Clinical Manifestations of COVID-19

Depression, anxiety, and stress among private shopkeepers after COVID-19 pandemic: A cross-sectional study from Mohali, India

Background

The COVID-19 pandemic affected almost all sections of society. The economy of the country collapsed and it affected the economic situation of the common man. Private shopkeepers also suffered as they could not open their shops. The current study was an effort to assess the psychological status of these people.

Aim

To assess depression, anxiety, and stress levels among private shopkeepers in Mohali after the COVID-19 pandemic who were previously mentally healthy.

Materials and Methods

This observational, cross-sectional study was conducted on 500 consenting private shopkeepers from 10 different topographically scattered markets of Mohali. Written informed consent was obtained. Ethical clearance was sorted by the institutional ethics committee. Sociodemographic data were recorded on sociodemographic proforma. Depression Anxiety Stress Scale -21 (DASS-21) was employed to assess depression, anxiety, and stress. The data obtained was statistically analyzed.

Results

A total of 34.2% of shopkeepers had depression, 31.4% had anxiety, and 44.80% had stress. Out of which street vendors had more depression (6.60%), anxiety (6.80%), and stress (7.40%) compared to other shopkeepers. Depression (36.07%), anxiety (32.61%), and stress (46.87%) were comparatively more among shopkeepers who had incurred financial loss compared to those who had received gain. Shopkeepers who had their shops closed were suffering from depression (35.42%), anxiety (33.26%), and stress (46.65%) comparatively more than individuals who had their shops open. A total of 59.75%, 51.57%, and 72.96% of shopkeepers whose products expired during the pandemic were suffering from depression, anxiety, and stress respectively.

Conclusion

Depression, anxiety, and stress are high in private shopkeepers after the pandemic. Mental health services should be more accessible, affordable, and available during a pandemic and its aftermath. The economy of the country should be strengthened after the pandemic keeping in interest the economic needs of the common man.

Mental Healthcare in Pediatrics During the COVID-19 Pandemic: A Call for International Public Health Action

Public health measures associated with coronavirus disease 2019 (COVID-19), such as lockdowns and quarantine of suspected cases, can negatively affect children's mental health status. Although the current crisis provides personal growth and family cohesion opportunities, pitfalls appear to outweigh the benefits. The magnitude and quality of its impact on children depend on several factors, including anxiety, lack of social contact, and a reduced opportunity for stress regulation, along with an increased risk for parental mental health issues, child maltreatment, and domestic violence. Children with special needs and social disadvantages like trauma experiences, disabilities, pre-existing mental illness, e.g., autism spectrum disorders and hyperactivity, and low socioeconomic status, may be at higher risk in this context. Here, the potentials social support can provide for pediatrics, both healthy children and children with special needs, are reviewed after an overview of quarantine's adverse effects on this special population during a pandemic. The most common psychological issues associated with the COVID-19 pandemic are sleep disorders, mood swings, depression, anxiety, decreased attention, stress, irritability, anger, and fear. Moreover, the impact of COVID-19 on children's physical health includes weight gain, reduced physical activity, immune dysregulation, and cardiometabolic disorders. All support systems, involving parents, teachers/school counselors, pediatricians, mental healthcare workers, and Health and Art (HEART) groups, need to enter the scene and make their share of children's mental health care.

Managing patients who are immunocompromised during the COVID-19 pandemic

ABSTRACT

The COVID-19 pandemic has caused distinct challenges for immunocompromised populations, including disease and social management. This article presents strategies to prevent infection and promote quality of life in patients who are immunocompromised.

Outpatient management of adults with COVID-19

ABSTRACT

This article discusses the outpatient management of adults with COVID-19 that reflects current evidence and best practices. Variants of concern, clinical presentation, assessment of the patient's clinical status, vaccination, medication management, and patient teaching are presented.

Profiling Antibody Response Patterns in COVID-19: Spike S1-Reactive IgA Signature in the Evolution of SARS-CoV-2 Infection

This contribution explores in a new statistical perspective the antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 141 coronavirus disease 2019 (COVID-19) patients exhibiting a broad range of clinical manifestations. This cohort accurately reflects the characteristics of the first wave of the SARS-CoV-2 pandemic in Italy. We determined the IgM, IgA, and IgG levels towards SARS-CoV-2 S1, S2, and NP antigens, evaluating their neutralizing activity and relationship with clinical signatures. Moreover, we longitudinally followed 72 patients up to 9 months postsymptoms onset to study the persistence of the levels of antibodies. Our results showed that the majority of COVID-19 patients developed an early virus-specific antibody response. The magnitude and the neutralizing properties of the response were heterogeneous regardless of the severity of the disease. Antibody levels dropped over time, even though spike reactive IgG and IgA were still detectable up to 9 months. Early baseline antibody levels were key drivers of the subsequent antibody production and the long-lasting protection against SARS-CoV-2. Importantly, we identified anti-S1 IgA as a good surrogate marker to predict the clinical course of COVID-19. Characterizing the antibody response after SARS-CoV-2 infection is relevant for the early clinical management of patients as soon as they are diagnosed and for implementing the current vaccination strategies.

Understanding the clinical utility of favipiravir (T-705) in coronavirus disease of 2019: a review

The coronavirus disease of 2019 (COVID-19) has caused significant morbidity and mortality among infected individuals across the world. High transmissibility rate of the causative virus - Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) - has led to immense strain and bottlenecking of the health care system. While noteworthy advances in vaccine development have been made amid the current global pandemic, most therapeutic agents are repurposed from use in other viral infections and are being evaluated for efficacy in COVID-19. Favipiravir, an orally administered drug originally developed in Japan against emerging influenza viral strains, has been shown to have widespread application and safety across multiple ribonucleic acid (RNA) viral infections. With a strong affinity toward the viral RNA-dependent RNA polymerase (RdRp), favipiravir could be a promising therapy against SARS-CoV-2, by targeting downstream viral RNA replication. Initial trials for usage in COVID-19 have suggested that favipiravir administration during initial infection stages, in individuals with mild to moderate infection, has a strong potential to improve clinical outcomes. However, additional well-designed clinical trials are required to closely examine ideal timing of drug administration, dosage, and duration, to assess the role of favipiravir in COVID-19 therapy. This review provides evidence-based insights and throws light on the current clinical trials examining the efficacy of favipiravir in tackling COVID-19, including its mechanism, pharmacodynamics, and pharmacokinetics.