Coronavirus Disease 2019 Lockdown Research Articles

Interaction between Lifestyle Changes and PNPLA3 Genotype in NAFLD Patients during the COVID-19 Lockdown.

The coronavirus disease 2019 (COVID-19) lockdown dramatically changed people’s lifestyles. Diet, physical activity, and the PNPLA3 gene are known risk factors for non-alcoholic fatty liver disease (NAFLD). Aim: To evaluate changes in metabolic and hepatic disease in NAFLD patients after the COVID-19 lockdown. Three hundred and fifty seven NAFLD patients were enrolled, all previously instructed to follow a Mediterranean diet (MD). Anthropometric, metabolic, and laboratory data were collected before the COVID-19 lockdown in Italy and 6 months apart, along with ultrasound (US) steatosis grading and information about adherence to MD and physical activity (PA). In 188 patients, PNPLA3 genotyping was performed. After the lockdown, 48% of patients gained weight, while 16% had a worsened steatosis grade. Weight gain was associated with poor adherence to MD (p = 0.005), reduced PA (p = 0.03), and increased prevalence of PNPLA3 GG (p = 0.04). At multivariate analysis (corrected for age, sex, MD, PA, and PNPLA3 GG), only PNPLA3 remained independently associated with weight gain (p = 0.04), which was also associated with worsened glycemia (p = 0.002) and transaminases (p = 0.02). During lockdown, due to a dramatic change in lifestyles, half of our cohort of NAFLD patients gained weight, with a worsening of metabolic and hepatologic features. Interestingly, the PNPLA3 GG genotype nullified the effect of lifestyle and emerged as an independent risk factor for weight gain, opening new perspectives in NAFLD patient care.

Back to school after lockdown: The effect of COVID-19 restrictions on children's device-based physical activity metrics

BackgroundThe coronavirus disease-2019 (COVID-19) pandemic and national lockdowns took away opportunities for children to be physically active. This study aimed to determine the effect of the COVID-19 lockdown on accelerometer-assessed physical activity (PA) in children in Wales. MethodsEight hundred participants (8–18 years old), stratified by sex, age, and socio-economic status, wore Axivity AX3 accelerometers for 7 days in February 2021, during the lockdown, and in May 2021, while in school. Raw accelerometer data were processed in R-package GGIR, and cut-point data, average acceleration (AvAcc), intensity gradient, and the acceleration above which the most active X minutes are accumulated (MX) metrics were extracted. Linear mixed models were used to assess the influence of time-point, sex, age, and socioeconomic status (SES) on PA. ResultsDuring lockdown, moderate-to-vigorous PA was 38.4 ± 24.3 min/day; sedentary time was 849.4 ± 196.6 min/day; mean ± SD. PA levels increased significantly upon return to school (all variables p < 0.001). While there were no sex differences during lockdown (p = 0.233), girls engaged in significantly less moderate-to-vigorous PA than boys once back in school (p < 0.001). Furthermore, boys had more favorable intensity profiles than girls (intensity gradient: p < 0.001), regardless of time-point. PA levels decreased with age at both time-points; upper secondary school girls were the least active group, with an average M30 of 195.2 mg (while in school). ConclusionThe lockdown affected boys more than girls, as reflected by the disappearance of the typical sex difference in PA levels during lockdown, although these were re-established on return to school. Upper secondary school (especially girls) might need specific COVID-recovery intervention.

Weight gain, weight management and medical care for individuals living with overweight and obesity during the COVID-19 pandemic (EPOCH Study).

