Corona health-care warriors in India: knowledge, attitude, and practices during COVID-19 outbreak

Knowledge, Awareness, and Influence of the COVID-19 Pandemic on Students of Biomedical Faculties: A Cross-Sectional Study

Background/Objectives: The COVID-19 pandemic has had a profound impact on physical, mental, and social aspects of life worldwide. This study aimed to explore and compare differences in knowledge, awareness, behavior, and the psychological impact of the pandemic among students of biomedical faculties at the University of Zagreb. Methods: A cross-sectional study was conducted between 27 November 2020 and 19 January 2021 involving 518 students from the School of Dental Medicine, School of Medicine, Faculty of Pharmacy and Biochemistry, and Faculty of Veterinary Medicine. An anonymous online questionnaire was distributed, assessing participants' knowledge about SARS-CoV-2, information sources, attitudes, and psychological responses. Data were analyzed using descriptive statistics and appropriate statistical tests. Results: The median knowledge score was 61.54%, with senior and female students demonstrating significantly more knowledge (p < 0.001 and p = 0.044, respectively). Students who consulted the scientific literature and official websites had higher knowledge levels (p < 0.001). Most participants used media and social networks for pandemic information, while scientific sources were underutilized. Psychological impacts were evident, with 46.3% expressing fear about the future and 25% reporting anxiety if they were to be infected. Additionally, those who engaged with the scientific literature were more likely to accept vaccination and showed lower levels of COVID-19 stigma. A majority (64.5%) believed that the media exaggerated the pandemic's risks. Conclusions: Biomedical students demonstrated moderate knowledge about COVID-19, with a clear link between scientific literacy and more informed, less stigmatizing attitudes. This study underscores the importance of reliable information sources in shaping public health awareness and highlights the need for further education on COVID-19 symptoms and preventive measures.

Biochemical profiles of patients with COVID-19 during the first and second waves in Ethiopia

Coronavirus disease 2019 (COVID-19) is a highly infectious disease caused by severe acute respiratory syndrome coronavirus 2. Nasopharyngeal swabs (NP swabs) were used for patients with COVID-19 who demonstrated serious clinical symptoms and disturbances in biochemical parameters. The biochemical profiles of these patients remain ambiguous and differ from wave to wave of COVID-19 infections. Herein, we conducted a multicenter retrospective cohort study with 538 patients with COVID-19 at six COVID-19 treatment centers in Ethiopia. Professional data collectors collected the data. Descriptive statistics were used to summarize the data, and independent t-tests and chi-square tests were used to assess the relationships between the continuous and categorical variables across waves, respectively. In total, 240 and 298 patients were included from the first and second waves, respectively. Men and individuals aged 53-69 years were more likely to be infected in each wave. The mean alkaline phosphatase (p < 0.001) and sodium levels (p = 0.035) significantly differed between patients across the two waves of COVID-19; the significant difference in the alkaline phosphatase levels of patients between the two waves was -45.425. All the symptoms of COVID-19 were significantly (p < 0.05) associated with the waves of the pandemic. Patients in both waves had no chronic disease comorbidities. This study showed that the mean alkaline phosphatase and sodium levels differed significantly across the first two waves of the pandemic at six COVID-19 treatment centers in Ethiopia while all clinical symptoms of COVID-19 were associated with the first two waves of the pandemic.

A Survey on Companion Animal Owners' Perception of Veterinarians' Communication About Zoonoses and Antimicrobial Resistance in Germany

The intimate bonds between humans and their pets create favourable conditions that support the mutual transmission of pathogens in either direction. In this context, veterinarians are essential in informing and educating pet owners about health risks linked to zoonotic pathogens and antimicrobial resistance (AMR). To effectively convey this information, veterinarians should have strong communication skills. To gather insights on pet ownership, veterinary consultations, and risk communication, an online questionnaire was used to survey dog and cat owners in Germany. The survey evaluated the frequency and perception of communication concerning zoonotic pathogens and AMR, deriving a communication score. The findings showed that pet owners rated veterinarian communication with a high average score, reflecting a high satisfaction level. The longer pet owners had been clients, the more frequently they received information on zoonoses and AMR, and the better they rated the communication. However, the results also indicated that the amount of information on zoonoses and/or AMR provided by veterinarians was still lower than desired by pet owners. Risk factors, including pathogen detection, vulnerable individuals, owning imported animals, and feeding them raw meat, fish, offal, or uncooked bones, were regularly present. These findings underscore the critical role of risk communication in preventing zoonoses and AMR.

Physical, psychological, and social experiences of women recovered from COVID-19 in Iran: A qualitative study

BACKGROUND

This paper aims to examine the impact of COVID-19 on various health aspects of women recovered from this disease in Ardabil province, Iran.

MATERIALS AND METHODS

This qualitative study using a content analysis approach was carried out through in-depth individual and focus group discussion using semi-structured interviews schedule in 26 women during June and August 2021. Interviews were recorded, transcribed, and MAXQDA six-stage analysis framework.

RESULTS

Negative consequences of COVID-19 were generally categorized into five main themes (including increased self-conscious excitement, perceived social stigma, depression, changes in behavioral patterns, and reduced level of quality of life) and 13 subthemes. The positive consequences were the following five themes (including the development of the spiritual attitude, increasing the importance of personal health, the rise of perceived support, increased sense of altruism, and increased financial management) and four subthemes.

CONCLUSION

Based on the findings, it is concluded that effective support by the government, society, and the medical staff could help to relieve people's psychological and social stress through providing financial aid, the right information, and training.

Assessment of the hematological profiles among COVID-19 patients during the first and second waves in Ethiopia: A multicenter retrospective cohort study

Background

The coronavirus disease 2019 is highly infectious and patients with coronavirus diseases demonstrated a series of clinical symptoms caused by severe acute respiratory syndrome coronavirus-2. Without a break of the wave's hematological profile of the patients is still ambiguous and differs from wave to wave.

Objective

This study aimed to assess the hematological profile among coronavirus disease 2019 patients during the first and the second waves in Ethiopia.

