Who Goes First? Government Leaders and Prioritization of SARS-CoV-2 Vaccines

What Matters for Depression and Anxiety During the COVID-19 Quarantine?: Results of an Online Cross-Sectional Survey in Seoul, South Korea

BACKGROUND

Amid the COVID-19 pandemic, quarantine measures are key to containing the spread of the virus. Millions of people have been required to quarantine throughout the pandemic; the quarantine itself is considered detrimental to mental health conditions.

OBJECTIVE

This study aims to investigate the factors associated with depression and anxiety among quarantined people in Seoul, South Korea.

METHODS

An online cross-sectional survey was administered from October to November 2020 involving people who were living in Seoul, aged 19 years or above, under a 2-week mandatory quarantine. Their mental health status was measured using the Patient Health Questionnares-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7).

RESULTS

Overall, 1,135 respondents were finally included, resulting in a 22.0% response rate. After controlling for potential confounders, variables, such as the "second half of quarantine period" (OR = 1.78 95% CI: 1.10-2.88), "female" (OR = 1.91 95% CI: 1.16-3.16), and "having pre-existing depression" (OR = 8.03 95% CI: 2.96-21.78) were significantly associated with depression while being quarantined. Those with correct knowledge about the rationale behind for the quarantine (OR = 0.39 95% CI: 0.21-0.72), an understanding of quarantine rules (OR = 0.68 95%CI: 0.52-0.91), and those who felt supported by others (OR = 0.74 95% CI: 0.55-0.99) were less likely to develop depression while quarantining. Similarly, anxiety was significantly associated with the second week (OR = 4.18 95% CI: 1.44-12.09), those with an unstable job status (OR = 3.95 95% CI: 1.60-9.79), perceived support (OR = 0.66, 95% CI: 0.45-0.96), and the fear of being infected (OR = 7.22 95% CI: 1.04-49.95).

CONCLUSIONS

This study highlights the need to develop precautionary measures to prevent depression and anxiety among people undergoing COVID-19 quarantine. In particular, individuals with depression prior to quarantine should be carefully monitored during the quarantine. Further studies with larger populations are needed.

The Vaccination Process against the COVID-19: Opportunities, Problems and mHealth Support

The vaccination against the COVID-19, finally available, has the potential to represent an important defence against the pandemic. The identification of both obstacles and tools to combat them are, at this moment, of strategic importance. Previous experiences on vaccinations have shown solutions and paths to take, also based on the behavioural sciences. The objective of the opinion is to face how mobile technology can help us both to fight these problems and to optimize the vaccination process. The opinion has four polarities. The first polarity consists in having detected the problems hampering an effective vaccination process. These problems have been grouped into the following four: Electronic and Informatic divide, Escape, Exposure risk, and Equity. The second polarity consists in having verified how the mobile technology can be useful to face the identified problems. The third polarity highlights the usefulness and importance of using electronic surveys. These tools are based on mobile technology. They are useful problem sensors for the stakeholders. The fourth polarity faces how mobile technology and mHealth can be of aid to optimize the flow of the vaccination process, from the first call up to the certification. This polarity is supported by an example based on the Italian national App IO. The study highlights: (a) on one side, the potential of mobile technology; on the other side, the need for interventions to reduce the digital divide with the purpose to increase its use. (b) How the role of mobile technology can be complementary to other intervention methods.

A Gastroenterologist' clinical experience in COVID 19 and in-hospital mortality and length of stay analysis

OBJECTIVES

COVID19 pandemic has forced physicians from different specialties to assist cases overload. Our aim is to assess gastroenterologist's assistance in COVID-19 by assessing mortality, ICU admission, and length of stay, and seek for risk factors for in-hospital mortality and longer hospital stay.

METHODS

A total of 41 COVID-19 patients assisted by gastroenterologist (GI cohort) and 137 assisted by pulmonologist, internal medicine practitioners, and infectious disease specialists (COVID expert cohort) during October-November 2020 were prospectively collected. Clinical, demographic, imaging, and laboratory markers were collected and compared between both cohorts. Bivariate analysis and logistic regression were performed to search for risk factors of mortality and longer hospital stays.

RESULTS

A total of 27 patients died (15.1%), 11 were admitted to ICU (6.1%). There were no differences between cohorts in mortality (14.6% vs 15.4%;p = 0.90), ICU admission (12.1% vs 4%;p = 0.13), and length of stay (6.67 ± 4 vs 7.15 ± 4.5 days; p = 0.58). PaO2/FiO2 on admission (OR 0.991;CI95% 0.984-0.998) and age > 70 (OR 17.54;CI95% 3.93-78.22) were independently related to mortality. Age > 70, history of malignancy, diabetes, and cardiovascular disease were related to longer hospital stays (p < 0.001, p = 0.03, p = 0.04, p = 0.02 respectively).

CONCLUSIONS

COVID-19 assistance was similar between gastroenterologist and COVID experts when assessing mortality, ICU admission, and length of stay. Age>70 and decreased PaO2/FiO2 on admission were independent risk factors of mortality. Age and several comorbidities were related to longer hospital stay.