ObjectiveMedical care and weight related experiences have been challenged by the coronavirus disease 2019 (COVID‐19) pandemic for those living with obesity. The magnitude of this impact requires further attention in order to optimize patient care and outcomes. The aim of this study was to assess the impact of the COVID‐19 pandemic and lockdown on access to, and experience of, medical care, weight gain and management strategies, as well as predictors of weight gain.MethodsAn online survey (June–October 2020) was conducted with two samples; one representative of Canadians living with overweight and obesity (n = 1089) and a second of individuals recruited through obesity clinical services or patient organizations (n = 980).ResultsLess than half of the total respondents thought that their providers were available for their medical care and most preferred in‐person appointments over telemedicine. Only one quarter were satisfied with their obesity care. Sixty percent of the respondents reported weight gain (on average 5.65 kilograms [kg] gained), with 39.0% gaining more than 5% of their body weight (10.2% gained more than 10%). Over half of the respondents experienced decreased motivation for healthy eating or exercise. One third experienced more frequent and greater food consumption. Although worsening sleep occurred in approximately 20%, there was no significant increase in smoking, alcohol, or cannabis use. Predictors of weight gain were younger patients, higher weight categories, those who struggled with obtaining medical care during the pandemic, as well as those who struggled with eating.ConclusionThese results suggest that the COVID‐19 pandemic negatively impacted patient care for those living with overweight and obesity and was associated with weight gain and interfered with weight management strategies. Greater attention to personalized weight management and interventions that focus on the predictors of weight gain should be undertaken.

Craving variations in patients with substance use disorder and gambling during COVID-19 lockdown: The Italian experience.

BACKGROUNDFollowing the development of the coronavirus disease-2019 (COVID-19) pandemic in Italy, a strict lockdown was imposed from March 9 to May 5, 2020. The risks of self-medication through alcohol or psychoactive substance abuse were increased, as well as the tendency to adopt pathological behaviors, such as gambling and internet addiction.AIMTo evaluate the impact of the COVID-19 pandemic and associated containment measures on craving in a group of patients suffering from substance use disorder and/or gambling disorder who were in treatment in outpatient units or in residency programs as inpatients.METHODSOne hundred and fifty-three patients completed a structured questionnaire evaluating craving and other behaviors using a visual analogue scale (VAS). Forty-one subjects completed a pencil and paper questionnaire during the interview. The clinician provided an online questionnaire to 112 patients who had virtual assessments due to lockdown restrictions. Statistical analyses were performed using Statistica version 8.0. Quantitative parameters are presented as the mean ± SD and qualitative parameters as number and percentage per class. The Kolmogorov-Smirnov test was used to check for normality of distributions. Analysis of variance and Duncan post hoc test were employed to analyze differences among subgroup means. The associations between variables were measured using Pearson's correlation. A P value of < 0.05 was considered significant.RESULTSThe variation in craving between the present and the month before showed VAS-related reductions of craving in 57%, increases in 24%, and no significant change in 19% of the sample. The level of craving was significantly higher (F = 4.36; P < 0.05) in outpatients (n = 97; mean = 3.8 ± 3.1) living in their own home during the quarantine compared with inpatients (n = 56; mean = 2.8 ± 2.8) in residential programs. Craving for tetrahydrocannabinol was the greatest (4.94, P < 0.001) among various preferred substances. CONCLUSIONThe unexpected result of this study may be explained by a perceived lack of availability of substances and gambling areas and/or decreased social pressure on a subject usually excluded and stigmatized, or the acquisition of a new social identity based on feelings of a shared common danger and fate that overshadowed the sense of exclusion and rejection in the abuser.

Enablers and inhibitors of efforts to reduce Scope 3 emissions – The case of an ODeL university

Background: The reconfiguration of the South African higher education landscape in 2003 and 2004 had a significant impact on the University of South Africa (UNISA) and Technikon SA (both distance education institutions) which merged to form the ‘new’ UNISA. Aim: The aim of this conceptual study is to explore the extent to which the policies of the post-merger UNISA are enablers or inhibitors of efforts to reduce its Scope 3 carbon emissions. Setting: Staff commuter patterns between the main campuses of UNISA and the policy environment that has an impact on such travel. Methods: The aim is achieved by means of a case study methodology that considers the relevant policies of the university and applicable results of a 2018 UNISA staff travel demand survey to determine whether the policies are incongruous with the institution’s attempts to reduce its carbon footprint in general, and its Scope 3 carbon emissions in particular. The impact of the coronavirus disease 2019 (COVID-19) pandemic on defining a ‘new normal’ for the university’s operations, and the impact thereof on staff commuting, have been discussed. Results: The study revealed that despite being an Open Distance E-Learning (ODeL) institution, the university has not put a coherent policy framework in place that undeniably supports its efforts to limit or reduce its Scope 3 carbon emissions. This was brought into stark focus by the measures the university was forced to put in place as a result of the COVID-19 lockdown regulations in South Africa, to ensure the continuation of its business. Conclusion: The conclusions will assist UNISA - and other universities which have had to revisit their operations as a result of the COVID-19 pandemic - to define a true ‘new normal’.

