First Wave Of COVID-19 Pandemic Research Articles

SARS-CoV-2 infection in pregnant patients on TNFα inhibitor: Real-life data with a review of literature

Tumor necrosis factor alpha (TNFα) is involved in the occurrence of negative pregnancy outcomes. The study aimed to evaluate the safety and efficacy of the immunosuppressive TNFα inhibitors (TNFαi) in the treatment of patients with a history of recurrent reproductive failure in the context of COVID-19 pandemics. We reviewed 85 patients who received TNFαi (certolizumab pegol) during Mainland China’s first wave of COVID-19 pandemic, from 21st Nov 2022–11 th Jan 2023. We also collected corresponding data from 130 pregnant patients who never used TNFαi for comparison. There were no significant differences in the history of previous pregnancy loss, miscarriage, embryo implantation failure, comorbidities and doses of COVID-19 vaccination. 82.2% and 87.7% pregnant patients contracted primary COVID-19 with symptoms in TNFαi group and no-TNFαi group. Duration of symptoms was significantly longer in TNFαi group and the incidences of cough and lethargy was significantly higher in TNFαi group. Both groups reported similar severity to same-aged close contacts, similar rates of other symptoms and hospitalization. No deaths were reported. In the in vitro fertilization (IVF) subgroup, we achieved a biochemical pregnancy loss rate of 17.4%, miscarriage rate of 21.7%, ongoing pregnancy rate and live birth rate of 34.2%. COVID-19 did not influence the live birth rate. We concluded that TNFαi administration in pregnancy was not associated with increased susceptivity to and severity of COVID-19. However, TNFαi users showed more prominent symptoms and longer recovery time. The pregnancy outcomes with TNFαi in such high-risk group for pregnancy loss was satisfactory.

Relatives’ grief at three moments after death of a loved one during COVID-19 pandemic (the CO-LIVE study)

COVID-19 has complicated grieving experiences. Rich qualitative description of these experiences is lacking. We interviewed 10 bereaved relatives (mainly daughters) 2–3 times each: shortly after their relative died in the first wave of COVID-19 pandemic, and after 12 and 18 months (29 interviews in total). Analyses took place according to inductive content analysis. Losses were threefold: the loss of the loved one; of the (desired) way to say farewell, and of social support. We identified five ways in which the three COVID-19 related loss experiences interacted: overshadowed grief, cumulative grief, triggered grief, derailed grief, and conciliatory grief. This study demonstrated that pre-COVID-19 diagnoses and understandings of grief are not sufficient to picture grief during and after the COVID-19 pandemic. These grief experiences are more complex and deserve further exploration.

Attachment styles, mental health, and trauma during the first wave of COVID-19 pandemic in an Italian adult population.

The COVID-19 pandemic has negatively impacted adults' mental health around the world. Various studies highlighted the role of sociodemographic risk factors, including age, gender, and level of education, in increasing this impact. Although insecure attachment styles are considered a vulnerability factor for psychopathology and difficulties in coping with stressful situations, few studies have examined the role of attachment styles in relation to psychological responses to the COVID-19 pandemic. This study aims to investigate the role of attachment styles in affecting psychopathological problems and post-traumatic symptoms during the COVID-19 pandemic in a sample of Italian adults (N=1548). During the first lockdown in Italy, the Attachment Style Questionnaire, the Impact of Event Scale-Revised, and Symptom Checklist 90-Revised were administered to the participants to assess attachment styles, trauma-related symptoms, and psychopathological problems. The results showed that 41% of the participants had symptoms of clinical and subclinical relevance during the pandemic. Anxious and avoidant insecure attachment styles predicted psychopathological problems and post-traumatic symptoms, whereas secure attachment style was a protective factor. Our results highlighted the significant role played by the quality of attachment styles on adult mental health during the pandemic, providing valuable elements for targeted psychological support interventions.

