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Bota AV, Bogdan I, Razvan DV, Ilie AC, Tudor R, Indries MF, Csep AN, Marincu I. A Three-Year Cross-Sectional Analysis of Depression, Anxiety, and Quality of Life in Patients with Post-COVID-19 Syndrome. Int J Gen Med 2024; 17:751-762. [PMID: 38476627 PMCID: PMC10929241 DOI: 10.2147/ijgm.s453247] [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: 12/04/2023] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
Background This study explores the longitudinal psychosocial impact of Long-COVID syndrome, also known as Post-COVID-19 syndrome, characterized by enduring symptoms after coronavirus disease (COVID-19) infection, over the years 2020, 2021, and 2022. It aimed to examine the variations in depression, anxiety, and quality of life among Post-COVID-19 patients during these years, hypothesizing significant inter-year differences reflecting the pandemic's evolving influence. Methods Conducted at Victor Babes Hospital for Infectious Diseases and Pulmonology, Romania, this cross-sectional research involved 324 patients diagnosed with mild to moderate COVID-19, assessed six months post-hospitalization. Standardized instruments, namely Short Form (SF-36) for quality of life, Generalised Anxiety Disorder Assessment (GAD-7) for anxiety, and Patient Health Questionnaire (PHQ-9) for depression, were utilized. Results The study observed a consistent average patient age of around 55 years across the years. A notable increase in COVID-19 vaccination rates was recorded, rising from 20.9% in 2020 to over 70% in 2022 (p<0.001). Trends in key post-COVID symptoms like fatigue and cognitive issues varied over the years. Importantly, there was a consistent decrease in feelings of sadness or depression, with scores declining from 7.3 in 2020 to 4.8 in 2022 (p<0.001). The SF-36 survey indicated a steady improvement in overall health, reaching 55.8±7.1 in 2022 (p=0.035). Both GAD-7 and PHQ-9 scores showed significant reductions in anxiety and depression over the years, with p-values of 0.030 and 0.031, respectively. Factors such as smoking status, substance use, and the initial severity of COVID-19 infection were significantly associated with depression levels. Conclusion The findings suggest that despite persistent physical symptoms, Long-COVID patients experienced enhancements in mental well-being and quality of life over the studied period. The increasing vaccination rates might have contributed to this improvement. Addressing modifiable risk factors like smoking and substance use could further optimize post-COVID care and mental health outcomes.
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Affiliation(s)
- Adrian Vasile Bota
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Doctoral School, “victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, 300041, Romania
| | - Iulia Bogdan
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Doctoral School, “victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, 300041, Romania
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, 300041, Romania
| | - David Vladut Razvan
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Doctoral School, “victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, 300041, Romania
| | - Adrian Cosmin Ilie
- Department III Functional Sciences, Division of Public Health and Management, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, 300041, Romania
| | - Raluca Tudor
- Second Discipline of Neurology, “victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, 300041, Romania
| | - Mirela Florica Indries
- Department of Psycho-Neuroscience and Recovery, University of Oradea, Faculty of Medicine and Pharmacy, Oradea, 410087, Romania
| | - Andrei Nicolae Csep
- Department of Psycho-Neuroscience and Recovery, University of Oradea, Faculty of Medicine and Pharmacy, Oradea, 410087, Romania
| | - Iosif Marincu
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
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Pérez-López FR, Blümel JE, Vallejo MS, Rodríguez I, Tserotas K, Salinas C, Rodrigues MA, Rey C, Ojeda E, Ñañez M, Miranda C, López M, Díaz K, Dextre M, Calle A, Bencosme A. Anxiety but not menopausal status influences the risk of long-COVID-19 syndrome in women living in Latin America. Maturitas 2024; 180:107873. [PMID: 37995422 DOI: 10.1016/j.maturitas.2023.107873] [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: 06/04/2023] [Revised: 10/08/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To study sociodemographic and clinical factors associated with the long-COVID-19 syndrome among women living in Latin American countries using undirected and directed methods. METHOD We studied 347 patients with COVID-19 (confirmed by polymerase chain reaction) living in nine Latin American countries between May 2021 and July 2022, including 70 premenopausal, 48 perimenopausal, and 229 postmenopausal women. We compared the sociodemographic and general health information of women with (n = 164) and without (n = 183) the long-COVID-19 syndrome. They also completed the Connor-Davidson Resilience Scale, the Fear of COVID-19 Scale, the Jenkins Sleep Scale, and the Menopause Rating Scale to define the minimum set of variables for adjustment. We designed a directed acyclic graph (DAG) to identify factors related to the long-COVID-19 syndrome. Data were submitted to categorical logistic regression analyses. Results are reported as means and standard deviations or β-coefficients and 95 % confidence intervals. RESULTS Women with long-COVID-19 syndrome had a poor lifestyle, severe menopause symptoms, hypertension, insomnia, depression, anxiety, chronic diseases/conditions, risk of hospitalization, sleep disturbance, and low menopause-related quality of life compared to women without the syndrome. The DAG identified the following long-COVID-19 covariates: age, obesity, anxiety, depression, cancer, lifestyle, smoking, and menstrual status. A multivariable logistic model with these covariates indicated that anxiety is the only factor to be significantly associated with long-COVID-19 syndrome, whereas other covariates were confounding factors. There was no significant influence of menopausal status on the long-COVID-19 syndrome. CONCLUSION Among factors selected by the DAG, only anxiety was significantly associated with the long-COVID-19. There was no significant influence of the menopause status on the long-COVID-19 syndrome in the studied population.
