Beginning Of COVID-19 Pandemic Research Articles

Occurrence of phthalates in facemasks used in India and its implications for human exposure

ABSTRACT Synthetic polymers with additives are used in the manufacturing of face masks (FMs); hence, FMs could be a potential source of exposure to phthalic acid esters (PAEs). India stands second in the world in terms of the FMs usage since the beginning of Covid-19 pandemic. However, little is known about the PAEs content of FMs used in India. Some PAEs, such as DEHP and DBP are suspected endocrine disrupting chemicals (EDCs); hence, wearing FM may increase the risk of exposure to these EDCs. In this study, we collected 91 samples of FMs from eight Indian cities and analyzed for five PAEs viz. DMP, DEP, DBP, BBP, and DEHP. The PAEs contents in FMs ranged from 101.79 to 27,948.64 ng/g. The carcinogenic risk of N 95 with filter, N-95, and cloth masks was higher than the threshold levels. The findings indicate the need to control PAEs in FMs through regulatory actions.

Disease Characteristics and Psychiatric Comorbidities in Adolescents with Anorexia Nervosa Hospitalized During COVID-19 Pandemic

Since the beginning of COVID-19 pandemic, an increase in new diagnoses and pediatric hospital admission for anorexia nervosa (AN) or atypical AN in adolescents have been reported, suggesting an adverse effect of COVID-19 on youth mental health. We hypothesized possible differences in prevalence of hospitalization and/or disease severity, related to socio-economic status and/or ethnicity. Retrospectively, patients were divided into two subgroups and compared according to the date of first hospital admission: "pre SARS-COV2 era" group (n. 45, 8th March 2016-8th March 2020) and "SARS-COV2 era" group (n. 43, 9th March 2020-8th March 2022). During the two years of the SARS-COV2 era, we reported an increase in hospital admission incidence more than doubled respect to the "pre-SARS-COV2 era". The "SARS-COV2 era group" showed a more rapid weight loss (p = 0.005), a minor duration of weight loss from lifetime maximum to admission (p = 0.019) and needed most frequently treatments with intravenous fluids (p < 0.0001), oral dietetic supplements (p <0.001) and enteral nutrition by nasogastric tube (p = 0.002). The same group presented higher prevalence of psychiatric comorbidities (63% vs. 22%, p < 0.0001) and required most frequently treatments with psychotropic drugs (56% vs. 24%, p = 0.002). We found higher family socioeconomic status (SES) in our patients with AN in both the periods and we did not find a shift in social class distribution over time. Our study confirms a significant increase in incidence of hospitalization and of psychiatric comorbidity in the pediatric population with AN during the second year of COVID-19 pandemic, regardless of SES or ethnic background. Further studies are needed to understand potential mechanisms that during COVID-19 pandemic trigger eating disorder symptoms.

Changes in HIV testing trends in Poland during COVID-19 pandemic.

At the beginning of COVID-19 pandemic, due to lockdown, limited mobility, as well as changes in the activity profile of some laboratories, the restriction also applied to access to various screening tests, including HIV screening tests. The aim of the study was to assess HIV testing trend during COVID-19 pandemic in laboratories in Poland and its comparison to the preceding years, with special focus on testing in the network of Voluntary Testing and Counselling (VCT) sites serving population with higher behavior risk, which increase the possibility of HIV infection. Analysis of the changes in HIV tests number was based on the results of the annual survey of HIV tests conducted among the laboratories throughout the country. The questionnaire included data on screening and positive tests by testing site type, age group and gender. In addition, we extracted data collected in comprehensive National AIDS Centre database, based on epidemiological and behavior data collected by VCT on people who come for testing. There are approximately 400,000 HIV tests annually run in general population in last years. COVID-19 pandemic, which occurred in beginning of 2020 did not have a huge impact on HIV test number among these population, because there was observed 1% decreased. Pandemic COVID-19, due to few lockdown reduced the HIV tests number among VCT clients - population with higher HIV risk infection. Tests number decreased by 44% compare to previous year, due to temporal closed of these centres. Data analysis shows that due to the pandemic, the structure of the surveyed people changed, especially in terms of age and gender, and the place where the study was performed. We confirmed low HIV testing rates in general population and low positivity rate over the studied period. The positivity rate was higher in the testing site network targeting individuals engaging in high risk behaviors. Changes observed in HIV testing trends in recent years have been affected by the COVID-19 pandemic.

