Post-pandemic Periods Research Articles

Surgical Challenges During the COVID-19 Crisis: A Comparative Study of Inguinal Hernia Treatment in Romania

Background and Objectives: The COVID-19 pandemic disrupted healthcare systems worldwide, leading to the postponement of elective surgeries, including inguinal hernia repair (IHR), as healthcare resources prioritized critical care. This study aims to evaluate the impact of the pandemic on the incidence and outcomes of IHR procedures. Materials and Methods: A retrospective review was conducted on 604 patients who underwent IHR over six years, spanning pre-pandemic, pandemic, and post-pandemic periods. Data on patient demographics, type of surgical procedure (elective or emergency), use of mesh, surgical duration, hospitalization period, and postoperative outcomes were analyzed across the three time frames. Results: Patient age remained consistent across the three periods, but a significant increase in female patients was observed during and after the pandemic (p < 0.001). Elective IHR surgeries significantly decreased during the pandemic (p < 0.001), paralleled by an increase in emergency cases (p = 0.004). In the post-pandemic period, elective surgeries rebounded, while emergency interventions declined (21.9% vs. 10.3%). Mesh repair usage increased notably in the post-pandemic phase (p < 0.001). Although surgeries took longer during the pandemic (p < 0.001), both total and postoperative hospital stays were reduced during and after the pandemic (p < 0.001). Minimal postoperative complications were reported throughout, with only one mortality during the pandemic. Conclusions: This study highlights the need for robust healthcare strategies to maintain elective surgical care during global crises, as delays in IHR may elevate risks for complications like hernia incarceration and strangulation.

C→U transition biases in SARS-CoV-2: still rampant 4 years from the start of the COVID-19 pandemic.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the pandemic and post-pandemic periods has shown a remarkable capacity to adapt and evade human immune responses and increase its human-to-human transmissibility. The genome of SARS-CoV-2 is also increasingly scarred by the effects of multiple C→U mutations from host genome editing as a cellular defense mechanism akin to restriction factors for retroviruses. Through the analysis of large data sets of SARS-CoV-2 isolate sequences collected throughout the pandemic period and beyond, we show that C→U transitions have driven a base compositional change over time amounting to a net loss of C bases and accumulation of U's at a rate of approximately 0.2%-0.25%/decade. Most C→U substitutions occurred in the absence of the preferred upstream-base context or targeting of unpaired RNA bases previously associated with the host RNA editing protein, APOBEC 3A. The analyses provide a series of testable hypotheses that can be experimentally investigated in the future.

Impact of Noncommunicable Diseases on Years of Life Lost in FB&H During the COVID-19 Pandemic

Abstract This study aims to comprehensively investigate the impact of noncommunicable diseases (NCDs) on years of life lost (YLL) within the Federation of Bosnia and Herzegovina (FB&H) across distinct phases: pre-pandemic, pandemic, and post-pandemic periods. Given that NCDs currently represent more than half of the global disease burden, our focus lies in assessing YLL specifically for cerebral infarction (I63-I64) and diabetes mellitus (E10-E14). Conducting a retrospective data analysis, we utilized mortality data sourced from the Institute for Statistics of FB&H to quantify YLL. This assessment involved multiplying age-specific mortality figures by the remaining life expectancy at the corresponding age, utilizing the GBD 2019 life expectancy table. Examining the period between 2019 and 2022, our analysis aimed to elucidate the pandemic’s potential influence on NCD burden, through the examination of age-standardized YLL rates based on the world standard population. In 2019, YLL attributable to I63-I64 for both sexes totaled 41,244 in 2019, escalating to 44,790 in 2020, and subsequently decreasing to 39,439 and 32,055 in the pandemic years of 2021 and 2022, respectively. For diabetes mellitus (E10-E14), YLL in 2019 amounted to 23,675, with figures for 2020, 2021, and 2022 standing retrospectively at 24,329, 24,114, 19,125. The increase in 2020 may be attributed, in part, to initial healthcare hesitancy during the pandemic’s onset, leading to delayed treatment and heightened mortality rates. Furthermore, patients who died in 2020 from C-19 without being tested may have skewed mortality registration by inflating rates attributed to pre-existing conditions. The declining rates thereafter could be due to a harvesting pandemic effect, in that people who were previously ill died prematurely from C-19. These insights show the pandemic’s profound impact on NCD-related mortality, underscoring the urgent need for targeted interventions and healthcare strategies. Key messages • A substantial reduction in years of life lost (YLL) related to certain noncommunicable diseases was observed during the pandemic. • The pandemic significantly influenced mortality among individuals with noncommunicable diseases, driven partly by healthcare hesitancy and potential misregistration of causes of death.

