Coronavirus Disease 2019 Pandemic Lockdown Research Articles

Eating behaviors and physical activity during the COVID-19 pandemic lockdown: Experiences of breast cancer patients on adjuvant hormonal therapy

Background/Aim. Since the coronavirus disease 2019 (COVID-19) pandemic led to a strict lockdown in Serbia, the population has experienced drastic lifestyle changes. Physical distancing, self-isolation, limited availability of essential food products, and the stress related to the availability of therapy during the pandemic particularly affected the lives of vulnerable groups, such as breast cancer (BrC) patients. The aim of this study was to examine the changes in eating behaviors and physical activity of postmenopausal BrC patients on adjuvant hormonal therapy under the COVID-19 lockdown conditions. Methods. This observational retrospective pre-post cohort study included 32 women treated with aromatase inhibitors (AIs) who responded to telephone interviews using a structured questionnaire. The questionnaire aims to collect data on eating habits (intake of certain foods on a daily/weekly basis, as well as changes in the usual choice of food), intake of supplements, changes in weight, and physical activity before and during the lockdown. Results. The results showed that, due to problems in obtaining groceries, the patients cooked and consumed homemade sweets and fruit more often (47% of the respondents), while fewer (31%) consumed fresh fish. Nearly 41% of patients reported increased food intake, and 88% reported decreased physical activity, which led to an increase in body weight in as many as 47% of subjects. The intake of supplements was doubled. Conclusion. The COVID-19 lockdown with home confinement exacerbated health risks and affected dietary patterns and physical activity, which may have had a negative impact on the long-term health of BrC patients treated with AIs.

Impact of the COVID-19 on asthma control among children: A systematic review.

In December 2019, the current outbreak of coronavirus disease 2019 (COVID-19) was reported in Wuhan, China. Asthmatic patients are thought to be more vulnerable to the more severe form of SARS-CoV-2 infection due to their weakened immune systems and increased risk of respiratory exacerbation when infected with respiratory viruses; however, there is little evidence to support this theory. The objective of this systematic review is to assess the impact of the COVID-19 lockdown during the pandemic on asthma management outcome measures among children and adolescents. To conduct the search, we used five bibliographic databases. The results were limited to those articles published between December 2019 and February 2022, selecting only articles published in English that included the study population (children aged 0-18 years). All study designs were considered. Independent assessments of the included studies' quality were made and reported. Among the 945 results of the bibliographic search, only 21 articles were found to fit our eligibility criteria We organized the results from the studies according to the effect of the lockdown at the start of the COVID-19 pandemic on common outcomes, including the Pediatric Emergency Department Visits, hospitalization rates of pediatric asthmatic patients during the pandemic, asthma control, asthma exacerbations, psychological effects on patients, and caregivers' concerns. The management of pediatric asthma improved more during the 2020 COVID-19 pandemic lockdown than in previous years.

Effect of the COVID-19 pandemic lockdown on the physique of school-age children in Japan.

Schools in Japan were closed nationwide from March to May 2020 because of the coronavirus disease 2019 (COVID-19) pandemic. Many suspect that this school closure affected children's mental and physical health. We investigated changes in school-age children's physiques to determine the effects of the COVID-19 lockdown and restrictions on their health. Data were extracted from a database of school physical examinations in Osaka elementary and junior high schools for 4 consecutive years from 2018 to 2021. The following characteristics were analyzed: short stature, tall stature, underweight, mild obesity, middle grade obesity, and severe obesity. The paired Student t-test was used to compare school examination data in the prepandemic period (2018-2019), pandemic lockdown (2019-2020), and post-lockdown period (2020-2021). Obesity rates in elementary school students aged 6-12 years, particularly in boys, were significantly higher during the lockdown than they were in 2019. After the pandemic, the tall stature rate continued to rise, while rates of short stature and underweight decreased in both sexes in 2020. In junior high school students aged 12-15 years, rates of obesity and underweight tended to decrease in 2020. However, these rates rebounded and rose in 2021 when the lockdown was lifted. During the COVID-19 pandemic lockdown, elementary school students gained weight, while junior high school students lost weight. The lockdown that was implemented during the COVID-19 pandemic had an unfavorable effect on weight gain, particularly in young school-age children.

Marked variability in institutional deliveries and neonatal outcomes during the COVID-19 lockdown in Nigeria.

