Epicenter Of Pandemic Research Articles

A Review of COVID-19 Hotels in New York City During the Early 2020 Outbreak: An Alternative Care Model.

New York City (NYC) was the epicenter of the early USCOVID-19 pandemic. From March to May 2020, overburdened healthcare centers precipitated an emergent need for non-traditional facilities to meet patient care demands. Given travel restrictions and NYC's underutilized tourist infrastructure, hotels were available to support emergency response needs. This article describes the process by which NYC's non-medical COVID-19 hotel programs were selected, mobilized, and operated, including lessons learned. NYC agencies and organizations collaborated, creating an interagency initiative that activated hotels to provide safe isolation and quarantine spaces for those diagnosed with or exposed to COVID-19, aiming to reduce community spread, increase capacity for NYC's strained healthcare system, and mitigate interagency redundancy. Interagency groups addressed hotel challenges, including infection prevention and control; behavioral health, intellectual, and developmental disorders; social determinants of health; and coordination, operations, and planning. NYC's COVID-19 hotel program successfully supported overburdened hospitals by providing alternate locations for non-inpatient COVID-19 individuals. Community engagement required a methodical approach, balancing quality assurance with efficient access. An interagency coordinating body developed and shared clinical criteria for hotel admissions, infection prevention and control (IPC) procedures, and discharge plans, enhancing the program's ability to scale and address complex needs. Lessons learned from this program can be applied for smoother implementation of similar programs in the future.

Updated Surveillance Metrics and History of the COVID-19 Pandemic (2020-2023) in Latin America and the Caribbean: Longitudinal Trend Analysis.

In May 2020, the World Health Organization (WHO) declared Latin America and the Caribbean (LAC) the epicenter of the COVID-19 pandemic, with over 40% of worldwide COVID-19-related deaths at the time. This high disease burden was a result of the unique circumstances in LAC. This study aimed to (1) measure whether the pandemic was expanding or contracting in LAC when the WHO declared the end of COVID-19 as a public health emergency of international concern on May 5, 2023; (2) use dynamic and genomic surveillance methods to describe the history of the pandemic in the region and situate the window of the WHO declaration within the broader history; and (3) provide, with a focus on prevention policies, a historical context for the course of the pandemic in the region. In addition to updates of traditional surveillance data and dynamic panel estimates from the original study, we used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data (GISAID) to identify the appearance and duration of variants of concern (VOCs). We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Additionally, we conducted a 1-sided t test for whether the regional weekly speed (rate of novel COVID-19 transmission) was greater than an outbreak threshold of 10. We ran the test iteratively with 6 months of data across the period from August 2020 to May 2023. The speed of pandemic spread for the region had remained below the outbreak threshold for 6 months by the time of the WHO declaration. Acceleration and jerk were also low and stable. Although the 1- and 7-day persistence coefficients remained statistically significant for the 120-day period ending on the week of May 5, 2023, the coefficients were relatively modest in magnitude (0.457 and 0.491, respectively). Furthermore, the shift parameters for either of the 2 most recent weeks around May 5, 2023, did not indicate any change in this clustering effect of cases on future cases. From December 2021 onward, Omicron was the predominant VOC in sequenced viral samples. The rolling t test of speed=10 became entirely insignificant from January 2023 onward. Although COVID-19 continues to circulate in LAC, surveillance data suggest COVID-19 is endemic in the region and no longer reaches the threshold of the pandemic definition. However, the region experienced a high COVID-19 burden in the early stages of the pandemic, and prevention policies should be an immediate focus in future pandemics. Ahead of vaccination development, these policies can include widespread testing of individuals and an epidemiological task force with a contact-tracing system.

