Coronavirus Disease 2019 Isolation Research Articles

Scanning Electron Microscopy of Glucose-Induced Cataract Treated with Garcinia mangostana Linn Pericarp Extract

The elderly is susceptible to infection due to immunosenescence causing high cases of infection with significant deaths due to Coronavirus Disease 2019 (COVID-19) pandemic. Many studies have examined inflammatory parameters as predictors of the outcome of COVID-19 cases, but there has been no comparison of the values of these parameters between the elderly and adult groups. This study aims to explain the relationship between inflammatory parameter values in the elderly group compared to the adult group with the outcome of confirmed COVID-19 patients treated at Ulin Hospital Banjarmasin. An analytical observational cross-sectional design study with the samples was patients with examined Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), Erythrocyte Sedimentation Rate (ESR), and C-reactive protein (CRP) when admitted to the COVID-19 isolation room at Ulin Banjarmasin Hospital and was divided into elderly and adult groups. A bivariate correlation test was conducted to assess the relationship between each parameter and continued by finding the cut-off value using the Receiver Operating Characteristic (ROC) curve. Odds Ratio (OR) is sought to find out how much the outcome risk prediction is based on the cut-off value. The relative coefficients of NLR, PLR, CRP, and ESR in the elderly group of 1147 subjects were 0.304; 0.119; 0.378; and 0.071. While the cut-off value of NLR, PLR, CRP, and ESR for the elderly group is 6.77; 257.5; 95.65, and 53.4. Outcomes prediction of the confirmed COVID-19 patients in the elderly group from the most significant are CRP, NLR, and PLR. Meanwhile, ESRs are statistically insignificant. The results showed that there are differences in inflammatory parameter values between the elderly and adult groups to predict the outcome of COVID-19 cases.

Comparison of Inflammation Parameters in the Elderly and Adults to the Outcomes of Confirmed Covid-19 Patients

The elderly is susceptible to infection due to immunosenescence causing high cases of infection with significant deaths due to Coronavirus Disease 2019 (COVID-19) pandemic. Many studies have examined inflammatory parameters as predictors of the outcome of COVID-19 cases, but there has been no comparison of the values of these parameters between the elderly and adult groups. This study aims to explain the relationship between inflammatory parameter values in the elderly group compared to the adult group with the outcome of confirmed COVID-19 patients treated at Ulin Hospital Banjarmasin. An analytical observational cross-sectional design study with the samples was patients with examined Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), Erythrocyte Sedimentation Rate (ESR), and C-reactive protein (CRP) when admitted to the COVID-19 isolation room at Ulin Banjarmasin Hospital and was divided into elderly and adult groups. A bivariate correlation test was conducted to assess the relationship between each parameter and continued by finding the cut-off value using the Receiver Operating Characteristic (ROC) curve. Odds Ratio (OR) is sought to find out how much the outcome risk prediction is based on the cut-off value. The relative coefficients of NLR, PLR, CRP, and ESR in the elderly group of 1147 subjects were 0.304; 0.119; 0.378; and 0.071. While the cut-off value of NLR, PLR, CRP, and ESR for the elderly group is 6.77; 257.5; 95.65, and 53.4. Outcomes prediction of the confirmed COVID-19 patients in the elderly group from the most significant are CRP, NLR, and PLR. Meanwhile, ESRs are statistically insignificant. The results showed that there are differences in inflammatory parameter values between the elderly and adult groups to predict the outcome of COVID-19 cases.

