li
- Brazilian Institute of Neuroscience and Neurotechnology, Department of Neurology of School of Medical Sciences, Unicamp, Campinas, SP, Brazil
| | - Carlos Silvado
- Comprehensive Epilepsy Program - EEG - Epilepsy Unit - Hospital de Clinicas, Federal University of Parana, Curitiba, PR, Brazil
| | - Luis Moura
- Production Engineering Program, Fuzzy Logic Laboratory - Labfuzzy, Coordination of Post Graduate Engineering Programs - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Harvey Cosenza
- Production Engineering Program, Fuzzy Logic Laboratory - Labfuzzy, Coordination of Post Graduate Engineering Programs - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Department of Engineering - REG, Science and Technology Institute - ICT, Fluminense Federal University - UFF, Campus Rio das Ostras, RJ, Brazil
| | - Jane P Messina
- School of Geography and the Environment, University of Oxford, UK; Oxford School of Global and Area Studies, University of Oxford, Oxford, UK
| | - Jane Hanna
- SUDEP Action, 18 Newbury Street, Wantage, Oxfordshire OX12 8DA, UK
| | - Josemir W Sander
- UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG & Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands
| | - Arjune Sen
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK.
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Social and psychological impact of the COVID-19 pandemic on people with Parkinson's disease: a scoping review. Public Health 2021; 199:77-86. [PMID: 34571441 PMCID: PMC8407946 DOI: 10.1016/j.puhe.2021.08.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/27/2021] [Accepted: 08/19/2021] [Indexed: 02/08/2023]
Abstract
Objectives The COVID-19 pandemic caused countries across the globe to impose restrictions to slow the spread of the virus, with people instructed to stay at home and reduce contact with others. This reduction in social contact has the potential to negatively impact mental health and well-being. The restrictions are particularly concerning for people with existing chronic illnesses such as Parkinson's disease, who may be especially affected by concerns about the pandemic and associated reduction of social contact. The aim of this review was to synthesise published literature on the impact of the COVID-19 pandemic on the social and psychological well-being of people with Parkinson's disease. Study design The design of this study is a scoping review. Methods We searched five electronic databases for English language articles containing primary data on this topic. Results Thirty-one relevant studies were found and included in the review. Six main themes were identified: impact of the pandemic on physical and mental health; COVID-19 concerns; access to health care; impact on daily and social activities; impact on physical activity and impact on caregivers. Levels of perceived risk of COVID-19 differed across studies, but most participants had adopted preventive measures such as staying at home and reducing social contacts. Participants in many studies reported a discontinuation of regular healthcare appointments and physiotherapy, as well as concerns about being able to obtain medication. Loss of daily activities and social support was noted by many participants. There was mixed evidence on the impact of the pandemic on physical exercise, with some studies finding no change in physical activity and others reporting a reduction; generally, participants with reduced physical activity had poorer mental health and greater worsening of symptoms. Caregivers of people with Parkinson's disease were more likely to be negatively affected by the pandemic if they cared for people with complex needs such as additional mental health problems. Conclusions The COVID-19 pandemic has had negative effects on the physical and mental health of people with Parkinson's disease, perhaps due to disruption of healthcare services, loss of usual activities and supports and reduction in physical activity. We make recommendations for policy, practice and future research.
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Saha R, Aich S, Tripathy S, Kim HC. Artificial Intelligence Is Reshaping Healthcare amid COVID-19: A Review in the Context of Diagnosis & Prognosis. Diagnostics (Basel) 2021; 11:1604. [PMID: 34573946 PMCID: PMC8471992 DOI: 10.3390/diagnostics11091604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/28/2021] [Accepted: 09/01/2021] [Indexed: 12/24/2022] Open
Abstract
Preventing respiratory failure is crucial in a large proportion of COVID-19 patients infected with SARS-CoV-2 virus pneumonia termed as Novel Coronavirus Pneumonia (NCP). Rapid diagnosis and detection of high-risk patients for effective interventions have been shown to be troublesome. Using a large, computed tomography (CT) database, we developed an artificial intelligence (AI) parameter to diagnose NCP and distinguish it from other kinds of pneumonia and traditional controls. The literature was studied and analyzed from diverse assets which include Scopus, Nature medicine, IEEE, Google scholar, Wiley Library, and PubMed. The search terms used were 'COVID-19', 'AI', 'diagnosis', and 'prognosis'. To strengthen the overall performance of AI in COVID-19 diagnosis and prognosis, we segregated several components to perceive threats and opportunities, as well as their inter-dependencies that affect the healthcare sector. This paper seeks to pick out the crucial fulfillment of factors for AI with inside the healthcare sector in the Indian context. Using critical literature review and experts' opinion, a total of 11 factors affecting COVID-19 diagnosis and prognosis were detected, and we eventually used an interpretive structural model (ISM) to build a framework of interrelationships among the identified factors. Finally, the matrice d'impacts croisés multiplication appliquée á un classment (MICMAC) analysis resulted the driving and dependence powers of these identified factors. Our analysis will help healthcare stakeholders to realize the requirements for successful implementation of AI.
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Affiliation(s)
- Rajnandini Saha
- School of Biotechnology, KIIT Deemed to be University, Bhubaneswar 751024, Odisha, India;
| | | | - Sushanta Tripathy
- School of Mechanical Engineering, KIIT Deemed to be University, Bhubaneswar 751024, Odisha, India
| | - Hee-Cheol Kim
- Institute of Digital Anti-Aging Healthcare, College of AI Convergence, u-AHRC, Inje University, Gimhae 50834, Korea
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22
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TAMAM Y, ÖZTÜRK Ü. COVID-19 ve Nöroloji. DICLE MEDICAL JOURNAL 2021. [DOI: 10.5798/dicletip.1004787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Khair AM, Husain S, Kaur G, Falchek S. Convulsive Status Epilepticus in a Child With Controlled Epilepsy and Concurrent COVID-19 Infection: A Case Report and a Quick Review. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2021; 13:1179547620984126. [PMID: 34456598 PMCID: PMC8388184 DOI: 10.1177/1179547620984126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/01/2020] [Indexed: 01/02/2023]
Abstract
The current unprecedented COVID-19 pandemic has been another step toward learning about the unique interaction between viral infections and human nervous system. Very few scientific papers explored neuroinvasive and neurotropic potentials of the SARS-CoV-2 virus in children. We report a child with convulsive status epilepticus and confirmed COVID-19 infection. Brief review of current available literature was discussed.
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Affiliation(s)
- Abdulhafeez M Khair
- Division of Neurology, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE, USA
| | - Sumair Husain
- Division of Neurology, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE, USA
| | - Gurcharanjeet Kaur
- Division of Neurology, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE, USA.,Thomas Jefferson University, Philadelphia, PA, USA
| | - Stephen Falchek
- Division of Neurology, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE, USA.,Thomas Jefferson University, Philadelphia, PA, USA
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24
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Yogev-Seligmann G, Kafri M. COVID-19 social distancing: negative effects on people with Parkinson disease and their associations with confidence for self-management. BMC Neurol 2021; 21:284. [PMID: 34284733 PMCID: PMC8289714 DOI: 10.1186/s12883-021-02313-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/30/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The purpose of this study was to describe the effects of COVID-19 social distancing on the function, health, and well-being of people with Parkinson disease (PD), and test the association of these effects with patients' activation levels, i.e., their skills and confidence in managing their health. METHODS Community-dwelling individuals with PD answered an anonymous web-based survey. Part 1 included 27 multiple-choice questions regarding changes in function, health, medical care, and well-being. Part 2 consisted of the Patient Activation Measure, which enquired about skills and confidence in managing one's health. RESULTS Respondents (N = 142) reported decreases in various function (24.8%-37.3%), health (33.8%-43%), and well-being (26.1%-47.1%) domains. Rehabilitation ceased for 61.2%. Among those reporting a worsening of health, 67.8% associated this with the cessation of rehabilitative treatments or decrease in physical activity. Patients' activation levels were inversely correlated with increased assistance for activities of daily living, increased tiredness, worsening symptoms, and lack of support from family and friends. CONCLUSIONS Social distancing had a major negative impact on the health and function of people with PD. PRACTICAL IMPLICATIONS Supporting people with PD skills and confidence in managing health may preserve their physical and mental health during this period of dramatic changes in life's circumstances.