Knowledge, Perception, and Attitudes of Residents of Northern Region of Ghana Towards COVID-19

Background: Africa is gradually becoming an epicenter of the COVID-19 pandemic. Based on the current disease trend, Africa might be the last hardest-hit continent. While scientific investigations continue to develop effective management through medications and vaccines, existing knowledge, perceptions, and attitudes could be harnessed to develop an effective strategy to curb community transmission of COVID-19. The present study assessed the awareness level, perceptions, and attitudes of people living in rural, peri-urban, and urban communities in Northern Ghana and their preparedness for the prevention and containment of COVID-19. Methods: We conducted a face-to-face interview and administered 553 semi-structured questionnaires in 18 rural, peri-urban, and urban communities in Tolon District, Kumbungu District, Sagnarigu Municipality, Savelugu Municipality, and Tamale Metropolis from April 23 to June 8, 2020. Results: The percentages of males and females among the respondents were 56.8% and 43.2%, respectively. Nearly half (41%) of the respondents had no formal education, and 91.3% of them were Muslims. Most respondents (85%) believed that COVID-19 is a punishment from God. There was a significant difference (P<0.001) between the first-time rural, peri-urban, and urban communities heard of COVID-19. The majority (63%) of the rural respondents depended on radio, while the peri-urban and urban respondents (51%) relied on TV for information on COVID-19. All respondents were aware of COVID-19, and 91.7% could mention at least two symptoms of the disease. However, 18% believed there was no COVID-19 in Ghana. Most respondents (69.6%) thought they would not contract the virus. Conclusion: Our findings may provide valuable data to the government and other stakeholders to control COVID-19.

Neuropsychiatric complications of coronavirus disease 2019: Mount Sinai Health System cohort study.

To describe the frequency of neuropsychiatric complications among hospitalized patients with coronavirus disease 2019 (COVID-19) and their association with pre-existing comorbidities and clinical outcomes. We retrospectively identified all patients hospitalized with COVID-19 within a large multicenter New York City health system between March 15, 2020 and May 17, 2021 and randomly selected a representative cohort for detailed chart review. Clinical data, including the occurrence of neuropsychiatric complications (categorized as either altered mental status [AMS] or other neuropsychiatric complications) and in-hospital mortality, were extracted using an electronic medical record database and individual chart review. Associations between neuropsychiatric complications, comorbidities, laboratory findings, and in-hospital mortality were assessed using multivariate logistic regression. Our study cohort consisted of 974 patients, the majority were admitted during the first wave of the pandemic. Patients were treated with anticoagulation (88.4%), glucocorticoids (24.8%), and remdesivir (10.5%); 18.6% experienced severe COVID-19 pneumonia (evidenced by ventilator requirement). Neuropsychiatric complications occurred in 58.8% of patients; 39.8% experienced AMS; and 19.0% experienced at least one other complication (seizures in 1.4%, ischemic stroke in 1.6%, hemorrhagic stroke in 1.0%) or symptom (headache in 11.4%, anxiety in 6.8%, ataxia in 6.3%). Higher odds of mortality, which occurred in 22.0%, were associated with AMS, ventilator support, increasing age, and higher serum inflammatory marker levels. Anticoagulant therapy was associated with lower odds of mortality and AMS. Neuropsychiatric complications of COVID-19, especially AMS, were common, varied, and associated with in-hospital mortality in a diverse multicenter cohort at an epicenter of the COVID-19 pandemic.

Perspectives from the pandemic epicenter: Sexual and reproductive health of immigrant women in New York City.

The United States' response to COVID-19 created a policy, economic, and healthcare provision environment that had implications for the sexual and reproductive health (SRH) of racialized and minoritized communities. Perspectives from heterogenous immigrant communities in New York City, the pandemic epicenter in the United States (US), provides a glimpse into how restrictive social policy environments shape contraception, abortion, pregnancy preferences, and other aspects of SRH for marginalized immigrant communities. We conducted in-depth interviews in 2020 and 2021 with 44 cisgender immigrant women from different national origins and 19 direct service providers for immigrant communities in New York City to explore how immigrants were forced to adapt their SRH preferences and behaviors to the structural barriers of the COVID-19 pandemic. We coded and analyzed the interviews using a constant comparative approach. Pandemic-related fears and structural barriers to healthcare access shaped shifts in contraceptive use and preferences among our participants. Immigrant women weighed their concerns for health and safety and the potential of facing discrimination as part of their contraceptive preferences. Immigrants also described shifts in their pregnancy preferences as rooted in concerns for their health and safety and economic constraints unique to immigrant communities. Understanding how immigrant women's SRH shifted in response to the structural and policy constraints of the COVID-19 pandemic can reveal how historically marginalized communities will be impacted by an increasingly restrictive reproductive health and immigration policy landscape.

