Treatment Of COVID-19 Patients Research Articles

Evaluation of safety and effectiveness of remdesivir in treating COVID-19 patients after emergency use authorization study.

Background: This study aimed to determine the real-world safety and effectiveness of remdesivir in hospitalized adult COVID-19 patients with moderate-to-critical disease in Indonesia. Methods: A multicenter, retrospective cohort study was conducted at four COVID-19 referral hospitals in Jakarta. A total of 587 patients were included, of whom 243 received remdesivir within 72h of admission. The safety endpoints were the proportions of patients with any adverse event (AE), any grade 3 AE, and AE of each system organ class. The effectiveness endpoints were ICU admission >24h from baseline, live discharge and mortality at day 14, live discharge and mortality at day 28, and virologic conversion. Patients who received remdesivir within 72h of admission were considered the treatment group, and those who did not were the control group. Multivariate adjustments were performed using a modified Poisson regression. Results: The study found no significant differences in safety endpoints between the two groups. However, the effectiveness endpoints showed that remdesivir was associated with a decreased risk of ICU admission >24h from baseline (RR 0.71, 95% CI 0.52-0.96), an increased probability of live discharge at day 14 (RR 1.37, 95% CI 1.08-1.74), and an increased probability of live discharge at day 28 (RR 1.28, 95% CI 1.05-1.57). The rate of virologic conversion was not significantly different between the two groups. Conclusion: The study concludes that remdesivir is safe and effective in the treatment of moderate-to-critical COVID-19 in a real-world setting in Indonesia.

Pengalaman Fisik Dan Psikologis Bidan Desa Puskesmas Cimareme Dalam Menghadapi Pandemi Covid-19

The increase in COVID-19 cases is a major challenge for health facilities and health workers. Previous research has reported that health workers treating COVID-19 patients experience physical and psychological stress. Village midwives during the pandemic received additional duties in handling and monitoring COVID-19 patients in their working areas. This study aims to explore village midwives' physical and psychological experiences in dealing with their duties and responsibilities during the COVID-19 pandemic. This research uses a qualitative phenomenological approach design. Subject selection technique using a homogenous sampling technique. The subjects in this research consisted of key informants, namely the Village Midwife and triangulation informants, namely the Head of the Community Health Center and the Coordinating Midwife. The determination of research subjects and the number of subjects in this research applies the principles of suitability and adequacy. The results of the research show that the village midwives at the Cimareme Health Center experienced the impact of physical and psychological pressure in dealing with their duties and responsibilities during the COVID-19 pandemic. The physical experiences experienced by the Village Midwife at the Cimareme Health Center are fatigue, lack of sleep, disturbed eating patterns, decreased body weight, decreased immune system, illness and contracting COVID-19. The psychological experiences felt by the village midwives at the Cimareme Health Center are worrying about their own and their family's health, fear of contracting COVID-19, worrying about problems that arise, sad to face death cases, depressed to face cases, and pressured to face the community.

Anthracyclines inhibit SARS-CoV-2 infection

Vaccines and drugs are two effective medical interventions to mitigate SARS-CoV-2 infection. Three SARS-CoV-2 inhibitors, remdesivir, paxlovid, and molnupiravir, have been approved for treating COVID-19 patients, but more are needed, because each drug has its limitation of usage and SARS-CoV-2 constantly develops drug resistance mutations. In addition, SARS-CoV-2 drugs have the potential to be repurposed to inhibit new human coronaviruses, thus help to prepare for future coronavirus outbreaks. We have screened a library of microbial metabolites to discover new SARS-CoV-2 inhibitors. To facilitate this screening effort, we generated a recombinant SARS-CoV-2 Delta variant carrying the nano luciferase as a reporter for measuring viral infection. Six compounds were found to inhibit SARS-CoV-2 at the half maximal inhibitory concentration (IC50) below 1 μM, including the anthracycline drug aclarubicin that markedly reduced viral RNA-dependent RNA polymerase (RdRp)-mediated gene expression, whereas other anthracyclines inhibited SARS-CoV-2 by activating the expression of interferon and antiviral genes. As the most commonly prescribed anti-cancer drugs, anthracyclines hold the promise of becoming new SARS-CoV-2 inhibitors.

