Psychological Effects of Home Confinement and Social Distancing Derived from COVID-19 in the General Population-A Systematic Review

Stress and the Consumption of Ultra-Processed Foods during COVID-19's Social Distancing: Are Mental Disorders Mediators in This Association? ELSA-Brasil Results

The COVID-19 pandemic exacerbated various determinants of mental disorders. Several behavioral changes were observed given this increase, including harmful health consequences, such as excessive consumption of ultra-processed foods (UPFs). To assess this relationship, we investigated the meditational role of symptoms of mental disorders (anxiety and depression) in the association between stress resulting from social distancing during the COVID-19 pandemic and the consumption of UPFs in 3884 Brazilian public employees in a supplementary study of the ELSA-Brasil study. Structural equation models (SEMs) were estimated to assess the direct and indirect effects mediated by symptoms of mental disorders. The results suggested a significant and positive mediational effect of the symptoms of mental disorders on the association between the stress resulting from social distancing and the consumption of UPFs. These findings contribute to informing the need for policies and early interventions in potentially stressful situations, with a focus on the promotion of mental health, and may thus help prevent or reduce the consumption of unhealthy foods.

Impact of the COVID-19-pandemic and perception of self-efficacy on the mental health of out-of-hospital emergency healthcare professionals by modality of care

OBJECTIVE

To analyse the influence of the COVID-19 pandemic and the perception of self-efficacy on the health professionals of the Spanish out-of-hospital emergency services.

DESIGN

Observational, cross-sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February-30 April, 2021).

METHODS

The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self-efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self-efficacy on mental health.

RESULTS

The means of the sample for stress, anxiety, depression and self-efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self-efficacy. Self-efficacy had a direct effect on the mental health for working in patient care.

CONCLUSIONS

Healthcare workers showed moderate stress, severe anxiety, mild depression and good self-efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self-efficacy is a determining factor of mental health in the direct care modality.

IMPLICATIONS

The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out-of-hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self-efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk.

REPORTING METHOD

We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros - ASISA Foundation (Spain). PATIENT OR PUBLIC CONTRIBUTION: 'No patient or public involvement'.

Excess Mortality During 2020 in Spain: The Most Affected Population, Age, and Educational Group by the COVID-19 Pandemic

OBJECTIVE

The objective of this work was to study mortality increase in Spain during the first and second academic semesters of 2020, coinciding with the first 2 waves of the Covid-19 pandemic; by sex, age, and education.

METHODS

An observational study was carried out, using linked populations and deaths' data from 2017 to 2020. The mortality rates from all causes and leading causes other than Covid-19 during each semester of 2020, compared to the 2017-2019 averages for the same semester, was also estimated. Mortality rate ratios (MRR) and differences were used for comparison.

RESULTS

All-cause mortality rates increased in 2020 compared to pre-covid, except among working-age, (25-64 years) highly-educated women. Such increases were larger in lower-educated people between the working age range, in both 2020 semesters, but not at other ages. In the elderly, the MMR in the first semester in women and men were respectively, 1.14, and 1.25 among lower-educated people, and 1.28 and 1.23 among highly-educated people. In the second semester, the MMR were 1.12 in both sexes among lower-educated people and 1.13 in women and 1.16 in men among highly-educated people.

CONCLUSION

Lower-educated people within working age and highly-educated people at older ages showed the greatest increase in all-cause mortality in 2020, compared to the pre-pandemic period.

Pre-pandemic adversity and maternal mental health during the COVID-19 pandemic: the mediating role of pandemic stress and family relationships

BACKGROUND

The COVID-19 pandemic was a time of increased stress for families. Parents with a history of adversity may have been at higher risk of experiencing mental health problems during this time. The current study aims to investigate the relationship between pre-pandemic adversity pandemic related stressors and maternal mental health outcomes during the pandemic.

METHODS

Data was drawn from the Mothers' and Young People's Study (MYPS), a longitudinal of first time mothers and their children. Participants were 418 mothers who completed the MYPS COVID-19 sub-study. Data was collected during pregnancy, at 1, 4, 10 years postpartum, and during the COVID-19 pandemic (approximately 14 years postpartum). Path-analysis was used to test the relationship indirect relationship between pre-pandemic adversity and maternal depressive and anxiety symptoms, via family functioning and pandemic related stress.

RESULTS

The hypothesised model was a good fit to the data accounting for 34 % and 33 % of the variance in maternal depressive and anxiety scores, respectively. A significant indirect effect was found between pre-pandemic adversity and both maternal anxiety and depressive systems via family relationships during the pandemic and pandemic related stress.

LIMITATIONS

MYPS participants who took part in the COVID-19 sub-study were more likely to be older, have a higher level of education, and speak English as a first language, compared to the total MYPS sample.

CONCLUSIONS

Family inclusive service responses which aim to strengthen family relationships may be particularly important for families where there is a history of adversity to support parental mental health.

COVID-19 and children's behavioral health: An overview

The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.

Unique SARS-CoV-2 Variants, Tourism Metrics, and B.1.2 Emergence in Early COVID-19 Pandemic: A Correlation Analysis in South Dakota

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus, which is the source of the coronavirus disease 2019 (COVID-19), was declared a pandemic in the March of 2020. Travel and tourism were severely impacted as restrictions were imposed to help slow the disease spread, but some states took alternative approaches to travel restrictions. This study investigated the spread of COVID-19 in South Dakota during the early pandemic period to better understand how tourism affected the movement of the virus within the region. Sequences from the fall of 2020 were retrieved from public sources. CDC and other sources were used to determine infections, deaths, and tourism metrics during this time. The data were analyzed using correlation and logistic regression. This study found that the number of unique variants per month was positively correlated with hotel occupancy, but not with the number of cases or deaths. Interestingly, the emergence of the B.1.2 variant in South Dakota was positively correlated with increased case numbers and deaths. Data show that states with a shelter-in-place order were associated with a slower emergence of the B.1.2 variant compared to states without such an order, including South Dakota. Findings suggest complex relationships between tourism, SARS-CoV-2 infections, and mitigation strategies. The unique approach that South Dakota adopted provided insights into the spread of the disease in areas without state-wide restrictions. Our results suggest both positive and negative aspects of this approach. Finally, our data highlight the need for future surveillance efforts, including efforts focused on identifying variants with known increased transmission potential to produce effective population health management.

Acclimating Nursing Students After the Pandemic: "It's ASNAP!"

BACKGROUND

This article describes the development of a comprehensive pilot program, "It's ASNAP!" (Acclimating Nursing Students After the Pandemic). The program incorporated the academic, social, and emotional well-being of undergraduate nursing students returning to campus after the coronavirus disease 2019 (COVID-19) pandemic.

METHOD

A purposeful sample of 488 students was recruited to participate via an anonymous survey on the academic, social, and emotional aspects of acclimating back to campus life.

RESULTS

A total of 121 undergraduate nursing students responded to the survey. The majority of students reported study groups (79%) and de-stressing events (86%) were the most helpful as they acclimated back to campus. Compared with the emotional and social areas of support, the academic area of support was of highest interest to the students.

CONCLUSION

The "It's ASNAP!" program has been acculturated into the school of nursing to support students via study halls, tutoring, and social activities, as well as resilient threads and listening sessions during finals week. [J Nurs Educ. 2023;62(9):516-518.].

Gestational diabetes mellitus and COVID-19: The epidemic during the pandemic

During the global coronavirus disease 2019 (COVID-19) pandemic, people worldwide have experienced an unprecedented rise in psychological distress and anxiety. In addition to this challenging situation, the prevalence of diabetes mellitus (DM), a hidden epidemic, has been steadily increasing in recent years. Lower-middle-income countries have faced significant barriers in providing accessible prenatal care and promoting a healthy diet for pregnant women, and the pandemic has made these challenges even more difficult to overcome. Pregnant women are at a higher risk of developing complications such as hyper-tension, preeclampsia, and gestational diabetes, all of which can have adverse implications for both maternal and fetal health. The occurrence of gestational diabetes has been on the rise, and it is possible that the pandemic has worsened its prevalence. Although data is limited, studies conducted in Italy and Canada suggest that the pandemic has had an impact on gestational diabetes rates, especially among women in their first trimester of pregnancy. The significant disruptions to daily routines caused by the pandemic, such as limited exercise options, indicate a possible link between COVID-19 and an increased likelihood of experiencing higher levels of weight gain during pregnancy. Notably, individuals in the United States with singleton pregnancies are at a significantly higher risk of excessive gestational weight gain, making this association particularly important to consider. Although comprehensive data is currently lacking, it is important for clinical researchers to explore the possibility of establishing correlations between the stress experienced during the pandemic, its consequences such as gestational gain weight, and the increasing incidence of gestational DM. This knowledge would contribute to better preventive measures and support for pregnant individuals during challenging times.