Profile of Teleconsultation in Dermatology at a Tertiary Care Hospital in South India during the First Wave of COVID-19 Pandemic

Abstract Background: There was a rapid expansion of teledermatology around the world with the onset of COVID-19 pandemic. This helped to reduce hospital visits with better adherence to medication and overall costs, especially in chronic dermatoses. Methodology: A retrospective study of teleconsultations during the first wave of COVID-19 pandemic at the dermatology department of a tertiary care hospital in South India was done from May to October 2020. Real-time video teleconsultations were done using the hospital’s teleconsultation portal. Demography, clinical profile of patients, and outcome of teleconsultation were studied. Results: During the study period, 476 teleconsultation sessions in 265 patients were carried out. The mean age of patients was 40.65 ± 16.79 years; geriatric population constituted 38 (14.3%) patients. Urban to rural population ratio was 1:1.3. Median disease duration was 2.5 years (interquartile range 4.75 years). Papulosquamous disorders and infectious diseases were the most common disorders constituting 52 (19.6%) and 51 (19.2%) cases, respectively. Patients with chronic dermatoses on systemic therapy constituted 268 (56.42%) teleconsultation sessions in 119 (44.9%) patients; common diseases being autoimmune blistering disorders (38; 31.9%), psoriasis (23; 19.3%), and leprosy (17; 14.3%). Optimization of therapy was done in 117 (44.2%) patients, initiation of new medication in 89 (33.6%), and continuation of therapy in 75 (28.3%) patients. An in-person review was advised in 46 (9.7%) sessions in 36 (13.6%) patients. Six (2.3%) patients were advised to have an urgent review. Conclusion: Teledermatology was an effective tool during the pandemic to extend hospital services. Optimization of therapy was the outcome in nearly half the sessions. This service can benefit patients from remote areas and geriatric population, especially with chronic dermatoses.

Impact of First Wave of COVID-19 Pandemic on Mortality at Emergency Department in Older Patients with COVID and Non-COVID Diagnoses

Introduction: Mortality in emergency departments (EDs) is not well known. This study aimed to assess the impact of the first-wave pandemic on deaths accounted in the ED of older patients with COVID and non-COVID diseases. Methods: We used data from the Emergency Department and Elderly Needs (EDEN) cohort (pre-COVID period) and from the EDEN-COVID cohort (COVID period) that included all patients ≥65 years seen in 52 Spanish EDs from April 1 to 7, 2019, and March 30 to April 5, 2020, respectively. We recorded patient characteristics and final destination at ED. We compared older patients in the pre-COVID period, with older patients with non-COVID and with COVID-19. ED-mortality (before discharge or hospitalization) is the prior outcome and is expressed as an adjusted odds ratio (aOR) with 95% interval confidence. Results: We included 23,338 older patients from the pre-COVID period (aged 78.3 [8.1] years), 6,715 patients with non-COVID conditions (aged 78.9 [8.2] years) and 3,055 with COVID (aged 78.3 [8.3] years) from the COVID period. Compared to the older patients, pre-COVID period, patients with non-COVID and with COVID-19 were more often male, referred by a doctor and by ambulance, with more comorbidity and disability, dementia, nursing home, and more risk according to qSOFA, respectively (p < 0.001). Compared to the pre-COVID period, patients with non-COVID and with COVID-19 were more often to be hospitalized from ED (24.8% vs. 44.3% vs. 79.1%) and were more often to die in ED (0.6% vs. 1.2% vs. 2.2%), respectively (p < 0.001). Compared to the pre-COVID period, aOR for age, sex, comorbidity and disability, ED mortality in elderly patients cared in ED during the COVID period was 2.31 (95% confidence interval [CI]: 1.76–3.06), and 3.75 (95% CI: 2.77–5.07) for patients with COVID. By adding the variable qSOFA to the model, such OR were 1.59 (95% CI: 1.11–2.30) and 2.16 (95% CI: 1.47–3.17), respectively. Conclusions: During the early first pandemic wave of COVID-19, more complex and life-threatening older with COVID and non-COVID diseases were seen compared to the pre-COVID period. In addition, the need for hospitalization and the ED mortality doubled in non-COVID and tripled in COVID diagnosis. This increase in ED mortality is not only explained by the complexity or severity of the elderly patients but also because of the system’s overload.

