Coronavirus Disease 2019 Lockdown Research Articles

Mental Health and Substance Use in NCAA Athletes in the Context of the COVID-19 Pandemic and Lockdown.

Background Although the coronavirus disease 2019 (COVID-19) pandemic had pervasive effects on the lives of individuals, its influence on the mental health ofcollegiate athletes remains unknown. This study aimed to assess changes in mental health and substance use in National Collegiate Athlete Association (NCAA) Division I athletes in Southern California during the COVID-19 pandemic. Methodology An online survey was created using the Qualtrics software (Qualtrics, Provo, Utah). NCAA Division I athletes in Southern California completed preseason surveys querying indices of mental health, substance use, and injury in the year before the COVID-19 pandemic (March 2019 to March 2020) and during the pandemic (March 2020 to March 2021). The athletes filled out the survey from June 2021 to September 2021. Participants were asked how likely they were to agree with the following statements: I have felt physically prepared for athletic competitions, I have been satisfied with my mental health, and I have had adequate sleep. Participants were also asked to compare their substance use between the two time periods. Sociodemographic information regarding participants' age, gender, sports team, as well as year in sport and school was also collected. Group comparison analyses were performed using Fisher's exact test. Correlations between mental health measures and other variables were examined using Spearman's correlation coefficients. Results A total of 189 athletes completed the survey (out of the 259 surveys that were started). Females were significantly less likely to feel satisfied with mental health (p < 0.01) and physically prepared for sport (p < 0.01). Across all respondents, satisfaction with mental health was positively correlated with adequate sleep (p < 0.01) and physical preparedness for sport (p < 0.01) and negatively correlated with injury (p < 0.05). There was no significant correlation between mental health status and history of COVID-19 infection (p = 0.84). The vast majority of athletes reported no significant change in substance use pre- to post-pandemic, with no differences according to sex. Conclusions The COVID-19 pandemic had a differential impact on the mental health of female versus male NCAA athletes. Mental health was correlated with sleep, physical preparedness, and being injury-free but not with a history of COVID-19 infection. Despite reports indicating increased substance use in the general population, athletes in this group reported no change in licit and illicit substance use.

Effect of COVID-19 on Orthopaedic Trauma Admissions and Operating in a London District General Hospital.

Background The coronavirus disease 2019 (COVID-19) has presented orthopaedic departments around the world with unprecedented challenges across all aspects of health care service delivery. This study explores the effect of the COVID-19 lockdown on trauma admissions and trauma theater utilization at a London District General Hospital. Methods Data was collected retrospectively from electronic patient records for 4 weeks from the initiation of two lockdown periods beginning March 16, 2020 and December 23, 2020. Results were compared with a comparable time period in 2019. Patient age, date of admission, time of admission, date of operation, length of stay, length of operation, type of operation, and length of anesthesia were analyzed. Results Fewer patients were admitted during the COVID-19 period for trauma (108 in 2019 vs. 65 in March 2020 and 77 in December 2020). In addition, there was a significant shift in patient demographics, with the mean age of patients being 55.6 years in 2019 and 64.1 years in March 2020 and December 2020 ( p = 0.038). The most common mechanism of injury in both years was due to falls; however, the proportion of injuries due to falls fell from 75% in 2019 to 62% March 2020, but not significant change from pre-COVID baseline in December 2020 (77% falls). The duration of anesthesia was significantly longer in March 2020 (136 minutes) compared with in 2019 (83 minutes) ( p < 0.00001). There was no statistically significant difference in operation length for each operation type, but there was an overall increase in median operation length of 13.6% in March 2020 from the previous year. Finally, although overall length of stay was roughly constant, the time between admission and operation was significantly reduced in March 2020 (1.22 vs. 4.74 days, p < 0.0000001). Conclusion Orthopaedic trauma remains an essential service which has always had to overcome the challenges of capacity and resources in busy cities like London. Despite the reduction in trauma volume during the COVID-19 lockdown there have still been significant pressures on the health care system due to new challenges in the face of this new disease. By understanding the effects of the lifestyle restrictions brought about by the lockdown on trauma services as well as the impact of COVID-19 on service delivery measures such as length of surgery and stay, health care managers can plan for service delivery in the future as we attempt to return to nonemergency orthopaedic services and move lockdown restrictions are eased.

