Fear and anxiety among COVID-19 Screening Clinic Beneficiaries of a tertiary care hospital of Eastern India

Depression, anxiety, stress, and fear of COVID-19 among Bangladeshi medical students during the first wave of the pandemic: a mixed-methods study

Aim

This study aims to investigate depression, anxiety, stress, and fear of the COVID-19 pandemic and the associated risk factors among Bangladeshi medical students. It also explored qualitative insights on mental health from medical students during the first wave of the pandemic.

Methods

This mixed-methods study was conducted online in Bangladesh from June 2020 to September 2020. Participants were Bangladeshi medical students from the first year to the final year. The quantitative part included a structured online survey. One focus group discussion (FGD) was organized using the Zoom platform to collect qualitative insights from the students. To determine levels of stress, anxiety, and depression, the Bangla-validated version of the Depression, Anxiety, and Stress Scale 21 (DASS-21) was used. A 7-item and Bangla-validated Fear of COVID-19 Scale, also known as FCV-19S, was used to explore the COVID-19-specific fear of the students. A semi-structured topic guide was used for exploring the qualitative insights of medical students' perceptions of fear of COVID-19, mental health impacts during COVID-19, overall recommendations to support students, and the impact of the pandemic on the future of the medical curriculum.

Results

The study reported that 51.20%, 59.40%, and 64% of the 406 respondents had moderate to severe stress, anxiety, and depressive symptoms, respectively, according to the DASS-21. The mean fear score for the COVID-19 scale was 19.4 (SD 6.4). Respondents with family members aged 50 years or older (B = 2.1; CI: 0.3-3.9) and those who had infected family members (B = 1.9; 95% CI: 0.1-3.7) exhibited a higher level of fear of COVID-19. Moreover, depression was associated with a history of having cancer among family members (AOR = 2.9, CI: 1.1-7.5), anxiety was strongly associated with having symptoms of COVID-19 (AOR = 2, CI: 1.3-3.2), and stress was associated with having symptoms of COVID-19 infection among family members (AOR = 1.9, CI: 1.3-3). Altered sleep was a potential risk factor for developing stress, anxiety, and depression symptoms. Manual thematic analysis of qualitative data generated four major themes, including the perception of fear of COVID-19, the perception of mental health impacts during COVID-19, the change in the medical curriculum along with the pandemic, and recommendations from the medical students to support the mental health concerns of medical students during public health crises like this pandemic. Qualitative findings showed that the participants experienced fear of their parents becoming infected by COVID-19, and this fear was more prominent in those who had their loved ones hospitalized. They were also stressed and anxious, with thoughts of death. Their fear also extended to their thoughts on academic progress and the effectiveness of online classes.

Conclusion

A substantial proportion of medical students experienced mental health difficulties in Bangladesh. Appropriate interventions should be designed, and adequate support should be provided to the medical students to protect their mental health and wellbeing, considering their potential impact on the future health system in a low-resource setting like Bangladesh.

Inflammatory and mental health sequelae of COVID-19

The COVID-19 pandemic has caused significant negative consequences to mental health. Increased inflammatory factors and neuropsychiatric symptoms, such as cognitive impairment ("brain fog"), depression, and anxiety are associated with long COVID [post-acute sequelae of SARS-CoV-2 infection (PASC), termed neuro-PASC]. The present study sought to examine the role of inflammatory factors as predictors of neuropsychiatric symptom severity in the context of COVID-19. Adults (n = 52) who tested negative or positive for COVID-19 were asked to complete self-report questionnaires and to provide blood samples for multiplex immunoassays. Participants who tested negative for COVID-19 were assessed at baseline and at a follow-up study visit (∼4 weeks later). Individuals without COVID-19 reported significantly lower PHQ-4 scores at the follow-up visit, as compared to baseline (p = 0.03; 95% CI-1.67 to -0.084). Individuals who tested positive for COVID-19 and experienced neuro-PASC had PHQ-4 scores in the moderate range. The majority of people with neuro-PASC reported experiencing brain fog (70% vs. 30%). Those with more severe COVID-19 had significantly higher PHQ-4 scores, as compared to those with mild disease (p = 0.008; 95% CI 1.32 to 7.97). Changes in neuropsychiatric symptom severity were accompanied by alterations in immune factors, particularly monokine induced by gamma interferon (IFN-γ) (MIG, a. k.a. CXCL9). These findings add to the growing evidence supporting the usefulness of circulating MIG levels as a biomarker reflecting IFN-γ production, which is important because individuals with neuro-PASC have elevated IFN-γ responses to internal SARS-CoV-2 proteins.