The cutaneous manifestations of COVID-19, personal protective equipment and treatment

Since the beginning of COVID-19 pandemic in late 2019, the symptoms and signs detailed in the medical literature and the media concentrated on the effect of causative virus SARS-COV-2 on the respiratory tract, the coagulopathy associated with severe forms of the disease and the febrile flu like illness in the mild cases. The widespread publicising of the symptoms has been one of the important public health measures in combatting the rapid spread of COVID-19. Less known is the direct or indirect effect of COVID-19 on the skin and underlying soft tissue. Recognising the various cutaneous manifestations may prove a useful tool in early detection and management of COVID-19.

NEUTROPHIL COUNTS RELATED TO PRESENTATION OF COVID IN AUTOIMMUNE NEUTROPENIA?

To describe 2 cases of autoimmune neutropenia (AIN) patients infected with Sars-Cov-2. Two subjects case report. Case report 1: A girl with primary AIN since 1 year and 10 months old, maintaining severe neutropenia and mild recurrent infections. Presented to the emergency department in June/2020, at 3 years and 8 months old, with flu-like symptoms, afebrile, in good general condition. Physical examination was normal. The absolute neutrophil count (ANC) was 0.279 × 10 9 /L. At hospital admission, Sars-Cov-2 (RT-PCR) tested positive and filgrastim (G-CSF) 5 μg/kg/day was initiated. Chest X-ray was also normal and blood culture resulted negative. She remained in great general condition, afebrile, and was discharged on the 2nd day of hospitalization, with clarithromycin (15 mg/kg/day). After G-CSF, ANC: 0.494 × 10 9 /L (1 st dose), 1.431 × 10 9 /L (2 nd dose). On outpatient follow-up, she had no long-term complications from Covid-19. Case Report 2: A man with chronic immune thrombocytopenia purpura (ITP) since 2008, autoimmune hemolytic anemia since 2013, evolved with AIN on May/2020, at 42 years old, with ANC lower than 0.5 × 10 9 /L. On 6/1/2020, he had ANC 0.170 × 10 9 /L. On 6/25/2020, he started flu-like symptoms, had ANC of 5.118 × 10 9 /L, and tested positive for Sars-Cov-2 (RT-PCR). He kept high fever (102,2°F) and was hospitalized for 10 days without use of G-CSF. After discharge, on outpatient follow-up, he had no long-term complications from Covid-19, and presented ANC 0.338 × 10 9 /L (Aug/2020). At beginning of Covid-19 pandemic, severity infection in children was unknown. Today is known that most of them have milder clinical course, regardless of chronic diseases. In adults, in contrast, the inflammatory response tends to exacerbation, with more severe clinical conditions. Furthermore, many case reports of patients infected by SARS-CoV-2 with comorbidities literature are published. However, to date there are no reports on the impact of COVID-19 in AIN patients. Increased neutrophil counts during infectious episodes are common in AIN, which appears to be related to the benign course of most infections. We reported 2 cases of AIN patients diagnosed with Covid-19, both with favorable clinical outcomes despite heterogenic clinical course. On the first case, she presented few symptoms and ANC increased only after using G-CSF. On the second reported patient, there was a spontaneous increase of ANC and greater inflammatory response than the first case. It could suggest a correlation between inflammatory response to COVID-19 and ANC in cases of autoimmune neutropenia. In the reported cases, clinical course of disease and neutrophil count were different between adult and pediatric patients. It is not possible to state whether this difference is due to age group, individual response to infection or other variables. It is important to assess other cases of AIN infected by COVID 19 to better understand correlation between severity of infection and neutrophil count response.

Effects of the BTN162b2 mRNA COVID-19 vaccine in humoral and cellular immunity in patients with chronic lymphocytic leukemia.

