Understanding COVID-19 vaccination attitudes is of paramount importance in order to estimate and influence the willingness to vaccinate. A cross-sectional study was performed in the spring of 2021 in Romania by sending a web-based questionnaire to patients with rheumatic autoimmune diseases in order to assess their willingness to vaccinate against SARS CoV-2 and to identify factors that might influence their decision. Variables derived from the questionnaire were analyzed in univariable and multivariable analysis. 71 patients, of which 60 (84.5%) women, were included in the study, with a 53.5% (38 subjects) willingness to vaccinate. A positive association was observed between the willingness to vaccinate and the patients’ trust in authorities, trust in the healthcare system and the choice of scientific sources of information in their decision making. A positive correlation was observed between the intention to vaccinate and the global VAX score, as well as the subscale VAX scores (p<0.05). Global VAX score emerged as a predictive factor for the intention to vaccinate on logistic regression (p<0.05). The present study underlines the importance of reliable scientific sources of information for pa-tients with autoimmune diseases and how the general attitude about vaccination becomes a pre-dictive factor for accepting COVID-19 vaccine.
During COVID-19 era, a special attention was considered for autoimmune disorders (AD), including at thyroid, which are regarded at higher risk knowing that stress and infections might aggravate the pattern of anti-thyroid antibodies as well as thyroid dysfunction. In this study, we aim to analyse how COVID-19 infection influenced the evolution of HT parameters versus patients with HT who did not go through infection. Study design: an observational, bi-centric study in Romania during first 14 months of pandemic. By the end of April 2022, Romania registered 1,047,520 total cases of COVID- 19 infection (a morbidity rate calculated for entire Romanian population of 5.23%) with 27,267 total deaths (a lethality rate of 2.6%) and around 2000 new patients a day. From our database of 2210 HT patients, a number of 386 HT subjects were assessed (14 months). Among them, 33/386 patients had a different form of COVID-19 infection. The prevalence of COVID- 19 infection among HT patients was 9.35% which is statistically significant higher when compare with official ratio for entire Romanian population (a morbidity rate of 5.23%, z = 3.162, p = 0.00033). A feminine prevalence was identified (89.37%, N=31/33), while age was not different between subgroups (average age over 50 y). At the moment of diagnostic, thyroid levels at the diagnostic time was 650 UI/mL in group 1 versus 840 UI/mL in group 2 (both groups had very high ATPO values, normal cut-offs below 34 UI/mL) with not statistical significance difference - of ATPO evolution was undulatory in 74.07% of patients, decreasing - 3.7%, increasing - 11.11%, unmodified (stationary) - 11.11%, similarly with group 2, meaning that ATPOs had the same profile, regardless the fact that some subjects went through COVID-19 infection. The rate of associated AD was 28.24% (N=2210), COVID-group of 42.42%, non-COVID group of 38.53% (z = 0.44, p = 0.66). In our COVID cohort of 33 patients with HT, we registered the following clinical stages of coronavirus infection: 4/33 patients who were asymptomatic; all women, average age: 65.65 years; 2/33 patients with lack of smell and taste; women, over 65 years old; 14/33 patients with mild form; from 31 years old to 70.5 years old (only one man); 10 patients with a moderate form; all women, from 34 to 71 years old; one 87-year-old male with a severe form; one 50-year old female with a very severe form in addition to a hematologic disease and a history of severe allergic reactions; and a single patient (a 68-year-old, obese female with a severe allergic background) died of COVID-19 infection (thus generating a lethality rate of 3.03%). Conclusion. Our study showed a higher prevalence of COVID-19 infection among HT patients. These individuals do not associate increased levels of ATPO or a elevated prevalence of AD when compare with non- COVID – HT group, and have similar age and sex ratio. Whether HT exposes the subjects to coronavirus infection is an open issue.