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Affiliation(s)
- Faustino R Pérez-López
- Instituto Aragonés de Ciencias de la Salud, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
| | - Juan Enrique Blümel
- Departamento de Medicina Interna Sur, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
| | | | - Ignacio Rodríguez
- Departamento de Obstetricia, Ginecología y Reproducción, Hospital Universitario Dexeus, Barcelona, Spain
| | | | | | - Marcio A Rodrigues
- Department Gynecology and Obstetrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Claudia Rey
- Medicina Ginecológica Consultorios Médicos, Buenos Aires, Argentina
| | - Eliana Ojeda
- Departamento Académico de Medicina Humana, Universidad Andina del Cusco, Cusco, Peru
| | - Mónica Ñañez
- II Cátedra de Ginecología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Carlos Miranda
- Hospital Central FAP-Instituto Médico Miraflores, Lima, Peru
| | - Marcela López
- Departamento Ginecología y Obstetricia Universidad de Santiago y Clínica Alemana, Santiago, Chile
| | - Karen Díaz
- Centro Ciudad Mujer, Ministerio de Salud, Asunción, Paraguay
| | - Maribel Dextre
- Ginecología Obstetricia, Clínica Internacional, Clínica Javier Prado, Lima, Peru
| | - Andrés Calle
- Centro Integral de Salud Obstétrica y Femenina-CISOF, Quito, Ecuador
| | - Ascanio Bencosme
- Ginecología Obstetricia, Hospital Metropolitano de Santiago, Santiago de los Caballeros, Dominican Republic
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Hinoveanu D, Anastasiu DM, Citu C, Popa ZL, Erdelean I, Dumitru C, Biris M, Olaru F, Neda-Stepan O, Fericean RM, Boia ER, Domuta EM, Stelea L. Impact of the COVID-19 Pandemic on Contraception Awareness and Mental Well-Being in Teenagers and Young Adult Women: A Three-Year Cross-Sectional Analysis. Healthcare (Basel) 2023; 11:2990. [PMID: 37998482 PMCID: PMC10671367 DOI: 10.3390/healthcare11222990] [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: 10/04/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
During the COVID-19 pandemic, significant shifts occurred in reproductive health, especially among teenagers and young adult women in Romania. This study, conducted from 2020 to 2022, aimed to longitudinally assess contraceptive awareness and its correlation with mental well-being in this demographic. A cohort of 210 participants aged 15-25, with a history of wanted or unwanted pregnancy, was studied. The research involved collaborations with Romanian educational institutions and strict adherence to ethical standards. Participants' data on contraceptive knowledge and practices were analyzed, considering factors like substance use and prior sexual education. Mental well-being was evaluated using the SF-36, WHOQOL-BREF, GAD-7, and PHQ-9 scales. The study revealed a positive correlation between increased contraceptive knowledge and improved mental health scores. In 2022, 68% of participants displayed proficient contraceptive awareness, up from 52% in 2020. Those with good contraceptive knowledge had an average SF-36 score of 72, indicating a better quality of life, compared to a score of 58 among those with limited knowledge. Furthermore, there was a notable decrease in GAD-7 and PHQ-9 scores among individuals with better contraceptive awareness, suggesting reduced anxiety and depression levels. The SF-36 survey results showed significant improvements across the years: the physical score increased from 52.1 (±6.3) in 2020 to 56.5 (±6.8) in 2022, the mental score from 51.4 (±7.2) to 55.0 (±6.9), and the total score from 53.6 (±7.9) to 57.5 (±8.0). WHOQOL-BREF results showed a substantial increase in the social domain score from 53.6 (±18.2) in 2020 to 63.0 (±20.5) in 2022. GAD-7 scores declined from 7.9 (±2.6) in 2020 to 6.5 (±3.3) in 2022, indicating a decrease in anxiety symptoms. PHQ-9 scores, measuring depression, also showed a downward trend, from 4.8 (±2.2) in 2020 to 3.9 (±2.8) in 2022. These findings highlight the intertwined nature of contraceptive awareness and mental well-being. The improvements in contraceptive awareness positively impacted mental health outcomes, emphasizing the need for targeted educational interventions in this demographic, particularly during global crises like the pandemic.
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Affiliation(s)
- Denisa Hinoveanu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (Z.L.P.); (I.E.); (C.D.); (M.B.); (F.O.); (L.S.)
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.N.-S.); (R.M.F.)
| | - Doru Mihai Anastasiu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (Z.L.P.); (I.E.); (C.D.); (M.B.); (F.O.); (L.S.)
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (Z.L.P.); (I.E.); (C.D.); (M.B.); (F.O.); (L.S.)
| | - Zoran Laurentiu Popa
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (Z.L.P.); (I.E.); (C.D.); (M.B.); (F.O.); (L.S.)
| | - Izabella Erdelean
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (Z.L.P.); (I.E.); (C.D.); (M.B.); (F.O.); (L.S.)
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (Z.L.P.); (I.E.); (C.D.); (M.B.); (F.O.); (L.S.)
| | - Marius Biris
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (Z.L.P.); (I.E.); (C.D.); (M.B.); (F.O.); (L.S.)
| | - Flavius Olaru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (Z.L.P.); (I.E.); (C.D.); (M.B.); (F.O.); (L.S.)
| | - Oana Neda-Stepan
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.N.-S.); (R.M.F.)
- Department VIII—Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Roxana Manuela Fericean
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.N.-S.); (R.M.F.)
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Eugen Radu Boia
- Department of ENT, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Eugenia Maria Domuta
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, Piata 1 Decembrie 10, 410073 Oradea, Romania;
| | - Lavinia Stelea
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (Z.L.P.); (I.E.); (C.D.); (M.B.); (F.O.); (L.S.)