Methods

A multi-centered facility-based retrospective cohort study design was conducted at six coronavirus disease 2019 treatment centers. A total of 538 study participants were enrolled in the selected coronavirus disease 2019 treatment centers during the first and second waves of the pandemic. The demographic characteristics, underlying diseases, symptoms, and hematological parameters of patients were recorded. Data were entered into Epi-Data Manager 4.6 and analyzed using STATA 14.2. An independent sample t-test was used to assess the mean differences in hematological parameters across waves. Associations between categorical variables across waves were also determined using Chi-square and Fisher exact tests.

Results

Among the total study participants, 240 (44.6%) and 298 (55.4%) patients were taken from wave-1 and wave-2, respectively. The average age of the study participants was 56.44 ± 16.25 years. The most frequent comorbidities in this study were hypertension, diabetes mellitus, ischemic heart disease, and asthma. The most presenting symptoms of COVID-19 infection across the two waves were presented. In the first wave, dry cough 166 (69.2%), fatigue 153 (63.75%), shortness of breath 148 (61.67%), and fever accounted 116 (48.33%), while during the second wave, dry cough 242 (81.2%), fatigue 244 (81.88%) shortness of breath 204 (68.47%) and fever account 180 (60.40%). White blood cells (WBC), neutrophils, and lymphocytes had shown increment during the first wave. Platelet count and platelet distribution width (p < 0.001) had significant mean differences across the two waves, while the other had no significant mean difference.

Conclusion

In the present study, dry cough, fatigue, shortness of breath, and fever were found to be the most presenting symptoms of COVID-19 infection across the two waves. Only the platelet count and platelet distribution width had significant mean differences across the two waves, while the other had no significant mean difference across waves.

Knowledge, attitudes, and practices toward COVID-19 and its prevention among medical and dental students in an educational institution in Telangana

BACKGROUND

Coronavirus disease 2019 (COVID-19) emerged as a global pandemic, threatening millions of lives worldwide. Everyone was overwhelmed by the plethora of information from different sources, creating confusion, misconceptions, and panic in the community.

AIMS

This study aimed to estimate the knowledge, attitudes, and practices (KAP) among medical and dental students toward COVID-19 and to identify factors influencing them.

MATERIALS AND METHODS

A cross-sectional study was conducted among undergraduate students enrolled in MBBS and BDS courses, and KAP scores were calculated using a self-administered questionnaire. The statistical analysis was done by unpaired t test and one-way analysis of variance.

RESULTS

MBBS students had higher KAP scores when compared with BDS students. Knowledge gaps were discovered in the areas of COVID-19 transmission through blood, World Health Organization (WHO)-designated variants of concern, disinfectant usage, and mandatory vaccination. A majority (91.33%) of the students had a positive attitude toward COVID-19. Better knowledge and practice scores were significantly associated with vaccinated students and those who trusted government website resources.

CONCLUSION

Curriculum modifications and creative teaching strategies can fill the lacunae in the KAP scores. Medical and dental students, as torchbearers of the healthcare fraternity, can play a critical role in raising awareness during public health emergencies.

Knowledge, attitudes and practices of French university students towards COVID-19 prevention-are health students better?

During the COVID-19 outbreak in 2020, public health measures (PHM) were implemented to prevent the spread of SARS-CoV-2. At university, we wondered whether health students would be more likely to comply with these safety measures against infectious disease transmission compared to other students. Thus, we collected 1 426 university students' responses to an online anonymous survey to describe their knowledge, attitudes and practices (KAP) of COVID-19 prevention measures and to compare the opinions and practices of health students and science students at the same university of Rouen Normandy (France). A higher proportion of science students (84.6%) compared to health students (73.9%) reported knowledge of the university's COVID-19 protocol, p<0.001. However, the health students compared to science students reported a higher compliance with PHM at home (91.4% vs 88.0%) and at university (94.1% vs 91.1%). In a multiple regression analysis, after adjustment for age, sex and university department, factors associated with higher compliance with PHM were knowledge of the university's COVID-19 protocol and a high perceived efficacy of PHM. A SARS-CoV-2 PCR result was not predictive of compliance with PHM. The results of this online survey in French students show a high level of knowledge and practices of COVID-19 prevention Although their performances could still be improved by training, the good results of health students regarding knowledge, attitudes and practices are encouraging as these students could be an added backup force to fight against viral pandemics.

Stigma Experienced by Patients Who Recovered from COVID-19 in Post-Vaccination Period in Thailand; Prevalence and Associated Factors

Purpose

Social stigma related to coronavirus disease-2019 (COVID-19) has been a public concern since its emergence, especially in the patients who are reintegrating into their society. However, the insights into COVID-19 stigmatization after vaccine availability are limited. This study aimed to estimate the prevalence, severity and associated factors of stigma experienced by patients who recovered from COVID-19 and reintegrated into their communities. The insights gained from this study are not only beneficial to COVID-19 but can also be used as a background information in future epidemics.

Patients and Methods

This study consisted of two phases. The first phase involved the translation and validation of the COVID-19-related stigma questionnaire. The second phase was a questionnaire-based cross-sectional survey conducted between January and February 2022, at the Vajira Hospital, Bangkok, Thailand. A series of questionnaires regarding stigma, negative emotions (Depression Anxiety Stress Scale-21), and personal information were administered to COVID-19 patients who were already discharged and returned to their communities from June 2021 to February 28, 2022 (N = 354).

Results

The prevalence of stigma among the patients who recovered from COVID-19 was 57.9%. These were classified as mild (28.2%), moderate (21.5%), and severe (8.2%). Pearson's correlation analysis revealed that longer admissions (r = - 0.151, p = 0.001) and longer duration from discharge (r = - 0.222, p = 0.001) were related to lower stigma. Higher stigma was associated with higher levels of depression (r = 0.528, p <0.001), anxiety (r = 0.506, p <0.001) and stress (r = 0.583, p <0.001).

Conclusion

Social stigma related to COVID-19 in Thailand declined during the post-vaccination period. However, this issue did not disappear, and still took a toll on mental health. Our findings suggested that providing appropriate assessment and help to the patients who recovered from COVID-19 is essential, even in the post-vaccination period.

