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Rzadkiewicz M, Chylińska J. Walking in their shoes: How primary-care experiences of adults aged 50+ reveal the benefits of e-learning intervention for general practitioners. Appl Psychol Health Well Being 2023; 15:1237-1253. [PMID: 36609871 DOI: 10.1111/aphw.12434] [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: 07/27/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023]
Abstract
Patient experiences and activation are increasingly researched. However, related data are limited in three areas: interventions for general practitioners (GPs) working with mature adults (50+), dedicated e-learning interventions for GPs, and assessments of e-learning for medical staff through patient experiences. We examined how e-learning intervention focused on improving GPs' skills in activating communication (understood as promoting engagement and active participation in healthcare) can enhance the experiences of mature patients. The intervention was designed for GPs, yet innovative assessment was based on patient experiences post-visit. Three research conditions for GPs (n = 165) were introduced: (1) e-learning or (2) pdf-article intervention and (3) control. Two independent waves of their patients participated before and after the intervention. Experience measures for patients (n = 1639) included the Patient Expectations Scale (post-visit), perceived GP's Communication Skills scale, and Patient Satisfaction with Visit scale. E-learning intervention compared with the control group had a favorable effect for 5 out of 8 dimensions of patient experience. Change in emotional support and quality of life was particularly visible. Mature patient experiences can be improved with the e-learning intervention for GPs. Measuring patient experience enriches the available knowledge and can help design future research and interventions.
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Affiliation(s)
- Marta Rzadkiewicz
- Department of Health Psychology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Chylińska
- Department of Health Psychology, Medical University of Warsaw, Warsaw, Poland
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Tan HJ, Shahren AAH, Khoo CS, Ng CF, Zaidi WAW, Kori N, Periyasamy P, Eu CL, Payus AO, Hod R. Anxiety among hospitalized COVID-19 patients: a case-control study from a tertiary teaching hospital in Malaysia. Front Psychiatry 2023; 14:1148019. [PMID: 37275980 PMCID: PMC10232945 DOI: 10.3389/fpsyt.2023.1148019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/27/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Anxiety has been increasingly recognized as part of the psychosocial health issues in COVID-19 patients. However, the impact of this topic may be underestimated in low- and middle-income countries. This study aimed to estimate the prevalence of and risk factors of anxiety in COVID-19 patients compared to controls in a local tertiary teaching hospital in Malaysia. Methods In this case-control study, we analyzed data on adult patients aged 18 years and above hospitalized for COVID-19 infection with matched hospitalized controls. The demographic, clinical data and anxiety measures using the Generalized Anxiety Disorder-7 questionnaire were analyzed using univariate and multivariate analysis. Results 86.6% in the COVID-19 group had anxiety, significantly higher than 13.4% in the control group (p = 0.001). The COVID-19 group was significantly associated with the GAD-7 severity (p = 0.001). The number of COVID-19 patients in the mild, moderate, and severe anxiety groups was 48 (84.2%), 37 (86%), and 18 (94.7%), respectively. Multiple logistic regression showed significant predictors for anxiety, including COVID-19 diagnosis and neurological symptoms. Anxiety was found 36.92 times higher in the patients with COVID-19 compared to those without COVID-19 (OR 36.92;95% CI 17.09, 79.78, p = 0.001). Patients with neurological symptoms were at risk of having anxiety (OR 2.94; 95% CI 1.03, 8.41, p = 0.044). Discussion COVID-19 patients experience a significant disruption in psychosocial functioning due to hospitalization. The burden of anxiety is notably high, compounded by a diagnosis of COVID-19 itself and neurological symptomatology. Early psychiatric referrals are warranted for patients at risk of developing anxiety symptoms.
