Onset Of COVID-19 Research Articles

What are the functional outcomes and service experiences of patients with head and neck cancer treated during the COVID-19 pandemic?

IntroductionHead and neck cancer (HNC) care was significantly impacted by the COVID-19 pandemic. The current study aimed to explore the functional outcomes and service experiences of patients with HNC treated during and prior the COVID-19 pandemic.MethodsMixed methods were used to (1) retrospectively compare HNC patients’ functional outcomes and allied health service usage across two time-controlled cohorts and (2) understand the experiences of HNC care using validated surveys and qualitative interviews.ResultsRetrospective data was extracted for 78 participants (pre-COVID-19, n = 43; during-COVID-19, n = 35), with n = 28 and n = 18 completing surveys and an interview, respectively. Significant differences were found in service modality between groups with significantly more phone and telehealth services provided during COVID-19. Service usage and functional outcomes were not significantly different between groups. During-COVID-19 participants reported being significantly less informed about their care and care was significantly less appropriate and acceptable. Thematic analysis of interviews revealed six broad themes related to communication, person-centred care, treatment logistics, care availability, safety of care, and impacts on experiences.ConclusionsThis study revealed that whilst HNC care rapidly changed at the onset of COVID-19, patient access to treatment and functional outcomes did not differ significantly. Rather, factors related to the patient experience of care were discussed. Healthcare professionals working in HNC have further evidence supporting building relationships based on transparent communication and partnering with patients to overcome rapid clinical changes, as experienced during COVID-19.

Study of hypothalamic-pituitary-testicular axis in Egyptian post-COVID-19 patients

ABSTRACT Background SARS-CoV-2, was identified as a global pandemic by the World Health Organization a few months after the first epidemic. It penetrates host cells through angiotensin-converting enzyme 2 receptors and spreads by respiratory droplets. Testes are among the several tissues that have high expression levels of ACE-2 receptors. The current study aimed to evaluate the hypothalamic-pituitary-testicular axis integrity among Egyptian post-COVID-19 patients. Methods This is a cross-sectional study that included patients with a history of COVID-19 infection, at least 3 months from the onset of COVID-19. A detailed clinical history was obtained, and a thorough examination was performed. Laboratory tests included FBG, total testosterone, free testosterone, bioactive testosterone, FSH, LH, prolactin, E2, albumin, and SHBG. Testicular ultrasonography was performed. The data were statistically analyzed. Results Eighty male patients were evaluated with a mean age of 35.53 ± 10.35 years. The mean serum total testosterone was 5.48 ± 1.65 ng/ml. Low testosterone was detected in 2.8% of the patients. High LH levels were detected in 17/80 patients (21.3%). High FSH levels were detected in 4/80 patients (5%). Six patients had elevated serum E2 level. The mean serum prolactin value was 10.90 ± 5.66 ng/ml. Fourteen patients had elevated prolactin levels. The mean serum T/LH ratio was 3.28 ± 1.52. The ratio of T/LH was decreased in eight COVID-19 patients (10%). In COVID-19 patients, a statistically significant negative correlation was found between age and free testosterone (FT) (r=-0.381, p < 0.001), bioavailable testosterone (Bio. T) (r=-0.375, p = 0.001), and androgen index (A. index) (r=-0.446, p < 0.001). Conclusion The data of the current study suggest that COVID-19 infection might deteriorate pituitary – gonadal axis. The prevalence of low testosterone in COVID-19 male survivors is low. The risk of hypogonadism is increased with advanced age. More studies are required to confirm the relationship between COVID-19 infection and male gonadal function.

Symptoms, Course, and Factors Related to Long-Term Morbidity, Including Differences between Infection Strains, in Patients with Long COVID in a Primary Care Clinic in Japan: An Observational Study.