Chronic lymphocytic leukemia (CLL), the most common leukemia in the western countries, is characterized by immunosuppression due to disease itself and cytotoxic treatments. Since the beginning of COVID‐19 pandemic, patients with CLL appear to be a vulnerable population. In addition, phase III mRNA vaccine trials did not provide information about the efficacy in immunocomprised population. In CLL, the antibody‐mediated response to SARS‐CoV‐2 vaccine is impaired. The goal of this study was to evaluate the effects of SARS‐CoV‐2 vaccination on humoral immune response and on cellular immunity in CLL patients. Humoral immune response to BNT162b2 messenger RNA COVID‐19 vaccine was evaluated in 44 CLL patients comprising 20 treatment‐naïve, 14 under treatment with ibrutinib and 10 in follow‐up after completion of therapy. A positive serological response to SARS‐CoV‐2 vaccination with IgG titers higher than 13 UA/ml was detected in 54.6% of CLL patients with a higher response in patients who obtained remission after treatment. Reduced antibody response was detected in patients under ibrutinib treatment. T‐cell response to overlapping pool of peptides representing the spike region was assessed in paired CLL samples collected before and after 1 month from the second dose of COVID‐19 vaccine in treatment‐naïve and ibrutinib‐treated CLL patients using cytokine secretion assay. Both CD3+ CD4+ and CD3+ CD8+ T cells are able to mount a cellular response to spike peptides with secretion of IFNγ and TNFα before and after vaccination in both treatment naïve and ibrutinib‐treated patients and this cellular immune response is independent by COVID‐19 vaccination. Collectively, T cell response to spike peptides appeared more blunted in CLL patients under treatment with ibrutinib compared to untreated ones. Our study supports the need for optimization of vaccination strategy to achieve an adequate immune response keeping strict preventive measures by CLL patients against COVID‐19.

Assessment of Clinician Diagnostic Concordance With Video Telemedicine in the Integrated Multispecialty Practice at Mayo Clinic During the Beginning of COVID-19 Pandemic From March to June 2020

There was a shift in patient volume from in-person to video telemedicine visits during the COVID-19 pandemic. To determine the concordance of provisional diagnoses established at a video telemedicine visit with diagnoses established at an in-person visit for patients presenting with a new clinical problem. This is a diagnostic study of patients who underwent a video telemedicine consultation followed by an in-person outpatient visit for the same clinical problem in the same specialty within a 90-day window. The provisional diagnosis made during the video telemedicine visit was compared with the reference standard diagnosis by 2 blinded, independent medical reviewers. A multivariate logistic regression model was used to determine factors significantly related to diagnostic concordance. The study was conducted at a large academic integrated multispecialty health care institution (Mayo Clinic locations in Rochester, Minnesota; Scottsdale and Phoenix, Arizona; and Jacksonville, Florida; and Mayo Clinic Health System locations in Iowa, Wisconsin, and Minnesota) between March 24 and June 24, 2020. Participants included Mayo Clinic patients residing in the US without age restriction. Data analysis was performed from December 2020 to June 2021. New clinical problem assessed via video telemedicine visit to home using Zoom Care Anyplace integrated into Epic. Concordance of provisional diagnoses established over video telemedicine visits compared against a reference standard diagnosis. There were 2393 participants in the analysis. The median (IQR) age of patients was 53 (37-64) years; 1381 (57.7%) identified as female, and 1012 (42.3%) identified as male. Overall, the provisional diagnosis established over video telemedicine visit was concordant with the in-person reference standard diagnosis in 2080 of 2393 cases (86.9%; 95% CI, 85.6%-88.3%). Diagnostic concordance by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision chapter ranged from 64.7% (95% CI, 42.0%-87.4%) for diseases of the ear and mastoid process to 96.8% (95% CI, 94.7%-98.8%) for neoplasms. Diagnostic concordance by medical specialty ranged from 77.3% (95% CI, 64.9%-89.7%) for otorhinolaryngology to 96.0% (92.1%-99.8%) for psychiatry. Specialty care was found to be significantly more likely than primary care to result in video telemedicine diagnoses concordant with a subsequent in-person visit (odds ratio, 1.69; 95% CI, 1.24-2.30; P < .001). This diagnostic study of video telemedicine visits yielded a high degree of diagnostic concordance compared with in-person visits for most new clinical concerns. Some specific clinical circumstances over video telemedicine were associated with a lower diagnostic concordance, and these patients may benefit from timely in-person follow-up.