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Gruescu ACS, Popoiu C, Levai MC, Burtic SR, Sanda II, Neda-Stepan O, Rosca O, Fericean RM, Dumitru C, Stelea L. Stress Dynamics in Families with Children with Neuropsychiatric Disorders during the COVID-19 Pandemic: A Three-Year Longitudinal Assessment. J Clin Med 2023; 12:7170. [PMID: 38002782 PMCID: PMC10672643 DOI: 10.3390/jcm12227170] [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: 10/13/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES This study explores the impact of the COVID-19 pandemic on families with children diagnosed with neuropsychiatric disorders, focusing on stress dynamics and quality of life. MATERIALS AND METHODS A longitudinal survey was conducted over three years (2020-2022) involving 168 families. The survey included data on demographics, diagnosed conditions, access to therapies, mental well-being, and perceived challenges. RESULTS The study involved 62, 51, and 55 families in 2020, 2021, and 2022, respectively. ADHD emerged as the most prevalent condition, diagnosed in approximately 32% of the children. The pandemic significantly affected therapy access, with parents reporting a decrease from an average score of 8.1 in 2020 to 6.5 in 2022 (p = 0.029). Parents also reported increased feelings of being overwhelmed, peaking at 8.0 in 2021 before declining to 6.3 in 2022 (p = 0.017). Despite these challenges, there was a positive trend in family mental well-being, with scores increasing from 5.1 in 2020 to 6.7 in 2022 (p = 0.031). The Parental Stress Index (PSI) indicated decreasing trends in Emotional Stress and Parent-Child Communication Difficulties (p < 0.001), and Behavioral Challenges in children showed a significant reduction across the years (p < 0.001). The Hospital Anxiety and Depression Scale (HADS) reflected a moderate reduction in anxiety levels from 7.6 in 2020 to 6.0 in 2022 (p = 0.038), although depression scores did not show a significant change. CONCLUSIONS The COVID-19 pandemic introduced notable challenges for families with neuropsychiatrically diagnosed children, particularly in therapy access and increased parental stress. However, the study also reveals a general improvement in family dynamics, mental well-being, and a decrease in behavioral challenges over time. The necessity of this study stems from the critical need to examine the impact of the COVID-19 pandemic on families with neuropsychiatrically diagnosed children, focusing on their resilience and adaptation in navigating therapy access, parental stress, and overall mental well-being.
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Affiliation(s)
- Ada Claudia Silvana Gruescu
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (A.C.S.G.); (C.P.)
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (S.R.B.); (I.I.S.); (O.N.-S.); (R.M.F.)
| | - Calin Popoiu
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (A.C.S.G.); (C.P.)
| | - Mihaela Codrina Levai
- Research Center for Medical Communication, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Sonia Roxana Burtic
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (S.R.B.); (I.I.S.); (O.N.-S.); (R.M.F.)
- Research Center for Medical Communication, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Isabella Ionela Sanda
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (S.R.B.); (I.I.S.); (O.N.-S.); (R.M.F.)
| | - Oana Neda-Stepan
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (S.R.B.); (I.I.S.); (O.N.-S.); (R.M.F.)
- Department VIII—Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ovidiu Rosca
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Roxana Manuela Fericean
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (S.R.B.); (I.I.S.); (O.N.-S.); (R.M.F.)
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.D.); (L.S.)
| | - Lavinia Stelea
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.D.); (L.S.)
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Seyedmirzaei H, Faramarzpour M, Saghazadeh A, Teixeira AL, Rezaei N. Post-COVID-19 depression and serum interleukin 6 levels: A systematic review and meta-analysis of COVID-19 convalescents with and without depression. World J Biol Psychiatry 2023; 24:811-821. [PMID: 37526618 DOI: 10.1080/15622975.2023.2242928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES Depression is among the psychiatric sequelae of COVID-19, affecting more than 20% of the convalescents. Its underlying pathophysiology remains unclear. Interleukin 6 (IL-6), a pro-inflammatory cytokine, plays a critical role in the COVID-19-associated cytokine storm, has been implicated in depressive disorders, and may thus be involved in post-COVID-19 depression. METHODS PubMed, Scopus, Embase, and Web of Science were systematically searched for relevant studies assessing peripheral IL-6 levels in convalescents who developed depression after COVID-19 vs. convalescents who did not. RESULTS Five studies were included in our systematic review, and four entered the meta-analysis. The meta-analysis revealed that post-COVID people with de novo depression did not have statistically significant differences in IL-6 levels compared to those without depression (standardised mean difference (SMD) = 0.09, 95% confidence interval (CI) = -0.35, 0.54, p-value = 0.68). CONCLUSIONS Although convalescents with depression did not have significantly higher IL-6 levels than convalescents without depression, the results should be interpreted considering the limited sample size and the low power of the included studies.
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Affiliation(s)
- Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mahsa Faramarzpour
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Antônio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Barbos V, Feciche B, Bratosin F, Tummala D, Shetty USA, Latcu S, Croitor A, Dema V, Bardan R, Cumpanas AA. Pandemic Stressors and Adaptive Responses: A Longitudinal Analysis of the Quality of Life and Psychosocial Dynamics among Urothelial Cancer Patients. J Pers Med 2023; 13:1547. [PMID: 38003862 PMCID: PMC10672688 DOI: 10.3390/jpm13111547] [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: 09/19/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
The 2019 coronavirus disease (COVID-19) pandemic has had a profound influence on different sectors of society, including health. This study hypothesized a significant impact of the pandemic on the quality of life and psychosocial well-being of urothelial cancer patients, specifically anticipating a decrease in anxiety and depression scores as the pandemic progressed. The primary objectives were to assess longitudinal changes in quality of life indexes, evaluate Healthcare Anxiety and Depression Scale (HADS) score trends over three years (2020-2022), and identify any correlational patterns between the progression of the pandemic and anxiety, depression, and stress levels among this cohort. A cross-sectional analysis was conducted on Eastern Cooperative Oncology Group (ECOG) 1 and Tumor Node Metastasis (TNM) stage 1 bladder cancer patients from the Timis County Emergency Clinical Hospital in Romania. Sixty patients were evaluated each year from 2020 to 2022, utilizing a detailed selection process involving the review of both the hospital database and paper records. Key data included demographic information, medical history, and responses to the Patient Health Questionnaire (PHQ-9), Short Form (SF-36), HADS, and Generalized Anxiety Disorder (GAD-7) questionnaires. A total of 163 completed questionnaires were analyzed, providing insight into various aspects of patients' experiences during the pandemic. Notably, the mean hospitalization days ranged from 3.6 ± 2.1 days in 2020 to 4.0 ± 2.4 days in 2022 (p = 0.663). Concerns that current symptoms might be pandemic-related spiked to 63.5% in 2021, but reduced to 50.9% in 2022, with this fluctuation being significant (p = 0.026). The perception of decreased quality of or accessibility to medical care was significant over the years, with a decline to 52.7% in 2022 (p = 0.033). Quality of life assessments demonstrated an upward trend, from an average score of 55.9 ± 8.9 in 2020 to 59.3 ± 8.8 in 2022 (p = 0.049). Interestingly, anxiety levels, as indicated by the HADS survey, revealed a significant decline from a score of 7.8 in 2020 to 6.5 in 2022 (p = 0.008). On the other hand, GAD-7 scores displayed a downward trend over the years, potentially indicative of developed coping strategies (p = 0.034). This study provides a comprehensive insight into the fluctuating dynamics of psychosocial factors and quality of life among urothelial cancer patients during the pandemic years. It underscores a potential adaptive response, as evidenced by the decrease in anxiety levels and an upward trend in the quality of life scores over the period. These findings highlight the resilience and adaptability of this patient cohort amidst the challenges posed by the pandemic, potentially guiding future interventions and supports in similar health crises.
