COVID-19 Wards Research Articles

Impact of COVID-19 on medical teaching and students

Impact of COVID-19 on medical teaching and students

A cross sectional study to clinically evaluate the retina of COVID-19 patients in a tertiary care Government designated COVID hospital

Importance: Retinal vacuities can cause visual disturbances if not treated on time. Past researchers have shown an association of COVID19 with retinal vacuities. Objective: To evaluate the retina of patients who tested RTPCR or Rapid Antigen test positive for COVID-19.Design: Cross-sectional studySetting: COVID-designated Government tertiary healthcare institution. Clinical evaluation of the retina of the patients who suffered COVID-19, either hospitalized or home isolated and/ or who come for follow up in the medicine outdoor patient department was done from September 2020 to January 2022. Participants: 18 years of age and above were included in the study (by convenience sampling). Patients in the acute phase were evaluated cot side in COVID wards while the patients in the convalescent phase were those who were screened at least 15 days after hospital discharge and after 2 weeks of symptom onset or COVID testing in OPDs. Since the possibility of COVID-19 occurrence is high in diabetes and hypertension such patients were included in study to assess whether it can increase the frequency of retinal vasculitisMain Outcomes and Measures: Proportion of retinal vasculitis in patients of COVID-19.Results: Of the 274 study participants having COVID-19 who were evaluated for retinal changes, 187 were males and 87 were females; age group 40-60 years mainly: The patients of three different COVID-19 waves, having mild to severe disease and from acute or convalescent phase of disease were observed (including diabetic and hypertensive patients). None of the patients had significant retinal vasculitis changes in absence of systemic comorbidities. We observed one case of venous fullness, a case with superficial hemorrhage, and one having hard exudates where such retinal lesions were found without any systemic comorbidities.

The psychological impact of COVID-19 on North Indian medical students: A cross-sectional and observational study

Background: In India, the second wave of COVID-19 had serious implications, including an increase in case load, a reduction in key treatment supplies, and an increase in death, particularly among the younger generation. Medical students were also plagued by this scenario, which included assignment in COVID wards and involvement in COVID patient treatment. We wanted to know how the second wave of COVID affected these medical students psychologically. For medical students, the COVID-19 epidemic has created a frustrating dichotomy. This virus not only has an impact on people’s physical health, but also mental health. According to the existing per-pandemic evidence, medical students’ health is worse than the general population. Aims and Objectives: The aim of the study was to study the psychological impact of COVID-19’s second wave on medical students. Materials and Methods: An online survey of depression, anxiety, and stress scale-21 (DASS-21) was conducted among the medical students of North India. Their sociodemographic information was collected, comparison of postgraduate and undergraduate DASS-21 scores was done, different component led DASS-21 scores were assessed in overall study population, students were also asked to report their timings in hospital and challenges during hospital hours. The statistical scores for the responses were calculated and other demographic parameters were compared. Appropriate statistical analysis of the collected data was done (IBM SPSS version 20.). Results: A total of 538 responses were gathered from all undergraduate and postgraduate students; out of which 47.6% were undergraduate students and 52.4% were postgraduate students working in different medical colleges of North India. We categorized the psychological stress in five categories: Normal, mild, moderate, severe, and extremely severe. To our surprise, we found that many students were suffering from extremely severe stress; among which 38.8% had depression, 56.7% had anxiety, and 28.9% had stress. We also categorized the students in undergraduate and postgraduate groups and found that the maximum psychological impact was among postgraduate students as compared to undergraduate students. In postgraduates, extremely severe depression, anxiety, and stress scores were 46.8%, 72.3%, and 43.3%, respectively, around 43% of postgraduate students were suffering from either depression, stress, or anxiety. We also found that females were more stressed and had greater scores than males. Conclusion: During second wave of the pandemic, students’ mental health was affected much more than we think. Thus, it needs to be continuously monitored as this will not only affect their working in wards and hospitals but will also impact their studies and future life.