Clinical surveillance systems obscure the true cholera infection burden in an endemic region

Our understanding of cholera transmission and burden largely relies on clinic-based surveillance, which can obscure trends, bias burden estimates and limit the impact of targeted cholera-prevention measures. Serological surveillance provides a complementary approach to monitoring infections, although the link between serologically derived infections and medically attended disease incidence—shaped by immunological, behavioral and clinical factors—remains poorly understood. We unravel this cascade in a cholera-endemic Bangladeshi community by integrating clinic-based surveillance, healthcare-seeking and longitudinal serological data through statistical modeling. Combining the serological trajectories with a reconstructed incidence timeline of symptomatic cholera, we estimated an annual Vibrio cholerae O1 infection incidence rate of 535 per 1,000 population (95% credible interval 514–556), with incidence increasing by age group. Clinic-based surveillance alone underestimated the number of infections and reported cases were not consistently correlated with infection timing. Of the infections, 4 in 3,280 resulted in symptoms, only 1 of which was reported through the surveillance system. These results impart insights into cholera transmission dynamics and burden in the epicenter of the seventh cholera pandemic, where >50% of our study population had an annual V. cholerae O1 infection, and emphasize the potential for a biased view of disease burden and infection risk when depending solely on clinical surveillance data.

Statistics did not prove that the Huanan Seafood Wholesale Market was the early epicentre of the COVID-19 pandemic

Abstract In a recent prominent study, Worobey et al. (2022. The Huanan Seafood Wholesale Market in Wuhan was the early epicenter of the COVID-19 pandemic. Science, 377(6609), 951–959) purported to demonstrate statistically that the Huanan Seafood Wholesale Market was the epicentre of the early COVID-19 epidemic. We show that this statistical conclusion is invalid on two grounds: (a) The assumption that a centroid of early case locations or another simply constructed point is the origin of an epidemic is unproved. (b) A Monte Carlo test used to conclude that no other location than the seafood market can be the origin is flawed. Hence, the question of the origin of the pandemic has not been answered by their statistical analysis.

Why do parents refuse to self-protect? Socio-cultural factors influencing the immediate response of the older generation to COVID-19 and their spatial heterogeneity in China

Immediately after the initial COVID-19 outbreak in January 2020 in China, an intriguing trend of distrust and anti-protection among the older generation appeared. Based on 1926 samples collected across the Chinese mainland within a short timeframe, this paper adopted a series of global and spatial statistical techniques to explore the socio-cultural reasons underlying the older generation's risk response and their spatial heterogeneity in China. First, the global Ordinary Least Square (OLS) model validated the significant effects of trust in government information, cultural traditions, and social conformity, but the spatial autocorrelation (Moran's I) test of the residuals suggested spatial nonstationarity of the model. Second, the results from the Local Indicators of Spatial Association (LISA) and Geographically Weighted Regression (GWR) confirmed the spatial heterogeneity of the older generation's protective patterns. An ‘inverted T-shaped’ high-protection belt centering on Wuhan City was identified, indicating that physical proximity to and social connectedness with the pandemic epicenter is crucial in motivating the older generation's protection. In areas distant from and less connected with the risk center, strong collectivistic values may play a vital role in stimulating trust in government information and fostering positive protective intentions of the older generation. However, in most areas, such strong government trust is absent, and the inhibitory cultural and social factors often prevail to result in an anti-protection norm of the older generation. Finally, suggestions were provided to develop locally effective risk management measures from the socio-cultural perspective, and more geographic investigations on public risk response were proposed.

Emergency department visits of newly diagnosed cardiovascular disease patients in Korea during the COVID-19 pandemic

This study aimed to examine the impact of the COVID-19 pandemic on the emergency department (ED) visits of cardiovascular disease (CVD) patients. The customized data of the National Health Insurance Service (NHIS) from 2017 to 2020 were analyzed. CVD patients were defined by the code ‘V192’ based on the NHIS coverage benefit expansion policy. The number of ED visits of CVD patients, as well as executed procedures in 2020 (during the pandemic), were compared to the corresponding average numbers in 2018 and 2019 (prepandemic). Stratification by age group, residential area and hospital location was performed. The number of ED visits of newly diagnosed CVD patients decreased by 2.1% nationwide in 2020 (2018–2019: 97,041; 2020: 95,038) and decreased the most (by 14.1%) in March (2018–2019: 8539; 2020: 7334). However, the number of executed procedures increased by 1.1% nationwide in 2020 (2018–2019: 74,696; 2020: 75,520), while it decreased by 11.9% in April (2018–2019: 6603; 2020: 5819). The most notable decreases in the number of newly diagnosed CVD patients (31.7%) and procedures (29.2%) in March 2020 were observed in the Daegu·Gyeongbuk area. CVD patients living in the epicenter of the COVID-19 pandemic may experience difficulty accessing healthcare facilities and receiving proper treatment.

