Monitoramento das Produções

by Esraa S. A. Alfadul, Malaz Mohammed Idrees Abdalmotalib, Salma Salah Khalid Alrawa, Rama Osman Abdelrahman Osman, Hadiea Mosaab AhmedElbashir Hassan, Alsamany taha albasheir, Elfatih A. Hasabo, Sagad O. O. Mohamed, Kamil Mirghani Ali Shaaban
Background Burnout prevalence and its consequences on healthcare workers during the Omicron wave are not well investigated in Sudan. This study aims to assess the prevalence of burnout and its associated factors among doctors and nurses during the omicron wave in COVID-19 isolation centres in Khartoum, Sudan. Method This cross-sectional survey study was conducted at multiple COVID-19 isolation centres in Khartoum state during the omicron wave of Coronavirus Disease 2019 between 20th February 2022 and 10th April 2022. A total of 306 doctors and nurses filled out the questionnaire, with a response rate of 64.8℅. They were recruited from 5 isolation centers scattered in the three cities of Khartoum Metropolis. The level of burnout was assessed using an online semi-structured questionnaire based on the Oldenburg Burnout Inventory questionnaire. Descriptive statistics were used for continuous variables and frequencies with percentages for categorical variables. The Chi-square test and Fisher exact test were used to identify variables associated with burnout. Logistic regression was used to determine the factors associated with burnout, and the p-value of ≤ .05 is considered statistically significant. Results The prevalence of burnout was 45.7%. Doctors were more likely to have burnout than nurses (OR: 2.01, CI 95% 1.24–3.27; p = 0.005). Also, married healthcare workers were more likely to suffer burnout than single healthcare workers (OR: 3.89, CI 95% 1.41–12.5; P = 0.013). The number of household members (p = 0.035) was associated with burnout among participants. Conclusion There is a high prevalence of burnout among healthcare workers in Khartoum Isolation Centers, which is more apparent among doctors.

by Brian D. Nicholson, Philip J. Turner, Thomas R. Fanshawe, Alice J. Williams, Gayatri Amirthalingam, Sharon Tonner, Maria Zambon, Richard Body, Kerrie Davies, Rafael Perera, Simon de Lusignan, Gail N. Hayward, F.D. Richard Hobbs, on behalf of the RAPTOR-C19 Study Group and the CONDOR Steering Committee
Background and objective Point-of-care lateral flow device antigen testing has been used extensively to identify individuals with active SARS-CoV-2 infection in the community. This study aimed to evaluate the diagnostic accuracy of two point-of-care tests (POCTs) for SARS-CoV-2 in routine community care. Methods Adults and children with symptoms consistent with suspected current COVID-19 infection were prospectively recruited from 19 UK general practices and two COVID-19 testing centres between October 2020 and October 2021. Participants were tested by trained healthcare workers using at least one of two index POCTs (Roche-branded SD Biosensor Standard™ Q SARS-CoV-2 Rapid Antigen Test and/or BD Veritor™ System for Rapid Detection of SARS-CoV-2). The reference standard was laboratory triplex reverse transcription quantitative PCR (RT-PCR) using a combined nasal/oropharyngeal swab. Diagnostic accuracy parameters were estimated, with 95% confidence intervals (CIs), overall, in relation to RT-PCR cycle threshold and in pre-specified subgroups. Results Of 663 participants included in the primary analysis, 39.2% (260/663, 95% CI 35.5% to 43.0%) had a positive RT-PCR result. The SD Biosensor POCT had sensitivity 84.0% (178/212, 78.3% to 88.6%) and specificity 98.5% (328/333, 96.5% to 99.5%), and the BD Veritor POCT had sensitivity 76.5% (127/166, 69.3% to 82.7%) and specificity 98.8% (249/252, 96.6% to 99.8%) compared with RT-PCR. Sensitivity of both devices dropped substantially at cycle thresholds ≥30 and in participants more than 7 days after onset of symptoms. Conclusions Both POCTs assessed exceed the Medicines and Healthcare products Regulatory Agency target product profile’s minimum acceptable specificity of 95%. Confidence intervals for both tests include the minimum acceptable sensitivity of 80%. In symptomatic patients, negative results on these two POCTs do not preclude the possibility of infection. Tests should not be expected to reliably detect disease more than a week after symptom onset, when viral load may be reduced. Registration ISRCTN142269.

by Jessica Soldavini, Margaret Read, Lauren Clay
Objective The goal of this scoping review is to examine the published research on federal nutrition assistance programs administered by the United States (U.S.) Department of Agriculture during the COVID-19 pandemic, in the U.S., U.S. territories, and tribal nations. The review will identify the scope of the available research and provide research and policy recommendations. Introduction The COVID-19 pandemic made individuals more vulnerable to experiencing food insecurity. Federal nutrition assistance programs help to address food insecurity and have been rapidly adapting to meet food and nutrition needs among affected communities during the COVID-19 pandemic. It is important to understand the scope of the current research on this topic to help inform future research, practice, and policy recommendations. Inclusion criteria This review will include studies focused on federal nutrition assistance programs administered by the U.S. Department of Agriculture during the COVID-19 pandemic. The scoping review will consider all primary research designs. Methods Pubmed, CINHAL, Scopus, and Proquest’s Health Management databases will be used for the literature search. Only articles published in English since March 1, 2020 will be considered. Titles/abstracts followed by full-text articles will be reviewed to determine which articles meet the inclusion criteria and should be included in the review. Data will be extracted from each included article using a data extraction template in Covidence that will be developed by the study team. Data extracted will include information on key findings related to the review questions. At each step, two independent reviewers will be assigned to each article. Data will be summarized and presented in tables, charts, and narrative summary.

by Jitka Slabá

This study evaluates the impacts of the COVID-19 pandemic on the reproductive behavior of men and women during the most restrictive period of the pandemic in Czechia. At the end of this period, data was collected for the Czech GGS COVID Pilot–Follow-up Study (April 2021), which included additional questions on reproductive plans and perceptions of the pandemic related to fertility. The study focuses in detail on the evaluation of the favorability of fertility during this period by considering the impact of the pandemic on the lives of individuals in various life areas. It subsequently attempts to determine to what extent this evaluation and personal experiences of the pandemic affected reproductive behavior (the intended number of children, current attempts to conceive and short-term fertility intentions). In summary, in most cases the respondents considered the most severe period of the pandemic to be unfavorable in terms of childbirth. Women provided an overall negative assessment of the favorability of childbirth in this period, which was reflected in a reduction in the planned number of children, while the men who considered this period favorable declared a higher chance of short-term fertility intentions.