SMART MEDICINE REMINDER AND DISPENSER

Because of our specialized understanding in our profession, engineers have a higher duty to address societal problems as they arise. Many individuals today all around the world suffer from common disorders like high blood pressure, diabetes, etc. People with chronic illnesses should take their medications on a regular basis to treat their conditions, but in today's hectic society, many people forget to do so. Elderly people frequently forget to take their medications or take the incorrect medication at the wrong time. The project that we selected is entirely for the health of the elderly and those who regularly take medication. Our solution combines a medication dispenser and a reminder to dispense the right medication at the right time. The whole control activity of the smart medicine reminder is regulated by this system's Arduino UNO board. The voice alarm used by the system to remind the patient to take their medication can be adjusted by the patient or their caretakers. The close relatives of the patient, like son, daughter, wife, husband, mother, or father, can be the voice used in this system. To keep the date and time accurate for the system, we use a real-time clock module. Also, we use a 1x5 keypad to set alarms, and an LCD display is used to show the current time and date as well as to set alarms. The dispensing section uses servo motors to provide the medication efficiently. To remind hospital patients to take their medications on time, this approach can also be utilized in hospitals. This Smart medicine dispensers and reminders are highly helpful in a variety of scenarios, including patient homes, hospitals, COVID wards, and quarantine areas. It may also be incorporated into the system in the patient monitoring system.

Acute Kidney Injury in COVID-19 Patients Admitted at a Tertiary Care Centre: A Descriptive Cross-sectional Study

Coronavirus disease can affect the renal system in various forms ranging from mild proteinuria to acute kidney injury, some even needing renal replacement therapy. This study aimed to find out the prevalence of acute kidney injury in patients admitted with COVID-19 at a tertiary care centre. This descriptive cross-sectional study was done in patients admitted in COVID-19 ward in our hospital from July 2021 to June 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 066-077/078). The serum creatinine level was used for the diagnosis of acute kidney injury. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Out of 80 patients with COVID-19, the prevalence of acute kidney injury was 25 (31.25%) (21.09-41.41, 95% Confidence Interval). The prevalence of acute kidney injury in COVID-19 patients was similar to other studies done in similar settings. acute kidney injury; COVID-19; Nepal.

The effect of a positive thinking program on psychological well-being of nurses working in COVID-19 wards

The effect of a positive thinking program on psychological well-being of nurses working in COVID-19 wards

Relationships Between Psychosocial Factors and Mental Health Among Nurses Working With COVID-19 Patients in Japan

Background Nurses who work with COVID-19 patients may suffer high levels of work-related stress, anxiety, and depressive symptoms. These impacts raise concerns about the deterioration of their mental health during this time. Objective This study examines the relationships between psychosocial factors (health, behavior, social, and economic factors) and mental health on among nurses working in a COVID-19 ward in Japan. Design A cross-sectional questionnaire-based study design was adopted. Methods We randomly selected 41 general hospitals that had over 400 beds. The participants were nurses who cared for COVID-19 patients at five hospitals. The questionnaire was completed by 56 nurses (seven men and 49 women) (response rate 46.6%). The survey asked participants about their basic attributes (gender, age, years of experience). It also included the Japanese version of the Patient Health Questionnaire-9, the Japanese version of the Generalized Anxiety Disorder-7, the Japanese version of the Impact of Event Scale-Revised, and the Maslach Burnout Inventory-General Survey to measure depression, anxiety, trauma experience, and burnout, respectively. To determine psychosocial factors, perception of damage from harmful rumors, nurses’ intention to quit their jobs, working environment changes, and changes in daily life were measured. Results Intention to quit was specifically associated with “wanting to continue nursing,” the posttraumatic stress disorder (PTSD) symptom of avoidance, depression, anxiety, and burnout. Nurses who had experienced the impact of harmful rumors in the workplace had high levels of PTSD symptoms, including intrusion, avoidance, and hyperarousal, as well as depression, anxiety disorder, and burnout cynicism. Regarding changes in the working environment, significant differences were confirmed in PTSD symptoms including intrusion, avoidance, and hyperarousal, as well as depression. We also examined the relationship between changes in daily life and mental health. We found that answering affirmatively to “the family income has decreased,” “I’ve had family problems,” and “I cannot do housework” related to mental health disorders among the nurses. Consideration: Psychosocial factors that may have been exacerbated during the COVID-19 pandemic were found to affect nurses’ mental health. Thus, reducing these psychosocial factors and building a mental health support system for nurses is crucial.

