Impact Of COVID-19 Pandemic Research Articles

The Impact of COVID-19 Pandemic on the Performance of Food and Beverage Micro and Small Enterprises (MSEs): A Case Study of Langsa City, Aceh Province

The PSBB and PPKM policies were perceived to have caused economic downturns by restricting community activities, including productive economic endeavors. The primary issue in this study is the decline in the GDP of the accommodation food, and beverage sectors in Langsa City in 2020. The research objectives are formulated as follows: (1) to analyze the impact of the Covid-19 pandemic on the income of food and beverage MSMEs in Langsa City; (2) to analyze the impact of the Covid-19 pandemic on the production levels of food and beverage MSMEs in Langsa City; (3) to analyze the impact of the Covid-19 pandemic on the assets of food and beverage MSMEs in Langsa City; and (4) to analyze the impact of the Covid-19 pandemic on the workforce of food and beverage MSMEs in Langsa City. The study was conducted in Langsa City, Aceh Province, utilizing primary data, A purposive sample of 50 MSME owners in Langsa City was selected. Respondents were not categorized by business scale (micro or small businesses). The accidental sampling method was used to determine respondents and data was collected through structured interviews using a questionnaire. The impact of the Covid-19 pandemic on the performance of food and beverage MSMEs in Langsa City was analyzed using for indicators: (1) MSME income, (2) sales volume, (3) assets, and (4) workforce size. A descriptive analysis was performed, followed by a paired sample t-test (with a = 0.05) to compare conditions before and during the Covid-19 pandemic. The analysis concluded that: (1) there was a significant decline in the income of food and beverage MSMEs in Langsa City during the Covid-19 pandemic; (2) there was a significant decline in sales volume; (3) there was a significant reduction in the value of MSME assets; and (4) there was a significant decrease in the number of employees. Keywords: Business, Assets, Number of Employees, Income, Sales, MSMEs

Subjective well-being and mental health during the COVID-19 pandemic in Hungary

Purpose This study aims to examine the impact of COVID-19 pandemics on subjective well-being (SWB) and mental health in Hungary, with a particular focus on the roles of socioeconomic and COVID-19-related factors in shaping these outcomes. Design/methodology/approach A cross-sectional online survey was conducted among 2,000 Hungarian adults from May 25 to June 8, 2021. The data was collected using standardized questionnaires, including the SWLS, GAD-7 and PHQ-9. Correlation analysis, one-way ANOVA and linear regression were used. Findings The study found significant anxiety (41.5%), depression (48.1%) and life dissatisfaction (41.9%) among 2,000 participants. Females reported higher anxiety and depression than males. Single individuals had the lowest life satisfaction. Higher income levels are correlated with greater life satisfaction. Quarantine and vaccination were linked to higher life satisfaction and lower psychological distress. The regression showed that older age, being married and higher income were linked to lower depression and anxiety. Severity of infection and quarantine increased both depression and anxiety. Infection reduced life satisfaction, but severe cases showed a slight improvement in satisfaction, highlighting complex health and well-being relationships. Practical implications The findings reveal complex relationships, including unexpected resilience in severe COVID-19 cases. Originality/value This study offers insights into the impact of the COVID-19 pandemic on SWB and mental health in Hungary. By analyzing socioeconomic, demographic and pandemic-related factors in a large sample, it highlights complex relationships between quarantine, infection severity, vaccination and well-being. The findings contribute to understanding how these factors influence mental health, informing targeted interventions during health crises.