Common Prognostic Biomarkers and Outcomes in Patients with COVID-19 Infection in Saudi Arabia

Background: COVID-19 is a respiratory disease that eventually became a pandemic, with 300 million people infected around the world. Alongside the improvement in COVID-19 management and vaccine development, identifying biomarkers for COVID-19 has recently been reported to help in early prediction and managing severe cases, which might improve outcomes. Our study aimed to find out if there is any correlation between clinical severity and elevated hematological and biochemical markers in COVID-19 patients and its effect on the outcome. Methods: We have collected retrospective data on socio-demographics, medical history, biomarkers, and disease outcomes from five hospitals and health institutions in the Kingdom of Saudi Arabia. Results: Pneumonia was the most common presentation of COVID-19 in our cohort. The presence of abnormal inflammatory biomarkers (D-dimer, CRP, troponin, LDH, ferritin, and t white blood cells) was significantly associated with unstable COVID-19 disease. In addition, patients with evidence of severe respiratory disease, particularly those who required mechanical ventilation, had higher biomarkers when compared to those with stable respiratory conditions (p < 0.001). Conclusion: Identifying biomarkers predicts outcomes for COVID-19 patients and may significantly help in their management.

Psychological distress and coping styles among baccalaureate nursing students: Promoting mental health of future nurses in COVID-19 pandemic

BACKGROUND

Coronavirus disease (COVID-19) causes significant psychological distress among nursing students. College-bound nursing students might have preferred different types of coping strategies to deal with psychological distress. This study aims to measure the psychological distress and role of coping styles to mediate the stress level among the baccalaureate nursing students amid the COVID-19 pandemic.

MATERIAL AND METHODS

A cross-sectional online survey was conducted in December 2020 at a nursing college attached to a tertiary care teaching hospital, North India. Nearly 251 baccalaureate nursing students completed the Impact of Event Scale-Revised (IES-R) and Coping Orientation to Problems Experienced Inventory (Brief-COPE) scale to report their psychological distress and coping styles, respectively. Chi-square test, independent sample t-test followed by binary and multivariable regression were used to identify the factors associated with distress in students during the pandemic.

RESULTS

Students' mean age was 22.22 ± 1.24 years. The mean IES-R was 19.59 ± 12.45 in nursing students. Psychological distress found a significant association with age (P = 0.022), academic class (P = 0.016), travel history (P = 0.034), and being positive reverse transcription-polymerase chain reaction (RT-PCR) for COVID-19 status of self (P = 0.018) and family members in the medical profession (P = 0.013). In binary logistic regression, stress level found a significant association with first-year academic level (OR: 3.250, 95% CI: 1.429-7.390, P = 0.005) and family members in the medical profession (OR: 4.44, 95% CI: 1.019-19.382, P = 0.047). Adaptive coping styles were more frequently preferred than maladaptive coping styles (54% vs 41%). Adaptive (r = 0.295, P < 0.001) and maladaptive coping (r = 0.403, P < 0.001) shows a significant positive relationship with stress in students, respectively.

CONCLUSIONS

Coronavirus pandemic causes significant distress among nursing students. Students were able to manage stress using acceptance and religious/spiritual coping strategies. During the pandemic, stress management to support mental health is highly recommended.

Impact of COVID-19 on postgraduate medical education: Cross sectional survey from an Indian Medical College

BACKGROUND

The corona virus disease (COVID-19) pandemic has caused widespread effect on the lives of health care professionals. The postgraduate medical students, who are the major pillars of medical institutions had to bear multitude of setbacks due to the pandemic involving academic, research and well-being issues.

MATERIALS AND METHODS

This was a cross sectional feedback based online survey done in the month of October 2021 to study the effect of COVID-19 pandemic induced changes in the postgraduate medical education; amongst 78 students pursuing MD/MS degree in all departments of a tertiary medical institute in Himalayan foothills of North India. The questionnaire consisted of ten questions; each of which needed to be answered on a five point Likert scale ranging from strongly disagree to strongly agree. Results were assessed for the most common answers of each question (represented by mode) and association between various components of the questionnaire analyzed by Spearman's rho correlation coefficient.

RESULTS

The internal consistency of the questionnaire as tested by Cronbach's Alpha (0.82) was good. Most number or respondents were from surgical branches (n = 31, 39.74%). There was a generalized agreement towards preference of resumption of onsite education (75.64%), the lack of variety of cases causing hampering of thesis work (88.46%) and increased mental stress during the pandemic (58.9%). While more time for self-study was seen as the only consensual positive aspect of online teaching (64%), most students opined that technical glitches are a major roadblock in online education (80.76%). Significant positive correlation was seen between disciplinary ease and punctuality in online teaching (R = 0.543, P < 0.001), lack of interaction and its effect on learning and mental health (R = 0.471; P < 0.001) and the lack of diversity in cases and difficulties in dissertation work (R = 0.351; P < 0.05). Negative correlation was observed between the satisfaction from overall learning through online teaching and the desire of resumption of offline classes (R = -0.491; P < 0.001).

CONCLUSION

COVID-19 pandemic and its effects on medical education are long lasting. A comprehensive approach is required to rebuild the medical education curriculum, inculcating both traditional and newer virtual methods of education. A consistent support in academics and overall growth needs to be provided to medical postgraduate residents who have been the first line fighters in face of the massive disaster compromising their basic needs and education.

Pandemic Fatigue in Nursing Undergraduates: Role of Individual Resilience and Coping Styles in Health Promotion

Introduction

The COVID-19 pandemic was soon declared a global health threat and had significant economic and health implications. Unprecedented government measures brought massive shifts in teaching-learning pedagogy in nursing to curb the infection. The study was conducted to explore the predictors of pandemic fatigue among nursing undergraduates and mediating role of individual resilience and coping styles during the third wave in India.

Methods

This online survey included 256 undergraduate nursing students studying at Tertiary Care Teaching Hospital in North India. Lockdown/Pandemic Fatigue Questionnaire, Brief Resilience Scale, and Coping Behavior Questionnaire were used to collect the information. Appropriate descriptive and inferential statistics were applied to compute the results.

