Second Wave Of COVID-19 Pandemic Research Articles

Positive mental health, depression and burnout in healthcare workers during the second wave of COVID-19 pandemic.

INTRODUCTION: Few studies focused on healthcare workers' positive mental health (i.e. high levels of psychological well-being) and its association with anxiety, depression and burnout in the second wave of the pandemic. To evaluate the protective role of well-being in buffering burnout and psychological distress. We evaluated 173 Italian healthcare workers with indicators of psychological distress (Depression Anxiety Stress Scales [DASS]-21), burnout (Copenhagen Burnout Inventory [CBI]) and positive mental health (Mental Health Continuum) and we cross-classified them according to their levels of mental health (flourishing, languishing and moderate mental health) and their levels of anxiety, depression and burnout. Forty-eight per cent of health workers were classified as flourishing, 10% as languishing and 42% as moderate mental health. Flourishing individuals presented lower scores on DASS and CBI scales, whereas no differences emerged between languishing and moderate mental health groups. More than 80% of health workers with clinically significant symptoms of anxiety, depression and risk of burnout were classified as not flourishing. This investigation documented the presence of flourishing mental health in almost half of the sample of Italian healthcare workers. However, those with moderate or languishing mental health manifested higher levels of anxiety, depression and higher risks of burnout. The study confirms the importance of maintaining and/or promoting the well-being of this population, with a crucial role of mental health nurses who can easily approach other healthcare workers and provide them informational (training, guidelines) and emotional support programmes (psychoeducation, mental health support team, peer support and counselling) when facing adverse working conditions.

Impact of the second wave of COVID-19 pandemic on food security among Ho indigenous community of Jharkhand, India

Abstract Background Food insecurity and hunger are global concerns further exacerbated by the unprecedented COVID-19 pandemic. There is a need to understand the depth of this impact, especially among smallholder farmers, and recognize specific coping strategies that offered resilience to inform preparedness in future. The present cross-sectional study assessed the impact of the second wave of COVID-19 pandemic on different dimensions of food security among smallholder farmers of Ho indigenous community of Jharkhand, India. It also explored potential resilient attributes of their food systems. Results Most of the respondents (67.2%) reported reduced food consumption at the household (HH) level. Majority faced difficulty in accessing food from different food sources; however, easier access to government food security programmes was highlighted. Around 40% reported change in their ability to purchase farming inputs. Market vendors reported disruptions in food procurement owing to travel restrictions; however, no change was reported for home-produced foods in agricultural lands/kitchen gardens. Prices of indigenous foods produced locally decreased/remained same; however, for cereals, pulses, and other HH staples, prices increased during second wave. Difficulty in accessing wild food environment (OR: 1.7, CI 0.40, 7.75), change in food prices (OR: 19.9, CI 5.25, 76.02), decrease in HH income (OR: 9.2, CI 2.99, 28.60) were found to be significantly associated with reduction in HH food consumption (p < 0.01). The coping strategies adopted by the community included sale of cultivated and wild produce in local weekly markets to ensure additional income. Conclusions The findings highlight the need to reinforce the traditional ecological knowledge of the Ho community and focus on practices around their food systems, engrained into their socio-cultural ecosystems that may offer resilience against future stresses. In addition, the need of systemic support to ensure the social and economic well-being of the community needs to be prioritized.

Anxiety and depression affecting Turkish pregnant women during the second wave of COVID-19 pandemic

Anxiety and depression affecting Turkish pregnant women during the second wave of COVID-19 pandemic

Correlation of Resilience, Stress, and Burnout in Doctors and Nurses Working at a Dedicated COVID-19 Hospital during Second Wave of COVID-19 Pandemic

