The association between schizophrenia and increased COVID-19 mortality in a cohort of over 2 million people in Brazil

OBJECTIVE

To describe the clinical outcomes and risk factors of death related to mental disorders in a cohort of Brazilian hospitalized patients with COVID-19.

METHODS

This retrospective cohort study utilized the Brazilian database SIVEP-Gripe to analyze patients aged ≥18 years who had been hospitalized with COVID-19 between 2020 and 2022. The exposure of interest were mental disorders (anxiety, depression, schizophrenia, and bipolar disorder), identified through self-reported fields. The primary outcome was in-hospital mortality. Covariates included demographic and clinical features. Descriptive statistics, t-tests, chi-square tests, and binary logistic regression were used to analyze the data.

RESULTS

A cohort of 2,124,285 patients was included in the analysis, with 23,246 individuals (1.1%) having self-reported mental disorders. Among these mental disorders, depression was the most prevalent (52.3%). The mortality rate of the patients with mental disorders was 30.8%. Analysis of risk factors for mortality revealed that age, gender, region, dyspnea, low oxygen saturation, and comorbidities were associated with an increased risk of death. Patients with schizophrenia had a higher mortality risk (aOR:1.68;95%CI:1.54-1.81).

CONCLUSIONS

Patients diagnosed with schizophrenia have a greater likelihood of COVID-19- related death than those without mental health conditions. These findings underscore the significant effect of serious mental disorders on COVID-19 mortality.

Generalized anxiety disorder and associated factors in primary health care workers in Minas Gerais, Brazil

BACKGROUND

The COVID-19 pandemic had direct and indirect impacts on public health, also affecting the mental health of the population.

OBJECTIVE

To analyze symptoms of generalized anxiety disorder (GAD) and associated factors, in primary health care (PHC) professionals.

METHODS

Cross-sectional and analytical study conducted with professionals who work in the Primary Health Care (PHC) of the Northern health macro-region of the state of Minas Gerais, Brazil. Data collection was carried out through an online, self-administered questionnaire, made available from August 27, 2021, to October 30, 2021 using the Google Forms tool. The questionnaire included sociodemographic questions as well as questions related to the history of anxiety and work during the pandemic. To assess anxiety symptoms, the General Anxiety Disorder-7 (GAD-7) instrument was used. Data treatment consisted of descriptive analysis of the variables, bivariate analysis followed by multivariate Poisson Regression with robust variance.

RESULTS

702 health professionals participated in the study and the general prevalence of GAD was 32.2%. Current anxiety symptoms were self-reported by 37.6% of the participants. In the final model, the associated factors identified were: female sex (PR = 1.82; 95% CI = 1.17-2.84; p = 0.007), previous symptoms (PR = 1.58; 95% CI = 1.19-2.10; p = 0.002) and (PR = 2.68; 95% CI = 2.00-3.62; p < 0.001) current self-reported anxiety.

CONCLUSION

The results show the need to implement actions in mental health promotion and anxiety prevention, through the dissemination of information about mental health care, health education activities, encouraging the adoption of healthy habits and professional monitoring when necessary.

Maternal consumption of caffeine and second-hand tobacco smoke as risk factors for the development of oral clefts

OBJECTIVE

The aim of this case-control study was to investigate environmental factors, such as caffeine, folic acid, nutritional iron supplementation, multivitamin complexes, alcohol, and tobacco (second-hand smoking), which have been described as risk factors for the development of oral clefts.

METHODS

This case-control study employed convenience sampling and included 409 mothers: 132 with children with oral clefts (cases) and 277 with children without oral clefts (controls). The age range of the children in both groups was 0 to 2 years. A questionnaire was administered to each mother to inquire about their habits and food consumption during the first trimester of pregnancy.

RESULTS

Folic acid supplementation was observed in 116 (87.8%) of the case group (p < 0.001) and 271 (97.8%) of the control group. Regarding the use of ferrous sulfate, 114 (86.3%) of the case group and 271 (97.8%) of the control group reported using it. In the case group, 84 (63.6%) mothers reported being exposed to second-hand smoke, and 5 (3.7%) reported alcohol consumption (p = 0.797). In terms of caffeine consumption, 127 mothers (95.4%) in the case group consumed it (p = 0.13), while 247 (88.8%) reported consumption in the control group.

CONCLUSIONS

The results suggest a direct relationship between secondhand smoke, alcohol consumption, and the lack of maternal supplementation with oral clefts.