Occupational contact dermatitis among healthcare workers in the COVID-19 Isolation ward

Occupational skin disease due to intensified infection prevention procedures among healthcare workers has been reported since the outbreak of coronavirus disease-2019 (COVID-19). This study was to determine the cause of Occupational Contact Dermatitis (OCD) among healthcare workers in the COVID-19 isolation ward using a skin patch test to prevent the recurrence of the disease. The allergens for the patch test included thiuram-mix 1%, 2-mercaptobenzothiazole 2%, and tetramethyl thiuram disulfide 1% which were contained in gloves, cobalt chloride 1%, and colophony 20% which were contained in adhesives, as well as irigasan 2% and lanolin 100% which were contained in hand hygiene products. Thirty healthcare workers who were diagnosed with OCD were included and underwent patch tests. The participants were dominated by females (90%) and nurses (66.67%). Six participants got weak positive (+) results from thiuram-mix 1%. Meanwhile 1 weak positive (+), 6 strong positive (++) and 1 extreme positive (+++) were found in lanolin 100% patch test. There was clinical relevance to these results. The infection prevention measures among healthcare workers in the COVID-19 isolation ward increased the risk of OCD, including the use of PPE and hand hygiene products.

Prevalence and predictors of depression, anxiety and stress among frontline healthcare workers at COVID-19 isolation sites in Gaborone, Botswana.

Coronavirus disease 2019 (COVID-19) has been associated with mental health outcomes and healthcare workers (HCWs) are at the highest risk. The aim of this study was to determine the prevalence and predictors of depression, anxiety and stress, among frontline HCWs at COVID-19 isolation and treatment sites in Gaborone, Botswana. This was a cross-sectional study using self-administered questionnaires at the six (6) isolation facilities. The 42-item Depression, Anxiety and Stress Scale (DASS-42) was used to assess for the outcomes. The proportions are presented with 95% confidence intervals (95% CI). Logistic regression analysis identified predictors of the outcomes. A p value of <0.05 was considered significant. A total of 447 participants with a median age of 30 years responded. Depression, anxiety and stress were detected in 94 (21.0% (95% CI 17.3-25.1%)), 126 (28.2% (CI 24.1-32.6%)) and 71 (15.9% (12.6-19.6%)) of the participants respectively. Depression was associated with smoking (AOR 2.39 (95% CI 1.23-4.67)), working at the largest COVID-19 isolation centre, Sir Ketumile Masire Teaching Hospital (SKMTH) (AOR 0.25 (95% CI 0.15-0.43)) and experience of stigma (AOR 1.68 (95% CI 1.01-2.81)). Tertiary education (AOR 1.82 (95% CI 1.07-3.07)), SKMTH (AOR 0.49 (95% CI 0.31-0.77)), household members with chronic lung or heart disease (AOR 2.05 (95% CI 1.20-3.50)) and losing relatives or friends to COVID-19 (AOR 1.72 (95% CI 1.10-2.70)) were predictors of anxiety. Finally, predictors of stress were smoking (AOR 3.20 (95% CI 1.42-7.39)), household members with chronic heart or lung disease (AOR 2.44 (95% CI 1.27-4.69)), losing relatives or friends to COVID-19 (AOR 1.90 (1.05-3.43)) and working at SKMTH (AOR 0.24 (0.12-0.49)). Depression, anxiety and stress are common among frontline HCWs working in the COVID-19 isolation sites in Gaborone. There is an urgent need to address the mental health outcomes associated with COVID-19 including addressing the risk factors identified in this study.

Accuracy of chest ultrasonography in the diagnosis of coronavirus disease 2019 pneumonia

