A multifaceted virus. Non-reducible and strangulated effects of COVID-19

The Impact of the COVID-19 Pandemic on Women’s Health: A Review

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During any crisis, whether it is health, economic, or environmental, people are more likely to experience stress, anxiety, and other psychological issues that jeopardize their general well-being. The Coronavirus, or COVID-19, is considered a global pandemic that affects millions of persons. Many people of different ages have significantly suffered from mental illness as a result of COVID-19, especially women affected vulnerable. As per the report, the death rates of men have doubled in comparison with women; this epidemic shows a bigger influence on the health of women than men. Even quarantine impacts make the females afraid, bewildered, and feel alone, which is terrible for them, as it also disturbs their health, such as pregnancy, sexual life, postpartum depression, etc. This review article reveals the COVID-19 impact on the health of women and finds a way to prevent and manage the health implications in women at various periods throughout their lives.

Impact of COVID-19 on Endometriosis Patients: An Integrative Review

Background:

During the Covid-19 pandemic, people's lives worldwide have undergone extensive changes. The pandemic has worsened the condition of patients with chronic diseases like women with endometriosis.

Objective:

This study aims to summarize available evidence on the impact of the COVID-19 pandemic on physical symptoms, mental health, and medical care of patients with endometriosis.

Methods:

In the present integrative review using PRISMA guidelines, related articles published from December 2019 to July 2023 in databases including MEDLINE, Science Direct, Scopus, and Google Scholar in the English language were extracted.

Results:

After evaluating the criteria for inclusion and exclusion, a total of 23 articles were chosen and examined. This study represents an open window to investigate the impact of COVID-19 on women with endometriosis. The COVID-19 pandemic has affected the symptoms, mental well-being, and medical care of women with endometriosis.

Conclusions:

There is a perceived necessity to provide supportive care for patients during pandemic restrictions. Remote work has had an unanticipated advantage, and it is recommended that women with endometriosis continue to work from home after COVID-19 to maintain their workplace effectiveness.

The "Magnificent Seven" in Oral and Systemic Health against COVID-19

The COVID-19 pandemic impacted all areas of daily life, including medical care. Unfortunately, to date, no specific treatments have been found for the cure of this disease, and therefore, it is advisable to implement all possible strategies to prevent infection. In this context, it is important to better define the role of all behaviors, in particular nutrition, in order to establish whether these can both prevent infection and improve the outcome of the disease in patients with COVID-19. There is sufficient evidence to demonstrate that immune response can be weakened by inadequate nutrition. Nutrition management and treatment are very important to enhance the immune response of an infected person against RNA viral infection. A complete nutritional assessment should include anthropometric, dietary, and laboratorial assessment, as well as a multidisciplinary discussion about the patient's clinical condition. In this way, it is possible to establish an individualized nutritional approach to contribute to improving clinical and nutritional prognoses. From this point of view, diet, through intake of vitamins and trace elements and maintaining adequate functioning of the intestinal barrier, can reduce the severity of the COVID-19 infection. In this study, we provide an overview of the effects of diet on COVID-19 infection in non-cancer patients. This notion needs to be further evaluated, and thus, identification, characterization, and targeting of the right nutrition principles related to the management of patients with COVID-19 are likely to improve outcomes and may prevent the infection or lead to a cure.

Menstrual Cycle Characteristics and Relative Factors Among Vietnamese Female Medical Students: A Cross-Sectional Study During the COVID-19 Pandemic

Aims:

To research menstrual cycle characteristics and related factors among Vietnamese female medical students.

Background:

Female medical students, juggling demanding academic schedules, face the additional challenge of managing the impact of their monthly cycles on daily routines, academic achievements, and professional obligations.

Objective:

To investigate the factors influencing the menstrual cycle during this particularly stressful period by surveying these students.

Methods:

This cross-sectional study was from 3rd year of female medical students studying full-time.

Results:

Individuals in the severe stress group experienced irregular periods in 100% of cases. Dysmenorrhea was the next most prevalent abnormal symptom, affecting 39.7% of students. Furthermore, abdominal pain and lower back pain were the most common symptoms of premenstrual syndrome (PMS). The percentage of menorrhagia in the overweight-obesity group was almost 5 times higher than that of the other groups. Besides, central obesity increased the incidence of menorrhagia by a factor of 19. Average to high levels of physical activity can increase the risk of having dysmenorrhea. Remarkably, students who were affected by COVID-19 in terms of quality of life were also more likely to experience dysmenorrhea.