The rs568408 variant in the IL-12A gene is associated with risk for COVID-19 in Iraqi patients.

The objective of the current study was to check the link between potential polymorphism in IL12A rs568408 and the possible risk of COVID-19 in the Iraqi population. Allele specific-polymerase chain reaction (PCR) technique was carried out for genotyping and detection of IL12A rs568408 gene polymorphism in a case-control study of 125 severe COVID-19 cases and 60 controls. Patients were admitted to either Marjan medical city or Al-Sadeq hospital's COVID-19 wards between January and June 2022 in Iraq. The diagnosis of COVID-19 in each patient was confirmed by severe acute respiratory coronavirus 2-positive reverse transcription-PCR. The distribution of both genotyping and allele frequencies of IL-12A rs568408 revealed significant differences between patients and control groups (P = 0.006 and P = 0.001, respectively). The IL12A rs568408 AA and AG variant genotypes were associated with a significantly increased risk of COVID-19 (odds ratio [OR] = 5.19, 95% confidence interval [CI]: 1.13-23.82; P = 0.034) and (OR = 2.39, 95% CI = 1.16-4.94, P = 0.018), respectively, compared with the wild-type GG homozygote. These findings indicate that IL12A rs568408 GA/AA variant may contribute to the risk of COVID-19. This study is the first report about the association of IL12A rs568408 with COVID-19.

The psychological impact of COVID-19 duty among resident doctors working in a COVID-hospital: A short-term follow-up study.

There is a dearth of longitudinal research that measures the impact of the pandemic on the mental health of resident doctors. This study aimed to estimate depression, anxiety, stress, burnout, and sleep disturbances (insomnia and nightmares) among resident doctors after COVID-19 duty. The study was a prospective longitudinal study among resident doctors posted in COVID-19 wards in a tertiary hospital in North India. The participants were assessed at two points of time, two months apart, on a semistructured questionnaire and self-rated scales for depression, anxiety, stress, insomnia, sleep quality, nightmare experience, and burnout. A significant proportion of resident doctors working in a COVID hospital had symptoms of depression (29.6%), anxiety (28.6%), stress (18.1%), insomnia (22%), and burnout (32.4%), even after two months of being off COVID duty. It was seen that these psychological outcomes had a strong positive correlation with each other. Compromised sleep quality and burnout significantly predicted depression, anxiety, stress, and insomnia. The current study has added to the psychiatric aspects of COVID-19 among resident doctors and the changes in these symptoms with time and highlights the need for targeted interventions to decrease these adverse outcomes.

Growth profile and bacterial resistance in blood cultures from hospitalized patients in COVID wards of Cariri, from reports of a laboratory in Crato-ce

The present study aims to evaluate the profile of bacterial growth and resistance in hemocultures of patients hospitalized in the COVID wards of Cariri, from reports of a laboratory in Crato-CE. This is an observational, cross-sectional, descriptive, quantitative research conducted through a data collection related to blood cultures in patients hospitalized in the ward designated to this pathology, through reports, in the period from March 2020 to March 2021. Patients who performed this type of collection but were not hospitalized in the COVID-19 ward, those who performed this exam on another date outside the period, as well as patients who, although they were with COVID-19, did not perform blood cultures or were hospitalized, have all been excluded. Through this study it was possible to observe that the most frequently isolated microorganisms were from the group of Negative Staphylococcus Coagulase (33%), Staphylococcus aureus (19.9%), Klebsiella pneumoniae (14.5%), Escherichia coli (9%), Acinetobacter baumanii (5.6%) and others with a lower incidence were identified, totaling 18%. Among the Gram-positive bacteria, a higher resistance to Ampicillin was observed occurring in 14.5% of the cases, Erythromycin suffered resistance in 14.25% of the Gram-positive bacteria, and the drug Oxacillin suffered resistance in 13.99%. It is possible to see that there are relevant levels of resistance in relation to the antimicrobials emphasized by the Gram-negative bacteria, especially Cefepime (8.35%), Ceftazidime (8.2%), Ampicillin (8.1%), Cotrimoxazole (7.7%) and Ciprofloxacin (7.51). With this study, it was possible to conclude that the microorganisms most frequently isolated in bloodstream infections in hospitalized patients was from the group of Negative Coagulase Staphylococcus, although they are from the normal skin microbiota, they are also opportunists, causing infections in debilitated patients. Similarly, the profile of bacterial resistance was analyzed, which enables a better targeting of the most effective antibiotic therapy in order to avoid indiscriminate use, especially in patients affected with COVID-19.