Abstract Background Coronavirus disease 2019 (COVID-19) virus infection is an ongoing, catastrophic, worldwide pandemic with significant morbidity and mortality. Large numbers of people who are getting COVID-19 virus infection are at high risk of developing COVID-19 pneumonia; early diagnosis of COVID-19 pneumonia, patient care, and isolation using simple, less expensive images are required. High-resolution computed tomography chest (HRCT chest) is the reference standard method for the diagnosis of COVID-19 pneumonia; however, it is expensive with increasing the exposure risk; chest ultrasonography (CUS) may be an alternative method. Patients and methods CUS is performed on patients accepting to participate in the study at presentation of COVID-19 suspicious cases. HRCT chest to confirm COVID-19 pneumonia were done within 24 h of CUS examination. Two chest consultants who are experts in CUS at Assiut University Hospital performed CUS. The CUS is done using a convex probe of 3.5 MHz. The CUS was considered positive for pneumonia if the examiners find the presence of abnormal multiple vertical B lines with or without the presence of consolidation dots unilateral or bilateral with good cardiac function; HRCT chest results are recorded. Results In all, 197 patients were included in the study (102 males, mean age 48 ± 16.2 years). Regarding comorbidity: 10% had diabetes mellitus and 9% had hypertension. Ten (5%) patients needed hospitalization with a mean oxygen saturation of 95 ± 5%. One hundred fifty-two patients confirmed COVID-19 pneumonia with HRCT chest, while 45 patients had normal HRCT chest. CUS showed positive pneumonic finding in 128 patients and normal picture in 69 patients. There was good association (r=0.690, P&lt;0.001) between both diagnostic modalities in COVID-19 pneumonia diagnosis. Sensitivity and specificity and accuracy of CUS in the diagnosis of COVID-19 pneumonia were 84.56, 95.83, and 87.31%, respectively, when compared with HRCT chest. One hundred and two patients were successfully followed; all of them showing clinical and ultrasonographic improvement.

Prevalence of Elevated Troponin- I among Hospitalized Patients with COVID- 19.

Background: Corona Virus Disease 2019 (COVID-19) pandemic caused millions of pneumonia related death since December 2019. Cardiac troponin-I elevation is associated with adverse outcomes in cardiovascular and non-cardiovascular disease. There is a lack of data regarding the role of troponin-I on the assessment and COVID-19 stage classification and stratification. Objective: The study was aimed to estimate prevalence of troponin-I among hospitalized patients with COVID-19. Methods: This cross sectional descriptive type of observational study was carried out at COVID-19 isolation unit of Sylhet Women’s Medical College Hospital during the period of six months from April 2021 to September 2021. Data were collected from purposively selected 204 patients with COVID-19 from patient files and EMR. Data were analyzed by using SPSS version 21.0. Results: The study results revealed that mean age of the patients with COVID-19 was 57.97 years with a standard deviation of 15.78 years. Majority of them (121, 59.3%) were female and the remaining (83, 40.7%) were male. Proportion of comorbidities were estimated and found that each 115 (56.4%) patients were hypertensive and diabetic. Thirty five (16.2%) had ischemic heart disease; 3 (1.5%) had congestive cardiac failure and 2 (1.0%) had asthma. Only 1 (0.5%) patent has atrial fibrillation. Minimum level of troponin-I was 0.01 ng/ml and the maximum level was 21.70 ng/ml with a range of 21.69 ng/ml. Mean troponin-I of patients with COVID-19 was 0.38±1.78 ng/ml. Estimated prevalence of elevated troponin-I was 39.1%. Level of troponin-I in patients of different age group was compared and Chi-square test showed no significant difference (p&gt;0.05). Elevation of troponin-I in both sex was compared and again Chi-square test showed no significant difference (p&gt;0.05). Elevation of troponin-I was significantly higher on those who were detected by RT-PCR than those who were detected by rapid antigen test (p=0.048).Conclusion: Though the pattern of elevation of troponin-I was found similar in younger and older patients and in males and females, a significant number of patients with COVID-19 (65/204, 39.1%) had elevated troponin-I which should be addressed to evaluate and manage patients with COVID-19 more efficiently.

Longitudinal analysis of built environment and aerosol contamination associated with isolated COVID-19 positive individuals.