The impact of covid-19 pandemic on syphilis notifications in northeast Brazil

This study aims to evaluate the impact of the COVID-19 pandemic on the number of syphilis notifications (acquired, during pregnancy and congenital) in northeastern Brazil. An ecological study was carried out using the database provided by the Ministry of Health through the Department of Informatics of the SUS (DATASUS). The monthly numbers of notifications of acquired, gestational and congenital syphilis were organized on the Google Sheets online platform and the data were statistically analyzed, using the Wilcoxon test, for the pandemic (Jan/2020-Jun/2021) and pre pandemic periods (Jan/2018-Dec/2019), with a statistical significance of 5%. There was a reduction in the number of notifications of total cases of syphilis in the Northeast in 2020 and in 2021 when compared to the pre-pandemic period (p < 0.001 and p = 0.031, respectively). This reduction represents a drop of 32.38% in 2020 and 28.84% in 2021. Regarding the states, there was no statistical significance in the number of notifications for Sergipe in 2020 (p = 0.638), Ceará in 2021 (p = 0.156) and Rio Grande do Norte in 2021 (p = 0.219) compared to 2018 and 2019. In addition, it was observed that in Sergipe there was an increase of 53.96% in notifications in 2021 compared to the same period (p = 0.031). These variations may be a consequence of social distancing, the reallocation of resources during the pandemic and socioeconomic issues, or even all of these factors combined.

The Impact of COVID-19 pandemic on addictive behaviors: an integrative review

Addictive behaviors and their impacts have been widely explored. Going through a pandemic moment requires further research since crisis situations involve higher propensity to dependency. The aim of this integrative review was to identify studies that have been conducted so as to explore behaviors related to brain’s reward system in a pandemic period, which include substance addiction, internet addiction, gaming and other overusing behaviors. In order to accomplish our objective an integrative search was conducted in CAPES periodicals. Some inclusion and exclusion criteria were used to select the studies and in total (N=12) were explored independently. The results showed that there is an increasingly concern about health care systems, especially for those addicted to substances who need daily support, since addictions habits may have also increased. Behavioral addictions also increased and were exploited in some studies, especially those related to technologies, such as gaming and smartphone usage.

Influencing Factors of Nurses' Well-Being in Critical Care During Pandemic Era: A Systematic Review.

To identify factors protecting and hindering the well-being of critical care nurses during the COVID-19 pandemic. The unique work challenges of critical care nurses can undermine their professional and mental well-being; as evidenced by the prevailing literature on burnout, compassion fatigue, and moral distress. The COVID-19 pandemic has seen these professionals on the front lines and has raised many questions about professional well-being. Identifying the factors that protect and hinder the well-being of critical care nurses would help to develop the strategies necessary to reduce worrying phenomena associated with professional malaise. A systematic review was conducted using electronic databases including PubMed, CINAHL, Scopus, Cochrane, PsycINFO, and Web on Science. After full text analysis, 25 papers were included in the current systematic review. Factors influencing the well-being of critical care nurses have been grouped into "Protective" and "Hindering." This review shows that critical care nurses' well-being is influenced by factors like personal resilience and supportive work environments, which enhance their experience. Challenges include sociodemographic issues and the COVID-19 pandemic's impact. Addressing these factors is crucial for their well-being and the effectiveness of healthcare systems. The well-being of nurses is intricately linked to the quality and security of patient care, ultimately influencing clinical outcomes. This review delves deeply into the multifaceted factors that affect the professional well-being of critical care nurses during the COVID-19 pandemic. Recognizing these elements is critical for directing health policy toward the development of initiatives that bolster healthcare workers' welfare. Prioritizing the professional well-being of nurses is imperative, as it is fundamental in mitigating the increasing inclination towards job turnover, a challenge that is profoundly impacting the healthcare sector.

Burden of Hyperlipidemia, Cardiovascular Mortality, and COVID-19: A Retrospective-Cohort Analysis of US Data.

Hyperlipidemia is a major cardiovascular disease (CVD) risk factor, but limited data on its mortality trends in CVD over time. We assessed annual hyperlipidemia-related CVD mortality trends in the United States, including the COVID-19 pandemic's impact. Mortality data were obtained from CDC repository between 1999 and 2020 among patients ≥15 years old, using ICD-10 codes hyperlipidemia (E78.0-E78.5) and CVD (I00-I99). Age-adjusted mortality rates (AAMR) per 1,000,000 population was standardized to the 2000 US population. Log-linear regression models were used to evaluate mortality shifts. Average annual percentage change (AAPC) from 1999-2019 was used to project 2020 AAMR, estimating pandemic-attributed excess deaths. From 1999 to 2020, 483,155 hyperlipidemia-related CVD deaths occurred. Despite a general CVD mortality decline, hyperlipidemia-related CVD AAMR rose from 36.33 in 1999 to 99.77 in 2019. Ischemic heart diseases (AAMR 49.39) were the leading cause while hypertension had the highest mortality increase (AAPC +10.23%). Mortality rates were higher in males (AAMR 104.87), non-Hispanic (AAMR 82.49), and rural populations (AAMR 89.98). Highest mortality was observed in Black populations (AAMR 84.35), those ≥75 years (AAMR 646.45), and Western US regions (AAMR 96.88). During the first pandemic year, deaths exceeded projections by 10.55%, with notable increases among ages 35-75 (14.23%), Hispanic (17.96%), Black (14.82%), and urban (11.68%) groups. Hyperlipidemia-related CVD mortality has risen over the past two decades, further heightened by the COVID-19 pandemic, with higher impact on males, Black Americans, the elderly, and rural residents. Further study is needed to understand contributing factors and mitigate disparities.

