Mental Health Indices of Intensive Care Unit and Emergency Room Frontliners during the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic in India

We currently find ourselves in the midst of a global coronavirus disease 2019 (COVID-19) pandemic, caused by the highly infectious novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we discuss aspects of SARS-CoV-2 biology and pathology and how these might interact with the circadian clock of the host. We further focus on the severe manifestation of the illness, leading to hospitalization in an intensive care unit. The most common severe complications of COVID-19 relate to clock-regulated human physiology. We speculate on how the pandemic might be used to gain insights on the circadian clock but, more importantly, on how knowledge of the circadian clock might be used to mitigate the disease expression and the clinical course of COVID-19.

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375. COVID 19 infection in a Massachusetts community hospital

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.570 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S257-S258

Author(s):

Raul Davaro ◽

alwyn rapose

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Essential Hypertension ◽

Severe Acute Respiratory Syndrome ◽

High Mortality ◽

Case Series ◽

World Health ◽

Minimal Risk ◽

The Impact

Abstract Background The ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has led to 105690 cases and 7647 deaths in Massachusetts as of June 16. Methods The study was conducted at Saint Vincent Hospital, an academic health medical center in Worcester, Massachusetts. The institutional review board approved this case series as minimal-risk research using data collected for routine clinical practice and waived the requirement for informed consent. All consecutive patients who were sufficiently medically ill to require hospital admission with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample were included. Results A total of 109 consecutive patients with COVID 19 were admitted between March 15 and May 31. Sixty one percent were men, the mean age of the cohort was 67. Forty one patients (37%) were transferred from nursing homes. Twenty seven patients died (24%) and the majority of the dead patients were men (62%). Fifty one patients (46%) required admission to the medical intensive care unit and 34 necessitated mechanical ventilation, twenty two patients on mechanical ventilation died (63%). The most common co-morbidities were essential hypertension (65%), obesity (60%), diabetes (33%), chronic kidney disease (22%), morbid obesity (11%), congestive heart failure (16%) and COPD (14%). Five patients required hemodialysis. Fifty five patients received hydroxychloroquine, 24 received tocilizumab, 20 received convalescent plasma and 16 received remdesivir. COVID 19 appeared in China in late 2019 and was declared a pandemic by the World Health Organization on March 11, 2020. Our study showed a high mortality in patients requiring mechanical ventilation (43%) as opposed to those who did not (5.7%). Hypertension, diabetes and obesity were highly prevalent in this aging population. Our cohort was too small to explore the impact of treatment with remdesivir, tocilizumab or convalescent plasma. Conclusion In this cohort obesity, diabetes and essential hypertension are risk factors associated with high mortality. Patients admitted to the intensive care unit who need mechanical ventilation have a mortality approaching 50 %. Disclosures All Authors: No reported disclosures

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A Study on the Safety of Percutaneous Tracheostomy in Patients with Severe Acute Respiratory Syndrome Novel Corona Virus 2 (SARS-nCoV2) Infection: A Single-Center Observational Cohort Study in a CoVID Intensive Care Unit

SN Comprehensive Clinical Medicine ◽

10.1007/s42399-021-00996-z ◽

2021 ◽

Author(s):

Krishna Kumar Mylavarapu ◽

Aditya Joshi ◽

Ranjith Nair ◽

Rangraj Setlur ◽

Rajan Kapoor

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Severe Acute Respiratory Syndrome ◽

Percutaneous Tracheostomy ◽

Observational Cohort Study ◽

Single Center ◽

Corona Virus ◽

Observational Cohort

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More skilled clinical management of COVID-19 patients modified mortality in an intermediate respiratory intensive care unit in Italy

Respiratory Research ◽

10.1186/s12931-021-01613-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Giovanna E. Carpagnano ◽

Giovanni Migliore ◽

Salvatore Grasso ◽

Vito Procacci ◽

Emanuela Resta ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Severe Acute Respiratory Syndrome ◽

Clinical Management ◽

Average Length ◽

Limited Attention ◽

Average Length Of Stay ◽

Before And After ◽

Respiratory Intensive Care Unit ◽

Transferred Patients

Abstract Background Some studies investigated epidemiological and clinical features of laboratory-confirmed patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) the virus causing coronavirus disease 2019 (COVID-19), but limited attention has been paid to the follow-up of hospitalized patients on the basis of clinical setting and the expertise of clinical management. Methods In the present single-centered, retrospective, observational study, we reported findings from 87 consecutive laboratory-confirmed COVID-19 patients with moderate-to-severe acute respiratory syndrome hospitalized in an intermediate Respiratory Intensive Care Unit (RICU), subdividing the patients in two groups according to the admission date (before and after March 29, 2020). Results With improved skills in the clinical management of COVID-19, we observed a significant lower mortality in the T2 group compared with the T1 group and a significantly difference in terms of mortality among the patients transferred in Intensive Care Unit (ICU) from our intermediate RICU (100% in T1 group vs. 33.3% in T2 group). The average length of stay in intermediate RICU of ICU-transferred patients who survived in T1 and T2 was significantly longer than those who died (who died 3.3 ± 2.8 days vs. who survived 6.4 ± 3.3 days). T Conclusions The present findings suggested that an intermediate level of hospital care may have the potential to modify survival in COVID-19 patients, particularly in the present phase of a more skilled clinical management of the pandemic.