Stressors and coping strategies among frontline nurses during COVID-19 pandemic.

Frontline nurses are more likely to be in close contact with COVID-19 patients and COVID ward duties make nurses to undergo serious emotional disturbances. The physical, psychological, and social well-being of the nurses can be affected in this time and proper training programs and counseling sessions should be undertaken. This study attempts to understand the stressors and coping strategies of nurses from a tertiary hospital. Descriptive survey design was adopted and data were collected in 2021 from 92 frontline nurses from a selected tertiary hospital in Raipur. The data collection tools used were sociodemographic proforma, structured questionnaire on stress factors, and structured checklist on coping strategies. The analysis was done using frequency and percentage distribution. Among the nurses, 51% reported stressors related work- and work-related environment, 50% reported stressors related to self-safety, and 52% on stressors related to family concerns. The coping strategies adopted by the nurses included realization of the fact that service to patients comes as first (75%), and availability of personal protective equipment kits, confidence in following strict protective measures (69%), talking to family members over phone daily (71%), and support from family and friends (70%). Learning about COVID-19 (65%), and team work (61%) also created confidence to work as frontline nurses during this pandemic. The present survey reports that nurses face various stressors and tries to impart different coping strategies to overcome the stress. Understanding their stressors and coping strategies will help the administration to implement measures to create a working situation which will strengthen the health man power resources.

Usage of Personal Protective Equipments during Covid-19 Pandemic: Quality assessment and problems faced by the workers in Pediatric Covid-19 Ward of Medical College, Kolkata

Usage of Personal Protective Equipments during Covid-19 Pandemic: Quality assessment and problems faced by the workers in Pediatric Covid-19 Ward of Medical College, Kolkata

Psychological Impact of COVID 19 On Patients and Their Family Members Giving Hospital Care In COVID-19 Ward of Tertiary Care Centre of Low And Middle Income Country Backgrounds In India. An Observational Study.

Psychological Impact of COVID 19 On Patients and Their Family Members Giving Hospital Care In COVID-19 Ward of Tertiary Care Centre of Low And Middle Income Country Backgrounds In India. An Observational Study.

The Impact of Coronavirus-2019 On General Health Anxiety Among Students of Iranian Medical Sciences

Background: During the Coronavirus 2019 (COVID-19) outbreak, Iranian medical sciences students were at higher risk of contracting this virus because they were in infected environments. So, they are predisposed to high levels of anxiety that could worsen their lives. The determent of factors and levels of anxiety could be helpful to reduce anxiety and control its worse effects. Hence, this study aimed to measure the anxiety index and its factors among medical sciences students during the COVID-19 pandemic in Iran. Materials and Methods: In this cross-sectional study, an online survey was sent to students from 27 medical sciences universities in Iran from 20th December 2020 to 10th March 2021. The online survey consists of the Health Anxiety Inventory (HAI) for measured general health anxiety as well as the baseline characteristics of students. Results: 723 students responded, including 483 (66.8%) females and mean HAI score was 16.76 ± 8.35. Based on our findings, gender, past medical, and drug history were significantly related to the high level of anxiety. However, there was no coloration between HAI scores with age, the field of study, study duration, university location, and attendance in the hospital and/or COVID-19 ward (P˃0.05). Conclusions: Students with notable past medical history and/or drug history and female students more than others were predisposed to anxiety in a pandemic such as COVID-19. Hence, in a pandemic situation, psychological care should concern them.