Abstract Introduction: Research conducted during the first wave of COVID-19 in India and world over has highlighted its psychological impact among health-care workers (HCWs), which kindled the current study of the aftermath of the second wave among HCWs. Objectives: The objective was to study the correlation between demographic factors, resilience, burnout, and stress among doctors and nurses working at a dedicated COVID-19 hospital (DCH) during the second wave. Methodology: The DCH doctors (residents and faculty) and nurses willing to participate in the online survey using Google forms were assessed cross-sectionally using a semi-structured questionnaire for demographic factors and psychometric scales – abbreviated Nicholson McBride Resilience Questionnaire, abbreviated Maslach Burnout Inventory, and Perceived Stress Scale-10 to measure resilience, burnout, and stress, respectively. The data were analyzed using Chi-square test and Pearson’s coefficient for correlation. Results: Out of 169 voluntary participants, 24.9% had severe perceived stress, 21% had moderate-to-severe burnout, and 49.7% had exceptional level of resilience. Severe perceived stress was seen in the lower age group (P = 0.018) and more in graduates than in postgraduates (P = 0.044). Moderate-to-severe burnout was seen in unmarried (P = 0.02), in junior doctors (P = 0.021), in those working in intensive care unit, fever clinic, and triage area (P = 0.038), and in those living away from family (P = 0.014). Exceptional level of resilience was statistically significant in nursing staff (P = 0.026). There was a statistically significant correlation between perceived stress and burnout (P < 0.001). Conclusion: The psychological impact of second wave was less among HCWs as compared to the first wave of COVID-19 pandemic.

Ocular surface changes during COVID-19 pandemic among university faculty members with dry eye disease in northern India: A longitudinal study

ObjectiveThe pandemic has brought a paradigm shift in pedagogical modalities throughout the world, with a resultant increase in screen time and ultra-violet light exposure among both students and teachers. The current study was conducted to analyze ocular surface changes in university faculty members with dry eye disease (DED) during the second wave of COVID-19 pandemic in India. MethodsA cross-sectional study was conducted among university faculty members of a medical university in India. An online questionnaire was sent via social media from December 2020 to January 2021, which consisted of questions on demographic details, DED symptoms and use of visual display terminals. All those participants who had DED based on Ocular Surface Disease Index (OSDI) score were followed-up after one month when the pandemic had subsided. ResultsOut of the 150 faculty members in the university, 130 completed the survey (response rate 86.7%). The number of participants with symptomatic DED based on OSDI score was 111 (85.3%). All these participants showed a statistically significant change in subjective measurement of DED symptoms after one month, using OSDI questionnaire. ConclusionDED symptoms increased during the pandemic and there was a statistically significant change in the OSDI scores suggestive of ocular surface damage and a positive relationship with increased digital screen time. The finding has implications as targeted interventions need to be undertaken to mitigate the effects of increased screentime, especially among populations with more duration of near work using digital screens.

Socio-demographic and morbidity patterns of second wave of covid-19 pandemic in Puttur taluk: A cross-sectional study

Introduction and Aim: In March 2020, India reported the first case of COVID-19 and by March 2021, first signs of second wave started across various Indian states which lasted until June. It was important to screen for active cases and their contacts to actively curb the spread of the infection. The aim was to study the demographic and morbidity patterns of the second wave of COVID-19 pandemic in Puttur taluk. Materials and Methods: A cross-sectional study conducted using the data collected during Universal Screening for COVID-19 in Puttur during June–July 2021. Data collected on general condition, symptoms, red flag signs, blood-pressure, GRBS, SpO2, and swabbing for RT-PCR. Results: Total screened were 2859; 1350(47.2%)-males, 1509(52.8%)-females. 59.4% aged <40 years, 79.8% were BPL. 91.9% had no comorbidities, 4.7% hypertensives, 1.4% Diabetics, 1.3% were Diabetic and Hypertensive. 4.1% had cough, fever, body ache, loss of smell or taste. 67.2% had contact history with COVID-19 patient(p<0.05), 1288(45.05%) did not follow any personal protective measures(p<0.05). Swabs taken in 1624(56.8%); subgroup-analysis showed no association between comorbidities and contracting COVID-19(p>0.05). Conclusion: COVID-19 suspects had no association with comorbidity status but only with positive contact history and not following personal protective measures.

The Impact of Mobility Restrictions, Sentiment, and Deaths on the Liquidity and Volatility of LQ 45 Index: A Comparative Study Between the First and the Second Wave of COVID-19 Pandemic

The Impact of Mobility Restrictions, Sentiment, and Deaths on the Liquidity and Volatility of LQ 45 Index: A Comparative Study Between the First and the Second Wave of COVID-19 Pandemic

Assessing the Physical and Psychological Well-being of Construction Workers During the COVID-19 Pandemic: A Prospective Study in Italy.