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Affiliation(s)
- Hui Jan Tan
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Abdool Alleem Hj Shahren
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Ching Soong Khoo
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Chen Fei Ng
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Wan Asyraf Wan Zaidi
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Najma Kori
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Petrick Periyasamy
- Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Choon Leng Eu
- Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Alvin Oliver Payus
- Department of Medicine, Faculty of Medicine, University Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
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Sabir Z, Asmara A, Dehraj S, Raja MAZ, Altamirano GC, Salahshour S, Sadat R, Ali MR. A mathematical model of coronavirus transmission by using the heuristic computing neural networks. ENGINEERING ANALYSIS WITH BOUNDARY ELEMENTS 2023; 146:473-482. [PMID: 36339085 PMCID: PMC9618448 DOI: 10.1016/j.enganabound.2022.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 10/23/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
In this study, the nonlinear mathematical model of COVID-19 is investigated by stochastic solver using the scaled conjugate gradient neural networks (SCGNNs). The nonlinear mathematical model of COVID-19 is represented by coupled system of ordinary differential equations and is studied for three different cases of initial conditions with suitable parametric values. This model is studied subject to seven class of human population N(t) and individuals are categorized as: susceptible S(t), exposed E(t), quarantined Q(t), asymptotically diseased IA (t), symptomatic diseased IS (t) and finally the persons removed from COVID-19 and are denoted by R(t). The stochastic numerical computing SCGNNs approach will be used to examine the numerical performance of nonlinear mathematical model of COVID-19. The stochastic SCGNNs approach is based on three factors by using procedure of verification, sample statistics, testing and training. For this purpose, large portion of data is considered, i.e., 70%, 16%, 14% for training, testing and validation, respectively. The efficiency, reliability and authenticity of stochastic numerical SCGNNs approach are analysed graphically in terms of error histograms, mean square error, correlation, regression and finally further endorsed by graphical illustrations for absolute errors in the range of 10-05 to 10-07 for each scenario of the system model.
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Affiliation(s)
- Zulqurnain Sabir
- Department of Mathematics and Statistics, Hazara University, Mansehra, Pakistan
| | - Adi Asmara
- Faculty of Teacher Training and Education, Mathematics Study Program, Universitas Muhammadiyah Bengkulu, Bengkulu, Indonesia
| | - Sanaullah Dehraj
- Department of Mathematics and Statistics, Quaid-e-Awam University of Engineering, Science and Technology, 67480 Nawabshah, Pakistan
| | - Muhammad Asif Zahoor Raja
- Future Technology Research Center, National Yunlin University of Science and Technology, 123 University Road, Section 3, Douliou, Yunlin 64002, Taiwan
| | | | - Soheil Salahshour
- Faculty of Engineering and Natural Sciences, Bahcesehir University, Istanbul, Turkey
| | - R Sadat
- Department of Mathematics, Zagazig Faculty of Engineering, Zagazig University, Egypt
| | - Mohamed R Ali
- Center of Research, Faculty of Engineering and Technology, Future University in Egypt New Cairo, 11835, Egypt
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Alhazmi FH, Alsharif WM, Alshoabi SA, Gameraddin M, Aloufi KM, Abdulaal OM, Qurashi AA. Identifying cerebral microstructural changes in patients with COVID-19 using MRI: A systematic review. Brain Circ 2023; 9:6-15. [PMID: 37151797 PMCID: PMC10158661 DOI: 10.4103/bc.bc_77_22] [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: 10/08/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 05/09/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an epidemic viral disease caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the excessive number of neurological articles that have investigated the effect of COVID-19 on the brain from the neurological point of view, very few studies have investigated the impact of COVID-19 on the cerebral microstructure and function of the brain. The aim of this study was to summarize the results of the existing studies on cerebral microstructural changes in COVID-19 patients, specifically the use of quantitative volumetric analysis, blood oxygen level dependent (BOLD), and diffusion tensor imaging (DTI). We searched PubMed/MEDLINE, ScienceDirect, Semantic Scholar, and Google Scholar from December 2020 to April 2022. A well-constructed search strategy was used to identify the articles for review. Seven research articles have met this study's inclusion and exclusion criteria, which have applied neuroimaging tools such as quantitative volumetric analysis, BOLD, and DTI to investigate cerebral microstructure changes in COVID-19 patients. A significant effect of COVID-19 was found in the brain such as hypoperfusion of cerebral blood flow, increased gray matter (GM) volume, and reduced cortical thickness. The insula and thalamic radiation were the most frequent GM region and white matter tract, respectively, that are involved in SARS-CoV-2. COVID-19 was found to be associated with changes in cerebral microstructures. These abnormalities in brain areas might lead to be associated with behaviors, mental and neurological alterations that need to be considered carefully in future studies.