EPID-31. IMPACT OF THE COVID-19 PANDEMIC ON THE UTILIZATION OF STEREOTACTIC RADIOSURGERY AMONG RACIAL MINORITIES DIAGNOSED WITH BRAIN METASTASES

Abstract OBJECTIVES Brain metastases (BM) is the most common form of adult brain tumors and one of the devastating consequences of cancer. Stereotactic radiosurgery (SRS) is an established and effective treatment for oligometastatic BMs. We examined how COVID-19 pandemic impacted clinical utilization of SRS in BM treatment and generalize such impact to outpatient care for patients with all cancer types. METHODS Three national-scale datasets were used: National Cancer Database (NCDB,N=5,238), the National COVID Cohort Collaborative database (N3C, N=13,106 for BM, N=203,706 for all cancer types), and SEER. Multivariable logistic regression models were performed to determine whether the pandemic affected clinical utilization of SRS in BM treatment and chemotherapy initiation for all cancer types. RESULTS Prior to 2019 (pre-pandemic), we observed no racial disparity in the odds of receiving SRS between non-Hispanic white (NHWs) and non-Hispanic black (NHBs) BMs in both NCDB and N3C. Between 2020 and 2021 (pandemic), however, NHBs were significantly less likely to receive SRS comparing to NHWs in both NCDB (NHB:aOR-0.77,p=0.002) and N3C (NHB:aOR-0.78,p<0.001). In SEER, the age-adjusted incidence rate of BM remained unchanged when comparing pre- and post-pandemic periods. Further substantiating the impact of COVID-pandemic on racial disparity in outpatient care for all cancer patients, we showed that NHB patients were more likely to receive delayed chemotherapy (>60 days since diagnosis of cancer) compared to NHWs during the pandemic (aOR-1.10, p<0.001), but such association was not detected before pandemic. Ratio of odds ratio (ROR) analysis confirmed that NHB patients comparing to NHWs during pandemic experienced 1.11-fold difference in the odds of delayed chemotherapy between NHBs and NHWs before pandemic [ROR=1.11, p<0.001]. CONCLUSION Racial disparity in SRS-receipt for BM patients has been exacerbated during COVID-19 pandemic and such impact could be generalized to outpatient care for all cancer types. Understanding the determinants giving rise to this disparity should augment the readiness of our cancer care infrastructure in anticipation of future pandemics or other public health crises.

Impact of COVID-19 pandemic on influenza vaccination rate among health care workers

ABSTRACT Vaccinations against influenza are critical in mitigating the severity of the disease, preventing its transmission, and restricting its dissemination. Concerns about vaccination hesitancy among healthcare workers (HCWs) have been duly recognized during and following the COVID-19 pandemic. To examine the extent to which the COVID-19 pandemic has influenced the adoption of vaccinations among HCWs. A cross-sectional online survey was conducted four years after the COVID-19 pandemic among HCWs in Saudi Arabia. We performed a logistic regression analysis using influenza vaccination uptake as the dependent variable and perceived COVID-19 pandemic’s impact, age, gender, marital status, employment status, education level, monthly income, respondent’s overall health, doctor visits, tobacco use, number of adults in the household, and number of children in the household as independent variables. The study included 574 participants, an 86% response rate. Of the sample, 47% reported they had the influenza vaccination. HCWs who reported a greater negative impact due to the COVID-19 pandemic were 40% more likely to acquire the influenza vaccine (OR = 1.4, 95% CI [1.24, 1.58]). Compared to HCWs without children, HCWs with a child had a 44% lower likelihood of taking the influenza vaccination (OR = 0.34, 95% CI [0.16, 0.69]). The odds of HCWs obtaining the influenza vaccine were 4.5 times higher for those who reported one yearly medical visit, 2.6 times higher for two, and 1.4 times higher for three or more. HCWs who experienced more severe COVID-19 outcomes were more likely to get vaccinated against the virus. However, long-term monitoring of this inclination is necessary.