Isolated nonsyndromic cleft palate: multicenter epidemiological study in the Brazil

BACKGROUND

Nonsyndromic orofacial clefts (NSOC) are the craniofacial most common congenital malformations. There are evidences that the nonsyndromic cleft palate (NSCP) development differs from other NSOC. However, most of the publications treat NSCP without considering that information. Furthermore, few studies focus on NSCP. The aim of this study was to describe epidemiological findings of patients with isolated NSCP in Brazil.

METHODS

In this cross-sectional multicenter study, four reference Centers for treatment in three different Brazilian states was investigated. Data were obtained from clinical records of patients, between November 2021 and June 2022. Researched variables were sociodemographic, clinical characteristics and pregnancy and family history. Pearson's chi-square and ANOVA One-way tests were used for associations.

RESULTS

Majority were female (58.1%), white (60.7%) with incomplete NSCP (61.2%). There was an association between complete NSCP and a positive history of medical problems during pregnancy (p = 0.016; 27.9%; OR: 1.94; 1.12-3.35). Systemic alterations were perceived in 40.6% of the sample with odds ratio for development of the complete type (OR: 1.21; 0.74-1.97). Higher OR was visualized in medication use during pregnancy (OR: 1.35; 0.76-2.37) and positive family history of oral cleft (OR: 1.44; 0.80-2.55). Dental and surgical care was associated with higher age groups (p < 0.050).

CONCLUSIONS

NSCP was most prevalent in white skin color female. Complete NSCP is associated with medical problems during pregnancy. Medication use during pregnancy and positive family history of oral cleft increase the chance of developing complete NSCP.

Common mental disorders in Primary Health Care professionals during the COVID-19 pandemic period: a cross-sectional study in the Northern health macro-region of Minas Gerais state, Brazil, 2021

OBJECTIVE

to analyze the prevalence of symptoms of common mental disorders (CMDs) in Primary Health Care professionals between August-October/2021.

METHODS

this was a cross-sectional study conducted with health professionals in the Northern health macro-region of Minas Gerais state; snowball sampling was used; the dependent variable, CMDs, was evaluated using the Self-Reporting Questionnaire (SRQ-20); Poisson regression was used to perform the statistical analysis.

RESULTS

a total of 702 health professionals took part in the study; the prevalence of CDMs was 43.2%. It was higher in those with previous [prevalence ratios (PR) = 2.42; 95%CI 1.43;4.08] and current (PR = 1.54; 95%CI 1.25;1.89) symptoms of mental disorders, overwork during the pandemic (PR = 1.42; 95%CI 1.16;1.73), previous symptoms of anxiety (PR = 1.27; 95%CI 1.01;1.61), depression (PR = 1.27; 95%CI 1.06;1.52) and other mental disorders (PR = 1.20; 95%CI 1.01;1.43).

CONCLUSION

there was an association between CDMs and presenting previous and current symptoms of mental disorders and work overload during the covid-19 pandemic.

Prevalência de transtornos mentais em profissionais de saúde durante a pandemia da COVID-19: revisão sistemática

RESUMO Objetivo: Realizar uma revisão sistemática da literatura avaliando a prevalência de transtornos mentais em profissionais da saúde durante a pandemia da COVID-19. Métodos: Trata-se de revisão sistemática conduzida com base no checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). As bases de dados usadas foram a Biblioteca Virtual de Saúde (BVS) e os serviços da United States National Library of Medicine (NLM) via PubMed, com as estratégias de busca: “COVID-19” AND “Saúde mental”; “COVID-19” AND “Saúde mental” AND “pessoal de saúde”, em português e inglês, selecionando artigos observacionais e/ou de prevalência publicados a partir de 2020. Resultados: A busca resultou na identificação de 18.643 artigos, e a amostra final foi composta por 9 artigos. Os sintomas mais frequentes foram os de depressão, ansiedade e insônia em profissionais que atuaram no período da pandemia da COVID-19, predominantemente do sexo feminino e idade média de 34,5 anos. A média da prevalência de ansiedade, depressão e insônia foi, respectivamente, de 40,3%, 39,9% e 36,1%, aferidas em 8.866 profissionais da saúde. Os profissionais atuantes na linha de frente no combate à COVID-19 apresentaram maiores prevalências de transtornos mentais comuns em relação a outros profissionais de saúde. Conclusões: Mostraram-se associadas a maiores prevalências de sintomas de TMC: sexo feminino, atuação na linha de frente, maior jornada de trabalho, histórico de uso de medicamentos psicotrópicos, condições inadequadas de trabalho, uso de álcool e tabaco e atuação na área de enfermagem. Observa-se a importância de estratégias de atenção à saúde mental dos profissionais de saúde.