Maintaining legitimacy in times of crisis for sharing economy platforms: Airbnb's relational strategies during COVID-19 and impacts on sustainability

Sharing economy platforms hold a promise of more sustainable uses of resources. However, their legitimacy remains “debated” as various ecosystem stakeholders hold different opinions, challenging platform's values and activities. One key contested aspect is their capacity to contribute to sustainability beyond a search for economic performance. Despite these criticisms, sharing economy platforms have managed to grow and spread worldwide. Nevertheless, little is known about how a sudden market crisis affects an online platform characterized by a debated legitimacy. Studying the relationships between Airbnb and its main stakeholders during the first wave of COVID-19 pandemic in New York City, our paper identifies three relational strategies - identity, professionalization, and selection - implemented by the platform to reinforce its legitimacy within its local ecosystem. Based on secondary and primary data analyses, we identify and describe the arbitrations and opportunistic choices made by Airbnb to manage various stakeholder groups, to maintain its legitimacy during the COVID-19 crisis, and their impact on sustainability.

To Assess The Knowledge And Perceptions Regarding Novel Coronavirus (Covid-19) During The First Surge Among Healthcare Workers Of Banke District, Nepal

Background: Human Coronaviruses (HCoVs), a large family of single-stranded RNA viruses in humans causes mainly respiratory tract infections. The current outbreak of coronavirus disease 2019 has emerged as pandemic causing severe public health issue of international concern. This study aims to assess the knowledge and perception regarding novel coronavirus (COVID-19) during first wave of pandemic among healthcare workers working at various Health care institutions. Method: This web-based cross-sectional study was conducted among 174 health care workers of Banke district, Nepal between May-July 2020 during first wave of COVID-19 pandemic using an online self-administered questionnaire. A 35-item self-administered survey instrument was developed using WHO course materials on emerging respiratory viruses, including COVID-19, and covered the domains of HCWs characteristics, knowledge, and perceptions of HCWs related to COVID-19. Descriptive statistics were reported as proportion and frequencies. Bivariate analysis was performed using chi-square test to assess the association of level of knowledge, and perception about COVID-19 with participants’ characteristics. A p-value of less than 0.05 was considered statistically significant. All the statistical analysis was performed using IBM SPSS software, version 23. Findings: Most of the participants (94.8%) had known about the virus from news (70.1%) and social media (68.4%). Among them only 36.2% participants had the opportunities to attend lectures, discussions, and training about the virus COVID-19. Overall, 55.7%, and 52.9% of the HCWs had adequate knowledge, and positive perception about COVID-19, respectively. Bivariate analysis showed no significant association of knowledge regarding COVID-19 among health care worker with participants characteristics whereas, the variables such as gender, occupation, working department showed significant association of perception regarding COVID-19 among health care worker. Conclusion: This study revealed lower level of knowledge and positive perception regarding COVID-19 and infection control measures among HCWs. There is a need of adequate training to enhance the knowledge and perception about covid-19 and safety measures to the HCWs.

Emotions, Perceived Stressors, and Coping Strategies Among Nursing Staff in Saudi Arabia During the COVID-19 Pandemic.