Objectives: The objectives were to investigate the clinical characteristics and course of long COVID, defined as the persistence of symptoms at least one month after the onset of COVID-19, in outpatients and to clarify differences in symptoms between SARS CoV-2 mutant strains. Methods: Our observational study in a primary care institution in Japan included 1053 patients with long COVID who visited our outpatient clinic between April 2021 and March 2023. Symptom distribution, performance status, and patient background at the time of the first outpatient visit were compared between infectious strains (Delta and before group and Omicron group). Background factors and symptoms related to time to remission were also analyzed. Results: The severity of COVID-19 in the acute phase was mild, moderate, and severe in 82.2%, 14.9%, and 2.9% in the Delta and before group; and in 97.6%, 1.7%, and 0.4% in the Omicron group, respectively. Vaccination coverage was significantly different between the Delta and before (37.1%) and Omicron groups (73.1%) (p < 0.001), probably due to the period of vaccine unavailability in the former group. Symptoms of fatigue and headache occurred most frequently, irrespective of infectious strain. The mean number of symptoms per patient was significantly higher in the Delta and before group than the Omicron group (3.4 vs. 2.7, p < 0.0001). The median time overall to remission of long COVID was 169 days. Cox hazard model analysis identified female sex, high body mass index, and dyspnea (but not infectious strain) as significant factors prolonging the time to remission (p < 0.05). Conclusions: Differences in the number of symptoms between infectious strains may be related to differences in viral virulence and/or vaccination coverage. However, the clinical course was found to be minimally influenced by the infectious strain. The present results should improve the understanding of prognosis in patients with long COVID from both the clinical and social perspectives.

Characterization of Change in Cognition Before and After COVID-19 Infection in Essential Workers at Midlife

BackgroundResearch into COVID-19-related cognitive decline has focused on individuals who are cognitively impaired following hospitalization for COVID-19. Our objective was to determine whether cognitive decline emerged after the onset of COVID-19 and was more pronounced in patients with postacute sequelae of SARS-CoV-2 infection (PASC). MethodsWe analyzed longitudinal cognitive data collected during a cohort study of essential workers at midlife that continued through the COVID-19 pandemic. We used longitudinal discontinuity models, a form of causal modeling, to examine the change in cognitive performance among 276 participants with COVID-19 in comparison to contemporaneously-collected information from 217 participants who did not have COVID-19. Cognitive performance across four domains was measured before and after the pandemic. Eligible study participants were those with validated COVID-19 diagnoses who were observed before having a verified COVID-19 infection who survived their initial infection, and for whom post-COVID-19 information was also available. ResultsThe mean age of the COVID-19 group was 56.0 ± 6.6 years old, while the control group was 58.1 ± 7.3 years old. Longitudinal models indicated a significant decline in cognitive throughput (β = -0.168, P = .001) following COVID-19, after adjustment for pre-COVID-19 functioning, demographics, and medical factors. Associations were larger in those with more severe COVID-19 and those who reported PASC. Observed changes in throughput were equivalent to 10.6 years of normal aging. ConclusionFindings from this longitudinal causal modeling study revealed that COVID-19 and PASC appeared to cause clincially relevant cognitive deterioration.

Approaching collaboration in primary care differently: Exploring boundaries and boundary objects.

In recent primary care policy, collaboration is often understood as an outcome, such as the delivery of team-based care or an integrated health system. This outcome-based understanding of collaboration in policy has proven challenging to achieve in practice. This article introduces the concepts of constructing boundaries and boundary objects used in other disciplines, to support our understanding of collaboration by observing the collaborative process. Multiple methods, such as semi-structured interviews, discourse analysis, and member-checking, were used to compare primary care collaborations across three distinct time periods during the onset of COVID-19 within Interior British Columbia. Data analysis revealed the changing nature of boundaries and boundary objects, providing insights into the collaborative process. Through the exploration of boundaries and boundary objects, this article provides a way to approach collaboration in practice differently. By better understanding the process of collaboration, this research could potentially improve collaborative outcomes.

Telehealth in Mental Health Social Work: Benefits and Limitations within Practice

ABSTRACT Telehealth is increasingly being adopted in mental health service delivery, particularly since the onset of COVID-19. However, the literature on the uses and applications of telehealth in mental health social work is still emerging, and a critical understanding of telehealth practice is vitally needed. This research explored how the use of telehealth impacts the practice of mental health social workers and what this means for service users. Ten semistructured interviews were undertaken with mental health social workers. It was found that although telehealth is becoming embedded into service delivery, there are implications for workload, training and support, and skills in reflexively adapting practice to ensure ethical practice when using telehealth technologies. Telehealth can align with the profession of social work if the practical benefits are clearly understood and the limitations of the approach are monitored and supported with adequate training and support. IMPLICATIONS Telehealth has many practical benefits for practice, but it presents a challenge for the relational skills social workers rely on for face-to-face practice. Social workers should be critically reflective on how telehealth can impact ethical practice. Training and support around the practical implications of telehealth for those implementing telehealth would be beneficial.