Impact of Coronavirus Disease Lockdown on Children With Type 1 Diabetes Mellitus in Al-Khobar, Saudi Arabia.

BackgroundAfter the emergence of the novel coronavirus disease pandemic, Saudi Arabia implemented lockdown restrictions to counter this infection and prevent its spread. There have been a lot of challenges to the majority of people, especially diabetic patients, which might result in an increased risk of developing complications and significant lifestyle changes, including physical inactivity, unhealthy diet, and psychological distress.ObjectiveThis study aims to assess the impact of coronavirus disease lockdown on children with type 1 diabetes (T1D) mellitus in Al-Khobar, Saudi Arabia.MethodsThis is a questionnaire-based cross-sectional study which was conducted in pediatric patients, aged ≤18 years old, with type I diabetes, who were attending the endocrine clinic at the King Fahd Hospital of the University (KFHU) in Al-Khobar, Saudi Arabia. A total of 250 patients were identified from the hospital databases, a total of 164 patients were included in the study, and one of the parents/guardians was interviewed through mobile phone after taking their consent.ResultsThe medication compliance during the lockdown has significantly increased as the percentage of children who did not miss any dose of medications increased to 92.7% in comparison to 70.7% before the lockdown (P=0.000). Also, diabetic ketoacidosis (DKA)-related intensive care unit admission had significantly decreased during the lockdown (P=0.001). Regarding the number of consumed meals, it increased from 53.7% up to 68.3% before and during the lockdown period, respectively (P=0.005). In addition, there was no significant change in children's psychological health during the lockdown period (p= 0.123).ConclusionThe study indicates that there was an increase in compliance to medications, a significant decrease in intensive care unit and emergency department admission due to hypo/hyperglycemia during the lockdown period. Medical practitioners are encouraged to educate diabetic patients regarding the importance of self-blood glucose monitoring, healthy lifestyle, psychological wellbeing, and regular follow-up through virtual clinics.

COVID-19 Pandemic and Lockdown: Psychological Distress Impact amongst PCL Nursing Students of Nepalgunj Nursing Campus, Kohalpur, Banke, Nepal

Introduction: The uncontrolled spread of COVID-19 worldwide has confined millions of people to their homes. In addition to being a public physical health emergency, COVID-19 (Corona Virus Disease 2019) has significantly resulted in a large number of psychological distress and impacts. The career oriented professional students are away from their academic environment.&#x0D; Aims: This study aims to assess the psychological distress impact of the COVID-19 pandemic among the Proficiency Certificate Level Nursing of Nepalgunj Nursing Campus, Kohalpur, Banke, Nepal.&#x0D; Methods: The online survey with a link directed to students of Proficiency Certificate Level (PCL) Nursing of Nepalgunj Nursing Campus, Kohalpur, Banke, Nepal conducted during lockdown (July 16th –July 21st 2020) which was open for 6 days. Sociodemographic characteristics are the independent variables. Psychological distress was constructed using the Kessler Psychological Distress Scale (K10) Scale as a dependent variables. Data were analyzed using Microsoft Excel.&#x0D; Results: The evidence of the survey showed that in total 80.2, % (severely distressed - 30.7%, moderately distressed -29.7%, mildly distressed- 19.8%) of the Proficiency Certificate Level Nursing students of Nepalgunj Nursing Campus, were having psychological distress during COVID-19 pandemic and lockdown assessed by using K10 scale.&#x0D; Conclusion: The present study showed that Proficiency Certificate Level Nursing students were moderately and severely distressed during lockdown of Covid-19 pandemic.