Grief in Children in the Aftermath of the COVID-19 Pandemic.

This review aims at reporting the current evidence of the impact of COVID-19 pandemic on grief in children. Evidence from the scientific literature shows that the severity of grief in children is impacted by numerous risk factors which can lead to prolonged grief disorder (PGD). Among these risk factors are the unpredictability of the death, the lack of understanding about what is happening by the child, the global insecurity raised by the context of the pandemic or again the impossibility for the child to find comfort with his peers due to the lock-down. No medical-based approach has proven efficient on PGD in children. However, cognitive based therapy can lower the severity of the symptoms. Future efforts should focus on developing therapeutic strategies to specifically fit the needs of children with PGD, in the context of a major crisis such as this pandemic.

Predoctoral US dental school applicants and first-time, first-year enrollees, 2023 Entering Class.

This article aims to provide an overview of the characteristics of applicants and first-time, first-year enrolled predoctoral oral health students in the 2023 Entering Class, while highlighting trends over the past decade. The study employs a descriptive analysis of predoctoral US dental school application data sourced from the ADEA Associated American Dental Schools Application Service (ADEA AADSAS®) and Texas Medical and Dental Schools Application Services (TMDSAS) portals. Between 2013 and 2023, the number of first-time, first-year enrollees increased by 14%. Applicant numbers rebounded post-COVID pandemic and were 0.5% higher in 2023 compared to 2019. The proportion of female predoctoral applicants and first-time, first-year enrollees each increased by 11 percentage points over the last decade. Racial and ethnic diversity among first-time, first-year enrollees improved, particularly among Hispanic or Latino and Black or African American students, with both groups increasing by 51% between 2013 and 2023. There has been a steady increase in first-time, first-year enrollees, reflecting growth in the number of US-trained predoctoral oral health professionals. Applicant numbers have rebounded from the impact of COVID-19 pandemic. The increase in the share of female dental school applicants and first-time, first-year enrollees has brought the gender distribution in predoctoral oral health programs more closely in line with that of postsecondary education. While progress has been made in terms of increased representation of historically underrepresented racial and ethnic (HURE) groups, much work remains to achieve greater representation.

Impact of COVID-19 Pandemic on Delay of Melanoma Diagnosis: A Systematic Review and Meta-Analysis

Introduction: Several studies have described how the restrictive measures due to COVID-19 have delayed melanoma diagnoses, resulting in an increased rate of more severe cases. Summarizing the sparse results in this context might help to understand the real impact of the COVID-19 pandemic on melanoma. We conducted a systematic review and meta-analysis to investigate how the clinical and prognostic factors of new melanoma diagnoses changed after COVID-19. Methods: A literature search in MEDLINE, EMBASE, and Scopus was conducted in September 2023. We included studies published in peer-reviewed journals reporting histopathological data on new diagnoses of cutaneous melanoma in adult patients during and/or after the lockdown compared to those diagnosed before the COVID-19 pandemic. A meta-analysis was conducted utilizing a random effects model. The between-study heterogeneity was assessed via Higgins’s I2 statistic. Publication bias was assessed using the Begg and Egger test. This study adhered to the updated PRISMA guidelines. The primary outcome was a comparison of melanoma thickness between the pre-COVID-19 and post-lockdown periods. The secondary outcomes were evaluations of the histopathological subtype, stage, and presence of ulceration and mitosis in melanomas diagnosed in these two pandemic phases. Results: The study included 45 articles. We found a significantly higher proportion of all factors indicating worse prognosis in the post-lockdown period compared to the pre-COVID-19 phase, including high thickness (SOR = 1.14, 95%CI 1.08–1.20 for 1–2 mm; SOR = 1.62, 95%CI 1.08–2.40, for >2 mm), the presence of ulcerations (SOR = 1.35, 95%CI 1.18–1.54), nodular subtype (SOR = 1.19, 95%CI 1.07–1.32), the presence of mitosis (SOR = 1.57, 95% CI 1.17–2.11), and stage III (SOR = 1.39, 95%CI 1.19–1.52) and IV (SOR = 1.44, 95%CI 1.26–1.63). Limitations include the limited studies’ geographical distribution and moderate heterogeneity affecting meta-analysis estimates. Conclusions: Our meta-analysis provided evidence of more advanced melanomas diagnosed in the post-COVID-19 pandemic period, emphasizing the importance of creating and updating pandemic preparedness plans to limit the impact of any future events on oncological care.