Gender-based violence and its determinants during the COVID-19 lockdown in a low-income country: a cross-sectional survey

Background:Coronavirus disease 2019 (COVID-19) is a recent global pandemic associated with multidimensional health-related effects. In the fight against the spread of this novel pandemic, the majority have been living under restrictive conditions during its related lockdown that has created a conducive environment for gender-based violence (GBV). Our study aimed to ascertain the burden and determinants of GBV during the COVID-19 pandemic-related lockdown and curfew (CPLC) in Uganda. Methods:We conducted a quantitative descriptive cross-sectional study in Bushenyi-Ishaka municipality, southwestern Uganda in May, 2020. This study involved 339 adult participants regardless of their gender or ethnicity. Only 12 potential respondents declined to participate in this survey. Results:The prevalence of GBV during the CPLC was 42 per cent. The majority (57%) of victims were women. More than half (54%) of the victims and survivors of GBV attributed the violence to the lockdown. The determinants of GBV included being married, using substances of abuse and having financial problems. Conclusion:The prevalence of GBV skyrocketed during the CPLC in Uganda when compared to the period prior to the pandemic. Women were significantly more affected in all aspects of GBV. Therefore, we recommend developing targeted behavioural change communication strategies based upon our findings.

The impact of social media on self-esteem during COVID-19

The outbreak of coronavirus disease 2019 (COVID-19) generated a global health crisis, resulting in people facing a distressing and unexpected situation. The risk of contamination and the experience of social distancing changed people's behaviors and impacted individual feelings, habits, and relationships. Uncertainty about the timeline of the growing pandemic, Isolation, and restrictions due to quarantine worsened feelings of anxiety and loneliness among both older and younger populations. Moreover, the loss of one's usual routine and reduced social contacts may cause boredom, frustration, and isolation, which can generate high levels of distress in individuals increasing the risk of mental disorders, such as anxiety, mood, addiction, and thought disorders. During the COVID-19 lockdown, there was a steep increase in social media usage as individuals were confined to their homes, which paved the way for many harmful effects on their mental health. Due to this wide popularity, many researchers are inspired to conduct several studies on excessive social media usage and its impact on our lives. One such prominent research area is the impact of social media on self-esteem. By reviewing different studies, it is evident that one gets a boost in their self-esteem when they get positive responses to their actions (posts, stories, etc.) on social media, on the other hand, as one gets exposed to other‘s highlighted episodes of life (promotion in job, vacations) they have a fundamental drive to compare these with their normal episodes (daily hassles, work routines, academic assignments) in their lives. This tendency called “upward comparisons” frequently occurs among social media users, especially among adolescents eventually leading to low self-esteem.

Change of obesity prevalence and lifestyle patterns before and during COVID-19 among Korean adolescents.

Purpose Lockdown measure for limiting coronavirus disease 2019 (COVID-19) spread cause an aggravation of the childhood obesity epidemic through lifestyle changes. The aim is to investigate how social restriction might have changed obesity prevalence and lifestyle patterns in Korean adolescents. We also evaluate the most fragile group and most influencing lifestyle parameters on obesity prevalence.Methods To assess the change in weight status and lifestyle, we compared the Korea Youth Risk Behavior Web-based Survey data 2019 (pre-COVID-19, n=57,303) and 2020 (post-COVID-19, n=54,948). Participants from middle schools and high schools, aged 12 to 18 years, voluntarily reported their weight status and lifestyles.Results The prevalence of obesity of the total subjects was 11.0% in 2019 and 12.1% in 2020. This prevalence difference varied by sex (males 1.8%, females 0.3%, p<0.001), age group (12–15 year 1.6%, 16–18 year 0.4%, p<0.001), and socioeconomic status. Male aged 12–15 years showed highest increase from 12.5% to 15.2%. Physical activities, fruit intake, consumption of sugar-sweetened beverages, and stress showed all decrease. Only, nonstudy sedentary time marked increased from 3.3±2.3 hr/day to 4.3±2.8 hr/day. Both moderate-intensity and vigorous-intensity physical activity marked decreased especially in male aged 12–15 years, while increased in female aged 16–18 years.Conclusions Korean adolescents showed increasing obesity prevalence after COVID-19 lockdown, with males aged 12–15 years mainly affected, mainly due to a reduced physical activity and increased sedentary time.