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Affiliation(s)
- Galit Yogev-Seligmann
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, 3498838 Haifa, Israel
| | - Michal Kafri
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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25
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Triki CC, Leonardi M, Mallouli SZ, Cacciatore M, Karlshoej KC, Magnani FG, Newton CR, Pilotto A, Saylor D, Westenberg E, Walsh D, Winkler AS, Thakur KT, Okubadejo NU, Garcia-Azorin D. Global survey on disruption and mitigation of neurological services during COVID-19: the perspective of global international neurological patients and scientific associations. J Neurol 2021; 269:26-38. [PMID: 34117527 PMCID: PMC8195244 DOI: 10.1007/s00415-021-10641-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The COVID-19 pandemic outbreak has dramatically disrupted healthcare systems. Two rapid WHO pulse surveys studied disruptions in mental health services, but did not particularly focus on neurology. Here, a global survey was conducted and addresses the impact of the pandemic on neurology services. METHODS A cross-sectional study was carried out in which 34 international neurological associations were asked to distribute the survey to national associations. The responses represented the national situation, in November-December 2020, with regard to the main disrupted neurological services, reasons and the mitigation strategies implemented as well as the disruption on training of residents and on neurological research. A comparison with the situation in February-April 2020, first pandemic wave, was also requested. FINDINGS 54 completed surveys came from 43 countries covering all the 6 WHO regions. Overall, neurological services disruption was reported as mild by 26%, moderate by 30%, complete by 13% of associations. The most affected services were cross-sectoral neurological services (57%) and neurorehabilitation (56%). The second wave of the pandemic, however, was associated with the improvement of service provision for diagnostics services (44%) and for neurorehabilitation (41%). Governmental directives were the major cause of services' disruption (56%). Mitigation strategies were mostly established through telemedicine (48%). Almost half of respondents reported a significant impact on neurological research (48%) and educational activities (60%). Most associations (67%) were not involved in decision making for neurological patients' issues by their national government. INTERPRETATION The COVID-19 pandemic affects neurological services and raises the universal need for the development of neurological health care at the policy, systems and services levels. A global national plan on mitigation strategies for disruption of neurological services during pandemic situations should be established and neurological scientific and patients associations should get involved in decision making.
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Affiliation(s)
- Chahnez Charfi Triki
- Child Neurology Department, Hédi Chaker Hospital, LR19ES15, Sfax University, Sfax, Tunisia
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - Salma Zouari Mallouli
- Child Neurology Department, Hédi Chaker Hospital, LR19ES15, Sfax University, Sfax, Tunisia
| | - Martina Cacciatore
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Kimberly Coard Karlshoej
- World Federation of Neurology, Cqhester House, Fulham Green, 81-83 Fulham High Street, London, SW6 3JA, UK
| | - Francesca Giulia Magnani
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Deanna Saylor
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Erica Westenberg
- Department of Neurology, Center for Global Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Donna Walsh
- European Federation of Neurological Associations, Brussels, Belgium
| | - Andrea Sylvia Winkler
- Department of Neurology, Center for Global Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Kiran T Thakur
- Department of Neurology, Columbia-Irving University Medical Center/New York Presbyterian Hospital, New York, USA
| | - Njideka U Okubadejo
- Neurology Unit, Department of Neurology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - David Garcia-Azorin
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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26
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Chattu VK, Lopes CA, Javed S, Yaya S. Fulfilling the promise of digital health interventions (DHI) to promote women's sexual, reproductive and mental health in the aftermath of COVID-19. Reprod Health 2021; 18:112. [PMID: 34088319 PMCID: PMC8177268 DOI: 10.1186/s12978-021-01168-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Vijay Kumar Chattu
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5G 2C4, Canada. .,Division of Occupational Medicine, Occupational Medicine Clinic, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, M5C 2C5, Canada.
| | - Claudia Abreu Lopes
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Sumbal Javed
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada.,The George Institute for Global Health, Imperial College London, London, UK
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27
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Noutsios CD, Boisvert-Plante V, Perez J, Hudon J, Ingelmo P. Telemedicine Applications for the Evaluation of Patients with Non-Acute Headache: A Narrative Review. J Pain Res 2021; 14:1533-1542. [PMID: 34103978 PMCID: PMC8179807 DOI: 10.2147/jpr.s309542] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/09/2021] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic has spurred a hasty transition to virtual care but also an abundance of new literature highlighting telehealth’s capabilities and limitations for various healthcare applications. In this review, we aim to narrate the current state of the literature on telehealth applied to migraine care. First, telemedicine in the context of non-acute headache management has been shown to produce non-inferior patient outcomes when compared to traditional face-to-face appointments. The assignment of patients to telehealth appointments should be made after referring more urgent cases to dedicated in-person clinics. During the virtual appointment, physicians can ask their patients about the “3 F’s” in order to perform a thorough assessment of their headaches: frequency of headache days, frequency of acute medication usage and functional impairment. Clinical assessment scores that have been studied and deemed feasible for telemedicine, safe and efficient include the HIT-6, VAS and MIDAS scores. Although MIDAS was found to be redundant and inadequate to use on a daily basis, we suggest that it can be useful in periodic remote follow-up appointments. Additionally, several mobile health apps have been studied including Migraine Buddy, Migraine Coach and Migraine Monitor. All of these are appropriate for use in telemedicine when combined with an adequate trial period with Migraine Buddy being rated the highest, as it captures the most detailed clinical picture. High satisfaction rates have been reported for virtual headache management which were shown to be equal to in-person consults. These are based on patients’ perceived increase in convenience due to avoided travel time, less disruption of their daily routine and feeling more comfortable in the environment of their choice. Despite this, limitations such as technological knowledge, access to videoconferencing modalities and having a more impersonal consultation with the physician may hinder some patients from adopting this service.
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Affiliation(s)
| | | | - Jordi Perez
- Alan Edwards Pain Management Unit. Montreal General Hospital, McGill University Health Center, Montreal, QC, Canada.,Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
| | - Jonathan Hudon
- Alan Edwards Pain Management Unit. Montreal General Hospital, McGill University Health Center, Montreal, QC, Canada.,Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada.,Edwards Family Interdisciplinary Complex Pain Centre, Montreal Children's Hospital, McGill University Health Center, Montreal, QC, Canada.,Faculty Lecturer (Clinical), Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Division of Secondary Care, Department of Family Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Pablo Ingelmo
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada.,Edwards Family Interdisciplinary Complex Pain Centre, Montreal Children's Hospital, McGill University Health Center, Montreal, QC, Canada
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28
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Li C, Li Y, Ma M, Zhang Y, Bao J, Ge W, Liu Y, Peng C, He L. The impact of COVID-19 pandemic on headache symptoms and drug withdrawal among patients with medication overuse headache: a cross-sectional study. J Headache Pain 2021; 22:41. [PMID: 34020588 PMCID: PMC8139545 DOI: 10.1186/s10194-021-01256-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/10/2021] [Indexed: 02/08/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) bring about a range of psychological distress and symptom deterioration to headache patients especially to some migraineurs. Compared to migraineurs or normal control, medication overuse headache (MOH) patients are more likely to experience a worse psychological distress and poorer outcome in non-COVID-19 time. However, in COVID-19 pandemic, whether MOH patients would have greater physical and mental symptom deterioration or worse relief of headache symptoms and medications overuse remained unclear. We aim to investigate the impact of COVID-19 on MOH patients to guide for a better management in this study. Methods We enrolled MOH patients who were diagnosed and treated at headache clinic of West China Hospital. Information of the pre-pandemic 3 months period and COVID-19 pandemic period was collected. Univariate and multivariate logistic regression were performed to identify independent factors associated with changes in headache symptoms and drug withdrawal. Results Seventy-eight MOH patients were enrolled into the study ultimately. In comparison to pre-pandemic period, fewer MOH patients reported decreased headache days, intensity and days with acute medications per month during the pandemic. Available access to regular prophylactic medications was significantly associated with a reduction of at least 50% in headache days and decrease in headache intensity per month with respective odds ratios of 39.19 (95% CI 3.75–409.15, P = 0.002) and 10.13 (95% CI 2.33–44.12, P = 0.002). Following abrupt withdrawal and high educational level were both significant factors in decreasing headache intensity. Male sex was significantly associated with decrease in days with acute medication per month during the pandemic (odds ratios 4.78, 95%CI 1.44–15.87, P = 0.011). Conclusions Our findings reflect that MOH patients experienced a worse relief of headache symptoms and drug withdrawal during the pandemic. Available access to regular prophylactic medications was the significant independent factor for improvement of headache symptoms. Male sex was significantly associated with decreased days with acute medications per month.