The appropriate clinical decision-making of the nurses can improve the patient outcome and reduce costs, otherwise delaying the recovery and preferably the death of the patient especially in acute care setting. The aim of this study was to describe the clinical decision making in care of patients with acute care in critical nurses. This study was a qualitative study conducted in 2020. Purposive sampling was used and continued until saturation. The study involved sixteen semi-structured interviews were conducted with critical nurses who had experience providing care for acute patients in critical care units. Interviews transcript and analyzed by qualitative content analysis. Two major themes were generated from the data included instantaneous decision-making and life-saving of the patient. This process was depended on the nurse’s ability to summarize in the moment, to consider everything, to focus on the patient, to combine experience and knowledge, to concern the patient's life, to prevent the deterioration of the patient's conditions and responsibility to their patients.
The present study aimed to examine the mediating role of ego-strength in the relationship between religious health behaviors and mental health symptoms during the COVID-19 pandemic in Iran. A total of 346 university students (301 women, 45 men) completed the Ego-Strength Scale, Religious Health Promoting Behaviors Inventory, and Mental Health Inventory from May 2021 to August 2021. The structural equation modeling and the Pearson correlation method were used. The results revealed that religious health behaviors have a positive and significant relationship with, psychological well- being, and ego-strength, as well as a negative significant relationship with psychological distress. The results also showed ego-strength has a negative relationship with psychological distress. Ego-strength mediated the relationship between religious health behaviors and symptoms of mental health. Ego-strength can be considered as a very important variable in religious health psychology; reinforcing ego-strength may have some implications for mental health during the Covid-19 pandemic.
Background and aim: After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes, in a Covid-19 support military hospital were analyzed. Methods: The national protocol for the treatment of Covid-19 infection was applied. The costs for laboratory tests, drugs, protection equipment and radiological investigations (imaging techniques such as computed-tomography or radiography), hospitalization days and food were assessed. Results: In our hospital, from August 2020 through June 2021, 241 patients were hospitalized with COVID-19: mean age 59.92±7.8 years, 46% men, 26% military personnel, 11.57±3 days of hospitalization; two third of patients had moderate and severe forms of COVID-19. The main manifestations were: 69% respiratory (18% with severe pneumonia), 3.3% cardiac (2.9% with pulmonary embolism, diagnosed by computed tomography angiography), 28% digestive and 33% psychiatric (most commonly anxiety). The average estimated costs were about 3000€/patient, without significant differences based on disease severity. Equipment costs were 2 times higher than for drugs and 3 times than for laboratory tests. Conclusions: In a Covid-19 support military hospital that cared for patients with predominantly moderate forms of COVID-19, the costs for equipment were much higher than those for treatment. New criteria for hospitalization of these forms of COVID-19 deserve to be analyzed in order to avoid useless costs.
During the COVID-19 pandemic, neuropsychiatric disorders have been diagnosed both in the acute phase, and in the aftermath of this disease. Inpatients, as well as outpatients recently diagnosed with mild, moderate or severe forms of Coronavirus infection have reported neuropsychiatric manifestations with variable duration, symptoms that could be directly or indirectly related to the viral pathogenic agent. Patients who are recovering from the acute phase of COVID-19 also may exhibit various psychopathological manifestations, during the so-called “post-COVID-19 syndrome” or “long COVID-19 syndrome”. Explanations regarding the onset of this type of clinical manifestations and the SARS-CoV-2 infection are extremely diverse, ranging from biological factors (e.g., direct central nervous system viral activity, cerebral hypo- oxygenation, high level of inflammatory response) to psycho-social stressors (e.g., isolation, fear of death, anxiety related to possible somatic complications or sequelae). Objectives: The primary objective of this article was to analyze psychiatric manifestations in patients with acute COVID-19 disease and in patients during post-COVID-19 phase. The secondary objective was to propose a conceptual framework for the evaluation and treatment of these patients. Methods: Patients included in this analysis were screened positive for COVID-19 infection in the last 6 months before their first psychiatric examination. These patients were further evaluated to detect any personal history of psychiatric disorders, somatic comorbidities, or significant concomitant pharmacological treatments. Specific scales for the measurement of symptoms severity and functional impairment were administered in all patients. Results: Five patients were included in this analysis, one during the acute phase of COVID-19 infection, and four patients were evaluated after the complete remission of this disease. Hyperactive delirium, mild neurocognitive disorder, major depressive episode, panic disorder with agoraphobia, or acute psychotic disorder were the main diagnoses in these patients. All patients received adequate treatment and they were monitored using psychological scales until symptoms remission or stabilisation. Conclusions: Psychosocial stressors, neurobiological changes, systemic inflammatory reaction, and individual vulnerability factors may contribute to a diathesis- stress model for psychiatric disorders onset within the acute phase or after the remission of acute manifestations in COVID- 19-diagnosed patients.