Effects of the COVID-19 Pandemic on the Behavioural Tendencies of Cats and Dogs in Japan

Physical and mental effects stemming from COVID-19 have impacted not only people's lives but also the lives of their pets, which in recent years are often seen as members of the family. This study aimed to explore the impact of the COVID-19 pandemic in Japan on pets and their owners. Participants reported changes in physical activity and mental health, as well as working conditions and frequency of interaction with pets, before and after behavioural restrictions due to the COVID-19 pandemic. We also asked about their pets' behaviours using the Feline Behavioural Assessment and Research Questionnaire (Fe-BARQ) and the Canine Behavioural Assessment and Research Questionnaire (C-BARQ). This study showed that most cat and dog owners spent more time at home due to the COVID-19 behavioural restrictions and that the frequency of contact interaction with their pets increased. However, this study showed higher stress-related behaviours (e.g., cats: excessive grooming; dogs: aggression towards owners) among pets whose owners increased contact interaction. Furthermore, owners' low mental health was correlated with high stress-related behaviours (e.g., touch sensitivity) in pets. The results of this study indicate that the lockdown caused by the COVID-19 pandemic in Japan may have affected not only the lives of owners but also the interaction between owners and their pets, and consequently their pets' behaviours. Therefore, there is also concern that changes in lifestyle patterns caused by pandemics could form a negative feedback loop between the health status of both owners and their pets.

Effects of social confinement during the first wave of COVID-19 in Mexico City

Background

The COVID-19 pandemic led to global social confinement that had a significant impact on people's lives. This includes changes such as increased loneliness and isolation, changes in sleep patterns and social habits, increased substance use and domestic violence, and decreased physical activities. In some cases, it has increased mental health problems, such as anxiety, depression, and post-traumatic stress disorder.

Objective

The objective of this study is to analyze the living conditions that arose during social confinement in the first wave of COVID-19 within a group of volunteers in Mexico City.

Methods

This is a descriptive and cross-sectional analysis of the experiences of volunteers during social confinement from 20 March 2020 to 20 December 2020. The study analyzes the impact of confinement on family life, work, mental health, physical activity, social life, and domestic violence. A maximum likelihood generalized linear model is used to determine the association between domestic violence and demographic and health-related factors.

Results

The findings indicate that social confinement had a significant impact on the participants, resulting in difficulties within families and vulnerable conditions for individuals. Gender and social level differences were observed in work and mental health. Physical activity and social life were also modified. We found that suffering from domestic violence was significantly associated with being unmarried (OR = 1.4454, p-value = 0.0479), lack of self-care in feeding habits (OR = 2.3159, p-value = 0.0084), and most notably, having suffered from a symptomatic COVID-19 infection (OR = 4.0099, p-value = 0.0009). Despite public policy to support vulnerable populations during confinement, only a small proportion of the studied population reported benefiting from it, suggesting areas for improvement in policy.

Conclusion

The findings of this study suggest that social confinement during the COVID-19 pandemic had a significant impact on the living conditions of people in Mexico City. Modified circumstances on families and individuals, included increased domestic violence. The results can inform policy decisions to improve the living conditions of vulnerable populations during times of social confinement.

Protective behaviors during COVID-19 confinement measures in Greece: the role of anxiety, perceived risk and risky-choice framing

Confinement measures at the beginning of the COVID-19 pandemic imposed major changes on the global population. The aim of this study was to explore the level to which the public adhered to protective guidelines by adopting the most appropriate behaviors at that time (such as hand washing with soap and using sanitizer gel) and to identify the determinants of these behaviors. A purposive sample of 1013 individuals was invited and voluntarily participated in the online survey. The questionnaire collected information on demographic data, hand washing, risk perception, anxiety (through the S = Anxiety scale of STAI) and risky-choice framing. Results showed increased levels of anxiety, a moderate perception of the risk of catching coronavirus and increased adoption of protective behaviors, such as handwashing and cleaning surfaces with disinfectant/antiseptic products. Multiple ordinal logistic regression models showed that being female, more educated and cleaning home with disinfectant / antiseptic products predicted handwashing with soap. Additionally, having an increased perception of getting the coronavirus, being older and cleaning the home with disinfectant / antiseptic products predicted handwashing with antiseptics. Public health interventions should take into consideration the unified cleaning pattern and the combined effect of sociodemographic variables and risk perception on the adoption of protective behaviour in the context of a health crisis which is out of people's control.

Increased adolescent game usage and health-related risk behaviors during the COVID-19 pandemic

This study examines adolescent game usage and corresponding health-related risk behaviors during a period of limited social interaction and activity due to the COVID-19 pandemic. Participants included 225 middle- and 225 high-school students in Seoul who completed a survey online from October 1 to 30, 2021. The study measured participants' game usage level and the health-related risk behavior index. Findings showed that participants who engaged in excessive gaming showed higher levels of health-related risk behaviors. A multivariate analysis of variance was conducted to compare the health-related risk behaviors of students in the general, potential, and high-risk groups on excessive gaming. Results indicated that female students in the high-risk group showed higher stress levels and fatigue (f = 5.549, p < .01, Cohen's d = 0.016) than the males of the same group. However, male students showed higher physical inactivity levels (f = 3.195, p > .05, Cohen's d = 0.009) than females. The post hoc test indicated clear sex distinctions among the general, potential, and high-risk groups on excessive gaming (p < .001). Among the high-risk game usage group, female students displayed a higher level of risk behaviors than males. Adolescent gaming addiction should be considered an emotional and behavioral disorder for which parental guidance and support are needed, and counseling experts and professionals must come together to provide a cure and reform program.

The Impact of COVID-19 Lockdown on Adults with Major Depressive Disorder from Catalonia: A Decentralized Longitudinal Study

The present study analyzes the effects of each containment phase of the first COVID-19 wave on depression levels in a cohort of 121 adults with a history of major depressive disorder (MDD) from Catalonia recruited from 1 November 2019, to 16 October 2020. This analysis is part of the Remote Assessment of Disease and Relapse-MDD (RADAR-MDD) study. Depression was evaluated with the Patient Health Questionnaire-8 (PHQ-8), and anxiety was evaluated with the Generalized Anxiety Disorder-7 (GAD-7). Depression's levels were explored across the phases (pre-lockdown, lockdown, and four post-lockdown phases) according to the restrictions of Spanish/Catalan governments. Then, a mixed model was fitted to estimate how depression varied over the phases. A significant rise in depression severity was found during the lockdown and phase 0 (early post-lockdown), compared with the pre-lockdown. Those with low pre-lockdown depression experienced an increase in depression severity during the "new normality", while those with high pre-lockdown depression decreased compared with the pre-lockdown. These findings suggest that COVID-19 restrictions affected the depression level depending on their pre-lockdown depression severity. Individuals with low levels of depression are more reactive to external stimuli than those with more severe depression, so the lockdown may have worse detrimental effects on them.

[Loneliness in Adolescents Against the Background of the COVID-19 Pandemic: A Risk Factor]

Loneliness in Adolescents Against the Background of the COVID-19 Pandemic: A Risk Factor Abstract. On the one hand, loneliness is the subjective experience of inadequate social integration and support. It is a normal phenomenon that can be dealt with in an emotional and action-oriented way within the framework of individual development. On the other hand, chronic loneliness goes hand in hand with considerable suffering, reduced quality of life, and an increased risk of psychological and somatic diseases. In the context of current social developments associated with the fragmentation of social networks and programmatic individualism, we discuss an increase in the problem of loneliness, especially among young people. Interventions to reduce the experience of loneliness are effective if, in addition to making social offers, they focus on the dynamics common in chronic loneliness (low self-esteem, evaluation of neutral communication as devaluing, etc.). There is no evidence that the use of virtual social networks persistently reduces feelings of loneliness in young people. In addition, the question arises on what basis of shared values and goals social integration of young people who experience loneliness will be possible in the future. According to the results of the first systematic surveys on the psychosocial consequences of the COVID-19 pandemic, we must assume that the loneliness problem of young people will continue to gain relevance because of the associated massive restrictions on real social life.