Results

Nursing undergraduates reported a moderate level of fatigue during the restrictions imposed at the time of the third wave. Students’ year of study (p = 0.001), tested positive during pandemic (p = 0.003), and post-COVID-19 hospitalization (p = 0.026) were found associated with higher fatigue status. Advanced age (p = 0.046) and higher personal resilience status (p &lt; 0.001) were associated with lower fatigue levels. Resilience status (ß = − 4.311 p &lt; 0.001) and second year of study (ß = 3.198, p = 0.015) were reported as independent predictors of pandemic fatigue in students.

Conclusion

Findings suggest that lockdown-related fatigue was common in nursing undergraduates. Considering negative consequences on mental health, routine psychosocial screening of the nursing students should be conducted. Recommending stress-relieving measures should be enforced to help nursing undergraduates to combat lockdown-induced exhaustion.

COVID-19 and Saudi Arabia: Awareness, Attitude, and Practice

The Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) pandemic has transformed our appreciation of healthcare awareness worldwide. The amount of related data accumulated during this time has surpassed any other outbreak of a viral pathogen. Healthcare awareness is related to one of the nine pillars of the “World health organization (WHO) operational planning guidelines to support country preparedness and response”. This review is structured around the awareness/knowledge, attitudes, and practices (KAP)-related publications in Saudi Arabia up to date to understand the impact of COVID-19 on these domains. The excellent communication effort response from governments, international, and individuals to keep the public informed about the outbreak is highlighted. Unraveling such impacts on the Saudi communities, including healthcare workers (HCWs)/professionals (HCPs), students, patients with different diseases, and non-professional individuals, is essential in containing the outbreak and planning preventive measures in case of future outbreaks.

COVID-19: Distance learning to empower educators and health assistants in rural areas

BACKGROUND

Educators and health assistants can act as key players in controlling the pandemic. In general, they are respected by the community, especially in rural areas, and can help guide and raise the population's awareness of preventive measures. The objective of this paper is to evaluate the results in knowledge progress of an e-learning course offered to educators and health assistants by a public university and to analyze the profile and satisfaction of the participants.

MATERIALS AND METHODS

A single group pre- and post-test design based on a questionnaire, interventional, study was conducted in the period from April 20^th to June 20^th. All participants of the course answered sociodemographic and satisfaction questionnaire and a pre- and post-test. Data were descriptively arranged and regarding the distribution and comparison of means and frequency, paired t-test for group comparisons. P < 0.05 was statistically significant. Data were collected from the Moodle® teaching platform, without identifying the participants.

RESULTS

A total of 674 participants were enrolled in the five groups, and 583 concluded the course (86.5%). The reasons for those who did not access the entire course (n = 47) were: Lack of time, difficulty in accessing the internet, and lack of experience with distance learning courses. On the evaluation of the course platform, from the tutors in general and the degree of satisfaction in several questions, participants marked maximum grades. The comparison between pre- and post-proficiency scores showed increased proficiency of the enrolled groups (P < 0.0001).

CONCLUSIONS

The course contributed to the training of health assistants and educators, preparing them to act in a participatory way in the prevention and control of the pandemic. The course was well evaluated and there was a progression of knowledge by the participants.

Perceived stress and quality of life among frontline nurses fighting against COVID-19: A web-based cross-sectional study

BACKGROUND

The coronavirus disease-2019 (COVID-19) crisis has changed many aspects of frontline nurses' lives. Nurses caring for patients with COVID-19 reported experiencing significant psychological distress and work-related anxiety. This study aimed to assess the perceived stress and quality of life among frontline nurses fighting against COVID-19.

MATERIALS AND METHODS

This web-based cross-sectional study was conducted on 322 frontline nurses fighting against COVID-19 in hospitals affiliated to Mazandaran University of Medical Sciences. Data were collected using the two following online questionnaires: the Perceived Stress Scale and World Health Organization Quality of Life-Brief. Data were compiled from October 23, 2020, to November 25, 2020. Data were analyzed using the independent sample t-test, Pearson's correlation test, and regression analysis test in the SPSS-21.

RESULTS

Average perceived stress scores was 30.27 (standard deviation [SD] = 7.01). Average quality of life subscale scores consist of physical health, psychological health, social relationships, and environment were 57.71 (SD = 12.74), 44.3 (SD = 15.58), 45.61 (SD = 16.99), and 47.6 (SD = 18.11), respectively. There was an inverse significant association between all the subscales of quality of life and perceived stress (P = 0.008). Based on the multiple linear regression analysis, the variables of age, gender, marital status, and perceived stress were the significant predictors of quality of life subscales.

CONCLUSIONS

Paying serious attention to addressing the concerns of frontline nurses, especially those who are at high risk, is necessary. It is recommended to take action as soon as possible to reduce the perceived stress and improve quality of life on nurses who care for patients with COVID-19.

Factors associated with knowledge of health care workers toward COVID-19 in health facilities West Guji zone, Southern Ethiopia, 2020

BACKGROUND

Coronavirus pandemic puts healthcare workers (HCWs) at high risk and challenges the abilities of healthcare systems to respond to the crisis. This study aimed to assess the level of knowledge of HCWs and associated factors in West Guji zone public health facilities in southern Ethiopia.

MATERIALS AND METHODS

A health facility-based quantitative cross-sectional study was undertaken from June 10 to July 10, 2020. Two hundred and eighty-three HCWs were involved in the study using a systematic sampling method. The instrument was pretested on 5% of the sample in Yabello Hospital. Data were analyzed using bivariate and multivariate logistic regression.

RESULTS

The HCW who had good knowledge was 84.7%. HCWs who had degree holders, masters and above holders, work experience of 2-4 years, and >4 years of experiences, had training on Coronavirus, and medical diseases were significantly associated with good knowledge of Coronavirus.

CONCLUSIONS

This study indicated that HCWs' knowledge about the Coronavirus was good. Improving the educational status of HCWs and giving updated training on the Coronavirus will improve HCW's knowledge of the Coronavirus.

