1
|
Zhengkai N, Yajing S. COVID-19 Patient Psychological Pain Factors. Front Psychol 2021; 12:649895. [PMID: 34093337 PMCID: PMC8173037 DOI: 10.3389/fpsyg.2021.649895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/09/2021] [Indexed: 12/18/2022] Open
Abstract
The level of psychological pain in patients with COVID-19 was investigated in this study by hypothesis testing, one-way ANOVA, multi factor ANOVA, and correlation analysis. The psychological pain thermometer and post-traumatic growth assessment scale were used as research tools. Many factors appear to influence the psychological state of COVID-19 patients including practical problems, communication problems, emotional problems, physical problems, and psychiatric/relative concerns. The severity of the disease, the surrounding environment, family health problems, life perceptions, interpersonal relationships, personal strength, mental changes, new possibilities, and the total post-traumatic growth score are also affected. There is a significant negative correlation between psychological pain and post-traumatic growth. There are significant differences in the degree of psychological pain across the demographic data. Practical problems, communication problems, emotional problems, physical problems, and spiritual/religious concerns show significant effects on the degree of psychological pain.
Collapse
Affiliation(s)
- Niu Zhengkai
- Institute of Analytical Psychology, City University of Macao, Macao, China
| | | |
Collapse
|
2
|
Seifirad S. Pirfenidone: A novel hypothetical treatment for COVID-19. Med Hypotheses 2020; 144:110005. [PMID: 32575019 PMCID: PMC7297676 DOI: 10.1016/j.mehy.2020.110005] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/04/2020] [Accepted: 06/15/2020] [Indexed: 01/01/2023]
Abstract
Cytokine storm, multiorgan failure, and particularly acute respiratory distress syndrome (ARDS) is the leading cause of mortality and morbidity in patients with COVID-19. A fulminant ARDS kills the majority of COVID-19 victims. Pirfenidone (5-methyl-1-phenyl-2-[1H]-pyridone), is a novel anti-fibrotic agent with trivial adverse effects. Pirfenidone is approved for the treatment of Idiopathic Pulmonary Fibrosis (IPF) for patients with mild to moderate disease. Pirfenidone could inhibit apoptosis, downregulate ACE receptors expression, decrease inflammation by several mechanisms and ameliorate oxidative stress and hence protect pneumocytes and other cells from COVID-19 invasion and cytokine storm simultaneously. Based on the pirfenidone mechanism of action and the known pathophysiology of COVID-19, I believe that pirfenidone has the potential for the treatment of COVID-19 patients.
Collapse
Affiliation(s)
- Soroush Seifirad
- Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Medicine, Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, USA.
| |
Collapse
|
3
|
McConeghy KW, White E, Panagiotou OA, Santostefano C, Halladay C, Feifer RA, Blackman C, Rudolph JL, Mor V, Gravenstein S. Temperature Screening for SARS-CoV-2 in Nursing Homes: Evidence from Two National Cohorts. J Am Geriatr Soc 2020; 68:2716-2720. [PMID: 33034046 PMCID: PMC7675320 DOI: 10.1111/jgs.16876] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Infection screening tools classically define fever as 38.0°C (100.4°F). Frail older adults may not mount the same febrile response to systemic infection as younger or healthier individuals. We evaluate temperature trends among nursing home (NH) residents undergoing diagnostic SARS-CoV-2 testing and describe the diagnostic accuracy of temperature measurements for predicting test-confirmed SARS-CoV-2 infection. DESIGN Retrospective cohort study evaluating diagnostic accuracy of pre-SARS-CoV-2 testing temperature changes. SETTING Two separate NH cohorts tested diagnostically (e.g., for symptoms) for SARS-CoV-2. PARTICIPANTS Veterans residing in Veterans Affairs (VA) managed NHs and residents in a private national chain of community NHs. MEASUREMENTS For both cohorts, we determined the sensitivity, specificity, and Youden's index with different temperature cutoffs for SARS-CoV-2 polymerase chain reaction results. RESULTS The VA cohort consisted of 1,301 residents in 134 facilities from March 1, 2020, to May 14, 2020, with 25% confirmed for SARS-CoV-2. The community cohort included 3,368 residents spread across 282 facilities from February 18, 2020, to June 9, 2020, and 42% were confirmed for SARS-CoV-2. The VA cohort was younger, less White, and mostly male. A temperature testing threshold of 37.2°C has better sensitivity for SARS-CoV-2, 76% and 34% in the VA and community NH, respectively, versus 38.0°C with 43% and 12% sensitivity, respectively. CONCLUSION A definition of 38.0°C for fever in NH screening tools should be lowered to improve predictive accuracy for SARS-CoV-2 infection. Stakeholders should carefully consider the impact of adopting lower testing thresholds on testing availability, cost, and burden on staff and residents. Temperatures alone have relatively low sensitivity/specificity, and we advocate any threshold be used as part of a screening tool, along with other signs and symptoms of infection.