Psychotherapy Engagement Before and After a Rapid Transition to Telehealth During COVID-19 for Older Adults With Dementia.

Objective: To understand the impact of the transition to telehealth during COVID-19 on psychotherapy visits for patients with dementia. Method: Retrospective study of older adults with dementia who had at least one psychotherapy visit in the 9months before and after the onset of COVID-19 at 3 U.S. health systems. Care disruptions were gaps of 45+days. Descriptive statistics and logistic mixed-effects models examined factors associated with care disruption. Results: 4953 patients with dementia made 19,902 psychotherapy visits. Gaps in psychotherapy were less frequent during COVID-19 (29.4%) than before (48.9%), with the odds of a patient experiencing a care disruption during COVID-19 0.54 times the odds prior to COVID-19 (95% CI: 0.50-0.59). Almost all patient subgroups had lower adjusted odds of care disruption during COVID-19. Discussion: There were fewer disruptions in psychotherapy care following the rapid shift to virtual care. Telehealth may be a viable option for patients with dementia.

Analysing COVID-19′s impact: Gold, oil, and stock markets in African oil-exporting economies

This article employs quantile regressions to investigate the link between oil prices, gold prices, and stock market returns in five African oil-exporting nations: Nigeria, Ghana, Egypt, Algeria, and Tunisia. The analysis utilises daily data spanning from January 1, 2017, through September 30, 2021. Before the onset of COVID-19, oil played a pivotal role as a hedge in Tunisia, Egypt, Algeria, and Ghana, providing stability in both normal and bullish market conditions. Furthermore, it functioned as a diversifier in Egypt and Ghana during bearish market phases. However, as the pandemic unfolded, oil took on the characteristics of a safe haven in Egypt, Ghana, Nigeria, Algeria, and Tunisia, particularly notable during bearish and normal market conditions. Gold, prior to the pandemic, served as a hedge in Egypt, Ghana, Nigeria, and Tunisia, while also acting as a diversifier across both bearish and bullish market conditions in these economies. Conversely, during the pandemic, gold predominantly functioned as a diversifier in most oil-exporting African economies, with significant hedge properties observed specifically in Algeria and Ghana. The practical implications of these findings are significant for various stakeholders, including oil exploration and production firms, businesses in the transport and hospitality sectors, policymakers, and investors with stocks sensitive to oil and gold prices.

Prescription Patterns in Jails Before and Since the COVID-19 Pandemic: A Multisite Serial Cross-Sectional Investigation.

In response to the COVID-19 pandemic, jails were advised to reduce facility census, particularly the growing population of those with medical/behavioral health vulnerabilities that increased susceptibility to adverse outcomes. Although jail census decreased across the nation in the initial days to months following pandemic declaration, there are minimal data regarding the health status of those who remained in jail. The current investigation aspired to describe jail census trends before/since the onset of COVID-19 and offer snapshots of temporal changes and context for prevalence estimates of medical/behavioral health conditions in jail detainees from 2019 to 2023. Using a serial cross-sectional design, prescription information for individuals residing in 18 jails across the United States on June 30 of each respective year was extracted and categorized using MediSpan's ontological system to determine prevalence estimates of prescribed agents/products. Although data evidenced an initial 31% census reduction (followed by gradual return to prepandemic rates), prescribing patterns for all major therapeutic drug classes steadily increased, with 10% more individuals prescribed at least one agent in 2023 than 2019. The largest increases were observed for behavioral health agents (e.g., 32.4% of the sample was prescribed psychotropic agents in 2023 compared with 25.7% in 2019). We provide considerations for future investigations.

Perceiving Others Through a Screen: Are First Impressions of Personality Accurate and Normative via Videoconferencing?

