Indirect Effects Of COVID-19 Pandemic Research Articles

Indirect Effects of COVID-19 Pandemic on Children’s Ocular Health (Myopia and Digital Eye Strain): A Narrative Review

Background: The outbreak of COVID-19 has significantly affected people’s lives worldwide. Governments have used various measures to contain the spread of the pandemic, including confinement policies that have changed children’s lifestyles. Children had to limit their outdoor activities and daily routine to indoor activities. Alternative learning systems, such as online and offline teaching via digital devices have replaced traditional teaching methods. Therefore, children have to spend many hours in front of digital devices. As a natural side effect of the pandemic, these changes may influence children’s ocular health who may not be able to complain about these problems as early as adults. Objectives: This study reviews the literature regarding the effects of the COVID-19 pandemic on children’s eye health, including myopia and digital eye strain. Methods: For this narrative review, a comprehensive literature search was performed on December 30, 2021, in Google Scholar, PubMed, and Scopus using the following keywords: “COVID-19,” “lockdowns,” “children,” “ocular health,” “eye health,” “visual health,” “ocular complications,” “myopia,” “ myopia progression,” “digital eye strain,” “computer vision syndrome,” “quarantine,” and “prevention.” A total of 22 eligible studies were identified for review. Results: Studies performed during the COVID-19 pandemic have shown an increase in myopia prevalence, incidence, and progression in children, especially among young children. Strategies imposed by governments to control the spread of COVID-19 during confinement have led to dramatic changes in children’s lifestyles. These measures have compelled children to restrict outdoor activities and increase their near-work time (e.g., online e-learning), which contributes to the increase in digital eye strain and myopia progression. Conclusions: Children’s eye health can be influenced by the COVID-19 outbreak. These can serve as a warning to policymakers, health professionals, teachers, parents, and children about the effects of pandemics, such as COVID-19, on children’s visual health and the need to implement preventive and therapeutic measures.

Unpreparedness and uncertainty: a qualitative study of African American experiences during COVID-19 pandemic

During disasters, vulnerable populations are disproportionately affected. COVID-19 disproportionately affected African American (AA) families, increasing their risk for COVID-19 morbidity and mortality. The pandemic also exacerbated existing negative milieu such as economic opportunity and access to social and healthcare services. We explored AA families’ experiences of indirect pandemic effects. Data were collected through semi-structured in-depth telephone interviews with 11 AA parent/grandparents of school-aged child (5–17 years). Line-by-line coding and thematic analysis were used to analyze and interpret the data. Three emergent themes highlighted the salient indirect effects of COVID-19 pandemic on AA families: (i) access to healthcare, (ii) access to food, and (iii) disaster unpreparedness. Participants expressed frustration with virtual healthcare services and inability to schedule in-person hospital appointments for health conditions unrelated to COVID-19. Lack of food products in stores and limited financial resources due to pandemic-related job layoffs were important food insecurity factors discussed. Unpreparedness on the part of institutions, state, and the nation, created heightened perceptions of vulnerability. Given the social vulnerability spectrum in the U.S., pandemic planning approaches that promote equity are critical if public officials are to develop effective adaptation, mitigation, response, and recovery plans that mobilize and serve diverse populations.

Indirect effects of COVID-19 pandemic on reproductive, maternal, newborn and child health services in Pakistan.

COVID-19 is having many impacts on health, economy and social life; some due to the indirect effects of closure of health facilities to curb the spread. Closures were implemented in Pakistan from March 2020, affecting provision of reproductive, maternal, newborn and child health (RMNCH) services. To appraise the effects of containment and lockdown policies on RMNCH service utilization in order to develop an early response to avoid the catastrophic impact of COVID-19 on RMNCH in Pakistan. Routine monitoring data were analysed for indicators utilization of RMNCH care. The analysis was based on Period 1 (January-May 2020, first wave of COVID-19); Period 2 (June-September 2020, declining number of cases of COVID-19); and Period 3 (October-December 2020, second wave of COVID-19). We also compared data from May and December 2020 with corresponding months in 2019, to ascertain whether changes were due to COVID-19. Reduced utilization was noted for all RMNCH indicators during Periods 1 and 3. There was a greater decline in service utilization during the first wave, and the highest reduction (~82%) was among children aged < 5 years, who were treated for pneumonia. The number of caesarean sections dropped by 57%, followed by institutional deliveries and first postnatal visit (37% each). Service utilization increased from June to September, but the second wave of COVID-19 led to another decrease. To reinstate routine services, priority actions and key areas include continued provision of family planning services along with uninterrupted immunization campaigns and routine maternal and child services.