Conclusion:

Although most medical students had normal menstrual cycles, abdominal pain and lower back pain were the leading PMS. Moreover, overweight-obesity, central obesity, physical activity, stress, and the COVID-19 pandemic may be relative factors of the menstrual cycle.

Understanding COVID-19-related Acute Renal Injury in Elderly Individuals: Preexisting Systemic Inflammation before COVID-19 (SIC)

In this study, we examined preexisting systemic inflammation before COVID-19 (SIC), as assessed through C-reactive protein (CRP) levels, to gain insights into the origins of acute kidney injury (AKI) in adults with comorbidities affected by COVID-19. Although aging is not categorized as a disease, it is characterized by chronic inflammation, and older individuals typically exhibit higher circulating levels of inflammatory molecules, particularly CRP, compared to younger individuals. Conversely, elevated CRP concentrations in older adults have been linked with the development of comorbidities. Simultaneously, these comorbidities contribute to the production of inflammatory molecules, including CRP. Consequently, older adults with comorbidities have higher CRP concentrations than their counterparts without comorbidities or those with fewer comorbidities. Given that CRP levels are correlated with the development and severity of AKI in non-COVID-19 patients, we hypothesized that individuals with greater SIC are more likely to develop AKI during SARS-CoV-2 infection than those with less SIC.

A Correlation Study to Comprehend the SAR-CoV-2 Viral Load, Antiviral Antibody Titer, and Severity of COVID-19 Symptoms Post-infection Amongst the Vaccinated Population in Kamrup District of As sam, Northeast India

BACKGROUND

As per the recommendation of the United States Food and Drug Administration, more research is needed to determine the antibody titer against COVID-19 vaccination.

OBJECTIVE

The study aimed to understand the relationship between the antibody titer to the demographics, infection severity, and cycle threshold (CT) values of confirmed COVID-19 patients.

METHODS

Initially, we obtained consent from 185 populations and included sixty RT-PCRpositive COVID-19 patients from Kamrup District in the Northeast State of Assam, India. The vaccination status was recorded and tested for the level of serum immunoglobulin (IgG). The CT values, gender, and clinical symptoms-based scoring (CSBS) correlated with their IgG value.

RESULTS

Around 48% of participants gained an antibody titer more than the threshold value and showed CT values between 18-25. Moreover, the maximum distributed score above the average was found between the CT values 18-25.

CONCLUSION

The IgG titer value differs significantly amongst the vaccinated population, which may depend upon their genetic and demographic variability.

Impact of COVID-19 on clinical outcomes of robotic inguinal hernia repair

PURPOSE

To investigate the impact of the COVID-19 pandemic on the clinical impact of the clinical outcomes of robotic inguinal hernia repair.

METHODS

Patients who underwent RIHR 2 years before and after March 10, 2020, were included in this retrospective study and assigned accordingly to the pre- or post-COVID group. Pre-, intra-, and postoperative variables including patients' demographics, hernia characteristics, complications, and hernia recurrence rates were compared between groups.

RESULTS

183 (94.5% male) and 141 (96.4% male) patients were assigned to the pre- and post-COVID groups, respectively. Patient demographics and medical comorbidities did not differ between groups. Operative time was approximately 40 min longer in the post-COVID group (p < 0.001) with higher rates of bilateral IHR (pre-COVID: 30.1% vs. post-COVID: 46.4%, p = 0.003). Mesh material differed between groups with predominance of polyester mesh in the pre-COVID group vs. polypropylene in the post-COVID one. Median hospital length of stay (LOS) was 0 days in both groups, and same-day discharge rates were 93.4% pre-pandemic and 92.8% post-pandemic (p = 0.09). There were no pulmonary complications recorded in either group or no cases of COVID-19 detected within two weeks postoperatively in the post-COVID group. Seromas were more frequent in the post-COVID group (pre-COVID: 2 vs. post-COVID: 8, p = 0.018) and no hernia recurrences were recorded.

CONCLUSION

This is the first study to describe the impact of COVID-19 on RIHR. Clinical outcomes and hernia-specific complications were not impacted by the COVID-19 pandemic.