The Impact of COVID-19 on the Behaviors and Attitudes of Children and Adolescents: A Cross-Sectional Study.

Background and objective Over the past few decades, new infectious diseases have emerged,and these have played a key role in changing behavior and lifestyle in all age groups. More recently, with the emergence of the coronavirus disease 2019 (COVID-19) pandemic, governments around the world have made unprecedented efforts to contain the epidemic by implementing quarantine measures, social distancing, and isolating infected individuals. Social behavioral adaptations (e.g., social distancing, isolation, etc.) impact children's and adolescents' lifestyle activities and lead to increased incidence of psychosocial problems, worsening of preexisting mental illness, and fears of infection, uncertainty, isolation, and stress. In light of this, this study aimed to assess the impact of COVID-19 on the behaviors and lifestyles of the children and adolescent population of Pakistan. Methodology A cross-sectional study was conducted involving 323 children and adolescents bytargeting parents of children and adolescents in the age group of 4-18 yearsliving in Pakistan.The study was conducted from April 2021 to September 2021. A well-designed structured questionnaire was used to collect data about the sociodemographic profile, attitudes, and behavioral factors impacted by COVID-19 in children and adolescents. SPSS Statistics version 23 (IBM, Armonk, NY)was used to enter and analyze data. Results Parents or caregivers of a total of 189 male and 134 female childrenaged between four and 18 years took part in this study.During COVID-19, the consumption of fast food and fried foods by children and adolescentsincreased significantly.In this study, out of 323 participants, almost all (289, 89.5%) had increased their screen time significantly.Nearly half of the total individuals experienced the feeling of depression and loneliness during the pandemic. Additionally, some children and adolescents felt fearful when leaving home. COVID-19 lockdowns have led to many changes in children's and adolescents' lifestyle habits. They reduced physical contact with others due to the fear of transmission of COVID-19. Based on our findings, the pandemic and its containment strategies have adversely affected the behaviors, lifestyles, and attitudes of children and adolescents. Conclusion Governments around the world have imposed social distancing during the COVID-19 pandemic, leading to adverse short-term and long-term negative mental health issues such as unhappiness, fear, worry, irritability, depressive symptoms, anxiety, and post-traumatic stress disorder (PTSD). Interventions are needed to focus on building resilience in children and adolescents, addressing their fears and concerns through better communication, encouraging routine and physical activity, and taking measures to alleviate loneliness.

Managing acute opioid withdrawal with tramadol during COVID-19 lockdown in a peri-urban setting.

BackgroundThe coronavirus disease 2019 (COVID-19) has highlighted the scope of heroin dependence and need for evidence-based treatment amongst marginalised people in South Africa. Acute opioid withdrawal management without maintenance therapy carries risks of increased morbidity and mortality. Due to the high costs of methadone, Tshwane’s Community Oriented Substance Use Programme (COSUP) used tramadol for opioid withdrawal management during the initial COVID-19 response.AimTo describe demographics, route of heroin administration and medication-related experiences amongst people accessing tramadol for treatment of opioid withdrawal.SettingThree community-based COSUP sites in Mamelodi (Tshwane, South Africa).MethodsA retrospective cross-sectional study was conducted. Data were collected using an interviewer-administered paper-based tool between April and August 2020. Descriptive statistics were used to analyse data.ResultsOf the 220 service users initiated onto tramadol, almost half (n = 104, 47%) were not contactable. Fifty-eight (26%) people participated, amongst whom most were male (n = 55, 95%). Participants’ median age was 32 years. Most participants injected heroin (n = 36, 62.1%). Most participants experienced at least one side effect (n = 47, 81%) with 37 (64%) experiencing two or more side effects from tramadol. Insomnia occurred most frequently (n = 26, 45%). One person without a history of seizures experienced a seizure. Opioid withdrawal symptoms were experienced by 54 participants (93%) whilst taking tramadol. Over half (n = 38, 66%) reported using less heroin whilst on tramadol.ConclusionTramadol reduced heroin use but was associated with withdrawal symptoms and unfavourable side effects. Findings point to the limitations of tramadol as opioid withdrawal management to retain people in care and the importance of access to first-line opioid agonists.ContributionThis research contributes to the limited data around short-acting tramadol for opioid withdrawal management in the African context, with specific focus on the need for increased access to opioid agonists for those who need them, in primary care settings.