by Nissim Arish, Gabriel Izbicki, Ariel Rokach, Amir Jarjou’i, George Kalak, Shmuel Goldberg

Patients with coronavirus 2019 (COVID-19) and obstructive sleep apnoea (OSA) have a worse prognosis than COVID-19 patients without OSA. This study aimed to examine the relationship between OSA risk and the severity of COVID-19 in patients undiagnosed with OSA. Patients diagnosed with COVID-19 and hospitalized or admitted to a community hotel were recruited for the study after recovery during a clinic check-up visit 6–8 weeks after discharge. At this visit, they answered the Epworth Sleeping Scale (ESS) and Berlin questionnaire. Demographic and clinical details were collected from electronic medical records. OSA risk was observed in 37 of 119 included patients (31.1%). Patients with high OSA risk were male, significantly older, had a higher body mass index (BMI), and had higher rates of hypertension and snoring than patients with low OSA risk. Moreover, OSA risk was associated with COVID-19 severity; 48.6% of patients with high risk for OSA suffered from severe COVID-19 compared to 22% of patients with low risk for OSA (p = 0.007). The duration of hospitalization for patients with a high OSA risk was 10.97±9.43 days, while that for those with a low OSA risk was 4.71±6.86 days (p = 0.001). After adjusting for BMI, age, hypertension, and chronic disease, the odds ratio was 4.3 (95%CI, 1.2–16, p = 0.029). A high OSA risk was associated with severe COVID-19 and longer hospitalization. Thus, we recommend that the Berlin and ESS questionnaires be completed for every COVID-19-infected patient at hospitalization, especially in the presence of comorbidities.

by Salomé Henriette Paulette Drouard, Tashrik Ahmed, Pablo Amor Fernandez, Prativa Baral, Michael Peters, Peter Hansen, Tawab Hashemi, Isidore Sieleunou, Munirat Iyabode Ogunlayi, Alain-Desire Karibwami, Julie Ruel Bergeron, Edwin Eduardo Montufar Velarde, Mohamed Lamine Yansane, Chea Sanford Wesseh, Charles Mwansambo, Charles Nzelu, Helal Uddin, Mahamadi Tassembedo, Gil Shapira
Background Availability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs. Methods Data were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE. Results There were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not. Conclusion After more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.

by Wenxuan Chen, Songlei Chao, Jianliang Ye

Optimizing the trade-off between economic growth and public health is a major goal of public administration, especially during public health events. Although containment measures are widely used to combat the Covid-19 outbreak, it is still debated how the measures affect the economy. Using a simplified susceptible-infected-recovered (SIR) model, this study investigates the dynamic impact of lockdown policy on social costs during the epidemic and the underlying mechanism, revealing that the lockdown policy has both a “shutdown effect” and an “anti-epidemic effect”, and should be implemented and lifted in a timely manner. Based on a micro-level dataset of 57,547 private enterprises in China in 2020, this study provided empirical evidence for the presence of negative “shutdown effect” and positive “anti-epidemic effect” of lockdown on reopening, both of which are in part mediated by labor input, factor mobility, and market demand recovery. Furthermore, the shutdown effect is weaker in regions with sufficient testing and quarantine resources, government capacity and preference for targeted response, whereas the anti-epidemic effect is stronger in densely populated areas with relatively low public compliance. Additionally, digital measures can aid in the containment of epidemics. The findings not only contribute to a better understanding of the rationality and effectiveness of the lockdown policy, but also provides practical evidence and implications for the government to improve the synergistic efficiency of epidemic control tools and strengthen the resilience of local economic growth.

by Alex Abramovich, Nelson Pang, Kawon Victoria Kim, Rowen K. Stark, Shannon Lange, Michael Chaiton, Carmen H. Logie, Hayley A. Hamilton, Sean A. Kidd
Introduction The objective of this study was to examine the impacts of the coronavirus 2019 (COVID-19) pandemic on various dimensions of wellbeing among 2SLGBTQ+ youth experiencing homelessness over a 12-month period during the COVID-19 pandemic. Methods 2SLGBTQ+ youth (recruited using a convenience sampling method) participated in three online surveys to assess mental health (depression, anxiety, suicidality), substance and alcohol use, health care access, and violence for 12-months between 2021–2022. Quantitative data analysis included non-parametric one-sample proportion tests, paired t-test and McNemar’s test. Longitudinal data collected across all three timepoints were treated as paired data and compared to baseline data using non-parametric exact multinomial tests, and if significant, followed by pairwise post-hoc exact binomial tests. For the purposes of analysis, participants were grouped according to their baseline survey based on pandemic waves and public health restrictions. Results 2SLGBTQ+ youth experiencing homelessness (n = 87) reported high rates of mental health challenges, including anxiety and depression, over 12-months during the pandemic. Youth participants reported experiencing poor mental health during the early waves of the pandemic, with improvements to their mental health throughout the pandemic; however, results were not statistically significant. Likewise, participants experienced reduced access to mental health care during the early waves of the pandemic but mental health care access increased for youth throughout the pandemic. Conclusion Study results showed high rates of mental health issues among 2SLGBTQ+ youth, but reduced access to mental health care, due to the COVID-19 pandemic. Findings highlight the need for 2SLGBTQ+ inclusive and affirming mental health care and services to address social and mental health issues that have been exacerbated by the pandemic.

by Katie J. Shillington, Julia Yates, Leigh M. Vanderloo, Shauna M. Burke, Victor Ng, Patricia Tucker, Jennifer D. Irwin