This prospective study aimed to assess the physical and psychological health of construction workers and examine the relationship between their well-being and the preventive measures implemented against SARS-CoV-2. During occupational visit, the workers were invited to participate the survey. Two measurements were made and compared: after the Italian lockdown and on the second wave of COVID-19 pandemic. Fifty-three workers participated in the study. The percentage of workers who considered themselves in good health increased from 66.0% to 81.1%, and there was a significant decrease in the 12-item General Health Questionnaire score (16.8 vs 14.0, P = 0.0003). This reduction was associated with a higher perception of security by preventive measures. The study highlights the importance of addressing the health and safety concerns of construction workers during the pandemic, and the positive impact of effective preventive measures.

Osteomyelitis of Jaw Bone due to Aspergillosis in Post-COVID-19 Patients: An Observational Study.

In the second wave of COVID-19 pandemic, there has been an increase in number of cases with Post-COVID-19 fungal osteomyelitis of jaws. Aspergillosis was found to be one of the causes of osteomyelitis of jaw bones in these patients. To evaluate the incidence and pattern of osteomyelitis of jaw due to aspergillosis in post-COVID-19 patients and to discuss the management protocol of the same. Data were obtained at our institution from the period of January 2021 to June 2021. Patients of all age groups with Post-COVID-19 osteomyelitis of jaw due to aspergillosis and those with combined aspergillosis and mucormycosis infection were included. Patients having rhino-orbito-cerebral fungal infection were excluded. A total of 47 patients reported to our center. Demographically the average age of the patients was 49.11years with 72% being males. All 47 patients (N = 100%) had received steroids. 21 of them (N = 44.7%) had diabetes mellitus and 14 (N = 29.8%) patients had other comorbidities. Out of 47 patients, 42 (N = 89.7%) patients were diagnosed with aspergillosis and the remaining 5 (N = 10.3%) cases had a mixed fungal infection of mucormycosis and aspergillosis. On fungal culture Aspergillus flavus was the most common species detected followed by Aspergillus niger and Aspergillus fumigatus. All patients were treated with oral Voriconazole and local surgical debridement. Prompt laboratory testing such as a timely KOH mount, galactomannan test, beta-D-glucan test, histopathology of tissue specimens could help to give an early and definitive diagnosis. The mortality rate we encountered in this study was nil. Early and definitive diagnosis and immediate initiation of antifungal drug therapy and surgical intervention will significantly reduce the rate of morbidity and mortality.

Impact of coronavirus disease pandemic on antimicrobials consumption and antimicrobial resistance during the first and second wave in a tertiary care hospital, in India

Background: This study measured the impact of the first and second wave of COVID-19 pandemic (in the year 2020-21) on the antibiotics uses and their effect on gram nehative bacterial species Klebsiella, Enterobacter, Pseudomonas and Acinetobacter. Methods: The number of patient admission month-wise, antibiotic consumption, blood cultures collected, number of positive BCs, and antibiotic resistance were analysed retrospectively for the years 2020, 2021, and 2019 for comparison, in tertiary care hospital (ca. 840 beds). Results: Half of patients admitted in years 2020 and 2021 in our hospital had COVID-19. A significant increase in total antibiotic consumption during the years 2020 (75.53 DDD per 100 admissions) and 2021 (91.71 DDD per 100 admissions) occurred in comparison to the year 2019 (52.5 DDD per 100 admissions). The rate ratio of BCs per 100 admissions increased by 74% in the year 2020, and 118% in the year 2021 in comparison with the rate ratio to the year 2019. The BSI rate per 100 admissions increased overall by 24% in March 2020 and 115% in April 2020, the rate ratio of BSIs per 100 admissions raised 58.4% for Klebsiella and 239.3% for E. coli, but remain the same for Acinetobacter and Aeruginosa. A sharp increase in the rate of BSIs caused by microorganisms resistant to cephalosporins was also observed in the years 2020 and 2021. Conclusions: present study highlights the impact of the first and second waves of the COVID-19 pandemic on antibiotic consumption and the increasing prevalence hospital-acquired infections and antimicrobial resistance.