Collapse
Affiliation(s)
- Kevin W McConeghy
- Department of Veterans Affairs, Center on Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.,Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Elizabeth White
- Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Orestis A Panagiotou
- Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Christopher Santostefano
- Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Christopher Halladay
- Department of Veterans Affairs, Center on Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA
| | | | | | - James L Rudolph
- Department of Veterans Affairs, Center on Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.,Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA.,Division of Geriatrics and Palliative Care, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Vince Mor
- Department of Veterans Affairs, Center on Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.,Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Stefan Gravenstein
- Department of Veterans Affairs, Center on Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.,Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, USA.,Division of Geriatrics and Palliative Care, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| |
Collapse
|
4
|
Fan J, Hambly BD, Bao S. The Epidemiology of COVID-19 in the Gansu and Jinlin Provinces, China. Front Public Health 2020; 8:555550. [PMID: 33042952 PMCID: PMC7517784 DOI: 10.3389/fpubh.2020.555550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 08/14/2020] [Indexed: 02/02/2023] Open
Abstract
The COVID-19 outbreak has become a pandemic. The outbreak was able to be controlled in China by mid-April through the implementation of critical measures; however, significant reverse transmission has resulted in hot spots perturbing prevention and control. To date, there have only been a total of 92 indigenous COVID-19 cases confirmed in the Gansu Province, which is considered to be a consequence of the strict screening approach applied during the outbreak. The emergency response level to COVID-19 were able to be decreased from high to low, despite some relatively minor reverse transmission cases from other countries in March 2020. The stringent preparative measures undertaken by the Gansu authorities, involving high-level, streamlined cooperation between the transportation, quarantine, and medical resource departments, have underpinned this success. There has been an emergence of clusters of freshly infected COVID-19 patients in the Jilin Province in northeast China. The single largest cluster has been in Shulan of the Jilin Province, involving 43 confirmed infections. A strict lockdown was implemented immediately. The source of the current outbreak of COVID-19 is suggested to be travelers returning from Russia. The current strategy from the Chinese authorities is aimed at preventing reverse transmission via international importation to avert a rebound of COVID-19 in China. These data highlight the need for an exceptionally high level of vigilance and for a pre-emptive response that is informative for the development of policy to prevent a second and further waves of infections in general.
Collapse
Affiliation(s)
- Jingchun Fan
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou, China.,Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Brett D Hambly
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou, China.,Discipline of Pathology, Faculty of Medicine and Health, The School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Shisan Bao
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou, China.,Discipline of Pathology, Faculty of Medicine and Health, The School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
5
|
Veerapandiyan A, Wagner KR, Apkon S, McDonald CM, Mathews KD, Parsons JA, Wong BL, Eichinger K, Shieh PB, Butterfield RJ, Rao VK, Smith EC, Proud CM, Connolly AM, Ciafaloni E. The care of patients with Duchenne, Becker, and other muscular dystrophies in the COVID-19 pandemic. Muscle Nerve 2020; 62:41-45. [PMID: 32329920 PMCID: PMC7264600 DOI: 10.1002/mus.26902] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has resulted in the reorganization of health-care settings affecting clinical care delivery to patients with Duchenne and Becker muscular dystrophy (DBMD) as well as other inherited muscular dystrophies. The magnitude of the impact of this public health emergency on the care of patients with DBMD is unclear as they are suspected of having an increased risk for severe manifestations of COVID-19. In this article, the authors discuss their consensus recommendations pertaining to care of these patients during the pandemic. We address issues surrounding corticosteroid and exon-skipping treatments, cardiac medications, hydroxychloroquine use, emergency/respiratory care, rehabilitation management, and the conduct of clinical trials. We highlight the importance of collaborative treatment decisions between the patient, family, and health-care provider, considering any geographic or institution-specific policies and precautions for COVID-19. We advocate for continuing multidisciplinary care for these patients using telehealth.
Collapse
Affiliation(s)
- Aravindhan Veerapandiyan
- Division of Neurology, Department of PediatricsUniversity of Arkansas for Medical Sciences, Arkansas Children's HospitalLittle RockArkansas
| | - Kathryn R. Wagner
- Center for Genetic Muscle Disorders, Kennedy Krieger Institute and Departments of Neurology and NeuroscienceJohns Hopkins School of MedicineBaltimoreMaryland
| | - Susan Apkon
- Department of Physical Medicine and RehabilitationUniversity of Colorado School of MedicineAuroraColorado
| | - Craig M. McDonald
- Department of Physical Medicine and Rehabilitation and Department of PediatricsUniversity of California Davis Health SystemSacramentoCalifornia
| | - Katherine D. Mathews
- Department of PediatricsUniversity of Iowa Carver College of MedicineIowa CityIowa
| | - Julie A. Parsons
- Department of Neurology and PediatricsUniversity of Colorado School of MedicineAuroraColorado
| | - Brenda L. Wong
- Department of Pediatrics and NeurologyUniversity of Massachusetts Medical SchoolWorcesterMassachusetts
| | - Katy Eichinger
- Department of NeurologyUniversity of Rochester Medical CenterRochesterNew York
| | - Perry B. Shieh
- Department of NeurologyUniversity of California Los AngelesLos AngelesCalifornia
| | - Russell J. Butterfield
- Department of Pediatrics and NeurologyUniversity of Utah School of MedicineSalt Lake CityUtah
| | - Vamshi K. Rao
- Division of Neurology, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of ChicagoNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Edward C. Smith
- Division of Neurology, Department of PediatricsDuke University Medical CenterDurhamNorth Carolina
| | - Crystal M. Proud
- Division of Neurology, Department of PediatricsChildren's Hospital of The King's DaughtersNorfolkVirginia
| | - Anne M. Connolly
- Division of Neurology, Department of PediatricsNationwide Children's Hospital, The Ohio State University College of MedicineColumbusOhio
| | - Emma Ciafaloni
- Department of NeurologyUniversity of Rochester Medical CenterRochesterNew York
| |
Collapse
|