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Affiliation(s)
- Changling Li
- Department of Neurology, West China Hospital of Sichuan University, No. 37 Wainan Guoxue Xiang, Chengdu, 610041, China
| | - Yanbo Li
- Department of Neurology, West China Hospital of Sichuan University, No. 37 Wainan Guoxue Xiang, Chengdu, 610041, China
| | - Mengmeng Ma
- Department of Neurology, West China Hospital of Sichuan University, No. 37 Wainan Guoxue Xiang, Chengdu, 610041, China
| | - Yang Zhang
- Department of Neurology, West China Hospital of Sichuan University, No. 37 Wainan Guoxue Xiang, Chengdu, 610041, China
| | - Jiajia Bao
- Department of Neurology, West China Hospital of Sichuan University, No. 37 Wainan Guoxue Xiang, Chengdu, 610041, China
| | - Wenjing Ge
- Department of Neurology, West China Hospital of Sichuan University, No. 37 Wainan Guoxue Xiang, Chengdu, 610041, China
| | - Yanqin Liu
- Department of Neurology, West China Hospital of Sichuan University, No. 37 Wainan Guoxue Xiang, Chengdu, 610041, China
| | - Cheng Peng
- Department of Neurology, West China Hospital of Sichuan University, No. 37 Wainan Guoxue Xiang, Chengdu, 610041, China
| | - Li He
- Department of Neurology, West China Hospital of Sichuan University, No. 37 Wainan Guoxue Xiang, Chengdu, 610041, China.
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29
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Katyal A, Bhaskar S. CTP-guided reperfusion therapy in acute ischemic stroke: a meta-analysis. Acta Neurol Scand 2021; 143:355-366. [PMID: 33188539 DOI: 10.1111/ane.13374] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Computed tomography perfusion (CTP) imaging could be useful in guiding reperfusion therapy or patient selection in acute ischemic stroke (AIS) patients. The aim of the current study was to determine the efficacy of the CTP-guided reperfusion therapy in AIS by performing a systematic review and meta-analysis. METHODS Medline/PubMed, Embase, and the Cochrane library were searched using the terms: "CT perfusion", "acute stroke" and "reperfusion therapy". The following studies were included: (a) studies reporting original data; (b) patients aged 18 years or above; (c) patients diagnosed with anterior circulation AIS; and (d) studies with good methodological design. RESULTS Twenty-two studies were finally included in the metanalysis with a total of 5, 687 patients. CTP-guided reperfusion therapy was associated with increased odds of good functional outcome without significant difference in safety profile. CONCLUSIONS CTP-guided reperfusion therapy improved functional outcomes in AIS, with increased benefits to patients treated with endovascular thrombectomy.
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Affiliation(s)
- Anubhav Katyal
- Neurovascular Imaging Laboratory Ingham Institute for Applied Medical Research Clinical Sciences Stream Sydney NSW Australia
- University of New South Wales (UNSW South Western Sydney Clinical School Sydney NSW Australia
| | - Sonu Bhaskar
- Neurovascular Imaging Laboratory Ingham Institute for Applied Medical Research Clinical Sciences Stream Sydney NSW Australia
- University of New South Wales (UNSW South Western Sydney Clinical School Sydney NSW Australia
- Department of Neurology & Neurophysiology Liverpool Hospital & South Western Sydney Local Health District Sydney NSW Australia
- Stroke & Neurology Research Group Ingham Institute for Applied Medical Research Sydney NSW Australia
- NSW Brain Clot Bank NSW Health Statewide Biobank and NSW Health Pathology Sydney NSW Australia
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30
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Tseng YH, Chen TH. Care for Patients With Neuromuscular Disorders in the COVID-19 Pandemic Era. Front Neurol 2021; 12:607790. [PMID: 33841296 PMCID: PMC8024582 DOI: 10.3389/fneur.2021.607790] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/16/2021] [Indexed: 12/26/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has prompted a rapid and unprecedented reorganization of medical institutions, affecting clinical care for patients with chronic neurological diseases. Although there is no evidence that patients with neuromuscular disorders (NMD) confer a higher infection risk of COVID-19, NMD and its associated therapies may affect the patient's ability to cope with infection or its systemic effects. Moreover, there is a concern that patients with chronic NMD may be at increased risk of manifesting severe symptoms of COVID-19. In particular, as respiratory compromises account for the major cause of mortality and morbidity in NMD patients, newly emerging data also show that the risk of exacerbation caused by COVID-19 accumulates in this particular patient group. For example, patients with motor neuron disease and dystrophinopathies often have ventilatory muscle weakness or cardiomyopathy, which may increase the risk of severe COVID-19 infection. Thus, the COVID-19 pandemic may severely affect NMD patients. Several neurological associations and neuromuscular networks have recently guided the impact of COVID-19 on patients with NMD, especially in managing cardiopulmonary involvements. It is recommended that patients with moderate- to high-risk NMD be sophisticatedly monitored to reduce the risk of rapid decline in cardiopulmonary function or potential deterioration of the underlying NMD. However, limited neuromuscular-specific recommendations for NMD patients who contract COVID-19 and outcome data are lacking. There is an urgent need to properly modify the respiratory care method for NMD patients, especially during the COVID-19 pandemic. Conclusively, COVID-19 is a rapidly evolving field, and the practical guidelines for the management of NMD patients are frequently revised. There must be a close collaboration in a multidisciplinary care team that should support their hospital to define a standardized care method for NMD patients during the COVID pandemic. This article reviews evidence-based practical guidelines regarding care delivery, modification, and education, highlighting the need for team-based and interspecialty collaboration.
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Affiliation(s)
- Yung-Hao Tseng
- Department of Pediatrics, Division of Pediatric Emergency, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tai-Heng Chen
- Department of Pediatrics, Division of Pediatric Emergency, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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31
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Mainali S, Darsie ME. Neurologic and Neuroscientific Evidence in Aged COVID-19 Patients. Front Aging Neurosci 2021; 13:648662. [PMID: 33833676 PMCID: PMC8021699 DOI: 10.3389/fnagi.2021.648662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 02/23/2021] [Indexed: 12/20/2022] Open
Abstract
The COVID-19 pandemic continues to prevail as a catastrophic wave infecting over 111 million people globally, claiming 2. 4 million lives to date. Aged individuals are particularly vulnerable to this disease due to their fraility, immune dysfunction, and higher rates of medical comorbidities, among other causes. Apart from the primary respiratory illness, this virus is known to cause multi-organ dysfunction including renal, cardiac, and neurologic injuries, particularly in the critically-ill cohorts. Elderly patients 65 years of age or older are known to have more severe systemic disease and higher rates of neurologic complications. Morbidity and mortality is very high in the elderly population with 6–930 times higher likelihood of death compared to younger cohorts, with the highest risk in elderly patients ≥85 years and especially those with medical comorbidities such as hypertension, diabetes, heart disease, and underlying respiratory illness. Commonly reported neurologic dysfunctions of COVID-19 include headache, fatigue, dizziness, and confusion. Elderly patients may manifest atypical presentations like fall or postural instability. Other important neurologic dysfunctions in the elderly include cerebrovascular diseases, cognitive impairment, and neuropsychiatric illnesses. Elderly patients with preexisting neurologic diseases are susceptibility to severe COVID-19 infection and higher rates of mortality. Treatment of neurologic dysfunction of COVID-19 is based on existing practice standards of specific neurologic condition in conjunction with systemic treatment of the viral illness. The physical, emotional, psychologic, and financial implications of COVID-19 pandemic have been severe. Long-term data are still needed to understand the lasting effects of this devastating pandemic.
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Affiliation(s)
- Shraddha Mainali
- Department of Neurology, The Ohio State University, Columbus, OH, United States
| | - Marin E Darsie
- Department of Emergency Medicine, University of Wisconsin Hospitals and Clinics, Madison, WI, United States.,Department of Neurological Surgery, University of Wisconsin Hospitals and Clinics, Madison, WI, United States
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32
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Bhaskar S, Nurtazina A, Mittoo S, Banach M, Weissert R. Editorial: Telemedicine During and Beyond COVID-19. Front Public Health 2021; 9:662617. [PMID: 33796502 PMCID: PMC8007781 DOI: 10.3389/fpubh.2021.662617] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/24/2021] [Indexed: 12/21/2022] Open
Affiliation(s)
- Sonu Bhaskar
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global, Sydney, NSW, Australia.,Department of Neurology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, NSW, Australia.,Neurovascular Imaging Laboratory & NSW Brain Clot Bank, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
| | - Alma Nurtazina
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global, Sydney, NSW, Australia.,Department of Epidemiology and Biostatistics, Semey Medical University, Semey, Kazakhstan
| | - Shikha Mittoo
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global, Sydney, NSW, Australia.,Department of Rheumatology, University Health Network and The University of Toronto, Toronto, ON, Canada
| | - Maciej Banach
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global, Sydney, NSW, Australia.,Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.,Cardiovascular Research Centre, University of Zielona Góra, Zielona Gora, Poland.,Department of Hypertension, Medical University of Lodz, Lodz, Poland
| | - Robert Weissert
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global, Sydney, NSW, Australia.,Department of Neurology, University of Regensburg, Regensburg, Germany
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Sharma S, Batra S, Gupta S, Sharma VK, Rahman MH, Kamal MA. Persons with co-existing neurological disorders: Risk analysis, considerations and management in COVID-19 pandemic. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2021; 21:228-234. [PMID: 33687889 DOI: 10.2174/1871527320666210308113457] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 01/08/2023]
Abstract
Increasing reports of neurological symptoms in COVID-19 patient's warrant clinicians to adopt and define the standardized diagnostic and managing protocols in order to investigate the linkage of neurological symptoms in COVID-19. Encephalitis, anosmia, acute cerebrovascular disease and ageusia are some of the emerging neurological manifestations which are reported in several cohort studies on hospitalized patients with COVID-19. Although the COVID-19 pandemic is primarily associated with respiratory tract system but measures like lockdown and restricted physical movements to control the spread of this infection will certainly have neurobehavioural implications. Additionally, some of the patients with pre-existing neurological manifestations like epilepsy, Parkinson's and Alzheimer's disease are more prone to infection and demands extra as well as improvisation in their treatment therapy. In this review we have focused on the neurovirological clinical manifestations associated with COVID-19 pandemic. Although the prevalence of neurovirological manifestations is rare but increasing reports cannot be ignored and needs to be discussed thoroughly with respect to risk analysis and considerations for developing management strategy. This also helps in defining the burden of neurological disorders associated with COVID-19 patients.