The impact of the COVID-19 lockdown on human psychology and physical activity; a space analogue research perspective

AbstractIntroductionAstronauts will encounter isolated, confined and extreme (ICE) conditions during future missions, and will have to be able to adapt. Until recently, however, few places on Earth could serve as acceptable space analogues (i.e., submarine and polar regions). The coronavirus disease-2019 (COVID-19)-related lockdowns around the globe provided a good opportunity to obtain more comprehensive datasets on the impact of prolonged isolation on human functioning in a very large sample.MethodsSeven hundred forty-eight individuals (Belgium 442, Spain 183, Germany 50, Italy 50, US 23; Mean age ± SD: 41 ± 14 years, with an age range of 18–83 years; 66% women) filled out an online survey assessing the impact of the COVID-lockdown on psychological, exercise and general health variables a first time near the beginning of the initial lockdown (hereafter ‘T1’; 24 ± 13 days after the start of the first lockdown; i.e., 3 weeks after the start of the first lockdown) and a second time a couple of weeks thereafter (hereafter ‘T2’; 17 ± 5 days after the first online survey; i.e., 6 weeks after the start of the first lockdown).ResultsFrom T1 to T2 an improvement of subjective sleep quality was observed (P = 0.003), that was related to an increase in subjective sleep efficiency and a decrease in sleep latency and disturbance (P ≤ 0.013). Weekly sitting time decreased, and the weekly amount of moderate and vigorous physical activity increased from T1 to T2 (P ≤ 0.049). No differences from T1 to T2 were observed in terms of mood, loneliness and state anxiety. A lower amount of sitting time was significantly correlated with improved subjective sleep quality (r = 0.096, P = 0.035) and with an increased amount of moderate (r = −0.126, P = 0.005) and vigorous (r = −0.110, P = 0.015) physical activity.ConclusionCompared to 3 weeks into the first COVID-imposed lockdown, 6-weeks after the start of the first COVID-imposed lockdown, physical activity and subjective sleep scores were positively impacted. The present, large sample size study further confirms exercise as a worthwhile countermeasure to psycho-physiological deconditioning during confinement.

Depression and Anxiety Plus Levels of Stress among Secondary School Students during the COVID-19 Lockdown: an Online CrossSectional Survey

Objective: To assess prevalence and factors associated with depression, anxiety and stress among adolescents experiencing lockdown during the 2019 coronavirus disease 2019 (COVID-19) in both Asian and Western countries. Material and Methods: From May-June 2020, secondary school students were enrolled in an online cross-sectional survey, through social media; including, but not limited to, Instagram, Snapchat, WhatsApp and LINE. We assessed the presence and severity of depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder Scale-7) and stress (Perceived Stress Scale-10) within the last month, and assessed significant associations with demographics, degree of social distancing, and other associated issues using univariate and multivariate logistic regression analyses.Results: From 392 respondents (56.4% male, 43.1% female), from Thailand (59.2%), the United Kingdom (26.5%) and other countries (14.3%), we identified depressive symptoms in 58.7%, anxiety in 40.3% and high levels of stress in 9.7%. By multivariate analysis, we found significant associations between being female and depression and anxiety, being in late secondary school years and depression, and changes in patterns of substance use and anxiety and stress. Participants not located in Thailand had increased risk of depression.Conclusion: Our study demonstrated depression, anxiety and stress in six, four and one out of ten adolescents, respectively, who were experiencing lockdowns due to the COVID-19 pandemic. We found female gender, older school years, and changes in substance use patterns to be significantly associated with these mental health conditions.

The Impact of COVID-19 Lockdown on Patients with Lymphedema.