Spatio-temporal analysis of air pollution dynamics over Bangalore city during second wave of COVID-19

The country wide lockdown implemented during 27th April to 14th June 2021 in order to prevent the spread of COVID-19 during the second wave in India. Effect of the restricted lockdown resulted in improved air quality. This study focuses on analyzing the spatio-temporal distribution analysis of major air pollutant concentration over Bangalore city in India. The inverse distance weighting (IDW) method is implemented for the spatial analysis in order to quantify the distribution of the pollutant concentrations at each location in the Urban city of Bangalore. The research considers the distinct periods of pre-lockdown and lockdown during the second wave of COVID-19 pandemic in 2021 to investigate the impact of reduced human activities on air quality over the city. The study mainly utilizes the air pollution data collected from Central Pollution Control Board (CPCB) monitoring stations across Bangalore, including measurements of pollutants such as PM2.5, PM10, O3, NO2, SO2, and CO. The IDW method is implemented to create the high-resolution pollution concentration maps for both the pre-lockdown and lockdown periods. This spatial distribution provides valuable insights into the variations in the pollution levels though out the Bangalore city. The comparative analysis of the concentration maps reveals significant changes in air pollution levels between the two periods; similarly, the temporal weekly average analysis also witnessed negative anomalies during the lockdown weeks. The results indicate substantial reductions in pollutant concentrations during the second wave COVID-19 lockdown, attributed to decreased vehicular emissions, industrial activities, and construction operations. The pre-lockdown period serves as a baseline for assessing the improvements in air quality during the lockdown. The spatio-temporal modeling approach enhances our understanding of the distribution patterns of air pollutants across the Bangalore metropolitan city. The findings underscore the potential benefits of implementing sustainable strategies to maintain improved air quality even after the pandemic subsides.

The Relation of Depression, Stress, Anxiety, and Burnout among Healthcare Workers during the Second Wave of COVID-19 Pandemic in India

Objectives The COVID-19 outbreak has taken a significant toll on frontline workers globally, resulting in psychological stress, burnout, and mental exhaustion. This online-based cross-sectional study aimed to explore the relationship between depression, anxiety, stress, and burnout among healthcare workers (HCWs) providing direct care to COVID-19 patients in the second wave of the COVID-19 pandemic in India. Material and Methods The sample size comprised HCWs who met specific inclusion criteria and had completed at least 1 week of posting in COVID-19 units and provided informed consent to participate. Data were collected using semi-structured socio-demographic Proforma, the Depression Anxiety Stress Scale-21 items (DASS-21), and the Copenhagen Burnout Inventory (CBI)-19 items. Results Out of 137 participants, 68.6% had moderate and 15.3% had severe depression; 48.9% had moderate and 24.1% had severe anxiety; and 3.6% had extremely severe anxiety. The prevalence of severe and extremely severe stress was 46.7 and 6.6%, respectively. The subscales of the Copenhagen Burnout Inventory, personal and work-related burnout had a positive correlation with all the subscales of the Depression Anxiety Stress Scale-21 items, while client-related burnout only correlated with the stress subscale. Conclusion The high prevalence of burnout and other mental health problems in the healthcare workers during the pandemic necessitate the need for the healthcare system to provide psychological support and interventions for physicians working during the pandemic.

Practice of silence to promote coping, emotion regulation, and future planning of imprisoned individuals during the COVID-19 pandemic: a qualitative study

Recent studies have emphasized that silence is a fundamental element in meditative practices for stress relief, well-being, and stimulating faith in the future. This study describes the educational experience of implementing the Practice of Silence Device in a prison setting during the second wave of Covid-19 pandemic (May–July, 2021). Interviews with 23 adult male imprisoned individuals (average age = 48.79; 65% Italians) were analyzed through a qualitative-phenomenological method. The results revealed this technique’s positive impact on rehabilitating imprisoned individuals across 3 dimensions: coping, emotion management, and ability to plan the future. Future studies should investigate specific silence-based techniques to support imprisoned individuals’ rehabilitation.