The use of videoconferencing platforms has globally risen to facilitate face-to-face communication since the onset of COVID-19. But how do our first impressions of people we meet on Zoom compare to in-person interactions? Specifically, do we view others' personalities as accurately (in line with their unique personality) and normatively (in line with the average, desirable personality) as in-person? Across two Zoom first-impression round-robin studies (exploratory study: N = 567, Dyads = 3,053; preregistered replication: N = 371, Dyads = 1,961), which we compared to an in-person round-robin study (N = 306; Dyads = 1,682), people viewed others' personalities as accurately and as normatively on Zoom as in-person. Moreover, people better liked interaction partners they viewed more accurately and normatively. However, in interactions of poorer audio-video quality, people viewed others less accurately, less normatively, and liked them less. Overall, through a screen, our impressions of others are as accurate and normative as face-to-face, but it depends on the quality of that screen.

Dynamic Silos: Increased Modularity and Decreased Stability in Intraorganizational Communication Networks During the COVID-19 Pandemic

Workplace communications around the world were drastically altered by the COVID-19 pandemic, related work-from-home orders, and the rise of remote work. To understand these shifts, we analyzed aggregated, anonymized metadata from over 360 billion emails within 4,361 organizations worldwide. By comparing month-to-month and year-over-year metrics, we examined changes in network community structures over the 24 months before and after COVID-19. We also examined shifts across multiple communication media (email, instant message, video call, and calendaring software) within a single global organization and compared them with communications shifts that were driven by changes in formal organizational structure. We found that in 2020, organizations around the world became more siloed than in 2019, evidenced by increased modularity. This shift was concurrent with decreased stability within silos. Collectively, our analyses indicate that following the onset of COVID-19, employees’ communications began to shift more dynamically between subcommunities (teams, workgroups, or functional areas). At the same time, once in a subcommunity, they limited their communication to other members of that community. We term these network changes dynamic silos. We provide initial insights into the meaning and implications of dynamic silos for the future of work. This paper was accepted by Lamar Pierce, organizations. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2022.02797 .

Primary healthcare in the aftermath of the COVID-19 pandemic: a qualitative interview study in Sweden

ObjectiveTo explore how primary healthcare workers in Sweden experienced and perceived the long-term impact of the pandemic on their work.DesignThis is a descriptive qualitative study with individual semistructured interviews conducted...

Segregation and the onset of COVID-19 in American cities

PurposeThis paper investigates one of the potential costs of rising segregation in American cities by evaluating empirically the extent at which ethnic-based segregation contributes to the onset and the speed of propagation of the COVID-19 pandemic.Design/methodology/approachRegression analysis based on matched data on early incidence of COVID-19 cases, segregation and covariates. Identification resorts on variations in segregation across MSAs and heterogeneity in the geography and timing of stay-at-home orders.FindingsOne cross-MSA standard deviation increase in segregation leads to a significant and robust rise of COVID-19 cases of 8.7 per 100,000 residents across urban counties.Originality/valueCombines spatial data on COVID-19 cases and segregation; use of a new segregation measure; focus on early incidence of the pandemic and its drivers.

Orbital Myositis Leading to Compressive Optic Neuropathy after COVID-19 mRNA Vaccination: A Case Report