Objective The COVID-19 pandemic resulted in heightened stress for nurses and other healthcare workers, particularly during the initial phase of the crisis. Despite the adoption of various coping strategies, psychological distress persisted, affecting nurses' well-being and jeopardizing the overall resilience of the healthcare system. This study assessed the emotional response, perceived stressors, and coping strategies among nurses' staff who worked during the first wave of COVID-19 pandemic. Method A cross-sectional study was carried out among nurses who worked during the initial phase of the COVID-19 crisis (June - August 2020), at a tertiary care center in Western Saudi Arabia. The questionnaire explored five main sections. The first section (15 items) assessed emotions experienced during the initial wave of COVID-19, capturing both positive and negative sentiments, such as "joy"or "fear." The second section (20 items) examined the presence of stressors, like "lack of protective equipment" or "fear of infection." The third section (14 items) evaluated the perceived effectiveness of certain stress-reducing factors, including "peer support" or "training." In the fourth section (13 items), participants rated their usage frequency of various coping strategies, such as "meditation" or "seeking advice." Lastly, the fifth section assessed the hypothetical impact of 10 incentives, like "financial bonuses" or "additional training," in motivating nurses' involvement in future epidemic responses. The questionnaire was completed with demographic and professional data. A convenience sampling method was employed, and 315 nurses participated in the study. Descriptive statistics were carried out using SPSS version 24 for Windows(IBM Corp., Armonk, NY). Result The most commonly experienced emotion was a feeling of responsibility and ethical duty, reported by 97.5% of the participants, followed by nervousness and fear (83.8%), anger (73.3%), and stigma (70.2%). On the other hand, 86.7% were expecting a financial compensation. The most common stressors were related to the nurses' own safety, or the safety of their families and colleagues, reported by 92.4-95.2% of the participants. The perceived uncontrollability of COVID-19 was also a significant stressor. The improvement of the health status of infected colleagues (98.1%) or patients (97.5%) were the most common factors associated with the reduction in nurses' stress. Among the coping strategies, five were almost systematically deployed by the nurses (>95%), all consisting of cognitive and behavioral mechanisms to enhance own knowledge and safety and avoid being infected. The most crucial determinants for commitment in future pandemics are the availability of a cure or vaccine (93.3%), family support (91.4%), adequate personal protective equipment from the hospital (90.8%), and exemption from overtime (90.2%). Conclusion The first wave of COVID-19 exerted a tremendous psychological stress on nurses, due to concerns about safety, disease uncertainties, and social isolation. Analyzing these impacts offers insights for enhancing institutional and national crisis strategies, emphasizing staff safety and psychological well-being, especially for first responders like nurses. Policy implications include prioritizing mental health support and preparedness in future crisis plans. Additionally, ensuring continuous training and strategic workload management is crucial for maintaining frontline commitment.

Home school at the edge of chaos during the lockdown: Social workers’ perspectives

As a response to prevent the spread of COVID-19, during the spring of 2020, home schooling replaced classroom education. From the social worker’s perspective, this paper explores how home school was organised among the social work client families and what types of resources were needed and launched to control the complexity of home schooling during the first wave of COVID-19 pandemic. The conceptual frameworks applied to theorise the self-organisation of home school and how resources were mobilised are complexity theory and social capital theory. The empirical analysis is based on digital diaries written by 33 Finnish social workers and analysed using a thematic qualitative content analysis.The findings demonstrate the intertwined combination ofsocial (social environment and communication), human (cultural, psychological andpedagogical) and physical (technological, spatial and biological) capital needed for the successful self-organising of home schooling. These capitals cannot predict the emergence of successful home schooling, nor can they function as a resource alone because self-organisation requiresinteractions between all essential dimensions. The results provide a deeper understanding for social work professionals regarding schooling and organising multidimensional support for children and their families.

Aggression against Nursing Personnel during the First Wave of COVID-19 Pandemic: An Internet-Based Survey.

(1) Background: health care workers, particularly nurses, have been regularly assaulted during the COVID-19 pandemic. Purpose: to evaluate the prevalence and location of assaults against nursing personnel in Latin America, and to determine predictor factors for aggression against nurses. (2) Methods: A cross-sectional online survey was answered by 374 nurses working in health care during the COVID-19 pandemic. The aggression against nurses was estimated using the Victimization Scale. (3) Results: A total of 288 nurses were included in this study. The victimization scale showed that 52.1% of nurses have suffered aggression by the general population during the COVID-19 pandemic. Males were more likely to be attacked than females (p < 0.05). Additionally, males were attacked more frequently on public transport (x2 = 6.72, p = 0.01). The home neighborhood and markets were other locations with a higher risk of being assaulted (OR: 3.39, CI: 1.53-7.50). (4) Conclusions: Our results indicate that nurses in Latin America who work during the COVID-19 pandemic and social isolation have been frequently assaulted by the general public. Males are more frequently attacked than females and the main places of aggression are public transportation, their home neighborhood and supermarkets. Implications for nursing practice: it is necessary to create and implement protocols and guidelines to support nursing personnel during the COVID-19 pandemic. This study was retrospectively registered at the Juarez Autonomous University of Tabasco (103/CIPDACS/2020) on the (08/2020).