Variation in health and well-being parameters: cross-country and temporal aspects

BACKGROUND: The coronavirus epidemic has stimulated large-scale structural and socio-economic changes throughout the world and led to increased attention to the problem of health in general. But has the epidemic affected the change in the attitude of people of different ages to their health, the perception of various parameters of subjective well-being? The article presents a comparative analysis of a number of assessments (about the level of happiness, satisfaction with income, healthcare, safety, communication, life, attitude towards people, etc.) of respondents from Europe and Central Asia for the period 2006–2021. AIM: The goal is to assess changes that have occurred over a 15-year time interval in relation to health and social determinants of well-being, to determine possible directions for changing the current situation. METHODS: To achieve this goal, the results of the tenth wave of the international comparative European Social Survey, conducted in 2021 (32 countries), were used in comparison with data from the third wave, conducted in 2006 (25 countries). The impact of the pandemic on the health of children and adolescents aged 11–15 years was based on materials from the international Health Behavior in School-Aged Children 2021–2022 in 44 countries in Europe and Central Asia. RESULTS: Despite the difficulties, dictated by the coronavirus, over the period 2006–2021 in most European countries stability in the perception of the world of work and the healthcare institution has been maintained, the psychological situation related to the safety of living has improved, and life satisfaction has increased. According to most of the parameters considered, Russians are outsiders among European countries; however, Russians’ responses to 7 indicators of health and well-being (out of 12) show positive changes. The results of studies of the health of children and adolescents during the pandemic and post-pandemic periods indicate significant negative consequences, mainly related to mental health. CONCLUSION: It is necessary to increase the attention of Russian government bodies to the health and well-being of Russians, first of all, to children and adolescents.

Assessing the Risk of Tuberculosis Relapse Development during the Period of Stabilization of the COVID-19 Epidemic

The objective: to evaluate risk factors for tuberculosis relapse development during stabilization of the COVID-19 situation.Subjects and Methods. 165 patients over 18 years of age were enrolled in the observational comparative study, those patients were followed up due to respiratory tuberculosis relapses in 2021-2023. Risk factors for early and late relapses that occurred during the pandemic (2021-2022) and post-pandemic (2023) periods were analyzed. They included age, gender, accommodation, social status, imprisonment, smoking, alcohol and substances abuse, comorbidities, clinical forms of tuberculosis, presence of cavities, bacterial excretion, and drug resistance of Mycobacterium tuberculosis.Results. The data obtained confirmed the assumption that the COVID-19 pandemic had led to changes in social and medical-biological risk factors for tuberculosis relapse.

Post-pandemic consumption of outpatient antibiotics in Switzerland up to pre-pandemic levels, 2018–2023: An interrupted time series analysis