The COVID-19 pandemic has provided a collective opportunity to engage in prosocial behaviours, including kindness; however, little is known about the long-term impacts of the pandemic on such behaviours. As a part of a larger study (Health Outcomes for Adults During and Following the COVID-19 Pandemic), the purpose of this mixed methods research was two-fold: (1) to quantitatively explore adults’ prosocial behaviour over time during the first 16 months of the pandemic in Ontario, Canada (April 2020-August 2021); and, (2) to more deeply explore, via focus groups, a sub-sample of Ontario adults’ lived experiences of prosocial behaviour (assessed March 2022). A total of 2,188 participants were included in this study, with the majority of participants identifying as female (89.5%). At three time points, participants completed online questionnaires which included demographics, Prosocialness Scale for Adults, and three global kindness questions. A subset of participants (n = 42) also participated in one of six focus groups exploring their experiences of prosocial behaviour during the pandemic. A series of one-way repeated measures ANOVAs revealed that participants’ self-reported prosocial behaviour increased significantly over time, while participants’ awareness of kindness, engagement in acts of kindness, and view of kindness as crucial significantly decreased. Thematic analysis revealed three main themes: (1) shift in prosocial behaviour during the pandemic; (2) kindness from various perspectives; and, (3) prosocial burnout. This study provides insight into the longer-term effects of the pandemic on adults’ prosocial behaviours and should be leveraged to help understand how individuals respond in times of crises.

by Iván Dueñas-Espín, María Echeverría-Mora, Camila Montenegro-Fárez, Manuel Baldeón, Luis Chantong Villacres, Hugo Espejo Cárdenas, Marco Fornasini, Miguel Ochoa Andrade, Carlos Solís
Objective To develop and validate a scoring system to predict mortality among hospitalized patients with COVID-19. Methods Retrospective cohort study. We analyzed 5,062 analyzed hospitalized patients with COVID-19 treated at two hospitals; one each in Quito and Guayaquil, from February to July 2020. We assessed predictors of mortality using survival analyses and Cox models. We randomly divided the database into two sets: (i) the derivation cohort (n = 2497) to identify predictors of mortality, and (ii) the validation cohort (n = 2565) to test the discriminative ability of a scoring system. After multivariate analyses, we used the final model’s β-coefficients to build the score. Statistical analyses involved the development of a Cox proportional hazards regression model, assessment of goodness of fit, discrimination, and calibration. Results There was a higher mortality risk for these factors: male sex [(hazard ratio (HR) = 1.32, 95% confidence interval (95% CI): 1.03–1.69], per each increase in a quartile of ages (HR = 1.44, 95% CI: 1.24–1.67) considering the younger group (17–44 years old) as the reference, presence of hypoxemia (HR = 1.40, 95% CI: 1.01–1.95), hypoglycemia and hospital hyperglycemia (HR = 1.99, 95% CI: 1.01–3.91, and HR = 1.27, 95% CI: 0.99–1.62, respectively) when compared with normoglycemia, an AST–ALT ratio >1 (HR = 1.55, 95% CI: 1.25–1.92), C-reactive protein level (CRP) of >10 mg/dL (HR = 1.49, 95% CI: 1.07–2.08), arterial pH 10 × 103 per μL (HR = 1.76, 95% CI: 1.35–2.29). We found a strong discriminative ability in the proposed score in the validation cohort [AUC of 0.876 (95% CI: 0.822–0.930)], moreover, a cutoff score ≥39 points demonstrates superior performance with a sensitivity of 93.10%, a specificity of 70.28%, and a correct classification rate of 72.66%. The LR+ (3.1328) and LR- (0.0981) values further support its efficacy in identifying high-risk patients. Conclusion Male sex, increasing age, hypoxemia, hypoglycemia or hospital hyperglycemia, AST–ALT ratio >1, elevated CRP, altered arterial pH, and leucocytosis were factors significantly associated with higher mortality in hospitalized patients with COVID-19. A statistically significant Cox regression model with strong discriminatory power and good calibration was developed to predict mortality in hospitalized patients with COVID-19, highlighting its potential clinical utility.

by Nikola Mitrovic, Milos Sabanovic, Ankica Vujovic, Jaroslava Jovanovic, Natasa Nikolic, Martina Jug, Nevena Todorovic, Ana Filipovic, Ivana Milosevic
Introduction Coronavirus disease of 2019 (COVID-19) is a global health problem. The impact of chronic liver diseases on the course and outcome of COVID-19 is still the subject of research. The aim of this study was to show the characteristics of COVID-19 patients with chronic liver diseases, and to establish the risk factors for unfavourable outcome. Methods A retrospective observational study was conducted at the Infectious Disease Clinic in Belgrade, Serbia, and included 80 patients with chronic liver diseases and COVID-19 within a time frame of two years (between 15 March 2020 and 15 March 2022). Characteristics of the affected persons, as well as the risk factors for a fatal outcome, were analyzed. Results Of the 80 subjects in the study, 23.8% had chronic viral hepatitis, 12.5% autoimmune liver diseases and alcoholic liver disease respectively, 30% had non-alcoholic fatty liver disease, while 11.2% had chronic liver diseases of unknown aetiology. A total of 33.7% had cirrhosis, 6.3% hepatocellular carcinoma and 5% had liver transplants. A total of 92.5% of respondents had pneumonia (21.2% were critically ill). A deterioration of chronic liver disease was registered among 33.7% of patients, and decompensation in 3.8%; 76.3% patients recovered, while 23.7% had a lethal outcome. Risk factors for lethal outcome by univariate analysis were: alcoholic liver disease, cirrhosis, increased transaminases values prior to COVID-19, malignancy, severe pneumonia and dyspnea. In a multivariate analysis, the presence of liver cirrhosis (OR = 69.1, p = 0.001) and severe pneumonia (OR = 22.3, p = 0.006) remained independently predictive for lethal outcome. Conclusion These findings will help with the evaluation of COVID-19 patients who have chronic liver diseases and will improve their risk stratification.

by Gilberto Sánchez-González, Renaud Condé

The Dengue virus (DENV) constitutes a major vector borne virus disease worldwide. Prediction of the DENV spread dynamics, prevalence and infection rates are crucial elements to guide the public health services effort towards meaningful actions. The existence of four DENV serotypes further complicates the virus proliferation forecast. The different serotypes have varying clinical impacts, and the symptomatology of the infection is dependent on the infection history of the patient. Therefore, changes in the prevalent DENV serotype found in one location have a profound impact on the regional public health. The prediction of the spread and intensity of infection of the individual DENV serotypes in specific locations would allow the authorities to plan local pesticide spray to control the vector as well as the purchase of specific antibody therapy. Here we used a mathematical model to predict serotype-specific DENV prevalence and overall case burden in Mexico.