The relationship among posttraumatic stress disorder, posttraumatic growth, and suicidal ideation among Italian healthcare workers during the first wave of COVID-19 pandemic.

The COVID-19 pandemic impacted mental health across different groups, including healthcare workers (HWs). To date, few studies focused on potential positive aspects that may follow the exposure to the pandemic. We investigated the prevalence of posttraumatic stress disorder (PTSD) in Italian HWs and whether posttraumatic growth (PTG) dimensions affected the risk of suicidal ideation (SI) during the first COVID-19 wave. An online self-report survey was conducted between April and May 2020. Sociodemographic data, information about COVID-19-related stressful events, Impact of the Event Scale-revised, and Post-Traumatic Growth Inventory-Short Form (PTGI-SF) scores were collected and compared between participants. Patient Health Questionnaire-9 scores were also collected to assess SI through item 9. Multivariate logistic regression was used to assess the relationship between PTGI and SI. Among 948 HWs, 257 (27.0%) reported a provisional PTSD diagnosis. The median PTGI-SF score was 24. Participants reporting PTSD symptoms had higher scores in the Spiritual change, Appreciation of life, and New possibilities domains, and in the total PTG scale. A total of 100 HWs (10.8%) screened positive for SI. Improvements in Relating to others domain of PTGI-SF (odds ratioOR: .46; 95% confidence interval: .25-.85) were associated with lower odds of SI. COVID-19 pandemic has been indicated as a risk factor for SI, also among HWs. PTG may have a protective role on suicide risk. Improvements in Relating to others domain reduced odds of SI, consistently with the role of loneliness and lack of connectedness with others in enhancing suicidal risk.

The death of migrant workers in India during the first wave of COVID-19 pandemic

Purpose COVID-19 lockdown imposed by the government in India affected markets, factories, industries, construction sites, restaurants, transport services, etc. in which migrant workers were engaged. Migrant workers expected that after the imposition of the lockdown government will facilitate transportation facilities to their hometowns as they lost their jobs. But due to negligence from both the central and the state governments, neither transportation was arranged nor food, shelter or health facilities were arranged. This paper aims to investigate the causes of the death of migrant workers under the theoretical framework of negligence theory. Design/methodology/approach The authors have applied the content analysis method and collected 926 death cases of migrant workers from 28 Indian states. The researchers applied this technique as the newspapers in India are one of the largest and most useful sources to generate a report/record on migrant workers causes during the COVID-19 lockdown. During the lockdown period, due to lack of attention from the government, police atrocities, hunger and accidental cases increased which resulted in the death of migrant workers. Findings The finding of the study proves that during the first phase of COVID-19 lockdown the death cases of migrant workers increased due to negligence by the governments. The number of death cases of migrant workers has been analysed through applying negligence theory which included duty, breach, cause, in fact, proximate cause and harm which increased the death cases. It has been noticed that the central government without any prior notice-imposed lockdown all over India, in which all the states were not received any guidelines or communication which indicate what they have to do or how to handle the Covid-19 situation. Originality/value To the best of the authors’ knowledge, this is an original work of researchers which is basically based on negligence theory.

Midwives' experiences with providing home-based postpartum care during the COVID-19 pandemic: A qualitative study.