BackgroundThe COVID-19 pandemic has been a challenge for health-care systems and antibiotic stewards as uncertainty regarding treatment and bacterial coinfections raised concern. MethodsThis retrospective observational study examined the association of the pandemic on outpatient antibiotic sales and prescriptions in Switzerland using interrupted time series (ITS) analyses. Data from IQVIA™ and the Sentinella Network were used to analyze antibiotic consumption and prescription patterns over a 72-month period from January 2018 to December 2023, divided into pre-pandemic, pandemic, and post-pandemic periods. ResultsAntibiotic consumption decreased during the pandemic and returned to pre-pandemic levels in the post-pandemic period. A decrease in level was most pronounced in the French-speaking region (−2.82 defined daily doses per 1,000 inhabitants per day (DID) per month, 95 %CI [−4.34, −1.30], p < 0.001) and the Italian-speaking region (−2.80 DID per month, 95 %CI [−4.78, −0.82], p < 0.01), followed by the German-speaking region (−1.72 DID per month, 95 %CI [−2.71, −0.74], p < 0.01). Similarly, in the ITS, the relative change of model estimates in antibiotic prescriptions by GPs and pediatricians for upper respiratory tract infections, was of −36.0 % and −50.3 % resp. in the pandemic period and +10.1 % and −2.6 % in the post-pandemic period compared with the pre-pandemic period. ConclusionsA decrease of antibiotic prescriptions was observed in GPs and pediatricians during the COVID-19 pandemic, followed by a return to pre-pandemic levels. The patterns in antibiotic prescriptions aligned with the epidemiology of respiratory infections and demonstrated a pronounced association with the implementation and subsequent removal of non-pharmaceutical interventions.

Unveiling asymmetric return spillovers with portfolio implications among Indian stock sectors during Covid-19 pandemic

This paper aims to provide a systematic inquiry into the return spillover dynamics between a network of Indian sectoral indices during the pre- and post-pandemic periods. To analyze the same, this paper uses the asymmetric time-varying parameter vector autoregressions (TVP-VAR) framework. Furthermore, in the spirit of Broadstock et al. (2020), we perform dynamic portfolio exercises based on common hedging techniques and the minimum connectedness portfolio approach to determine what better captures asymmetry. Our daily dataset includes 12 sectoral stocks spanning from January 01, 2017, to May 5, 2023. The findings reveal that negative connectedness dominates throughout the sample period, demonstrating that profit-maximizing agents and risk-averse investors are more likely to react negatively to news. We also show that in the network, the average net transmitters are the banking and other financial service sectors, whereas the net receivers are the information technology, pharmaceutical, and fast-moving consumer goods sectors throughout the period under consideration. Our results show that the minimum connectedness portfolio (MCoP) approach is a very useful method based on Sharpe ratios, as it is either the first or second most profitable among these three competing methods. These results, therefore, yield valuable insights for policymakers and investors

Was receipt of any specialty alcohol treatment during the pandemic effective at reducing drinking for patients with or at risk of AUD?

IntroductionThe COVID-19 pandemic changed the way healthcare providers delivered most health services, including treatment for alcohol use disorder (AUD). Specialty alcohol treatment remained available through the pandemic, and within some systems treatment use increased likely due to telehealth availability. However, the field knows little about the relationship between the pandemic's expanded access to specialty alcohol treatment and alcohol use outcomes. MethodsThe sample included 14,712 patients from Kaiser Permanente Northern California who screened positive for unhealthy alcohol use in primary care and had an AUD diagnosis or risked developing an AUD by reporting 5 or more heavy drinking days in a 3-month period between 1/1/2019 and 2/29/2020 (pre-pandemic). The study examined the receipt of any specialty alcohol treatment (including at least one outpatient, inpatient, or telehealth specialty treatment encounter, or pharmacotherapy prescription) from 3/1/2020 (pandemic start) to either the first completed follow-up alcohol screening or 6/20/2022 (study period end). The outcomes of alcohol use included changes in heavy drinking days, drinks per week, drinking days per week, and drinks per drinking day between the pre- and post-pandemic periods. ResultsOn average patients significantly decreased alcohol use across all four alcohol use measures examined, regardless of whether they received treatment. However, those who received any treatment compared to those who did not have greater reductions in alcohol use, with an additional decrease of −3.55 heavy drinking days (95 % CI = −5.93, −1.17), −3.80 drinks per week (95 % CI = −5.18, −2.42), −0.72 drinks per drinking day (95 % CI = −1.14, −0.30), and − 1.01 drinking days per week (95 % CI = −1.30, −0.72). Treatment effects were greatest among patients who exceeded both daily and weekly limits pre-pandemic, with an additional decrease of −10.75 heavy drinking days (95 % CI = −15.28, −6.21), −12.83 drinks per week (95 % CI = −16.31, −9.35), −1.67 drinks per drinking day (95 % CI = −2.19, −1.14), and −2.02 drinking days per week (95 % CI = −2.41, −1.63). ConclusionsOn average, patients decreased alcohol use during the onset of the pandemic, however, those who had any specialty alcohol treatment had significantly greater decreases, suggesting that the hybrid in-person and telehealth treatment approach was effective during the pandemic.