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Affiliation(s)
- Vlad Barbos
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
- Doctoral School, Victor Babes University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
| | - Bogdan Feciche
- Department of Urology, Emergency County Hospital Oradea, Strada Gheorghe Doja 65, 410169 Oradea, Romania
| | - Felix Bratosin
- Doctoral School, Victor Babes University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
- Department XIII, Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Durganjali Tummala
- Department of General Medicine, K.S. Hegde Medical Academy, Mangaluru 575018, India;
| | | | - Silviu Latcu
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
| | - Alexei Croitor
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
| | - Vlad Dema
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
| | - Razvan Bardan
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
| | - Alin Adrian Cumpanas
- Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (V.B.); (S.L.); (A.C.); (V.D.); (R.B.); (A.A.C.)
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7
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Botea MO, Lungeanu D, Petrica A, Sandor MI, Huniadi AC, Barsac C, Marza AM, Moisa RC, Maghiar L, Botea RM, Macovei CI, Bimbo-Szuhai E. Perioperative Analgesia and Patients' Satisfaction in Spinal Anesthesia for Cesarean Section: Fentanyl Versus Morphine. J Clin Med 2023; 12:6346. [PMID: 37834990 PMCID: PMC10573232 DOI: 10.3390/jcm12196346] [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: 08/29/2023] [Revised: 09/17/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
Perioperative analgesia for cesarean section aims to ensure the mother's comfort, facilitate a smooth surgical experience, and promote a successful recovery. One-hundred-ninety patients were enrolled in a randomized double-blind study designed to assess the quality of perioperative analgesia, level of satisfaction, and incidence of adverse reactions in elective cesarean section under spinal anesthesia when fentanyl or morphine was added to bupivacaine. Two treatment groups comprising 173 subjects were compared in the per-protocol analysis: F (fentanyl, standard dose 25 μg) and M (morphine, standard dose 100 μg). Numerical pain scores were recorded perioperatively for 72 h (both at rest and on mobilization), with overall postoperative satisfaction and analgesic-related side effects. The patients in the morphine group had significantly better pain management (Mann-Whitney U test, p < 0.001) and higher level of satisfaction (Mann-Whitney U test, p < 0.001). The latter was related to the greater need for rescue medication in the fentanyl group (OR = 4.396; p = 0.019). On the other hand, fentanyl had significantly fewer non-life-threatening side effects, such as high-intensity pruritus (Mann-Whitney U test, p < 0.001), nausea (OR = 0.324; p = 0.019), vomiting and dizziness upon first mobilization (OR = 0.256; p < 0.001). It remains for future clinical trials to help establish doses that will tilt the scale to one side or the other.
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Affiliation(s)
- Mihai O. Botea
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (M.O.B.); (M.I.S.)
- Pelican Clinic, Medicover Hospital, 4104869 Oradea, Romania
| | - Diana Lungeanu
- Center for Modeling Biological Systems and Data Analysis, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alina Petrica
- Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (C.B.); (A.M.M.)
- Emergency Department, “Pius Brinzeu” Emergency Clinical County Hospital, 300736 Timisoara, Romania
| | - Mircea I. Sandor
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (M.O.B.); (M.I.S.)
| | - Anca C. Huniadi
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (M.O.B.); (M.I.S.)
- Pelican Clinic, Medicover Hospital, 4104869 Oradea, Romania
| | - Claudiu Barsac
- Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (C.B.); (A.M.M.)
- Clinic of Anaesthesia and Intensive Care, “Pius Brinzeu” Emergency Clinical County Hospital, 300736 Timisoara, Romania
| | - Adina M. Marza
- Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (C.B.); (A.M.M.)
- Emergency Department, Emergency Clinical Municipal Hospital, 300079 Timisoara, Romania
| | - Ramona C. Moisa
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (M.O.B.); (M.I.S.)
| | - Laura Maghiar
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (M.O.B.); (M.I.S.)
| | - Raluca M. Botea
- Oradea County Clinical Emergency Hospital, 410169 Oradea, Romania
| | - Codruta I. Macovei
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (M.O.B.); (M.I.S.)
- Pelican Clinic, Medicover Hospital, 4104869 Oradea, Romania
| | - Erika Bimbo-Szuhai
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (M.O.B.); (M.I.S.)