To explore midwives' experiences with providing home-based postpartum care during the COVID-19 pandemic in Norway. A descriptive and explorative qualitative study. The study is based on semi-structured individual interviews with 11 midwives experienced in offering home-based postpartum care. We explored their experiences of such care during the first wave of the COVID-19 pandemic. Data collection occurred from October through November 2020. An inductive thematic analysis was performed using Systematic Text Condensation (STC) by Malterud (2012). The following two main results emerged from the analyses: (1) the midwives adapted quickly to changes in postpartum care during the pandemic and (2) midwives saw the experience as an opportunity to re-evaluate their practices. This study highlights midwives' resilience and adaptability during the first wave of COVID-19 pandemic. It emphasises the crucial role of face-to-face interactions in postpartum care, while recognising the value of technology when direct access is limited. By shedding light on midwives' experiences, this research contributes to improving postpartum care in unforeseen circumstances. It underscores the significance of interdisciplinary integration in planning postpartum care services and the lasting influence of lessons learned on addressing future challenges. The valuable insights gained from lessons learned during the COVID-19 pandemic may have a lasting influence on the postpartum care system, empowering it to tackle unforeseen challenges both today and in the future. The current study addressed midwives' experience with providing home-based postpartum care during the COVID-19 pandemic in Norway. Midwives received an opportunity to re-evaluate their own practices and valued being included when changes were implemented. The current findings should alert policy makers, leaders and clinicians in postpartum care services when planning future practice.

Coping with challenges of the first months of COVID-19 pandemic among medical university community: a mixed-method study from Poland.

Universities played a significant role in meeting the challenges of the COVID-19 pandemic, with both students and staff having to identify and use available coping resources. The main aim of the study was to describe the academic community's experiences of the pandemic and their impact on health and wellbeing. Related variables were also explored, such as sense of coherence (SOC), gratitude, and subjective health assessment (SHA). During the first wave of COVID-19 pandemic, an online questionnaire was sent to the community of the Medical University of Lodz. It included 4 open-ended questions on ways to remain healthy during the pandemic. The responses (N = 144) were analyzed using a general inductive approach. For the purpose of this study, the resource utilization rate (RUR) was defined and calculated based on the number of categories with responses indicating resource usage. Additionally, a Polish adaptation of the 29-item Sense of Coherence scale (SOC-29), the Gratitude Questionnaire (GQ-6), and subjective health assessment were measured. Correlations between variables were calculated. The main areas of resource identification and utilization were interpersonal relationships, views of reality, physical activity, pleasure activities, social contacts, and healthy diet. Physical activity has been found to be the most commonly-reported strategy of taking care of both health and emotional state more frequently among students than employees (p < 0.01). The RUR was strongly associated with SOC in male employees (ρ = 0.7, p < 0.05) and with GQ-6 in both male and female student groups (ρ = 0.56, p < 0.05 and ρ = 0.28, p < 0.05, respectively). Relationships between RUR and SOC seem to be gender- and age-related. The relationships between health and resource utilization are worth exploring in the university setting. Int J Occup Med Environ Health. 2023;36(3):365-78.

Evaluation of Adjunctive Homoeopathy Treatment in COVID-19 Hospitalised Patients at the Gujarat State’s Dedicated COVID-19 Hospitals and Covid-Care Clinics During the First Wave of COVID-19 Pandemic: A Multicentric, Single-Arm Retrospective Data Analysis Study