Psychosocial Perceptions as Significant Impact Modifiers - A Mixed Method Research Among Hospitalized Covid-19 Patients in A Tertiary Care Hospital in Coimbatore District, Tamil Nadu

Context: Covid 19 pandemic which evolved in successive waves had profound pyschosocial impact on affected individuals. Perceptions had impact on both individual and environmental level with potential behavioural consequences. The aim of the research is to study the psychosocial perception and psychological impact of COVID- 19 among hospitalized COVID-19 patients. Methodology: The study was a mixed method research (Quan-Qual sequential design) conducted in the Covid wards of a tertiary care hospital in Coimbatore district. The psychological impact was assessed using the General Health Questionnaire, Perceived Stress Scale. The results of quantitative analyses and qualitative analyses were expressed as proportions and done using thematic analysis using grounded theory respectively. Results: About 55% of the hospitalized Covid-19 patients had psychological impact. On multivariate analysis, the factors which emerged as independent risk factors for presence of psychological morbidities due to COVID were presence of high stress level, sleep disturbances and their perception of COVID as high threat. Conclusions: Focussed Counselling with specific reference to attend to spiritual health component in addition, would go a long way in diminishing immediate and long-term psychological impact due to covid-19 illness.

Impact of Covid-19 Patients with Diabetes Mellitus and its Association with Clinical Outcomes

INTRODUCTION COVID-19 is a debilitating disorder affecting lungs with multiple organs. Diabetes mellitus is considered as a common co-mor- bidity whose impact has not been fully understood. There is a hypothesis that patients with diabetes are at increased risk of severe disease or death due to COVID-19. The main objective of the present study was to find the the association of COVID-19 diabetes mellitus (DM) and non-diabetes mellitus patients with the clinical outcomes. MATERIAL AND METHODS This cross-sectional study was conducted in hospitalized patients with COVID-19 at Universal College of Medical Sciences (UCMS), Bhairahawa. Total of 200 patients were enrolled in the study period from July 2021 to January 2022 whose clinical profile, socio-demographic and biochemical variables were assessed. The study variables taken were symptoms, random blood glucose (RBG), glycosylated hemoglobin (HbA1c) and their outcomes like High Dependency Unit/Intensive Care Unit (HDU/I- CU) or COVID ward admission, hospital stay and mortality. RESULTS A total of 40% of the patients require HDU/ICU hospitalization with 20% requiring ventilator support. The findings revealed a strong link between diabetes mellitus and fatigue (p=0.012) as well as mortality (p=0.032). The difference in hospital stay between ventilator and non-ventilator groups was substantial (p=0.001). The hospital stay in the mortality group was significantly shorter (p=0.026). Likewise, RBG and HbA1c are higher than in the non-mortality group (189 vs 167; 5.7 vs 5.6 %). CONCLUSION Hypertension and diabetes are the most common morbidities associated with COVID-19 individuals. Diabetes mellitus was found to have a substantial link to fatigue, but there was no link between HbA1c and the length of hospital stay or the method of ventilation.

Nurses’ Family Support System in Pandemic Covid-19

Background: The Covid-19 pandemic is being 2 years and the fluctuated cases made the nurses workload were increasing. The effects are stress, anxiety, and burnout. To decrease these sequences, need family support. Family support advantage to them for increasing their confidence and being valuable. Purpose: the major aim of the study is to know the difference between family support for nurses who work in Covid and non-Covid wards.Methods: Quantitative method were used in its study and used 149 nurses as a respondent. The inclusion criteria were working at hospital at least a year and lived with nuclear family. The questioner used Family Support Scale (FSS) with 19 sentences. It used Mann-Whitney test with SPSS 21 software.Results: Most of the respondent were nurses who work in Covid ward (64.4%) and majority is an associate nurse (84.9%). The p value was 0.077 (p0.05) which indicate that there were not differences of family support between nurses who work in Covid and non-Covid wards.Conclusion: There were not differences of family support between nurses who work in Covid and non-Covid wards.

Experiencing and witnessing disruptive behaviors toward nurses in COVID-19 teams, patient safety, and errors in care.