Beyond the screen: a comparative study of the student's perception of online education effectiveness in pre- and post-pandemic times

This research was carried out to compare the effectiveness of online education in pre- and post-pandemic periods as perceived by the students of higher education institutions in developing countries facing financial and technological limitations. For this purpose, time-lagged data from 288 students of higher education institutions were collected and analysed in SPSS version 26 using the paired sample t-test for differences. Using adapted questionnaires, the effectiveness of online education was assessed in terms of blended learning, goal setting, interaction, time management, self-evaluation, learning environment, skills to use online learning tools, quality of learning technologies, and learning motivation. Results indicate that students' perception significantly differs during the pandemic compared to the pre-pandemic period, compared to all dimensions of online education. It was found that the students, teachers, and institutions have acquired the requisite knowledge, skills, and technology during the pandemic. Therefore, the usefulness of online education has improved in the post-pandemic period. These results significantly affect all stakeholders, including students, teachers, researchers, institutions, and policymakers. The study suggests continuing blended learning systems in higher education institutions to ensure extended access to equitable education and the sustainability of online learning practices.

Temporal Volatility of Brent Oil Prices and Interrelation With Maritime Traffic Density in the Turkish Straits During COVID-19 Crisis

This research evaluated variations in Brent oil prices and the interrelation with maritime traffic density in the Turkish Straits during the COVID-19 pandemic. The number of commercial ships that made non-stop over passage through the Turkish Straits in the last 5 years, covering the COVID-19 -and post-pandemic periods with economic instabilities was investigated along with variables of vessel characteristics such as; gross tonnage, size and type of vessel loads. Results of the present study reveal that the maritime traffic density between 2019 and 2023, was influenced by the pandemic crisis, when harsh quarantine measures of lockdown and curfews in the first shock wave. In the aftermath, conflicts between Ukraine and Russia led to economic recession or upheaval with instabilities in Brent oil prices. For the period examined in this study, the number of non-stop over passage vessels and gross tonnages used the Turkish Straits were affected by the pandemic outbreak and Brent oil price variations. The number of vessels decreased by 5.22% from 84,871 to 80,440 during the epidemic in 2020, and by 5.38% from 43.342 to 42.340 during the global recession in 2022. Overall, the number of non-stop over passage vessels using the Turkish Straits between 2019 and 2023 declined by 1.15%, while the gross tonnage and ship length increased by 3.44% and 13.24%, respectively. In total, the number of non-specific tankers (TTA) and those carrying chemicals (TCH) increased by 2.92% and 10.97%, respectively, but a 13.25% decrease was noted for the liquefied petroleum gas (LPG) tankers over the 5 years. Considering that the world trade network is largely dependent on maritime transportation, identifying the changes in maritime transportation with the interrelation of Brent oil during global crises may provide important data for strategy building of best trade management with foresights to world economic crises.