Background: The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to management of lymphedema. The aim of this study was to assess general health conditions and evaluate the problems and concerns of lymphedema patients with regard to access to care and provision of management and control follow-ups during the lockdown period between March and June 2020. Methods: A web-based online survey, which included questions about demographic and clinical properties, compliance with restrictions and self-management, complications, needs, and difficulties in accessing health care, as well as the presence of psychological symptoms, was applied. Results: Two hundred three patients (190 female and 13 male) replied. Majority of them (73.4%) were between 30 and 60 years old and had high school/university education (67%). The duration of lymphedema was more than 3 years and sites were commonly extremities with mild to moderate intensity in 70.5% patients. Majority of them adhered to stay home warnings (88.7%). Weight gain was a common problem and self-care methods were generally skipped (81.8%). Seventeen percent of them had wounds and/or cellulitis. Forty percent of patients needed to apply to health centers to renew the pressure garment, but could not reach it. More than 70% of patients had sleep disorders and anxiety/stress. Majority of patients used television and social media to get information related to COVID-19 and the exposure time was commonly 2 to 6 hours. Conclusions: The COVID-19 lockdown had a great impact on lymphedema patients' health care not only from medical but also from psychosocial aspects. All these implications have to be identified and dealt with properly to avoid concerns and consequences of future pandemic lockdowns. Lymphedema services should be well prepared to be delivered virtually, enable effective care, and share knowledge to meet the needs of patients suffering from lymphedema.

Impact of COVID-19 on Blood Donation and Supply: A Multicenter Cross-Sectional Study from Saudi Arabia.

Background The coronavirus disease-19 (COVID-19) pandemic caused a major impact on blood donation process and supply globally. A lockdown management procedure was launched nationally in Saudi Arabia to manage this global health crisis. The main aim of this study was to determine the effect of COVID-19 lockdown on blood donation services and supply in different regions of Saudi Arabia. Study Design and Methods. A retrospective cross-sectional study was conducted in the blood bank centers of 5 major cities including Riyadh, Jeddah, Dammam, Hail, and Jizan in Saudi Arabia. Demographic and blood characteristics were retrieved from the first 6 months of 2019 (January–June) and compared to the same period of 2020. Results Our findings showed variation in the characteristics of blood donation and supply among the centers surveyed, as some of these centers were adversely affected, while others showed an increase in the availability of blood products during the pandemic. For example, Jeddah's center was significantly affected by COVID-19 lockdown whereas Hail's center showed a significant increase in the analyzed characteristics of blood donation services in 2020 compared to 2019. Overall, there was no major difference among the surveyed centers between 2020 and 2019, and this might be due to the effective management of blood supply and transfusion. Discussion. Although blood supply and transfusion practice was slightly affected at various degree among the surveyed centers, the whole process did not show a significant effect on the overall outcome. This is in fact due to the proper preparedness, management of blood requirements and supplies, and efficient response of the surveyed centers in Saudi Arabia.

Changes in Dietary Intake Patterns and Weight Status during the COVID-19 Lockdown: A Cross-Sectional Study Focusing on Young Adults in Malaysia.