Knowledge, attitude and practice towards COVID-19 and perceived challenges of working during the movement control order: a quantitative analysis among healthcare workers in a Malaysian northwestern state

OBJECTIVE

This study aimed to assess COVID-19 knowledge, attitude and practice (KAP) among healthcare workers (HCWs) in northwest Malaysia and recognize the challenges faced working during the Movement Control Order (MCO). Commonly referred to as "MCO", this order enforcement is a series of national quarantine and cordon sanitaire measures implemented by the federal government of Malaysia in response to the COVID-19 pandemic as of 18th March 2020. It is akin to a national lockdown.

METHODS

A multi-centric cross-sectional web-based study was conducted from 29th May to 27th July 2020 among HCWs in Perlis, Malaysia using a 19-item validated questionnaire [Cronbach's alpha: 0.61 (knowledge domain), 0.74 (attitude domain), and 0.72 (practice domain)]. Challenges when working during MCO were identified from a self-rated five-point Likert scale of 14-item.

RESULTS

There were a total of 373 respondents (response rate more than 40%); 48.0% were nurses, 14.7% were medical doctors, and 12.9% were administrative and technical support staffs. Majority of HCWs (90.1%, n = 336) had good knowledge, optimistic attitude (54.7%, n = 204) and good COVID-19 preventive measure practices (90.9%, n = 339). Multiple logistic regression demonstrated that profession was the single significant factor for good COVID-19 KAP. Though having lesser odds of good knowledge (aOR 0.07, 95% CI:0.01-0.36, p = .009), nurses showed greater odds of good attitude (aOR 3.14, 95% CI: 1.71-5.76, p = .011) and practice (aOR 10.69, 95% CI:2.25-50.86, p = .022) as compared to doctors and dentists. Main challenges identified when working during MCO were increased workload (44.5%, n = 166), difficulty going out shopping (48.3%, n = 180), to exercise (40.2%, n = 150) and meet with family members (64.3%, n = 240).

CONCLUSION

Generally, HCWs in Perlis had good KAP with regards to COVID-19 infection and its preventive measures. Challenges underlined by HCWs while working during the MCO were increased workload, difficulty to shop for daily essentials, exercise and meet with family members. Should good COVID-19 KAP be sustained, they might contribute to success in combating this disease.

A cross sectional study to assess the expressed COVID-19 preventive practices among the health care workers and public visiting tertiary care hospital, AIIMS, Jodhpur

BACKGROUND

The corona virus disease-2019 (COVID-19) infection is a current public health crisis, and it is challenging to the world health-care system. As there is no treatment, prevention is the crucial importance to break the chain of transmission of infection and prevent fatality among the high-risk populations. The aim of the study was to assess the Expressed COVID-19 preventive practices among health-care workers (HCWs) and the public visiting tertiary care hospital, AIIMS, Jodhpur.

METHODOLOGY

A cross-sectional study was conducted among 406 HCWs and 238 public, recruited by convenient sampling technique. A validated and pretested self-structured practice questionnaire used to collect the data regarding COVID-19 preventive practice. The data were collected through online Google Forms and interview techniques and analyzed by software SPSS 26 version.

RESULTS

Majority of 87.7% HCWs and 76.5% public always followed practice of hand wash with soap and water and sanitize for 20 s. Majority of 79.6% HCWs and 49.2% public maintain social distance in public place. Gender (χ ² = 18.806 P ≤ 0.001) and education (χ ² = 43.270 P ≤ 0.001) among HCWs and in public demographic variable income (χ ² = 21.102 P = 0.002), religion (χ ² = 13.302 P = 0.006) and source of information (χ ² = 17.030 P = 0.026) was significantly associated with level of COVID-19 preventive practice.

CONCLUSION

The study showed moderate level of COVID-19 preventive practice among HCWs and public. Based on this result, an effective IEC intervention programs can be designed to educate public and HCWs and follow a safe COVID-19 preventive practice.

Using logistic regression to develop a diagnostic model for COVID-19: A single-center study

BACKGROUND

The main manifestations of coronavirus disease-2019 (COVID-19) are similar to the many other respiratory diseases. In addition, the existence of numerous uncertainties in the prognosis of this condition has multiplied the need to establish a valid and accurate prediction model. This study aimed to develop a diagnostic model based on logistic regression to enhance the diagnostic accuracy of COVID-19.

MATERIALS AND METHODS

A standardized diagnostic model was developed on data of 400 patients who were referred to Ayatollah Talleghani Hospital, Abadan, Iran, for the COVID-19 diagnosis. We used the Chi-square correlation coefficient for feature selection, and logistic regression in SPSS V25 software to model the relationship between each of the clinical features. Potentially diagnostic determinants extracted from the patient's history, physical examination, and laboratory and imaging testing were entered in a logistic regression analysis. The discriminative ability of the model was expressed as sensitivity, specificity, accuracy, and area under the curve, respectively.

RESULTS

After determining the correlation of each diagnostic regressor with COVID-19 using the Chi-square method, the 15 important regressors were obtained at the level of P < 0.05. The experimental results demonstrated that the binary logistic regression model yielded specificity, sensitivity, and accuracy of 97.3%, 98.8%, and 98.2%, respectively.

CONCLUSION

The destructive effects of the COVID-19 outbreak and the shortage of healthcare resources in fighting against this pandemic require increasing attention to using the Clinical Decision Support Systems equipped with supervised learning classification algorithms such as logistic regression.

Effect of Public Empathy with Infection-Control Guidelines on Infection-Prevention Attitudes and Behaviors: Based on the Case of COVID-19

Since the outbreak of the novel coronavirus disease (COVID-19), the government has provided infection-control guidelines to prevent the spread of the virus. The authors of this study examined the structure (causal relationship) of factors that influence public behavior toward COVID-19 and verified the effect of public empathy with infection-control guidelines in each structure. Data were collected using a self-administered questionnaire survey from 211 Korean adults. The results showed that (1) the perceived susceptibility and severity of economic damage had a positive effect on infection-prevention attitudes and infection-prevention attitudes had a positive effect on infection-prevention behaviors; (2) the perceived severity of economic damage had a positive effect on infection-prevention attitudes; and (3) public empathy with infection-control guidelines positively moderated the effect of the perceived severity of economic damage on infection-prevention behaviors and that of perceived susceptibility on infection-prevention attitudes. Accordingly, the authors of this study present the following three suggestions to prevent the spread of an infectious disease: engage in risk communication focused on a potential virus infection and cooperation, make multifaceted efforts to increase public empathy with infection-control guidelines, and implement measures to alleviate or reduce economic damage to the public in a viral pandemic.