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Affiliation(s)
- Sumit Sharma
- Chitkara College of Pharmacy, Chitkara University, Punjab. India
| | - Sonali Batra
- Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science and Technology, Hisar, Haryana. India
| | - Saurabh Gupta
- Chitkara College of Pharmacy, Chitkara University, Punjab. India
| | | | - Md Habibur Rahman
- Department of Pharmacy, South East University, Banani, Dhaka-1213. Bangladesh
| | - Mohammad Amjad Kamal
- Enzymoics, 7 Peterlee place, Hebersham, NSW 2770, Novel Global Community Educational Foundation. Australia
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Ambulatory Patients with Cardiometabolic Disease and Without Evidence of COVID-19 During the Pandemic. The CorCOVID LATAM Study. Glob Heart 2021; 16:15. [PMID: 33833939 PMCID: PMC7894376 DOI: 10.5334/gh.932] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background SARS-CoV-2 pandemic has modified the cardiovascular care of ambulatory patients. The aim of this survey was to study changes in lifestyle habits, treatment adherence, and mental health status in patients with cardiometabolic disease, but no clinical evidence of COVID-19. Methods A cross-sectional survey was conducted in ambulatory patients with cardiometabolic disease using paper/digital surveys. Variables investigated included socioeconomic status, physical activity, diet, tobacco use, alcohol intake, treatment discontinuation, and psychological symptoms. Results A total of 4,216 patients (50.9% males, mean age 60.3 ± 15.3 years old) from 13 Spanish-speaking Latin American countries were enrolled. Among the study population, 46.4% of patients did not have contact with a healthcare provider, 31.5% reported access barriers to treatments and 17% discontinued some medication. Multivariate analysis showed that non-adherence to treatment was more prevalent in the secondary prevention group: peripheral vascular disease (OR 1.55, CI 1.08-2.24; p = 0.018), heart failure (OR 1.36, CI 1.05-1.75; p = 0.017), and coronary artery disease (OR 1.29 CI 1.04-1.60; p = 0.018). No physical activity was reported by 38% of patients. Only 15% of patients met minimum recommendations of physical activity (more than 150 minutes/week) and vegetable and fruit intake. Low/very low income (45.5%) was associated with a lower level of physical activity (p < 0.0001), less fruit and vegetables intake (p < 0.0001), more tobacco use (p < 0.001) and perception of depression (p < 0.001). Low educational level was also associated with the perception of depression (OR 1.46, CI 1.26-1.70; p < 0.01). Conclusions Patients with cardiometabolic disease but without clinical evidence of COVID-19 showed significant medication non-adherence, especially in secondary prevention patients. Deterioration in lifestyle habits and appearance of depressive symptoms during the pandemic were frequent and related to socioeconomic status.
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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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Telemedicine Treatment and Care for Patients with Intellectual Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041746. [PMID: 33670152 PMCID: PMC7916831 DOI: 10.3390/ijerph18041746] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/30/2021] [Accepted: 02/06/2021] [Indexed: 12/17/2022]
Abstract
In recent years, telemedicine has been developing very dynamically. The development of new technologies allows their use in the treatment of dermatological, cardiological, endocrine and other diseases. However, there are few reports on the use of digital technologies in the mental health care of people with intellectual disabilities. Intellectual disability is a disease that affects a large number of people. Patients suffering from intellectual disability encounter barriers that make it difficult for them to fully use telemedicine, however, these barriers can be overcome with appropriate support and adaptation. A review of the literature on telemedicine solutions in the care of people with intellectual disabilities indicates that the applications support the communication of these people with the doctor, enable simple behavioral interventions, stimulate cooperation in treatment, provide simple medical education as well as record medical data for the doctor. The authors present the potential risks related to the use of telemedicine solutions for people with intellectual disabilities as well as the project of creating a new, multi-module telemedicine system.
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Giordano A, Siciliano M, De Micco R, Sant'Elia V, Russo A, Tedeschi G, Tessitore A. Correlates of psychological distress in epileptic patients during the COVID-19 outbreak. Epilepsy Behav 2021; 115:107632. [PMID: 33373874 PMCID: PMC7674117 DOI: 10.1016/j.yebeh.2020.107632] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/01/2020] [Accepted: 11/06/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Following the severe consequences of the coronavirus disease 2019 (COVID-19) outbreak, on March 9th, 2020 the Italian Government implemented extraordinary measures to limit viral transmission, including restrictive quarantine measures. Psychological distress represents the seizure-precipitating factor most often reported by patients with epilepsy. To date, no studies have analyzed the role played by the different dimensions of psychological distress quarantine-induced in patients with epilepsy. MATERIALS AND METHODS We included a total of 40 patients, 18 suffered from generalized, and 22 from focal epilepsy. The patients previously seen in the outpatient clinic during the pre-lockdown period between January and February 2020 were reevaluated after the lockdown period. Psychological distress was evaluated by using the three subscales of Impact of Event Scale-Revised (IES-R). Finally, we employed logistic regression analyses to explore the demographic and clinical features associated to high scores on IES-R. RESULTS Patients with higher scores on IES-R Intrusion and IES-R Avoidance subscales demonstrated an increased number of epileptic attacks compared to prelockdown period. Multivariate logistic regression analyses showed that a specific subgroup of patients (i.e., older, female with more anxious symptoms) are at higher risk of increased seizure frequency. CONCLUSIONS Our study confirmed that the frequency of epileptic seizures increased during lockdown when compared to pre-lockdown period. The early identification of patients more vulnerable to worsening is crucial to limit the risk of requiring hospital or clinical treatment during the COVID-19 outbreak.
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Affiliation(s)
- Alfonso Giordano
- Department of Advanced Medical and Surgical Sciences, MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138 Naples, Italy.
| | - Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences, MRI Research Center Vanvitelli-FISM, University of Campania “Luigi Vanvitelli”, Piazza Miraglia 2, 80138 Naples, Italy,Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico 31, 81100 Caserta, Italy
| | - Rosa De Micco
- Department of Advanced Medical and Surgical Sciences, MRI Research Center Vanvitelli-FISM, University of Campania “Luigi Vanvitelli”, Piazza Miraglia 2, 80138 Naples, Italy
| | - Valeria Sant'Elia
- Department of Advanced Medical and Surgical Sciences, MRI Research Center Vanvitelli-FISM, University of Campania “Luigi Vanvitelli”, Piazza Miraglia 2, 80138 Naples, Italy
| | - Antonio Russo
- Department of Advanced Medical and Surgical Sciences, MRI Research Center Vanvitelli-FISM, University of Campania “Luigi Vanvitelli”, Piazza Miraglia 2, 80138 Naples, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, MRI Research Center Vanvitelli-FISM, University of Campania “Luigi Vanvitelli”, Piazza Miraglia 2, 80138 Naples, Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgical Sciences, MRI Research Center Vanvitelli-FISM, University of Campania “Luigi Vanvitelli”, Piazza Miraglia 2, 80138 Naples, Italy
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Puteikis K, Jasionis A, Mameniškienė R. Recalling the COVID-19 lockdown: Insights from patients with epilepsy. Epilepsy Behav 2021; 115:107573. [PMID: 33268021 PMCID: PMC7700727 DOI: 10.1016/j.yebeh.2020.107573] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/09/2020] [Accepted: 10/17/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of our study was to explore health changes among people with epilepsy (PWE) during a national COVID-19 lockdown in the context of patients' clinical characteristics and their experience of receiving epilepsy-related medical services. METHODS A questionnaire was distributed for adult PWE both online and at a tertiary epilepsy center after the end of a national lockdown in Lithuania. PWE were asked to evaluate their health status during the lockdown and estimate changes in their seizure patterns. Additional questions concerned the accessibility and quality of epilepsy-related consultations. RESULTS The study sample consisted of 143 PWE (59 [41.3%] male, mean age 35.1 ± 13.4 years), 94 (65.7%) completed the survey in person, 49 (34.3%) - online. A deterioration in reported physical and mental health during lockdown was observed (Z = -4.604, p < 0.0001 and Z = -4.253, p < 0.0001, respectively) and 22 (15.4%) PWE reported seizure exacerbation. In an ordinal logistic regression model (analysis of data from all participants), baseline seizure frequency (b = 0.413, p = 0.031), reported physical health before lockdown (b = -0.462, p = 0.031) and the ease of proper antiepileptic drug (AED) use during the imposed restrictions (b = -0.535, p = 0.006) were statistically significant variables associated with changes in seizure frequency. The latter were not affected by modifications in AED use (Mann-Whitney U = 1127.0, p = 0.307) irrespective of the data collection method. With teleconsultations being predominant during the lockdown, an overall decline in the quality of epilepsy-related consultations was observed (Z = -2.895, p = 0.004). Among all participants, 46 (32.2%) lost an epilepsy-related consultation or medical service because of the lockdown. This loss was found to be associated with seizure exacerbation (Mann-Whitney U = 1622.5, p = 0.046). CONCLUSION Our study indicates that a national COVID-19 lockdown may have led to worse seizure control and health status in some PWE. Easy access to AEDs and their appropriate use may be especially useful to prevent seizure exacerbation during strict COVID-19 restrictions. The quality and accessibility of remote epilepsy-related consultations was suboptimal and may require further improvement during disruption of in-person services.
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Adebayo PB, Oluwole OJ, Taiwo FT. COVID-19 and Teleneurology in Sub-Saharan Africa: Leveraging the Current Exigency. Front Public Health 2021; 8:574505. [PMID: 33569366 PMCID: PMC7868436 DOI: 10.3389/fpubh.2020.574505] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 12/30/2020] [Indexed: 12/22/2022] Open
Abstract
Africa has over 1.3 billion inhabitants, with over 60% of this population residing in rural areas that have poor access to medical experts. Despite having a ridiculously huge, underserved population, very few African countries currently have any form of sustained and organized telemedicine practice, and even fewer have dedicated tele-neurology services. The ongoing COVID-19 pandemic has proved to be one of the most significant disruptors of vital sectors of human endeavor in modern times. In the healthcare sector, there is an increasing advocacy to deliver non-urgent care via telemedicine. This paper examined the current state of tele-neurology practice and infrastructural preparedness in sub-Saharan Africa. Currently, there is over 70% mobile phone penetration in most of the countries and virtually all of them have mobile internet services of different technologies and generations. Although the needed infrastructure is increasingly available, it should be improved upon. We have proposed the access, costs, ethics, and support (ACES) model as a bespoke, holistic strategy for the successful implementation and advancement of tele-neurology in sub-Saharan Africa.
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Affiliation(s)
- Philip Babatunde Adebayo
- Neurology Section, Department of Internal Medicine, Aga Khan University, Dar es Salaam, Tanzania
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Di Lorenzo F, Ercoli T, Cuffaro L, Barbato F, Iodice F, Tedeschi G, Bombaci A. COVID-19 impact on neurology training program in Italy. Neurol Sci 2021; 42:817-823. [PMID: 33443668 PMCID: PMC7807224 DOI: 10.1007/s10072-020-04991-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 12/11/2020] [Indexed: 01/15/2023]
Abstract
The ongoing COVID-19 pandemic is having a huge impact on clinical activity of all hospitals, including the ones involved in training of residents. In addition, neurology residents underwent substantial modifications of their training program. Aim of our investigation was to evaluate the impact of COVID-19 pandemic on the educational activities of Italian neurology residents through an online questionnaire delivered to neurology residents. The results obtained showed that almost 30% of the respondents were redistributed to COVID-19 units. Neurology departments underwent substantial modifications of their organization influencing clinical educational activities; lessons and seminars were rescheduled online and research protocols were stopped and transferred to remote working, when feasible. There was a relevant use of telemedicine approach even if most of the respondents had never been trained before. Some of the changes had a North-South gradient, following the epidemiology of the pandemic. The data obtained from our survey highlight those points to address to be prepared for possible future emergencies.
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Affiliation(s)
- Francesco Di Lorenzo
- Noninvasive Brain Stimulation Unit, Scientific Institute for Research, Hospitalisation and Health Care Santa Lucia Foundation, Rome, Italy
| | - Tommaso Ercoli
- Department of Medical Sciences and Public health, Institute of Neurology, University of Cagliari, Cagliari, Italy
| | - Luca Cuffaro
- Department of Biomedicine, Neuroscience and Advanced Diagnostic, University Hospital "Paolo Giaccone", Palermo, Italy
| | | | - Francesco Iodice
- Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy
| | - Gioacchino Tedeschi
- Department of Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Bombaci
- "Rita Levi Montalcini" Department of Neurology, University of Turin, Turin, Italy.
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Zullo S, Ingravallo F, Crespi V, Cascioli M, D'Alessandro R, Gasperini M, Lalli C, Lugaresi A, Marogna M, Mori M, Pesci I, Pistoia F, Porteri C, Vedovello M, Veronese S, Pucci E, Solari A. The impact of the COVID-19 pandemic on people with neurological disorders: an urgent need to enhance the health care system's preparedness. Neurol Sci 2021; 42:799-804. [PMID: 33433758 PMCID: PMC7801877 DOI: 10.1007/s10072-020-04984-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Silvia Zullo
- Department of Legal Studies, University of Bologna, Bologna, Italy
| | - Francesca Ingravallo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Vittorio Crespi
- Ethics Committee "Brianza", S. Gerardo Hospital, Monza, Italy
| | - Marta Cascioli
- Hospice 'La Torre sul Colle', Azienda USL Umbria 2, Spoleto, Italy
| | - Roberto D'Alessandro
- Servizio di Epidemiologia e Biostatistica, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Marcella Gasperini
- Rehabilitation Department, Marzana Hospital, AULSS 9 (VR), Marzana, Italy
| | | | - Alessandra Lugaresi
- UOSI Riabilitazione Sclerosi Multipla, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Maura Marogna
- SC Neurologia, Ospedale Villa Scassi ASL3, Genoa, Italy
| | - Maurizio Mori
- Dipartimento di filosofia e scienze dell'educazione, University of Turin, Turin, Italy
| | - Ilaria Pesci
- Multiple Sclerosis Center, Ospedale di Vaio, Fidenza, PR, Italy
| | - Francesca Pistoia
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Corinna Porteri
- Bioethics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | | | - Alessandra Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
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Lebrasseur A, Fortin-Bédard N, Lettre J, Bussières EL, Best K, Boucher N, Hotton M, Beaulieu-Bonneau S, Mercier C, Lamontagne ME, Routhier F. Impact of COVID-19 on people with physical disabilities: A rapid review. Disabil Health J 2021; 14:101014. [PMID: 33158795 PMCID: PMC7603994 DOI: 10.1016/j.dhjo.2020.101014] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/10/2020] [Accepted: 10/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The COVID-19 pandemic caused drastic changes in the lives of the general population. People with physical disabilities, who commonly encounter daily challenges such as barriers to community mobility, reduced access to healthcare services and higher risk of suffering from depression, may face additional challenges in the context of the pandemic. OBJECTIVE This study aims to review the impact of the COVID-19 pandemic, and associated isolation and protective measures, among people with physical disabilities. METHODS A rapid review of the published literature was conducted on August 10, 2020 through a search in six online databases to synthesize results from original studies regarding the impact of the COVID-19 pandemic on people with physical disabilities. The International Classification of Functioning, Disability and Health was used to describe the population and the personal and environmental factors with a unified and standard health language. RESULTS Eleven records were extracted from 1621 individual papers retrieved from the search strategy. Various impacts on daily functioning such as a decrease in access to healthcare have been noted during the pandemic. Changes in social and lifestyle habits, mood changes and decreased levels of physical activity were also noted. CONCLUSIONS Our results highlighted the lack of early research about the impacts of COVID-19 experienced by people with physical disabilities. Future studies should focus on specific consequences and needs of this vulnerable population to ensure their inclusion in public health recommendations and consideration by policy makers.