by Candace C. Fuller, Austin Cosgrove, Mayura Shinde, Edward Rosen, Katie Haffenreffer, Christian Hague, Laura E. McLean, Jonathan Perlin, Russell E. Poland, Kenneth E. Sands, Natasha Pratt, Patricia Bright, Richard Platt, Noelle M. Cocoros, Sarah K. Dutcher

We described care received by hospitalized children with COVID-19 or multi-system inflammatory syndrome (MIS-C) prior to the 2021 COVID-19 Omicron variant surge in the US. We identified hospitalized children 6 years old (54% COVID-19, 70% MIS-C). High-risk conditions included asthma (14% COVID-19, 11% MIS-C), and obesity (9% COVID-19, 10% MIS-C). Pulmonary complications in children with COVID-19 included viral pneumonia (24%) and acute respiratory failure (11%). In reference to children with COVID-19, those with MIS-C had more hematological disorders (62% vs 34%), sepsis (16% vs 6%), pericarditis (13% vs 2%), myocarditis (8% vs 1%). Few were ventilated or died, but some required oxygen support (38% COVID-19, 45% MIS-C) or intensive care (42% COVID-19, 69% MIS-C). Treatments included: methylprednisolone (34% COVID-19, 75% MIS-C), dexamethasone (25% COVID-19, 15% MIS-C), remdesivir (13% COVID-19, 5% MIS-C). Antibiotics (50% COVID-19, 68% MIS-C) and low-molecular weight heparin (17% COVID-19, 34% MIS-C) were frequently administered. Markers of illness severity among hospitalized children with COVID-19 prior to the 2021 Omicron surge are consistent with previous studies. We report important trends on treatments in hospitalized children with COVID-19 to improve the understanding of real-world treatment patterns in this population.

by Onur Elbasan, Feyza Bayram, Ceyda Dinçer Yazan, Tuğçe Apaydın, Saida Dashdamirova, Hamza Polat, Ebru Arslan, İpek Yılmaz, Nastaran Karimi, Buket Ertürk Şengel, Sultan Seval Yılmaz, Ömer Faruk Çelik, Pınar Ata, Goncagül Haklar, Hülya Gözü
Background The renin-angiotensin-aldosterone system was shown to be activated in severe COVID-19 infection. We aimed to investigate the relationship between angiotensin converting enzyme (ACE) levels, ACE gene polymorphism, type 2 diabetes (T2DM), and hypertension (HT) and the prognosis of COVID-19 infection. Methods This cross-sectional study analyzed the clinical features of adult patients with SARS-CoV-2 infection. ACE gene analysis and ACE level measurements were performed. The patients were grouped according to ACE gene polymorphism (DD, ID or II), disease severity (mild, moderate, or severe), and the use of dipeptidyl peptidase-4 enzyme inhibitor (DPP4i), ACE-inhibitor (ACEi) or angiotensin receptor blocker (ARB). Intensive care unit (ICU) admissions and mortality were also recorded. Results A total of 266 patients were enrolled. Gene analysis detected DD polymorphism in the ACE 1 gene in 32.7% (n = 87), ID in 51.5% (n = 137), and II in 15.8% (n = 42) of the patients. ACE gene polymorphisms were not associated with disease severity, ICU admission, or mortality. ACE levels were higher in patients who died (p = 0.004) or were admitted to the ICU (p

by Ida Ayu Sutrisni, Aria Kekalih, Dewi Friska, Diana Timoria, Ralalicia Limato, Ragil Dien, Claus Bogh, Mary Chambers, Sonia Lewycka, Jennifer Ilo Van Nuil, Raph L Hamers, on behalf of the OUCRU COVID-19 Research Group
Introduction During the COVID-19 pandemic, healthcare workers (HCWs) faced unprecedented challenges, increased workload, and often struggled to provide healthcare services. We explored the experiences faced by HCWs working at primary healthcare centers (PHCs) and hospitals across urban and rural settings in Indonesia. Methods As part of a larger multi-country study, we conducted semi-structured in-depth interviews with a purposive sample of Indonesian HCWs. We used thematic analysis to identify the main challenges described by the participants. Results We interviewed 40 HCWs between December 2020 and March 2021. We identified that challenges varied depending on their role. i) For those in clinical roles, challenges included maintaining trust with communities, and patient referral issues; ii) for those in non-clinical roles, sub-optimal laboratory capacity and logistics, and lack of training were the main challenges; iii) for managerial roles, challenges included access to budget and supplies, and staff shortages due to isolation and overwork. There were also several cross-cutting challenges across all the roles including limited or rapidly changing information (in urban settings), and culture and communication (in rural settings). All of these challenges contributed to mental health issues among all HCW cadres. Conclusions HCWs across roles and settings were confronted with unprecedented challenges. Understanding the various challenges across different healthcare cadres and within different settings is crucial for supporting HCWs during pandemic times. In rural areas, in particular, HCWs should be more sensitive to cultural and linguistic differences to enhance the effectiveness and awareness of public health messages.

by Remco H. A. Ebben, Tim Woensdregt, Etty Wielenga-Meijer, Thomas Pelgrim, Annet de Lange, Sivera A. A. Berben, Lilian C. M. Vloet