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Affiliation(s)
- Fahad H. Alhazmi
- Department of Diagnostic Radiology Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Walaa M. Alsharif
- Department of Diagnostic Radiology Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Sultan Abdulwadoud Alshoabi
- Department of Diagnostic Radiology Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Moawia Gameraddin
- Department of Diagnostic Radiology Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
- Address for correspondence: Dr. Moawia Gameraddin, Department of Diagnostic Radiology Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia. E-mail:
| | - Khalid M. Aloufi
- Department of Diagnostic Radiology Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Osama M. Abdulaal
- Department of Diagnostic Radiology Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Abdualziz A. Qurashi
- Department of Diagnostic Radiology Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
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Zhao Y, Wang H, Zhang Q, Hu Y, Xu Y, Liu W. Evaluation of adverse events of bamlanivimab, bamlanivimab/etesevimab used for COVID-19 based on FAERS database. Expert Opin Drug Saf 2022; 22:331-338. [PMID: 36178050 DOI: 10.1080/14740338.2023.2130888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND We study the adverse events (AEs) of bamlanivimab (BAM), bamlanivimab/etesevimab (BAM/ETE) to alert risk factors during coronavirus disease 2019 (COVID-19) treatment and provide references for drug safety. RESEARCH DESIGN AND METHODS Extract AEs from the COVID-19 Emergency Use Authorization (EUA) FDA Adverse Event Reporting System (FAERS) Public Dashboard. Disproportionality analysis was performed by the proportional reporting ratio (PRR), the reporting odds ratio (ROR), the Medicines and Healthcare Products Regulatory Agency (MHRA), and the Empirical Bayes Geometric Mean (EBGM) to discover the potential risks of BAM and BAM/ETE. RESULTS : With COVID-19 drugs as the research background, the number of BAM/ETE signals is about half that of BAM, and 80% of signals overlap with BAM. Signals such as atrial fibrillation, tachycardia, and confusional state are present in BAM but not in BAM/ETE. With BAM and BAM/ETE as the research background, potential safety signals of BAM/ETE such as acute respiratory failure, hypersensitivity, and infusion related reaction require long-term observation, especially acute respiratory failure which isn't in the label. CONCLUSIONS The AEs reports on this study confirm most of the label information of BAM and BAM/ETE. BAM/ETE is relatively safe, while the risk signals such as acute respiratory failure and infusion related reaction require to be monitored.
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Affiliation(s)
- Yunfei Zhao
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Huiling Wang
- School of Pharmaceutical Sciences, Zhengzhou Railway Vocational and Technical College, Zhengzhou, China
| | - Qingsong Zhang
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Yongxin Hu
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Yulong Xu
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Wei Liu
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
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Thapa Magar S, Lokhandwala HI, Batool S, Zahoor F, Zaidi SKF, Sahtiya S, Khemani D, Kumar S, Voloshyna D, Saleem F, Ghaffari MAZ. A Systematic Review of Neurological Manifestations of COVID-19. Cureus 2022; 14:e28309. [PMID: 36168382 PMCID: PMC9506361 DOI: 10.7759/cureus.28309] [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] [Accepted: 08/23/2022] [Indexed: 11/06/2022] Open
Abstract
The coronavirus can infect the upper respiratory tract, sinuses, and nose, and its severity manifests in its respiratory symptoms and neurological and psychological consequences. The majority of people who have COVID-19 present with moderate flu-like illness, and patients who are elderly with comorbid conditions, such as hypertension and diabetes, are more prone to experience severe illness and death. However, in the ongoing COVID-19 pandemic, neurological consequences have become a substantial source of morbidity and mortality. COVID-19 poses a global hazard to the nervous system because of its widespread dispersion and multiple pathogenic pathways. This review offers a critical assessment of the acute and long-term neurological effects of the COVID-19 virus. Some neurological problems include headache, dizziness, myalgia/fatigue, meningitis, ischemic/hemorrhagic stroke, and myelitis. Other people who have contracted COVID-19 also exhibit neurological features such as loss of taste and smell, reduced consciousness, and Guillain-Barré syndrome. This study seeks to help neurologists comprehend the wide range of neurologic aspects of COVID-19, as understanding neurological symptoms may help with the management and enhance the patient's outcomes.
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Chiam M, Ho CY, Quah E, Chua KZY, Ng CWH, Lim EG, Tan JRM, Wong RSM, Ong YT, Soong YL, Kwek JW, Yong WS, Loh KWJ, Lim C, Mason S, Krishna LKR. Changing self-concept in the time of COVID-19: a close look at physician reflections on social media. Philos Ethics Humanit Med 2022; 17:1. [PMID: 35078488 PMCID: PMC8789479 DOI: 10.1186/s13010-021-00113-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/17/2021] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may have profound effects on their mental and physical health, personal relationships and professional efficacy. METHODS With mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria. RESULTS A total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms. CONCLUSION It is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19's impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as 'compensatory' to one another, with coping mechanisms buffering and fortifying the physician's overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures.
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Affiliation(s)
- Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Chong Yao Ho
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Elaine Quah
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Keith Zi Yuan Chua
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Caleb Wei Hao Ng
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Elijah Gin Lim
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Javier Rui Ming Tan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Ruth Si Man Wong
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Yoke Lim Soong
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
- Division of Radiation Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Jin Wei Kwek
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
- Division of Oncologic Imaging, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Wei Sean Yong
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
- Division of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Kiley Wei Jen Loh
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - Crystal Lim
- Medical Social Services, Singapore General Hospital, Outram Rd, Singapore, 169608, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK
| | - Lalit Kumar Radha Krishna
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK.
- Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK.
- Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore.
- Centre of Biomedical Ethics, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore.
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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Meng ZQ, Leng Q, Wang X, Xu CH, Xu J, Liu Y. Comparative analysis of anxiety/depression scores in COVID-19 patients with disease severity, sleep patterns, and certain laboratory test results. Arch Med Sci 2022; 18:1262-1270. [PMID: 36160342 PMCID: PMC9479708 DOI: 10.5114/aoms/136111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/26/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is associated with severe emotional changes. This research aims to investigate the prevalence of anxiety and depression in COVID-19 patients and its relationship with disease severity, sleep patterns, lifestyle, and specific laboratory test results. MATERIAL AND METHODS An observational study of 52 Chinese patients with COVID-19 was conducted to assess the relation between anxiety and depression (evaluated with the Hospital Anxiety and Depression Scale) and laboratory findings (lymphocytes, C-reactive proteins, leukocytes, alanine aminotransferase, aspartate aminotransferase). The relationships between the severity of COVID-19 in patients, the Insomnia Severity Index (ISI) score, and the Hospital Anxiety and Depression Scale (HADS) score were also investigated. RESULTS There were statistically significant associations between disease, smoking, and HADS-A scores (p = 0.011/0.020). The HADS-D score of patients with the disease was higher than in those without a past medical history (p = 0.008). The difference in C-reactive protein (CRP) between different lung infections, the HADS-A and HADS-D scores between different ages and ISI groups, and the correlation between the two scores were statistically significant. CONCLUSIONS Anxiety and depression are associated with poor sleep quality, smoking, and past medical history in patients with COVID-19. Additionally, anxiety and depression were seen to coexist, and there was a positive correlation between them. Further, the inflammatory index CRP was significantly increased in bilateral lung infections.
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Affiliation(s)
- Zi-Qiang Meng
- Department of Hepatology, Xixi Hospital of Hangzhou, Hangzhou, China
| | - Qi Leng
- Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China
| | - Xu Wang
- Department of Ophthalmology, Xixi Hospital of Hangzhou, Hangzhou, China
| | - Chun-Hai Xu
- Department of Infection, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jing Xu
- Department of Hepatology, Xixi Hospital of Hangzhou, Hangzhou, China
| | - Yan Liu
- Department of Hepatology, Xixi Hospital of Hangzhou, Hangzhou, China
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Impact of knowledge, attitude and anxiety levels about COVID-19 on the quality of life in pregnant women. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.975044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gogia B, Pujara D, Thottempudi N, Ghanayem T, Ajam Y, Singh A, Dabi A, Patil S, Curtis K, Fang X, Patel K, Bhardwaj A, Rai P. Impact of Acute Confusional State in Patients With COVID-19 and a Predictive Score. Cureus 2021; 13:e18360. [PMID: 34646712 PMCID: PMC8478964 DOI: 10.7759/cureus.18360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Acute confusional state (ACS) in COVID-19 is shown to be associated with poor clinical outcomes. METHODS We assessed the impact of ACS - defined as a documented deterioration of mental status from baseline on the alertness and orientation to time, place, and person - on inpatient mortality and the need for intensive care unit (ICU) transfer in inpatient admissions with active COVID-19 infection in a single-center retrospective cohort of inpatient admissions from a designated COVID-19 tertiary care center using an electronic health record system. Furthermore, we developed and validated a neurological history and symptom-based predictive score of developing ACS. RESULTS Thirty seven out of 245 (15%) patients demonstrated ACS. Nineteen (51%) patients had multifactorial ACS, followed by 11 (30%) patients because of hypoxemia. ACS patients were significantly older (80 [70-85] years vs 50.5 [38-69] years, p < 0.001) and demonstrated more frequent history of dementia (43% vs 9%, p < 0.001) and epilepsy (16% vs 2%, p = 0.001). ACS patients observed significantly higher in-hospital mortality (45.9% vs 1.9%, aOR [adjusted odds ratio]: 15.7, 95% CI = 3.6-68.0, p < 0.001) and need for ICU transfer (64.9% vs 35.1%, aOR: 2.7, 95% CI = 1.2-6.1, p = 0.015). In patients who survived hospitalization, ACS was associated with longer hospital stay (6 [3.5-10.5] days vs 3 [2-7] day, p = 0.012) and numerically longer ICU stay (6 [4-10] days vs 3 [2-6] days, p = 0.078). A score to predict ACS demonstrated 75.68% sensitivity and 81.73% specificity at a cutoff of ≥3. CONCLUSION A high prevalence of ACS was found in patients with COVID-19 in our study cohort. Patients with ACS demonstrated increased mortality and need for ICU care. An internally validated score to predict ACS demonstrated high sensitivity and specificity in our cohort.
