COVID-19

Introduction: Anxiety and depression are highly prevalent psychiatric disorders among patients admitted for organic causes. Objective: To determine whether patients hospitalized with severe COVID-19 pneumonia present symptoms of anxiety and/or depression that are directly proportional to their clinical course. Materials and Methods: A longitudinal, prospective, observational study was conducted in the High Specialty and Advanced Medicine Building of the UANL University Hospital. Spanish-speaking patients of both sexes, aged 18 and over, diagnosed with severe COVID-19 pneumonia, were surveyed from September 2020 to January 2021. Sociodemographic data were obtained, including age, sex, comorbidities, occupation, education, marital status, national origin and religion, length of stay, and oxygen requirements. These data were collected directly from the patient or the most recent information from the patient's medical record. Anxiety and depression symptoms were assessed on the day of admission using the Hospital Anxiety and Depression Scale (HADS). Results: 57 patients hospitalized with COVID-19 pneumonia were followed during their hospital stay, until discharge, or until the patient required invasive mechanical ventilation. The mean age of the patients was 57.8 years. Upon admission, 29.8% of the patients presented symptoms suggestive of anxiety, and 7% presented clinically significant anxiety morbidity. In comparison, 8.8% of the patients presented symptoms suggestive of depression and 3.5% clinically indicative of comorbid depression. At the last evaluation in our study of patients, up to 12% presented anxiety symptoms (2% clinically morbid) and 2% significant depression morbidity. The trend toward depression and anxiety decreased over time and was highest in the first days of hospitalization. We found no association between these symptoms and having been intubated at any point during their stay. The median length of stay was 7 (4-10) days, and most were admitted with low-flow oxygen therapy (78.9%). Furthermore, we found a low to very low correlation between length of hospital stay, oxygen saturation, and oxygen volume with HADS scores for anxiety and depression. Conclusions: The prevalence of comorbid depression and anxiety was higher in the first days of hospital stay and was not related to patient clinical data, hospital stay, or receipt of invasive mechanical ventilation during their stay.

Citizen’s makeup a country or a nation, and their cohesive coexistence can be assumed to be tied to a common belief, faith or trust in those ruling or leading them and once this trust or common belief is violated by assume or presumed actions of those in position of trust, the sequela or consequences will be a breakdown of law and order at the long run, national disunity and a collapse of all national norms. The management of the COVID-19 pandemic has remained highly divisive and criticized by various groups in the US leading to draconic censorship, mandates, especially when it came to mandating the experimental use vaccines. This writer is writing from a personal perspective and seeks to explore what was told, what was observed and how these may or may not affect national security via citizens compliance for future interventions in health issues.

ABSTRACT From 2019, the world has faced the pandemic of high severity ever inexperienced: COVID 19. It has called the efforts of various stakeholders for prevention of its propagation, treatment of infected persons, limitation of its effects, etc. Healthcare workers have been at the forefront of response to COVID-19, risking their lives and their physical and mental health. Despite many efforts to improve the overall quality of healthcare service delivery during COVID-19 era, a number of patients reported to receive inadequate healthcare service. The objective of this research was to understand factors associated with the quality of healthcare service delivery, especially those linked to COVID-19 pandemic. Findings of research will contribute on the efforts for effective strategies for quality assurance in healthcare services delivery. This research was conducted in Kigali City, Southern and Eastern provinces of Rwanda, from January to April 2022. 385 respondents were identified among healthcare service providers and beneficiaries of those services. Data was collected using a questionnaire and interview guide. Quantitative data collected using a questionnaire was analyzed using SPSS version 22. On the other hand, qualitative data collected through interviews was analyzed using thematic analysis method. Results from data analysis were discussed before addressing conclusion and recommendations. The big proportion of healthcare service providers (56%) and beneficiaries (61%) ranked healthcare service delivery as good, while 78.6% of beneficiaries and 100% of healthcare service providers confirmed that they have observed the change in healthcare service delivery during this COVID-19 era. The great change was reported by 3.6% of beneficiaries, while only 17.8% of beneficiaries have not observed the change. The quality of healthcare service delivery has not been affected at the same level in all health institutions. The increased workload in health sector has been mentioned as the main factor which has strongly affected healthcare service delivery in public hospitals and health centers, while lockdowns have particularly affected healthcare service delivery for beneficiaries of referral hospitals. Specific short-term, medium-term, and long-term recommendations to strengthen health system or accessible high quality health care services during and after COVID-19 era were addressed. Keywords: COVID-19, SARS-COV-2, healthcare, healthcare service delivery

ABSTRACT Immunosuppressed kidney transplant recipients may have increased risk of causing severe disease during hospitalization of COVID-19. We conducted this review for better understanding the clinical characteristics and outcomes of this population. A literature search was undertaken to identify the studies which reported outcomes of kidney transplant recipients hospitalized with COVID-19 by searching MEDLINE, EMBASE, Web of Science and Google Scholar from January 1, 2019 to July 1, 2020. 38 studies reporting 217 KTR hospitalized with COVID-19 were included in the current study. All patients experienced fever, cough or dyspnea before hospitalization. 52.6% of recipients were classified as severe patients. The mortality of overall patients and discharged patients including those discharged alive and dead was 20.3% and 30.8%, respectively. Among discharged patients, 53.3% of those admitted to ICU, 73.3% requiring invasive ventilation and 38.5% receiving non-invasive ventilation died. 47.3% of in-hospital KTR developed AKI. Among the severe patients who developed AKI, 32.1% requiring renal replacement therapy during hospitalization. In conclusion, immunosuppressed kidney transplant recipients hospitalized with COVID-19 are at higher risk of developing severe disease (53.3%) at a relatively young age and have higher mortality (30.8%) and higher prevalence of acute kidney injury (47.3%) compared to the general population with COVDI-19. Keywords: Acute kidney injury; COVID-19; mortality; SARS-CoV-2; systematic review; transplantation

As per the reports of World Health Organisation (WHO), the first positive case of novel coronavirus infection (COVID-19) triggered on 8th of January 2020 in China and the disease as on 2020 May 13, prevalent over 215 countries. During this period, the virus have claimed over two lac lives and infected over twenty nine lac people around the globe despite substantial prophylactic measures and modernized health-care facilities. The virus causing COVID-19 pandemic outbreak was named as severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) and is believed to be transmitted initially from animals to human and later occurrence of person-to-person transmission is reported. India adopted “Lock Down” throughout the country as a strategic measure, well in advance to combat the disease like most of the other foreign countries. As a consequence, all types of large and small industrial sectors have been badly affected, resulting in a major socio-economic impact. The pandemic has created an unprecedented level of risk, causing investors to suffer significant losses in a very short period of time which is the worst crash since 1987 and there is a knock of $1.1 trillion, off the expected growth of global Gross Domestic Product (GDP). The government of India and most of the other countries has declared special packages for the workers of unorganized sectors, women, small and medium sized industries to deal with the situation. This review will focus on the overall information regarding the virus, global transference pattern analysis, socio-economic impact, treatment and management strategies by different countries and strategies to prevent future viral pandemics like this COVID-19 outbreak.