Monte Carlo Simulation Study on the Optimal Neutron Energy and Boron Concentration for SARS-COV-2 Inactivation through BNCT

Researchers have been exploring various radiation therapies to treat COVID-19 patients ranging from mild to severe. One technique that has shown promise is Boron Neutron Capture Therapy (BNCT). This therapy involves administering of 10B isotope to the targeted area, which is then exposed to chargeless neutrons. These neutrons can be absorbed by areas with high concentrations of 10B. When the neutrons react with the 10B (10B + n?7Li + 4He reaction), it results in the transfer of highly ionizing energy, causing confined lethality and destroying the targeted area. In this study, we used the Particle and Heavy Ion Transport Code System simulation to evaluate whether Boron Neutron Capture Therapy could be effective as an anti-viral therapy. The study involves creating a model of the SAR-COV-2 target phantom's geometry and defining its chemical composition to collect data. It was found out that when tested at different neutron energies and concentrations (30 ppm, 50 ppm, and 100 ppm), a sufficient amount of dose to cause biological damage to the Sars-CoV-2 enveloped protein could be achieved with 30 ppm boron concentration and a neutron energy of 1.0x10-10 MeV.

ROLE OF VITAMIN-D SUPPLEMENTATION IN COVID-19 PATIENTS

COVID-19 has become a global pandemic and has affected millions of people worldwide. While there is still much to learn about the virus, it is clear that individuals with weakened immune systems and pre-existing health conditions are at higher risk of severe illness and death. The study's main objective is to find the role of Vitamin-D supplementation in COVID-19 patients. The study included 300 COVID-19 patients admitted to a tertiary care hospital between January 2021 and May 2021. Using computer-generated randomization, participants were randomly assigned to either the intervention group or the control group. The intervention group received a daily dose of 4000 IU of Vitamin D3 for 14 days, while the control group received standard care without Vitamin D supplementation. Per hospital guidelines, all patients received standard medical treatment for COVID-19, including oxygen therapy, antiviral therapy, and corticosteroids. The study showed that Vitamin D supplementation significantly reduced the time to clinical improvement in COVID-19 patients. The median time to clinical improvement was 7 days in the intervention group, compared to 9 days in the control group (p <0.001). The intervention group also had a significantly shorter length of hospital stay, with a median of 9 days, compared to 11 days in the control group (p <0.001). In conclusion, vitamin D supplementation's role in treating COVID-19 patients is an area of active research and has generated considerable interest in the scientific community. The results of the available studies suggest that vitamin D supplementation may have potential benefits in reducing the risk of severe COVID-19 and improving clinical outcomes.

Physical and stressful psychological impacts of prolonged personal protective equipment use during the COVID-19 pandemic: A cross-sectional survey study