The indoor environment is the primary location for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), largely driven by respiratory particle accumulation in the air and increased connectivity between the individuals occupying indoor spaces. In this study, we aimed to track a cohort of subjects as they occupied a COVID-19 isolation dormitory to better understand the impact of subject and environmental viral load over time, symptoms, and room ventilation on the detectable viral load within a single room. We find that subject samples demonstrate a decrease in overall viral load over time, symptoms significantly impact environmental viral load, and we provide the first real-world evidence for decreased aerosol SARS-CoV-2 load with increasing ventilation, both from mechanical and window sources. These results may guide environmental viral surveillance strategies and be used to better control the spread of SARS-CoV-2 within built environments and better protect those caring for individuals with COVID-19.

Early evolution of biochemical markers in severe and non-severe patients infected with Covid-19

Coronavirus disease 2019 (COVID-19) is an emerging infection that has caused a pandemic, it is due to a virus of the coronavirus family called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which can evolve into severe forms leading to death. Several biochemical alterations have been described in COVID-19 patients with great significance for clinical diagnosis and outcome prediction. The aim of this study is to compare early evolution of biochemical disturbances in COVID-19 patients and correlate them to severity of the disease. This study was conducted in 70 COVID-19 patients hospitalized at the Avicenna military hospital. 20 patients in the medical intensive care unit (severe group) and 50 patients in the COVID-19 isolation hospital (non-severe group). Across our laboratory data analysis of the two groups of COVID-19 patients, we demonstrated that high titles and early elevation of ferretinemia, Interleukin-6, High-Sensitivity Troponin T(us), NT-Pro-BNP, Blood Urea nitrogen, Creatinine and LDH are significantly correlated to severity of the disease. The analysis of this study through the recent scientific literature demonstrates the interest of early monitoring of biochemical markers in the diagnosis of severity and monitoring of severe forms of covid-19.

Time taken by individuals with respiratory symptoms to present to primary care: a descriptive study of assessments at Australian General Practitioner-led respiratory clinics.

Effective control of coronavirus disease 2019 (COVID-19) has been challenging, in part due to significant asymptomatic and pre-symptomatic transmission of disease. Reducing the time between symptom onset and COVID-19 testing and isolation allows enhanced outbreak control. The purpose of this study is to describe the time taken by participants to present to general practitioner-led (GP) respiratory clinics for assessment following the development of symptoms, and to explore associations between demographic and geographic characteristics and the time to presentation. A total of 314,148 participants, who were assessed in GP respiratory clinics between 1 February and 31 August 2021, were included in the analysis. The median age of participants at presentation was 33 years (interquartile range, IQR: 15-49). The median time from development of symptoms to presentation for assessment at GP respiratory clinics was 2 days (IQR: 1-3). Participants were more likely to present within one day of symptom onset if they were aged between 15 and 64 years (43.4%), lived in urban areas (40.9%) or were non-Indigenous (40.2%). Participants in New South Wales and Victoria had twice the odds (OR 2.01; 95% confidence interval (CI): 1.95, 2.08) of presenting at a GP respiratory clinic within one day of symptom onset in August 2021, when there was a COVID-19 outbreak in those states, than they did in March 2021, when there was no COVID-19 outbreak in Australia. The number of days from symptom onset to presentation at a GP respiratory clinic was strongly associated with the presence of a COVID-19 outbreak. Participant age, location of the clinic, and Indigenous status of participants were also associated with the time to presentation. This study highlights the importance of recognising COVID-19 as a potential cause of symptoms, as well as the importance of providing easily accessible, and culturally appropriate, testing facilities for the population.

Correlation between Acute Kidney Injury and Inflammatory markers in Coronavirus Disease 2019