- Pelican Clinic, Medicover Hospital, 4104869 Oradea, Romania
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8
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Marusca LM, Reddy G, Blaj M, Prathipati R, Rosca O, Bratosin F, Bogdan I, Horhat RM, Tapos GF, Marti DT, Susan M, Pingilati RA, Horhat FG, Adelina M. The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review. Diseases 2023; 11:104. [PMID: 37606475 PMCID: PMC10443358 DOI: 10.3390/diseases11030104] [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: 07/04/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/23/2023] Open
Abstract
Childhood respiratory tract infections (RTIs) pose a significant health burden, especially in children under six years old. The main objective of this systematic review was to assess the effectiveness of vitamin D supplementation in the prevention of RTI in this population while also exploring potential effect modifiers such as age, baseline vitamin D status, and type of respiratory infection. A systematic review of the literature published up to February 2023 was conducted according to PRISMA guidelines, searching PubMed, Web of Science, Cochrane, and Scopus databases. Eight studies met the inclusion criteria, which investigated the association between vitamin D supplementation and respiratory infections in children between zero and five years old. The included studies were conducted between 2012 and 2021, encompassing a total of 2189 children from five randomized trials, two case-control studies, and one prospective cohort study. The relationship between vitamin D supplementation and the prevention of childhood RTI was not consistently observed across all included studies. Pooled results demonstrated varied effects of vitamin D supplementation on respiratory infection incidence, severity, and symptoms. Three studies reported statistically significant associations between low vitamin D levels and respiratory infections (OR = 4.90, OR = 6.97), while one study found that children who received vitamin D supplementation of 800 UI/day for 3 months during the cold season had fewer episodes of respiratory symptoms (RR = 0.55) and recovered more quickly from acute RTI. Lastly, according to one study, vitamin D intake < 80 IU/kg/day was significantly associated with the risk of acquiring pneumonia (OR 7.9) but not bronchiolitis. The remaining five studies found no statistically significant differences in infection rates or severity (p-value > 0.050). The available evidence on the effectiveness of vitamin D supplementation for preventing and treating respiratory infections in children under six years old is limited, with only a few favorable effects being reported. In some cases, a dose of 80 UI/kg/day was found to provide significant protection for acute respiratory infections, although in the major trials the only benefit was a quicker recovery and fewer respiratory symptoms, with no impact on incidence and severity of respiratory infections. Nevertheless, the study protocol, the supplementation dose, and duration of supplementation had significant variations between studies, leading to inconclusive findings.
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Affiliation(s)
- Larisa Mihaela Marusca
- Laboratory Medicine, “Louis Turcanu” Emergency Hospital for Children, Doctor Iosif Nemoianu Street, 300011 Timisoara, Romania;
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (I.B.)
| | - Gowry Reddy
- New York Medical College at St. Mary’s and St. Clare’s Hospital, Denville, NJ 07834, USA;
| | - Mihaela Blaj
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, 700115 Iasi, Romania
| | | | - Ovidiu Rosca
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Felix Bratosin
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (I.B.)
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Iulia Bogdan
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (I.B.)
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Razvan Mihai Horhat
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Gabriela-Florentina Tapos
- Department of Emergency Medicine, Arad County Emergency Clinical Hospital, Calea Victoriei, 310037 Arad, Romania;
| | - Daniela-Teodora Marti
- Department of Biology and Life Sciences, Faculty of Medicine, “Vasile Goldis” Western University of Arad, Revolutiei Square 94, 310025 Arad, Romania;
| | - Monica Susan
- Department of Internal Medicine, Discipline of Medical Semiology I, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Raja Akshay Pingilati
- Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India;
| | - Florin George Horhat
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Mavrea Adelina
- Department of Internal Medicine I, Cardiology Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
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9
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Dumitrescu A, Doros G, Lazureanu VE, Septimiu-Radu S, Bratosin F, Rosca O, Patel H, Porosnicu TM, Vitcu GM, Mirea A, Oancea C, Mihaicuta S, Stoicescu ER, Barata PI. Post-Severe-COVID-19 Cardiopulmonary Rehabilitation: A Comprehensive Study on Patient Features and Recovery Dynamics in Correlation with Workout Intensity. J Clin Med 2023; 12:4390. [PMID: 37445425 DOI: 10.3390/jcm12134390] [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: 05/30/2023] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
The aftermath of severe COVID-19 frequently involves considerable cardiopulmonary damage, necessitating rehabilitation. This study aimed to evaluate the impact of COVID-19 on cardiopulmonary health and assess the effectiveness of various rehabilitative interventions. Conducted between September 2021 and September 2022, this prospective study included patients who had been diagnosed with severe COVID-19 and admitted at the "Victor Babes" Infectious Diseases and Pulmonology Hospital, Timisoara, Romania. The patients were stratified into low- and high-intensity rehabilitation groups. The rehabilitation protocols were individually tailored, and the patient recovery was closely monitored over a 3-month period. Our cohort comprised 84 patients, with a mean age of 56.3 years for the low-intensity group (n = 42) and 53.1 years for the high-intensity group (n = 42). Both groups showed significant improvements in the lung injury area, need for oxygen supplementation, ejection fraction, systolic pulmonary artery pressure, and forced vital capacity. Additionally, considerable enhancements were observed in maximal voluntary ventilation, FEV1, FEV1/FVC ratio, peak expiratory flow, and forced expiratory flow at 25-75%. The work intensity also demonstrated substantial improvements from the initial testing to the 3-month mark in both groups. This study provides evidence that personalized, targeted rehabilitation strategies can improve long-term cardiopulmonary health in patients recovering from severe COVID-19, proving both low-intensity and high-intensity training as sufficient to improve heart and lung function if performed correctly and over a relatively short duration of 3 months. The study findings underscore the importance of implementing comprehensive cardiopulmonary rehabilitation protocols in the care of post-COVID-19 patients and highlight the value of stratified rehabilitation intensity based on individual patient dynamics and recovery features.