Nurse managers and team co-workers' disruptive behaviors (DBs) are negatively associated with a perceived safe climate. Moreover, DBs are a risk factor for patients' safety. Yet, it remains unknown whether and to what extent these effects were prevalent in COVID-19 wards and among witnesses of DBs. A cross-sectional study. A questionnaire was distributed on social networks and completed by nurses in various Israeli healthcare organizations using snowball sampling between October and December 2021. The questionnaire included seven previously published measures and a question checking whether the participants had worked in a COVID-19 ward. The minimal sample size for any analysis was 236. Hypotheses were tested with correlations and structural equation modeling. DBs of nurse managers and team co-workers toward nurses were higher in COVID-19 teams. As hypothesized, DBs were negatively correlated with a safe climate and positively with patient safety (fewer errors). The data were consistent with a model suggesting that a safe climate is related to fewer DBs and DBs largely mediate the effects of safe climate on errors. Surprisingly and importantly, the strongest predictor of errors, including preventable mortality, is witnessing DBs and not being a victim of DBs. DBs may impede open communication and collaboration among co-workers, particularly in COVID-19 teams. This study shows the links between nurse shaping of a safe climate, DBs toward nurses, and patient safety. Nurse managers who create a safe climate and show zero tolerance for DBs could reduce the risk of errors in care.

Psychological Conditions among Nurses in Caring for the COVID-19 Patients: A Study from Referral Hospitals of Aceh, Indonesia

Introduction: Nurses as frontline health care providers during the COVID-19 pandemic were at high risk and vulnerable to virus infection. Physical and mental conditions in caring for COVID-19 patients in hospitals may be associated with the exacerbation of the nurses experiencing depression, anxiety, and stress among the nurses. Objective: The study aimed to identify the psychological conditions (depression, anxiety, and stress) among nurses providing clinical assistance in caring for COVID-19 patients. Methods: This investigation employed a comparative study with a cross-sectional study design. The respondents were 109 nurses working in the COVID-19 wards in two referral hospitals offering care for COVID-19 patients. Data were collected using the standardized DASS-21 questionnaire and analyzed using the Mann-Whitney U-test. Results: The results showed psychological conditions among nurses caring for COVID-19 patients with depression (moderate) among 60.0% and 58.8%, anxiety (severe) at 60,0% and 58.8%, and stress levels (mild) at 56% and 52.9% for hospital A and B, respectively. The study also found no significant difference in depression (p=0.890), anxiety (p=0.846), and stress levels (p=0.806, α=0.05) between the nurses in the COVID-19 wards of the two hospitals. Conclusion: The demographic data of nurses, such as age, education level, working experience, hospital facilities, attended workshops/training on the use of personal protective equipment (PPE)/Hazmat, and management of COVID-19 patients might contribute to psychological conditions (depression, anxiety, and stress) among nurses in caring for the COVID-19 patients.

A cross-sectional study on knowledge, attitude, and practices of donning and doffing of personal protective equipment: an institutional survey on interns during the COVID-19 pandemic

Background: Personal protective equipment (PPE) is a physical barrier that healthcare workers (HCW) wear to stop the transmission of a pathogen from a pathologic specimen or a confirmed or suspected case. It prevents the spread of disease from patient to HCWs as well as the other way around. Eyewear, face shield, surgical mask, particulate respirators, glove, disposable gowns and boots, and head coverings are some examples of these physical barriers. The primary objective of the study is to assess the knowledge, attitude and practices (KAP) of interns towards appropriate use of PPE and secondary objective is to find the role of training on donning and doffing of PPE of interns towards appropriate use of PPE.Methods: This is an institutional based, analytical cross-sectional study. Data was collected from interns (n=130) posted in COVID-19 ward using a universal sampling method. A predesigned questionnaire was used for study. The data was analyzed using SPSS 26 trial versionResults: Interns were aware of the importance and criticality of donning and doffing procedure, overall level of KAP of donning and doffing of PPE were 96.90%, 73.10% and 86.20% respectively. We found that there was statistically significant mean difference between the KAP scores with respect to training of PPE.Conclusions: There were some gaps in KAP at institutional level among the interns with regards to donning and doffing of PPE during the beginning of this pandemic.