Background and Objectives: Coronavirus Disease 2019 (COVID-19) particularly when severe may commonly present with Acute Kidney Injury and may show elevated blood levels of inflammatory markers. Current study aims at determining the correlation between AKI and raised inflammatory markers in COVID-19.&#x0D; Materials and Methods: Medical records of 250 patients admitted in COVID-19 isolation intensive care unit of Farooq Hospital, Westwood Branch, Lahore between 1st July, 2021 and 30th September, 2021 were retrospectively reviewed and data comprising of demographic, clinical and laboratory parameters was collected. Patients with confirmed diagnosis of COVID-19 from Real Time Polymerase Chain Reaction (RT-PCR) were included in the study while those with incomplete medical records or known history of Chronic Kidney Disease (CKD) were excluded. Statistical analysis of collected data was then made and p value &lt; 0.05 was considered statistically significant.&#x0D; Results: Among 176 patients who fulfilled the inclusion criteria, most (138(78.4%)) were males with mean age of 51.26±15.20 years. Diabetes Mellitus was most common comorbidity observed in 70(39.8%) patients and mean length of hospital stay was 8.46±4.12 days. AKI was found in 91(51.7%) patients while remaining 85(48.3%) patients didn’t have AKI. All four inflammatory markers: C-Reactive Protein (CRP), D-dimers, ferritin and procalcitonin (PCT) were found significantly raised in COVID-19 patients having AKI compared with non-AKI group (p &lt; 0.05).&#x0D; Conclusions: Raised inflammatory markers in patients having severe COVID-19 are associated with increased risk of AKI.

Depression in healthcare workers from the COVID-19 Care and Isolation Center - Villa Panamericana: a single-center prospective study in Peru.

ABSTRACTObjective Depression is a mental problem that affects the well-being of healthcare workers, impacting the quality of care and even leading to commit suicide. We aim to the levels of depression in frontline healthcare workers during the first severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in Peru.Methods A prospective cohort study was designed in the coronavirus disease 2019 (COVID-19) Care and Isolation Center – Villa Panamericana in eastern Lima. Care and Isolation Center-Villa Panamericana houses about 150 healthcare workers and COVID-19 patients. The Montgomery-Asberg Depression Rating scale was used for depression assessment.Results A total of 96 participants (30±5.6 years) were analyzed: 15 (15.6%) physicians, 39 (40.6%) nurses, 14 (14.6%) medical technologists, and 28 (29.2%) nurse technicians. Mild, moderate, and severe depression were present in 35 (36.5%), 44 (45.8%), and 9 (9.4%) of the cases, respectively. The physicians and nurses reported more severe levels of depression: 8 (53.3%) physicians and 18 (46.2%) nurses presented moderate depression; and 2 (13.3%) physicians and 3 (7.7%) nurses presented severe depression (p=0.005). This study determined greater symptoms of depression according to years of work (p=0.001). Thirty-two healthcare workers had COVID-19, 4 (12.5%) physicians, 9 (28.1%) nurses, 7 (21.9%) medical technologists, and 12 (37.5%) nurse technicians. Twenty-four (75%) participants showed symptoms of COVID-19 and developed moderate (12 [37.5%]) and severe (3 [9.4%]) symptoms of depression (p=0.041).Conclusion This study clearly demonstrated a high prevalence of depression in the Care and Isolation Center-Villa Panamericana frontline healthcare workers during the COVID-19 pandemic in Peru.

Risk Factors Associated with COVID-19 Infections among Healthcare Workers in Eswatini: A Cross-Sectional Study