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Affiliation(s)
- Andreea Dumitrescu
- Cardioprevent Foundation, Calea Dorobantilor 3, 300134 Timisoara, Romania
| | - Gabriela Doros
- Third Discipline of Pediatrics, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Voichita Elena Lazureanu
- Department XIII, Discipline of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Susa Septimiu-Radu
- Department XIII, Discipline of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Felix Bratosin
- Department XIII, Discipline of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ovidiu Rosca
- Department XIII, Discipline of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Harshkumar Patel
- Department of General Medicine, Pandit Deendayal Upadhyay Medical College, Rajkot 360001, Gujarat, India
| | - Tamara Mirela Porosnicu
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Intensive Care Unit, "Victor Babes" Clinical Hospital for Infectious Diseases and Pneumology, 300041 Timisoara, Romania
| | - Gabriela Mut Vitcu
- Cardioprevent Foundation, Calea Dorobantilor 3, 300134 Timisoara, Romania
| | - Andrei Mirea
- Cardioprevent Foundation, Calea Dorobantilor 3, 300134 Timisoara, Romania
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Stefan Mihaicuta
- Cardioprevent Foundation, Calea Dorobantilor 3, 300134 Timisoara, Romania
| | - Emil Robert Stoicescu
- Discipline of Physiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Paula Irina Barata
- Discipline of Physiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Department of Physiology, Faculty of Medicine, "Vasile Goldis" Western University of Arad, Revolutiei Square 94, 310025 Arad, Romania
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10
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Porosnicu TM, Sirbu IO, Oancea C, Sandesc D, Bratosin F, Rosca O, Jipa D, Boeriu E, Bandi SSS, Pricop M. The Impact of Therapeutic Plasma Exchange on Inflammatory Markers and Acute Phase Reactants in Patients with Severe SARS-CoV-2 Infection. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050867. [PMID: 37241099 DOI: 10.3390/medicina59050867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Due to the poor prognosis and the very high mortality rate associated with severe SARS-CoV-2 infections, various regimens have been tried to stop the evolution of the inflammatory cascade, such as immunomodulatory therapy and plasma clearance of the acute phase reactants involved. Therefore, the objective of this review was to analyze the effects of using therapeutic plasma exchange (TPE), also known as plasmapheresis, on the inflammatory markers of critically ill COVID-19 patients admitted to the intensive care unit (ICU). Materials and Methods: A thorough scientific database search was performed, and it included a review of articles published on PubMed, Cochrane Database, Scopus, and Web of Science from the beginning of the COVID-19 pandemic in March 2020 until September 2022 that focused on the treatment of SARS-CoV-2 infections using plasma exchange for patients admitted to the ICU. The current study included original articles, reviews, editorials, and short or special communications regarding the topic of interest. Results: A total of 13 articles were selected after satisfying the inclusion criterion of three or more patients enrolled with clinically severe COVID-19 that were eligible for TPE. From the included articles, it was observed that TPE was used as a last-resort salvage therapy that can be regarded as an alternative treatment method when the standard management for these patients fails. TPE significantly decreased the inflammatory status as measured by Interleukin-6 (IL-6), C-reactive protein (CRP), lymphocyte count, and D-dimers, as well as improving the clinical status measured with PaO2/FiO2 and duration of hospitalization. The pooled mortality risk reduction after TPE was 20%. Conclusions: There are sufficient studies and evidence to show that TPE reduces inflammatory mediators and improves coagulation function and the clinical/paraclinical status. Nevertheless, although it was shown that TPE decreases the severe inflammatory status without significant complications, the improvement of survival rate remains unclear.
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Affiliation(s)
- Tamara Mirela Porosnicu
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Intensive Care Unit, "Pius Brinzeu" Emergency Clinical County Hospital, 300723 Timisoara, Romania
| | - Ioan Ovidiu Sirbu
- Center for Complex Network Sciences, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Disease, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Dorel Sandesc
- Department of Anesthesia and Intensive Care, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Felix Bratosin
- Department XIII, Discipline of Infectious Disease, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ovidiu Rosca
- Department XIII, Discipline of Infectious Disease, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Daniel Jipa
- Intensive Care Unit, "Pius Brinzeu" Emergency Clinical County Hospital, 300723 Timisoara, Romania
| | - Estera Boeriu
- Department of Pediatrics, Discipline of Pediatric Oncology and Hematology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Satya Sai Sri Bandi
- Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India
| | - Marius Pricop
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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11
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Slusher AL, Acevedo EO. Stress induced proinflammatory adaptations: Plausible mechanisms for the link between stress and cardiovascular disease. Front Physiol 2023; 14:1124121. [PMID: 37007994 PMCID: PMC10065149 DOI: 10.3389/fphys.2023.1124121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/07/2023] [Indexed: 03/19/2023] Open
Abstract
Initiating from Hans Selye’s conceptualization of stress physiology, to our present understanding of allostatic load as the cumulative burden of chronic psychological stress and life events, investigators have sought to identify the physiological mechanisms that link stress to health and disease. Of particular interest has been the link between psychological stress and cardiovascular disease (CVD), the number one cause of death in the United States. In this regard, attention has been directed toward alterations in the immune system in response to stress that lead to increased levels of systemic inflammation as a potential pathway by which stress contributes to the development of CVD. More specifically, psychological stress is an independent risk factor for CVD, and as such, mechanisms that explain the connection of stress hormones to systemic inflammation have been examined to gain a greater understanding of the etiology of CVD. Research on proinflammatory cellular mechanisms that are activated in response to psychological stress demonstrates that the ensuing low-grade inflammation mediates pathways that contribute to the development of CVD. Interestingly, physical activity, along with its direct benefits to cardiovascular health, has been shown to buffer against the harmful consequences of psychological stress by “toughening” the SAM system, HPA axis, and immune system as “cross-stressor adaptations” that maintain allostasis and prevent allostatic load. Thus, physical activity training reduces psychological stress induced proinflammation and attenuates the activation of mechanisms associated with the development of cardiovascular disease. Finally, COVID-19 associated psychological stress and its associated health risks has provided another model for examining the stress-health relationship.
