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Electrocardiographic features of patients with COVID-19: One year of unexpected manifestations

A multidisciplinary approach is relevant in the management of patients with chronic obstructive pulmonary disease (COPD). Identification of risk groups for the development of anxiety and depressive disorders among patients with different body weight will help to ensure an integrated approach to diagnosis and treatment. Objective — to determine the levels of anxiety and depression in patients with COPD exacerbation with different body weight. Materials and methods. We examined 40 patients with exacerbation of COPD (19 women and 21 men, the median age was 60 years), who were divided into groups: with normal weight (n = 15), overweight (n = 10) and obese (n = 15). The severity of anxiety and depression was determined by the Hospital Anxiety and Depression Scale (HADS). The results were analysed statistically. Results and discussion. It was found that the level of depression in patients with COPD exceeded the level of anxiety (11.0 [9.0; 13.0] vs. 9.5 [6.5; 11.0] points; p < 0.05). Symptoms of anxiety were noted in (67.5 ± 9.0) % of patients with COPD, symptoms of depression — in (90.0 ± 4.7) % patients (p < 0.05). The severity of depression in obese patients was significantly higher than in patients with normal body weight (12.0 [10.0; 14.0] vs. 9.0 [8.0; 11.0] points; p = 0.003). Subclinically expressed anxiety and depression were recorded in (30.0 ± 7.2) % and (35.0 ± 7.5) % of the subjects, clinically expressed — in (37.5 ± 7.6) % and (55.0 ± 7.9) %. Clinically manifested anxiety was observed significantly more often in overweight patients and clinically manifested depression — in obese patients ((60.0 ± 15.5) vs. (20.0 ± 10.3) % in normal weight; (73.3 ± 11.4) vs. (33.3 ± 12.2) % in normal weight; both p < 0.05). The body mass index of the examined patients directly correlated with the severity of depression (τ = 0.3; p = 0.005). Conclusions. Symptoms of anxiety and depression were detected in the majority of patients with COPD (67.5 and 90.0 %) and their clinically expressed forms — in 37.5 and 55.0 %. Patients with COPD and obesity are at risk of depression, which indicates the need for diagnostic measures to detect it in this category of patients and ensure timely correction.

To compare the levels of depression, anxiety, physical activity, and mobility restrictions between the first wave in June 2020 and the fourth wave in January 2022 of the coronavirus disease-2019 (COVID-19) pandemic in Brazil. Brazilian citizens answered a self-administered questionnaire that included questions related to personal information, mobility restriction levels, physical activity levels, and the status of mood disorders in June 2020 (n=1853) and January 2022 (n=728). The levels of mobility restrictions (p<0.001), anxiety (p<0.001), and depression (p<0.001) significantly decreased from 2020 to 2022. In June 2020, 23.2% of the participants presented moderate to severe anxiety, and in January 2022, this percentage decreased to 14.8%. In June 2020, 29.6% of the participants presented moderate to severe depressive symptoms, and in January 2022 this percentage decreased to 19.3%. On the contrary, physical activity levels significantly increased between 2020 and 2022 (p<0.001). During the fourth wave of the COVID-19 pandemic, participants were less restricted and more physically active than in the first wave. Furthermore, anxiety and depression levels were significantly lower in the fourth wave than in the first wave. Despite this reduction, levels of anxiety and depression remain high; therefore, the authors suggest measures to encourage physical activity and promote mental health.