The coronavirus disease 2019 (COVID-19) pandemic and the interventions to mitigate its spread impacted access to healthcare, including hospital births and newborn care. This study evaluated the impact of COVID-19 lockdown measures on newborn service utilization in Nigeria. The records of women who delivered in hospitals and babies admitted to neonatal wards were retrospectively reviewed before (March 2019-February 2020) and during (March 2020-February 2021) the COVID-19 pandemic lockdown in selected facilities in Nigeria. There was a nationwide reduction in institutional deliveries during the COVID-19 lockdown period in Nigeria, with 14 444 before and 11 723 during the lockdown-a decrease of 18.8%. The number of preterm admissions decreased during the lockdown period (30.6% during lockdown vs 32.6% pre-lockdown), but the percentage of outborn preterm admissions remained unchanged. Newborn admissions varied between zones with no consistent pattern. Although neonatal jaundice and prematurity remained the most common reasons for admission, severe perinatal asphyxia increased by nearly 50%. Neonatal mortality was significantly higher during the COVID-19 lockdown compared with pre-lockdown (110.6/1000 [11.1%] vs 91.4/1000 [9.1%], respectively; p=0.01). The odds of a newborn dying were about four times higher if delivered outside the facility during the lockdown (p<0.001). The COVID-19 lockdown had markedly deleterious effects on healthcare seeking for deliveries and neonatal care that varied between zones with no consistent pattern.

Effects of the COVID-19 Pandemic on Anxiety Symptoms in Long-Term Care Residents: A Multilevel Growth Curve Analysis.

The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted the mental health functioning of older adults residing in long-term care (LTC) settings. This study examines the impact of the lockdown on anxiety symptoms over time in LTC residents. Secondary data analysis was conducted on clinical data obtained with permission from a large behavioral health company that provides behavioral health services in long-term care (LTC) and assisted living (AL) facilities. Data were obtained from 1149 adults (mean age 72.37, 70% female) in LTC and AL facilities across the United States who were receiving psychological services 1 year prior, and 1 year after, the COVID-19 pandemic lockdown. Changes in anxiety (measured using a clinician rating scale) over time before and after the pandemic were assessed using latent growth curve modeling with psychiatric diagnosis, psychiatric medication, and demographic factors included as covariates. Anxiety severity decreased over time before and after the onset of the COVID-19 pandemic. Although pandemic-level factors such as facility closure and telehealth availability did not affect anxiety over time, individual treatment factors such as obsessive compulsive disorder diagnosis, initial anxiety severity, bipolar disorder diagnosis, and prescriptions for anxiolytic and antipsychotic medications affected the trajectory of anxiety during the pandemic. These results demonstrate that individual covariates such as diagnosis, symptom severity, and medication use impacted the trajectory of anxiety symptoms before and during the COVID-19 pandemic more strongly than pandemic-related circumstances (facility closure, telehealth availability). The impact of the COVID-19 pandemic may be better observed through treatment-relevant variables, rather than pure symptom severity. In preparation for future pandemics or other large-scale disasters potentially impacting service delivery, facilities should continue to prioritize continuity of care or a timely resumption of services attending to individual treatment factors.

Assessment of Healthcare Service Provision to Pediatric Patients With Chronic Diseases During the COVID-19 Lockdown

Background: The Coronavirus disease 2019(COVID-19) pandemic’s impact on essential health services is of great concern. The most important step in managing any patient with chronic disease is compliance with follow-up visits. Aim: This study aims to assess healthcare services during the period of the COVID-19 pandemic lockdown regarding chronic patient visits and care, as well as to assess patient satisfaction with the provision of healthcare services during the lockdown period. Methods: a cross-sectional study was performed at Cairo University Specialized Children Hospital, Egypt, through an interview questionnaire with the caregivers of chronic patients about the health care services throughout the COVID-19 pandemic from December 2020 to July 2021. Results: More than 60% were satisfied with the healthcare service provision during the COVID-19 pandemic lockdown. Satisfaction toward medical sub-specialties was significantly higher than that of surgical ones. Patients who attended for follow-up markedly decreased during the lockdown. Conclusion: During the COVID-19 pandemic, healthcare service provision was negatively affected. Follow-up of chronic patients and continued medical care were challenging points.

Prevalence and associated factors of insomnia symptoms during the COVID-19 pandemic lockdown among Mettu town residents.