Social Media, Anxiety and COVID-19 Lockdown Measurement Compliance

The aim of the present research was to analyze the effect of anxiety levels during the COVID-19 pandemic in the use of social media and compliance with lockdown measures during the confinement. A total of 1723 participants (32.1% males and 77.9% females; 32.6 ± 9.2 years) were interviewed by a Spanish version of the Spielberger State-Trait Anxiety Inventory. From the results obtained, the sample was divided into two 50th percentile groups, a high anxiety group (HAG) and a low anxiety group (LAG). We found how the LAG had lower use of social networks such as Facebook and Twitter during confinement. Also, this group presented a higher rate of leaving home during the confinement and higher values in people with whom they had lived with during confinement than high anxiety group. Regardless of the lack of results in the remaining variables, the present study nuances the high levels of anxiety experienced during COVID-19 confinement. The multifactorial analysis of factors related to the perception of anxiety during COVID-19 confinement may be a useful tool to measure multiple social behaviors when examining mental health factors. Thus, explaining and preventing the psychological consequences of the COVID-19 pandemic. The present knowledge could be used to determine key intervention factors for reducing the perception of fear and anxiety.

Avoidance of fitness or sports facilities during a lockdown: Gender and training environment could be protective factors

The COVID-19 pandemic has swept the world, claiming nearly seven million lives by now. Despite a decline in the mortality rate, in November 2022, the virus-linked death cases still exceeded 500 every day. There is a belief that it is over now, but similar health-crisis situations may re-occur, and therefore it is essential to learn from such human disasters. It is an accepted fact that the pandemic has changed people's lives worldwide. One specifically and significantly affected life domain, especially during the lockdown, is the practice of sports and planned physical activities. Hence, this study examined the exercise practices and attitudes towards attending fitness facilities in 3053 working adults during the pandemic, along with the differences associated with the preferred training environment, including fitness/sports facilities, home, outdoor, or their combinations. The results revealed that women (representing 55.3% of the sample) are more precautious than men. Further, exercise behavior and COVID-19 attitudes broadly vary among people choosing different training venues. In addition, age, exercise frequency, place of exercise, fear of infection, flexibility in training form, and desire to exercise freely are predictors of non-attendance (avoidance) of fitness/sports facilities during the lockdown. These results expand earlier findings to exercise settings, suggesting that women are more precautious than men in the exercise context too. They are also the first to indicate that the preferred exercise environment entails attitudes that shape exercise patterns and beliefs associated with the pandemic differently. Therefore, men and regular fitness center attendees need more attention and special guidance in enforcing legislative prevention measures during a health crisis.

The correlation between lifestyle health behaviors, coping style, and mental health during the COVID-19 pandemic among college students: Two rounds of a web-based study

Background

During the last months of 2019, worldwide attention has focused on a pandemic of COVID-19, and the pandemic spread rapidly, becoming a public health emergency of international concern. The Chinese government has quickly taken quarantine measures and the drastic measures incurred to curtail it, which could have harmful consequences for everyone's behavior and mental health.

Objective

This study aimed to investigate the correlation of influencing factors and mental health symptoms among Chinese college students according to two rounds of surveys during the COVID-19 pandemic.

Materials and methods

This study was divided into two stages of cross-sectional investigation. In February 2020 and May 2020, two cross-sectional surveys were conducted on college students in the above areas by means of cluster sampling. From February 4 to February 12, 2020, 14,789 college students completed the first round of online study from 16 cities and universities in 21 in China, excluding participants who completed the questionnaire, and finally included 11,787 college students. After 3 months, we also conducted a large-scale questionnaire survey based on the first study area to observe the behavioral changes and psychological symptoms of college students within 3 months. Using the convenience sampling method, a survey on the cognitive and psychological status of COVID-19 among college students was conducted in 21 universities in 16 regions in May 2020. The regions among the two surveys are divided into Wuhan (District 1), neighboring Hubei (District 2), first-tier cities, namely, Beijing, Shanghai and Guangzhou (District 3), and other provinces (District 4).

Results

(1) In the first survey, the average age of the participants was 20.51 ± 1.88 years. One-third of the college students were male. In total, 25.9 and 17.8% of college students reported depression and anxiety symptoms, respectively. College students, who reported higher ST, lower PA, higher soda beverage and tea beverage intake, have Chinese herbal medicine and vitamin drinking, and decreased frequency of diet had higher depression and anxiety symptoms. Moreover, infection risk, perceived resistance to COVID-19, concerns about physical symptoms, family/friends directly/indirectly contacted with confirmed cases, and seeking psychological counseling had significant associations with anxiety and depression symptoms. (2) In the second round of surveys, 6803 males (41.7%) and 9502 females (58.3%) had a mean age of 20.58 ± 1.81 years. The prevalence of depressive symptoms and anxiety symptoms during COVID-19 was 30.7 and 23.9%, respectively. (3) In both surveys, college students who reported having higher ST, lower PA, higher soda beverage and tea beverage intake, Chinese herbal medicine and vitamin drinking, and decreased frequency of diet also had higher depression and anxiety symptoms. Coping styles with COVID-19 partially mediate the association between some related lifestyle behaviors and anxiety and depression. The results of the conditional process model analysis support our hypothesis that lifestyle behaviors, and coping styles are both predictors of anxiety and depression symptoms, with both direct and indirect effects moderated by gender level. In logistic regression analysis, the correlation of depression and anxiety in the second rounds of the survey was higher than that in the first survey. In two surveys, there was a correlation between lifestyle health behaviors and coping style, gender and mental health.

Conclusions

Our findings demonstrated that the prevalence of anxiety and depression in the two rounds of surveys was different, and the prevalence in the second round was higher than that in the first round, as well as that in the two rounds of surveys. All survey identified that unhealthy lifestyle behaviors were positively associated with depression and anxiety symptoms. Compared with the emerged city of risk areas, other pandemic regions have a lower risk of mental health problems. The survey findings complement each other. Lifestyle health behaviors and coping style alleviated mental health symptoms. COVID-19-related social stressors were positively associated with mental health symptoms. The study also suggests that at the beginning of the pandemic, the effective management of college students' mental health problems, corresponding coping measures and maintaining a good lifestyle play a key role in the prevention and control of other cities. Understanding the college students' lifestyle behaviors during COVID-19 lockdown will help public health authorities reshape future policies on their nutritional recommendations, in preparation for future pandemics.

Joys or Sorrows of Parenting During the COVID-19 Lockdown: A Scoping Review

Objectives: The aim of this scoping review was to map out the existing evidence of the impact of the COVID-19 lockdown on parents of children and adolescents. We sought to: 1) identify parenting domains that were particularly affected by lockdown measures, 2) describe the challenges and opportunities of lockdown measures in these domains, and 3) define protective and exacerbating factors modulating the effect of lockdown measures on parents. Methods: We identified five main domains investigated in the context of parenting during the early COVID-19 lockdown derived from 84 studies: health and wellbeing, parental role, couple functioning, family and social relationships, and paid and unpaid work. For each domain, we listed challenges and opportunities, as well as discriminant factors. Results: The lockdown impacted all five different but interconnected domains, introduced new roles in parents' lives, and particularly affected women and vulnerable populations. Conclusion: This scoping review highlights the importance of approaching public health policymaking from a social justice perspective. Such an approach argues for social and public health policies to promote health accounting for its social, economic, political, and commercial determinants.

COVID-19-related mental health difficulties among marginalised populations: A literature review

The COVID-19 pandemic has had negative consequences on the mental health of the population, which has been documented. Marginalised groups that are at risk of poor mental health overall have been particularly impacted. The purpose of this review is to describe the mental health impact of the COVID-19 pandemic on marginalised group (i.e. persons who are socio-economically disadvantaged, migrants and members of ethno-racial minorities, experience homelessness) and identified interventions which could be well-suited to prevent and address mental health difficulties. We conducted a literature review of systematic reviews on mental health difficulties since the beginning of the COVID-19 epidemic and appropriate interventions among marginalised groups published from January 1, 2020 to May 2, 2022, using Google Scholar and PubMed (MEDLINE). Among 792 studies on mental health difficulties among members of marginalised groups identified by keywords, 17 studies met our eligibility criteria. Twelve systematic reviews examining mental health difficulties in one or several marginalised groups during the COVID-19 pandemic and five systematic reviews on interventions that can mitigate the mental health impact of the COVID-19 pandemic were retained in our literature review. The mental health of marginalised groups was severely affected during the COVID-19 pandemic. Most frequently reported mental health difficulties included symptoms of anxiety and depression. Additionally, there are interventions that appear effective and well-suited for marginalised populations, which should be disseminated on a large scale to mitigate the psychiatric burden in these groups and at the population level.