BackgroundHealthcare workers (HCWs) caring for COVID-19 infected patients are exposed to stressful and traumatic events with potential for severe and sustained adverse mental and physical health consequences. Our aim was to assess the magnitude of physical and mental health outcomes of HCWs due to the prolonged use of personal protective equipment (PPE) treating COVID-19 patients. MethodsThis cross-sectional study assessed the symptoms of stress, anxiety, insomnia, and psychological resilience using the Stress and Anxiety to Viral Epidemics (SAVE) scale, Insomnia Severity Index (ISI), and Resilience Scale (RS), respectively, in Italy between 1st February and 31st March 2022. The physical outcomes reported included vertigo, dyspnea, nausea, micturition desire, retroauricular pain, thirst, discomfort at work, physical fatigue, and thermal stress. The relationships between prolonged PPE use and psychological outcomes and physical discomforts were analyzed using Generalized Linear Models (GLMs). We calculated the factor mean scores and a binary outcome to measure study outcomes. FindingsWe found that 23% of the respondents reported stress related symptoms, 33% anxiety, 43% moderate to severe insomnia, and 67% reported moderate to very low resilience. The GLMs suggested that older people (>55 years old) are less likely to suffer from stress compared to younger people (<35 y.o); conversely, HCW aged more than 35 years are more inclined to suffer from insomnia than younger people (<35 y.o). Female HCW reported a lower probability of resilience than males. University employed HCWs were less likely to report anxiety than those who worked in a community hospital. The odds of suffering from insomnia for social workers was significantly higher than for other HCWs. Female HCW>3 years old, enrolled in training programs for nursing, social work, technical training and other healthcare professionals increased the probability of reported physical discomforts. HCW that worked on non COVID-19 wards and used PPE for low-medium exposure level, were at lower risks for lasting physical side effects as compared to the HCW who worked in high-risk PPE intense, COVID-19 environments. InterpretationThe study suggests that frontline HCWs who had extensive PPE exposure while directly engaged in the diagnosis, treatment, and care for patients with COVID-19 are at significant risks for lasting physical and psychological harm and distress.

Identification of potential biomarkers to predict organ morbidity in COVID-19: A repository based proteomics perspective

SARS-CoV-2 causes substantial extrapulmonary manifestations in addition to pulmonary disease. Some of the major organs affected are cardiovascular, hematological and thrombotic, renal, neurological, and digestive systems. These types of muti-organ dysfunctions make it difficult and challenging for clinicians to manage and treat COVID-19 patients. The article focuses to identify potential protein biomarkers that can flag various organ systems affected in COVID-19. Publicly reposited high throughput proteomic data from human serum (HS), HEK293T/17 (HEK) and Vero E6 (VE) kidney cell culture were downloaded from ProteomeXchange consortium. The raw data was analyzed in Proteome Discoverer 2.4 to delineate the complete list of proteins in the three studies. These proteins were analyzed in Ingenuity Pathway Analysis (IPA) to associate them to various organ diseases. The shortlisted proteins were analyzed in MetaboAnalyst 5.0 to shortlist potential biomarker proteins. These were then assessed for disease-gene association in DisGeNET and validated by Protein-protein interactome (PPI) and functional enrichment studies (GO_BP, KEGG and Reactome pathways) in STRING. Protein profiling resulted in shortlisting 20 proteins in 7 organ systems. Of these 15 proteins showed at least 1.25-fold changes with a sensitivity and specificity of 70%. Association analysis further shortlisted 10 proteins with a potential association with 4 organ diseases. Validation studies established possible interacting networks and pathways affected, confirmingh the ability of 6 of these proteins to flag 4 different organ systems affected in COVID-19 disease. This study helps to establish a platform to seek protein signatures in different clinical phenotypes of COVID-19. The potential biomarker candidates that can flag organ systems involved are: (a) Vitamin K-dependent protein S and Antithrombin-III for hematological disorders; (b) Voltage-dependent anion-selective channel protein 1 for neurological disorders; (c) Filamin-A for cardiovascular disorder and, (d) Peptidyl-prolyl cis-trans isomerase A and Peptidyl-prolyl cis-trans isomerase FKBP1A for digestive disorders.

CO149 Prevalence of Chain-of-Event and Contributing Conditions Among Treated COVID-19 Patients in the United States: Identifying Risk Factors Associated with Deaths