Introduction: The coronavirus disease 2019 (COVID-19) isolation has altered individuals’ food purchasing behaviour and dietary intake patterns. Therefore, this study aims to investigate the changes in dietary intake patterns and their impacts on the weight status of young adults in Malaysia during the COVID-19 lockdown. Methods: This cross-sectional study involved 1045 young adults in Malaysia. The changes in dietary intake patterns were assessed using the Dietary Diversity Questionnaire with slight modifications, while anthropometric measurements including body height, body weight before the pandemic and current body weight were self-reported. Results: Overall, nearly half of the respondents (48.8%) gained weight during the confinement, with an average increment of 4.06 ± 3.23 kg. Of 1045, 45.3% reported consuming more fruits and 60.2% had higher plain water intake during the pandemic. It is observed that 41.0% to 66.8% of the young adults changed their dietary intake patterns during the pandemic. Increased consumption in cereals and grains (β = 0.084, p = 0.015, 95% CI = 0.017–0.160), as well as oils and fats (β = 0.123, p = 0.001, 95% CI = 0.059–0.241), was positively associated with weight gain during the pandemic. On the contrary, an increased plain water intake was negatively associated with weight gain during the lockdown (β = −0.100, p = 0.003, 95% CI = −0.171–−0.034). Findings in the current study also suggested that cutting back cereals and grains (β = 0.156, p < 0.001, 95% CI = 0.122–0.288), as well as oils and fats (β = 0.091, p = 0.012, 95% CI = 0.022–0.183), contributed significantly to weight loss during the pandemic confinement. Conclusion: In conclusion, the enforcement of the Movement Control Order (MCO) drove up the prevalence of overweight/obesity among young adults in Malaysia. Increased consumption of cereals and grains and oils and fats contributed to weight gain in the pandemic lockdown. Nonetheless, a noticeable proportion of young adults in Malaysia shifted to a healthier food choice by increasing the consumption of fruits and vegetables.

Mental health services at the Tokyo 2020 Olympic and Paralympic Games during the COVID-19 pandemic

Mental health services at the Tokyo 2020 Olympic and Paralympic Games during the COVID-19 pandemic

Variation in the rate of diagnosis of childhood acute lymphoblastic leukemia in about to the COVID-19 Pandemic: a single-center study

Background. Greaves delayed infection hypothesis states that acute lymphoblastic leukemia (ALL) in children develops in two critical steps, with the first step (first hit) occurring in utero and the second step (second hit) occurring in the postnatal period and involving leukemia-associated genetic changes, depending upon the timing of exposure to common childhood infections. In this study, we investigated whether isolation of children at home as part of the lockdown during the Coronavirus Disease 2019 (COVID-19) pandemic resulted in a reduction in the number of new childhood ALL cases by avoiding the second hit. Materials and metods. This retrospective study included all newly diagnosed pediatric ALL patients aged 1–18 years. The study periods were from 15 March 2020 to 31 December 2020 (COVID-19 lockdown period) and from 15 March 2019 to 31 December 2019 (control period). Results. Acute leukemia was diagnosed in 73 children between January 2019 and December 2020. Of these, there were 58 ALL cases and 15 acute myeloid leukemia cases. During the COVID-19 lockdown period, 14 of the children were diagnosed with ALL. In the control period, 21 children were diagnosed with ALL. No pediatric patients diagnosed with ALL in August, September, and October 2020. Conclusions. We observed a reduced incidence within the lockdown period, possibly related to the potential role of SARS-CoV-2 infection as a second hit in childhood ALL.

Knowledge, attitude, and practice on digital eye strain during coronavirus disease-2019 lockdown: A comparative study

Computer vision syndrome is a group of eye and vision-related problems that result from prolonged computer use. The worldwide pandemic of coronavirus disease-2019 (COVID-19) lockdown has led to an increase in the digital screen exposure as jobs as well as academic learning have majorly shifted online. This has caused an increase in digital eye strain (DES) globally. The aims and objectives of this study were to compare the knowledge, attitude, and practices among medical and nonmedical professionals with regard to DES in a background of COVID-19 lockdown. A cross-sectional, observational, online questionnaire-based research survey analysis was conducted among medical professionals with age- and sex-matched nonmedical professionals. Responses were collected over a week and analyzed. The level of significance was set at a P < 0.05. Statistical Package for the Social Sciences software version 23.0 was used for the result analysis. Our study included 353 (50.4%) medical and 347 (49.6%) nonmedical personnel. It was noted that 266 (75.4%) of medical professionals and 268 (77.2%) of nonmedical professionals experienced eye problems after prolonged digital screen exposure. A significant proportion of respondents experienced an increase in symptoms following COVID-19 lockdown with 140 (52.6%) being medical professionals and 163 (60.8%) nonmedical professionals (P = 0.015). DES is a preventable lifestyle-associated disorder. Awareness among the masses can reduce the adverse effects. Proper lighting, adequate viewing distance, voluntary blinking, and using lubricating eye drops are a few ways to reduce the chances of DES. Further studies are needed to formulate standardized guidelines for the management of DES.