Background:Headache is one of the commonly reported symptoms of coronavirus disease-2019 (COVID-19) illness. A number of studies have been done so far focusing on headache associated with COVID-19 with variable incidence and characteristics.Material and Methods:This study is a prospective study conducted on 120 patients with confirmed COVID-19 illness. Critically ill and ventilated patients were excluded. Demographic data, COVID illness symptom profile, headache characteristics were documented. Patients were followed up at 2 weeks and 4 weeks. For the statistical analysis, Statistical Package for the Social Sciences (SPSS), version 24.0 was used.Results:120 COVID-19 positive cases were included in the study with a mean age of 54.59 ± 14.89 years (range 21-84 years) with male-to-female ratio of 3:2. 78.33% (94) of patients had various comorbidities. 43.33% (52) cases were diabetic. The presenting symptoms were fever (65%), cough (53.33%), shortness of breath (35%) and myalgia (31.66%). 26 (21.66%) patients reported headache during the COVID illness. 18 (15%) cases had headache attributed as secondary to COVID-19 illness. Out of them, 12 cases were new onset with no past history of headache and 6 cases had a significant change in previous headache episodes. COVID-19 illness precipitated headache episodes similar to past headache type in 8 cases. Headache was the presenting symptom in 8 (6.66%) patients with COVID-19 being detected in the regular hospital screening protocol.Conclusion:Headache was a common symptom in COVID-19 patients. New onset headaches or change in past headache type in patients in the setting of ongoing pandemic should be screened for COVID-19.

Relationship Between Tinnitus Severity and Psychiatric Disorders

Psychiatric symptomatology and health-related quality of life in children with epilepsy

Famotidine Use Is Not Associated With 30-day Mortality: A Coarsened Exact Match Study in 7158 Hospitalized Patients With Coronavirus Disease 2019 From a Large Healthcare System

The coronavirus disease 2019 (COVID-19) pandemic has been assumed to affect mental health of college students. The present cross-sectional study was conducted to examine levels of knowledge and anxiety about COVID-19, as well as attitude towards the back-to-school arrangement among college students in China in May 2020. A total of 716 students (312 males, 404 females) were included. Only 38.1% of the participants showed good knowledge about COVID-19. Moderate and severe anxiety was observed among 7.6% of the students. There were 15.6% of the participants opposing the back-to-school arrangement. Female students had more risk of having anxiety symptoms and negative attitude towards the back-to-school arrangement (p < 0.05). In addition, the level of anxiety was positively associated with the negative attitude towards the back-to-school arrangement (r = 0.11, p < 0.05). We therefore suggest that health education and psychological interventions should be given to college students, especially females and those without health-related backgrounds during the COVID-19 pandemic.

To compare the prevalence and severity of depression and anxiety among patients with vocal fold (VF) nodules, polyps and edema. At the same time the aim was to analyse association between severity of distress and the level of vocal handicap as well as to identify other factors related to severity of depression and anxiety in these patients. To all participants were given five questionnaires: (1) questionnaire on socio-demographic and some other characteristics of patient; (2) Beck's Depression Inventory (BDI); (3) State-Trait Anxiety Inventory (STAI) 1 (State Anxiety); (4) STAI 2 (Trait Anxiety); and (5) Voice Handicap Index (VHI)-10. A total of 205 patients were included in this study. Mild-to-severe depression, according to BDI was present in 79 (38.6%) patients. Mild-to-severe state anxiety and trait anxiety were present in 199 (97.1%) and 200 (97.6%) patients, respectively. Only 10 patients had VHI-10 score ≤ 11. Multivariate analyses showed that there were no significant differences in the level of depression and anxiety between patients with VF nodules, polyps and edema. The VHI-10 score was significantly higher in patients with VF edema in comparison with VF nodule patients (p = 0.001), as well as in comparison with VF polyp patients (p = 0.001). The present study identified a high prevalence of psychological and vocal distress among patients with vocal disorders. Severity of depression and anxiety did not differ between patients with VF nodules, polyps and edema, and it was not related to the level of vocal handicap.