Casting a wide NET: an update on uncontrolled NETosis in response to COVID-19 infection

Dysregulation of neutrophil extracellular trap (NET) formation has been shown to mediate disease pathology in multiple viral infections, including SARS-CoV-2. At the beginning of COVID-19 pandemic, Thierry and Roch wrote a perspective on the mechanisms by which severe SARS-CoV-2 infection may lead to uncontrolled NET formation that leads to acute respiratory distress syndrome (ARDS), systemic vascular permeability, and end organ damage. In this commentary, the progress that has been made in regards to the ideas postulated by the perspective will be discussed, with a focus on the therapeutics that target NET formation.

P1358: WILL COVID-19 PANDEMIC CHANGE MOBILIZATION STRATEGY OF HEMATOPOIETIC STEM CELLS IN MULTIPLE MYELOMA PATIENTS FOR THE BETTER?

Background: Autologous hematopoietic stem cell transplantation (ASCT) is the current standard of care for younger patients (pts) with multiple myeloma (MM), improving overall survival (OS) and progression free survival (PFS). According to EBMT, use of chemotherapy, typically cyclophosphamide (Cy), in combination with granulocyte colony-stimulating factor (G-CSF) is the preferred strategy for hematopoietic stem cell (HSC) mobilization to peripheral blood (PB). However, major disadvantages are therapy-related toxicity and higher mobilization failure. Plerixafor plus G-CSF has been shown to be superior to G-CSF alone, leading to higher CD34+ yields in fewer apheresis sessions; however there are few data in comparison to chemomobilization. Since the beginning of COVID-19 pandemic, our center adopted G-CSF ± Plerixafor as initial strategy to mobilize HSC in MM pts. Aims: To evaluate the efficacy, length of hospitalization and safety of G-CSF ± Plerixafor mobilization of HSC in MM pts, compared to chemomobilization. Methods: We performed a retrospective study of MM pts submitted to mobilization and 1st ASCT between 2018 and 2021. Pts who underwent mobilization with Cy (1.5 g/m2) plus pegylated G-CSF were included in group A; pts who received G-CSF ± Plerixafor were included in group B. Group B only received Plerixafor if they presented PB CD34+ cells < 15/mL on day 4 of mobilization with G-CSF. Results: We identified a total of 126 pts, excluded 4 (2 under hemodialysis and 2 receiving different protocols) and included 122 pts, 83 (68%) in group A and 39 (32%) in group B. Demographic characteristics and disease stage (ISS and R-ISS) were similar between the groups, presenting a male predominance (n=73, 60%) and a median age of 61 years. Since frontline protocol in MM changed recently, induction therapy in group A and B was, respectively, VCD 60 vs 26%; VRD 30 vs 75%; VTD 10 vs 0% (P<0.001). No differences were observed in pre-ASCT quality of responses (89.2 vs 89.7% ≥VGPR; P=0.532). The impact of apheresis in terms of length of hospitalization (4 vs 2 days, P<0.001) and median time from the 4th day of mobilization with G-CSF until first apheresis was lower in group B; 2 vs 1 days, P<0.001). There was no difference in the number of apheresis sessions (1 vs 1; P=0.260). The volume of DMSO was higher in group B (22 vs 30 mL, P=0.001). In group B, 16 (41%) pts did not need Plerixafor and there were no differences in length of hospitalization or the number of apheresis sessions compared with those who received Plerixafor. Mobilization failure was only seen in group A, (n=14, 17%, P=0.006). Poor mobilizers were remobilized with G-CSF + Plerixafor and presented longer hospitalization (4 vs 2 days, P=0.001) and number of apheresis sessions (2 vs 1 days, P=0.001) when compared to group B. During mobilization, grade ≥3 complications were observed in 8.4% (n=3) in group A, being febrile neutropenia the most frequent; mobilization was interrupted in 2 pts. All pts presented neutrophil and platelet engraftment and there was no difference in time of engraftment after ASCT between groups A and B (12 days in both, P=0.711). No differences were observed in PFS (74.5 vs 40 months, HR 0.8[0.2-2.9], P=0.782) or OS (82.6 vs NR, HR 1.1[0.2-6.0], P=0.839) between groups. Summary/Conclusion: The mobilization protocol changed, due to COVID-19 pandemic, from chemomobilization to G-CSF ± Plerixafor and resulted in less hospital resource utilization and less febrile neutropenia, without compromising ASCT success. Unlike prior reports, number of apheresis sessions after mobilization with G-CSF alone was similar to G-CSF + Plerixafor.