Background: The coronavirus disease 2019 (COVID-19) pandemic has spread with alarming speed, infecting millions globally, including Eswatini. Despite the institutionalization of measures by the Ministry of Health (MoH) to fight the pandemic, the cumulative number of people infected with COVID-19 has kept increasing daily. We sought to assess risk factors for COVID-19 infections among Health care workers (HCWs) in selected health facilities of the Lubombo region of Eswatini. Methods: A cross-sectional design and systematic stratified sampling were used to select the participants. Results: The study enrolled 333 HCWs, with the majority (201, 60.4%) being females, and the participants’ mean age was 33 years. The study showed that not having an isolation arrangement in a health facility for people suspected to have COVID-19 presents risk to HCWs for COVID-19 (Crude Odds Ratio (COR) = 2.5, 95%CI: 1.0–6.2), p = 0.50; Adjusted Odds Ratio (AOR) = 3.0, 95% confidence interval (CI) 1.0–8.7, p = 0.038). Likewise, HCWs who rarely followed infection prevention and control (IPC) measures were at higher risk of COVID-19 infection than those who followed such measures (COR = 4.2, 95%CI: 1.1–17.2, p = 0.041; AOR = 6.5, 95%CI: 1.4–30.0, p = 0.016), and HCWs exposed to a colleague diagnosed with COVID-19 were at higher risk of being infected themselves (AOR = 11.4; 95%CI: 0.9–135.7; p = 0.054). Conclusion: An active COVID-19 symptoms screening, triage and isolation arrangement for suspected COVID-19 clients for all clients entering the facility increases protection of HCWs from COVID-19. Reinforcement of all infection prevention and control measures to prevent exposures from infected patients and colleagues is essential.

Ocular Manifestations in Patients with Coronavirus Disease 2019 (COVID-19): A Real World Multicenter Observational Study in Egypt

Background: The aim of the work was to evaluate the ocular manifestations in the patients with COVID-19 and its role in the prediction of the course and the outcome of the disease. Methods: This retrospective study was conducted at two tertiary referral COVID-19 isolation hospitals in two major university hospitals in Egypt. Two hundred and twenty-eight patients were enrolled in the study. The medical records of patients who had clinically confirmed COVID-19 between 1/5/2020 to 15/7/2020 were retrospectively reviewed. Data were collected from patient charts, including age, sex, accommodation, ocular manifestations, fever, headache, cough, dyspnea, anosmia, cyanosis, abdominal pain, anorexia, liver, kidney, cardiac manifestations, CT, X-ray finding, blood tests, and outcome of the disease. Results: Thirty-four patients with ocular manifestation were finally enrolled in the study with a mean age of 42.1 years; 20 patients (58.8%) were men. The incidence of ocular manifestation was 14.9% (34/228). All patients with ocular manifestations had conjunctivitis (redness, epiphora, foreign body sensation), which had been treated and resolved completely within 10 days in all patients without any permanent ocular damage. There was a trend between the presence of ocular manifestations and the associated milder disease course, although this trend was not statistically significant. Conclusion: Ophthalmic manifestation is common in patients with COVID-19 and it occurs more frequently in patients with mild to moderate form of COVID-19, but it could not predict the patient’s mortality.

Ocular Manifestations in Patients with Coronavirus Disease 2019 (COVID-19): A Real World Multicenter Observational Study in Egypt

Background: The aim of the work was to evaluate the ocular manifestations in the patients with COVID-19 and its role in the prediction of the course and the outcome of the disease. Methods: This retrospective study was conducted at two tertiary referral COVID-19 isolation hospitals in two major university hospitals in Egypt. Two hundred and twenty-eight patients were enrolled in the study. The medical records of patients who had clinically confirmed COVID-19 between 1/5/2020 to 15/7/2020 were retrospectively reviewed. Data were collected from patient charts, including age, sex, accommodation, ocular manifestations, fever, headache, cough, dyspnea, anosmia, cyanosis, abdominal pain, anorexia, liver, kidney, cardiac manifestations, CT, X-ray finding, blood tests, and outcome of the disease. Results: Thirty-four patients with ocular manifestation were finally enrolled in the study with a mean age of 42.1 years; 20 patients (58.8%) were men. The incidence of ocular manifestation was 14.9% (34/228). All patients with ocular manifestations had conjunctivitis (redness, epiphora, foreign body sensation), which had been treated and resolved completely within 10 days in all patients without any permanent ocular damage. There was a trend between the presence of ocular manifestations and the associated milder disease course, although this trend was not statistically significant. Conclusion: Ophthalmic manifestation is common in patients with COVID-19 and it occurs more frequently in patients with mild to moderate form of COVID-19, but it could not predict the patient’s mortality.