Occurrence and outcome of COVID-19 in AIRD patients on concomitant treatment with Tofacitinib- results from KRA COVID COHORT (KRACC) subset

IntroductionWe assessed the risk factors and outcome of COVID-19 in patients with autoimmune rheumatic diseases(AIRD) who contracted infection while on background treatment with tofacitinib.MethodsThis is a non-interventional, cross-sectional, questionnaire based telephonic study which included consecutive AIRD patients on tofacitinib co-treatment. Data related to the AIRD subset, disease modifying anti rheumatic drugs(DMARDs) including glucocorticoids and comorbidities, was collected from 7 rheumatology centers across Karnataka during the second wave of COVID-19 pandemic. The information about COVID-19 occurrence and COVID-19 vaccination was recorded.ResultsDuring the study period (Jun-July 2021), 335 AIRD patients (80.6% female) on treatment with tofacitinib were included. The mean duration of tofacitinib use was 3.4+/-3.1months. Thirty-six(10.75%) patients developed COVID-19. Diabetes mellitus (p = 0.04 (OR 2.60 (1.13–5.99)) was identified as a risk factor for COVID-19 in our cohort. Almost half of our cohort was COVID-19 vaccinated with at least one dose, with resultant decline in incidence of COVID-19(OR 0.15 (0.06–0.39) among the vaccinated. Recovery amongst COVID-19 infection group was 91.2%.ConclusionsThe subset of AIRD patients who were on treatment with tofacitinib were found to have a higher rate of COVID-19 infection as compared to our KRACC cohort. Pre-existing comorbidity of diabetes mellitus was the significant risk factor in our cohort. This subset of the KRACC cohort shows RA patients had a lesser infection and PsA patients had a higher infection.

Predictors of Adherence to Personal Preventive Behaviors Among Nursing Students Based on Health Belief Model: Cross Sectional Study During the Second Wave of COVID-19 Pandemic in Indonesia

Introduction: Personal preventive behaviors was cited as effective strategy to prevent the SARS-CoV-2 transmissions. When vaccine become available, preventive behavior must still be implemented to significantly decreased the COVID-19 infection risk in the emergence of novel SARS-CoV-2 variants of concern with immune escape phenotype. The Health Belief Model (HBM) is the most widely recognized behaviour theory, but its capacity to predict the preventive behaviours have been inconsistent. This study aimed to assess predictors adherence to COVID-19 preventive behaviour among nursing students based on HBM during the second wave of COVID-19 in Indonesia. Methods: An online cross-sectional study was conducted from May to September 2021. Undergraduate nursing students (n=1,413) from 10 universities in Indonesia was recruited using consecutive sampling. Online self-administered questionnaire was used to collect the data. Binary logistic regression was employed to analyse the association between sociodemographic and HBM construct with adherence to preventive behaviors. Results: Most of the students (n=804; 56.9 %) had poor adherence to COVID-19 preventive behaviors, and poor physical distancing identified as the most dominant non-adherence type (n=774; 54.8 %). First year students (AOR=1.313; 95%CI: 1.020-1.690), low perceived susceptibility (AOR=1.530; 95%CI: 1.193-1.962), low perceived severity (AOR= 1.756; 95%CI: 1.337-2.307), low perceived effectiveness (AOR=1.910; 95%CI: 1.315-2.777), and low self-efficacy (AOR=4.795; 95%CI: 3.566-6.447) significantly associated with poor adherence (p<0.05). Nagelkerke R square value was 0.313 suggesting that the whole model explained 31.3% of variance in adherence. Conclusion: Intervention that targeting health belief model could be useful to increased adherence level to COVID-19 preventive measures among nursing students.

Dietary Supplement Consumption and Mental Health in Indonesian Adults During Second Wave of COVID-19 Pandemic.