This retrospective data analysis study aims to analyze the data collected during adjunctive homeopathy treatment of COVID-19 patients by the Homoeopathic medical officers (HMO) in Gujarat state-dedicated COVID-19 hospitals (DCH) during the first wave of the pandemic. The HMOs used the standard data collection forms/sheets to record each patient's demographic information, clinical symptoms, homoeopathic management, and outcome data. Data of all cases hospitalized with COVID-19 of any age, and both genders were included, and entries with missing values or incomplete/ incorrect information were excluded from the analysis. The outcome measure is the recovery duration, time to clinical improvement, worsening symptoms, and indicated homeopathic medicines. Data from 2581 cases analyzed showed clinical recovery time after adjunctive homeopathy as 05 days (IQR: 3-7); the Mean was 5.19 days (SD:4.62), with 80% of patients (2063 out of 2581) discharged between 0-7 days out of which more than 20.4% patients (419 out of 2063) having at least one of the comorbidities. Only 03 deaths of male patients above 50 years with comorbidities and 67 cases (2.6%) with worsening symptoms were reported. The homeopathic medicines used were &lt;em&gt;Arsenic album&lt;/em&gt; in 73.0% and &lt;em&gt;Bryonia alba&lt;/em&gt; in 17.6% of cases. Adjunctive Homoeopathy and standard care in COVID-19 patients had a promising role in the early relief of clinical symptoms and less progression into severity in the risk group of elderly patients with comorbidities. There were no reported adverse effects of taking the adjunctive Homoeopathy, making it a potential choice for integrated use in managing COVID-19 patients.

A retrospective evaluation of characterization, clinical course and anaesthesia management of emergency trauma surgical patients during first wave of COVID-19 pandemic at a tertiary care center in India

: The COVID-19 pandemic resulted in nationwide lockdown followed by phased unlock to break the chain of transmission of the SARS-CoV-2 virus in India. Management of emergency trauma patients has been particularly challenging for anaesthesiologists in order to treat these high risk group of patients and preventing cross infection to healthy patients as well as health care personnel. : It is a single centre retrospective observational cohort study conducted at tertiary care hospital in North India in the patients who underwent emergency trauma surgeries during 31 March 2020-31 May 2020(Lockdown) and compared with data from 1 June 2020-31 July 2020(Unlock). To compare the effect of lockdown and unlock during first wave of Covid-19 pandemic on the volume of emergency trauma surgical patients operated within 24 hours of admission.: To evaluate the difference between the two periods of lockdown and unlock a) in the mortality rates b) covid status c) the length of hospital stay d) the mechanism of injury e)severity of injury f)proportion of aerosol generating procedures (AGP) utilized and g)demographics of the patients. Our anaesthesia experience of managing the patients differently in the pandemic, identify areas for improvement, particularly in terms of minimising exposure and optimising resource usage in the management of such emergency patients in the event of a future healthcare crisis is also discussed. Over the 2 periods of lockdown and unlock there was no statistical difference in number, age or sex distribution of the patients presenting for emergency trauma surgery. Number of covid positive patients were slightly higher during unlock but it was statistically insignificant (p=0.07) and the number of patients died during unlock was also higher during unlock as compared to lockdown but statistically insignificant(p=0.3). The median injury severity score and length of stay was also not statistically significant between two periods. Road traffic accidents were most common type of injury in both the groups, self-inflicted injury occurred in 5 patients during lockdown and zero during unlock, none of these showed a significant difference (p &amp;#62; 0.06). General anaesthesia was the most common anaesthesia technique used in both the periods.Emergency trauma surgeries will continue to occur even in different phases of pandemics, anaesthesiologists should plan and prepare appropriately to provide anaesthesia and emergency care to these patients and prevent cross infection in healthy patients and health care workers.

Effects of the first wave of COVID-19 pandemic on implied stock market volatility: International evidence using a google trend measure

This paper investigates the relationship between investors' attention, as measured by Google search queries, and equity implied volatility during the COVID-19 outbreak. Recent studies show that search investors' behavior data is an extremely abundant repository of predictive data, and investor-limited attention increases when the uncertainty level is high. Our study using data from thirteen countries across the globe during the first wave of the COVID-19 pandemic (January–April 2020) examines whether the search “topic and terms” for the pandemic affect market participants’ expectations about future realized volatility. With the panic and uncertainty about COVID-19, our empirical findings show that increased internet searches during the pandemic caused the information to flow into the financial markets at a faster rate and thus resulting in higher implied volatility directly and via the stock return-risk relation. More specifically for the latter, the leverage effect in the VIX becomes stronger as Google search queries intensify. Both the direct and indirect effects on implied volatility, highlight a risk-aversion channel that operates during the pandemic. We also find that these effects are stronger in Europe than in the rest of the world. Moreover, in a panel vector autoregression framework, we show that a positive shock on stock returns may soothe COVID-related Google searches in Europe. Our findings suggest that Google-based attention to COVID-19 leads to elevated risk aversion in stock markets.