The COVID-19 pandemic has a significant impact on the health and well-being of all healthcare professionals. However, for ambulance care professionals it is unknown on which health outcomes the impact of COVID-19 is measured, and what the actual impact on these health outcomes is. Therefore, the aim of this study was to gain insight in a) which type of health outcomes were measured in relation to the impact of COVID-19 among ambulance care professionals, and b) to determine the actual impact on these outcomes. A rapid review was performed in PubMed (including MEDLINE) and APA PsycInfo (EBSCO). All types of study designs on health and well-being of ambulance care professionals were included. Selection on title an abstract was performed by pairs of two reviewers. Full text selection, data extraction and quality assessment were performed by one reviewer, with a check by a second independent reviewer. The systematic searches identified 3906 unique hits, seven articles meeting selection criteria were included. Six studies quantitatively measured distress (36,0%) and PTSD (18.5%-30.9%), anxiety (14.2%-65.6%), depression (12.4%-15.3%), insomnia (60.9%), fear of infection and transmission of infection (41%-68%), and psychological burden (49.4%-92.2%). These studies used a variety of instruments, ranging from internationally validated instruments to self-developed and unvalidated questionnaires. One study qualitatively explored coping with COVID-19 by ambulance care professionals and reported that ambulance care professionals use five different strategies to cope with the impact of COVID-19. There is limited attention for the health and well-being of ambulance care professionals during the COVID-19 pandemic. Although the included number of studies and included outcomes are too limited to draw strong conclusions, our results indicate higher rates of distress, PTSD and insomnia compared to the pre-COVID-19 era. Our results urge the need to investigate the health and well-being of ambulance care professionals during and after the COVID-19 pandemic.

by Naween Weerasinghe, Ashani Weerasinghe, Yulashika Perera, Sanduni Tennakoon, Nilmini Rathnayake, Punmadara Jayasinghe

The apparel and textile industry is the backbone of the Sri Lankan economy, contributing significantly to the country’s gross domestic product (GDP). The coronavirus (COVID-19) pandemic, which also triggered the ongoing economic crisis in Sri Lanka, has a profound effect on the organizational performance of apparel sector firms in Sri Lanka. In this context, the study examines the impact of multi-dimensional corporate sustainability practices on organizational performance in the said sector. The study employed the partial least squares structural equation modelling (PLS-SEM) technique for analysing and testing the hypothesis of the study while using Smart PLS 4.0 software as the analysis tool. Relevant data were collected through a questionnaire from 300 apparel firms registered with the Board of Investment of Sri Lanka (BOI). The study results indicated that "economic vigour,” “ethical practices," and "social equity" have a significant impact on organizational performance, while "corporate governance" and "environmental performance" have an insignificant impact. Unique discoveries from this study would be useful to prosper organizational performance and formulate novel sustainable future strategies not limited to the garment industry even during harsh economic conditions.

by Tiffany A. Walker, Alex D. Truong, Aerica Summers, Adviteeya N. Dixit, Felicia C. Goldstein, Ihab Hajjar, Melvin R. Echols, Matthew C. Woodruff, Erica D. Lee, Seema Tekwani, Kelley Carroll, Ignacio Sanz, F. Eun-Hyung Lee, Jenny E. Han
Background The impact of COVID-19 severity on development of long-term sequelae remains unclear, and symptom courses are not well defined. Methods This ambidirectional cohort study recruited adults with new or worsening symptoms lasting ≥3 weeks from confirmed SARS-CoV-2 infection between August 2020–December 2021. COVID-19 severity was defined as severe for those requiring hospitalization and mild for those not. Symptoms were collected using standardized questionnaires. Multivariable logistical regression estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between clinical variables and symptoms. Results Of 332 participants enrolled, median age was 52 years (IQR 42–62), 233 (70%) were female, and 172 (52%) were African American. Antecedent COVID-19 was mild in 171 (52%) and severe in 161 (48%). In adjusted models relative to severe cases, mild COVID-19 was associated with greater odds of fatigue (OR:1.83, CI:1.01–3.31), subjective cognitive impairment (OR:2.76, CI:1.53–5.00), headaches (OR:2.15, CI:1.05–4.44), and dizziness (OR:2.41, CI:1.18–4.92). Remdesivir treatment was associated with less fatigue (OR:0.47, CI:0.26–0.86) and fewer participants scoring >1.5 SD on PROMIS Cognitive scales (OR:0.43, CI:0.20–0.92). Fatigue and subjective cognitive impairment prevalence was higher 3–6 months after COVID-19 and persisted (fatigue OR:3.29, CI:2.08–5.20; cognitive OR:2.62, CI:1.67–4.11). Headache was highest at 9–12 months (OR:5.80, CI:1.94–17.3). Conclusions Mild antecedent COVID-19 was associated with highly prevalent symptoms, and those treated with remdesivir developed less fatigue and cognitive impairment. Sequelae had a delayed peak, ranging 3–12 months post infection, and many did not improve over time, underscoring the importance of targeted preventative measures.

by Prativa Baral, Tashrik Ahmed, Pablo Amor Fernandez, Michael A. Peters, Salome Henriette Paulette Drouard, Pierre Muhoza, George Mwinnyaa, Charles Mwansambo, Charles Nzelu, Mahamadi Tassembedo, Md. Helal Uddin, Chea Sanford Wesseh, Mohamed Lamine Yansane, Julie Ruel Bergeron, Alain-Desire Karibwami, Tania Inmaculada Ortiz de Zuniga Lopez Chicheri, Munirat Iyabode Ayoka Ogunlayi, Isidore Sieleunou, Tawab Hashemi, Peter M. Hansen, Gil Shapira
Background Vaccine hesitancy remains a critical barrier in mitigating the effects of the ongoing COVID-19 pandemic. The willingness of health care workers (HCWs) to be vaccinated, and, in turn, recommend the COVID-19 vaccine for their patient population is an important strategy. This study aims to understand the uptake of COVID-19 vaccines and the reasoning for vaccine hesitancy among facility-based health care workers (HCWs) in LMICs. Methods We conducted nationally representative phone-based rapid-cycle surveys across facilities in six LMICs to better understand COVID-19 vaccine hesitancy. We gathered data on vaccine uptake among facility managers, their perceptions of vaccine uptake and hesitancy among the HCWs operating in their facilities, and their perception of vaccine hesitancy among the patient population served by the facility. Results 1,148 unique public health facilities participated in the study, with vaccines being almost universally offered to facility-based respondents across five out of six countries. Among facility respondents who have been offered the vaccine, more than 9 in 10 survey respondents had already been vaccinated at the time of data collection. Vaccine uptake among other HCWs at the facility was similarly high. Over 90% of facilities in Bangladesh, Liberia, Malawi, and Nigeria reported that all or most staff had already received the COVID-19 vaccine when the survey was conducted. Concerns about side effects predominantly drive vaccine hesitancy in both HCWs and the patient population. Conclusion Our findings indicate that the opportunity to get vaccinated in participating public facilities is almost universal. We find vaccine hesitancy among facility-based HCWs, as reported by respondents, to be very low. This suggests that a potentially effective effort to increase vaccine uptake equitably would be to channel promotional activities through health facilities and HCWs.However, reasons for hesitancy, even if limited, are far from uniform across countries, highlighting the need for audience-specific messaging.