Insomnia is a prevalent sleep disorder that affects people all over the world. Creating suitable interventions will require a better understanding of the magnitude and determinants of insomnia. This study aimed to assess the prevalence and associated factors of insomnia symptoms among residents of Mettu town during the pandemic lockdown. A community-based cross-sectional study was conducted among residents of Mettu town from October 1st to October 15th, 2020. Residents who lived in Mettu town at least for six months were included. To determine the prevalence and determinants of insomnia symptoms, both descriptive and inferential analyses were used. The chi-squared test of association and logistic regression was used to identify predictors of insomnia symptoms among residents of Mettu town. We used SPSS version 25 for all statistical analyses. The prevalence of depressive symptoms among residents of Mettu town was 52.6%. According to results of multivariable binary logistic regression, being female [AOR = 3.677, 95%CI: 2.124-6.365], being aged between 19 and 40 [AOR = 13.261, 95%CI: 6.953-25.291], being aged above 41 [AOR = 2.627, 95%CI: 1.120-6.159], smoking [AOR = 15.539, 95%CI: 7.961-30.329], satisfaction with information available [AOR = 0.310, 95%CI: 0.168-0.570], fear Corona Virus Disease 2019 (COVID-19), [AOR = 2.171, 95%CI: 1.262-3.733], feeling alienated from others [AOR = 3.288, 95%CI: 1.897-5.699], having somatic symptoms [AOR = 2.298, 95% CI: 1.360-3.884], having depressive symptoms [AOR = 1.841, 95% CI: 1.073-3.160], and experiencing psychological distress [AOR = 1.962, 95% CI: 1.173-3.281] were significantly associated with insomnia symptoms. In this study, the prevalence of insomnia symptoms was found to be high among residents of Mettu town. Being female, being aged between 19 and 40, being aged above 41 years, smoking, fear of Corona Virus Disease 2019, feeling alienated from others, having somatic symptoms, having depressive symptoms, and experiencing psychological distress were all associated with an increased risk of developing insomnia symptoms while being satisfied with the information available decreased the risk of insomnia symptoms among residents of Mettu town. Interventions should be put in place to promote healthy sleep among residents of Mettu town.

Exploring Nursing Staff's Experiences and Perspectives of COVID-19 Lockdown in a Residential Aged Care Setting in Australia

An exploratory qualitative study was performed to evaluate the experiences of nursing staff (N = 10) working in a residential aged care facility (RACF) during the coronavirus disease 2019 (COVID-19) pandemic lockdown. Semi-structured, in-person interviews were performed, and thematic analysis was used to analyze the data. Care staff had little or no knowledge of how to cope with a lockdown necessitated by a pandemic. However, management developed proactive plans as they aligned with the changing care circumstances and ongoing government directives. Five major themes were identified: Prolonged Use and Shortage of Personal Protective Equipment; "Blind Leading the Blind"; Communication and Teamwork; Lack of Education; and Resident Response. RACF staff described working under stressful conditions during the initial COVID-19 pandemic lockdown; yet with experience, care staff and the management team adapted to pandemic requirements to meet the needs of residents in their care. RACFs should be prepared for the impact of pandemics on staff and ensure care resources and support are available for the continuity of safe and quality care of residents. [Journal of Gerontological Nursing, 49(3), 34-39.].

A qualitative exploration of the perspectives of international medical students residing in university hostels amid COVID-19 pandemic lockdown

Background: The coronavirus disease 2019 (COVID-19) pandemic has portentously frightened the existence of life globally. The lockdown approach was adopted as a containment strategy as the disease itself has manifested severe social, economic, and psychiatric implications. This study was conducted to explore the perception and preparedness of international medical students residing in university hostels amid the COVID-19 pandemic lockdown. Methods: A total of 11 international medical students were selected through the purposive sampling technique and interviewed face-to-face through the semi-structured interview guide. All the interviews were audio-taped, transcribed verbatim, and then analyzed for thematic content by standard content analysis framework. Results: The 5 major themes were yielded: familiarity with COVID-19, perceptions and attitudes toward COVID-19, preparedness for safety against COVID-19, barriers to lifestyle, and psychological perspectives. Adequate knowledge regarding the overview of COVID-19; preventive approaches such as social distancing, use of masks, gloves, and sanitizers; and compliance with the lockdown measures were reported by the respondents. The pertinent issue raised by the respondents was the disturbance in normal routine due to distortion in social life and isolation. Conclusion: The findings from this study lighten the people’s perspectives that help the government to prepare public health strategies based on population-focused approaches. The present study demonstrates the respondents’ opinion on COVID-19 management through personal hygiene, social distancing, and complying with the lockdown measures. Furthermore, it demands the adoption of timely and evidence-based teaching-learning techniques for students’ engagement which ensures mental health and self-motivation as well.