Conspiratorial Ideation Is Associated with Lower Perceptions of Policy Effectiveness: Views from Local Governments during the COVID-19 Pandemic

Governments around the world struggled to formulate an effective response to the coronavirus disease 2019 pandemic, which was hampered by the widespread diffusion of various conspiracy theories about the virus. Local governments are often responsible for the implementing mitigation measures such as mask mandates and curfews but have received very limited attention in the scholarly literature. In this article, the authors use data from local policy actors in Colorado to evaluate the relationship between conspiratorial beliefs and perceptions of mitigation policy effectiveness. The authors find that many local policy actors hold conspiratorial beliefs, which combine with partisanship to contribute to lower perceptions of policy effectiveness. The authors conclude by discussing future research directions, noting that the broad adoption of conspiracy theories likely changes enforcement at the local scale.

Protective effects of physical activity on mental health outcomes during the COVID-19 pandemic

The COVID-19 pandemic has been linked with increased reports of depression, anxiety, and stress. Stay-at-home directives during the pandemic-imposed lifestyle changes, including eating and sedentary behaviors that can further undermine mental health outcomes. Physical activity is a vital component for metabolic health, as well as for mental health by serving as an active coping strategy to manage stress and promote resilience. Global reports of increased sedentary leisure behaviors have been associated with feelings of depression and anxiety, but it unclear whether the relationship between physical activity and depression or anxiety persists over time. In this longitudinal study, we investigated (i) whether physical activity at the onset of the pandemic was related to feelings of depression or anxiety over time and (ii) whether this relationship was mediated by stress appraisals during the pandemic. We surveyed 319 adults living in Canada or the United States to assess physical activity, stress appraisals, and mental health outcomes at two time points over a 6-month period. We found a reduction in leisure-time physical activity that was linked to subsequent feelings of depression. Furthermore, individuals with lower levels of physical activity were more likely to appraise their COVID-19 situation to be uncontrollable at pandemic onset and as the pandemic continued. Stress appraisals of threat and uncontrollability were also positively related to feelings of depression. Modelling these three factors together showed that appraising a situation as uncontrollable mediated the relationship between initial physical activity and subsequent depressive feelings. Although correlational, these data highlight the protective role of leisure-time physical activity against worsened mental health outcomes during periods of prolonged stress.

Mental Disorders and Level of Resilience in Eight High-Altitude Cities of Peru during the Second Pandemic Wave: A Multicenter Population-Based Study

COVID-19 has led us to take preventive measures, such as social isolation, to reduce the high transmissibility of the disease. This could have affected the mental health of various population groups and the development of resilience as a mitigator. A cross-sectional analytical study was conducted with 700 participants from eight cities. The dependent variables were depression, anxiety, and post-traumatic stress disorder (PTSD). The independent variable was resilience. Generalized logistic regressions were used to identify the associations between the variables. The population consisted mostly of university students (65.0%); the rest of the population was distributed among workers of public or private institutions, housewives, and others (35.0%). High prevalences of anxiety (72.7%), depression (64.1%), and PTSD (15.1%) were found, as well as a median (interquartile range) resilience score of 24 points was determined. Factors associated with a high prevalence of PTSD were having lost employment and having a family member who died from COVID-19. For depression, associated factors were severe food insecurity and hypersomnia. For anxiety, associated factors were were having a deceased family member with COVID-19 and mild food insecurity. Our results show that, during the pandemic, the general population had a higher prevalence of mental disorders. In addition, anxiety was the most prevalent of the dependent variables. Special attention should be paid to the factors influencing the development of mental disorders and mental health prevention and promotion programs should be established.

Estimation of Lockdowns' Impact on Well-Being in Selected Countries: An Application of Novel Bayesian Methods and Google Search Queries Data

Lockdowns introduced in connection with the COVID-19 pandemic have had a significant impact on societies from an economic, psychological, and health perspective. This paper presents estimations of their impact on well-being, understood both from the perspective of mental health and considering economic security and similar factors. This is not an easy task because well-being is influenced by numerous factors and the changes happen dynamically. Moreover, there are some obstacles when using the control group. However, other studies show that in certain cases it is possible to approximate selected phenomena with Google search queries data. Secondly, the econometric issues related to the suitable modeling of such a problem can be solved, for example, by using Bayesian methods. In particular, herein the recently gaining in popularity Bayesian structural time series and Bayesian dynamic mixture models are used. Indeed, these methods have not been used in social sciences extensively. However, in the fields where they have been used, they have been very efficient. Especially, they are useful when short time series are analyzed and when there are many variables that potentially have a significant explanatory impact on the response variable. Finally, 15 culturally different and geographically widely scattered countries are analyzed (i.e., Belgium, Brazil, Canada, Chile, Colombia, Denmark, France, Germany, Italy, Japan, Mexico, the Netherlands, Spain, Sweden, and the United Kingdom). Little evidence of any substantial changes in the Internet search intensity on terms connected with negative aspects of well-being and mental health issues is found. For example, in Mexico, some evidence of a decrease in well-being after lockdown was found. However, in Italy, there was weak evidence of an increase in well-being. Nevertheless, the Bayesian structural time series method has been found to fit the data most accurately. Indeed, it was found to be a superior method for causal analysis over the commonly used difference-in-differences method or Bayesian dynamic mixture models.

1.5 years pandemic - Psychological burden over the course of the COVID-19 pandemic in Germany: A nine-wave longitudinal community study

BACKGROUND

The dynamic COVID-19 pandemic has been associated with mental strain. However, most studies focused primarily on the beginning of the pandemic and rarely took into account the long-term course. The aim of this prospective-longitudinal study was to investigate levels and changes of pandemic-related fears, unspecific anxiety, depressive symptoms, and psychosocial-behavioral factors over the first 1.5 years of the pandemic.

METHODS

We conducted a nine-wave longitudinal online-survey from March 2020 to October 2021 with a total of 8148 participants of the adult general population in Germany. Descriptive examination and multilevel analysis were carried out to assess psychological burden, risk-bearing and protective psychosocial-behavioral factors, and associations with sociodemographics and the pandemic's duration and severity over the course of the pandemic.

RESULTS

Symptoms of mental strain fluctuated across the pandemic and displayed a relative maximum at the pandemic's early beginning and during the second and third COVID-19 waves. Most participants (approximately 67.4 %-82.1 %) reported mild and transient symptoms, but a substantial portion (approximately 17.9 %-32.6 %) experienced pronounced mental health problems during the pandemic. Symptom severity was negatively associated with the duration of the pandemic and positively associated with the rate of new infections.

LIMITATIONS

The observational study design, non-probability-sampling methods, and online self-report assessments limit the generalizability of our results.

CONCLUSIONS

The fluctuating course of psychological burden during the pandemic emphasizes the relevance of continuous monitoring during this challenging time. Particularly individuals with pronounced subclinical symptoms or manifesting mental disorders should be targeted with adequate prevention and early intervention programs.

Effects of long-term COVID-19 confinement and music stimulation on mental state and brain activity of young people

The Corona Virus Disease 2019 (COVID-19) pandemic may have had a negative emotional impact on individuals. This study investigated the effect of long-term lockdown and music on young people’s mood and neurophysiological responses in the prefrontal cortex (PFC). Fifteen healthy young adults were recruited and PFC activation was acquired using functional near-infrared spectroscopy during the conditions of resting, Stroop and music stimulation. The Depression Anxiety Stress Scales mental scale scores were simultaneously recorded. Mixed effect models, paired t-tests, one-way ANOVAs and Spearman analyses were adopted to analyse the experimental parameters. Stress, anxiety and depression levels increased significantly from Day 30 to Day 40. In terms of reaction time, both Stroop1 and Stroop2 were faster on Day 40 than on Day 30 (P = 0.01, P = 0.003). The relative concentration changes of oxyhemoglobin were significantly higher during premusic conditions than music stimulation and postmusic Stroop. The intensity of functional connectivity shifted from inter- to intracerebral over time. In conclusion, the reduced hemodynamic response of the PFC in healthy young adults is associated with negative emotions, especially anxiety, during lockdown. Immediate music stimulation appears to improve efficiency by altering the pattern of connections in PFC.