Effect of Lockdown Period of COVID-19 Pandemic on Maternal Weight Gain, Gestational Diabetes, and Newborn Birth Weight.

This study aimed to determine whether the lockdown period of the initial novel coronavirus disease 2019 (COVID-19) surge in New York affected gestational weight gain (GWG), newborn birth weight (BW), and the frequency of gestational diabetes mellitus (GDM). Maternal and newborn outcomes during the first wave of the pandemic were compared with those during the same timeframe in the previous 2 years. Retrospective cross-sectional study of all live singleton term deliveries from April 1 to July 31 between 2018 and 2020 at seven hospitals within a large academic health system in New York. Patients were excluded for missing data on: BW, GWG, prepregnancy body mass index, and gestational age at delivery. We compared GWG, GDM, and BW during the pandemic period (April-July 2020) with the same months in 2018 and 2019 (prepandemic) to account for seasonality. Linear regression was used to model the continuous outcomes of GWG and BW. Logistic regression was used to model the binary outcome of GDM. A total of 20,548 patients were included in the study: 6,672 delivered during the pandemic period and 13,876 delivered during the prepandemic period. On regression analysis, after adjustment for study epoch and patient characteristics, the pandemic period was associated with lower GWG (β = -0.46, 95% confidence interval [CI]: -0.87 to -0.05), more GDM (adjusted odds ratio [aOR] = 1.24, 95% CI: 1.10-1.39), and no change in newborn BW (β = 0.03, 95% CI: -11.7 to 11.8) compared with the referent period. The largest increases in GDM between the two study epochs were noted in patients who identified as Hispanic (8.6 vs. 6.0%; p < 0.005) and multiracial/other (11.8 vs. 7.0%; p < 0.001). The lockdown period of the pandemic was associated with a decrease in GWG and increase in GDM. Not all groups were affected equally. Hispanic and multiracial patients experienced a larger percentage change in GDM compared with non-Hispanic white patients. · The COVID-19 lockdown was associated with decreased GWG and increased GDM.. · No change in newborn BW was seen during the lockdown.. · Overall, the lockdown did not have a large clinical effect on these pregnancy outcomes..

Citizens’ use of public urban green spaces at the time of the COVID-19 pandemic in Italy

Since early 2020, Coronavirus Disease 2019 (COVID-19) has spread rapidly, quickly becoming a global pandemic. To counter the COVID-19 outbreak, national governments have issued different measures and restrictions, forcing citizens to adapt to a whole new lifestyle. These restrictions have impacted on the use of green spaces by citizens owing to many factors: more available free time, increased flexibility in the work environment, and a need to relax in Nature to relieve anxiety and stress. Urban green spaces provide many benefits for the physical and psychological well-being of citizens (e.g., habitat conservation, pollution control, recreational and leisure opportunities). To understand if citizens’ habits have changed due to the COVID-19 restrictions, this study provides insights from a web-based survey monitoring the use of such spaces before and during the COVID-19 lockdowns in Italy. A web-based questionnaire was conducted via “Facebook Messenger” and “WhatsApp” at the end of the second wave of COVID-19 (May–June 2021). Data collection having been concluded, 1075 completed questionnaires were collected and processed. The results show that while many reduced their weekly frequentation of green areas (−16.5%), the number of people frequenting green areas near their home every day increased (+7.7%). Two main groups of people were identified: the first, those who intensified their visits to green areas being those who desired to spend time in contact with Nature; the second, those who were reluctant to visit green areas for fear of being infected. The results also show most of the respondents felt urban green areas were either very important (82.1%) or important (14.4%). Overall, the results reveal that COVID-19 induced a positive perception of the benefits provided by urban green areas, with a consequent greater use of them, which seems destined to last even once the public health emergency has passed.