It Is Time to Take Complaints Seriously? An Exploratory Analysis of Communications Sent by Users to a Public Healthcare Agency before, during and after the COVID-19 Pandemic

Taking due account of users’ perspectives is crucial for improving the quality of healthcare services. This study aimed to analyse the representations and evaluation criteria that users of a public health agency express towards care and treatment services and to explore whether and how the content and meaning of their communications varied according to pre-pandemic, pandemic or post-pandemic periods. A total of 501 communications sent to the public relations office of an Italian health agency were collected. An automatic content analysis procedure was applied to the textual corpus. Four main thematic cores were identified concerning the request for care and respect, the value of the doctor–patient relationship and the difficulties in contacting services and accessing care. Two main latent dimensions of meaning were identified, which capture the dialectic between the demand for relationships and the demand for access to care, and between attention to the relational competence of health workers and attention to the needs and rights of users. Communications collected during the pre-pandemic and post-pandemic periods mainly concern the difficulty of access to care; those collected during the pandemic period mainly concern the doctor–patient relationship. Interpersonal aspects and timely access to care appear to be crucial in users’ assessment of the quality of care.

Trends in hospitalisations for lower respiratory infections after the COVID-19 pandemic in France

We aimed to evaluate the impact of the pandemic and post-pandemic periods on hospital admissions for LRTI, with a focus on patients with chronic respiratory disease (CRD). From July 2013 to June 2023, monthly numbers of adult hospitalisations for LRTI (excluding SARS-CoV-2) were extracted from the French National Hospital Discharge Database. They were modelled by regressions with autocorrelated errors. Three periods were defined: (1) early pandemic and successive lockdowns; (2) gradual lifting of restrictions and widespread SARS-CoV-2 vaccination; (3) withdrawal of restriction measures. Pre-pandemic incidence was 96 (90.5 to 101.5) per 100,000 population. Compared with the pre-pandemic period, no more seasonality and significant reductions were estimated in the first two periods: -43.64% (-50.11 to -37.17) and -32.97% (-39.88 to -26.05), respectively. A rebound with a positive trend and a seasonal pattern was observed in period 3. Similar results were observed for CRD patients with no significant difference with pre-pandemic levels in the last period (-9.21%; -20.9% to 1.67%), albeit with differential changes according to the type of CRD. COVID-19 pandemic containment measures contributed to changes in LRTI incidence, with a rapid increase and return to a seasonal pattern after their lifting, particularly in patients with CRD.

Eating Disorders in Children, Adolescents, and Young Adults During and After the COVID-19 Pandemic: ADanishNationwide Register-Based Study.

To assess incidence rates of clinically diagnosed eating disorders among Danish youth before, during, and after the COVID-19 pandemic. This study used a population-based time series analysis with individual-level data from Danish healthcare registries. Participants included all Danish individuals aged 6-24 years from January 1, 2015, to December 31, 2023. Monthly incident cases of any eating disorder, anorexia nervosa, and bulimia nervosa were analyzed using interrupted time-series analysis. We estimated the cumulative number of excess cases of incident eating disorder diagnoses and risk ratios (RR) associated with the pandemic and post-pandemic periods compared with pre-pandemic predictions. The study population encountered a mean of 1,310,542 individuals during the study period. The study included 11,693 individuals diagnosed with an eating disorder, median age 17 (IQR 14-20 years). Incident cases increased during the pandemic (RR 1.29, 95% CI 1.15-1.45) and normalized post-pandemic (RR 1.07, 95% CI 0.91-1.25) compared with pre-pandemic predictions. Similar patterns were seen for anorexia and bulimia. Increases were significant for ages 13-16 (RR 1.19, 95% CI 1.02-1.38), 17-19 (RR 1.51, 95% CI 1.25-1.83), and 20-24 (RR 1.35, 95% CI 1.12-1.64). Post-pandemically, a continued increase was observed only for ages 20-24 (RR 1.32, 95% CI 1.02-1.71). The study documents a temporary increase in diagnosed eating disorders among Danish youths during the COVID-19 pandemic, with rates later returning to pre-pandemic levels. These results provide insights into the pandemic's impact on adolescents and youths.