Purpose: We present a case of bilateral compressive optic neuropathy secondary to orbital myositis after COVID-19 messenger ribonucleic acid (mRNA) vaccination.Case summary: A 51-year-old man developed acute bilateral visual loss and painful ophthalmoplegia shortly after receiving the second dose of the BNT162b2 COVID-19 mRNA vaccine (Comirnaty, Pfizer®, New York, NY, USA). His best-corrected visual acuity was counting fingers at 30 cm and 50 cm in the right and left eyes, respectively. Bilateral eyelid swelling, erythema, conjunctival injection, and color vision deficit were observed. Orbital magnetic resonance imaging revealed diffuse enhancement and hypertrophy of the bilateral extraocular muscles. The patient had no significant ophthalmic history and systemic work-up revealed no evidence of underlying inflammatory disease. Based on the clinical presentation and imaging findings, he was tentatively diagnosed with bilateral compressive optic neuropathy secondary to orbital myositis after COVID-19 mRNA vaccination. He was treated with intravenous corticosteroids for 3 days followed by low-dose oral corticosteroids. One month later, his visual acuity and color vision improved; moreover, the inflammatory signs in the eyelids, conjunctiva, and extraocular muscles resolved. However, after developing COVID-19, he experienced a recurrence of symptoms and was retreated with corticosteroids. Radiotherapy was administered to address persistent color vision deficit in the right eye and recurrent eyelid edema, erythema, and conjunctival injection. This treatment effectively resolved all inflammatory signs and color vision deficits, without signs of recurrence.Conclusions: Acute fulminant orbital myositis with associated compressive optic neuropathy can manifest after COVID-19 mRNA vaccination and onset of COVID-19. Anti-inflammatory treatment measures can effectively control these manifestations.

Evaluating Universal Design for Learning and Active Learning Strategies in Biology Open Educational Resources (OERs)

With the onset of COVID-19, colleges and universities moved to emergency remote teaching, and instructors immediately adjusted their curricula. Many instructors adapted or developed new online lessons that they subsequently published as Open Educational Resources (OERs). While much has been examined related to how entire course designs evolved during this period, the same attention has not been paid to how individual lessons were structured to meet online learners’ needs. As such, we evaluated OER lessons for the integration of universal design for learning (UDL) guidelines and active learning strategies. We evaluated OER lessons published in CourseSource, which is an open-access, peer-reviewed journal that focuses on biology lessons implemented in undergraduate classrooms and provides the necessary details and supporting materials to replicate the lesson. We found that biology instructors used a variety of UDL guidelines and active learning strategies to encourage student learning and engagement in online teaching environments. This study also provides a collection of OER online lessons that instructors and educational developers can use to inform the practice of engaging biology students.

The Mindful Interactions (MI) tool: promoting student mental health in tertiary education

This conceptual paper introduces the Mindful Interactions (MI) tool designed to enable university teaching academics to promote student mental health and in so doing, impact positively on academic outcomes. The MI tool is comprised of three elements: understandings to provide theoretical guidance which inform pedagogy, practices to provide strategies for translating theory into practice, and guiding principles which provide a catalyst for critical reflexion, challenge existing beliefs, and create a shared vision from which to work. Relationships are at its core, acknowledging that university students report teacher-student relationships as key to their mental health. Issues related to university student mental health, of which psychological distress is an important component, have been well documented and exacerbated since the onset of COVID-19, increasing demands on universities to meet student mental health needs. It is contended in this paper that understanding the causes of psychological distress, particularly in relation to Adverse Childhood Experiences, offers an alternative lens through which to view student mental health. This lens suggests additional ways of thinking about how university teaching academics and universities might proactively respond to student mental health needs. Cultural Historical Activity Theory informed the theoretical framework for the study, whilst two ‘approaches’ (the ‘Three Pillars of Trauma-informed Care’ and ‘Trust Based Relational Intervention’) along with associated trauma literature underpinned the development of the MI tool.

Interrelation of plasma haemostasis and heart rate variability in patients with chronic coronary syndrome in combination with COVID-19

The aim of the study was to identify the relationship between activated partial thromboplastin time, prothrombin time, fibrinogen, D-dimer and indicators of N-N interval deviations, heart rate, on the one hand, and to identify the relationship between parasympathetic and sympathetic heart rate activity and dynamic blood viscosity, on the other hand. The COVID-19 pathogen affects the functioning of the parasympathetic and sympathetic nervous systems, which also changes the heart rate. To study this process, a group of 10 patients with chronic coronary syndrome in combination with COVID-19 without comorbidities aged 35-48 years was observed in a hospital. To study this relationship, plasma haemostasis parameters (activated partial thromboplastin time, prothrombin time, fibrinogen, D-dimer) and heart rate variability were taken at the time of admission to the hospital and after discharge from the hospital. A direct correlation between the indicators was found: in patients 1 and 4, at the time of admission to the hospital, there was an increase in activated partial thromboplastin time, prothrombin time, D-dimer and a decrease in fibrinogen, which coincides with an increase in heart rate, 5-10 minute and long-term deviation of the N-N segments. That is, changes in blood plasma affect the rhythm of the heart already at the onset of COVID-19 in combination with chronic coronary syndrome. Patients 1 and 4 had an increase in D-dimer at the time of discharge from the hospital, which coincided with an increase in heart rate. Patients require further follow-up, as these are signs of a cautious prognosis. All other plasma haemostasis parameters are normal in all patients, with minor changes. It is necessary to monitor plasma haemostasis and heart rate variability to adjust treatment during hospitalization of patients with chronic coronary syndrome in combination with COVID-19 and after discharge from hospital