Virtual Reality Distraction Is No Better Than Simple Distraction Techniques for Reducing Pain and Anxiety During Pediatric Orthopaedic Outpatient Procedures: A Randomized Controlled Trial.

In-office procedures can be painful and anxiety-provoking for pediatric patients. Minimizing such pain and anxiety in children improves the patient experience and promotes a rewarding and productive patient-caregiver-provider relationship, which may for some young patients be their first memorable encounter with the healthcare system. Although virtual reality (VR) techniques have proven to be helpful in minimizing pain and anxiety during procedures in pediatric intensive care settings, it remains unclear how VR affects objective and subjective measures of pain and anxiety in children undergoing in-office orthopaedic procedures such as cast removal or percutaneous pin removal after fracture healing. Is a VR gaming simulation more effective than either of two forms of noninteractive visual distraction (VR goggles or tablet computer displaying a noninteractive video) for reducing (1) objective measures of pain and anxiety and (2) subjective measures of pain and anxiety in children undergoing in-office cast removal or percutaneous pin removal? This study was a randomized controlled trial with two parallel, separately analyzed cohorts: children undergoing in-office cast removal or in-office percutaneous pin removal at a single urban tertiary institution. We approached eligible patients who were scheduled to undergo outpatient cast or percutaneous pin removal and who met prespecified inclusion criteria. We enrolled until 105 patients were available for analysis in each of the cast removal and pin removal cohorts. Of note, the study institution was in an urban epicenter of the coronavirus-19 pandemic, and clinical research was paused sporadically, which resulted in a longer-than-expected enrollment period. In the cast removal cohort, all patients were eligible for inclusion and were enrolled and randomized into one of three groups: VR gaming simulation (n = 37), VR goggles with a noninteractive video (n = 36), or a tablet computer with the same noninteractive video (n = 40). Eleven percent (4), 8% (3), and 3% (1) withdrew from each of the three intervention groups, respectively. In the pin removal cohort, all patients were eligible for inclusion and were enrolled and randomized into the same three groups (37, 44, and 41 patients, respectively). In the pin removal group, 14% (5), 18% (8), and 10% (4) withdrew from each of the three intervention groups, respectively. In all, 235 patients were enrolled in the study and 210 patients (mean ± SD age 9 ± 3 years; 48% [100] girls) were included in the final analyses. There were no clinically important differences in age, gender, preprocedure pain, or anxiety among the intervention groups. Primary outcomes included preprocedure-to-maximum heart rate increase (objective measure) and preprocedure and postprocedure pain and anxiety using a VAS (subjective measures). One-way ANOVA and Bonferroni-adjusted pairwise comparisons were used to calculate between-group differences for the primary outcomes. There were no intervention-level groupwise differences between VR goggles with an interactive game, VR goggles with a noninteractive video, or the tablet computer with the same video in preprocedure-to-maximum heart rate increase in the cast removal cohort (18 ± 21 bpm versus 14 ± 11 bpm versus 20 ± 16 bpm, respectively; largest mean difference -6 bpm [95% CI -16 to 3]; p = 0.36) or pin removal cohort (27 ± 20 bpm versus 23 ± 12 bpm versus 24 ± 19 bpm, respectively; largest mean difference 4 bpm [95% CI -7 to 14]; p = 0.99). Similarly, there were no intervention-level groupwise differences in preprocedure to postprocedure VAS pain in the cast removal cohort (1 ± 1 versus 1 ± 2 versus 0 ± 2, respectively; largest mean difference 0 points [95% CI 0 to 1]; p = 0.89) or pin removal cohort (0 ± 3 versus 2 ± 3 versus 0 ± 3 points, respectively; largest mean difference 1 point [95% CI 0 to 3]; p = 0.13). Finally, there were no intervention-level groupwise differences between the same intervention groups in preprocedure to postprocedure VAS anxiety in the cast removal cohort (-2 ± 2 versus -1 ± 2 versus -1 ± 2 points, respectively; largest mean difference -1 point [95% CI -2 to 1]; p = 0.63) or pin removal cohort (-3 ± 3 versus -4 ± 4 versus -3 ± 3 points, respectively; largest mean difference -1 point [95% CI -2 to 1]; p = 0.99). During in-office cast and pin removal in pediatric patients, simple distraction techniques such as tablet video viewing are as effective as higher-fidelity VR headset video and interactive games in minimizing objective measures of procedural pain and subjective measures of pain and anxiety. Because of these findings and because of the associated costs, implementation logistics, and variable tolerance by young patients, widespread use of VR distraction techniques in the pediatric orthopaedic outpatient setting is unnecessary. Level I, therapeutic study.