This study aimed to measure supplement consumption behavior and mental health status among Indonesian adults during the second year of COVID-19. Online questionnaire regarding supplement consumption, and Depression, Anxiety, Stress Scale 21 (DASS-21) was distributed from March to June 2021 and obtained 1006 valid and completed questionnaires. Descriptive and inferential analyses were conducted to determine the frequency and predictor factors of the respondents' supplement consumption behavior and mental health status. Respondents were divided into two groups, vulnerable and non-vulnerable individuals. The finding showed that 34.5% respondents were vulnerable individuals, including the elderly and those with comorbid disease(s). The vulnerable and non-vulnerable groups exhibited a high prevalence of supplement consumption, with the vulnerable group demonstrating a greater tendency for regular use. The incidence of mental health problems in both groups did not significantly differ (23-38%), where anxiety was higher than depression and stress. Supplement consumption was associated with mental health status. Several positive predicting factors for supplement consumption behavior included older age, higher economic status, and higher education. While the younger age and unmarried respondents were more likely to develop mental health problems. Taken together, given dietary supplement consumption increased during the pandemic and the potential associations between supplement consumption and mental health, controlling the correct information and regulation regarding supplements, especially their risks and benefits, was important. Additionally, support for mental health issues was necessary, since it might affect self-medication behavior.

Panic buying in the second wave of COVID-19: the moderating effect of past buying experience

PurposeWith the advent of the second wave of COVID-19 pandemic, there is a need to analyse the scenario of panic buying (PB) behaviour of the customers which was evident in the first wave. This paper aims to examine the PB scenario as well as the moderating effect of past buying experience (PBE) on PB in the second wave of the COVID-19 pandemic.Design/methodology/approachThis study is based on the theories of stimulus–organism–response model and the competitive arousal model. Based on these theories, this paper investigates how panic situation created by external stimuli such as perceived scarcity (PS), perceived risk (PR), news in media (NM) and social learning affect the perceived arousal (PA) among people which in turn influence the PB behaviour of customers. Data were collected from 253 customers from different parts of India. Structural equation modelling is used to analyse the moderating effect of PBE on the PB in the second wave of COVID-19 pandemic.FindingsThe results indicate that the PS, PR and NM continue to be strong predictors of a buyer for PA. However, the PB is not reinforced by the moderation effect of PBE.Research limitations/implicationsThis paper investigates the consumers’ PB behaviours in the wake of third wave of COVID-19 pandemic which add to the existing literature of COVID-19 pandemic. Moreover, this study also examines how previous buying experience can moderate the PB behaviour of the customers in subsequent phases of COVID-19 pandemic. This supports the potential effectiveness of self-regulation as an intervention strategy for reducing PB behaviours during the COVID-19 pandemic.Practical implicationsThis study emphasises the impact of external stimuli like PS, PR and media coverage on PB behaviour, marketers and policymakers should manage to avoid triggers. Although PBE may not moderate PB during a pandemic, it can play a significant role in future buying behaviour. Anticipating potential triggers and designing effective marketing strategies that cater to customers' needs can help manage PB behaviour during disasters or pandemics. In addition, promoting conscious consumption awareness and self-regulation practices among customers can help manage PB behaviour, benefit the environment and society and make customers more responsible buyers.Originality/valueTo the best of the authors’ knowledge, this study examines the PB behaviour of customers during the second wave of COVID-19 pandemic for the first time. This study also investigates the moderating effect of PBE on the PB behaviour of customers during a pandemic which is new and significant that extends the literature on PB behaviour during a pandemic.

COVID-19 pandemic on coronary artery and cerebrovascular diseases in Southern Spain: interrupted time series analysis.

Healthcare systems have been put under intense pressure by the COVID-19 pandemic, although some studies have shown a decline in hospital admissions for cardiovascular and cerebrovascular diseases during the first and second wave of the pandemic. In addition, studies analyzing gender and procedural differences are scarce. The present study aimed to determine the impact of the pandemic on hospital admissions for acute myocardial infarction (AMI) and cerebrovascular disease (CVD) in Andalusia (Spain) and analyzed differences by gender and by percutaneous coronary interventions performed. An interrupted time series analysis of AMI and CVD hospital admissions in Andalusia (Spain) was carried out to measure the impact of the COVID-19 outbreak. AMI and CVD cases admitted daily in public hospitals of Andalusia between January 2018 and December 2020 were included. During the pandemic, significant reductions in AMI [-19%; 95% confidence interval (CI): (-29%, -9%), p<0.001] and CVD [-17%; 95% CI: (-26%, -9%); p<0.01] in daily hospital admissions were observed. Differences were also produced according to the diagnosis (ST-Elevation Myocardial Infarction, Non-ST-Elevation Myocardial Infarction, other AMI and stroke), with a greater reduction in females for AMI and in males for CVD. Although there were more percutaneous coronary interventions during the pandemic, no significant reductions were observed. A decline in AMI and CVD daily hospital admissions during the first and second wave of COVID-19 pandemic was noted. Gender differences were observed, but no clear impact was observed in percutaneous interventions.