The neglected spectrum of COVID-19 pandemic - postpartum depression among COVID-19 infected South-Indian women - a cohort study

The study aims to explore the burden of postpartum depression among COVID-19-infected mothers and stressor factors. A single-centre observational cohort study was conducted in South India to evaluate postpartum depression among 106 COVID-19-infected women who delivered from December 2020 to May 2021. Also, stressor factors related to COVID-19 infection were figured out to analyse their role in depression. Almost half of the COVID-19-infected mothers had a global EPDS score ≥ 10 and were at risk of depression during the pandemic. The depressive symptoms were not confined to the immediate postpartum period, but significantly impacted mothers until 6 months following childbirth. SYNOPSIS: COVID-19 infection not only affects the physical well-being but also adversely affects the mental health of the infected persons. Postpartum mothers who require the utmost care and support, are facing social deprivation due to the COVID-19 pandemic. This triggers the already fragile mental state of postpartum women and may worsen the level of depression.

The Effect of COVID-19 Fear in Patients and Clinical Nurses on Night Nursing Care

This study was conducted with the aim of determining the effect of fear of COVID-19 in patients and clinical nurses on night nursing care. This was a cross-sectional study. The research sample consisted of 604 patients and 270 clinical nurses selected by the convenience sampling method. Data were collected between August 2021 and July 2022 using a Patients' Information form, a Nurse's Information form, the Fear of COVID-19 scale, and the Night Nursing Care instrument. No significant difference was found between the total mean scores of the patients and the nurses on the Fear of COVID-19 scale or the Night Nursing Care instrument (rho = -0.017, p = .702; rho = -0.020, p = .741). It was found that patients' and nurses' fears of COVID-19 did not affect their perceptions of night nursing care.

The Fear of Covid-19 Among Adults with Chronic Disease

Objective: The Covid-19 epidemic is known to have caused many setbacks worldwide. This study determined the Covid-19 fears in the epidemic process of individuals with chronic disease and the factors that could cause this fear. This study aims to be a guide in the process of the Covid-19 epidemic and the development of the right health strategies for potential new outbreaks. Methods: The universe of our work is composed of 92,350 people over 18 who applied to XXX Faculty of Medicine between 01.07.2020 and 30.09.2020. When the sample was calculated with a 5% margin of error, a 95% confidence interval and a 10% chance of data loss, 421 people were identified. The data was obtained through the application of surveys generated by the literature screening using face-to-face discussions with the volunteers. In addition to various questions about sociodemographic features and the epidemic process, the coronavirus (Covid-19) scare scale has been applied in the survey. Statistical analysis was performed using the SPSS 21.0 package program. Results: In our study, the majority of the healthy group (52.5%) is made up of men, while the majority of the patient group (56.9%) in women. The healthy group has the most common 53.1 to 18-34% age group, and the patient group has the most common 33.0 to 50-64% age group. The frequency of 65 years and older was 0.6% in the healthy group and 13.8% in the patient group. The difference between age groups is statistically significant (p

Cognitive functions and anxiety among blue-collar workers in hospitals during COVID-19 pandemic

Background

The rapid spread of COVID-19 poses a major threat to public health worldwide. Hospital blue-collar workers, like other health care workers, may be under severe physical and psychological stress. This psychological distress is mainly described as symptoms of anxiety and depression, stress and cognitive function. This study aimed to investigate the effects of anxiety on cognitive function among laundry and sterilization center workers in 4 hospitals during COVID-19 pandemic.

Method

This study has a cross-sectional design and it was conducted among health service workers who were occupied in health facilities (laundry and sterilization center) in 4 hospitals. In the present study, two questionnaires and a test were used to collect the data included a general health questionnaire (GHQ-28), a health anxiety index questionnaire (HAI-18) and a cognitive function test. Descriptive statistics and Spearman correlation coefficient by SPSS version 19 were used.

Results

The results showed that the overall score of coronavirus anxiety in male and female workers was 38.72 ± 5.94 and 40.92 ± 4.11, respectively. The correlation between auditory attention and coronavirus anxiety is moderate and has a negative trend (P = 0.050, n = 50, and r = -0.315). Workers with higher anxiety expressed lower auditory attention. Also, correlation between visual attention and coronavirus anxiety was weak and negative (P = 0.032, n = 50, and r = -0.179).