Impact of Video Modules-Based Training on Knowledge, Attitude, and Practices of Cleaning and Disinfection Among Housekeeping Staff at a Tertiary Care Center During the COVID-19 Pandemic

Aim

To assess the knowledge, attitude, and practice toward cleaning and disinfection among housekeeping (HK) staff amid the coronavirus disease 2019 (COVID-19) pandemic.

Methods

A quasi-experimental was undertaken among HK staff at a tertiary care hospital. A 30-item structured questionnaire was used in the study, which consisted of questions pertaining to knowledge (11), attitude (8), and practice (11) toward cleaning and disinfection.

Result

One-hundred-two participants were included by convenient sampling, with mean age = 30-37 years. There was an improvement in pre-test and post-test knowledge (6.21 to 9.7) and practice score (9.97 to post-test 10.52). However, the attitude score did not show a significant change in the post-test score (p=0.964), showing that they were having a positive attitude toward the practices before training too. 

Conclusion

Improvement in the post-test score shows that periodic targeted training sessions on cleaning and disinfection among housekeeping staff help improve their knowledge, attitude, and practices toward infection prevention and control (IPC) during the COVID-19 pandemic, thus minimizing the spread of the virus in a hospital environment, reducing their apprehension, and preparing them to work in such pandemic situations.

A nationwide cross-sectional study to assess the impact of COVID-19 on surgical residency programs in India

BACKGROUND

The COVID-19 pandemic with its plenitude of hardships has been a challenge for residents in training. Besides the fear of contracting the disease, the complete reconfiguration of hospital services has severely affected the surgical residency programs across India. The current study highlights the lacunae that have arisen in the residency programs and design appropriate solutions to reframe the remaining part of the surgical training.

MATERIALS AND METHODS

The present study is an observational study based on a questionnaire survey done in November 2020 aimed at gauging the mood and perspective of residents across India pursuing surgical residency programs on how the pandemic has impacted various domains of their residency namely surgical training, clinical skills, research, academic curriculum, and mental health. The analysis was performed using an Internet-based program.

RESULTS

Seventy-eight percent of residents felt that they have lost crucial months of surgical training. Impact on clinical skills was reported by 73.9% of residents. Almost half of the residents (49.1%) believed that there has been a definite increase in research activities and 81.7% believed that the academic curriculum was affected during the past 6 months. Furthermore, 86% of respondents admitted to have had a profound impact on their mental health as a result of the pandemic.

CONCLUSION

Formulating reform policies in the current residency programs is paramount to train the current and future generation of surgeons. Whereas personal safety and wellness of the residents is paramount during these times, residency training via digital medical education and various other innovative ways needs to continue.

Determinants of COVID-19 Vaccination Willingness among Health Care Workers: A Quick Online Survey in India

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has caused a large number of deaths along with severe socio-economic effects. The vaccine is considered to be the last hope to control viral transmission. This study aimed to explore the determinants of health care workers' (HCWs) willingness to take the COVID-19 vaccination.

METHODS

A structured, pre-validated, and pre-tested questionnaire was administered online to 599 HCWs including physicians, residents, and nurses from different types of healthcare set-ups across India. Information was collected regarding vaccine acceptability, attitude toward vaccination, and reasons for hesitancy. The chi-square test, followed by multinomial regression analysis, was applied to determine the factors associated with HCWs' vaccination willingness.

RESULTS

It was found that 73 % (n=437) of HCWs were willing to accept the vaccines, while 10.85% (n=65) refused and 16.2% (n=96) needed more time to decide. Gender (P<0.001), occupation (P=0.040), working as front-line workers (P=0.008), vaccine manufacturing country preferences (P<0.001), and perceived risk of catching COVID-19 in the next 6 months (P=0.005) had a significant association with intent to receive vaccination (the response were "yes" vs. "no" and "not sure"). The reasons for vaccine hesitancy were vaccine safety and efficacy concerns, antivaccine attitude and beliefs, personal choice, and not wanting to take a vaccine before others.

CONCLUSION

The majority of HCWs agreed to take COVID-19 vaccines once available. Nevertheless, providing support to manage evolving vaccine environments will help change the perception of HCWs who refuse or are reluctant to take the vaccines.

COVID-19 vaccine acceptability, determinants of potential vaccination, and hesitancy in public: A call for effective health communication

BACKGROUND

Coronavirus disease rapidly spreads across the entire world in < 2 months and gravely jeopardizes the regular human routine. The medical fraternity recommends a vaccine as one of the best solutions to save the universe. However, to be effective, the population should reflect an encouraging attitude to accept it. The study aimed to measure vaccine acceptability and reason for hesitancy among the public.

MATERIALS AND METHODS

Eight hundred and forty one adults visiting a tertiary care hospital responded to a pretested validated questionnaire on vaccine acceptability and hesitancy. The Chi-square test and independent t-test, followed by multinomial logistic regression, were used to analyze the findings.

RESULTS

Overall, 53.4% (n = 445) of participants interested to take vaccine, 27.2% (n = 229) were not sure, and the remaining 19.4% (n = 163) did not intent to vaccinate. Gender (P = 0.013), information on the vaccine (P = 0.022), chances to get coronavirus disease in the next 6 months (P < 0.001), awareness on India COVID-19 vaccine (P < 0.001), Indian manufacturing company of vaccine (P < 0.001), family history of the laboratory-confirmed case (P < 0.001), and health status (P = 0.011) found a significant association with intention to vaccination (a response "yes" vs. "no" and "not sure"). Reasons for vaccine hesitancy included specific antivaccine attitudes and beliefs, a concern of fear and phobia, lack of information, and safety issues on the vaccine.