Depressive symptoms and suicidal ideation among university students before and after the COVID-19 pandemic

BackgroundThe COVID-19 pandemic and lockdown have had negative effects on students' mental health. However, little information is available regarding the frequencies of depressive symptoms and suicidal ideation during the post-pandemic period. We aimed to determine the effect of the COVID-19 pandemic on depressive symptoms and suicidal ideation among French university students. MethodsIn this comparative study, 4463 students were recruited during the pre-COVID-19 pandemic period (2013-2020) and 1768 students, during the post-COVID-19 pandemic period (2022-2023). Standardized frequencies of depressive symptoms and suicidal ideation were compared between the two time periods. Changes in the level of depressive symptoms and suicidal ideation between the pre- and post-pandemic periods, were then analyzed using interrupted time series analysis. ResultsCompared to participants from the pre-pandemic sample, participants from the post-pandemic sample had higher standardized rates of depressive symptoms (40.6 % vs 25.6 %) and suicidal ideation (29.3 % vs 21.1 %). Segmented logistic regression showed an about 50 % increased risk of depressive symptoms (aOR, 1.47; 95 % CI, 1.01–2.13) and a 100 % increased risk of suicidal ideation (aOR, 2.00; 95 % CI, 1.33–3.00) in the post-pandemic period. Before the pandemic, there was no significant time-trend for depressive symptoms (aOR, 1.002; 95 % CI, 0.999–1.006) and suicidal thoughts (0.999–1.006; aOR, 0.999; 95 % CI, 0.995–1.002). LimitationsPotential biases related to self-selection of participants in the study and information bias. History of depression and suicide attempt were self-reported. ConclusionsThese findings reveal an alarming deterioration of students' mental health in the post-pandemic period compared to the pre-pandemic era.

Six-year (2016-2022) longitudinal patterns of mental health service utilization rates among children developmentally vulnerable in kindergarten and the COVID-19 pandemic disruption.

In the context of the COVID-19 pandemic, it becomes important to comprehend service utilization patterns and evaluate disparities in mental health-related service access among children. This study uses administrative health records to investigate the association between early developmental vulnerability and healthcare utilization among children in Alberta, Canada from 2016 to 2022. Children who participated in the 2016 Early Development Instrument (EDI) assessment and were covered by public Alberta health insurance were included (N = 23 494). Linear regression models were employed to investigate the association between service utilization and vulnerability and biological sex. Separate models were used to assess vulnerability specific to each developmental domain and vulnerability across multiple domains. The service utilization was compared between pre- and post-pandemic onset periods. The analysis reveals a significant decrease in all health services utilization from 2016 to 2019, followed by an increase until 2022. Vulnerable children had, on average, more events than non-vulnerable children. There was a consistent linear increase in mental health-related utilization from 2016 to 2022, with male children consistently experiencing higher utilization rates than females, particularly among vulnerable children. Specifically, there was a consistent linear increase in the utilization of anxiety-related services by children from 2016 to 2022, with females having, on average, 25 more events than males. The utilization of ADHD-related services showed different patterns for each group, with vulnerable male children having more utilization than their peers. Utilizing population-wide data, our study reveals sex specific developmental vulnerabilities and its impact on children's mental health service utilization during the COVID-19 pandemic, contributing to the existing literature. With data from kindergarten, we emphasize the need for early and targeted intervention strategies, especially for at-risk children, offering a path to reduce the burden of childhood mental health disorders.

Unveiling BTX dynamics, source identification, and health implications during COVID-19 lockdown

The COVID-19 pandemic of 2020, marked by stringent lockdowns and reduced human activity, resulted in a significant decrease in air pollutant emissions. This study investigates the impact of these altered atmospheric conditions on human health by focusing on Volatile Organic Compounds (VOCs) such as benzene, toluene, and meta-xylene (BTX), comparing data from before, during, and after the pandemic lockdowns. The objectives were to assess changes in Total VOC (TVOC) concentrations and to evaluate the associated health risks, particularly Lifetime Cancer Risk (LCR) from benzene exposure. Analysis of the data revealed a notable reduction in TVOCs during the 2020 lockdown, with average concentrations of 12.15 ± 20.49 µg/m3 in 2019, 8.08 ± 5.50 µg/m3 in 2020, and 5.12 ± 7.56 µg/m3 in 2021. LCR values also fluctuated, with averages of 1.12 × 10−5, 1.23 × 10−5, and 6.91 × 10−6 or pre-pandemic, during-pandemic, and post-pandemic periods, respectively. The findings highlight the potential effectiveness of lockdowns in reducing air pollution and underscore the need for continued, targeted environmental policies to improve public health.