by Tasneem M. Al-Jaberi, Anas A. Al-Nabulsi, Tareq M. Osaili, Amin N. Olaimat, Sawsan Mutlaq

Concerns over food safety issues during the coronavirus pandemic (COVID-19) have sparked worldwide interest. Being part of a farm-to-fork food safety chain, food handlers at home are the final line of defense in reducing foodborne diseases. The present study used a cross-sectional survey to investigate the knowledge, attitudes, and practices (KAP) of women food handlers in Jordan. The survey investigated the effect of the COVID-19 pandemic on women who handle food at home in terms of food safety KAP. One thousand one hundred twenty-six respondents completed a food safety questionnaire during the COVID-19 pandemic. With a mean score of 22.1 points out of 42, the results showed that women who handle food in their houses had insufficient knowledge, negative attitudes, and incorrect practices concerning food safety. The respondents demonstrated high knowledge, attitudes, and practices in the personal hygiene, cleaning and sanitation areas (≥ 60.0%). On the other hand, participants’ knowledge, attitudes, and practices regarding contamination prevention, health issues that would affect food safety, symptoms of foodborne illnesses, safe storage, thawing, cooking, keeping, and reheating of foods, as well as COVID-19 were all low ( 60.0%). The correlations between participants’ total food safety KAP scores and education, age, experience, region, and the pandemic effect on food safety were statistically significant (P ≤ 0.05). To the best of our knowledge, this study is the first conducted in Jordan to investigate food safety knowledge, attitudes, and practices by women handling food at home during the COVID-19 pandemic.

by Nitai Roy, Md. Bony Amin, Mohammed A. Mamun, Bibhuti Sarker, Ekhtear Hossain, Md. Aktarujjaman
Background The COVID-19 pandemic has had a profound impact on the mental health of individuals across various populations. People with disabilities (PWDs) are particularly vulnerable to these effects, yet there is a lack of studies investigating the mental health of PWDs in Bangladesh. This study aims to investigate the prevalence of and factors associated with depression, anxiety, and stress among PWDs during the COVID-19 pandemic in Bangladesh. Methods Data was collected through interviews with 391 PWDs between December 2020 and February 2021. Demographic information, clinical characteristics, and scores from the Depression, Anxiety, and Stress Scale (DASS-21) were obtained. Chi-square tests and logistic regression analyses were conducted to examine the relationship between psychological measures and potential risk factors. Results The prevalence was found to be 65.7% for depression, 78.5% for anxiety, and 61.4% for stress, respectively. Several factors were identified as associated with these mental health issues, including gender (male), marital status (being married), low education levels, multiple impairments, comorbid medical illnesses, poor sleep quality, rural residency, hearing disability, disability onset later in life, and testing positive for COVID-19. Conclusions The prevalence was found to be 65.7% for depression, 78.5% for anxiety, and 61.4% for stress, respectively. Several factors were identified as associated with these mental health issues, including gender (male), marital status (being married), low education levels, multiple impairments, comorbid medical illnesses, poor sleep quality, rural residency, hearing disability, disability onset later in life, and testing positive for COVID-19.

by Bruna Ramos dos Santos, Amanda Bruno da Silva Bellini Ramos, Renata Priscila Barros de Menezes, Marcus Tullius Scotti, Fábio Antônio Colombo, Marcos José Marques, Juliana Quero Reimão

Toxoplasmosis, caused by the obligate intracellular parasite Toxoplasma gondii, affects about one-third of the world’s population and can cause severe congenital, neurological and ocular issues. Current treatment options are limited, and there are no human vaccines available to prevent transmission. Drug repurposing has been effective in identifying anti-T. gondii drugs. In this study, the screening of the COVID Box, a compilation of 160 compounds provided by the "Medicines for Malaria Venture" organization, was conducted to explore its potential for repurposing drugs to combat toxoplasmosis. The objective of the present work was to evaluate the compounds’ ability to inhibit T. gondii tachyzoite growth, assess their cytotoxicity against human cells, examine their absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties, and investigate the potential of one candidate drug through an experimental chronic model of toxoplasmosis. Early screening identified 29 compounds that could inhibit T. gondii survival by over 80% while keeping human cell survival up to 50% at a concentration of 1 μM. The Half Effective Concentrations (EC50) of these compounds ranged from 0.04 to 0.92 μM, while the Half Cytotoxic Concentrations (CC50) ranged from 2.48 to over 50 μM. Almitrine was chosen for further evaluation due to its favorable characteristics, including anti-T. gondii activity at nanomolar concentrations, low cytotoxicity, and ADMET properties. Administering almitrine bismesylate (Vectarion®) orally at dose of 25 mg/kg/day for ten consecutive days resulted in a statistically significant (p 0.001) reduction in parasite burden in the brains of mice chronically infected with T. gondii (ME49 strain). This was determined by quantifying the RNA of living parasites using real-time PCR. The presented results suggest that almitrine may be a promising drug candidate for additional experimental studies on toxoplasmosis and provide further evidence of the potential of the MMV collections as a valuable source of drugs to be repositioned for infectious diseases.

by Ma. Teresa Tuason, Kelly Perniciaro, Richel Lamadrid, Jego Mallillin, C. Dominik Güss