Impact of COVID-19 lockdown in a biomedical research campus: A gender perspective analysis

From March to September 2020, researchers working at a biomedical scientific campus in Spain faced two lockdowns and various mobility restrictions that affected their social and professional lifestyles. The working group "Women in Science," which acts as an independent observatory of scientific gender inequalities on campus launched an online survey to assess the impact of COVID-19 lockdowns on scientific activity, domestic and caregiving tasks, and psychological status. The survey revealed differences in scientific performance by gender: while male researchers participated in a larger number of scientific activities for career development, female researchers performed more invisible scientific tasks, including peer review or outreach activities. Mental impact was greater in researchers caring for children or dependents, and this was aggravated for women. Results spot a disproportionate impact of COVID-19 lockdowns on female scientific career development, and urges for equity measures to mitigate the consequences of an increase in the gender gap in biomedical sciences for current and future pandemics.

The Social Distance Impacts from COVID-19 Pandemic on the Development of Two Orders of a Concurrent Training Programme for Morbidly Obese Patients

BACKGROUND

Although there is relevant information regarding the consequences of the coronavirus SARS-CoV-2 (COVID-19), little is known about the impact of the imposed social confinement (at home) on the development of exercise training programmes in populations with morbid obesity.

AIM

To describe the effects of the imposed COVID-19 confinement on the cardiometabolic health benefits acquired through a concurrent training programme that started before the pandemic in populations with morbid obesity.

METHODS

This was an experimental randomized clinical study, in which sedentary morbidly obese women were assigned 1:1 to a high-intensity interval training (HIIT) plus resistance training (RT) group (HIIT + RT; n = 11; BMI 42.1 ± 6.6) or to the same exercise dose, but in different order group of RT plus HIIT group (RT + HIIT; n = 7; BMI 47.5 ± 8.4). Both groups undertook two sessions/week. When COVID-19 confinement at home started, a post-test was applied in January 2020 (Post1) and after 20 months (Post2). The main outcomes were waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), high-density lipids (HDL-c), triglycerides (Tg), and fasting plasma glucose (FPG).

RESULTS

In the HIIT + RT group, the WC showed significant increases from Post1 to Post2 (Δ + 3.1 cm, p = 0.035); in the RT + HIIT group, it decreased from Post1 to Post2 (Δ - 4.8 cm, p = 0.028). In the HIIT + RT group, SBP showed significant increases from Post1 to Post2 (Δ + 6.2 mmHg, p = 0.041); the RT + HIIT group decreased SBP from Pre0 to Post1 (Δ - 7.2 mmHg, p = 0.026) and increased DBP from Pre0 to Post1 (Δ + 8.1 mmHg, p = 0.015). Tg in the HIIT + RT group decreased from Pre0 to Post1 (Δ - 40.1 mg/dL, p = 0.023) but increased from Post1 to Post2 (Δ + 86.3 mg/dL, p < 0.0001).

CONCLUSIONS

The COVID-19 social confinement worsened metabolic syndrome (MetS) outcomes that had improved from 20 weeks' RT + HIIT during the training period, such as WC, SBP, and Tg from HIIT + RT, when, worryingly, SBP increased to another more serious clinical classification in both groups.

Post-Traumatic Stress Disorder and Alcohol Use Disorder During the COVID-19 Outbreak: Do Dissociation and Emotional Metacognitive Beliefs Mediate the Role of Emotion Dysregulation?

OBJECTIVE

Despite the well-documented relationship between emotion dysregulation and both post-traumatic stress disorder (PTSD) and alcohol use disorder symptoms, no studies investigated this issue in the context of the outbreak. Moreover, additional research investigating the role of mediators intervening in these pathways is required. Dissociation and emotional beliefs are two factors that may explain such relationships. However, a poor number of studies empirically tested their role.

METHODS

A cross-sectional study on a sample of 719 community participants (32.5% males; Mage=34.36, standard deviation=14.38 years) was conducted. Participants fulfilled a battery of self-report questionnaires measuring levels of PTSD outbreak-related symptoms, alcohol use disorder, emotion dysregulation, emotional beliefs, and dissociation.

RESULTS

Partial r-Pearson correlations showed that PTSD symptoms' level was positively and significantly related to all variables investigated in the study whereas alcohol use disorder level was positively and significantly associated with emotion dysregulation and only some dimension of emotional beliefs and dissociation. Results drawn from a structural equation model highlight the mediating role of both emotional belief and dissociation in the relationship linking emotion dysregulation and alcohol use disorder whereas only dissociation, but not emotional beliefs, mediated the link between emotion dysregulation and PTSD symptoms.

CONCLUSION

Most of the hypotheses have been supported stressing the relevance of both dissociation and emotional beliefs in PTSD and alcohol use disorder symptoms. These two variables appear important framework from which deepen the impact of emotion dysregulation in psychopathology.

The Level of COVID-19 Anxiety among Oncology Patients in Poland

Cancer patients tend to have a high psychological burden. Half of cancer patients suffer from severe affective disorders and anxiety disorders, while one-third struggle with mild forms of these. The COVID-19 pandemic is damaging the mental health of the population due to social restrictions. A growing number of studies note the role of COVID-19 anxiety in the health and quality of life of cancer patients. The purpose of this study is to estimate the level of COVID-19 anxiety among oncology patients and to test the utility of the FCV-19S scale in a population study of cancer patients. The study included 600 respondents (300 oncology patients and 300 control subjects not undergoing oncological treatment). The FCV-19S scale and the GAD-7 scale were used in the study. The results were interpreted according to the following verbal scale: 76-100%, high anxiety; 56-75%, moderate anxiety; 26-55%, low COVID-19 anxiety; <25%, no COVID-19 anxiety. In the analysis of the GAD-7 questionnaire results, the mean score obtained was 8.21 (min. 0; max. 21; SD 5.32). For 81% of respondents in the group of oncology patients, the total score indicated the presence of anxiety symptoms with varying degrees of severity; in the control group, this proportion was 55% of respondents. The FCV-19S scale score as a percentage was 57.4% for oncology patients, indicating a moderate level of fear of the SARS-CoV-2 virus, and 30.3% for the control group, indicating a low level of fear of the SARS-CoV-2 virus. One-fifth of oncology patients were afraid of losing their lives due to the SARS-CoV-2 virus; in the control group, this proportion was 13% of respondents. Oncology patients were characterized by a higher prevalence of sleep disturbance than control group respondents, which was associated with greater anxiety. The study, therefore, shows that oncology patients have moderate levels of anxiety associated with the COVID-19 pandemic, and non-oncology patients show lower levels of anxiety.

COVID-19 vaccination roll-outs in eleven small countries within the WHO European region; Lessons learned

The development and administration of COVID-19 vaccines has been an essential element in controlling the COVID-19 pandemic. However, countries worldwide have faced challenges in planning and implementing vaccination strategies. The aim of the current paper is to describe the situation faced by small countries in the WHO European Region in implementing their national vaccination strategies during the first stages of the planned roll-out (up to May 2021). This paper uses information from the WHO Small Countries Initiative (SCI), which includes a network of 11 countries with populations of ≤ 2 million (Andorra, Cyprus, Estonia, Iceland, Latvia, Luxembourg, Malta, Monaco, Montenegro, San Marino, and Slovenia). The SCI countries faced many challenges including: a lack of appropriate vaccination centers, adequate workforce, and registration/booking systems to cope with the unprecedented vaccine storage and administration demands; difficulties for high-risk groups (e.g., older individuals and those with health problems or cognitive impairment) to access vaccination sites or use digital registration/booking systems; vaccine wastage due to canceled appointments; and inequalities in vaccine uptake. Innovative programmatic interventions were implemented to facilitate the vaccination uptake of the populations such as: the creation of non-medical vaccination sites and mobile vaccination units; on-site vaccination of people in long-term residential facilities and long-term medical wards; diversifying health workforce like redeployment of healthcare professionals and use of medical students and retired medical professionals; campaigns with clear information to the general public (in multiple languages where necessary) both offline and online; use of digital registration/booking systems and alternative (non-digital) registration/booking systems for relevant individuals; and administration of excess vaccine doses to non-priority groups to avoid wastage.