The Impact of Covid-19 Pandemic on the Situation of Micro, Small, and Medium Sized Enterprises in the Transport Sector in Poland

The Impact of Covid-19 Pandemic on the Situation of Micro, Small, and Medium Sized Enterprises in the Transport Sector in Poland

Impact of COVID-19 pandemic on tuberculosis notification and outcome in a district of South Gujarat

ABSTRACT Context/Background: The COVID-19 pandemic affected the health care services worldwide, with the target of END TB 2025; it was important to make sure that the TB notification and linkage services were not hampered. The current study aims to document the overall impact of COVID-19 on TB notification and treatment services. Aims/Objectives: To document the impact of COVID-19 on notification and comparison of their outcome between pre-COVID-19 and COVID-19 era. Methodology: Programmatic data of 9893 notified TB cases reported from Surat rural between 2019 and 2021 were collected from Nikshay portal through DTO Surat. Detailed comparison of pre- and COVID-19 era was performed using stratified analysis. Results: There was a significant (P = 0.02) 29% decline in cases reported in 2020 as compared to the cases reported in the previous year. The impact of COVID-19 was also seen on mortality of the reported cases (18% increase). The overall proportion of treatment failure was increased (28%), whereas difference of 20% was seen in cases where treatment regimen was required to be changed. Conclusions: Despite the overall impact of COVID-19 on TB services (2020), the health department has proactively countered and bounce back in 2021 with an overall increase in notification and treatment services.

Impact of COVID-19 pandemic on stage of gynecologic cancers at presentation and time to treatment

Impact of COVID-19 pandemic on stage of gynecologic cancers at presentation and time to treatment

Career Advancement Insights from Certified Pharmacy Technicians: Enhanced Opportunities for the Pharmacy Technician Workforce

Sustainable career advancement opportunities for pharmacy technicians will be a critical part of patient-centered community pharmacy environments as the role of the pharmacist provider expands. (1) To determine the impact of a Pharmacy Technician Certification Board pharmacy (PTCB) certification on career advancement and professional growth metrics; (2) To assess technicians' role in advanced pharmacy services before and after certification; and (3) To identify changes in pharmacist services when a certified pharmacy technician (CPhT) was added to the provider team. A 73-question web-based survey was distributed to all PTCB certified pharmacy technicians (CPhT) in the United States, Washing D.C., Puerto Rico, Guam, and the US Virgin Islands. The survey was distributed by PTCB in April 2021 with a 28-day collection period. The survey included multiple choice, rating scale, and free text questions centered on five domains: Practice experience, Career aspirations, Compensation, Pharmacy practice motivations, and Impact of COVID-19 pandemic. 23,007 CPhTs completed the survey. Respondents were primarily female (85.5%), age 30-39 (32.8%), and ≥ 10 years CPhT experience (42.8%). The majority of respondents cited improvement of patient health (77.4%), career advancement opportunities (53.5%), the ability to expand their role during emergencies (e.g., COVID-19) (52.6%), and future career advancement opportunities (51.7%) as benefits of CPhT certification. Increases in job responsibility after certification included changes occurring in roles related to clinical pharmacy services, patient education, preventive health services, provider communication, and staff training. Respondents agreed that PTCB-certification allowed for the expansion of pharmacists' services where they practiced, including clinical services (18.5%), patient education (18.3%), and preventive health services (18.1%). CPhT's value certification for its benefits on career advancement, personal growth, and salary enhancement. Affirmation of skill and training through certification is also recognized to positively influence patient care and the pharmacy's ability to provide advanced patient care and services.