Long-term effects of COVID-19 pandemic on physical activity and eating behaviour of the Italian population: a longitudinal study.

Restrictive measures due to the Covid-19 pandemic strongly impacted lifestyle and daily behaviour. The purpose of this longitudinal retrospective study was to investigate short-term and long-term effects of Covid-19 pandemic on physical activity and eating habits of the Italian population investigating three time periods: pre-, during- and post-lockdown. A sample of 2773 adults recruited through social media provided data by an online survey administered from July to October 2023. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Mediterranean Diet Adherence Screener (MEDAS) and provided information about eating habits, socio-demographic and anthropometric characteristics. There was a significant increase (p < 0.001) in mean BMI from pre-pandemic period (24.53 ± 5.34 Kg/m2) to post-pandemic period (25.22 ± 6.0 Kg/m2). Physical Activity significantly decreased during the pandemic period compared to the pre-pandemic period (χ² = 271.97; p < 0.001; φ = 0.31) with an increase in inactive subjects from 25.7% to 52.8%. In the post pandemic period, there was an increase in the level of Physical Activity compared to the pandemic period (χ² = 413.61; p < 0.001; φ = 0.39) with a reduction of inactive subjects from 52.8% to 25.6%. Adherence to Mediterranean Diet score significantly (p < 0.001) increase from pre-pandemic (7.18 ± 1.58) to during-pandemic (7.29 ± 1.69) and post-pandemic (7.75 ± 1.63) periods with significant differences emerged in the consumption of single MEDAS items during the pandemic period by different BMI classes. Consumption of seasonal fruit and vegetables, water intake, the preparation/consumption of traditional or local dishes and the time dedicated for dinner and lunch significant increase (p < 0.001) during pandemic. The Covid-19 pandemic changed people's lifestyles, but in different ways for Physical Activity and diet. During the pandemic there was a negative effect for PA that decreased while the time spent sitting increased. This seems to be a temporary effect as, after the end of the phase of mandatory restrictions, it returns to the original level. The lockdown period improved the quality of the Italian population's eating habits, with an increase in adherence to the Mediterranean diet even after the end of the pandemic showing a rediscovery of traditional dishes, increase in consumption of seasonal products, greater preference for local products and more time spent preparing meals.

The Concept of Health Debt Incurred during the COVID-19 Pandemic on the Example of Basal Cell Skin Cancer Diagnosis in Lower Silesia.

Introduction: This study explores the impact of the COVID-19 pandemic on the diagnosis of basal cell carcinoma (BCC) in Lower Silesia, Poland, comparing pre-pandemic, pandemic, and post-pandemic periods. It investigates how different medical facilities adapted to the pandemic's challenges and the subsequent implications for cancer diagnosis. Methods: Data from histopathology and cytology laboratories were analyzed, focusing on BCC diagnoses from 2018 to 2022. This study included various medical centers categorized by size and source of implementation. Statistical analyses were conducted to compare diagnoses before, during, and after the pandemic. Results: During the initial wave of the pandemic, there was a significant reduction in newly diagnosed BCC cases, followed by a surge post-pandemic. Larger medical centers adapted more effectively, while district hospitals faced challenges. Private practices maintained stable diagnosis rates. The increase in diagnoses post-pandemic suggests a backlog of undiagnosed cases during the pandemic. Discussion: Challenges in accessing healthcare during the pandemic led to delayed cancer diagnoses. Larger medical centers were better equipped to handle the crisis, while district hospitals struggled. Private practices maintained stability, possibly due to pre-scheduled appointments. Recommendations include public education on symptom recognition and standardizing histopathological evaluation protocols. Conclusions: Despite data limitations, this study provides valuable insights into the pandemic's impact on cancer diagnosis, highlighting the need for proactive measures in future health crises to ensure timely detection and treatment of cancer cases.