COVID-19-related posttraumatic stress disorder in adults with lived experience of psychiatric disorder

BACKGROUND

Prevalence estimates of COVID-19-related posttraumatic stress disorder (PTSD) have ranged from 1% to over 60% in the general population. Individuals with lived experience of a psychiatric disorder may be particularly vulnerable to COVID-19-related PTSD but this has received inadequate attention.

METHODS

Participants were 1571 adults with lived experience of psychiatric disorder who took part in a longitudinal study of mental health during the COVID-19 pandemic. PTSD was assessed by the International Trauma Questionnaire (ITQ) anchored to the participant's most troubling COVID-19-related experiencevent. Factors hypothesised to be associated with traumatic stress symptoms were investigated by linear regression.

RESULTS

40.10% of participants perceived some aspect of the pandemic as traumatic. 5.28% reported an ICD-11 PTSD qualifying COVID-19 related traumatic exposure and 0.83% met criteria for probable ICD-11 COVID-19-related PTSD. Traumatic stress symptoms were associated with younger age, lower income, lower social support, and financial worries, and lived experience of PTSD/complex PTSD. Depression and anxiety measured in June 2020 predicted traumatic stress symptoms at follow-up approximately 20 weeks later in November 2020.

CONCLUSIONS

We did not find evidence of widespread COVID-19-related PTSD among individuals with lived experience of a psychiatric disorder. There is a need for future research to derive valid prevalence estimates of COVID-19-related PTSD.

Mental Health Impact of the COVID-19 Pandemic on Mexican Population: A Systematic Review

The COVID-19 pandemic has had an impact on mental health in the general population, but no systematic synthesis of evidence of this effect has been undertaken for the Mexican population. Relevant studies were identified through the systematic search in five databases until December, 2021. The selection of studies and the evaluation of their methodological quality were performed in pairs. The Newcastle-Ottawa Scale (NOS) was used for study quality appraisal. The protocol of this systematic review was registered with PROSPERO (protocol ID: CRD42021278868). This review included 15 studies, which ranged from 252 to 9361 participants, with a total of 26,799 participants. The findings show that COVID-19 has an impact on the Mexican population’s mental health and is particularly associated with anxiety, depression, stress and distress. Females and younger age are risk factors for development mental health symptoms. Mitigating the negative effects of COVID-19 on mental health should be a public health priority in Mexico.

Personal growth initiative moderates the mediating effect of COVID-19 preventive behaviors between fear of COVID-19 and satisfaction with life

This study focused on a moderated mediation model. First, it determined the mediating effect of COVID-19 preventive behaviors between fear of COVID-19 and satisfaction with life. Next, it examined whether personal growth initiative moderated the mediation effect. The study comprised 461 Pakistani university students (52% men and 48% women) between 18 and 35 years (M = 24.66, SD = 3.51). Results indicated that higher levels of fear of COVID-19 were linked to greater adherence to COVID-19 preventive behaviors, which in turn were related to higher levels of satisfaction with life (mediation model). With regard to the hypothesized moderated mediation model, results showed that personal growth initiative moderated the mediating path from fear of COVID-19 to satisfaction with life and from COVID-19 preventive behaviours to satisfaction with life. Further, results suggested that fear of COVID-19 and COVID-19 preventive behaviours had stronger effects on satisfaction with life when personal growth initiative was high, but not when it was low or moderate. It was therefore concluded that personal growth initiative may play a protective role in buffering the negative effect of higher levels of fear of COVID-19 on satisfaction with life and an enabling role in strengthening the relationship between COVID-19 preventive behaviors and satisfaction with life. Theoretical contribution and practical implications of the results are discussed as well as the study limitations and future research prospects.

The Impact of COVID-19 Related Social Distancing on Mental Health Outcomes: A Transdiagnostic Account

The COVID-19 pandemic, and the social distancing practices that followed, have been associated with increased prevalence of emotional disorders. However, not all individuals affected by COVID-19-related social distancing experienced elevations in emotional disorder symptoms. Understanding this phenomenon is of crucial public health significance given the burden of emotional disorders on individuals and systems. In this narrative review, we consider the differential impact of COVID-19-related social distancing on mental health outcomes from a transdiagnostic perspective. We argue that individuals high in negative affect and aversive reactivity to emotion, that is, neuroticism, and who respond to such emotional experiences with emotion-motivated avoidant coping, are most likely to experience emotional disorders in the context of COVID-19 social distancing. We acknowledge the pro-social and adaptive function of some types of avoidance during the pandemic, which may have initially buffered against negative mental health outcomes. Implications of this conceptualization for treatment of emotional disorders in the present sociocultural context are discussed.

Impact of COVID-19 social distancing on medical research from the perspective of postgraduate students: a cross-sectional online survey

Objective

To investigate the impact of COVID-19 social distancing on medical research from the perspective of postgraduate students.

Methods

A cross-sectional study using an online survey was conducted from October 31 to November 1, 2021. A questionnaire was used to assess the impact of COVID-19 social distancing on medical research among postgraduate students. The questionnaire included basic information, medical research information, and information about social distancing measures. Participants also completed the self-made Research Work Affected Scale of Postgraduates (RWAS-P; qualitative evaluation: very mildly 0-10; mildly 11-20; moderately 21-30; severely 31-40; very severely 41-50). Logistic regression was used to identify factors related to the impact of COVID-19 social distancing.

Results

A total of 468 participants were analyzed; 95.2% of the participants adhered to social distancing measures. The median total RWAS-P score was 22. The median RWAS-P scores for earlier research data, current research projects, future research plans, paper publication, and graduation schedule were 2, 6, 6, 6, and 4, respectively (score range 0-10). The higher grade of students, experimental research, and existence of inappetence or sleeplessness were related to negative attitude towards COVID-19 social distancing (odd ratio = 6.35, 9.80, 2.31, 2.15, 1.95, respectively).

Conclusions

Participants reported that social distancing had a moderate overall impact on their medical research. Social distancing had the greatest impact on current research projects, future research plans, and paper publications among postgraduate students. Higher grade level, experimental research type, inappetence, and sleeplessness were related to the impact of social distancing on their medical research.

Performance and Application Evaluation of SARS-CoV-2 Antigen Assay

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) nucleic acid detection is the gold standard for the laboratory diagnosis of coronavirus disease 2019 (COVID‐19). However, this method has high requirements for practitioners' skills and testing sites, so it is not easy to popularize and promote the application in places other than large hospitals. In addition, the detection flux of SARS‐CoV‐2 nucleic acid is small, and the whole detection process takes much time, which cannot meet the actual needs of rapid screening in large quantities. The WHO conditionally approved a batch of SARS‐CoV‐2 antigen reagents for clinical application to alleviate this contradiction. SARS‐CoV‐2 antigen detection offers a trade‐off among clinical performance, speed and accessibility. With the gradual increase in clinical application, the accumulated clinical data show that the sensitivity and specificity of the SARS‐CoV‐2 antigen assay are over 80% and 97%, respectively, which can basically meet the requirements of the WHO. However, the sensitivity of the SARS‐CoV‐2 Antigen Assay among asymptomatic people in low prevalence areas of COVID‐19 cannot meet the standard, leading to a large number of missed diagnoses. In addition, the detection ability of SARS‐CoV‐2 antigen reagent for different SARS‐CoV‐2 mutant strains differs greatly, especially for those escaping the COVID‐19 vaccines. In terms of results interpretation, it is highly reliable to exclude SARS‐CoV‐2 infection based on the high negative predictive value of the SARS‐CoV‐2 antigen assay. However, in the low prevalence environment, the probability of false positives of the SARS‐CoV‐2 antigen assay is high, so the positive results need to be confirmed by the SARS‐CoV‐2 nucleic acid reagent. The SARS‐CoV‐2 antigen assay is only a supplement to SARS‐CoV‐2 nucleic acid detection and can never completely replace it. To date, SARS‐CoV‐2 nucleic acid detection continues to be the standard laboratory method for COVID‐19 diagnosis.

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID-19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (G-SES) were the study’s main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.