The Impact of the Second Wave of COVID-19 Pandemic on the Level of Satisfaction of Patients in a Gastroenterology Unit

INTRODUCTION: Currently, wherever you are in the world, the COVID-19 pandemic has had a global impact on every human being. This pandemic has had major consequences on the majority of the population, increasing feelings of instability, distrust and tension in access to health care. This study aimed to assess the level of satisfaction and the feeling of safety of clients who underwent endoscopic exams at a Gastroenterology unit during the second wave of the COVID-19 pandemic, as well as the impact of the measures taken to mitigate the influence of this circumstance on the experience of patients.METHODS: A closed clinical interview made up of 10 questions focused on the feeling of safety and user satisfaction. Sixty individuals were interviewed, selected randomly, after using the Gastroenterology unit to perform endoscopic exams. Inclusion criteria were: age over 18, minimum education level, without cognitive or cerebral impairment.RESULTS: The results have shown that, in general, users are satisfied with having done the exams (90%). However, some of the patients showed some concern before doing them (45%). Due to the equipment used in the context of the pandemic, some patients experienced difficulties in communicating with health professionals (63.3%). In spite of this, they felt confident and safe in carrying out the exams (66.9%), as well as safe in the hygienic conditions of the unit (58.3%).CONCLUSION: Despite the context of insecurity, tension and instability, the measures taken and the approach of the unit’s professionals managed to transmit safety and tranquillity in the performance of the exams, enhancing a good level of patient satisfaction.

Radiological Manifestations of Rhino-Orbito-Cranial Mucormycosis in COVID-19 Patients Correlated With Pathological and Clinical Outcomes and Emphasis on Magnetic Resonance Imaging-Based Scoring System.

We utilized GE 1.5 tesla, 16-channeled MRI machine for scanning the clinically suspected mucormycosis patients and did plain and contrast study of the paranasal sinuses, orbito-facial study and included brain as and when required. Images were acquired in axial, coronal, and sagittal planes using T1, T2, and fat-saturated short tau inversion recovery sequences (STIR), fat-saturated contrast sequences for better evaluation of the extent of the disease. Diffusion-weighted sequence was also acquired to detect ischemic changes in optic nerve or brain parenchyma. Contrast study was used to detect any major vessel occlusion or cavernous sinus thrombosis in the study population. Total number of cases (n) included in the study were 32. The mean age group was 41-50 years with the median age was 47 years. Out of 32 cases (n=32), in 16 cases (50%) the disease was limited only to the paranasal sinuses and in remaining 16 (50%) cases, disease has spread to other regions such as orbits, facial soft tissues, optic nerve, and brain parenchyma. All the 18 cases with Mild score (MRI ROCM score 1-3) survived and all those with severe score (2 cases) (MRI ROCM score 7-10) did not survive. During the second wave of COVID-19 pandemic, we observed a significant rise in acute invasive mucormycosis infection primarily involving the paranasal sinuses and spread to orbito-facial, cerebral parenchyma causing related complications and hence increased morbidity and death. Radiologically, using MRI, it was effectively possible to detect early extrasinonasal spread and other fatal complications thereby guiding the physicians and surgeons in the proper early aggressive management of the disease. Here, we have described the radiological characteristics of paranasal sinus mucormycosis and its spread to other regions.We also proposed an MRI-based Scoring System for standardized assessment of the disease severity. We observed in our study that the extent of disease on MRI is directly correlating with mortality.