Associations between social support and anxiety during the COVID-19 lockdown in young and middle-aged Israelis: A cross-sectional study.

BACKGROUNDThis study examined the associations between social support and anxiety during the coronavirus disease 2019 (COVID-19) in an Israeli sample.AIMTo examine the associations between social support and anxiety during the COVID-19 in an Israeli sample.METHODSData for this cross-sectional study were retrieved from an online survey. Linear regression, logistic regression and restricted cubic spline models were conducted to test for associations between social support and anxiety.RESULTSA total of 655 individuals took part in the present study. In the univariate linear regression model, there is a negative correlation between the Generalized Anxiety Disorder-7 score (GAD-7) and the Multidimensional Perceived Social Support Scale (MSPSS) score. For MSPSS score, the multivariable adjusted regression coefficient and 95% confidence interval (CI) of GAD-7 score were -0.779 (-1.063 to -0.496). In the univariate logistic regression model, there was a negative correlation between anxiety (GAD-7 ≥ 9) and MSPSS score, and there was still a negative correlation in multivariate logical regression analysis. The odds ratios and 95%CI were 0.709 (0.563-0.894).CONCLUSIONSocial support was inversely correlated with anxiety during COVID-19 in an Israeli sample.

The relationship between perceived stress and depressive symptoms in adolescents during high stress: The moderating role of emotion regulation.

This study examined the moderating role of adaptive and maladaptive emotion regulation in the relationship between general perceived stress and depressive symptoms during the first coronavirus disease 2019 (COVID-19) lockdown in March-April 2020 in Belgium, while controlling for past depressive symptoms in 2016. Participants were 110 adolescents (55% female; Mage = 16, SDage = 1.80) who filled out different questionnaires assessing maladaptive and adaptive emotion regulation strategies (ERS), perceived stress, and depressive symptoms. Results revealed that only maladaptive ERS statistically significantly moderated the relationship between perceived stress and depressive symptoms. More specifically, the amount of perceived stress is positively associated with the level of depressive symptoms, especially in adolescents who use more maladaptive ERS. The repertoire of adaptive ERS might not be sufficient for adolescents to flexibly cope with a highly stressful situation such as the COVID-19 pandemic and lockdown. Study findings highlight the need to support youth, particularly those who use more maladaptive ERS, in adaptively coping with intense stressful life events.

Impact of the COVID-19 Pandemic on Patterns of Prescription Opioid Use: A Retrospective Cohort Study of Adults Without a Cancer Diagnosis Initiating Opioids Using Administrative Claims Data.

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has led to disruptions of healthcare delivery and may thus have impacted patterns of prescription opioid use, including risk factors for long-term use.ObjectiveWe aimed to describe changes in patterns of prescription opioid use due to the COVID-19 pandemic in community-dwelling adults without a cancer diagnosis.MethodsUsing administrative claims data of the province of Quebec, Canada, a random sample of adults (aged ≥18 years) was selected. These were members of the public drug plan without a cancer diagnosis who initiated a prescription opioid in the outpatient setting between 1 January, 2018 and 28 December, 2020. We assessed the daily dose of initial prescription opioids, the number of days’ supply of initial dispensing, and the total duration of opioid use over the first 6 months following initiation. We applied interrupted autoregressive integrated moving average models to examine weekly patterns of prescription opioids before and during the pandemic (starting at the lockdown). Our models included a step intervention function (immediate change) and a ramp intervention function (slope change).ResultsThere were 112,650 and 34,261 patients who initiated opioid therapy, respectively, in the 115-week pre-pandemic period and in the 41-week pandemic period. At the start of the lockdown, there was a significant immediate decrease in opioid treatment initiation (−326; 95% confidence interval [CI] −419 to −234) and initial daily dose (−1.7 morphine milligram equivalents; 95% CI −2.7 to −0.7). Conversely, there was a significant immediate increase in the number of days’ supply of initial dispensing (1.4 days; 95% CI 1.0 to 1.8) and the total duration of opioid use over 6 months (5.7 days; 95% CI 4.6 to 6.8). All these weekly measures returned to values close to those of the pre-pandemic period 10 weeks after the start of lockdown.ConclusionsOur findings showed that the COVID-19 lockdown had an impact on initial number of days’ supply, which is a risk factor for long-term use and ultimately opioid-related harm. However, over time, prescription practices and use reverted to those observed in the pre-pandemic period.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40801-022-00329-z.