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Affiliation(s)
- Audrey Lebrasseur
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada; Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Noémie Fortin-Bédard
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada; School of Social Work and Criminology, Université Laval, Quebec City, QC, Canada
| | - Josiane Lettre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada
| | - Eve-Line Bussières
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada; Departement of Psychology, Université Du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Krista Best
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada; Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Normand Boucher
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada; School of Social Work and Criminology, Université Laval, Quebec City, QC, Canada
| | - Mathieu Hotton
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada; Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Simon Beaulieu-Bonneau
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada; School of Psychology, Université Laval, Quebec City, QC, Canada
| | - Catherine Mercier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada; Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Marie-Eve Lamontagne
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada; Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale, Quebec City, QC, Canada; Department of Rehabilitation, Université Laval, Quebec City, QC, Canada.
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Pandemic forward: Lessons learned and expert perspectives on multiple sclerosis care in the COVID-19 era. Mult Scler Relat Disord 2020; 49:102715. [PMID: 33486401 PMCID: PMC7832784 DOI: 10.1016/j.msard.2020.102715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/21/2020] [Indexed: 12/01/2022]
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Bhaskar S, Rastogi A, Menon KV, Kunheri B, Balakrishnan S, Howick J. Call for Action to Address Equity and Justice Divide During COVID-19. Front Psychiatry 2020; 11:559905. [PMID: 33343410 PMCID: PMC7744756 DOI: 10.3389/fpsyt.2020.559905] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/13/2020] [Indexed: 12/29/2022] Open
Abstract
The coronavirus 2019 disease (COVID-19) is deepening the inequity and injustice among the vulnerable communities. The current study aims to present an overview of the impact of COVID-19 on equity and social justice with a focus on vulnerable communities. Vulnerable communities include, but not limited to, healthcare workers, those from lower socioeconomic backgrounds, ethnic or minority groups, immigrants or refugees, justice-involved populations, and people suffering from chronic diseases or mental illness. The implications of COVID-19 on these communities and systemic disparities beyond the current pandemic are also discussed. People from vulnerable communities' experience disproportionately adverse impacts of COVID-19. COVID-19 has exacerbated systemic disparities and its long-term negative impact on these populations foretell an impending crisis that could prevail beyond the COVID-19 era. It is onerous that systemic issues be addressed and efforts to build inclusive and sustainable societies be pursued to ensure the provision of universal healthcare and justice for all. Without these reinforcements, we would not only compromise the vulnerable communities but also severely limit our preparedness and response to a future pandemic.
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Affiliation(s)
- Sonu Bhaskar
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- Department of Neurology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, NSW, Australia
- Neurovascular Imaging Laboratory & NSW Brain Clot Bank, Ingham Institute for Applied Medical Research, The University of New South Wales, Sydney, NSW, Australia
| | - Aarushi Rastogi
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- South West Sydney Clinical School, The University of New South Wales Sydney, Sydney, NSW, Australia
| | - Koravangattu Valsraj Menon
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- Department of Psychiatry, South London and Maudsley NHS Foundation Trust, Kings Health Partners, London, United Kingdom
- Manasvi, Kochi, India
| | - Beena Kunheri
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- Department of Radiation Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Sindhu Balakrishnan
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- Department of Anaesthesia and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Jeremy Howick
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Health Equity and Justice Study Group, Sydney, NSW, Australia
- Faculty of Philosophy and Oxford Empathy Programme, University of Oxford, Oxford, United Kingdom
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Sharma D, Bhaskar S. Addressing the Covid-19 Burden on Medical Education and Training: The Role of Telemedicine and Tele-Education During and Beyond the Pandemic. Front Public Health 2020; 8:589669. [PMID: 33330333 PMCID: PMC7728659 DOI: 10.3389/fpubh.2020.589669] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/06/2020] [Indexed: 12/22/2022] Open
Abstract
Medical students are the future of sustainable health systems that are severely under pressure during COVID-19. The disruption in medical education and training has adversely impacted traditional medical education and medical students and is likely to have long-term implications beyond COVID-19. In this article, we present a comprehensive analysis of the existing structural and systemic challenges applicable to medical students and teaching/training programs and the impact of COVID-19 on medical students and education. Use of technologies such as telemedicine or remote education platforms can minimize increased mental health risks to this population. An overview of challenges during and beyond the COVID-19 pandemic are also discussed, and targeted recommendations to address acute and systemic issues in medical education and training are presented. During the transition from conventional in-person or classroom teaching to tele-delivery of educational programs, medical students have to navigate various social, economic and cultural factors which interfere with their personal and academic lives. This is especially relevant for those from vulnerable, underprivileged or minority backgrounds. Students from vulnerable backgrounds are influenced by environmental factors such as unemployment of themselves and family members, lack of or inequity in provision and access to educational technologies and remote delivery-platforms, and increased levels of mental health stressors due to prolonged isolation and self-quarantine measures. Technologies for remote education and training delivery as well as sustenance and increased delivery of general well-being and mental health services to medical students, especially to those at high-risk, are pivotal to our response to COVID-19 and beyond.
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Affiliation(s)
- Divyansh Sharma
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global, Sydney, NSW, Australia
- Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Sonu Bhaskar
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Global, Sydney, NSW, Australia
- Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales (UNSW), Sydney, NSW, Australia
- Department of Neurology and Neurophysiology, Liverpool Hospital and South West Sydney Local Health District (SWSLHD), Sydney, NSW, Australia
- NSW Brain Clot Bank, NSW Health Statewide Biobank and NSW Health Pathology, Sydney, NSW, Australia
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46
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Bhaskar S, Tan J, Bogers MLAM, Minssen T, Badaruddin H, Israeli-Korn S, Chesbrough H. At the Epicenter of COVID-19-the Tragic Failure of the Global Supply Chain for Medical Supplies. Front Public Health 2020; 8:562882. [PMID: 33335876 PMCID: PMC7737425 DOI: 10.3389/fpubh.2020.562882] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/02/2020] [Indexed: 11/13/2022] Open
Abstract
The tragic failure of the global supply chain in the face of the current coronavirus outbreak has caused acute shortages of essential frontline medical devices and personal protective equipment, crushing fear among frontline health workers and causing fundamental concerns about the sustainability of the health system. Much more coordination, integration, and management of global supply chains will be needed to mitigate the impact of the pandemics. This article describes the pressing need to revisit the governance and resilience of the supply chains that amplified the crisis at pandemic scale. We propose a model that profiles critical stockpiles and improves production efficiency through new technologies such as advanced analytics and blockchain. A new governance system that supports intervention by public-health authorities during critical emergencies is central to our recommendation, both in the face of the current crisis and to be better prepared for potential future crises. These reinforcements offer the potential to minimize the compromise of our healthcare workers and health systems due to infection exposure and build capacity toward preparedness and action for a future outbreak.