Alcohol ban during the COVID-19 pandemic lockdown: Lessons for preventing foetal alcohol spectrum disorder in South Africa

During the two national lockdowns implemented in South Africa to curb the spread of the coronavirus disease 2019 (COVID-19) pandemic, the sale and consumption of alcoholic beverages were prohibited. There is observational evidence from the literature suggesting a drastic reduction in the emergency and trauma unit admissions in many South African hospitals and clinics with alcohol-related restrictions. This article explores the potential benefits of the restrictions placed on the sale and consumption of alcohol during the COVID-19 pandemic on preventing foetal alcohol spectrum disorder (FASD) in South Africa. Following the potential benefits of the alcohol bans, we recommended that the current South African national liquor policy and the 2012 South African government-drafted Bill for Control of Marketing of Alcoholic Beverages should be fully implemented and enforced. Furthermore, the 'best buys' by the World Health Organization (WHO) should be adapted (based on local evidence) and executed. Implementing the abovementioned policies can reduce alcohol abuse by limiting and regulating the manufacturing, distribution, advertising, sponsorship, promotion, physical availability and hours of sale of alcoholic beverages in South Africa.Contribution:This article shows that alcohol bans during the coronavirus disease 2019 (COVID-19) lockdown reduced the short-term effects of alcohol. We believe that this could be a game-changer for the prevention of FASD in South Africa and positively impact the incidence and prevalence of FASD. This piece provides evidence that policymakers, health practitioners and academics can use to continue advocating for stricter alcohol control measures in South Africa.

Has Lockdown and COVID-19 Led to a Change in the Characteristics of Deep Vein Thrombosis and Patients Who Are Afflicted With It?

There is growing evidence identifying coronavirus disease 2019 (COVID-19) as a significant risk factor for thrombosis in inpatients. However, it remains uncertain if patients in the community have been influenced during the COVID-19 pandemic and national lockdown. This study, across four centres in the United Kingdom (UK), reviewed outpatients with deep vein thrombosis (DVT). This study aims to find out whether lockdown and COVID-19 led to a change in the characteristics of DVT and patients who are afflicted with it, alongside a review of DVT service. Data was collected retrospectively from electronic patient records system for the following periods: April 1 to June 30, 2019, and April 1 to June 30, 2020. These were the key months during the first national lockdown in UK. Data were analysed for patient demographics, risk factors, characteristics of DVT, management, and DVT reoccurrence. Statistical analyses were performed using GraphPad Prism 8 (Dotmatics, Boston, Massachusetts, United States). During the study periods, 227 outpatients from the community sustained DVT in 2019 and 211 in 2020. Of these patients, 13 in 2020 were COVID-19 positive. There was a difference in gender distribution with 128 males and 99 females in 2019, and 93 males and 118 females in 2020 (p= 0.0128). No significant difference was noted in the incidence of thrombophilia with nine in 2019 and three in 2020 (p=0.1437). Fewer long-haul journeys were made in 2020 (only two), compared to 16 in 2019 (p=0.012). Fewer patients had immobility as a risk factor in 2020 (n=55) compared to 2019 (n=79) (p=0.0494). However, there were more patients using oral contraceptive pills, with one in 2019 and nine in 2020 (p=0.0086) . There is no significant difference in the characteristics, extent, and management of DVT prior to and during the COVID-19 lockdown. National lockdowns do not affect DVT in the community; however, it is important to highlight the surrounding inpatient numbers.

Being a Mother under the COVID-19 Pandemic Lockdown: Evaluation of Perinatal Anxiety, Prenatal Attachment, and Maternal-Infant Attachment.