A 2021 CDC report on 378,048 US deaths attributed to COVID-19 identified a co-occurring diagnosis of chain-of-event condition (COE) (e.g., pneumonia, respiratory failure), or significant contributing condition (SCC) (e.g., diabetes, dementia), or both; in 91.9% of the patients. This study assessed the prevalence of comorbid COE and/or SCC among diagnosed COVID-19 patients in a large open-source US claims database. Patients with any claim including COVID-19 diagnosis in IQVIA’s longitudinal medical and pharmacy claims databases from 4/1/2020 to 4/30/2022 were identified. Among these COVID-19 patients, presence of a COE diagnosis (within +/- 7d of COVID-19 diagnosis) or history of SCC, or both, were identified. Within this subset, patients with no subsequent claims activity > 30 days after the last COVID-19 diagnosis were flagged. Flagged patients were linked to Veritas database containing >33 million death records. Among the 17,682,111 patients with any claim for COVID-19, acute respiratory failure (7.4%), pneumonia (5.1%) and asphyxia (4.7%) were the most common COE conditions. Essential hypertension (36.5%) was the most common SCC, followed by hyperlipidemia (22.5%), obesity (19.7%) and type 2 diabetes (19.1%). Overall, 970,324 patients were flagged with COE and/or SCC and no subsequent claims activity >30 days after the last COVID-19 diagnosis; of those, 34.6% patients aged 65-75 and 42.4% aged >75 years had a death flag in Veritas data. The prevalence of metabolic SCC is high among patients treated for COVID-19 in the US. Concurrent COE/SCC and an end of claims activity within 30 days was associated with over a third of deaths among elderly patients. The findings from this study could be used in combination with other known risk factors for poor outcomes among COVID-19 patients to identify patients at high risk of mortality.

MT27 Comparison of High-Flow Nasal Canula and Non-Invasive Mechanical Ventilation in Treating COVID-19 Patients

The World Health Organization has declared COVID-19 a global pandemic in March 2020. Multiple COVID-19 waves are putting tremendous stress on healthcare systems. Evidence showed that high-flow nasal canula (HFNC) reduced the need for mechanical ventilation and shortened the time to clinical recovery among patients with severe COVID-19. This study aimed to assess the effect of using HFNC compared to non-invasive mechanical ventilation (NIV), on adult patients with COVID-19. This retrospective study included patients hospitalized due to COVID-19 between October 2020 to December 2021 with appropriate ICD-10 diagnosis recorded in a commercially available, all-payer administrative database across 300+ hospitals. The identified patients were divided in two cohorts, one being the patients treated with HFNC as the first line respiratory support and another with NIV. Outcomes included all-cause mortality rate and length of stay. Multivariable analyses were performed to adjust for baseline characteristics. Out of 16,534 eligible patients, 4,334 patients received HFNC as the first line respiratory support, whereas 12,200 received NIV. The all-cause mortality rate was 20.24% and 37.14% in the HFNC and NIV group, respectively. After adjusting for baseline characteristics, the all-cause mortality rate in the HFNC group was lower compared to NIV (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.47-0.55; p<0.001). The total length of stay was around 15 days for all patients. No different was observed between groups ( mean difference 0.3 days; 95% CI, -0.27 – 0.92 days; p>0.05). Patients treated with HFNC showed lower mortality rates compared to NIV for hospitalized COVID-19 patients. However, further studies are still needed to better elucidate the clinical and economic benefit of HFNC in COVID-19 patients.

Pharmaceutical approaches for COVID-19: An update on current therapeutic opportunities.

SARS-CoV-2, a newly discovered coronavirus, has been linked to the COVID-19 pandemic and is currently an important public health issue. Despite all the work done to date around the world, there is still no viable treatment for COVID-19. This study examined the most recent evidence on the efficacy and safety of several therapeutic options available including natural substances, synthetic drugs and vaccines in the treatment of COVID-19. Various natural compounds such as sarsapogenin, lycorine, biscoclaurine, vitamin B12, glycyrrhizic acid, riboflavin, resveratrol and kaempferol, various vaccines and drugs such as AZD1222, mRNA-1273, BNT162b2, Sputnik V, and remdesivir, lopinavir, favipiravir, darunavir, oseltamivir, and umifenovir, resp., have been discussed comprehensively. We attempted to provide exhaustive information regarding the various prospective therapeutic approaches available in order to assist researchers and physicians in treating COVID-19 patients.