Acute Appendicitis in the Epicenter of the COVID-19 Pandemic: A New York City Single-Center Experience.

Appendectomy is the gold standard for simple appendicitis. During the coronavirus-19 pandemic, it was estimated that appendectomies in the United States decreased by 24%. We aimed to describe trends in acute appendicitis management at a center located in one of the largest epicenters of the pandemic. This is a retrospective cohort study in a single institution located in Queens, New York, of patients who presented with acute appendicitis. A pre-COVID time period, March-June 2019, was compared to peak-COVID, March-June 2020, and late-COVID, March-June 2021. Of the 382 patients admitted with appendicitis during the time periods, 164 were admitted pre-COVID. Appendicitis presentations decreased by 44% during peak-COVID and 23% in late-COVID. Patients were younger during peak-COVID compared to pre-COVID (39 vs 34years old, P = .036). Incidence of complicated appendicitis in pre-, peak-, and late-COVID was equivalent (41% vs 46% vs 45%) and operative management was similar (85% vs 76% vs 79%). Non-operative patients had shorter lengths of stay (pre- vs peak-COVID: 4.6 vs 2.9days, P = .006). Readmission rates were similar between the cohorts across time periods. During peak-COVID, there was a significant decrease in presentation of acute appendicitis but clinical presentation and outcomes remained similar between the cohorts. Patients who were managed non-operatively may be discharged earlier without increased rates of readmissions.

Benign inoperable tracheal stenosis in COVID versus non-COVID patients at the pandemic epicenter: a case series.

The COVID-19 pandemic has exponentially expanded the number of patients requiring treatment for chronic respiratory failure. One consequence is an increase in the number of patients requiring intubation and mechanical ventilation. Benign inoperable tracheal stenosis presents a challenge, especially in COVID-19 patients. We describe a case series of 15 patients with Benign inoperable tracheal stenosis treated with interventional bronchoscopy over a 15-month period. These patients were divided into two groups, COVID and non-COVID. We used an electrocautery snare as an electrocautery knife to cut the stenotic segment followed by four injections of 1mg submucosal Decadron via a Wang needle. Patients were subsequently followed by the pulmonary clinic. Institutional review board approval was not required as per our institutional policy for a retrospective case series. There was a high degree of success with this intervention, with a low rate of recurrence. We also noticed the following differences between the two subgroups. COVID tracheal stenosis was longer in length, had a higher percentage of cartilage involvement, and was located more distal to cords than the non-COVID group. The median age was younger in the COVID group. COVID pandemic an enormous number of intubations and tracheotomies have been performed. As a result, there will be an increased prevalence of tracheal stenosis. Most of these cases can be effectively treated with surgery. Dealing with complex inoperable cases remains a dilemma. Our case series/research article is an attempt to provide an easy technique with a high cure rate.