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Affiliation(s)
- Aaron L. Slusher
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, United States
- Department of Athletics, Yale University, New Haven, CT, United States
- *Correspondence: Aaron L. Slusher,
| | - Edmund O. Acevedo
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, United States
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12
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Septimiu-Radu S, Gadela T, Gabriela D, Oancea C, Rosca O, Lazureanu VE, Fericean RM, Bratosin F, Dumitrescu A, Stoicescu ER, Bagiu I, Murariu M, Mavrea A. A Systematic Review of Lung Autopsy Findings in Elderly Patients after SARS-CoV-2 Infection. J Clin Med 2023; 12:jcm12052070. [PMID: 36902856 PMCID: PMC10004532 DOI: 10.3390/jcm12052070] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/27/2023] [Accepted: 03/05/2023] [Indexed: 03/08/2023] Open
Abstract
Although COVID-19 may cause various and multiorgan diseases, few research studies have examined the postmortem pathological findings of SARS-CoV-2-infected individuals who died. Active autopsy results may be crucial for understanding how COVID-19 infection operates and preventing severe effects. In contrast to younger persons, however, the patient's age, lifestyle, and concomitant comorbidities might alter the morpho-pathological aspects of the damaged lungs. Through a systematic analysis of the available literature until December 2022, we aimed to provide a thorough picture of the histopathological characteristics of the lungs in patients older than 70 years who died of COVID-19. A thorough search was conducted on three electronic databases (PubMed, Scopus, and Web of Science), including 18 studies and a total of 478 autopsies performed. It was observed that the average age of patients was 75.6 years, of which 65.4% were men. COPD was identified in an average of 16.7% of all patients. Autopsy findings indicated significantly heavier lungs, with an average weight of the right lung of 1103 g, while the left lung mass had an average weight of 848 g. Diffuse alveolar damage was a main finding in 67.2% of all autopsies, while pulmonary edema had a prevalence of between 50% and 70%. Thrombosis was also a significant finding, while some studies described focal and extensive pulmonary infarctions in 72.7% of elderly patients. Pneumonia and bronchopneumonia were observed, with a prevalence ranging from 47.6% to 89.5%. Other important findings described in less detail comprise hyaline membranes, the proliferation of pneumocytes and fibroblasts, extensive suppurative bronchopneumonic infiltrates, intra-alveolar edema, thickened alveolar septa, desquamation of pneumocytes, alveolar infiltrates, multinucleated giant cells, and intranuclear inclusion bodies. These findings should be corroborated with children's and adults' autopsies. Postmortem examination as a technique for studying the microscopic and macroscopic features of the lungs might lead to a better knowledge of COVID-19 pathogenesis, diagnosis, and treatment, hence enhancing elderly patient care.
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Affiliation(s)
- Susa Septimiu-Radu
- Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Tejaswi Gadela
- School of General Medicine, Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, India
| | - Doros Gabriela
- Department of Pediatrics, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ovidiu Rosca
- Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Voichita Elena Lazureanu
- Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Roxana Manuela Fericean
- Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Felix Bratosin
- Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Andreea Dumitrescu
- Cardioprevent Foundation, Calea Dorobantilor 3, Timisoara 300134, Romania
| | - Emil Robert Stoicescu
- Doctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Department of Radiology and Medical Imaging, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Iulia Bagiu
- Department of Microbiology, Multidisciplinary Research Center on Antimicrobial Resistance, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Correspondence:
| | - Mircea Murariu
- Doctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Department of Pediatrics, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Adelina Mavrea
- Department of Internal Medicine I, Cardiology Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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13
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COVID-19 Clinical Features and Outcomes in Elderly Patients during Six Pandemic Waves. J Clin Med 2022; 11:jcm11226803. [PMID: 36431282 PMCID: PMC9692444 DOI: 10.3390/jcm11226803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Many elderly patients with severe SARS-CoV-2 infections and COVID-19 infections are admitted to intensive care units. Age was previously identified as an independent risk factor for death and contributed to the greater severity of COVID-19. The elderly may have diminished lung functions, poor reactions to artificial ventilation, and compromised immune systems. However, it is yet uncertain how each pandemic wave and the predominant SARS-CoV-2 strains contribute to varying results and how patient groups such as the elderly are impacted. Comparing six COVID-19 pandemic waves, the objective of this study was to examine the variation in case severity, symptomatology, ICU hospitalizations, and mortality among SARS-CoV-2-infected elderly individuals. The study followed a retrospective design, including 60 eligible patients older than 70 years in each of the six pandemic wave groups, after matching them by the number of comorbidities and gender. SARS-CoV-2 infection during the first, third, and fourth pandemic waves had a significantly higher risk of mortality for hospitalized patients. Confusion and dyspnea at admission were significant risk factors for ICU admission in elderly patients (β = 1.92, respectively β = 3.65). The laboratory parameters identified decreased lymphocytes (β = 2.11), elevated IL-6 (β = 1.96), and procalcitonin (β = 2.46) as the most significant risk factors. The third and fourth COVID-19 waves had considerably more severe infections (31.7% and 26.7%) than the sixth wave (13.3%). Median ICU stay and percentage of patients receiving oxygen support also differed across pandemic waves. However, mortality rates between the six pandemic waves were similar. The average length of hospitalization varied dramatically among the six pandemic waves. Although senior patients are more likely to have worse COVID-19 outcomes after hospitalization, this risk is mitigated by the greater prevalence of comorbidities and frailty among the elderly. The six pandemic waves that were specifically evaluated did not reveal considerably disproportionate variations in terms of patient mortality; however, during the fourth pandemic wave, there were likely more hospitalized patients with severe COVID-19 in Romania. It is probable that certain circulating SARS-CoV-2 strains were more infectious, resulting in an increase in infections and a strain on healthcare systems, which might explain the variations found in our research.