Gender Differences in the Impact of COVID-19 Pandemic on Mental Health of Italian Academic Workers

The 2020 pandemic for coronavirus SARS-CoV-2 infection has required strict measures for virus spreading reduction, including stay-at-home orders. To explore gender differences in mental health status after the first wave of the pandemic and in teleworking, we analyzed the frequency and distribution of emotions and coping strategies for facing the pandemic stratified by gender using data from an online survey conducted at the University of Salerno, Italy, between 11 May and 10 June 2020. The online questionnaire included 31 items on demographics, teleworking, COVID-19 emergency, and gender-based violence, with multiple-choice answers for some questions. Females felt significantly sadder (p = 0.0019), lonelier (p = 0.0058), more fearful (p = 0.0003), and more insecure (p = 0.0129) than males, experienced more sleep disorders (p = 0.0030), and were more likely to sanitize surfaces compared to males (p < 0.0001). Our results show gender differences in awareness and concerns about the COVID-19 pandemic that differently influenced mood, as females were more frightened and worried than males.

Predictors of social distancing and hand washing among adults in five countries during COVID-19

The purpose of this cross-sectional study is to examine disparities in hand washing and social distancing among 2,509 adults from the United States, Italy, Spain, the Kingdom of Saudi Arabia, and India. Respondents were recruited via Qualtrics' participant pool and completed an online survey in the most common language spoken in each country. In hierarchical linear regression models, living in a rural area (β = -0.08, p = .001), older age (β = 0.07, p < .001), identifying as a woman (β = 0.07, p = .001), and greater educational attainment (β = 0.07, p = .017) were significantly associated with hand washing. Similar results were found regarding social distancing, in which living in a rural area (β = -0.10, p < .001), country of residence (β = 0.11, p < .001), older age (β = 0.17, p < .001), identifying as a woman (β = 0.11, p < .001), and greater educational attainment (β = 0.06, p = .019) were significant predictors. Results from the multivariable linear regression models demonstrate more nuanced findings with distinct and significant disparities across the five countries found with respect to hand washing and social distancing. Taken together, the results suggest multiple influencing factors that contribute to existing disparities regarding social distancing and hand washing among adults internationally. As such, more tailored public interventions are needed to promote preventive measures to mitigate existing COVID-related disparities.

Changes in Prevalence of Mental Illness Among US Adults During Compared with Before the COVID-19 Pandemic

The authors review trend and cohort surveys and administrative data comparing prevalence of mental disorders during, versus, and before the COVID-19 pandemic and changes in mental health disparities. Best evidence suggests clinically significant anxiety-depression point prevalence increased by relative-risk (RR) = 1.3 to 1.5 during the pandemic compared with before. This level of increase is much less than the implausibly high RR = 5.0 to 8.0 estimates reported in trend studies early in the pandemic based on less-appropriate comparisons. Changes in prevalence also occurred during the pandemic, but relative prevalence appears not to have changed substantially over this time.

Alcohol Use and Anxiety in Primary Health Care Patients During the COVID-19 Pandemic: a Phone-Based Study

In March 2020, physical distancing and quarantine measures were implemented in Brazil, which may have affected the physical and mental health of the population. This cross-sectional study used a convenience sample and telephone-based interviews to identify anxiety symptoms and alcohol use patterns among 1,264 Brazilian primary health care (PHC) patients during the COVID-19 pandemic. The State-Trait Anxiety Inventory-State 6 and Alcohol Use Disorders Identification Test (AUDIT-C) questionnaires were used to assess anxiety symptoms and alcohol use patterns, respectively. According to the AUDIT-C results, the prevalence of harmful drinking was 38.5%. Those who reported that their alcohol consumption decreased during the pandemic had high scores on the AUDIT-C, indicating a moderate/severe risk of drinking. Moderate or severe anxiety was observed in 60.1% of participants. These results highlight the needs to assess the pandemic's consequences on the mental health of the population and to encourage the implementation of preventive approaches in PHC settings to address anxiety and harmful alcohol consumption.

A Peek into Pandora’s Box: COVID-19 and Neurodegeneration

Ever since it was first reported in Wuhan, China, the coronavirus-induced disease of 2019 (COVID-19) has become an enigma of sorts with ever expanding reports of direct and indirect effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on almost all the vital organ systems. Along with inciting acute pulmonary complications, the virus attacks the cardiac, renal, hepatic, and gastrointestinal systems as well as the central nervous system (CNS). The person-to-person variability in susceptibility of individuals to disease severity still remains a puzzle, although the comorbidities and the age/gender of a person are believed to play a key role. SARS-CoV-2 needs angiotensin-converting enzyme 2 (ACE2) receptor for its infectivity, and the association between SARS-CoV-2 and ACE2 leads to a decline in ACE2 activity and its neuroprotective effects. Acute respiratory distress may also induce hypoxia, leading to increased oxidative stress and neurodegeneration. Infection of the neurons along with peripheral leukocytes’ activation results in proinflammatory cytokine release, rendering the brain more susceptible to neurodegenerative changes. Due to the advancement in molecular biology techniques and vaccine development programs, the world now has hope to relatively quickly study and combat the deadly virus. On the other side, however, the virus seems to be still evolving with new variants being discovered periodically. In keeping up with the pace of this virus, there has been an avalanche of studies. This review provides an update on the recent progress in adjudicating the CNS-related mechanisms of SARS-CoV-2 infection and its potential to incite or accelerate neurodegeneration in surviving patients. Current as well as emerging therapeutic opportunities and biomarker development are highlighted.

Association of Different Restriction Levels With COVID-19-Related Distress and Mental Health in Somatic Inpatients: A Secondary Analysis of Swiss General Hospital Data

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic and related countermeasures hinder health care access and affect mental wellbeing of non-COVID-19 patients. There is lack of evidence on distress and mental health of patients hospitalized due to other reasons than COVID-19-a vulnerable population group in two ways: First, given their risk for physical diseases, they are at increased risk for severe courses and death related to COVID-19. Second, they may struggle particularly with COVID-19 restrictions due to their dependence on social support. Therefore, we investigated the association of intensity of COVID-19 restrictions with levels of COVID-19-related distress, mental health (depression, anxiety, somatic symptom disorder, and mental quality of life), and perceived social support among Swiss general hospital non-COVID-19 inpatients.

METHODS

We analyzed distress of 873 hospital inpatients not admitted for COVID-19, recruited from internal medicine, gynecology, rheumatology, rehabilitation, acute geriatrics, and geriatric rehabilitation wards of three hospitals. We assessed distress due to the COVID-19 pandemic, and four indicators of mental health: depressive and anxiety symptom severity, psychological distress associated with somatic symptoms, and the mental component of health-related quality of life; additionally, we assessed social support. The data collection period was divided into modest (June 9 to October 18, 2020) and strong (October 19, 2020, to April 17, 2021) COVID-19 restrictions, based on the Oxford Stringency Index for Switzerland.

RESULTS

An additional 13% (95%-Confidence Interval 4-21%) and 9% (1-16%) of hospital inpatients reported distress related to leisure time and loneliness, respectively, during strong COVID-19 restrictions compared to times of modest restrictions. There was no evidence for changes in mental health or social support.

CONCLUSIONS

Focusing on the vulnerable population of general hospital inpatients not admitted for COVID-19, our results suggest that tightening of COVID-19 restrictions in October 2020 was associated with increased COVID-19-related distress regarding leisure time and loneliness, with no evidence for a related decrease in mental health. If this association was causal, safe measures to increase social interaction (e.g., virtual encounters and outdoor activities) are highly warranted.

TRIAL REGISTRATION

www.ClinicalTrials.gov, identifier: NCT04269005.

COVID-19 lockdowns and incidence of psychoactive substance exposure according to age and sex

BACKGROUND

The lockdown periods imposed in 2020 by governments had deleterious consequences on population mental health. Several studies based on declarative data have suggested that the lockdown periods were associated with changes in psychoactive substance use but few relied on toxicological analyses.

AIMS

We studied the impact of lockdowns on the pattern of routine care toxicological screening performed on patients hospitalized at the emergency ward (EW) and intensive care units (ICU) at the Grenoble University Hospital.

METHOD

This was a retrospective, monocentric study comparing routine care toxicology biological tests performed in children older than 12 years of age and adults hospitalized at the ICU and EW in 2018, 2019, and 2020. Alcohol, illicit drugs, and medications were screened. Generalized linear models were generated to evaluate the effect of the lockdown periods on toxicology results, considering age and sex.