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Affiliation(s)
- Bhanu Gogia
- Neurology/Vascular Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Deep Pujara
- Neurology, Case Western Reserve University, Cleveland, USA
| | | | - Tamer Ghanayem
- Neurology, Vanderbilt University Medical Center, Nashville, USA
| | - Yousaf Ajam
- Neurology, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Ayush Singh
- Neurology, Emory University School of Medicine, Atlanta, USA
| | - Alok Dabi
- Neurology, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Shekhar Patil
- Internal Medicine, Northeast Internal Medical Associates, Fort Wayne, USA
| | - Kyra Curtis
- Neurology, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Xiang Fang
- Neurology, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Kamakshi Patel
- Neurology, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Anish Bhardwaj
- Neurology, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Prashant Rai
- Neurology, University of Texas Medical Branch at Galveston, Galveston, USA
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Bonizzato S, Ghiggia A, Ferraro F, Galante E. Cognitive, behavioral, and psychological manifestations of COVID-19 in post-acute rehabilitation setting: preliminary data of an observational study. Neurol Sci 2021; 43:51-58. [PMID: 34642823 PMCID: PMC8510572 DOI: 10.1007/s10072-021-05653-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 10/06/2021] [Indexed: 01/07/2023]
Abstract
Psychological, emotional, and behavioral domains could be altered in COVID-19 patients and measurement of variables within these domains seems to be mandatory. Neuropsychological assessment could detect possible cognitive impairment caused by COVID-19 and the choice of appropriate tools is an important question. Aim of this exploratory study was to verify the effectiveness of an assessment model for patients with COVID-19. Twelve patients were enrolled and tested with Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Anxiety and Depression Short Scale (AD-R), and the Neuropsychiatry Inventory (NPI), at the time of their entrance (T0) and discharge (T1) from a rehabilitative unit. Moreover, a follow-up evaluation after 3 months (T2) has been conducted on eight patients. Results showed that at baseline (T0), 58.3% of the patients reported a score below cut-off at MMSE and 50% at MoCA. Although a significant amelioration was found only in NPI scores, a qualitative improvement has been detected at all tests, except for MoCA scores, in the T0-T1 trend analysis. A one-way repeated measures analysis of variance showed a significant variation in AD-R depression score, considering the three-assessment time (T0, T1, and T2). The evaluation and tracking over time of the impact of COVID-19 on cognitive, psychological, and behavioral domains has relevant implications for rehabilitation and long-term assistance needs planning. The choice of assessment tools should consider patients vulnerability and match the best compromise among briefness, sensitivity, and specificity.
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Affiliation(s)
- Silvia Bonizzato
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, Italy
| | - Ada Ghiggia
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy.
| | - Francesco Ferraro
- Neuro-Motor Rehabilitation Unit, Neuroscience Department, Azienda Socio Sanitaria Territoriale Di Mantova, via XXV Aprile 71, Bozzolo, Mantova, Italy
| | - Emanuela Galante
- Neuro-Motor Rehabilitation Unit, Neuroscience Department, Azienda Socio Sanitaria Territoriale Di Mantova, via XXV Aprile 71, Bozzolo, Mantova, Italy
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Walecka I, Ciechanowicz P, Dopytalska K, Mikucka-Wituszyńska A, Szymańska E, Bogucki J, Kock J, Kułakowska K, Tuszyńska-Bogucka W. Psychological consequences of hospital isolation during the COVID-19 pandemic - research on the sample of polish firefighting academy students. CURRENT PSYCHOLOGY 2021; 42:6856-6865. [PMID: 34220176 PMCID: PMC8238034 DOI: 10.1007/s12144-021-01982-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 01/08/2023]
Abstract
Currently, a very important thread of research on COVID-19 is to determine the dimension of the psychopathological emotional reactions induced by the COVID-19 pandemic. A non-experimental online research project was designed to determine the predictors of the severity of psychopathological symptoms, such as depression and PTSD symptoms, and the nature of the feedback mechanism between them in groups of men, remaining in hospital isolation due to infection and at-home isolation during the COVID-19 epidemic. The presence of symptoms of depression, post-traumatic stress disorder (PTSD) and a sense of threat due to the pandemic were assessed using the following screening tests: IES-R by Weiss and Marmar, PHQ-9 by Spitzer et al., and a self-constructed sliding scale for assessing COVID-19 anxiety. The study was carried out on a group of 57 firefighting cadets, hospitalized in a COVID-19 isolation room (Mage = 23.01), staying in isolation due to SARS-CoV-2 virus infection and a control group of 57 healthy men (Mage = 41.38) staying at home during quarantine and national lockdown. COVID-19 pandemic causes many psychopathological reactions. The predictive models revealed that the predictors of symptoms of PTSD in isolated patients included depression and the experienced sense of COVID-19 threat resulting from the disease, while in the control group the symptoms of depression were the only predictor of PTSD. PTSD experiences are usually associated with depression. It may also be a form of the re-experiencing process or the effect of high affectivity, indirectly confirmed by the participation of hyperarousal in the feedback loop. Our findings highlight the importance of mental health aspects in patients treated during the COVID-19 pandemic. The COVID-19 pandemic requires social distancing, quarantine and isolation, which may cause psychopathological symptoms not only in affected people, but also in the general population. Moreover, the need for greater psychological support can be emphasized for both: the sick and the general population.