Statistical assessment of COVID-19 lockdowns on ambient air quality, Himachal Pradesh and learnings for implementing clean technologies: insight from industrial town, India

PurposeThe current study investigates the impact of the coronavirus disease 2019 (COVID-19) lockdown restrictions on air quality in an industrial town in Himachal Pradesh (HP) (India) and recommends policies and strategies for mitigating air pollution.Design/methodology/approachThe air quality parameters under study are particulate matter10 (PM10), PM2.5, SO2 and NO2. One-way ANOVA with post-hoc analysis and non-parametric Kruskal–Wallis test, and multiple linear regression analysis are used to validate the data analysis results.FindingsThe findings indicate that the lockdown and post-lockdown periods affected pollutant levels even after considering the meteorological conditions. Except for SO2, all other air quality parameters dropped significantly throughout the lockdown period. Further, the industrial and transportation sectors are the primary sources of air pollution in Paonta Sahib.Research limitations/implicationsFuture research should include other industrial locations in the state to understand the relationship between regional air pollution levels and climate change. The findings of this study may add to the discussion on the role of adopting clean technologies and also provide directions for future research on improving air quality in the emerging industrial towns in India.Originality/valueVery few studies have examined how the pandemic-induced lockdowns impacted air pollution levels in emerging industrial towns in India while also considering the confounding meteorological factors.Graphical abstract

Physical Activity Levels and Psychological Well-Being during COVID-19 Lockdown among University Students and Employees.

During the lockdown for the coronavirus disease 2019 (COVID-19), entire populations were instructed to live in home confinement. We investigated the effects of the COVID-19 lockdown on the physical activity (PA) and mental health of students and employees in a Colombian University. A cross-sectional study was conducted through an online survey during the first isolation. A total of 431 respondents (192 males) aged 18–60 years old (28.1 ± 11.1 years) participated. The international Physical Activity Questionnaire (IPAQ) and the short version of the Psychological General Well-Being Index (PGWBI-S) were used. The lockdown had a negative effect on PA levels, with students exhibiting the greatest decrease (~34%; p ˂ 0.001) compared to employees (~24%; p ˂ 0.01). The analysis showed a greater change in PA behavior before and during the lockdown in highly active student participants (5750 vs. 5141 MET min/week; p < 0.05). Additionally, the psychological assessment revealed a lower score in students compared to employees in the male (70.1 vs. 82.6) and female groups (60.2 vs. 79.6). Moreover, the results revealed an influence of sex, with only the female students exhibiting a state of distress. Self-reported PA and psychological well-being were compromised during the COVID-19 lockdown in the academic community, with students and females being more affected.

Hospital admissions from alcohol-related acute pancreatitis during the COVID-19 pandemic: A single-centre study.

BACKGROUNDThe United Kingdom government introduced lockdown restrictions for the first time on 23 March 2020 due to coronavirus disease 2019 (COVID-19) pandemic. These were partially lifted on 15 June and further eased on 4 July. Changes in social behaviour, including increased alcohol consumption were described at the time. However, there were no data available to consider the impact of these changes on the number of alcohol-related disease admissions, specifically alcohol-related acute pancreatitis (AP). This study evaluated the trend of alcohol-related AP admissions at a single centre during the initial COVID-19 lockdown.AIMTo evaluate the trend in alcohol-related AP admissions at a single centre during the initial COVID-19 lockdown in the United Kingdom.METHODSAll patients admitted with alcohol-related AP from March to September 2016 to 2020 were considered in this study. Patient demographics, their initial presentation with AP, any recurrent admissions, disease severity and length of stay, were evaluated using ANOVA and χ2 and Kruskal–Wallis tests.RESULTSOne hundred and thirty-six patients were included in the study. The highest total number of AP admissions was seen in March–September 2019 and the highest single-month period was in March–May 2020. Admissions for first-time presentations of AP were highest in 2020 compared to other year groups and were significantly higher compared to previous years, for example, 2016 (P < 0.05). Furthermore, the rate of admissions decreased by 38.89% between March–May 2020 and June–September 2020 (P < 0.05), coinciding with the easing of lockdown restrictions. This significant decrease was not observed in the previous year groups during those same time periods. Admissions for recurrent AP were highest in 2019. The median length of hospital stay did not differ between patients from each of the year groups.CONCLUSIONAn increased number of admissions for alcohol-related AP were observed during months when lockdown restrictions were enforced; a fall in figures was noted when restrictions were eased.