CONCLUSIONS

This institute-specific survey revealed that approximately every 4 in 8 people were not sure to take the vaccine, and one in five people refused to be vaccinated. The study recommends using target-based health education to understand and address vaccine-specific concerns to enhance vaccine coverage, and boost confidence among the population.

Comparison of the Rapid Antigen Testing Method With RT-qPCR for the Diagnosis of COVID-19

Background: Coronavirus disease 2019 (COVID-19) has till now affected about 110 million people globally. It has not spared any country and has led to 24 lakh deaths. As a result, the testing had to be increased manifold leading to depletion in the number of the quantitative reverse transcription polymerase chain reaction (RT-qPCR) kits. Point-of-care rapid antigen-based tests were developed in order to meet the increasing demands. The objective of this study was to compare the performance of a rapid chromatographic test (index test) with a gold standard test (RT-qPCR).

Methods: A retrospective analysis was done at a tertiary care teaching hospital in Eastern Uttar Pradesh, India. Paired samples were taken from all patients reporting to the clinic for antigen-based rapid diagnostic testing (RDT) and RT-qPCR. The sensitivity and specificity were calculated to evaluate the performance of the RDT.

Results: The overall sensitivity and specificity of the RDT were observed to be 53.6% (39.7-67.0) and 97.35% (94.6-98.9), respectively. In symptomatic individuals, the sensitivity was higher 61.0% (44.5-75.8). The test positivity rates of RDT were found to be higher at a ​​cycle threshold value ≤20.

Conclusion: RDT can be used as a screening test to rule in the infection especially in symptomatic patients who are more prone to spread the disease. It is an important weapon in the armamentarium of public healthcare for the containment of COVID-19.

Predictors of critical illness and mortality based on symptoms and initial physical examination for patients with SARS-CoV-2: A retrospective cohort study

INTRODUCTION

An unidentified cluster of pneumonia was identified in Wuhan city of China in the last week of December 2019, named Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2). The current study explored the predictors associated with critical illness and mortality based on symptoms at the time of admission and initial physical examination findings in patients with SARS-CoV-2.

MATERIAL AND METHODS

A total of 249 records of laboratory-confirmed SARS-COV-2 patients were analyzed. Demographic profile and findings of initial physical examination were collected and analyzed. Bivariate logistic and multivariable stepwise forward regression analysis was used to identify the predictors of critical illness and mortality.

RESULTS

A total of 249 records of SARS-COV-2 patients were retrospectively studied, of whom 66 (26.5%) developed a critical illness, and 58 (23.29%) died. The mean age of patients was 45.15 (16.34) years; 171 (68.71%) were men. From 27 potential predictors for developing a critical illness, 15 were reported independent predictors for critical illness, and 13 were for increased risk of mortality. Stepwise forward regression reported dyspnea as a single strongest predictor (OR, 5.800, 95% CI-2.724-12.346; p = 0.001, R2 = 0.272) to develop critical illness. Likewise, the respiratory rate was alone reported as a strong predictor (OR, 1.381, 95% CI- 1.251-1.525; p = 0.000, R2 = 0.329) for mortality.

CONCLUSIONS

Coronavirus disease is a new challenge to the medical fraternity, leading to significant morbidity and mortality. Knowledge of potential risk factors could help clinicians assess patients' risk with unfavourable outcomes and improve hospitalization decisions in the early stage.

Awareness, perception, and mitigating measures on COVID-19: Do we still need to educate our masses on COVID-19?

BACKGROUND

COVID-19 was declared an emergency of international concern by the World Health Organization in 2020. This study assesses patients' awareness, perception, and mitigating measures taken during the COVID-19 outbreak visiting an apex tertiary health-care center in North India.

MATERIALS AND METHODS

A cross-sectional study was conducted between September 15, 2020, and November 15, 2020, in a tertiary care public hospital, North India, using a structured self-administered questionnaire. The survey included 809 patients using a consecutive sampling strategy. The self-structured and prevalidated questionnaire was used to collect information on study variables. Chi-square test and independent samples t-test, followed by binary and multivariate logistic regression, was used to determine the factors associated with awareness toward COVID-19.

RESULTS

The mean age of participants was 32.41 (±11.24) years. Multivariate logistic regression shows that married participants (OR: 0.660, 95 % CI: 0.440-0.989, P= 0.044), reading books/magazine or attended institutional lectures (OR: 2.241, 95% CI: 1.545-3.249, P = 0.001), and watching television and radio (OR: 1.824, 95% CI: 1.283-2.592, P = 0.001) are significantly more aware than their counterparts. Participants with higher income group (>20,000 Indian rupee) significantly had higher awareness than participants having salary <10,000 rupees (OR: 0.280, 95% CI: 0.178-0.440, P = 0.001) or 10,001-20,000 rupees (OR: 0.481, 95% CI: 0.297-0.777, P = 0.003). Patients avoiding traveling across or abroad had significantly much reasonably good awareness than their counterparts (OR: 0.357, 95% CI: 0.139-0.918, P = 0.033).

CONCLUSIONS

Participants demonstrated good awareness, encouraging perception, and complied with appropriate mitigating measures during the outbreak. Considering frequent waves and the pandemic's long duration, consistent reinforcement of government measures, including masks, maintaining social distance, and frequent handwashing, is much needed.

Comparison of Positivity Rates of Rapid Antigen Testing and Real-Time Polymerase Chain Reaction for COVID-19 During the First and Second Waves of the Pandemic in Eastern Uttar Pradesh, India

Background

The advent of the second wave of coronavirus disease 2019 (COVID-19) in India caused a new range of challenges in diagnosing the virus. Various point-of-care tests have been introduced for rapid diagnosis. Although rapid antigen tests are the most commonly used, the false-negative rates are high. Therefore, the purpose of this study was to compare the positivity rate of real-time polymerase chain reaction (RT-PCR) testing in rapid antigen-negative cases of COVID-19 during the first and second waves of the COVID-19 pandemic.

Methodology

This was an observational study conducted in the Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur.

Results

In total, 2,168 patients were tested. The percentage positivity rate of the RT-PCR tests among the antigen-negative samples was 4.34% in the first wave of the pandemic whereas it was 8.08% in the second wave.