The Association of Opium Abuse with Mortality Amongst Hospitalized COVID-19 Patients in Iranian Population.

Opioid abuse is a serious problem in the society. Since the first months of COVID-19 pandemic, several myths, rumors and misconceptions have been spread about the benefits of opium consumption for COVID-19 outcome. In addition, data are limited on the relationship between opium abuse and COVID-19 mortality amongst hospitalized COVID-19 patients. In this historical cohort study, we assessed the risks of several variables for mortality amongst all hospitalized COVID-19 patients from the beginning of COVID-19 pandemic in South of Iran from March 15th, 2021 to October 14th, 2021. Data was acquired from the Medical Care Monitoring Center (MCMC), affiliated to Shiraz University of Medical Sciences. A total of 64,427 hospitalized COVID-19 patients were included into the analysis. The mortality rate was 10.59% (n = 6756). Of all, 2030 (3.15%) patients—1702 males and 328 females—reported the positive history of opium abuse with a mean age of 57 ± 17.21 years. The results of multivariable risk showed that the positive history of opium abuse had a significant association with mortality (adjusted RR: 1.173; p = 0.007). Other significant predictive risk factors were male gender, elder ages, and comorbidities such as pulmonary diseases, cardiovascular disease, cancer, nephrological diseases, neurological diseases, and diabetes. However, being a health care worker and having thyroid gland diseases were protective factors amongst hospitalized COVID-19 patients (adjusted RR: 0.650 and 0.642; p = 0.040 and < .0001, respectively). Opium abuse is a risk factor for mortality amongst hospitalized COVID-19 patients. It is vital to educate societies about the consequences of unauthorized opium consumption.

The early Impact of stress related to COVID-19 Pandemic on physicians in Tunisia

IntroductionContagious disease outbreaks can have major repercussions on medical stuff. Doctors in Tunisia were requested to act as the first-line filter in managing active cases during the beginning of COVID19 pandemic.ObjectivesThis study aims to assess perceived stress in Tunisian doctors during COVID19 pandemic early stages and to identify factors associated to stress in order to guide prevention strategies.MethodsThis was a cross-sectional study conducted through an online survey, from April 18th 2020 to June 6th 2020. A 62-item semi-structured survey was created, consisting of 5 series of questions and scales. Linear regression models were performed to identify the associations between the study variables and the perceived stress score of the participants.ResultsWe included 203 physicians in this study. Stress levels were high among Tunisian doctors with a mean perceived stress score (PSS) of 28.6. One hundred fifteen participants (56.3%) scored for high PSS. This study identified vulnerable subgroups too stress. The female gender, working in the capital and working in critical medicine units were risk factors for high PSS. Managing COVID19 patients was not itself correlated to stress, however social isolation, stigma and luck of access to information were correlated to high stress levels.ConclusionsSeveral stressors can affect the well-being of doctors during the COVID-19 pandemic, which can lead to adverse psychosocial outcomes. The findings of this study may guide decision-makers to implement early mental health interventions for doctors.DisclosureNo significant relationships.