A GWAS in the pandemic epicenter highlights the severe COVID-19 risk locus introgressed by Neanderthals

Large GWAS indicated that genetic factors influence the response to SARS-CoV-2. However, sex, age, concomitant diseases, differences in ancestry, and uneven exposure to the virus impacted the interpretation of data. We aimed to perform a GWAS of COVID-19 outcome in a homogeneous population whoexperienced a high exposure to the virus and with a known infection status. We recruited inhabitants of Bergamo province-that in spring 2020 was the epicenter of the SARS-Cov-2 pandemic in Europe-via an online questionnaire followed by personal interviews. Cases and controls were matched by age, sexand risk factors. We genotyped 1195 individuals and replicated the association at the3p21.31 locuswith severity, but with a stronger effect size that further increased in gravely ill patients. Transcriptome-wide association study highlighted eQTLs for LZTFL1 and CCR9. We also identified 17loci not previously reported, suggestive for an association with either COVID-19 severity or susceptibility.

A Comprehensive Analysis of Deep Learning-Based Approaches for Prediction and Prognosis of Infectious Diseases.

Artificial intelligence is the most powerful and promising tool for the present analytic technologies. It can provide real-time insights into disease spread and predict new pandemic epicenters by processing massive amount of data. The main aim of the paper is to detect and classify multiple infectious diseases using deep learning models. The work is conducted by using 29,252 images of COVID-19, Middle East Respiratory Syndrome Coronavirus, Pneumonia, normal, Severe Acute Respiratory Syndrome, tuberculosis, viral pneumonia, and lung opacity which has been collected from various disease datasets. These datasets are used to train the deep learning models such as EfficientNetB0, EfficientNetB1, EfficientNetB2, EfficientNetB3, NASNetLarge, DenseNet169, ResNet152V2, and InceptionResNetV2. The images have been initially graphically represented using exploratory data analysis to study the pixel intensity and find anomalies by extracting the color channels in an RGB histogram. Later, the dataset has been pre-processed to remove noisy signals using image augmentation and contrast enhancement techniques. Further, feature extraction techniques such as morphological values of contour features and Otsu thresholding have been applied to extract the feature. The models have been evaluated on the basis of various parameters, and it has been discovered that during the testing phase, the InceptionResNetV2 model generated the highest accuracy of 88%, best loss value of 0.399, and root mean square error of 0.63.

Kebijakan- Kebijakan Pemerintah Di Masa Pandemi Dalam Perspektif Hukum Kesehatan

This study examines government policies during the COVID-19 pandemic in terms of health law. Health law is one of the laws reviewed in the COVID-19 pandemic. In handling the COVID-19 pandemic, the Government has issued several legal products such as Government Regulations that also implement the PSBB and Physical Distancing policies, but these policies are not effective in breaking the chain of COVID-19 spread, as seen the number of COVID-19 cases in Indonesia on January 28, 2021, has reached through 1 million cases, the highest in Southeast Asia. This type of research is a normative juridical research that is descriptive in nature by providing solutions to the handling of COVID-19 in Indonesia. This study concludes that the legal politics taken by the government (PSBB and physical distancing) in handling COVID-19 have not maximally protected the right to health of the Indonesian people as mandated by the constitution Article 28H paragraph (1) and Article 34 paragraph (2) and (3) of the 1945 Constitution. The government should implement a partial lockdown policy as China's success in carrying out a partial lockdown in Wuhan. With a partial lockdown in Jakarta Province as the epicenter of the COVID-19 pandemic in Indonesia, the virus will not spread to other provinces.

How are Brazilian university students coping with the COVID-19 pandemic? Results of an online survey on psychosocial well-being, perceived burdens, and attitudes toward social distancing and vaccination.

The COVID-19 pandemic caused significant disruption to education systems worldwide, increasing pre-existing concerns regarding university students' mental health. Brazil was among the countries most affected by COVID-19 cases and deaths and was considered a pandemic epicenter. This study aimed to investigate Brazilian university students' mental health status and perceived burdens during the COVID-19 pandemic. From November 2021 to March 2022, a cross-sectional and anonymous online survey was conducted among students of a Brazilian federal university. Mental health status (depressive symptoms, alcohol and drug consumption) and social and emotional aspects in the pandemic context (social support, perceived stress, loneliness, resilience, and self-efficacy) were assessed with standardized measures. Students' attitudes toward the COVID-19 pandemic and vaccination and perceived burdens of the pandemic were also investigated. A total of N = 2,437 students completed the online survey. The PHQ-9 mean sum score was 12.85 (SD = 7.40), while n = 1,488 (61.10%) participants reported a sum score of 10 or more, indicating clinically relevant depressive symptoms. Further, n = 808 (33.1%) of the total sample reported suicidal thoughts. Levels of depressive symptoms, perceived stress, and loneliness were higher among undergraduate/bachelor students than doctoral students. Almost all participants (97.3%) reported being fully vaccinated against COVID-19. Multiple regression analyses showed that being single, having an income decreased during the pandemic, having a previous mental illness, having a chronic somatic condition, not finding positive aspects in the pandemic, lower self-efficacy, lower social support, lower resilience, and higher experienced loneliness were significantly associated with higher levels of depression. The study showed high levels of depressive symptoms and suicidal ideation among Federal University of Parana students. Therefore, health care providers and universities need to recognize and address mental health issues; psychosocial policies must be enhanced to mitigate the impact of the pandemic on students' mental health and wellbeing.