Behavioural and Emotional difficulties in School children during COVID 19 pandemic using narrowband dimensions of SDQ: Online survey from North? East India.

Containment strategies such as lockdown during coronavirus disease 2019 (COVID-19) pandemic have forced home confinement of many children. Data on psychological difficulties in children during lockdown are scarce from this part of the country. The aim of the study is to describe the burden and pattern of behavioral and emotional problems of schoolchildren during COVID-19 lockdown in a small town from Northeastern India. Caregivers of children (4-17 years old) attending English medium schools of the town were invited to participate in the study. A descriptive cross-sectional online survey using purposive nonprobability sampling was conducted between August and September 2020. Strengths and Difficulties Questionnaire (SDQ) was used to measure behavioral and emotional difficulties of children. Responses were based on child's behaviors over the last 6 months which coincided with the ongoing lockdown period in the region. A total of 304 responses were received, among which 242 were considered for analysis. The parent-reported SDQ showed 23.1% of children having emotional or behavioral problems during the COVID-19 lockdown. Peer problems (43.4%) were the most common, followed by conduct problems (25.6%), emotional problems (23.1%), and hyperactivity (11.1%). Type of family (nuclear/joint/extended) was significantly associated with total difficulties (χ2 = 6.608, P = 0.03), conduct problems (χ2 = 8.492, P = 0.01), and hyperactivity (χ2 = 5.908, P = 0.05). Socioeconomic status of the family was associated with hyperactivity (χ2 = 8.755, P = 0.01). Significant number of children have behavioral and emotional difficulties during COVID-19 lockdown period.

Abstract- Poster

Background • Coronavirus disease 2019 (COVID-19) outbreak and lockdown has caused negative impact on mental health status of health care workers including the physiotherapists as physiotherapists are also involved in the care of patients with COVID-19 infection.• Taking care of COVID-19 infected patients can be exhaustive both physically and mentally due to involved risk of contracting the disease which may prove fatal for some.• Due to ongoing lockdown many physiotherapists are not able to work either fully or partially as per their potential. So, physiotherapists like other health care workers are not immune to mental health impacts of COVID-19 lockdown. Aim• To assess relationship between psychological impact of COVID-19 in the form of anxiety and depression, and the resilience among physiotherapists.Methods• Data were collected from total 378 physiotherapists.• Beck’s depression inventory (BDI), generalized anxiety disorder 7 item (GAD-7) scale, and brief resilience scale (BRS) were used to assess depression, anxiety, and resilience respectively among the study participants.• Data were analyzed by using SPSS 15 and, Chi-sqaure, Fisher exact, and Person’s correlation tests.Results• Prevalence of anxiety and depression were 37.8% and 31% respectively.• As regards the resilience, 2.9% had high, 74.3% had normal, and 22.8% had low resilience levels.• Physiotherapists who had high level of resilience had lower rates of anxiety on GAD-7 and lower rates of depression on BDI.Conclusion• Strengthening the resilience of physiotherapists can promote their mental health in longer run in face of stressful event like COVID-19 lockdown.• So, resilience strengthening programs must be the priority.

Machine Learning Based Depression, Anxiety, and Stress Predictive Model During COVID-19 Crisis