Future of COVID-19 Treatment Without Vaccine and Painful Needles

Ever since the beginning of COVID-19 Pandemic, researchers from across the world have been investigating different options for the treatment of SARS-COV-2. This is critical even after two years from the start of pandemic due to different variants resulting in new waves of this virus spreading globally. In this regard, December 22 and 23rd, 2021 are landmark days, when FDA granted authorization to Pfizer’s Paxlovid and Merck’s Molnupiravir (COVID-19 Oral Antiviral products) for emergency use (EUA). The director of the FDA’s Center for Drug Evaluation and Research Patrizia Cavazzoni, M.D., described this an enormous step to tackle this global pandemic

Hospital Readiness for Covid 19 Pandemic in Bekasi District Hospital

Background: In the beginning of Covid-19 pandemic, most of hospitals were unplanned to handle this pandemic. The purpose of this study’s are to analyze the hospital readiness to cope with pandemic circumstances by evaluating hospital strategies as well as action which implement by the hospital. Methods: The study employs a method approach that includes both mix quantitative and qualitative methods. Quantitative design use main data while score and percentage as an outcome of response from checklist based on WHO Rapid Hospital Readiness as a quantitative study supported with qualitative study by in-depth interview utilize response from 12 different components on the checklist. Measurement of Hospital Readiness was carried out in Bekasi District Hospital and responses were obtained three times within seven months duration. Results: The results are as follows, first period as a baseline data in December 2020, the average score assessed is 69%, second period were taken on April 2021 average score slightly improve to 81% and the last period in July 2021 result increased to 90%. In the last period among other component, Component 10 have the lowest percentages (60%). By accomplishing the strategy for each period and continuously evaluated, the score or percentage by assessment of surge capacity readiness due to the Covid-19 pandemic has increased in Bekasi District Hospital, indicating the hospital is more ready to deal with surge capacity, and hospital perseverance is good enough. Conclusion: The checklist of the hospital readiness can be used as a baseline and a tool for hospital and health facilities evaluation.

Psychiatric comorbidities and dehydration are more common in children admitted to the emergency department for eating disorders in the COVID-19 era.

PurposeSince the beginning of COVID-19 pandemic, social distancing and home confinement had a significant impact on children, especially on those with eating disorders (ED). The primary objective of this retrospective study was to describe and analyze the demographic and clinical profiles of children presenting with ED during the COVID-19 pandemic.MethodsWe conducted a retrospective review of clinical charts of patients with ED younger than 18 years who accessed the emergency department of the Bambino Gesù Children’s Hospital, Rome, between March 2019 and March 2021. Of these, we reported and compared the demographic, clinical and laboratory data before and after the COVID-19 pandemic and looked for predictors of ED severity.ResultsA total of 211 admissions for ED were recorded. The patients, mostly females (86.3%) were on average 14.1 years old. The mean weight loss on admission was 11 kg. Bradycardia was observed in 31.3% of the study sample. 16.6% of patients had an associated psychiatric disorder and 60.2% required psychotropic drugs. 68.7% of the patients required hospitalization. Respectively, 96 and 115 patients were admitted before and during the COVID-19 pandemic. The latter were hospitalized more (78.3 vs 57.3%; p = 0.001), yet for less time (19 vs 26 days; p = 0.004), had a higher mean serum creatinine (0.68 vs 0.47; p < 0.001) and were more frequently diagnosed with an associated psychiatric disorder (23.5 vs 8.3%; p = 0.003).ConclusionOur study shows a significant increase of hospitalizations of children with ED during the COVID-19 pandemic, along with a shorter length of stay, more psychiatric comorbidities, and some distinctive features at the laboratory work-up, such as an increase of serum creatinine and/or a reduction of serum albumin.Level of evidenceIII, evidence obtained from well-designed cohort or case–control analytic studies.