Self-Reported Depression and Anxiety among Graduate Students during the COVID-19 Pandemic: Examining Risk and Protective Factors

Depression and anxiety among students in higher education are well-established public health concerns with rates that have steadily increased over the past several decades. The global COVID-19 pandemic caused a need for rapid transition on campuses to online learning, a disruption of research, and uncertainty about meeting program requirements and employment. Graduate students often feel overlooked at the best of times and the potential for the pandemic to worsen this perception cannot be understated. This study examined the rates of self-reported depressive and anxiety symptoms among graduate students who were located at the national epicenter of the COVID-19 pandemic in the United States in the spring of 2020. Demographic characteristics, loneliness, and coping to determine potential risk and protective factors were also examined. A comprehensive online survey was created including the University of California Los Angeles (UCLA) 3-Item Loneliness Scale, the Patient Health Questionnaire Depression Scale (PHQ-9), and the Generalized Anxiety Disorder scale (GAD-7). Descriptive statistics, Pearson’s chi-squared test, Spearman’s correlation, and unadjusted and adjusted multivariable logistic ordinal regression models were used to describe the sample and to assess factors associated with depression and anxiety. 341 surveys were analyzed; respondents had a mean age of 31.88, 68% were female, 63% were White, and 23% identified as lesbian/gay/bisexual. Approximately 89% of students reported moderate-severe depression, and 76% moderate-severe anxiety. Risk factors associated with depression (p < 0.05) were being “sometimes’ lonely”, “often/always lonely”, and time spent searching COVID-19 information. Emotional support, having children, and perceived emotional/mental health were protective against depression (p < 0.05). Risk factors associated with anxiety were “‘often/always lonely”, identifying as lesbian/gay/bisexual, and time searching COVID-19 information. Coping, having children, being born outside of the U.S., and perceived emotional/mental health were protective against anxiety (p < 0.05). Based on study findings, it is recommended that universities include more focused interventions for graduate students in consideration of their unique personal and professional needs. Graduate students are part of the emerging professional workforce and as such employers are also advised to integrate wellness and mental health programs and interventions into their employee assistance programs.

Post COVID-19 Lockdown in Ghana: What is the Wellbeing Status of the Young Adults?

Although optimal wellbeing of young adults (YA) is a vital asset for productivity and measurable and sustainable development, there is a dearth of information on the wellbeing status of YA, especially after the COVID-19 lockdown in Ghana. The study has established the post-lockdown wellbeing status of YA in the COVID-19 pandemic epicenters of Ghana. The wellbeing status of 1783 (24.49 ± 4.62 year) Ghanaian YA from Kumasi, Accra, and Kasoa (known epicentres of COVID) was assessed in this cross-sectional study. Body mass index (BMI) was calculated, and physical, social, emotional, spiritual and intellectual states were assessed. More females were found to be overweight (315, 17.7%) and obese (160, 9.0%) compared to males. The majority (714; 40.0%) of the young adults were between the ages 25-30 years and overweight, with a mean BMI of 25.46 ± 4.67 kg/m2. Overall, 157 (8.8%) had poor, 755 (42.3%) average, 479 (26.9%) good, while 392 (22.0%) had outstanding wellbeing. Specifically, the average grade was recorded for physical (29.07 ± 6.67), spiritual (29.32 ± 6.80), and intellectual (28.29 ± 6.56), while 'good grade' was obtained for social (32.16 ± 5.13) and emotional (31.54 ± 5.07) dimensions of wellbeing. Average Ghanaian YA in the study were overweight (BMI value) and had average wellbeing, which may suggest the risk of cardiovascular diseases. Educational and physical activity interventions with meticulous dietary control and proper understanding of family history, age and genetic factors will help to improve the wellbeing of Ghanaian YA.