The COVID-19 pandemic revealed more than anticipated about global human functioning and resiliency. This Philippines-based study replicated a recent U.S. COVID analysis on psychological well-being (PWB). Factors examined herein were grouped into categories for analysis: 1) predictors of PWB, 2) areas of greatest stress or worry (biggest concerns), 3) perceived or real losses across SES, and 4) identified “unintended gifts” across PWB. Participants (n = 1345) were volunteers who responded to an online survey from August to September 2021, peak of the Delta variant. Three general groups of predictors (biological, psychological, and socio-economic) contributed to PWB. A regression model containing a total of 11 variables was significant, F(11, 1092) = 116.02, p .00, explaining 53.9% of the variance. The model indicated PWB was significantly predicted by physical health, age, spirituality, emotional loneliness, social loneliness, sense of agency, and income. The strongest predictors of PWB were a sense of agency, social loneliness, and spirituality. Qualitative data analysis was conducted examining biggest concerns, losses due to COVID, and unintended gifts. Top ranking participant concerns were the health of family and friends, personal wellness, and governmental inefficiency/lack of concern. Losses compared to pre-COVID life were analyzed by SES group, with the most frequent responses being missing face-to-face interactions and the freedom to go/do what they please. Low SES groups were most likely to endorse missing everyday routine and experiencing changes in housing conditions due to the pandemic. Unintended gifts of COVID explored by PWB, high PWB individuals significantly appreciated intentional time with family and friends, deepening their spiritual lives, the ability to work from home, less pollution, and more time for physical exercise. Low PWB individuals reported nothing gained, except more time playing video games and watching TV. Those with higher PWB identified more unintended gifts of COVID and coped more actively.

by Margaret Lartey, Ernest Kenu, Vincent Jessey Ganu, Franklin Asiedu-Bekoe, Baafour Kofi Opoku, Alfred Yawson, Sally-Ann Ohene
Introduction Health care workers (HCWs) are crucial to the fight against COVID-19 and are at risk of being infected. We sought to determine the risk factors and associations of COVID-19 among HCWs in Ghana during the period of the pandemic. Materials and methods A case-control study was conducted using the WHO COVID-19 HCWs exposure risk assessment tool. A HCW was categorized as “high risk” for COVID-19 if s/he did not respond “always, as recommended” to adherence to Infection Prevention and Control (IPC) measures during a healthcare interaction. A HCW was categorized as “low risk” if s/he responded “always, as recommended” to adherence to IPC measures. We used univariate and multiple logistic regression models to determine associated risk factors. Statistical significance was set at 5%. Results A total of 2402 HCWs were recruited and the mean age was 33.2±7.1 years. Almost 87% (1525/1745) of HCWs had high risk for COVID-19 infection. Risk factors identified were profession (doctor- aOR: 2.13, 95%CI: 1.54–2.94; radiographer—aOR: 1.16, 95% CI: 0.44–3.09)), presence of comorbidity (aOR: 1.89, 95%CI: 1.29–2.78), community exposure to virus (aOR: 1.26, 95% CI: 1.03–1.55), not performing hand hygiene before and after aseptic procedures performed (aOR: 1.6, 95% CI: 1.05–2.45); not frequently decontaminating high-touch surfaces always as recommended (aOR: 2.31, 95%CI: 1.65–3.22; p = 0.001) and contact with a confirmed COVID-19 patient (aOR: 1.39, 95% CI: 1.15–1.67). Among those who came into any form of contact with confirmed COVID-19 patient, providing direct care (aOR: 2.0, 95%CI: 1.36–2.94), face-to-face contact (aOR: 2.23, 95%CI: 1.41–3.51), contact with environment/materials used by COVID-19 patient (aOR: 2.25, 95%CI: 1.45–3.49) and presence during conduct of aerosol generating procedures (aOR: 2.73, 95%CI: 1.74–4.28) were associated with COVID-19 infection. Conclusion Non-adherence to IPC guidelines puts HCWs at increased risk of COVID-19 infection thus ensuring IPC adherence is key to reducing this risk.

by Leib Litman, Zohn Rosen, Rachel Hartman, Cheskie Rosenzweig, Sarah L. Weinberger-Litman, Aaron J. Moss, Jonathan Robinson

Survey respondents who are non-attentive, respond randomly, or misrepresent who they are can impact the outcomes of surveys. Prior findings reported by the CDC have suggested that people engaged in highly dangerous cleaning practices during the COVID-19 pandemic, including ingesting household cleaners such as bleach. In our attempts to replicate the CDC’s results, we found that 100% of reported ingestion of household cleaners are made by problematic respondents. Once inattentive, acquiescent, and careless respondents are removed from the sample, we find no evidence that people ingested cleaning products to prevent a COVID-19 infection. These findings have important implications for public health and medical survey research, as well as for best practices for avoiding problematic respondents in all survey research conducted online.

by Mario Mischkulnig, Benjamin Hopp, Lisa I. Wadiura, Farjad Khalaveh, Barbara Kiesel, Karl Rössler, Georg Widhalm, Christian Dorfer
Background Throughout the last years, the coronavirus disease 2019 (COVID-19) pandemic posed a major challenge to the optimal and timely treatment of neurooncological patients around the world. While the importance of prompt surgical treatment in high-grade gliomas is widely accepted, there is sparse data on the impact of the pandemic on patients suffering from this malignant disease. Methods We performed a retrospective analysis of patients undergoing surgical high-grade glioma treatment at the Medical University of Vienna between March 2020 and February 2021, as well as a control cohort of patients who received treatment between January and December 2019. Time lag between referral for surgical treatment to actual surgery, preoperative tumor volume and overall patient survival were compared between groups. Results A total of 118 patients, including 62 cases treated during the first year of the COVID-19 pandemic, as well as 56 control patients, were investigated in this study. Median interval to surgery was significantly shorter in patients treated during COVID-19 compared with the control group (4.00 versus 7.00 days; p = 0.0005). In contrast, patients treated during COVID-19 exhibited marginally larger preoperative tumor volumes, while overall patient survival was comparable between groups. Conclusions The COVID-19 pandemic did not negatively affect the overall survival of patients undergoing surgical high-grade glioma treatment at our institution. The significantly shorter treatment delay in patients treated during the pandemic likely reflects increased resource allocation for this critical patient population.