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Parent Psychological Distress in the Neonatal Intensive Care Unit Within the Context of the Social Ecological Model: A Scoping Review

Journal of the American Psychiatric Nurses Association ◽

10.1177/1078390318765205 ◽

2018 ◽

Vol 24 (6) ◽

pp. 495-509 ◽

Cited By ~ 5

Author(s):

Kristy Loewenstein

Keyword(s):

Mental Health ◽

Intensive Care Unit ◽

Intensive Care ◽

Psychological Distress ◽

Neonatal Intensive Care Unit ◽

Scoping Review ◽

Neonatal Intensive Care ◽

Family Cohesion ◽

Ecological Model ◽

Well Being

BACKGROUND: Neonatal intensive care unit (NICU) parents are at risk for psychological distress and impaired mental health, and statistics related to parent psychological distress vary. OBJECTIVE: To determine the scope of literature regarding the mental health and psychosocial well-being of parents in the NICU. DESIGN: A scoping review within the Arksey and O’Malley framework and the SEM was undertaken to answer, “What factors contribute to parent’s mental health in the NICU?” A systematic review of the literature was performed using the PRISMA methodology. RESULTS: Common socioeconomic factors and infant and parent characteristics may place parents at a greater risk for developing distress. History of mental illness, family cohesion, birth trauma, altered parenting role, gestational age, birth weight, and severity of prematurity/illness emerged as themes. CONCLUSION: Further research is required to provide a standard for the screening and assessment of parents’ mental health and psychosocial well-being during a NICU hospitalization. The experiences of nonbirth parents in the NICU should be explored to examine the effects of the hospitalization on all types of parents.

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Best practice guidelines on parental mental health in the neonatal intensive care unit: The importance and impact on infant health and developmental outcomes

Early Human Development ◽

10.1016/j.earlhumdev.2020.105277 ◽

2020 ◽

pp. 105277

Author(s):

Margaret K. Hoge ◽

Richard J. Shaw

Keyword(s):

Mental Health ◽

Intensive Care Unit ◽

Intensive Care ◽

Practice Guidelines ◽

Neonatal Intensive Care ◽

Best Practice ◽

Infant Health ◽

Developmental Outcomes ◽

Parental Mental Health ◽

Best Practice Guidelines

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Palliative care in critical areas (intensive care unit/emergency room): Actuation directed to a humanized multidisciplinary care and adequate allocation of resources

Journal of Critical Care ◽

10.1016/j.jcrc.2017.09.116 ◽

2017 ◽

Vol 42 ◽

pp. 407

Author(s):

Juraci Aparecida Rocha ◽

Douglas Henrique Crispim ◽

Daniel Dei Santis ◽

Ednalda Maria Franck ◽

Francimar Felipa da Costa ◽

...

Keyword(s):

Intensive Care Unit ◽

Palliative Care ◽

Intensive Care ◽

Emergency Room ◽

Multidisciplinary Care ◽

Allocation Of Resources ◽

Critical Areas

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The impact of EEG in the diagnosis and management of patients with acute impairment of consciousness

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2012000100008 ◽

2012 ◽

Vol 70 (1) ◽

pp. 34-39 ◽

Cited By ~ 5

Author(s):

João A. G. Ricardo ◽

Marcondes C. França Jr. ◽

Fabrício O. Lima ◽

Clarissa L. Yassuda ◽

Fernando Cendes

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Emergency Room ◽

Medical Management ◽

Clinical Management ◽

Epileptiform Activity ◽

Acute Setting ◽

Diagnosis And Management ◽

The Impact ◽

Electroencephalogram Eeg

OBJECTIVES: To assess the frequency of electroencephalogram (EEG) requests in the emergency room (ER) and intensive care unit (ICU) for patients with impairment of consciousness (IC) and its impact in the diagnosis and management. METHODS: We followed patients who underwent routine EEG from ER and ICU with IC until discharge or death. RESULTS: During the study, 1679 EEGs were performed, with 149 (8.9%) from ER and ICU. We included 65 patients and 94 EEGs to analyze. Epileptiform activity was present in 42 (44.7%). EEG results changed clinical management in 72.2% of patients. The main reason for EEG requisition was unexplained IC, representing 36.3% of all EEGs analyzed. Eleven (33%) of these had epileptiform activity. CONCLUSION: EEG is underused in the acute setting. The frequency of epileptiform activity was high in patients with unexplained IC. EEG was helpful in confirming or ruling out the suspected initial diagnosis and changing medical management in 72% of patients.

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