Corona Virus Disease-2019 (COVID-19) was reported at first in Wuhan city, China by December 2019. World Health Organization (WHO) declared COVID-19 as a pandemic i.e., global health crisis on March 11, 2020. The outbreak of COVID-19 pandemic and subsequent lockdowns to curb the spread, not only affected the economic status of a number of countries, but it also resulted in increased levels of Depression, Anxiety, and Stress (DAS) among people. Therefore, there is a need exists to comprehend the relationship among psycho-social factors in a country that is hypothetically affected by high levels of stress and fear; with tremendously-limiting measures of social distancing and lockdown in force; and with high rates of new cases and mortalities. With this motivation, the current study aims at investigating the DAS levels among college students during COVID-19 lockdown since they are identified as a highly-susceptible population. The current study proposes to develop Intelligent Feature Subset Selection with Machine Learning-based DAS predictive (IFSSML-DAS) model. The presented IFSSML-DAS model involves data preprocessing, Feature Subset Selection (FSS), classification, and parameter tuning. Besides, IFSSML-DAS model uses Group Gray Wolf Optimization based FSS (GGWO-FSS) technique to reduce the curse of dimensionality. In addition, Beetle Swarm Optimization based Least Square Support Vector Machine (BSO-LSSVM) model is also employed for classification in which the weight and bias parameters of the LSSVM model are optimally adjusted using BSO algorithm. The performance of the proposed IFSSML-DAS model was tested using a benchmark DASS-21 dataset and the results were investigated under different measures. The outcome of the study suggests the development of specialized programs to handle DAS among population so as to overcome COVID-19 crisis.

Sedentary Time and Fast-Food Consumption Associated With Weight Gain During COVID-19 Lockdown in Children and Adolescents With Overweight or Obesity.

BackgroundThe coronavirus disease pandemic is predicted to have adverse health effects on children and adolescents who are overweight or obese due to restricted school activity and stay-at-home orders. The purpose of this observational study was to determine the factors associated with weight gain in children and adolescents with overweight and obesity during coronavirus disease 2019 (COVID-19) lockdown.MethodsNinety-seven participants (sex- and age-specific body mass index (BMI) ≥ 85th percentile) were included. A baseline examination was conducted pre-COVID-19 (August 2019 to January 2020), and re-examination was performed post-lockdown (June to September 2020) and the results were compared. Correlation and regression analyses were conducted to investigate the association among changes in cardiometabolic markers and lifestyle behaviors with changes in BMI z-score.ResultsDuring the COVID-19 pandemic, an increase in BMI z-score (2.56 [2.01–2.94] to 2.62 [2.03–3.18]) was noticed in children and adolescents with obesity. Changes in cardiometabolic markers including liver enzymes, triglycerides (r = 0.398), leptin (r = 0.578), and adiponectin (r = −0.326), as well as muscular strength (r = −0.212), were correlated with the increase in BMI z-score. According to a multivariate regression analysis, changes in sedentary time (B = 0.016; 95% confidence interval [CI], 0.001–0.032) and fast-food consumption (B = 0.067; 95% CI, 0.013–0.122) were the lifestyle variables associated with BMI z-score increase.ConclusionChanges in lifestyle behaviors including fast-food consumption and sedentary time during the COVID-19 pandemic may be associated with weight gain. In order to prevent health-related risks in children and adolescents with obesity during the pandemic, it is important to maintain the level of physical activity and healthy dietary habits.

Narratives of loss: the impact of Covid-19 lockdown on experiences of loss, grief, and bereavement.

Introduction Restrictions imposed to eliminate the spread of the coronavirus disease 2019 (COVID-19) virus had significant implications on peoples' experiences of caring for family/whānau at the end of life, and on their own bereavement process. Aim This qualitative research explored the impact of COVID-19 lockdown restrictions on experiences of loss, grief and bereavement in Aotearoa New Zealand. Methods This qualitative narrative research used semi-structured interviews with 10 participants who experienced the loss of a loved one during Levels 3 or 4 lockdown in Aotearoa New Zealand (23 March-13 May 2020). Interviews were coded using NVivo software and inductive thematic analysis was used to evaluate the data. Results Results were grouped into three themes: death experience; mourning in isolation; and availability of support. These themes provide insight into the challenges and difficulties participants faced when they experienced the death of a loved one during a COVID-19 lockdown, and the impact of these restrictions on their experiences of grief and bereavement. Discussion The findings from this research suggest there is an increased risk of prolonged grief among those bereaved during lockdown. Primary care professionals need to be aware of this increased risk in order to identify need and provide access to bereavement support.