Effects of Three-Hour Wearing Personal Protective Equipment on Heart Rate Variability in Healthcare Workers for the Treatment of COVID-19 Patients.

Personal protective equipment (PPE), an essential shield to protect healthcare workers (HCWs) during the COVID-19 pandemic, has been reported to affect their heart rate variability (HRV). To investigate the changes of very short-term heart rate variability in HCWs after three hours of wearing PPE to treat COVID-19 patients at different working times and intensities, and related factors. Sixty-five healthy HCWs were enrolled at the Number 2 Infectious Field Hospital (formed by Military Hospital 103), Vietnam. Two-minute 12-lead electrocardiograms were recorded before wearing and after removing PPE. After three hours of wearing PPE, the mean heart rate of HCWs increased (p = 0.048) meanwhile, the oxygen saturation decreased significantly (p = 0.035). Standard deviation of all normal to normal intervals (SDNN), mean intervals RR (mean NN), and root mean square successive difference (rMSSD) after wearing PPE was also reduced significantly. SDNN, Mean NN, and rMSSD decreased as the working intensity increased (as in mild, moderate, and severe patient departments). In univariate regression analysis, logSDNN, logmean NN and logrMSSD were positively correlated with SpO2 and QT interval (r = 0.14, r = 0.31, r = 0.25; r = 0.39, r = 0.77, r = 0.73, respectively) and were negatively correlated with ambient temperature inside PPE (r = -0.41, r = -0.405, r = -0.25, respectively) while logmean NN and log rMSSD were negatively correlated with diastolic blood pressure (r = -0.43, r = -0.39, respectively). In multivariable regression analysis, logSDNN and logmean NN were negatively correlated to ambient temperature inside PPE (r = -0.34, r = -0.18, respectively). Time-domain heart rate variability decreased after wearing PPE. Time-domain HRV parameters were related to ambient temperature inside PPE, diastolic blood pressure, QT interval, and SpO2.

Physician's hesitancy in treating COVID-19 patients and its associated occupational risk factors in Indonesia: an online cross-sectional survey.

This cross-sectional survey aims to investigate physician hesitancy in treating COVID-19 patients in Indonesia, particularly among those who have already contracted the disease, along with associated occupational risk factors. The study involved distributing a questionnaire to physicians across the country, using contact information from the Indonesian Physician Association database. The results show that out of the 383 participants, 25.6% experienced moderate symptoms of COVID-19, and 2.9% required critical care. The study found that 20.3% of physicians demonstrated hesitancy to treat suspected, probable, or confirmed COVID-19 patients. Interestingly, older physicians and those with less experience in treating COVID-19 patients were found to have a higher hesitancy rate, while specialist trainees and those working in public hospitals demonstrated the lowest hesitancy. These findings highlight the significant hesitancy among physicians who have suffered from COVID-19 and underline the need for management and policymakers to take further action to address this issue. Understanding the effects and benefits of physician hesitancy in treating COVID-19 patients is crucial for ensuring the effective delivery of healthcare services during pandemics like COVID-19.

Pengetahuan, Sikap, dan Perilaku Penggunaan Suplemen dan Obat Tradisional pada Tenaga Kesehatan di Jember selama Pandemi COVID-19

Healthcare workers play the role as the front line in treating COVID-19 patients, so they are at risk of being exposed by this virus therefor it is necessary to always maintain health and increase their immunity. One way is taking supplements or traditional medicines. The behavior of taking supplements or traditional medicines is influenced by knowledge and attitudes. The purpose of this study was to determinate the knowledge, attitudes, and behavior of using supplements and traditional medicines among healthcare workers in Jember during the COVID-19 pandemic. This research was an observational analytic study with a cross-sectional design involving 376 healthcare workers in Jember selected by convenience sampling method.The data collection instruments was questionnaires. The results showed that the majority of respondents had good knowledge (52.1%) and moderate attitudes (59.0%). Sociodemographic factors that influence knowledge are level of education and the type of healthcare worker, while the factors that influence attitudes are age, level of education, type of health worker, and working time. There is a significant relationship (p≤0.05) between knowledge and attitudes which can be concluded that knowledge influences attitudes towards the use of supplements and/or traditional medicines&#x0D;