Mechanical ventilation practice of pediatric patients with Covid-19 in Indonesian tertiary hospital

Background: Coronavirus Disease-2019 (COVID-19) in children tend to have milder clinical manifestation. However, some develop critical conditions and require mechanical ventilation in the Pediatric Intensive Care Unit (PICU). Various modalities are recommended for mechanical ventilation, such as High Flow Nasal Cannula (HFNC), Continuous Positive Airway Pressure (CPAP), or invasive ventilation with intubation. This study aims to describe the clinical feature, ventilation modalities usage, and the outcome of children with critical COVID-19.&#x0D; Methods: This is a retrospective study in COVID-19 children with respiratory distress who were treated in the COVID-19 isolation PICU room of Saiful Anwar General Hospital for one year. The data was gained from the medical record and analyzed descriptively. Data were analyzed using Ms. Excel for Windows.&#x0D; Results: A total of 51 children with COVID-19 were admitted to Saiful Anwar general Hospital in one year period, with 12 of them in critical condition and 6 children require mechanical ventilation. The main signs developed were fever and dyspnea. Invasive mechanical ventilation applicated in 5 patients, and only 1 patient received Non-Invasive Ventilation (NIV). The mean of PEEP used in invasive ventilation is 7-9 cmH2O, lower than ESPNIC’s recommendation of 8-10 cmH2O. Length of ventilator usage is 2-21 days, with 2 patients passed away, both with a comorbid and organ system injury.&#x0D; Conclusion: The mechanical ventilation setting must be determined individually based on the patients’ condition, despite several guidelines providing the recommendation.

Telecounseling and guided relaxation for addressing patient, student, and health-care worker distress: An experience

Introduction: In the face of the coronavirus disease 2019 (COVID-19) pandemic, the leadership of the institute felt a need for mental health interventions among patients admitted in COVID-19 isolation, university students, and health-care workers engaged in COVID-19 care. This article aims to share our experience in providing these services. Methodology: COVID-19 inpatients were telephonically counseled. Counseling protocol was based on national guidelines. Students of the university were assessed for emotional problems using a symptom checklist and Kessler 10-item Distress Scale. Subsequently, the faculty assigned as mentors were trained in providing telephonic psychological first aid (PFA) to the students. Psychosocial help was offered to health-care workers through daily guided relaxation sessions. Results: Forty-two of 69 COVID-19 inpatients were telephonically contacted. New-onset mental health problems were found in 40%. Half of the COVID-19 confirmed patients and half of the females had a higher prevalence of mental health problems. On the symptom checklist, 330 students were responded. Worry about the future, contagion, and boredom were reported by the majority of students. On the Kessler 10-item Distress Scale, 272 students were responded. Thirty-seven percent had likely mental disorders (22 males and 79 females). Twenty-two students contacted psychiatrists through mentors and were provided teleconsultation. Eighty health-care workers attended guided relaxation sessions. Twenty-nine responded on the feedback form. Most respondents felt guided relaxation was useful in reducing stress, with strongly agree (n = 12) and agree (n = 14) responses. Conclusions: Emotional problems were significantly prevalent among students and COVID-19 patients. Training faculty in PFA can help address students in distress. Guided relaxation may help frontline workers manage stress.

Effect of COVID-19 quarantine on patients admitted to neurosurgery outpatient Clinic individuals with COPD

Coronavirus disease 2019 (COVID-19) emerged in Wuhan, China, and was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Throughout the pandemic period, numerous countries around the world have implemented nationwide isolation measures to control the spread and transmission of COVID-19. During this period, the prevalence of some physical and mental diseases have increased due to prolonged home isolation measures. In the present study, we aimed to examine the effect of the COVID-19 isolation measures imposed in Turkey on patients admitted to our neurosurgery outpatient clinic.