The impact of the COVID-19 pandemic on the number of patients presenting with appendicitis to the emergency department

INTRODUCTION

The COVID-19 pandemic has had an influence on the number of patients presenting to the emergency department (ED) with surgical conditions.

AIM

To evaluate the number of patients presenting with acute appendicitis (AA) and the percentage of complicated appendicitis before and after the COVID-19 disease outbreak.

MATERIAL AND METHODS

This is a retrospective study based on the data of all patients presenting with AA to the ED of a tertiary COVID referral university hospital in Greece. We analysed the number of patients treated with AA, patient characteristics, and the proportion of patients with complicated appendicitis, and we compared the 2 groups of patients treated 12 months before and 12 months after COVID-19 onset in Greece.

RESULTS

A total of 152 patients were included in this study. There was a significant decrease in the number of patients presenting with AA after COVID-19 onset in Greece. Respectively, 91 and 61 patients were subjected to appendectomy 12 months before and after COVID-19 onset. Comparing the 2 groups of patients, there was a statistically significant increase in the operation time (p = 0.01) after COVID-19 onset, whereas the percentage of complicated appendicitis, the duration of symptoms before presenting to the ED (< 24 h, > 24 h), and the type of operation (laparoscopic, open, converted) did not differ significantly between the 2 groups of patients.

CONCLUSIONS

The number of patients presenting to the ED with AA decreased after COVID-19 onset, most likely because patients hesitated to seek help in a COVID-19 referral hospital.

Impact of COVID-19 pandemic on older cancer patients: Proposed solution by the International Geriatric Radiotherapy Group

Older cancer patients are disproportionally affected by the Coronavirus 19 (COVID-19) pandemic. A higher rate of death among the elderly and the potential for long-term disability have led to fear of contracting the virus in these patients. This fear can, paradoxically, cause delay in diagnosis and treatment that may lead to a poor outcome that could have been prevented. Thus, physicians should devise a policy that both supports the needs of older patients during cancer treatment, and serves to help them overcome their fear so they seek out to cancer diagnosis and treatment early. A combination of telemedicine and a holistic approach, involving prayers for older cancer patients with a high level of spirituality, may improve vaccination rates as well as quality of life during treatment. Collaboration between health care workers, social workers, faith-based leaders, and cancer survivors may be crucial to achieve this goal. Social media may be an important component, providing a means of sending the positive message to older cancer patients that chronological age is not an impediment to treatment.

The Impact of the COVID-19 Pandemic on Hernia Surgery: The South-East Scotland Experience

Aim

The coronavirus disease 2019 (COVID-19) pandemic resulted in a lockdown in South East Scotland on 23 March 2020. This had an impact on the volume of benign elective surgery able to be undertaken. The degree to which this reduced hernia surgery was unknown. The aim of this study was to review the hernia surgery workload in the Lothian region of Scotland and assess the impact of COVID-19 on hernia surgery.

Methods

The Lothian Surgical Audit database was used to identify all elective and emergency hernia operations over a six-month period from 23 March 2020 and for the same time period in 2019. Data were collected on age, gender, anatomical location of the hernia, hernia repair technique, and whether elective or emergency operation. Statistical analysis was performed using the chi-squared test in R-Studio, with a p-value of <0.05 accepted as statistically significant.

Results

The total number of hernia repairs reduced considerably between 2019 and 2020 (570 vs 149). The majority of this can be explained by a decrease in elective operating (488 vs 87), with the percentage of elective repairs reducing significantly from 85.6% to 58.4% (p<0.001). The inguinal hernia subgroup had a 24% rise in emergency operations from 21 to 26 operations, despite a reduction from 270 to 84 total inguinal repairs. There were just two elective hernia repairs carried out in the first three months of the 2020 study period (5.6% of all operations for April-June) compared to 265 (87.7%) for the same period in 2019 (p<0.001). No statistically significant differences were observed in the rates of laparoscopic versus open operating techniques across the two study periods on any analysis. The age and gender of the patients were similar over the two time periods.

Conclusion

The COVID-19 pandemic led to a marked reduction in the number of elective hernia repairs (especially incisional hernia surgery), with the effect most pronounced over the first three months of lockdown. Despite an overall reduction in total emergency operative figures, possibly due to more widespread use of non-operative strategies, there was still an increase in emergency inguinal hernia repairs during the lockdown. Further studies are needed to evaluate if the delays to elective operating will result in a long-term increase in the rates of emergency presentation.