Spanish psychometric properties of the moral distress scale—revised: a study in healthcare professionals treating COVID-19 patients

BackgroundMoral distress appears when a healthcare professional is not able to carry out actions in accordance with their professional ethical standards. The Moral Distress Scale-Revised is the most widely used to assess levels of moral distress, but it is not validated in Spanish. The aim of the study is to validate the Spanish version of the Moral Distress Scale – utilised within a sample of Spanish healthcare professionals treating COVID–19 patients.MethodsThe original (english) and the portuguese and french versions of the scale were translated into spanish by native or bilingual researchers and reviewed by an academic expert in ethics and moral philosophy as well as by a clinical expert. Research design: Descriptive cross-sectional study carried out using a self-reporting online survey. The data was collected between June- November 2020. A total of 661 professionals responded to the survey (N = 2873). Participants: healthcare professionals with more than two weeks of experience treating COVID–19 patients at the end of their life and working in the public sector of the Balearic Islands Health Service (Spain). Analyses included descriptive statistics, competitive confirmatory factor analysis, evidence on criterion-related validity and estimates of reliability. The study was approved by the Research Ethics Committee at the University of Balearic Islands.ResultsAn unidimensional model in which a general factor of moral distress explained by 11 items of the Spanish version of the MDS–R scale was an adequate representation of the data: χ2(44) = 113.492 (p 0.001); Comparative Fit Index = 0.965; Root Mean Square Error of Approximation = 0.079[0.062,0.097]; and Standarized Root Mean-Square = 0.037. Evidence of reliability was excellent: Cronbach’s alpha = 0.886 and McDonald’s omega = 0.910. Moral distress was related to discipline, with nurses having statistically significant higher levels than physicians. Additionally, moral distress successfully predicted professional quality of life, with higher levels of moral distress being related to poorer quality of life.ConclusionsThe Spanish version of Moral Distress Scale–Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by health professionals. This tool will be highly useful for managers and applicable to a variety of healthcare professionals and settings.

Pulmonary and Extra Pulmonary Manifestations of COVID-19

Global public health emergency: COVID-19, triggered by SARS-CoV-2. A thorough search was conducted using Web of Science, PubMed, and Scopus databases, and 36 relevant studies were identified. COVID-19 has spread to over 200 nations, causing 14 million infections as of July 18, 2020. SARS-CoV-2 affects more than only the respiratory system, causing fever, cough, and dyspnea. COVID-19 extrapulmonary symptoms are little documented [1]. This study covers COVID-19's cardiovascular and neurological symptoms. COVID-19's clinical characteristics will be compared to SARS and MERS. The goal is to raise knowledge of the organ systems impacted by SARS-CoV-2 and explain the clinical similarities and distinctions of these disorders. COVID-19 patients also have arrhythmias. COVID-19 individuals also experience gastrointestinal problems. These symptoms include moderate diarrhea to severe vomiting and abdominal discomfort. COVID-19 has pulmonary and extrapulmonary symptoms. The most prevalent symptoms are pulmonary (ARDS, pneumonia, and respiratory failure) and extrapulmonary (cardiovascular and gastrointestinal). Understanding these symptoms helps physicians treat COVID-19 patients [2]. COVID-19 causes pneumonia, ARDS, and respiratory failure. Severe COVID-19 can lead to ARDS. Lung inflammation causes fluid collection and respiratory problems. X- rays and CT scans can detect COVID-19-related pneumonia. Severe COVID-19 patients often have a respiratory failure when their lungs cannot provide adequate oxygen.