The novel coronavirus disease 2019 (COVID-19) pandemic has caused both physical and emotional stress throughout the population due to its worldwide impact. The unknowns about the disease, social isolation, pregnant women's concerns regarding exposure to the COVID-19, inaccessibility to necessary care, and the possibility of harm to their fetus may cause increased psychological distress during the perinatal period. We aimed to evaluate the association between perinatal anxiety, prenatal attachment, and maternal-infant attachment status among women with those who delivered their child in a tertiary-care center with rigid hospital restrictions. Term pregnant women who experienced the last trimester of their pregnancy during COVID-19 curfews between December 2020 and May 2021 were asked specifically about their concerns during the COVID-19 pandemic and they filled out the Perinatal Anxiety Screening Scale (PASS) and the Prenatal Attachment Inventory (PAI). Those who continued the follow-up within a month of period following the delivery were invited to fill out the Maternal Attachment Inventory (MAI). A total of 600 women completed the survey. While the evaluation of the relationship between participants' mean PAI and MAI scores showed a statistically significant positive correlation between scales (r = 0.124, p = 0.002), mean PAI and PASS scores showed a statistically significant negative correlation between scale scores (r = - 0.137, p = 0.001). Examining the factors, affecting the attachment process of pregnant and puerperal women, will guide the improvement of the quality of health services in the COVID-19 pandemic. · COVID-19 caused psychological distress, with increased anxiety among perinatal women.. · Elevated levels of anxiety about COVID-19 during pregnancy may lead to insecure attachment.. · Insecure attachment in the prenatal period will negatively contribute to mother - infant attachment..

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.

‘We Are Proactive against the Thieves’: Community Mobilisation against COVID-19 Criminality in Ibadan, Nigeria

One of the unintended consequences of coronavirus disease 2019 (COVID-19) preventive protocols that restricted movements and disrupted livelihoods was the changing nature of criminal behaviour from the streets to residential neighbourhoods. While studies on COVID-19 have focussed on economic losses, disrupted livelihoods and changes in social relations, scant attempt has been made to understand how fear of insecurity during the health pandemic could reinforce the need for community policing. Against this background, this study investigated community mobilisation against insecurity of lives and properties during COVID-19 pandemic lockdown in Ibadan, Nigeria. Using participant observation and in-depth interviews with 15 purposively selected residents, the study shows how collective perceived insecurity can engender social and communal bonding in the formation of defensible spaces. Findings showed that mobilisation for community policing was executed because of the insecurity experienced in neighbouring communities. A decentralised mechanism was established to allow zonal community executives take charge of their community security. This involved daily midnight house-to-house mobilisation with whistle, deployment of vigilante to hotspots, burn fires to signal the presence of community guards and decentralisation of residents into different patrol groups to community borders to guard against invasion.

Has the Frequency of Precocious Puberty and Rapidly Progressive Early Puberty Increased in Girls During the COVID-19 Pandemic?

Objective:Early puberty is development of secondary sex characteristics earlier than the expected normal age range. We subjectively observed an increased frequency of early puberty during the Coronavirus disease-2019 (COVID-19) lockdown and aimed to show the clinical, demographic characteristics of the cases and the change in its incidence.Methods:Female patients with central precocious puberty (CPP, n=28) and rapidly progressive early puberty (RPEP, n=61), presenting to our clinic before (January 2019-March 2020) and during the COVID-19 pandemic (April 2020-June 2021) were included.Results:Among 28 CPP cases, six (21%) presented before the pandemic lockdown, whereas 22 (79%) were diagnosed during the COVID-19 pandemic lockdown. While RPEP was seen in 16 (26%) patients before the pandemic, 45 (74%) patients were diagnosed during the lockdown period. Presentation with menarche was seen in 15 RPEP patients; two (13%) were in the prepandemic period and 13 (87%) were in the lockdown period. Chronological age, bone age, bone age to chronological age ratio, height, weight, and body mass index standard deviation scores of patients with RPEP and CPP were similar between the prepandemic and pandemic period.Conclusion:In this cohort, the frequency of CPP and RPP cases were significantly (p<0.001) increased during the COVID-19 pandemic, possibly due to environmental changes.

Efficacy of telerehabilitation for spine pain during the Coronavirus pandemic lockdown: a retrospective propensity score-matched analysis