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Affiliation(s)
- Irena Walecka
- grid.414852.e0000 0001 2205 7719Dermatology Department, Centre of Postgraduate Medical Education / Central Clinical Hospital MSWiA, 137, Wołoska St., 02-507 Warsaw, Poland
| | - Piotr Ciechanowicz
- grid.414852.e0000 0001 2205 7719Dermatology Department, Centre of Postgraduate Medical Education / Central Clinical Hospital MSWiA, 137, Wołoska St., 02-507 Warsaw, Poland
| | - Klaudia Dopytalska
- grid.414852.e0000 0001 2205 7719Dermatology Department, Centre of Postgraduate Medical Education / Central Clinical Hospital MSWiA, 137, Wołoska St., 02-507 Warsaw, Poland
| | - Agata Mikucka-Wituszyńska
- grid.414852.e0000 0001 2205 7719Dermatology Department, Centre of Postgraduate Medical Education / Central Clinical Hospital MSWiA, 137, Wołoska St., 02-507 Warsaw, Poland
| | - Elżbieta Szymańska
- grid.414852.e0000 0001 2205 7719Dermatology Department, Centre of Postgraduate Medical Education / Central Clinical Hospital MSWiA, 137, Wołoska St., 02-507 Warsaw, Poland
| | - Jacek Bogucki
- grid.411484.c0000 0001 1033 7158Department of Clinical Genetics, Medical University of Lublin, 1, Aleje Racławickie St., 20-059 Lublin, Poland
| | - Janusz Kock
- grid.411484.c0000 0001 1033 7158Department of Clinical Genetics, Medical University of Lublin, 1, Aleje Racławickie St., 20-059 Lublin, Poland
| | - Karolina Kułakowska
- grid.7841.aDepartment of Anatomical, Histological, Forensic Medicine and Orthopedic Science, Sapienza University of Rome, 5, Piazzale Aldo Moro, 00-185 Rome, Italy
| | - Wioletta Tuszyńska-Bogucka
- grid.449665.c0000 0004 0494 5204Department of Human Sciences, University of Economics and Innovation in Lublin, 4, Projektowa St., 20-209 Lublin, Poland
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Baker TL, Greiner JV. Guidelines for Reopening a Nation in a SARS-CoV-2 Pandemic: A Path Forward. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:496. [PMID: 34068853 PMCID: PMC8153561 DOI: 10.3390/medicina57050496] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/26/2021] [Accepted: 05/04/2021] [Indexed: 02/06/2023]
Abstract
Background and Objectives: Action, not fear, is the path forward in the coronavirus infectious disease 2019 (COVID-19) pandemic. Since early 2020, the world's nations have faced conundrums over severe acute respiratory syndrome corona virus type 2 (SARS-CoV-2) infections resulting in COVID-19 resulting in national closures, and thus, a clear understandable plan that nations can implement is required to reopen. The healthcare benefits of reopening a nation more likely than not exceed the benefits of continued pandemic-related closure. Pandemic-related closures have resulted in countless delayed or avoided urgent care evaluations. Furthermore, routine care of acute and chronic illnesses, including evaluations, diagnoses, and treatments, has also been delayed. Isolation, loss of income, and fear have resulted in mental health conditions or exacerbated existing conditions. The magnitude of untoward ramifications is unknown and may ultimately represent an inestimable degree of danger and morbidity, and even death. The pandemic of SARS-CoV-2 has created an atmosphere of fear of COVID-19 that has directly and indirectly injured the world's population. Since this has resulted in increasing morbidity and mortality, creating economic chaos, and near systemic collapse of educational systems with no well described plan forward, it is the purpose of this study to provide guidelines that provide a path forward to safely open a nation. Physicians often equipped by their education, training, and experiences across disciplines are uniquely positioned to comprehend, coordinate, and teach other physicians, business owners, and municipal and government leaders from guidelines. As such, physicians may take the lead in a path forward to reopening a nation, including opening businesses, educational facilities, and religious establishments, while minimizing the risk of SARS-CoV-2 infection. Materials and Methods: Reviews of the literature among the disciplines of environmental air, sanitation, social interaction, medical testing, vaccination, protection, and disease