Impact of Dexamethasone on the Pathogen Profile of Critically Ill COVID-19 Patients.

Even though several therapeutic options are available, COVID-19 is still lacking a specific treatment regimen. One potential option is dexamethasone, which has been established since the early beginnings of the pandemic. The aim of this study was to determine its effects on the microbiological findings in critically ill COVID-19 patients. A multi-center, retrospective study was conducted, in which all the adult patients who had a laboratory-confirmed (PCR) SARS-CoV-2 infection and were treated on intensive care units in one of twenty hospitals of the German Helios network between February 2020-March 2021 were included. Two cohorts were formed: patients who received dexamethasone and those who did not, followed by two subgroups according to the application of oxygen: invasive vs. non-invasive. The study population consisted of 1.776 patients, 1070 of whom received dexamethasone, and 517 (48.3%) patients with dexamethasone were mechanically ventilated, compared to 350 (49.6%) without dexamethasone. Ventilated patients with dexamethasone were more likely to have any pathogen detection than those without (p < 0.026; OR = 1.41; 95% CI 1.04-1.91). A significantly higher risk for the respiratory detection of Klebsiella spp. (p = 0.016; OR = 1.68 95% CI 1.10-2.57) and for Enterobacterales (p = 0.008; OR = 1.57; 95% CI 1.12-2.19) was found for the dexamethasone cohort. Invasive ventilation was an independent risk factor for in-hospital mortality (p < 0.01; OR = 6.39; 95% CI 4.71-8.66). This risk increased significantly in patients aged 80 years or older by 3.3-fold (p < 0.01; OR = 3.3; 95% CI 2.02-5.37) when receiving dexamethasone. Our results show that the decision to treat COVID-19 patients with dexamethasone should be a matter of careful consideration as it involves risks and bacterial shifts.

Association of fear of COVID-19 and resilience with psychological distress among health care workers in hospitals responding to COVID-19: analysis of a cross-sectional study.

It remains unclear how fear of COVID-19 and resilience are related to psychological distress based on occupations among healthcare workers (HCWs) in hospitals treating patients with COVID-19. We conducted a survey on the mental health of HCWs during the COVID-19 pandemic to determine the relationship between factors such as fear of COVID-19 and resilience as well as mental distress in each occupation of HCWs. We conducted a web-based survey among HCWs at seven hospitals treating COVID-19 patients in Japan from December 24, 2020 to March 31, 2021. A total of 634 participants were analyzed, and information regarding their socio-demographic characteristics and employment status was collected. Several psychometric measures were used, including the Kessler's Psychological Distress Scale (K6), the fear of COVID-19 Scale (FCV-19S), and the Resilience Scale (RS14). Factors related to psychological distress were identified by logistic regression analysis. The association between job title and psychological scales was examined by one-way ANOVA, and t-tests were conducted to examine the association between the FCV-19S and hospital initiatives. It was found that nurses and clerical workers were associated with psychological distress without considering FCV-19S or RS14; in a model that included FCV-19S, FCV-19S was associated with psychological distress, but job title was not; when RS14 was considered, resilience was protective. In terms of occupation, FCV-19S was lower among physicians and higher among nurses and clerical workers, while RS14 was higher among physicians and lower among other occupations. Having access to in-hospital consultation regarding infection control as well as to psychological and emotional support was associated with lower FCV-19S. Based on our findings, we can conclude that the level of mental distress differed by occupation and the differences in the fear of COVID-19 and resilience were important factors. In order to provide mental healthcare for HCWs during a pandemic, it is important to create consultation services that enable employees to discuss their concerns. In addition, it is important to take steps to strengthen the resilience of HCWs in preparation for future disasters.