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Affiliation(s)
- Sonu Bhaskar
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, Innovation & Supply Chain Pandemic REPROGRAM Study Group, Sydney, NSW, Australia.,Department of Neurology & Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District, Liverpool, NSW, Australia.,Neurovascular Imaging Laboratory, Clinical Sciences Stream and NSW Brain Clot Bank, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,UNSW Medicine, South Western Sydney Clinical School, The University of New South Wales, Sydney, NSW, Australia
| | - Jeremy Tan
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, Innovation & Supply Chain Pandemic REPROGRAM Study Group, Sydney, NSW, Australia.,UNSW Medicine, South Western Sydney Clinical School, The University of New South Wales, Sydney, NSW, Australia
| | - Marcel L A M Bogers
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, Innovation & Supply Chain Pandemic REPROGRAM Study Group, Sydney, NSW, Australia.,Innovation, Technology Entrepreneurship and Marketing (ITEM) Group, Eindhoven University of Technology, Eindhoven, Netherlands.,Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark.,Garwood Center for Corporate Innovation, University of California, Berkeley, Berkeley, CA, United States
| | - Timo Minssen
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, Innovation & Supply Chain Pandemic REPROGRAM Study Group, Sydney, NSW, Australia.,Center for Advanced Studies in Biomedical Innovation Law, University of Copenhagen, Copenhagen, Denmark.,Faculty of Law, Lund University, Lund, Sweden
| | - Hishamuddin Badaruddin
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, Innovation & Supply Chain Pandemic REPROGRAM Study Group, Sydney, NSW, Australia.,College of Health and Human Development, Penn State University, State College, PA, United States
| | - Simon Israeli-Korn
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, Innovation & Supply Chain Pandemic REPROGRAM Study Group, Sydney, NSW, Australia.,Department of Neurology, Movement Disorders Institute, Sheba Medical Center, Ramat Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Henry Chesbrough
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, Innovation & Supply Chain Pandemic REPROGRAM Study Group, Sydney, NSW, Australia.,Garwood Center for Corporate Innovation, University of California, Berkeley, Berkeley, CA, United States.,Maire Tecnimont Professor of Open Innovation, Luiss University, Rome, Italy
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47
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Delussi M, Gentile E, Coppola G, Prudenzano AMP, Rainero I, Sances G, Abagnale C, Caponnetto V, De Cesaris F, Frattale I, Guaschino E, Marcinnò A, Ornello R, Pistoia F, Putortì A, Roca ME, Roveta F, Lupi C, Trojano M, Pierelli F, Geppetti P, Sacco S, de Tommaso M. Investigating the Effects of COVID-19 Quarantine in Migraine: An Observational Cross-Sectional Study From the Italian National Headache Registry (RICe). Front Neurol 2020; 11:597881. [PMID: 33240213 PMCID: PMC7683429 DOI: 10.3389/fneur.2020.597881] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 10/05/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Previous studies during SARS and Ebola pandemics have shown that quarantine is associated with several negative psychological effects, such as post-traumatic stress symptoms, confusion, and anger. These conditions may affect the course of many diseases, including migraine. Although it is possible that the quarantine measures for the current COVID-19 pandemic affect migraine burden, no information is currently available on this issue. Aim: In this study, we aimed to: (1) explore the possible changes in migraine frequency, severity, and days with acute medication intake during quarantine period; (2) evaluate possible differences in migraine outcomes in consideration of lifestyle changes, emotions, pandemic diffusion, and COVID-19 infection. Methods: We interviewed patients who were included in the observational Italian Headache Registry (Registro Italiano Cefalee, RICE), retrospectively collecting information on main headache features, lifestyle factors, emotions, individual infection status, and perception of COVID-19 for 2 months before (pre-quarantine) and after the beginning of the quarantine (quarantine). Inclusion criteria were: age > 18, diagnosis of migraine without aura, migraine with aura and chronic migraine, last in-person visit more than 3 months preceding the beginning of quarantine. Results: A total of 433 migraine subjects agreed to be interviewed. We found an overall reduction in headache frequency (9.42 ± 0.43 days with headache vs. 8.28 ± 0.41) and intensity (6.57 ± 0.19 vs. 6.59 ± 0.21) during the quarantine, compared to pre-quarantine. There was a correlation between improvement and number of days of stay-at-home. When results were stratified for geographic area, we found a tendency toward worsening of headache frequency in northern Italy. Disgust regarding viral infection corresponded to a minor improvement in migraine. Conclusions: Migraine patients showed a mild improvement of migraine features, probably attributable to resilient behavior toward pandemic distress. Disgust regarding the contagion whereas potentially favoring defensive behavior, could potentially worsen migraine. The spontaneous limitation of migraine burden during quarantine could favor patient follow-up via the use of telemedicine visits, reliable diaries, and frequent remote contacts.
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Affiliation(s)
- Marianna Delussi
- Applied Neurophysiology and Pain Unit, Scienze Mediche di Base, Neuroscienze e Organi di Senso Department, Bari Aldo Moro University, Bari, Italy
| | - Eleonora Gentile
- Applied Neurophysiology and Pain Unit, Scienze Mediche di Base, Neuroscienze e Organi di Senso Department, Bari Aldo Moro University, Bari, Italy
| | | | | | - Innocenzo Rainero
- Department of Neuroscience “Rita Levi Montalcini,” Headache Center, University of Torino, Turin, Italy
| | - Grazia Sances
- Headache Science Centre, Istituto di Ricerca a Carattere Scientifico Mondino Foundation, Pavia, Italy
| | | | - Valeria Caponnetto
- Headache Regional Referral Center, Azienda Sanitaria Locale 1 Abruzzo, L'Aquila University, L'Aquila, Italy
| | | | - Ilaria Frattale
- Headache Regional Referral Center, Azienda Sanitaria Locale 1 Abruzzo, L'Aquila University, L'Aquila, Italy
| | - Elena Guaschino
- Headache Science Centre, Istituto di Ricerca a Carattere Scientifico Mondino Foundation, Pavia, Italy
| | - Andrea Marcinnò
- Department of Neuroscience “Rita Levi Montalcini,” Headache Center, University of Torino, Turin, Italy
| | - Raffaele Ornello
- Headache Regional Referral Center, Azienda Sanitaria Locale 1 Abruzzo, L'Aquila University, L'Aquila, Italy
| | - Francesca Pistoia
- Headache Regional Referral Center, Azienda Sanitaria Locale 1 Abruzzo, L'Aquila University, L'Aquila, Italy
| | - Alessia Putortì
- Headache Science Centre, Istituto di Ricerca a Carattere Scientifico Mondino Foundation, Pavia, Italy
| | - Maria Elena Roca
- Headache Center, Amaducci Neurological Clinic, Policlinico General Hospital, Bari, Italy
| | - Fausto Roveta
- Department of Neuroscience “Rita Levi Montalcini,” Headache Center, University of Torino, Turin, Italy
| | | | - Maria Trojano
- Headache Center, Amaducci Neurological Clinic, Policlinico General Hospital, Bari, Italy
| | - Francesco Pierelli
- Sapienza University of Rome Polo Pontino, Latina, IRCCS - Neuromed, Pozzilli, Italy
| | | | - Simona Sacco
- Headache Regional Referral Center, Azienda Sanitaria Locale 1 Abruzzo, L'Aquila University, L'Aquila, Italy
| | - Marina de Tommaso
- Applied Neurophysiology and Pain Unit, Scienze Mediche di Base, Neuroscienze e Organi di Senso Department, Bari Aldo Moro University, Bari, Italy
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Bhaskar S, Bradley S, Sakhamuri S, Moguilner S, Chattu VK, Pandya S, Schroeder S, Ray D, Banach M. Designing Futuristic Telemedicine Using Artificial Intelligence and Robotics in the COVID-19 Era. Front Public Health 2020; 8:556789. [PMID: 33224912 PMCID: PMC7667043 DOI: 10.3389/fpubh.2020.556789] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 10/07/2020] [Indexed: 12/17/2022] Open
Abstract
Technological innovations such as artificial intelligence and robotics may be of potential use in telemedicine and in building capacity to respond to future pandemics beyond the current COVID-19 era. Our international consortium of interdisciplinary experts in clinical medicine, health policy, and telemedicine have identified gaps in uptake and implementation of telemedicine or telehealth across geographics and medical specialties. This paper discusses various artificial intelligence and robotics-assisted telemedicine or telehealth applications during COVID-19 and presents an alternative artificial intelligence assisted telemedicine framework to accelerate the rapid deployment of telemedicine and improve access to quality and cost-effective healthcare. We postulate that the artificial intelligence assisted telemedicine framework would be indispensable in creating futuristic and resilient health systems that can support communities amidst pandemics.