prevention and safety allowed for the conceptualization and eventual genesis of identifiable interventions which either reduce the viral load in the environment or inactivate the virus from replication. Each of the guidelines was selected based on the principle that it involved the elimination or inactivation of the viral particle. With a reduction in viral load or inactivation of replication, the implementation of these guidelines is expected to allow for reopening a nation with an increased level of safety. Results: The guidelines identified, including air exchange (ventilation), air filtration, personal protective filtering devices (masks), hand hygiene, social distancing, screening and testing, vaccines, high-risk patient protection, medical management, and adjunctive therapies, are described and referenced. Conclusions: In that the pandemic is primarily a public health issue, the path forward is best coordinated by local, regional, and national physicians. Many physicians with a breadth of experiences are uniquely positioned to coordinate the implementation of these interdisciplinary guidelines. Using these guidelines as a planned, coordinated action, not fear, is a path forward. Nations have a decision to make: closuring versus opening.
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Affiliation(s)
- Terrance L. Baker
- Johns Hopkins Community Physician, Baltimore, MD 21287, USA;
- School of Nursing, University of Maryland, Baltimore, MD 20742, USA
- School of Nursing, State University of New York at Stony Brook, Brookhaven, NY 11794, USA
- Sollay Medical Center, Sollay Kenyan Foundation, Katani Hospital, Katani, Kenya
| | - Jack V. Greiner
- Eye Research Institute of Massachusetts Eye & Ear, 20 Staniford St., W239, Boston, MA 02114, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA 02155, USA
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Deshetler L, Gangadhar M, Battepati D, Koffman E, Mukherjee RK, Menon B. Learning on Lockdown: A Study on Medical Student Wellness, Coping Mechanisms and Motivation during the COVID-19 Pandemic. MEDEDPUBLISH 2021; 10:50. [PMID: 38486599 PMCID: PMC10939617 DOI: 10.15694/mep.2021.000050.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background: The COVID-19 pandemic forced drastic changes to the educational settings and living conditions of medical students nationwide. Due to the sudden onset of remote learning, drastic educational changes likely induced fear and anxiety among students. Therefore, the purpose of this study was to assess medical students' academic and personal wellbeing, coping mechanisms, and motivation during the Stay at Home order through a survey-based study. Methods: The researchers obtained Institutional Review Board approval, and the study was classified as exempt category 2. In total, 705 medical students representing all four years were recruited from the researchers' institution. The survey was administered through an anonymous link in Qualtrics to the medical student listserv, and responses were collected over a two-week period. The instrument was comprised of four demographic questions, twenty-two closed-ended questions, and four open-ended questions. Results: A total of 188 medical students completed the survey for a response rate of 26.7%. Due to a very low response rate (n=3, 1.6%) from fourth-year students, quantitative data from this group were excluded. Quantitative analysis of the survey results showed that most respondents experienced nervousness and stress at some point during the pandemic. While most claimed to have successfully overcome challenges and achieved their goals, only about half of the participants admitted to being able to handle their personal problems, and nearly 70% of the respondents expressed difficulty focusing while studying. The qualitative data suggest that changes in study environment, long-term home confinement, and isolation were the most challenging aspects for participants. Conclusions:Overall, this study showed that the COVID-19 pandemic induced stress and anxiety among students; nevertheless, most were able to employ effective coping strategies, pursue mental wellness assistance, achieve goals, and maintain motivation during the pandemic.