Background: Coronavirus disease 2019 (COVID-19) was recognized by the World Health Organization (WHO) as a global pandemic on March 11, 2020. Since then, researchers worldwide have focused their attention on identifying effective treatments and developing vaccines to combat this disease. Aim: To report the effectiveness of the drugs employed in the COVID-19 treatment protocols based on data from clinical trial studies conducted from the beginning of the pandemic until December 10, 2020. Methods: Following the PRISMA guidelines, we conducted an advanced search in several electronic databases. A total of 13553 studies was screened by two people simultaneously and separately based on the article title, abstract and full-text. The quality of the studies was evaluated using the Cochrane criteria. Results: Of the 13553 studies identified, 50 clinical trials were included in this systematic review. Of these, three studies explored the use of remdesivir, nine studies the use of hydroxychloroquine, five studies the use of lopinavir/ritonavir, six studies the use of favipiravir, one study the use of tocilizumab, two studies the use of interferon beta-1a and two studies the use of umifenovir.
The prevalence of coronavirus disease 2019 (COVID-19) is the third registered spillover of an animal coronavirus to humans from the early 21st century. Coronaviruses are important human and animal pathogens. The 2019 novel coronavirus (2019-nCoV) rapidly spreads, resulting in an epidemic throughout China, followed by an increasing number of cases in other countries throughout the world. Recently, a wide range of inhibitors have been introduced for treatment of COVID-19, and also promising vaccines are in late phase of development. Here, we aim to present an overview of recent findings of the biological and clinical aspects of SARS-CoV-2 infection, along with possible treatments and future vaccines.
Evaluated efficacy of Respiratory Physiotherapy and Remdesivir on patients with COVID-19 pneumonia. In current systematic review and meta-analysis study, articles published January 2019 to December 1, 2021 were reviewed in the databases of PubMed, Scopus, Web of Science, and EBSCO. Risk ratio and mean differences with 95% confidence interval (CI), fixed effect model and Mantel–Haenszel or Inverse-variance formula were calculated. The Meta analysis have been evaluated with the statistical software Stata/MP v.16 (The fastest version of Stata). Mean differences of PaO2/FiO2 ratio at 6h after chest Respiratory Physiotherapy was (MD, 66 mmHg 95 % CI 64.71 mmHg, 67.28 mmHg; p=0.0007). Risk ratio of recovery rate between experimental and control group was 0.20 (RR, 0.20 95 % CI 0.15, 0.25) with high heterogeneity (I2 =78.84%; p=0.00). Risk ratio of mortality rate between experimental and control group was -0.34 (RR, -0.34 95 % CI -0.65, - 0.03) with low heterogeneity (I2<0%; p=0.51). Based on the findings of meta-analysis, Respiratory Physiotherapy can play an effective role in respiratory therapy and rehabilitation of patients admitted to the ICU with COVID-19. A meta-analysis showed that treatment with Remdesivir could increase the recovery rate, especially in the early days of COVID-19; also reduces the mortality rate.
Acute kidney injury (AKI) and glomerulonephritis can be complications in COVID-19 patients, which is announced with widely incidence rates in different investigations and is determined to have a major effect on the prognosis of the disease. There are considerable variations in AKI and glomerulonephritis rates between other countries. The rate is generally lower than in Western Europe and the United States in China. Heterogeneity in different racial and ethnic lines can be a potential explanation. This investigation systematically reviews the scientific resources regarding AKI and glomerulonephritis among hospitalized COVID-19 patients. Both observational and interventional investigations(including case reports) with English full-text provide essential data, with no limitation in release or peer-review. More evidence is required to assess the AKI, especially glomerulonephritis in Covid-19 patients, for better management of Covid-19.