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Affiliation(s)
- Sonu Bhaskar
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Study Group, Sydney, NSW, Australia
- Neurovascular Imaging Laboratory & NSW Brain Clot Bank, Department of Neurology, Liverpool Hospital and South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, The University of New South Wales, Sydney, NSW, Australia
| | - Sian Bradley
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Study Group, Sydney, NSW, Australia
- The University of New South Wales (UNSW) Medicine Sydney, South West Sydney Clinical School, Sydney, NSW, Australia
| | - Sateesh Sakhamuri
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Study Group, Sydney, NSW, Australia
- The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Sebastian Moguilner
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Study Group, Sydney, NSW, Australia
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Vijay Kumar Chattu
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Study Group, Sydney, NSW, Australia
- Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Shawna Pandya
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Study Group, Sydney, NSW, Australia
- Alberta Health Services and Project PoSSUM, University of Alberta, Edmonton, AB, Canada
| | - Starr Schroeder
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Study Group, Sydney, NSW, Australia
- Penn Medicine Lancaster General Hospital and Project PoSSUM, Lancaster, PA, United States
| | - Daniel Ray
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Study Group, Sydney, NSW, Australia
- Farr Institute of Health Informatics, University College London (UCL) & NHS Foundation Trust, Birmingham, United Kingdom
| | - Maciej Banach
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Study Group, Sydney, NSW, Australia
- Polish Mother's Memorial Hospital Research Institute (PMMHRI) in Lodz, Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
- Department of Hypertension, Medical University of Lodz, Łódź, Poland
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49
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Ugbolue UC, Duclos M, Urzeala C, Berthon M, Kulik K, Bota A, Thivel D, Bagheri R, Gu Y, Baker JS, Andant N, Pereira B, Rouffiac K, Clinchamps M, Dutheil F. An Assessment of the Novel COVISTRESS Questionnaire: COVID-19 Impact on Physical Activity, Sedentary Action and Psychological Emotion. J Clin Med 2020; 9:E3352. [PMID: 33086648 PMCID: PMC7603364 DOI: 10.3390/jcm9103352] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/29/2020] [Accepted: 10/09/2020] [Indexed: 12/15/2022] Open
Abstract
Globally the COVID-19 pandemic outbreak has triggered an economic downturn and a rise in unemployment. As a result, global communities have had to face physical, health, psychological and socio-economical related stressors. The purpose of this study was to assess and report the impact of isolation and effect of coronavirus on selected psychological correlates associated with emotions. Following ethical approval, a mixed methods observational study was conducted using the validated COVISTRESS questionnaire. Two observational study scenarios were evaluated namely "Prior" to the COVID-19 outbreak and "Currently", i.e., during the COVID-19 pandemic. 10,121 participants from 67 countries completed the COVISTRESS questionnaire. From the questionnaire responses only questions that covered the participant's occupation; sociodemographic details, isolation and impact of coronavirus were selected. Further analyses were performed on output measures that included leisure time, physical activity, sedentary time and emotions. All output measures were evaluated using the Visual Analogue Scale (VAS) with an intensity ranging from 0-100. Descriptive statistics, Wilcoxon signed-rank test and Spearman correlational analysis were applied to the leisure time, physical activity, sedentary time and emotional feeling datasets; p = 0.05 was set as the significance level. Both males and females displayed similar output measures. The Wilcoxon signed rank test showed significant differences with respect to "Prior" COVID-19 and "Currently" for sedentary activity (Z = -40.462, p < 0.001), physical activity (Z = -30.751, p < 0.001) and all other emotional feeling output measures. A moderate correlation between "Prior" COVID-19 and "Currently" was observed among the Males (r = 0.720) in comparison to the Females (r = 0.639) for sedentary activity while weaker correlations (r < 0.253) were observed for physical activity and emotional feeling measurements, respectively. Our study reported incremental differences in the physical and psychological output measures reported, i.e., "Prior" COVID-19 and "Currently". "Prior" COVID-19 and "Currently" participants increased their sedentary habits by 2.98%, and the level of physical activity reduced by 2.42%, depression levels increased by 21.62%, anxiety levels increased by 16.71%, and stress levels increased by 21.8%. There were no correlations (r) between leisure, physical activity and sedentary action (i.e., "Prior" = -0.071; "Currently" = -0.097); no correlations (r) between leisure physical activity and emotion (i.e., -0.071 > r > 0.081) for "Prior"; and poor correlations (r) between leisure, physical activity and sedentary action (i.e., -0.078 > r > 0.167) for "Current". The correlations (r) between sedentary action and emotion for "Prior" and "Currently" were (-0.100 > r > 0.075) and (-0.040 > r > 0.041) respectively. The findings presented here indicate that the COVISTRESS project has created awareness in relation to the physical and psychological impact resulting from the COVID-19 pandemic. The findings have also highlighted individual distress caused by COVID-19 and associated health consequences for the global community.
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Affiliation(s)
- Ukadike Chris Ugbolue
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.G.); (J.S.B.)
- Institute for Clinical Exercise & Health Science, School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire G72 0LH, Scotland, UK
- Department of Biomedical Engineering, University of Strathclyde, Glasgow G11XQ, UK
| | - Martine Duclos
- Department of Sport Medicine and Functional Exploration, University Hospital CHU G. Montpied, INRA, UNH, CRNH Auvergne, Clermont Auvergne University, Clermont-Ferrand, F-63000 Clermont-Ferrand, France;
| | - Constanta Urzeala
- Sports and Motor Performance Department, Faculty of Physical Education and Sports, National University of Physical Education and Sports, 060057 Bucharest, Romania;
| | - Mickael Berthon
- LaPSCo, Catech, Université Clermont Auvergne, CNRS, F-63000 Clermont-Ferrand, France;
| | - Keri Kulik
- Health and Physical Education Program, Indiana University of Pennsylvania, Bloomington, IN 47405-1006, USA;
| | - Aura Bota
- Department of Teaching Staff Training, Faculty of Physical Education and Sports, National University of Physical Education and Sports, 060057 Bucharest, Romania;
| | - David Thivel
- Laboratory of Metabolic Adaptations to Exercise under Physiological and Pathological conditions (AME2P), Université Clermont Auvergne, CRNH Auvergne, F-63000 Clermont-Ferrand, France;
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, 8174673441 Isfahan, Iran;
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.G.); (J.S.B.)
| | - Julien S. Baker
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.G.); (J.S.B.)
- Department of Sport, Physical Education and Health, Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong 999077, Hong Kong, China
| | - Nicolas Andant
- Biostatistics Unit, DRCI, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (N.A.); (B.P.)
| | - Bruno Pereira
- Biostatistics Unit, DRCI, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France; (N.A.); (B.P.)
| | - Karine Rouffiac
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France;
| | - Maëlys Clinchamps
- Physiological and Psychosocial Stress, LaPSCo, CNRS, Preventive and Occupational Medicine, WittyFit, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.C.); (F.D.)
| | - Frédéric Dutheil
- Physiological and Psychosocial Stress, LaPSCo, CNRS, Preventive and Occupational Medicine, WittyFit, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.C.); (F.D.)
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50
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Bhaskar S, Bradley S, Chattu VK, Adisesh A, Nurtazina A, Kyrykbayeva S, Sakhamuri S, Yaya S, Sunil T, Thomas P, Mucci V, Moguilner S, Israel-Korn S, Alacapa J, Mishra A, Pandya S, Schroeder S, Atreja A, Banach M, Ray D. Telemedicine Across the Globe-Position Paper From the COVID-19 Pandemic Health System Resilience PROGRAM (REPROGRAM) International Consortium (Part 1). Front Public Health 2020; 8:556720. [PMID: 33178656 PMCID: PMC7596287 DOI: 10.3389/fpubh.2020.556720] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/21/2020] [Indexed: 01/03/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has accelerated the adoption of telemedicine globally. The current consortium critically examines the telemedicine frameworks, identifies gaps in its implementation and investigates the changes in telemedicine framework/s during COVID-19 across the globe. Streamlining of global public health preparedness framework that is interoperable and allow for collaboration and sharing of resources, in which telemedicine is an integral part of the public health response during outbreaks such as COVID-19, should be pursued. With adequate reinforcement, telemedicine has the potential to act as the "safety-net" of our public health response to an outbreak. Our focus on telemedicine must shift to the developing and under-developing nations, which carry a disproportionate burden of vulnerable communities who are at risk due to COVID-19.
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Affiliation(s)
- Sonu Bhaskar
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Department of Neurology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, NSW, Australia
- Neurovascular Imaging Laboratory & NSW Brain Clot Bank, Ingham Institute for Applied Medical Research, The University of New South Wales, UNSW Medicine, Sydney, NSW, Australia
| | - Sian Bradley
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- The University of New South Wales (UNSW) Medicine Sydney, South West Sydney Clinical School, Sydney, NSW, Australia
| | - Vijay Kumar Chattu
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Department of Medicine, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Anil Adisesh
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Department of Medicine, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Alma Nurtazina
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Department of Epidemiology and Biostatistics, Semey Medical University, Semey, Kazakhstan
| | - Saltanat Kyrykbayeva
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Department of Epidemiology and Biostatistics, Semey Medical University, Semey, Kazakhstan
| | - Sateesh Sakhamuri
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Sanni Yaya
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
| | - Thankam Sunil
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Department of Public Health, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Pravin Thomas
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Viviana Mucci
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- School of Science, Western Sydney University, Sydney, NSW, Australia
| | - Sebastian Moguilner
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Simon Israel-Korn
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Movement Disorders Institute, Department of Neurology, Sheba Medical Center, Tel Hashomer, Ramat Gan & Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jason Alacapa
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- metaHealth Insights and Innovation, Manila, Philippines
| | - Abha Mishra
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Department of Anthropology, University of Delhi, New Delhi, India
| | - Shawna Pandya
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- University of Alberta, Alberta Health Services and Project PoSSUM, Edmonton, AB, Canada
| | - Starr Schroeder
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Penn Medicine Lancaster General Hospital and Project PoSSUM, Lancaster, PA, United States
| | - Ashish Atreja
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Icahn School of Medicine, Mount Sinai Hospital, Mount Sinai, New York, NY, United States
| | - Maciej Banach
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Polish Mother's Memorial Hospital Research Institute (PMMHRI) in Lodz, Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
| | - Daniel Ray
- Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, REPROGRAM Telemedicine Sub-committee, Sydney, NSW, Australia
- Farr Institute of Health Informatics, University College London (UCL) & NHS Foundation Trust, Birmingham, United Kingdom
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