COVID-19 vaccination intention at the beginning of COVID-19 pandemic in Slovenia

Background: With the successful development and introduction of vaccines to protect against COVID-19 disease, the pandemic is expected to end. The success of a vaccination programme depends on the uptake rates in the Slovenian population and especially among healthcare workers (HCWs), who are at higher risk of infection. Recently, several studies have examined the readiness of different population groups worldwide to be vaccinated. This study compares COVID-19 vaccination intentions between lay people and HCWs, and relationships between socio-demographic characteristics, attitudes and beliefs about COVID-19 vaccination, and vaccination intentions reported in the early stages of epidemics.&#x0D; Methods: A cross-sectional study based on an online survey was performed in Slovenia between 13 and 14 March 2020, when the epidemic was officially announced in the country. Data from 2,494 eligible respondents were analysed.&#x0D; Results: The study has shown that 33.2% of all respondents expressed the intention to get vaccinated against COVID-19 disease. This intention was expressed slightly more frequently among HCWs (38.9%) than among lay respondents (30.3%). Men compared to women, older and younger HCWs compared to middle-aged adults, and university graduates compared to HCWs with lower levels of education were more likely to get vaccinated against the disease. More HCWs than lay respondents believed that the COVID-19 vaccine would be safe and effective, and they were also more in favour to support vaccination of high-risk groups than mandatory vaccination of the general population.&#x0D; Conclusion: It is critical to communicate the importance of vaccination against COVID-19 appropriately and on a sound scientific basis through various health education programmes and the media, as only one-third of respondents and less than a half of HCWs indicated that they would be willing to get vaccinated once a vaccine is available.

Dynamics of magazine’s travel-content and the Internet portal “Vokrug Sveta” at the beginning of COVID-19 pandemic

The relevance of research is related to the study of Russian travel journalism in the context of the COVID-19 pandemic. The purpose of work is to find out how the travel content of the “Vokrug Sveta” magazine and its official website has changed, as well as to identify key authorial tasks in the travel texts of the magazine for 2020. Based on the results of a content analysis of 41 materials of major genre forms (travel essays, digest, narrative history) in the “Travel” section both in the printed version and on the website, we justify that the magazine began to pay more attention to Russia – in quantitative terms, there are 2 times more materials on domestic tourism compared to the second half of 2019 than about the world. We demonstrate that in terms of content, this content has evolved from introductory materials in the format of thematic collections to full-fledged travel guides about Russian cities and areas. We conclude that the “Vokrug Sveta” editors at the beginning of the COVID-19 pandemic helped tourists in a changed world find new ways to travel and be optimistic about everything that happened at that time. In addition, we find that the publication sought to find ways to provide the audience with a quick and convenient format for obtaining information about tourist places, gave practical recommendations to travelers.

Значение феномена границы и его социальная трансформация в период первой «волны» COVID-19 и локдауна в России

The Russian lockdown 2020 introduced due to the COVID-19 pandemic pro­duced a number of changes not only in the public health, economic and justice system, but also in the sphere of understanding by society of its own place in so­cial reality. The article deals with the question of transformations in social under­standing of physical space. The authors primarily emphasize the changes of boundary phenomenon in the public perception. During the beginning of COVID-19 pandemic, in the conditions of information deficit and physical clo­sure of borders, Russia found itself in the situation, when the lack of precise knowledges about the events, associated with the global pandemic led to the degradation of established ideas about the surrounding space. The purpose of this article is to highlight the key factors, which led to the qualitative changes in the boundary understanding on the level of the social existence. For the achieve­ment of this goal the authors consecutively solve the following problems: to ana­lyze the types of the boundaries, that have been existing in the public discourse before the lockdown; to follow the process of the new boundaries-understanding genesis and to highlight the main media-factors, that led to the transformations of the boundary-phenomenon in the modern society. The methodical system of this research bases on the analyses of the narrations, existing in the Russian soci­ety short before the lockdown (spring 2020). The special attention was paid to the media background, that had constructed world view of an individual at the pan­demic’s beginning. The authors conclude, that the lockdown not only restricted the physical space for a human, but also influenced in the qualitative way on the human’s spiritual and emotional space perception. From the line, dividing two political entities, the boundary turned into the special bastion, whose func­tion consisted in, first, separation from the unknown space, where there was the danger of COVID-19, second, physic protection from this danger.

The challenges of the medical doctors working in the intensive care unit during COVID-19 pandemic