Purpose Despite increased usage of telemedicine to deliver treatment during the coronavirus disease 2019 (COVID-19) pandemic, the efficacy of telerehabilitation for spine pain is unknown. This study aimed to investigate the effect of telerehabilitation on pain and disability in patients with spine pain treated during the COVID-19 pandemic and compare the results to in-clinic rehabilitation. Materials & Methods In this propensity score-matched analysis, 428 patients with spine pain who underwent telerehabilitation during the 6 months of COVID-19 pandemic lockdown and 428 patients who underwent in-clinic multimodal rehabilitation treatment during the 6-month period prior to lockdown were compared. Propensity score matching was done based on gender, age, pre-treatment pain, and disability. Post-treatment numerical pain rating scale (NPRS), Oswestry or Neck disability index (ODI or NDI), and minimal clinical important difference (MCID) achieved for NPRS and ODI/NDI scores were compared between the 2 groups. Results Post-treatment, the mean NPRS (mean difference − 1, p < 0.0001) and ODI/NDI (mean difference − 5.8, p < 0.0001) scores, were significantly lower in the telerehabilitation group when compared to control group. Similarly, the percentage of patients who achieved MCID of ≥ 2 for NPRS (mean difference − 6%, p = 0.0007) and MCID of ≥ 10 for ODI/NDI (mean difference − 7.5%, p = 0.005) scores were significantly higher in the telerehabilitation group. Conclusions Telerehabilitation achieved significant reduction in pain and disability among patients with spine pain, better than in-clinic rehabilitation. These encouraging results during the COVID-19 pandemic indicate the need to further explore and test the efficacy and wider application of telerehabilitation for treating spine pain. IMPLICATIONS FOR REHABILITATION Telerehabilitation can help achieve significant reduction in pain and disability among patients with spine pain. These encouraging results indicate the need to further explore a wider application of telerehabilitation for treating patients with spine pain during non-pandemic times.

Effect of the COVID-19 Pandemic Lockdown on the Management of Diabetic Retinopathy: A Cross-Sectional Study.

IntroductionWorldwide, diabetic retinopathy (DR) is one of the leading causes of vision loss. Early treatment and screening for DR have a major role in reducing the rate of the disease and the coronavirus disease 2019 (COVID-19) pandemic-related restrictions have altered real-world practice patterns in managing DR.Aims and objectivesTo evaluate the impact of the COVID-19 pandemic on the management of DR amongst patients presenting to a tertiary eye care center in Gujarat, India.MethodsThis is a cross-sectional study comparison of ophthalmic findings of 72 patients who presented to a tertiary care hospital with the manifestation of DR before and after the COVID-19 outbreak and subsequent lockdown. All the patients underwent detailed ophthalmic examinations, including optical coherence tomography (OCT) and fundus fluorescein angiography (FFA).ResultsThe mean age of participants was 54.5 years, with the mean duration of diabetes being five years since first detected. Diabetes was present in 26 patients out of 72. The number of follow-up visits to an ophthalmologist before COVID-19 was at least every one to three months, which significantly decreased after the lockdown of COVID-19. We found a significant progression of DR and clinically significant macular edema (CSME) in patients with diabetes. Before COVID-19, there were two mild non-proliferative diabetic retinopathy (NPDR), seven moderate NPDR, 15 severe NPDR, and 15 very severe NPDR, which were increased post lockdown to three, nine, 27, and 21, respectively. The proliferative diabetic retinopathy (PDR) vitreous hemorrhage (VH) and tractional retinal detachment (TRD) were also increased to 12 after lockdown as compared to only six before the COVID-19 lockdown. The causes for progression are inability to attend regular check-ups, inability to take proper treatment of diabetes and DR, poor control of diabetes, episode of COVID-19, history of high dose of steroid use, poor kidney function, and not knowing that there is a progression of the disease. A common reason for not visiting an ophthalmologist was fear of the unknown due to COVID-19.ConclusionsCOVID-19 has severely impacted the routine follow-up of DR and, in the subsequent years, there might be an increased incidence of severe outcomes due to DR. The second wave of COVID-19 and its lockdown have had very significant effects on the visual outcome of untreated DR patients.

The Social Conundrums of COVID-19 Pandemic and Stringent Lockdown Policy Response: Nigeria in Context

Abstract The global spread of Coronavirus Disease 2019 (COVID-19) pandemic created a grave public health crisis, threatened human survival and called for stringent lockdown policy response implementation. Further to the implementation, studies have been provided to explain the response impacts in developed countries with little attention on low and middle-income countries with a large population. The ones which focused on Nigeria were economic-based while paying less attention to social structures that influence development. Therefore, in the form of a documentary review, this paper addressed such academic rarity with an emphasis on poverty and livelihood, employment and workforce, education, human rights, crime and security to understand the situation in Nigeria. It established widespread poverty, crime perpetration, human rights abuse, massive job loss in both formal and informal sectors, disruption in education affecting 40 million students as the social impacts of the lockdown. Therefore, this paper emphasised social security for the general population, incentives to businesses against losses, improvement of the healthcare and education system, monitoring of police officers and reforms in managing future pandemics.