Individual level changes in body weight among Finnish adult population during the COVID-19 pandemic

BackgroundThe indirect effects of COVID-19 pandemic are yet undefined, but behavioral and lifestyle consequences of the containment measures may cause weight changes, with different concerns across demographic groups. Our aim was to determine weight changes based on the data collected from same individuals before (2017) and during (2020) the COVID-19 pandemic.MethodsParticipants aged 25+ years, from the nationally representative FinHealth 2017 Study and its follow-up survey in autumn 2020, with information on self-reported weight in both years were included (n = 4770). Weight maintenance was defined as < ± 5% change in body weight for each individual (i.e. weight loss = ≥5% loss; weight gain = ≥5% gain). Prevalence was estimated using inverse probability weights, acknowledging sampling design and non-response.ResultsOverall, two thirds of the population maintained weight during follow-up, but prevalence rates for weight change differed by age and sex. Prevalence of weight loss was highest among 70+ year olds (22% in men, 95% confidence interval (CI) 17-27; 26% in women, 95% CI 22-30), while they rarely experienced weight gain. Among 50-69 year olds weight gain was as common as loss, being around 15% for both indicators and sexes. Prevalence of weight gain was highest among 25-49 year olds (20% in men, 95% CI 18-23; 36% in women, 95% CI 33-40). Men with lowest education had gained weight more often (24%, 95% CI 19-30) than those with middle (16%, 95% CI 14-19) or high (14%, 95% CI 12-16) education, while for women no differences emerged, the prevalence ranging between 20-24% by education.ConclusionsThe weight loss among 70+ year olds seems worrying, but might be age related. Moreover, younger women and men with low education gained weight, groups known to be vulnerable for weight gain. Further analyses are required to evaluate whether containment measures related to COVID-19 pandemic have caused additional change compared to ageing and time related change.Key messages Few weight changes were observed in the Finnish adult population. As weight gain/loss may take longer time to develop, further studies are needed to address the long term effects of COVID-19 pandemic.To avoid increasing health inequity after pandemic, public health promotion should stress obesity prevention among young women plus men with low education. Weight loss is a concern among the elderly.

Indirect effects of COVID-19 Pandemic in ST-segment elevation myocardial infarction: insights from a multicentric national survey

Abstract Objective Coronavirus disease 2019 (COVID-19) pandemic may have indirect consequences in ST-segment elevation myocardial infarction (STEMI) outcomes due to difficulties in healthcare access, but also due to reperfusion delays. The objective of this study was to evaluate the performance indicators in STEMI during the early phase of the lockdown following the COVID-19 pandemic. Methods The “patient delay” and the “system delay” were evaluated in 312 patients with suspected STEMI, in the period of the first State of Emergency in Portugal, through a survey called “Moment COVID” implemented within 18th March to 2 May 2020, in 18 national centers of Interventional Cardiology where PPCI is carried out 24/7. These patients were compared with a historical cohort of 267 patients from the 5th year after integration of SFL Initiative in Portugal (Moment 2015) in which the same survey was applied. Patients with late presentation of STEMI (&amp;gt;12 hours of symptoms onset) were excluded from this analysis. Results In “Moment COVID” there was a trend towards a longer “patient delay” (incremental median 20 min; p=0.059) and a significant longer system-delay (incremental median 17 min; p=0.033) compared to the historical cohort of “Moment 2015”. Consequently, times to revascularization tended to be longer (incremental median 26 min; p=0.074). Indeed, in “Moment COVID” patients were less compliant with the times recommended by the European guidelines: door-to-balloon time &amp;lt;60 min was achieved in 47.6% of patients compared to 57.0% (p=0.052) in “Moment 2015” and system-delay &amp;lt;90 min in 13.9% compared to 21.8% (p=0.033). Conclusion These results from a multicentric national analysis demonstrated a trend to longer time from symptom onset to request healthcare system assistance and a significantly longer time from first medical contact to revascularization among patients with STEMI during COVID-19 pandemic. This delay for treatment could negatively impact the STEMI prognosis at the long-term. Funding Acknowledgement Type of funding sources: None.

The direct and indirect effects of COVID-19 pandemic in a real-life hematological setting.

BackgroundClinical outcomes of novel coronavirus 2019 disease (COVID‐19) in onco‐hematological patients are unknown. When compared to non‐immunocompromised patients, onco‐hematological patients seem to have higher mortality rates.AimsWe describe the characteristics and outcomes of a consecutive cohort of 24 onco‐hematological patients with COVID‐19 during the first month of the pandemic. We also describe variations in healthcare resource utilization within our hematology department.Methods and ResultsData from patients between the first month of the pandemic were retrospectively collected. Clinical and logistic data were also collected and compared with the average values from the prior 3 months of activity. Prevalence of COVID‐19 in our hematological population was 0.4%. Baseline characteristics were as follows: male sex: 83%, lymphoid diseases: 46%, median age: 69 (22‐82) years. Median follow‐up in survivors was 14 (9‐28) days and inpatient mortality rate was 46%. Average time to moderate/severe respiratory insufficiency and death were 3 (1‐10) and 10 (3‐18) days, respectively. Only 1 out of every 12 patients who developed moderate to severe respiratory insufficiency recovered. Upon univariate analysis, the following factors were associated with higher mortality: age ≥ 70 years (P = .01) and D‐dimer ≥900 mcg/L (P = .04). With respect to indirect effects during the COVID‐19 pandemic, and when compared with the prior 3 months of activity, inpatient mortality (excluding patients with COVID‐19 included in the study) increased by 56%. This was associated with a more frequent use of vasoactive drugs (+300%) and advanced respiratory support (+133%) in the hematology ward. In the outpatient setting, there was a reduction in initial visits (−55%) and chemotherapy sessions (−19%). A significant increase in phone visits was reported (+581%).ConclusionCOVID‐19 pandemic is associated with elevated mortality in hematological patients. Negative indirect effects are also evident within this setting.