Conclusion

This study revealed that cognitive and psychological aspects of mental health can be affected by COVID-19 exposure and its due anxiety in blue-collar workers in hospitals. These findings indicate that purposeful supportive interventions should be implemented to promote workers' health and cognitive function.

Self medication practices and its determinants in health care professionals during the coronavirus disease-2019 pandemic: cross-sectional study

Background The exposure of health care professionals (HCP) to patients with coronavirus disease-2019 (COVID-19) in the course of performing their professional duties may expose them to contracting the virus. This may likely increase their tendency to self-medicate for prevention or treatment of perceived infection. Aim This study determined the prevalence of COVID-19 related self-medication and its determinants among HCPs in three tertiary hospitals in Southern Nigeria. Method This was a cross-sectional study that enrolled 669 adult HCPs from three tertiary hospitals in three Southern Nigerian States using a non-probability convenience sampling method. A structured self-administered questionnaire was used for data collection. Data entry and analysis were done using IBM SPSS version 22. Results The mean age of the respondents was 35.6 ± 8.7 years. Two hundred and forty-three respondents (36.3%) reported having practiced COVID-19 related self-medication. The commonly used medications were ivermectin, azithromycin, vitamin C, chloroquine and zinc. Factors associated with self-medication were older age (p =  < 0.0001), being pharmacist (p = 0.03), higher income (p =  < 0.0001), previous COVID-19 testing (p < 0.001). Predictors of self medication were > 44 years (Adjusted Odd Ratio[AOR]:2.77,95% Confidence Interval [CI]: 1.62–4.75, p =  < 0.0001), previous COVID-19 testing (AOR = 2.68, 95% CI: 1.82–3.94, p =  < 0.0001). Conclusion About one-third of HCPs practiced COVID-19 related self-medication. HCPs that are often assumed to be health literate may not necessarily practice safe health behavior. Regular health education of the HCPs on implications of self-medications is highly recommended. There should also be formulation and effective implementation of policies that regulate purchase of medications.

Lessons learnt from emergency medicine services during the COVID-19 pandemic: A case study of India and the United States

India and the United States have both witnessed a high burden of COVID-19 infections since the pandemic was declared in early 2020. However, the COVID-19 restrictions have met with mixed responses in India and the US. Despite recommendations to continue social isolation and personal hygiene measures, India has not been able to curb the rise in daily cases. Our findings demonstrate the difference in the manner by which India and the US differ in their emergency handling of patients. We conducted a thorough review of the existing protocols and data concerning emergency responses in India and the US. The triage and care of suspected COVID-19 positive patients is different across India and the US. We find that there is a shortage of oxygenation, vaccination and other essential supplies in India. Further, the US is able to triage patients through telemedicine and EMS before suspected COVID-19 patients arrive, which is less prevalent in India. Our study identifies the importance of the emergency department (ED) as a critical contributor to the prevention and care of suspected and confirmed COVID-19 patients. Hospitals in India have been struggling to accommodate a huge influx of patients during its second wave with the ED playing a key link in their COVID-19 response.

Anxiety among pregnant women during the COVID-19 pandemic in India - A multicentric study

While higher anxiety during antenatal period cause several maternal and foetal health related complications, lower anxiety levels are found to be associated with lesser "precautionary behaviours" and consequently greater risk of infection, during the COVID-19 pandemic. In this study, we aimed to assess rates and determinants of generalized anxiety at the time of the pandemic as well as anxiety that was specific to the context of being pregnant during the COVID-19 pandemic. (COVID-19-antenatal anxiety) in Indian women. This hospital-based, cross-sectional study using face-to-face interviews was conducted at antenatal clinics of five medical college hospitals in India. The Generalized Anxiety Disorder-7 scale (GAD -7) and a customized scale to assess antenatal COVID-19 anxiety along with other tools that assessed social support and COVID-19-risk perception were administered to 620 pregnant women. We found that the percentage of women with moderate or severe anxiety based on GAD -7 was 11.1%. Multivariate analysis showed that higher COVID-19-risk perception, greater antenatal COVID-19 anxiety and lower perceived support significantly predicted moderate and severe generalized anxiety. Greater number of weeks of gestation, lower education, semiurban habitat and lower perceived social support were significant predictors of antenatal COVID-19 anxiety. We conclude that the rates of anxiety in pregnant women though not very high, still warrant attention and specific interventions.