Impact of in-hospital statin use on mortality in COVID-19 patients from a majority African American population

BackgroundThe COVID-19 pandemic has claimed over 6.4 million lives globally. Finding effective medications to reduce mortality in hospitalized COVID-19 patients remains critical. No previous study has been published on the effects of statin use in a majority African American COVID-19 patient population. ObjectiveThis study aims to assess the relationship between in-hospital statin use and mortality in this population. MethodsA retrospective chart review of patients diagnosed with COVID-19 from March 2020 to June 2020 admitted to the Phoebe Putney Health System in Albany, Georgia, an early epicenter of the COVID-19 pandemic, was conducted. The outcomes of 735 hospitalized COVID-19 positive patients from over 40 counties in Georgia were analyzed. The primary outcome of interest was all-cause mortality, with secondary outcomes of interest of ICU care, length of ICU stay, need for mechanical ventilator, duration of intubation, and need for dialysis. Multivariate logistic regression and Cox proportional hazards analysis were conducted to examine the effect of in-hospital statin use and mortality. Results186 of 735 total patients were prescribed statins in-hospital. 83.8% were African American. Multivariate logistic regression found in-hospital statin use was not significantly associated with the primary outcome – all-cause mortality (p=0.23). Similar findings were seen in need for ICU care, length of ICU stay, need for mechanical ventilator, duration of intubation, and need for dialysis (p>0.05). Additionally, results from a Cox proportional hazards model found in-hospital statin use was not associated with survival time. Sensitivity analysis conducted on only African American patients validated that in-hospital statin use was not associated with all-cause mortality in these patients. Of note, immunosuppression and severe disease presentation were associated with a six-fold increase in risk of mortality and the largest decreases in survival time. ConclusionIt is possible statins have no mortality benefit for this patient population, but further research beyond this association study would need to be conducted to determine this conclusively. From this study, the best clinical recommendation would be to continue statins for COVID-19 patients with pre-hospital statin use and to launch a randomized clinical trial to definitively determine the efficacy of statins in the treatment of hospitalized COVID-19 patients.

Burnout dimension profiles among healthcare workers in Indonesia

BackgroundBesides biological impact, COVID-19 also poses a threat to psychological wellbeing and the quality of life. Healthcare workers, especially those assuming a front-line post, are at a higher risk of being affected, both physically and psychologically. This study aims to analyse variables potentially associated with burnout and psychological distress among healthcare workers with various health center stratifications, where we commenced a nationwide survey to establish the baseline data. MethodAn analytic observational study with a cross-sectional design was conducted on the 11th – September 18, 2020. Participants were enrolled from healthcare institutions represented by epicenter of the COVID-19 pandemic in Indonesia, which were Java, Sumatra, Bali, and were asked questionnaires, including the Depression, Anxiety and Stress Scale 21 (DASS-21), Maslach Burnout Inventory (MBI), Somatic Symptom Scale 8 (SSS-8), also Well-Being Index (WBI). A linear mixed effect model was used to analyse how three dimensions of burnout vary across occupations. ResultsA total of 3629 healthcare workers were analysed in this study. Burnout syndrome was found in 37.5% of healthcare workers. The prevalence of burnout among medical personnel, nurses, and midwives was 44.6%, 33.5%, and 36.2%, respectively. The prevalence of burnout in healthcare workers was most common in Java (38.4%) and healthcare workers who work in the hospital (28.6%). Based on the burnout dimensions, 48.2% of healthcare workers experienced moderate to high emotional exhaustion, 51.8% moderate to high depersonalization, and 96.9% high personal accomplishment. The R2 values was 0.33,0.28,0.27 for emotional exhaustion, depersonalization and personal accomplishment model. Calculated power of the emotional exhaustion and depersonalization model was 100% for both midwife and nurse variable. Meanwhile, the power of the personal accomplishment model was 100% for midwife and 94.7% for nurse variable. ConclusionThe extent of the three burnout dimensions is pervasive in all occupational levels and the place of work (hospital/community health center).