RESULTS

The study included 13,910 samples from 11,786 patients. There was no significant difference in the repartition of sex or age over the three years. The frequency of positive toxicological tests increased during the lockdown periods (adjusted odds ratio (OR) 95% confidence interval (CI): 1.14, (1.01-1.28), p = .026). The frequency of poly-exposures also rose during these periods (OR 1.43 (1.11-1.82), p = .004) mostly among men (OR 1.54 (1.02-2.04), p = .022), 12-25-year-old patients (OR 1.69 (1.07-2.31), p = .016), and seniors (>56 years) (OR 1.54 (1.00-1.97), p = .032).

CONCLUSIONS

This study suggests that lockdown episodes were associated with increased incidence of psychoactive substance poly-exposures, highlighting the need for preventive strategies for high-risk populations.

Factors Related to Women's Psychological Distress during the COVID-19 Pandemic: Evidence from a Two-Wave Longitudinal Study

BACKGROUND

A growing body of research has highlighted the negative effects of the COVID-19 pandemic on women's mental health. Previous studies showed that women have higher levels of depression, anxiety and PTSD, and worse psychological adjustment than men, which also persisted after the earlier phase of the pandemic. This study aimed to evaluate changes in women's psychological distress during the pandemic and to evaluate the factors that have a more significant impact in predicting women's psychological distress.

METHODS

This two-wave longitudinal study (T1 = Italian first lockdown, and T2 = second phase, when the restrictive measures were eased) involved 893 women (Mage = 36.45, SD = 14.48). Participants provided demographic and health data as well as measures of psychological distress, emotion regulation processes, and ability to tolerate uncertainty.

RESULTS

No significant changes were found in women's psychological distress between T1 and T2, i.e., during and after the first lockdown. Lower social stability status and higher maladaptive emotional coping predicted high psychological distress.

CONCLUSIONS

Results showed that modifiable psychological variables play a central role in predicting distress and indicated that emotion regulation interventions might be helpful in increasing psychological resilience and mitigating the adverse impacts of the COVID-19 pandemic within the female population.

Efficacy of the FIBROWALK Multicomponent Program Moved to a Virtual Setting for Patients with Fibromyalgia during the COVID-19 Pandemic: A Proof-of-Concept RCT Performed Alongside the State of Alarm in Spain

FIBROWALK is a multicomponent program including pain neuroscience education, therapeutic exercise, cognitive behavioral therapy and mindfulness training that has recently been found to be effective in patients with fibromyalgia (FM). This RCT started before the COVID-19 pandemic and was moved to a virtual format (i.e., online videos) when the lockdown was declared in Spain. This study is aimed to evaluate the efficacy of a virtual FIBROWALK compared to Treatment-As-Usual (TAU) in patients with FM during the first state of alarm in Spain. A total of 151 patients with FM were randomized into two study arms: FIBROWALK plus TAU vs. TAU alone. The primary outcome was functional impairment. Secondary outcomes were kinesiophobia, anxiety and depressive symptomatology, and physical functioning. Differences between groups at post-treatment assessment were analyzed using Intention-To-Treat (ITT) and completer approaches. Baseline differences between clinical responders and non-responders were also explored. Statistically significant improvements with small-to-moderate effect sizes were observed in FIBROWALK+TAU vs. TAU regarding functional impairment and most secondary outcomes. In our study, the NNT was 5, which was, albeit modestly, indicative of an efficacious intervention. The results of this proof-of-concept RCT preliminarily support the efficacy of virtual FIBROWALK in patients with FM during the Spanish COVID-19 lockdown.

Role of Nucleocapsid Protein Antigen Detection for Safe End of Isolation of SARS-CoV-2 Infected Patients with Long Persistence of Viral RNA in Respiratory Samples

Background. In SARS-CoV-2 infection, viral RNA may persist in respiratory samples for several weeks after the resolution of symptoms. Criteria to assess the end of infectivity are not unequivocally defined. In some countries, time from diagnosis is the unique criterion used, in addition to symptom cessation. This study evaluates the role of the Lumipulse^® Antigen Assay (LAA) for the safe end of isolation of patients ≥21 days after the diagnosis of infection. Methods. A total of 671 nasopharyngeal swabs from patients diagnosed with infection at least 21 days before were assessed by RT-PCR and LAA, and the role of LAA in predicting the absence of infectivity was evaluated by virus cell culture. Results. Viable virus was present in 10/138 cultured samples. Eight out of ten infective patients suffered from a concomitant disease, predisposing them to long-term shedding of infective virus. In particular, infectious virus was isolated from 10/20 RT-PCR+/LAA+ cultured samples, whereas no viable virus was found in all 118 RT-PCR+/LAA– cultured swabs. LLA and RT-PCR agreed in 484/671 (72.1%) samples, with 100% and 26.7% concordance in RT-PCR negative and positive samples, respectively. Conclusions. Viable virus can be found ≥21 days after diagnosis in immunocompromised or severely ill patients. LAA better than RT-PCR predicts non-infectivity of patients and can be safely used to end isolation in cases with long persistence of viral RNA in the respiratory tract.

Sleep Habits during COVID-19 Confinement: An Exploratory Analysis from Portugal

COVID-19 pandemic consequences are tragic, and many problems will persist after the health problem ends. Some studies have focused on mental health issues, reporting worrying percentages. It is known that there is a bidirectional relationship between mental health and sleep quality, and it would be expected that sleep would be affected by the pandemic. In order to know the Portuguese people’s habits before and during the confinement, we carried out a survey of 188 people aged 13 to 84 (38 ± 15) to find out the most frequent sleep patterns, habits and disorders before and during confinement. With this survey it was also intended to measure the most frequent changes in sleep patterns, habits, and disturbances on the general population and according to demographic data (gender, age group and professional status), sleep disorders arise, perceptions about sleep during confinement and if Portuguese think that in the future the sleep patterns will be the pre or during outbreak. Results indicate that, comparing before and during confinement, there is a slight correlation between gender and sleep disorders (before vs. during), a correlation between age group and professional status time to wake up, and between professional status and sleep disorders, and a strong correlation between the professional situation and changes in the invigorated feeling level (p < 0.001). Support for mental health and interventions to improve sleep quality should be offered to the population in general, and, according to our study, the Portuguese population.

Validation of the Japanese Version of the Center for Epidemiologic Studies Depression Scale-Revised: A Preliminary Analysis

To make the Japanese version of the CESD-R—a revised version of the Center for Epidemiologic Studies depression scale (CES-D)—in the assessment of depressive symptoms in a general population. The English version of CESD-R was translated into Japanese, and back-translated into English by three native speakers of Japanese and English; then, we selected the version most completely consistent with the original items. The CESD-R was applied to 398 community-dwelling people (191 men: 48.0%, and 207 women: 52.0%) who were over 40 years old. The Japanese version of the CES-D was also carried out in the same population. Factor analysis was performed. Additionally, the correlations between the CESD-R and CES-D results were identified. The CESD-R scores showed a significantly positive correlation with CES-D scores (r = 0.74, p < 0.0005). Analysis of the CESD-R yielded a Cronbach’s alpha result of 0.90. Factor analysis revealed one principal factor in the CESD-R, whereas the original CES-D had two factors because of reversed items. The Japanese version of the CESD-R appears to have the reliability to be applicable for assessing depressive symptoms in population-based samples. However, because the Japanese expressions for some items might be unusual, our study population was also limited; further studies on other populations and on incorporating improved Japanese terminology will be needed.

Working and Learning during the COVID-19 Confinement: An Exploratory Analysis with a Small Sample from Portugal

The epidemiological situation caused by the COVID-19 pandemic led to efforts to mitigate the transmission of the infection, forcing workers and students to stay at home. Universities closed, as did many businesses, forcing education and work to adapt to the new situation. While for some people it was a positive experience, for others it was not. This article analyzes the responses of 89 respondents, over 18 years old, in teleworking or enrolled in university online education, in a survey at the beginning of 2021, when Portugal was in a new state of emergency. Variables such as gender, age and parenthood were used, as well as ownership of equipment, own workspace, and quality of internet, comparing distance learning/work with traditional methods and measuring levels of satisfaction and willingness to adopt this model in the future. These results suggest an association of gender and parenting in the valuation of telework/distance education; women were more positive than men and participants with children were more positive than participants without children. The same was the case for respondents with their own workspace and better-quality internet. There is a strong relation between paternity and the preference for the distance model, in the sense of valuing the distance model, as well as a relation between those who have their own work space and the appreciation of the distance model. In general, respondents to our survey showed that they are not fond of adopting telework/distance learning in the future.