Aim: Healthcare professionals working in intensive care unit (ICU) have been in the frontline from the beginning of COVID-19 pandemic. We aimed to evaluate the technical and psychological difficulties encountered by medical doctors working in the ICU of the hospitals within XXX University Faculty of Medicine during this pandemic. &#x0D; Material and Methods: A questionnaire consisting of 52 questions was applied to the medical doctors working in the ICUs of Başkent University affiliated centers. &#x0D; Personal protective equipment (PPE) includes; surgical mask, N95: N95 mask, face shield, glove, overalls, overshoe, goggles, intubation cabin. &#x0D; Results: Out of the 73 ICU physicians who were invited to participate, 62 (84.9%) of them completed the survey. Out of 59.7% of the participants stated that they did not feel safe while caring for the patients. The most common reason for their insecurity was the fear of contamination (70.3%). Out of 69.4% ICU physicians stated that their anxiety level was moderate. It was observed that the anxiety level of ICU physicians decreased as the number of patients followed up increased (p = 0.025), the increase in the number of hospital beds was found to be significantly associated with increased anxiety level (p = 0.015). It was found that the presence of anxiety complaint increased the state of having high anxiety related to COVID-19 disease 28.3 times (p = 0.001). &#x0D; Conclusion: We found that more than half of the physicians participating in our study didn’t have any problem of protective personal equipment (PPE) deficiency, which is one of the most important technical difficulties. Regarding psychological difficulties, we found that doctors who had anxiety complaints before had much more difficulties in managing the pandemic process than others.

Clinical Learning in Medical and Health Professions Education amid COVID-19 Pandemic: A Literature Review of Various Methods and Innovations

BACKGROUND: COVID-19 has caused disruption to medical education and health care systems around the world. The highly contagious nature of the virus makes it difficult for educational institutions to continue their studies as usual, thus affecting the medical and health professions education which is based on face-to-face lectures, practicum, skills laboratories, and clinical practice in health facilities. AIM: This paper discovers clinical learning initiatives across the globe and highlights the contribution toward educational processes. METHODOLOGY: This study utilized an integrated literature review method. A systematic search for articles published was performed in Springer, ScienceDirect, PubMed, and EBSCOHost. Primary search monetary terms were e-learning (all synonyms) and health sciences education (all synonyms), including COVID-19. Articles published within the period of COVID-19 pandemic included in this study. For the synthesis, the 20 included studies selected were coded. In this study, data were synthesized through narrative synthesis using thematic analysis (TA). To identify the recurrent themes author followed six steps when synthesizing data using TA, for example, familiarizing with the data, developing initial (sub) codes, searching for (sub) themes, reviewing (sub) themes, compiling ideas or issues, and producing final data in line with the study aims and objectives. RESULTS: Out of records identified, a total of citations was screened, of which 20 were found to be of relevance to this study most were quantitative (14.70%) in design. Studies were published in 2020 since the beginning of COVID-19 pandemic. The geographical range of papers covered mostly the moderate-income regions. On conducting TA of the included studies, it was possible to obtain two broad descriptive themes/categories: enablers or drivers of, and barriers or challenges to, under which important themes have emerged. CONCLUSION: Study suggests that developing e-learning in effective clinical learning is needed, not only limited to moving the learning process but also needing to follow the instructional design, so that learning outcomes can be achieved by students. In addition, a learning process that promotes self-directed-learning is needed so that students have flexibility, use relevant learning styles and are able to integrate knowledge, skills and attitudes as a meaningful learning process.

Evaluation of the Changes in Mental Health State at the Beginning of COVID-19 in Hospital Personnel

Objective: In the present study, it was aimed to determine the changes in the mental states of hospital personnel at the beginning of COVID-19 pandemic, and the factors affecting these changes. Methods: The research sample consisted of 299 hospital personnel in Turkey, who could be reached with the online method. The data were collected using the “Information Form”, which was prepared in line with the literature and the pandemic process, “The Impact of Event Scale (IES)” and the “Depression-Anxiety-Stress Scale (DAS-21)”. Results: It was found that the sociodemographic characteristics, medical history, and the characteristics related to COVID-19 were effective on the participants in terms of their mental states and the way they perceived traumatic experiences. According to the multiple linear regression analyses, it was found that hyper arousal and reexperiencing predicted stress, anxiety, and depression with a rate of 58.5%, 59.0% and 60.6%, respectively. Conclusion: At the beginning of the pandemic, it was observed that the responses of frontline hospital employees to traumatic experiences affected their mental states. Psychiatric nurses should take an active role in the development and implementation of psychosocial support programs for hospital personnel. Bangladesh J Medicine July 2022; 33(1) : 19-26