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Affiliation(s)
- Lori Deshetler
- University of Toledo College of Medicine and Life Sciences
| | | | | | - Erin Koffman
- University of Toledo College of Medicine and Life Sciences
| | | | - Bindu Menon
- University of Toledo College of Medicine and Life Sciences
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Baloch GM, Sundarasen S, Chinna K, Nurunnabi M, Kamaludin K, Khoshaim HB, Hossain SFA, AlSukayt A. COVID-19: exploring impacts of the pandemic and lockdown on mental health of Pakistani students. PeerJ 2021; 9:e10612. [PMID: 33604167 PMCID: PMC7866897 DOI: 10.7717/peerj.10612] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/30/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND As of the present, the twenty-first century is experiencing what may be one of its most devastating events, in respect to infected and dead people by the virus. Now known to the world as COVID-19, the devastating disease of what has become a pandemic started its spread from Wuhan, China and swiftly engulfed the whole world with almost 11 million cases, in a span of around six months. It has not only increased the global burden of disease but has heavily dented many social institutions, including education. METHODS This study investigates how the COVID-19 pandemic and subsequent measures of lockdown, quarantine, and social distancing have affected students. We look specifically into the effects on individuals' mental health, that is, the stress and anxiety levels of college and university students using the Zung Self-rating Anxiety Scale (SAS). RESULTS Among 494 respondents, 61% were females, and the majority (77.3%) of the students were in the age group of 19-25 years. Among the respondents, 125 (25.3%), 45 (9.1%) and 34 (6.9%) experienced minimal to moderate, severe, and most extreme levels of anxiety, respectively. The variables of gender, age and year of study were significant at the 0.25 level by univariate analyses. Nevertheless, the ordinal regression indicates that only gender was significant. The odds of a female student being more anxious are higher compared to a male student (OR = 1.779, 95% CI [1.202-2.634], P = 0.004). The most prominent stressors attained from the qualitative feedback from the Pakistani students are associated with online teaching, concerns about their academic performance and completion of the current semester, uncertainty related to exam dates, and the status of the following semester. CONCLUSIONS This study will add to the existing body of literature on the impacts of the COVID-19 pandemic on the social and psychological health of students. The study outcomes will provide basic data for further applied and action research and a framework for universities and policy makers in Pakistan and the neighboring countries in the region with the same cultural contexts. Thus, relevant health interventions can be designed for better mental health and educational attainments of students from higher educational institutions. This pathological pandemic may well lead to another pandemic of mental and behavioral illness. All stakeholders should join force regardless of pre-existing differences and inequalities to ensure the well-being of future generations, specifically students from higher educational institutions. The long-lasting impacts and the aftermath of this pandemic will unquestionably need further and future investigations. Keywords: Anxiety, students, mental health, COVID-19, Pakistan.
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Affiliation(s)
- Gul Muhammad Baloch
- School of Medicine, Faculty of Medical and Health Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Sheela Sundarasen
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Karuthan Chinna
- School of Medicine, Faculty of Medical and Health Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Mohammad Nurunnabi
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Kamilah Kamaludin
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Heba Bakr Khoshaim
- Deanship of Admission and Registration, Prince Sultan University, Riyadh, Saudi Arabia
| | - Syed Far Abid Hossain
- College of Business Administration, International University of Business Agriculture and Technology, Dhaka, Bangladesh
| | - Areej AlSukayt
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
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Unnithan AKA. A brief review of the neurological manifestations of the coronavirus disease. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020; 56:109. [PMID: 33250631 PMCID: PMC7681186 DOI: 10.1186/s41983-020-00244-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/09/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION It has been demonstrated experimentally that the coronavirus can enter the central nervous system through olfactory nerves and can even reach medulla. Neurological manifestations are observed more frequently in patients with coronavirus disease. MAIN TEXT The aim of the review is to seek evidence for infection of the nervous system by the human coronavirus and study the neurological manifestations of the coronavirus and its treatment. A search was done in PubMed, Google Scholar, CrossRef, and Scopus. There is evidence for the coronavirus infection of the nervous system from experimental studies, autopsy reports, and clinical studies. The virus can damage the nervous system either by direct viral damage to the neural cells or by immunopathology. Cerebral edema, neuronal degeneration, encephalitis, meningoencephalitis, acute disseminated encephalomyelitis, Guillain-Barré Syndrome, Bickerstaff's brainstem encephalitis, Miller Fisher syndrome, polyneuritis, toxic encephalopathy, and stroke can occur. The coronavirus has been demonstrated in the cerebrospinal fluid by polymerase chain reaction technique in infected patients. The abnormalities of the coagulation system increase the risk of cerebrovascular disease. Chloroquine analogs, lopinavir/ritonavir combination, remdesivir, dexamethasone, and immunoglobulin have been shown to be useful for the treatment. CONCLUSION There is substantial evidence for infection of the nervous system by the different strains of the human coronavirus. The coronavirus enters the nervous system either by the blood or from the olfactory nerves. The neurological diseases correlate with the severity of the coronavirus disease. The treatment is mainly supportive. The reports of patients with encephalitis, encephalomyelitis, and brainstem encephalitis show slow recovery. But a stroke has a high mortality.
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