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Jiao G, Fan X, Wang Y, Weng N, Ouyang L, Wang H, Pan S, Huang D, Han J, Zhang F, Chen W. Dissection of the Active Ingredients and Potential Mechanism of Han-Shi-Yu-Fei-Decoction in Treating COVID-19 Based on In Vivo Substances Profiling and Clinical Symptom-Guided Network Pharmacology. ACS OMEGA 2022; 7:36598-36610. [PMID: 36268464 PMCID: PMC9578366 DOI: 10.1021/acsomega.2c04589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
This work was aimed to elucidate the mechanism of action of Han-Shi-Yu-Fei-decoction (HSYFD) for treating patients with mild coronavirus disease 2019 (COVID-19) based on clinical symptom-guided network pharmacology. Experimentally, an ultra-high performance liquid chromatography technique coupled with quadrupole time-of-flight mass spectrometry method was used to profile the chemical components and the absorbed prototype constituents in rat serum after its oral administration, and 11 out of 108 compounds were identified. Calculatingly, the disease targets of Han-Shi-Yu-Fei symptoms of COVID-19 were constructed through the TCMIP V2.0 database. The subsequent network pharmacology and molecular docking analysis explored the molecular mechanism of the absorbed prototype constituents in the treatment of COVID-19. A total of 42 HSYFD targets oriented by COVID-19 clinical symptom were obtained, with EGFR, TP53, TNF, JAK2, NR3C1, TH, COMT, and DRD2 as the core targets. Enriched pathway analysis yielded multiple COVID-19-related signaling pathways, such as the PI3K/AKT signaling pathway and JAK-STAT pathway. Molecular docking showed that the key compounds, such as 6-gingerol, 10-gingerol, and scopoletin, had high binding activity to the core targets like COMT, JAK2, and NR3C1. Our work also verified the feasibility of clinical symptom-guided network pharmacology analysis of chemical compounds, and provided a possible agreement between the points of views of traditional Chinese medicine and western medicine on the disease.
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Affiliation(s)
- Guangyang Jiao
- Institute
of Chinese Materia Medica, Shanghai University
of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xiangcheng Fan
- Department
of Pharmacy, Changzheng Hospital, (Second Military Medical University), Naval Medical University, Shanghai 200003, China
- Shanghai
Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China
| | - Yejian Wang
- Department
of Pharmacology, Anhui University of Chinese
Medicine, Hefei 230012, Anhui, China
| | - Nan Weng
- Department
of Pharmacy, Changzheng Hospital, (Second Military Medical University), Naval Medical University, Shanghai 200003, China
- School
of Traditional Chinese Material, Shenyang
Pharmaceutical University, Shenyang 11001, China
| | - Luolan Ouyang
- School of
Pharmacy, Shanghai University of Chinese
Medicine, Shanghai 201203, China
| | - Haoqian Wang
- School of
Pharmacy, Shanghai University of Chinese
Medicine, Shanghai 201203, China
| | - Sihan Pan
- School of
Pharmacy, Shanghai University of Chinese
Medicine, Shanghai 201203, China
| | - Doudou Huang
- Institute
of Chinese Materia Medica, Shanghai University
of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jun Han
- Department
of Gastroenterology, Changzheng Hospital, (Second Military Medical
University), Naval Medical University, Shanghai 200003, China
| | - Feng Zhang
- Department
of Pharmacy, Changzheng Hospital, (Second Military Medical University), Naval Medical University, Shanghai 200003, China
- Shanghai
Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China
- Department
of Pharmacology, Anhui University of Chinese
Medicine, Hefei 230012, Anhui, China
| | - Wansheng Chen
- Institute
of Chinese Materia Medica, Shanghai University
of Traditional Chinese Medicine, Shanghai 201203, China
- Department
of Pharmacy, Changzheng Hospital, (Second Military Medical University), Naval Medical University, Shanghai 200003, China
- Shanghai
Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China
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The Implication of Misinformation and Stigma in Age-Related Quality of Life, Depression, and Coping Mechanisms of Adult Patients with Psoriasis. Medicina (B Aires) 2022; 58:medicina58101420. [PMID: 36295580 PMCID: PMC9610553 DOI: 10.3390/medicina58101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/01/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Stigma and lack of acceptance in society might have detrimental effects on the quality of life of patients with psoriasis, sometimes being comparable with other chronic diseases and conditions that affect the appearance of a patient, such as burns. Therefore, we surveyed our patients diagnosed with psoriasis to determine the implications of misinformation and stigma for their quality of life, depression, and coping strategies stratified by different age categories. Materials and Methods: A cross-sectional study was designed for a sample size of a minimum of 45 patients considering a prevalence of psoriasis of 2–3% in the general population. The study participants (patients and controls) were given both a paper-based unstandardized questionnaire and an online version of three standardized surveys. The cohort of patients was further split into three age groups to determine their age-related quality of life and coping mechanisms. Results: The proportion of patients with a history of depression and depressive symptoms among patients with psoriasis was significantly higher. Multiple discrepancies were observed between patients and controls regarding questions that targeted stigma and misinformation. On the Coping Orientation to Problems Experienced Inventory (COPE-60) questionnaire, older patients were more likely to use positive coping mechanisms such as engagement and problem-focused coping, while the young patients were using more emotion-focused coping mechanisms. However, patients in the 30–50 age range group scored the highest on physical and mental health among all participants who filled the 12-Item Short Form Survey (SF-12) survey. The Dermatology Life Quality Index (DLQI) results showed significantly more patients answering “a lot and very much” concerning embarrassment and social activities, while sexual difficulties affected the older patients. The strongest correlations with depression were observed in the young patient group, who believed that psoriasis can cause skin cancer (rho = 0.418) and who had sexual difficulties (rho = 0.414) and embarrassment (rho = 0.359) as evaluated by the DLQI survey. In the 30- to 50-year-old group, the strongest correlations were with the feeling of being stigmatized (rho = 0.376), having sexual difficulties (rho = 0.367) and disengagement coping style (rho = 273). Conclusions: While the respondents are reasonably well-informed regarding psoriasis, a degree of stigma remains, likely due to involuntary emotional responses such as repulsion and embarrassment. It is essential to establish initiatives aimed at educating the general public, raising awareness, and establishing a more tolerant social environment for psoriasis patients.
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