The coronavirus disease 2019 (COVID-19) pandemic has presented a globally challenging situation for human physical and mental health. Healthcare workers (HCWs) are affected by increased levels of anxiety, stress, and insomnia. This study aimed to evaluate the effect of COVID-19 on HCWs anxiety, stress, and insomnia levels. This cross-sectional study employed the Hospital Anxiety and Depression Scale, Perceived Stress Scale 10, and Insomnia Severity Index to assess anxiety, stress, and insomnia among HCWs at 10 COVID-19 isolation and treatment hospitals/centers after the first COVID-19 wave in Jordan. A web-based survey was used to collect data from 183 participants. Statistical analysis of factors affecting the mean scores of anxiety, stress, and insomnia was carried using student t-test or ANOVA while factors associated with differences in anxiety, stress, and insomnia frequencies were tested using Chi-square/Fisher exact test. Multivariate analysis was performed to determine the independent risk factors. Among participants, 97.3% reported moderate to severe levels of stress, 68% reported borderline to high abnormal levels of anxiety, and 32% had moderate to severe insomnia. The mean of anxiety total score was 9.8 ± 4.8, stress total score was 22.7 ± 4.5, and insomnia total score was 11.0 ± 7.1. Significant positive correlations were noted between anxiety, stress, and insomnia (P < .005). Female gender, migraine, less working years, increased time spent with patients, lower workforce, clinical insomnia and high stress were significant independent factors associated with anxiety (P < .05). Younger age, being single or divorced, heart disease, smoking, occupation (nurses), lower workforce, vaccination dose, and anxiety were significant independent factors associated with insomnia (P < .05). Increased time spent with patients, lower workforce, lower spouse and colleagues support, sadness due to isolation and anxiety were significant independent factors associated with stress. HCWs at COVID-19 centers had high levels of stress, anxiety, and insomnia. Appropriate interventions to maintain HCWs mental health are recommended.

Prevalence and risk factors for depression and anxiety in adult patients with epilepsy: Caregivers’ anxiety and place of residence do mater

The recent pandemic of coronavirus disease 2019 (COVID-19) have forced countries to be under lockdown,1 with strict emphasis being placed on self-isolation and social distancing.2 The major impact of this mandate is on patients with chronic diseases.3 Parkinson's disease (PD) is a chronic neurodegenerative disease, and anxiety is one of the most frequent neuropsychiatric disorders in PD, with an incidence higher than in any other chronic medical diseases (38% vs. 11%).4 The recent outbreak of coronavirus in Iran could be a contributing factor for worsening anxiety in this group of individuals. Therefore, to test this hypothesis we undertook this study by quantifying anxiety levels using the Beck Anxiety Inventory. This cross-sectional, case-control survey approved by the Iran National Committee for Ethics in Biomedical Researches (IR.SBMU.MSP.REC.1399.033) to evaluate the level of anxiety among PD patients compared with the general population. The study was carried out using a web-based questionnaire keeping in accordance with the current recommendations of preventing in person interviews to limit person-to-person contact. The questionnaire was administered to 500 patients with PD who were being followed up at the referral Movement Disorders Center in Tehran. The questionnaire consisted of Beck Anxiety Inventory II–Persian, which was validated in Persian. We excluded those patients who had a history of psychosis or a Mini-Mental State Examination score of ≤12 based on medical records.4 The questionnaire was also broadcasted over the internet using the WeChat public platform and over the mainstream media for the control group. Histories of PD and dementia were the exclusion criteria for healthy controls. A total of 137 subjects were diagnosed cases of PD who responded to the questionnaire, 95 were caregivers of the PD subgroup, and 442 participants were designated as controls after they were age and gender matched to the patient population. Table 1 provides the demographic details and disease-related and COVID-19–related variables. The mean Beck Anxiety Inventory II total score among PD patients and the control group was 18.34 ± 11.37 and 8.9 ± 8.26, respectively. Severe anxiety was recorded in 25.5% of the cases and 4.8% of controls. Furthermore, 60% of the caregivers had anxiety with 4.2% demonstrating severe anxiety. Therefore, there was a significant difference between the 3 groups with regard to the frequency of anxiety, and it was highest in the PD subgroup followed by their caregivers. In addition, people with a higher education had more anxiety. There was no correlation between PD duration and severity of anxiety, but there was a strong correlation between severity of anxiety in PD patients and fear of getting COVID19, and this correlation was significantly higher than the control group. There was also a strong correlation between being infected by COVID-19 and anxiety in PD patients. We also found higher levels of anxiety in patients with PD who were concerned about drug availability during the lockdown as well as in those with comorbid chronic medical conditions. Although the long-term impact of the COVID-19 pandemic on PD patients is yet to be determined, it seems that these patients are more prone to psychological disturbances attributed to the imposition of quarantine measures, social distancing, and fear of getting infected by COVID-19. These psychological disturbances may be attributed to the worsening of a preexisting anxiety, uncertainty regarding obtaining medications during lockdown, and the perceived higher risk of contracting COVID-19 because of an underlying chronic medical condition. (1) Research Project: A. Conception, B. Organization, C. Execution; (2) Statistical Analysis: A. Design, B. Execution, C. Review and Critique; (3) Manuscript: A. Writing of the First Draft, B. Review and Critique. M.S.: 1A, 1B, 1C, 2C, 2B, 3A, 3B A.R.Z.: 1B, 1C, 3B F.A.: 1A, 1C, 3B M.E.: 1A, 1B, 2C, 3B S.S.H.: 1A, 2C, 3B N.H.:2A, 2B, 2B, 2C H.A.: 1C, 2C, 3A