Effect of the second and third COVID-19 pandemic waves on routine outpatient malaria indicators and case management practices in Uganda: an interrupted time series analysis

BackgroundReports on the impact of COVID-19 pandemic on the quality of malaria care and burden in sub Saharan Africa have provided a mixed picture to date. The impact of the 2nd (Delta) and 3rd (Omicron) COVID-19 waves on outpatient malaria indicators and case management practices was assessed at three public health facilities with varying malaria transmission intensities in Uganda.MethodsIndividual level data from all patients presenting to the out-patient departments (OPD) of the three facilities (Kasambya, Walukuba and Lumino) between January 2019 and February 2022 were included in the analysis. Outcomes of interest included total number of outpatient (OPD) visits, proportion of patients suspected to have malaria, proportion of suspected malaria cases tested with a malaria diagnostic test, test positivity rates (TPR) and proportion of malaria cases prescribed artemether-lumefantrine (AL). Using the pre-COVID-19 trends between January 2019 and February 2020, interrupted time series analysis was used to predict the expected trends for these study outcomes during the 2nd wave (May 2021–August 2021) and 3rd wave (November 2021–February 2022). The observed trends of the study outcomes were compared with the expected trends.ResultsThere were no significant differences between the observed versus expected overall outpatient visits in the 2nd wave, however, a significant decline in OPD attendance was observed during the 3rd wave (15,101 vs 31,154; incidence rate ratio (IRR) = 0.48 [0.41–0.56]). No significant differences in the overall observed versus expected proportions of suspected malaria cases and test positivity rates in both COVID waves. However, a significant decrease in the overall proportion of suspected malaria cases tested with a malaria diagnostic test was observed during the 3rd wave (99.86% vs 99.99%; relative percent ratio [RPR] = 0.99 [0.99–0.99]). Finally, a significant decline in the overall proportion of malaria cases prescribed AL was observed during the 2nd wave (94.99% vs 99.85%; RPR = 0.95 [0.92–0.98]) but not the 3rd wave.ConclusionSignificant declines in OPD attendance and suspected malaria cases tested with malaria diagnostic test were observed during the 3rd COVID-19 wave, while AL prescription significantly reduced during the 2nd COVID-19 wave. These findings add to the body of knowledge highlighting the adverse impact of COVID-19 pandemic on the malaria which could explain the increase in the malaria burden observed during this period.

Impact of COVID-19 pandemic on medical and non-medical students at a private university in Malaysia

Background: Worldwide the COVID-19 pandemic affected people in various ways. Despite all the constraints students were in a unique position of being thrown into a lockdown situation where they had to learn from home and online. This had its own repercussions, and our aim was to study the effect of learning, as well as the mental and financial impact it had on the students at this private university. Methods: Using a pre-validated google questionnaire, we conducted a cross-sectional study amongst the undergraduate students from the various faculties. We used a modified DASS-21, with 15 questions rated on a Likert’s scale to assess mental health. Academic assessment and the financial impact assessment had 8 questions each. Sample size was 177. Cronbach’s for overall internal consistency was 0.860. Results: We had 208 respondents, where 66.3% were female and 62% Chinese. The mean score for medical students (mean=38.3, SD=12.9) was slightly higher than non-medical students (mean=37.3, SD=11.6). Overall non-medical students faced more challenges than the medical students academically as seen in poor contact with lecturers (chi square 10.73, p=0.030), their home environment was not conducive for learning (chi square 4.38, p=0.036) and have significantly more distraction from family members (chi square 4.87, p=0.027). Financially, a significant number of non-medical students struggled to pay for food expenses (chi square 12.92, p≤0.001). Conclusions: There was no significant difference between medical and non-medical students on mental health issues. Non-medical students were impacted more academically and financially.

Impact of COVID-19 pandemic on healthcare provision in youth with systemic lupus erythematosus.

Impact of COVID-19 pandemic on healthcare provision in youth with systemic lupus erythematosus.