Adverse Impacts of Temporomandibular Disorders Symptoms and Tooth Loss on Psychological States and Oral Health-Related Quality of Life During the COVID-19 Pandemic Lockdown.

BackgroundEmotion and quality of life may have been impacted by the coronavirus disease 2019 (COVID-19) crisis, especially in the lockdown. The impact of temporomandibular disorders (TMD) symptoms and tooth loss on mental status and Oral Health-Related Quality of Life (OHRQoL) are not fully understood in a stressful situation.ObjectivesWe aimed to investigate whether TMD and tooth loss were the impaired risks of psychological states and OHRQoL in COVID-19 lockdown, and attempt to explore other potential risk factors.MethodsThis cross-sectional study surveyed residents via an online self-reported questionnaire, when Yangzhou was in lockdown. Demographic data, clinical information, the level of anxiety, depression and OHRQoL were collected and analyzed.ResultsPainful TMD symptoms and tooth loss are the risks of more severe anxiety and depression. TMD symptoms and tooth loss worsened OHRQoL. Lower education degree (OR: 6.31, P = 0.019), TMD-related pain symptoms (OR: 10.62, P = 0.005), tooth loss (OR: 3.12, P = 0.035), sleep disorders (OR: 2.92, P = 0.049) and relatively close contacts (OR: 3.95, P = 0.020) were verified as risk factors for increased level of anxiety. With respect to depression, low socio-economic status (OR: 6.22, P = 0.021), TMD-related pain (OR: 7.35, P = 0.012), tooth loss (OR: 4.48, P = 0.009), sleep disorders (OR: 5.13, P = 0.007) and relatively close contacts (OR: 12.94, P = 0.001) were identified as independent factors for developing depression. Additionally, drinking (B: −2.584, P = 0.013) and never going to the dental clinic (B: −3.675, P = 0.024) were relevant to better OHRQoL, while TMD without pain (B: 2.797, P = 0.008), TMD-related pain (B: 12.079, P < 0.001), tooth loss (B: 2.546, P = 0.006), sleep disorders (B: 2.598, P = 0.003) were independent factors for impaired OHRQoL.ConclusionPainful TMD symptoms, tooth loss and sleep disorders were the impaired risks of psychological states. TMD symptoms and tooth loss damaged OHRQoL when the city was in lockdown. Therefore, individualized psychological counseling is supposed to maintain control of mental health and OHRQoL under the stressful event.

Living donor liver transplant outcomes during the COVID-19 pandemic: does a decrease in case volume impact the overall outcomes?

BackgroundHigh-volume centers (HVCs) are classically associated with better outcomes. During the coronavirus disease 2019 (COVID-19) pandemic, there has been a decrease in the regular liver transplantation (LT) activity at our center. This study analyzed the effect of the decline in LT on posttransplant patient outcomes at our HVC.MethodsWe compared the surgical outcomes of patients who underwent LT during the COVID-19 pandemic lockdown (April 1, 2020 to September 30, 2020) with outcomes in the pre-pandemic calendar year (April 1, 2019 to March 31, 2020).ResultsDuring the 6 months of pandemic lockdown, 60 patients underwent LT (43 adults and 17 children) while 228 patients underwent LT (178 adults and 50 children) during the pre-pandemic calendar year. Patients in the pandemic group had significantly higher model for end-stage liver disease (MELD) scores (24.39±9.55 vs. 21.14±9.17, P=0.034), Child-Turcotte-Pugh scores (11.46±2.32 vs. 10.25±2.24, P=0.03), and incidence of acute-on-chronic liver failure (30.2% vs. 10.2%, P=0.002). Despite performing LT in sicker patients with COVID-19-related challenges, the 30-day (14% vs. 18.5%, P=0.479), 3-month (16.3% vs. 20.2%, P=0.557), and 6-month mortality rates (23.3% vs. 28.7%, P=0.477) were lower, but not statistically significant when compared to the pre-pandemic cohort.ConclusionsDuring the COVID-19 pandemic lockdown the number of LT procedures performed at our HVC declined by half because prevailing conditions allowed LT in very sick patients only. Despite these changes, outcomes were not inferior during the pandemic period compared to the pre-pandemic calendar year. Greater individualization of patient care contributed to non-inferior outcomes in these sick recipients.