In-hospital cardiac arrest survival before and after the COVID-19 pandemic: Have higher performing hospitals stayed high-performing?

BackgroundSurvival for in-hospital cardiac arrest (IHCA) has declined since the COVID-19 pandemic. Because the burden of COVID-19 was uneven throughout the U.S., it remains unknown if top-performer hospitals in IHCA survival have remained top-performers since the pandemic. MethodsWithin Get With The Guidelines®-Resuscitation, we identified hospitals with at least 2 years of registry participation pre-pandemic (2017–2019) and post-pandemic (July 2020–2022) and with at least 20 IHCA cases in both periods. Using multivariable hierarchical models with hospital as a random effect and adjusting for patient and arrest characteristics, we calculated risk-standardized survival rates to discharge (RSSR) for IHCA at each hospital during the pre- and post-pandemic periods. We then assessed the correlation between a hospital’s pre-pandemic and post-pandemic RSSR for IHCA, and whether the correlation differed by the proportion of Black or Hispanic IHCA patients at each hospital. ResultsA total of 243 hospitals were included, comprising 122,561 IHCAs (pre-pandemic: 57,601; post-pandemic: 64,960). Pre-pandemic, the mean RSSR was 26.8% (SD, 5.2%) whereas the mean RSSR post-pandemic was 21.7% (SD, 5.5%). There was good correlation between a hospital’s pre- and post-pandemic RSSR: correlation of 0.55. When hospitals were categorized into tertiles based on the proportion of their IHCA patients who were Black or Hispanic, this correlation remained similar: 0.48, 0.68, and 0.45 (interaction P-value: 0.69) for hospitals in the upper, middle and lower tertiles, respectively. ConclusionAlthough the COVID-19 pandemic affected the U.S. unevenly, there was good correlation in a hospital’s performance for IHCA survival before and after the pandemic, even at hospitals caring for a larger proportion of Black and Hispanic patients. Future studies are needed to understand what characteristics of high-performing hospitals pre-pandemic allowed many to continue to excel in the post-pandemic period.

Parental vaccine hesitancy and influenza vaccine type preferences during and after the COVID-19 Pandemic

BackgroundSeasonal influenza vaccine (SIV) greatly reduces disease burden among school-aged children, yet parental vaccine hesitancy remains a persistent challenge. Two types of SIV are available for children in Hong Kong and other locations: inactivated influenza vaccine (IIV), administered through intramuscular injection, and live attenuated influenza vaccine (LAIV), administered via nasal spray. We aimed to understand how vaccine hesitancy shaped parental preference for LAIV versus IIV, particularly amidst important public health events, such as the COVID-19 pandemic and the massive rollout of COVID-19 vaccination campaigns.MethodsWe employed a concurrent mixed-methods design. The quantitative part involves longitudinal surveys spanning three years, from pre-pandemic to post-pandemic periods, tracking parental vaccine hesitancy and preference for SIV types. The qualitative part involves 48 in-depth interviews, providing insights into parental preference for SIV types, underlying reasons, and related values.ResultsOur quantitative analyses show an overall increase in parental vaccine hesitancy and preference for LAIV over IIV after the onset of the COVID-19 pandemic and especially after the rollout of the COVID-19 vaccination campaign. Further logistic regression modelling based on the cohort data shows that higher vaccine hesitancy, coupled with the COVID-19 vaccination campaign rollout, predicts a greater preference for LAIV over IIV. The qualitative analysis complements these results, highlighting that LAIV’s non-invasive nature aligns with parental values of prioritizing natural immunity and concerns about overmedication, leading to a more acceptable attitude towards LAIV.ConclusionsLeveraging the higher acceptability of LAIV compared to IIV among parents with high vaccine hesitancy could promote childhood vaccination uptake.