Conclusions

The main conclusion of this study was that antigen tests should never be used alone for the diagnosis of COVID-19. Instead, they should be confirmed with a RT-PCR test.

Promoting Mental Health of Nurses During the Coronavirus Pandemic: Will the Rapid Deployment of Nurses' Training Programs During COVID-19 Improve Self-Efficacy and Reduce Anxiety?

Introduction The nursing profession is extremely demanding and stressful. Nurses have been facing a tremendous amount of fear and anxiety during the ongoing coronavirus disease 2019 (COVID-19) pandemic. General self-efficacy is considered one of the most influential factors that can modify the impact of anxiety on nurses' mental health. In this study, we aimed to determine the predictors of self-efficacy and anxiety among nurses during the current COVID-19 pandemic. Methods We conducted a cross-sectional survey involving 368 nurses working in a tertiary care hospital. The General Self-Efficacy scale (GSE) and Generalized Anxiety Disorder Scale-7 (GAD-7) were used for assessing self-efficacy and anxiety. The chi-square test followed by bivariate and multivariable regression analyses was performed to identify the determinants of self-efficacy and anxiety. Results The mean age of the nurses was 28.91 years (SD=3.68), with a mean working experience in the nursing field of 5.32 years (SD=2.48). The mean self-efficacy and anxiety scores were 32.19 (SD=4.53) and 3.82 (SD=2.87), respectively. Multivariable analysis showed that higher age (>30 years, p=.003), professional education acquired through a diploma course instead of a graduate degree (p<.001), and lack of training on handling COVID-19 patients (p=.003) were significant determinants of higher anxiety among nurses. Similarly, higher economic status (p=.001), sufficient COVID-19 training (p=.049), having family members tested positive for COVID-19 (p=.012), professional experience (≤5 years, p<0.001), and quarantine period (≤14 days, p=.002) were revealed to be independent determinants of a higher sense of self-efficacy among nurses during the COVID-19 pandemic. Conclusion Receiving adequate levels of training on COVID-19 plays a vital role in improving self-efficacy and reducing anxiety among nurses during the ongoing pandemic. Managing anxiety, increasing self-efficacy, and ensuring more exposure to COVID-19-related training may improve nurses' mental health and prepare them for fighting pandemics in a much better and more efficient manner.

Hematological profile and biochemical markers of COVID-19 non-survivors: A retrospective analysis

Background

Coronavirus disease is primarily transmitted through the respiratory route and bodily contact. The fatality in COVID-19 cases was alarming in the initial days. This study analyzes hematological and biochemical markers of COVID-19 non-survivors.

Material and methods

In this single-center study, records of 249 patients hospitalized with COVID-19 were studied for hematological profile and biochemical markers. Records of patients with laboratory-confirmed COVID-19 disease hospitalized between April 14, 2020, to August 15, 2020, were included in the analysis.

Results

Significantly, the disease mortality was associated with increased procalcitonin (P < 0.05), C-reactive protein (P < 0.05), aspartate transaminase (P < 0.05), serum potassium (P < 0.05), neutrophils count (P < 0.05), white blood cell count (P < 0.05), prothrombin time (P < 0.05) and activated prothrombin time (P < 0.05) in patients reported abnormal x-ray findings. Further, patients with abnormal radiological findings significantly showed a reduced level of lymphocyte counts (P < 0.05), oxygen saturation (P < 0.05), and partial oxygen pressure (P < 0.05). Reduced level of aspartate aminotransferase (P < 0.05), alanine aminotransferase (P < 0.05) and lactate dehydrogenase (P < 0.05) reported significant association with mortality among patients with COVID-19.

Conclusions

The clinicians may consider the hematological and biochemical parameters in the patients with COVID-19 in future decision-making. These indicators might support clinical decisions to identify high fatality cases and poor diagnosis in the initial admission phase. In COVID-19 patients, we recommend close monitoring on procalcitonin, C-reactive protein, neutrophils count, and white blood cell count as a clinical indicator for potential progression to critical illness.

Effectiveness of Video-Based Online Training for Health Care Workers to Prevent COVID-19 Infection: An Experience at a Tertiary Care Level Institute, Uttarakhand, India

Purpose Amidst the current COVID-19 pandemic, traditional teaching methodology took a back foot. However, an urgent need for training health care worker (HCW) on preventive measures for COVID-19 infection was the need of the hour. Keeping in mind the precautionary measures required to combat COVID-19 infection, the only promising option for training was by adopting an online learning method. This study was undertaken to determine the effectiveness of video-based training using online platforms for infection prevention and control (IPC) training during the COVID-19 pandemic. Methods A quasi-experimental study, with only one experimental group comprising of HCWs, was undertaken to assess the effect of intervention which included video-assisted teaching-learning regarding IPC measures with a special focus on COVID-19 at a tertiary care Institute in North India. Online sessions were conducted on Do's and Don'ts, Hand Hygiene, donning and doffing of personal protective equipment (PPE), cleaning and disinfection, and bio-medical waste (BMW) management with the help of pre-recorded videos which was pre-validated. The session was followed by online interaction with participants by a single resource person. Pre-test and post-test were conducted through google forms before commencement and at the end of the online session respectively. The data were analyzed in terms of descriptive frequencies and percentages of different domains to describe the pre- and post-test knowledge. Results A total of 576 participants were included in the study. There was a statistically significant gain in scores of all questions related to cleaning and disinfection; and BMW. No significant change was observed in knowledge regarding the sequence of doffing (p-value: 0.94). The result of pairwise comparisons pre-test and post-test scores showed that intervention through video-assisted teaching-learning resulted in improvement of knowledge which was found to be statistically significant (p-value < 0.001). Conclusion Video-assisted teaching-learning through virtual platforms effectively trained health personnel on infection prevention and control practices during the COVID-19 pandemic. Video-assisted training can successfully be handled by a single resource person to impart the knowledge and skill to the trainee. Virtual teaching and learning is a feasible and efficient method to deliver training to HCWs on infection control practices and this methodology may be adopted in the future for several other training in manpower crunch situations, similar restrictive circumstances as posed by the COVID-19 pandemic.