Insomnia Prevalence and Associated Factors Among University Students in Saudi Arabia During the COVID-19 Pandemic and Lockdown: A Large-Scale Survey.

PurposeThe coronavirus disease 2019 (COVID-19) pandemic has many psychological and physical effects to which university students are vulnerable. We aimed in this study to assess the prevalence of insomnia among university students in Saudi Arabia during the COVID-19 pandemic and lockdown and associated factors.Patients and MethodsWe conducted a cross-sectional study using a questionnaire to collect the responses of 5140 students from Saudi universities between April 24 and 30, 2020. Responders completed demographic questions and psychological scales, including the Insomnia Severity Scale (ISI), during the national lockdown period in Saudi Arabia.ResultsApproximately, 41% of the sample suffered from moderate to severe insomnia. The mean ISI score was recorded as 12.9 (SD 6.62). Insomnia was associated with female sex, younger age, students from new universities, junior students, if a relative suffered from COVID-19, having a chronic medical illness, and having a psychiatric disorder. Insomnia was associated also with suicidal ideation.ConclusionInsomnia prevalence was very high among Saudi university students during the COVID-19 pandemic lockdown. There were sociodemographic and medical factors associated with high insomnia prevalence. Universities need to plan and implement protective and intervention strategies to deal with this important issue.

A Study on Impact of COVID-19 Pandemic on Persons with Preexisting Psychotic Disorder, their Coping Strategies, and Compliance with Preventive Measures

Background: Coronavirus disease 2019 (COVID-19) pandemic has impacted persons with preexisting psychiatric disorders negatively. There is a lack of studies on the impact on people with preexisting psychotic disorder. Aims: We studied the impact of the COVID-19 pandemic and lockdown on patients with a preexisting psychotic disorder and whether they were following the recommended preventive measures for COVID-19. We also studied coping strategies used by them and their caregivers. We compared persons with first-episode psychosis (FEP) and chronic psychotic disorders (CPD). Methodology: The study sample was a part of the National Institute of Health Research Psychosis Research Group cohort. The subjects belonged to two groups: FEP consisted of patients with the first episode of psychosis, with the duration of illness ≥3 months and ≤2 years, and CPD group consisted of patients with psychosis, with the duration of illness ≥2 years. They were interviewed telephonically on a semistructured questionnaire. Thematic analysis was done to identify coping strategies. Results: Fifty patients were interviewed: 24 in the FEP (26·12 ± 8·0 years) and 26 in the CPD group (34 ± 7.5 years). Forty-six (92%) patients reported difficulty in access to hospitals and 32 (64%) had difficulty in contacting a doctor. Eight (16%) of them reported worsening of symptoms and 12 (24%) reported irregular adherence to treatment. The two groups differed significantly on doing household chores, occupational functioning, and financial issues. The majority of them used emotion-focused coping strategies. Three-fourth (79.1%) of the patients in the FEP group were following all four recommended preventive measures, whereas, in the CPD group, three-fourths (73.1%) were able to follow only one measure. Conclusion: The COVID-19 pandemic had impacted FEP and CPD groups differently. CPD group could follow recommended preventive measures less frequently than FEP.