414. Observed Time Burden with Nursing Practices in an Emergency Room COVID-19 Isolation Zone at a University Affiliated Hospital in Korea

BackgroundThe coronavirus disease 2019 (COVID-19) has caused great burdens on emergency room (ER) and front-line ER healthcare personnel faced with great challenges, including threats to their safety. This study aimed to provide a basis for additional workload of ER nurses who are charged with providing care for COVID-19 confirmed or suspicious cases.Table 1. Summary of Frequency and Time Burden with Nursing Practices in an Emergency Room COVID-19 Isolation Zone. Note. IV, intravenous; IM, intramuscular; ID, intradermal; SC, subcutaneous; PPE, personal protective equipment; CPR, cardiopulmonary resuscitation MethodsWith institutional review board approval, we recruited ER nurses who were assigned to COVID-19 isolation zone with more than 6 months’ ER work experience. After their demographic information were collected through a questionnaire, their nursing practices and practice time during their 1 shift (day or evening) were recorded by one researcher using a stopwatch and an observation form. For each observation shift, unit-related information was collected, including the numbers of hospitalized patients, admission, discharge, and transfer of patients. For each nursing practice, frequency and total time spent were analyzed using descriptive statistics with SPSS 26.0 program. ResultsFrom January 4 to February 22, 2021, a total 18 nurses (27.4 years old on average with 25.2 months of ER experience) were observed from 20 different shifts. During the observation period, the average number of nurses’ working hours was 8.27 ± 0.39 hours. A total of 6,567 tasks were monitored with 337,703 seconds (93.81 hours) of the total time spent. Infection control practices were most frequent (33.88%) followed by nursing management (27.80%), assessment and observation (11.07%), medication (10.35%), pre and post examination care(4.86%), education (4.37%), communication (4.10%), safety care (1.10%), and others (0.03; Table 1). Nursing management (e.g., nursing recording) was most time-consuming (49.29%) followed by assessment and observation (15.03%), medication (12.94%), patient education (6.10%), infection control (5.30%), and safety care (1.64%).ConclusionThis study showed that infection control practices were most frequent while time spent was relatively insignificant among ER nurses in charge of COVID-19 isolation zones. Further studies for more observations or with different study designs at other ER settings are necessary to understand nurse’s burdens with COVID-19 emergency care.Disclosures All Authors: No reported disclosures

Perioperative Infection Prevention Beyond COVID‐19

Perioperative Infection Prevention Beyond COVID‐19

Ethical considerations for clinicians faced with patients lacking the capacity to form reasoned judgments regarding COVID-19 tests and isolation.

Dealing with patients suffering severe mental health problems during the Coronavirus disease 2019 (COVID-19) pandemic have raised several, complex, clinical and ethical questions (1). Such patients may need to be treated within secure facilities where many patients and staff live in close proximity, increasing the risk of disease transmission. In February 2020, in the Daenam hospital in South Korea, an infection cluster was found in the psychiatric ward, with 101/103 patients testing positive (2). In this pandemic’s unprecedented circumstances, psychological pressure on medical staff has been severe (3). Clinical staff have been significantly at risk when dealing with psychiatric inpatients, especially in areas where high infection levels have led to shortfalls in personal protective equipment supply. Several strategies are required to reduce infection risks for psychiatric inpatients and their caregivers. Such strategies may include a comprehensive test program, mask-wearing, and social distancing. However, psychiatric patients would frequently not possess the capacity to make reasoned judgments regarding the refusal of testing or noncompliance with anti-infection protocols. Because of psychiatric illness, such patients may refrain from being tested or following protocols such as mask-wearing or isolation. Thus, clinicians have faced with serious ethical problems when dealing with psychiatric inpatients during this pandemic, in that they must balance the requirements of respecting patient autonomy and allowing them as much freedom of self-determination as is appropriate, against the need to protect the patient from infection and prevent them from infecting others. This commentary aimed at assisting clinicians facing with such ethical dilemmas.