No more government-imposed societal-level COVID-19 control measures but still significant self-experienced burden for severely immunocompromised individuals – A cross-sectional survey in the Netherlands

ObjectivesIn March 2023, all societal-level COVID-19 control measures were lifted by the Dutch government. This study was performed to understand the self-experienced burden of this new phase of COVID-19 on the perspectives and behaviors of severely immunocompromised individuals. MethodsThis is an observational, descriptive, cross-sectional study in The Netherlands. An online survey was completed by severely immunocompromised individuals, to capture their general well-being (score from 1 = worst to 10 = best), mental and physical health, and daily and social activities during survey conduct and retrospectively for before onset of COVID-19. The survey was open for completion from May 24th until August 7nd, 2023. ResultsOf the 236 respondents, 96.6 % had been vaccinated against COVID-19 and 24.6 % were shielding to avoid COVID-19 during survey conduct. The general well-being score for all respondents was 7.5 (±1.2 SD) before onset of the COVID-19 pandemic and 6.9 (±1.6 SD) during survey conduct (P<0.001). For the shielding group (n = 58), these scores were 7.6 (±1.0 SD) and 5.7 (±1.6 SD), respectively (P<0.001). Generally, for all questions about mental and physical health and daily and social activities, there was a trend towards more negative answers during survey conduct, compared with before onset of the COVID-19 pandemic, which was more pronounced for the shielding group. ConclusionsDespite absence of government-imposed societal measures, COVID-19 avoidance still had a self-experienced burden on perspectives and behaviors of immunocompromised individuals in The Netherlands, with a significantly lower general well-being during survey conduct, compared with before onset of COVID-19.

A cohort study of engagement in telehealth psychotherapy versus in-person services

Objective Although telehealth psychotherapies have been studied for over 20 years, mental health services remained largely delivered in person until the COVID-19 pandemic forced clinics to reconsider the utility of telehealth psychotherapy. This study aims to compare patient engagement in in-person versus telehealth services in outpatient psychotherapy for mood and anxiety disorders. Method A cohort investigation was conducted, using a propensity score matched sample, extracted from an electronic health record (EHR) to compare engagement in psychotherapy for 762 patients who used in-person services before the pandemic to a cohort of 762 patients who used telehealth psychotherapy after the onset of COVID-19. The authors compared cohorts on initial engagement in psychotherapy services following an initial intake, number of psychotherapy sessions attended, and the rate of missed sessions. Results There was a 26% increase in the total number of individual psychotherapy sessions attended when the clinics transitioned to telehealth services (p < .001). In addition, patients who received telehealth psychotherapy were five times more likely to not cancel or miss any scheduled sessions (p < .001). Conclusion These results indicate that telehealth services may result in improved treatment engagement for outpatient centers focused on brief evidence-based psychotherapies for mood and anxiety disorders.

"We're Not Valued, We're Not Heard": Voices of Seasoned Nurses in a Rural State Following the Onset of COVID-19.

The COVID-19 crisis shone a spotlight on long-standing issues in the nursing profession. Currently, nurses feel overworked, unsupported, and undervalued. This interpretive phenomenological study shares the perspectives of 10 seasoned nurses. The overarching theme is "My job doesn't love me back," supported by "Enough pizza already," "Band-Aid on a hemorrhage," "We were heroes and now no one remembers us," "We used to be so trusted," and "Nursing is psychological warfare." It is imperative that systems and leaders listen to the concerns of nurses and provide avenues for nurses to take action to collaborate and convene organizational culture change.