Analysing the impact of COVID-19 trade disruptions on port authority pricing and container shipping in South Africa

Background: The coronavirus disease 2019 (COVID-19) pandemic directly affected the shipping industry globally, and South Africa experienced decreased cargo volumes and increased freight rates. In addition, National Ports Authority (NPA) charges are 69% and cargo dues 166% above the global benchmark mean. The NPA uses a rate of return (RR) model to calculate tariff increases that are contested by port stakeholders.Objectives: The study aimed to analyse the impact of COVID-19 trade disruptions and examine the associated higher liner freight rates, tariff applications for higher NPA tariffs and reduced investment in port infrastructure. It showed that adjusting the RR model variables can result in reduced tariffs and large cost savings for port users.Method: This study analysed the impact of the pandemic on South Africa’s cargo volumes and freight rates. It critiqued the regulatory asset base, the asset beta, and the tax rate to be applied and calculated the adjustments to these RR model variables using five scenarios for FY2022/2023.Results: The results show a sharp decrease in cargo volumes during COVID-19 lockdowns, and a parallel increase in freight rates. The five-scenario results show how the NPA tariffs could be much lower, calculating a tariff decrease of 5.7% in scenario 4 and a 20% decrease in scenario 5.Conclusion: Amid the global rise of shipping rates and the economic impact of the pandemic on South Africa’s trade, the results show that there is a potential to enhance South Africa’s trade competitiveness through a decrease in NPA-weighted average tariff by 20%.

Impact of a Coronavirus Pandemic on Smoking Behavior in University Students: An Online Survey in Türkiye.

Coronavirus Disease-2019 (COVID-19) pandemic has a massive impact on human health, causing sudden lifestyle changes. As it affects health, determining the lifestyles of university students related to smoking has gained importance. This study provides evidence of change in smoking behavior among university students in Türkiye during the ongoing COVID-19 pandemic. This cross-sectional survey study was conducted via an electronic questionnaire approximately 2020-2021 among university students in Türkiye. The study comprised a structured questionnaire that inquired about demographic information; and the Fagerström Test for Nicotine Dependence. The questionnaire was distributed randomly to university students; it required 6 min to complete. A total of 749 respondents were included in the study, aged between 19 and 35 years (54.8% females). Of 749 participants, 571 health science students (medicine, pharmacy, dentistry, etc.) completed the survey. The pre-pandemic and COVID-19 pandemic mean nicotine dependence scores were 3.03 and 2.97, respectively. A difference was seen pre-pandemic (p= 0.002) and during pandemic (p= 0.005) for those studying in health and other departments. Students who had middle socio-economical status had significantly higher nicotine dependence scores pre- COVID-19, compared to during the pandemic (p= 0.027). Compared to pre and during the pandemic, the mean score of dependence was significantly lower in students, whose parents were non-smokers during the pandemic. In this study, we have provided the first data on the Turkish university student's nicotine dependence changes during the COVID-19 lockdown. The nicotine dependence level may change based on various factors including behavioral changes. Crucial times such as pandemics can affect individuals, thus, smoking addiction can increase. Behavioral support for quitting smoking such as digital platforms, internet, and television programs should also assist to support smokers quitting successfully during this supreme time.

Neuro-ophthalmological manifestations of diabetes mellitus during COVID-19-related lockdown in India.

The coronavirus disease 19 (COVID-19) pandemic has resulted in a huge impact on the health care system. Diversion of health care workforce toward management of a high number of COVID-19 cases and lockdown restrictions have affected the follow-up of patients. The objective of this study was to analyze the impact of this situation on the control of diabetes, eventually resulting in related neuro-ophthalmological complications. This retrospective case series included diabetic patients visiting the neuro-ophthalmology clinic at a tertiary care eye center in India from 25 March 2020 to 25 September 2020 during the lockdown. The incidence of diabetes-related neuro-ophthalmological complications, including third, fourth, sixth nerve palsies and non-arteritic anterior ischemic optic neuropathy (NAION) was evaluated and compared with that of the same period during 2019. Overall disease incidence rate was significantly higher in the year 2020 (60.2%) compared to the previous year of 2019 (29.8%). The proportion of third nerve palsy (4.8% vs 16.3%, P < 0.001) and NAION (0.3% vs 14.3%, P < 0.001) had increased. Even though the percentage of sixth nerve palsy was 25% in 2020, this was not significantly different from 2019. There was a reduction in the percentage of fourth nerve palsy cases from the year 2019 to 2020. There was a significant increase in diabetes-related neuro-ophthalmic complications during the COVID-19 lockdown. This can possibly be attributed to worsening of glycemic control in diabetic patients.