The Impact of the Covid-19 Pandemic on Physicians in Turkey Towards Informed Consent

Background: The study aimed to figure out whether, how, and why the COVID-19 pandemic has changed physicians’ attitudes toward informed consent in Turkey. Materials and Methods: An online questionnaire was distributed to physicians through the snowball sampling method and 528 physicians treating COVID-19 patients turned in the questionnaire. Findings: Most of the physicians (n= 317) indicated that the COVID-19 pandemic has influenced their attitudes on informed consent, while 39.96% of them (n= 211) stated that the pandemic did not change their behaviors on informing patients and/or families. An overwhelming majority of the physicians (n= 259) emphasized the impact of the higher mortality rate of the disease, the lack of standard treatment for the disease, and the higher demand from patients and families for information on providing patients and/or families with more information. On the other hand, 18.30% (n= 58) of the physicians admitted that the pandemic has caused them to disclose less information because of the lack of time to provide information, the need for urgent treatment, and the lack of information regarding the risks, benefits, and outcomes of applied treatments. Conclusion: COVID-19 pandemic affected the majority of the physicians attitudes and behaviors toward informed consent.

Practicing dentistry in the age of COVID-19: Perception changes due to the new PPE standards.

This study aimed to determine how the COVID-19 pandemic and extensive use of personal protective equipment (PPE) have affected the perception of the practice of dentistry in an urban dental school in the USA. In 2021, an electronic cross-sectional questionnaire was sent to school faculty via email, while predoctoral, clinical dental students were invited to participate during clinical group meetings. Data were analyzed using descriptive statistics. Sixty-six faculty and 209 students completed the questionnaire (n=275, response rate=39%). The faculty self-identified into two groups: dentists who only teach (teaching faculty, n=33) and dentists who teach and also work in outside clinics (practicing faculty, n=33). Practicing faculty (45.5%) were significantly more pessimistic about the future of dentistry than the other two groups. Students were the least concerned with treating COVID-19 patients compared to other groups and only 15.8% of students reported a change in enthusiasm toward dentistry. Practicing faculty did not feel that extra PPE presented a physical challenge. Teaching faculty were least alarmed by extra PPE and least concerned about PPE increasing patient stress. More faculty were in favor of vaccination requirements (90.9%) than students (73.7%). Neither COVID-19 nor the use of extensive PPE negatively affected the participants' perception of the future of dentistry. Most participants felt safe wearing extra PPE during the pandemic but were concerned about the negative environmental effects. Students did not feel strongly that vaccination should be a requirement for clinical dentists and staff.

High levels of burnout among health professionals treating COVID-19 patients in two Nile basin countries with limited resources

Burnout syndrome is a real cause for concern in African health facilities. Healthcare professionals (HCPs) burnout is considered a great public health problem and especially during pandemics as several physical and emotional stressors on this population can lead to increased burnout. This study aimed to investigate the frequency and associated factors of occupational burnout among HCPs working at COVID-19 isolation facilities in Egypt and Sudan. This is important to summarize lessons learned and inform relevant interventions for future pandemic responses. A cross-sectional survey was conducted among frontline HCPs from May 2021 to July 2021. An online, anonymous, self-administered questionnaire was used for data collection. Occupational burnout was estimated using the Oldenburg Burnout Inventory. A total of 362 HCPs participated in the study and were equally recruited from Egypt (181) and Sudan (181) with a mean age of (31.84 ± 8.32) years. More than half of HCPs were females (60%) and physicians (58.3%). Most HCPs included in the study had high levels of work disengagement (75.4%) and emotional exhaustion (98.6%). Burnout syndrome was present in 75% of the HCPs with 77% among Egyptian HCPs and 71% among Sudanese HCPs. Multivariate logistic regression was used to determine predictors of burnout, working hours per week were the parameters associated with burnout syndrome among Egyptian HCPs; while for Sudanese HCPs, these were age and number of days off. The study revealed a high level of burnout syndrome among HCPs working at COVID-19 isolation facilities in both Egypt and Sudan. Appropriate actions should be taken to preserve the mental health status of HCPs through the establishment of effective and efficient coping strategies.