Impact of COVID-19 on cardiology and neurology services in a peripheral hospital in Northern Israel

Abstract Background The indirect impact of COVID-19 pandemic on clinical services remains incompletely described in secondary care hospitals outside major urban centers. We compared clinical outcomes before and during the pandemic in a disrupted service (Neurology) and a non-disrupted one (Cardiology) in a peripheral hospital in Israel, using Cerebral Vascular Accident (CVA) and ST-elevation myocardial infarction (STEMI) as clinical indicators, respectively. Methods We compared demographics, treatment and outcomes from CVA and STEMI patients who attended Ziv Medical Center, Israel, during the pandemic (15/3/2020-15/4/2022) and before (1/1/2018-14/3/2020), Using chi-square, t-test and Wilcoxon-Mann-Whitney tests. Results 1029 CVA and 497 STEMI patients were included. Those who arrived during the pandemic were demographically comparable to those arriving before. Compared to pre-pandemic, intra-pandemic median time for CVA patients from arrival to imaging was longer (23 vs. 19 minutes, p = 0.001). However, timing from arrival to tissue Plasminogen Activator administration was similar (49 vs. 45 min, p = 0.61). The likelihood of transfer to another hospital was higher (20.3% vs. 14.4% p = 0.01) and median length of stay (LOS) was shorter (3 vs. 4 days, p < 0.05). Among STEMI patients, median time from arrival to percutaneous coronary intervention during the pandemic was shorter than before (45 vs. 50 minutes p = 0.02) and median ejection fraction at discharge was higher (50% vs. 45% p = 0.02). Mean LOS was shorter (3.86 vs. 4.48 p = 0.01), and unplanned re-admission to the ED was less frequent (7.8% vs. 14.6% p = 0.01). No significant changes in mortality were observed. Conclusions Our data shows no major negative impact of the COVID-19 pandemic on CVA and STEMI outcomes, and possibly improved care in the less disrupted department. Follow-up qualitative studies with neurology and cardiology staff already in action to comprehend how quality of care was maintained during the crises. Key messages • In peripheral setting, COVID-19 hadn’t negatively impact Neurology or Cardiology acute clinical outcomes. • The consequences of maintaining clinical performance when working under adverse conditions requires further research.

Impact of time and COVID-19 pandemic on GP mental health consultations in deprived neighborhoods

Abstract Background The stringent lockdown measures and limited physical access to GP care at the start of COVID-19 pandemic resulted into a decrease of mental health consultations. It raised concerns about the access of patients with mental health problems. The aim of this study is to investigate the mental health GP consultations amongst patients from deprived neighborhoods before and during COVID-19 pandemic, especially after the stringent lockdown in the Netherlands. Methods In an observational study (2018-2022), medical data of 360,645 patients were analyzed for the proportions of mental health consultations (segmented per month) by comparing the lockdown phase (March 2020-May 2020) and post-lockdown phase (June 2020-June 2022) with the pre-pandemic period the patients living in deprived and non-deprived neighborhoods. Results Analyzing a total of 759,863 mental health consultations showed that during the lockdown phase of COVID-19, less mental health problem consultations were observed than pre-pandemic. This decrease was not significant for patients from deprived neighborhoods, but the decrease was significant for patients from non-deprived neighborhoods, RR = 0.990; 95%CI=0.934-1.051 and RR = 0.918; 95%CI=0.885-0.953 respectively. Conversely, the number of post-lockdown phase consultations for patients in deprived neighborhoods was significantly increased compared to pre-pandemic levels (RR = 1.074;95%CI=1.002-1.152), but not for patients in non-deprived neighborhoods (RR = 1.000; 95%CI=0.959-1.043). This increase in post-lockdown phase consultations in deprived neighborhoods can be explained by the higher frequency of consultations per patient. Conclusions Consistently over time, demand for GP mental health care was and remains higher among patients from deprived neighborhoods, with an increase in post-lockdown consultations. Sufficient access to primary health care should be guaranteed to ensure treatment of mental health problems for social-economic disadvantaged groups. Key messages • Socioeconomic status has a negative sustainable impact on demand for mental health consultations in deprived neighbourhoods. • To ensure the treatment of mental health problems for social-economic disadvantaged groups, sufficient access to the primary health care should be guaranteed at all times.