An increase in cesarean section rate during the first wave of COVID-19 pandemic in Iran

BackgroundThe COVID-19 pandemic and its impact on healthcare services is likely to affect birth outcomes including the delivery mode. However, recent evidence has been conflicting in this regard. The study aimed to assess changes to C-section rate during the COVID-19 pandemic in Iran.MethodsThis is a retrospective analysis of electronic medical records of women delivered in the maternity department of hospitals in all provinces of Iran before the COVID-19 pandemic (February-August 30, 2019) and during the pandemic (February-August 30, 2020). Data were collected through the Iranian Maternal and Neonatal Network (IMAN), a country-wide electronic health record database management system for maternal and neonatal information. A total of 1,208,671 medical records were analyzed using the SPSS software version 22. The differences in C-section rates according to the studied variables were tested using the χ2 test. A logistic regression analysis was conducted to determine the factors associated with C-section.ResultsA significant rise was observed in the rates of C-section during the pandemic compared to the pre-pandemic (52.9% vs 50.8%; p = .001). The rates for preeclampsia (3.0% vs 1.3%), gestational diabetes (6.1% vs 3.0%), preterm birth (11.6% vs 6.9%), IUGR (1.2% vs 0.4%), LBW (11.2% vs 7.8%), and low Apgar score at first minute (4.2% vs 3.2%) were higher in women who delivered by C-section compared to those with normal delivery (P = .001).ConclusionsThe overall C-section rate during the first wave of COVID-19 pandemic was significantly higher than the pre-pandemic period. C-section was associated with adverse maternal and neonatal outcomes. Thus, preventing the overuse of C-section especially during pandemic becomes an urgent need for maternal and neonatal health in Iran.

Privacy-Preserving-Enabled Lightweight COVID-19 Simulation Model for Mobile Intelligent Application

In order to control the first wave of COVID-19 pandemic in 2020, many models have shown effectiveness in predicting the spread of new coronary pneumonia and the different interventions. However, few models can collect large amounts of high-quality real-time data faster under the premise of protecting privacy, considering the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant and the mass vaccination program as a new intervention. Therefore, we developed a mobile intelligent application that can collect a large amount of real-time data while protecting privacy and conducted a feasibility study by defining a new COVID-19 mathematical model SEMCVRD. By simulating different intervention measures, the prediction model of the mobile intelligent application used in this article simulates the epidemic situation in the U.K. as an example. The findings are as below: the optimal intervention strategy is to suppress the intervention at <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$P=3$ </tex-math></inline-formula> (intervention intensity: the average number of contacts per person per day) before the end of March 2021, then gradually release the intervention intensity at a rate of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$P+2$ </tex-math></inline-formula> , and finally release the intensity to <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$P=9$ </tex-math></inline-formula> in June 2021. The COVID-19 pandemic will end at the end of June 2021, when the total number of deaths will reach 128772. This strategy will be able to balance the tradeoff between loss of life and economic loss. Compared with the official statistics released by the U.K. government on May 31, 2021, our model can accurately predict the relative error rate of the total number of cases is less than 6.9%, and the relative error rate of the total number of deaths is less than 1%. Furthermore, the model is also suitable for collecting data from countries/regions around the world.

Takuo Aoyagi, inventor of pulse oximetry: the great scientist passed away three years ago, in the middle of the first wave of COVID-19 pandemic

Antoine-Laurent de Lavoisier (1743-1794), the recognized father of modern chemistry, was the discoverer of both oxygen and hydrogen, as well as the first scientist to understand the importance of oxygen in animal respiration. Following his discoveries, researchers have tried to measure oxygenation of both blood and tissues for the next two centuries. [...]