by Mohamed I. Elsaid, Xiaochen Zhang, Anne L. R. Schuster, Jesse J. Plascak, Cecilia DeGraffinreid, Electra D. Paskett
Background The impacts of socioeconomic status (SES) on COVID-19-related changes in cancer prevention behavior have not been thoroughly investigated. We conducted a cohort study to examine the effects of SES on changes in cancer prevention behaviors during the COVID-19 pandemic. Methods We invited adult participants from previous studies conducted at Ohio State University to participate in a study assessing the impact of COVID-19 on various behaviors. Post-COVID-19 cancer prevention behaviors, including physical activity, daily intake of fruits and vegetables, alcohol and tobacco consumption, and qualitative changes in post-COVID-19 behaviors relative to pre-COVID levels, were used to construct a prevention behavior change index that captures the adherence status and COVID-related changes in each behavior, with higher index scores indicating desirable changes in prevention behaviors. Participants were classified into low, middle, or high SES based on household income, education, and employment status. Adjusted regression models were used to examine the effects of SES on changes in cancer prevention behaviors during the COVID-19 pandemic. Results The study included 6,136 eligible participants. The average age was 57 years, 67% were women, 89% were non-Hispanic Whites, and 33% lived in non-metro counties. Relative to participants with high SES, those with low SES had a 24% [adjusted relative ratio, aRR = 0.76 (95%CI 0.72–0.80)], 11% [aRR = 0.89 (95%CI 0.86–0.92)], and 5% [aRR = 0.95 (95%CI 0.93–0.96)], lower desirable changes in prevention behaviors for physical activity, fruit and vegetable intake, and tobacco use, respectively. Low SES had a higher desirable change in alcohol consumption prevention behaviors, 16% [aRR = 1.16 (95%CI 1.13–1.19)] relative to high SES. The adjusted odds of an overall poor change in prevention behavior were adjusted odds ratio (aOR) 1.55 (95%CI 1.27 to 1.89) and aOR 1.40 (95%CI 1.19 to 1.66), respectively, higher for those with low and middle SES relative to those with high SES. Conclusion The adverse impacts of COVID-19 on cancer prevention behaviors were seen most in those with lower SES. Public health efforts are currently needed to promote cancer prevention behaviors, especially amongst lower SES adults.

by Tomoya Kitayama

The COVID-19 pandemic has created an extraordinary situation for undergraduate students. The aim of this study is to evaluate the impact of the COVID-19 pandemic on the national examination for pharmacists in Japan. In this study, we analyzed the content of Twitter to assess the impact of COVID-19 on the national exam, including psychological aspects. Tweets including the words "national examinations" and "pharmacists" were compiled from December 2020 to March 2021. ML-Ask, a python library, was used to evaluate the emotional register of the tweets on the basis of ten elements: Joy, Fondness, Relief, Gloom, Dislike, Anger, Fear, Shame, Excitement, and Surprise. The presence of COVID-19-related terms was clearly visible in tweets about the national examination of pharmacists between December 1st–and 15th, 2020. It was precisely during this period that the government had announced a strategy regarding national examinations, in the light of COVID-19. The analysis found that post December 16th, words associated with negative emotions were mainly related to the examination, but not to COVID-19. As a result of analyzing only infected areas, a relationship between employment and negative feeling was detected.

by Thomas Farrell, Fathima Minisha, Salwa Abu Yaqoub, Abubaker Abdel Rahim, Mai Omar, Huda Ahmed, Stephen Lindow, Merlin Rajam Abraham, Mahmoud Gassim, Nader Al-Dewik, Shamsa Ahmed, Hilal Al-Rifai, Q-precious group
Background The novel coronavirus disease (COVID-19) pandemic has impacted pregnant women, increasing maternal and neonatal morbidity. The placenta is a potential target for the pathophysiological processes due to the increased thrombotic inflammatory activation and inadequate uteroplacental perfusion and oxygenation, potentially causing intrauterine growth restriction. This study investigates the impact of gestational age at diagnosis of COVID-19 and the presence of symptoms on intrauterine fetal growth in pregnant women. Methods A retrospective review of COVID-19 positive pregnant women in Qatar from March 2020 to March 2021 was conducted. They were divided based on trimester of pregnancy in which they were infected. The outcomes included birthweight, customised fetal birthweight centiles, small for gestational age (SGA) baby and daily growth increments, compared between the trimesters and between symptomatic and asymptomatic women. Results In our cohort, 218 women (20.5%) were infected in the first trimester, 399 (37.5%) in the second and 446 (42%) in the third. Women in the second trimester were significantly younger and symptomatic. Women infected in the first trimester were least likely to have diabetes. The mean birthweight, risk of SGA (11.5% vs 10% vs 14.6%, p = 0.302), and median customized growth centiles (47.6% vs 45.9% vs 46.1%)were similar between the groups. Symptomatic women had significantly lower mean birthweight (3147 gms vs 3222 gms) and median birthweight centiles (43.9% vs 54.0%)compared to the asymptomatic (p

by Higinio Fernández-Sánchez, Ziad Zahoui, Jennifer Jones, Emmanuel Akwasi Marfo
Objective To conduct a rapid review and determine the acceptability, access, and uptake of the COVID-19 vaccine among global migrants. Materials and methods A rapid review was conducted May 2022 capturing data collected from April 2020 to May 2022. Eight databases were searched: PubMed, Ovid Medline, EMBase, CINAHL, SCOPUS, Google Scholar, LILACS, and the Web of Science. The keywords “migrants” AND COVID-19” AND “vaccine” were matched with terms in MeSH. Peer-reviewed articles in English, French, Portuguese, or French were included if they focused on COVID-19 immunization acceptability, access, or uptake among global migrants. Two independent reviewers selected and extracted data. Extracted data was synthesized in a table of key characteristics and summarized using descriptive statistics. Results The search returned 1,186 articles. Ten articles met inclusion criteria. All authors reported data on the acceptability of the COVID-19 vaccine, two on access, and one on uptake. Eight articles used quantitative designs and two studies were qualitative. Overall, global migrants had low acceptability and uptake, and faced challenges in accessing the COVID-19 vaccine, including technological issues. Conclusions This rapid review provides a global overview of the access, acceptability, and uptake of the COVID-19 vaccine among global migrants. Recommendations for practice, policy, and future research to increase access, acceptability, and uptake of vaccinations are discussed.