Depression and anxiety are prevalent psychiatric conditions and are associated with overactive bladder. The objective of this study was to determine prevalence and severity of anxiety and depression associated with overactive bladder (OAB) in women. 274 women with clinical diagnosis of OAB were recruited from 2012 to 2015. They were submitted to the International Consultation on Incontinence Questionnaire-Overactive Bladder (ICIQ-OAB), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Severe or moderate depression was present in 59.8% of women and severe or moderate anxiety was identified in 62.4%. Higher scores of depression and anxiety were associated with higher scores of ICIQ-OAB (P = 0.0031 and 0.0049). Women with severe depression had higher nocturia score than those with mild depression (P = 0.0046). Also, women with severe depression had higher urgency incontinence score than those with minimal depression (P = 0.0261). Patients with severe anxiety had higher nocturia score than those with minimal anxiety (P = 0.0118) and women with moderate anxiety had higher urgency incontinence score than with minimal anxiety (P = 0.0300). Moderate or severe depression and anxiety are prevalent in women with OAB. There is a correlation between intensity of OAB symptoms with depression and anxiety. Anxiety and depression levels are mainly related with urgency incontinence and nocturia.

IntroductionResistin is reported to form a cytokine network and cause endothelial damage. The pathogenesis of coronavirus disease 2019 (COVID-19) remains unknown, but the association between cytokine storm and endothelial damage is crucial. This study aimed to evaluate resistin in COVID-19 pathogenesis compared with sepsis.Materials and MethodsFirst, we evaluated the association of plasma resistin levels and disease severity and clinical outcome in two large cohorts: a publicly available cohort including 306 COVID-19 patients in the United States (MGH cohort) and our original cohort including only intubated 113 patients in Japan (Osaka cohort 1). Second, to understand pathogenesis, we evaluate resistin, cytokines and endothelial cell adhesion molecules in COVID-19 compared with sepsis. Blood samples were collected from 62 ICU-treated COVID-19 patients and 38 sepsis patients on day 1 (day of ICU admission), days 2-3, days 6-8, and from 18 healthy controls (Osaka cohort 2). The plasma resistin, inflammatory cytokines (IL-6, IL-8, MCP-1 and IL-10) and endothelial cell adhesion molecules (ICAM-1 and VCAM-1) were compared between patients and control. Correlations among resistin, inflammatory cytokines and endothelial cell adhesion molecules were evaluated in COVID-19 and sepsis.ResultsIn the MGH cohort, the day 1 resistin levels were associated with disease severity score. The non-survivors showed significantly greater resistin levels than survivors on days 1, 4 and 8. In the Osaka cohort 1, 28-day non-survivors showed significantly higher resistin levels than 28-day survivors on days 6-8. Patients with late recovery (defined as the day of weaning off mechanical ventilation >12 or death) had significantly higher resistin levels than those with early recovery on day 1 and days 6-8. In the Osaka cohort 2, plasma resistin levels were elevated in COVID-19 and sepsis patients compared to controls at all measurement points and were associated with inflammatory cytokines and endothelial cell adhesion molecules.ConclusionResistin was elevated in COVID-19 patients and was associated with cytokines and endothelial cell adhesion molecules. Higher resistin levels were related to worse outcome.

Nosocomial septicemia in COVID-19 nosocomial K. pneumoniae, A. baumannii, and Elizabethkingia meningoseptica septicemia in a patient of COVID-19