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Sleep, Stress, and Symptoms Among People With Heart Failure During the COVID-19 Pandemic.
O'Connell, M, Jeon, S, Conley, S, Linsky, S, Redeker, NS
The Journal of cardiovascular nursing. 202301;38(2):E55-E60
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COVID-19 pandemic raised concerns about the effects of stress on mental health and sleep deficiency. Cognitive behavioural therapy for insomnia (CBT-I) has been shown to improve sleep quality and insomnia severity, as well as anxiety and depression, and may be protective during times of stress, including the COVID-19 pandemic. The aim of this study was to examine changes in sleep, sleep-related cognitions, stress, anxiety, and depression among people with heart failure (HF). This study was a randomised controlled trial of the effects of CBT-I compared with HF self-management education (attention-control condition), the “HeartSleep Study.” Results showed that improvements in insomnia severity, sleep quality, latency, and efficiency, sleep-related cognitions and stress, anxiety, and depression after participation in CBT-I or an HF self-management class were sustained during the pandemic. Authors conclude that their findings confirm the clinical benefits of CBT-I for people with HF and comorbidities and also suggest the potential benefits of HF self-management education.
Abstract
BACKGROUND The COVID-19 pandemic raised concerns about the effects of stress on sleep and mental health, particularly among people with chronic conditions, including people with heart failure (HF). OBJECTIVE The aim of this study was to examine changes in sleep, sleep-related cognitions, stress, anxiety, and depression among people with HF who participated in a randomized controlled trial of cognitive behavioral therapy for insomnia before the COVID-19 pandemic. METHODS Participants self-reported sleep characteristics, symptoms, mood, and stress at baseline, 6 months after cognitive behavioral therapy for insomnia or HF self-management education (attention control), and during the pandemic. RESULTS The sample included 112 participants (mean age, 63 ± 12.9 years; 47% women; 13% Black; 68% New York Heart Association class II or III). Statistically significant improvements in sleep, stress, mood, and symptoms that occurred 6 months post treatment were sustained during the pandemic. CONCLUSIONS Improving sleep and symptoms among people with HF may improve coping during stressful events, and cognitive behavioral therapy for insomnia may be protective.
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Food Insecurity in Greece and across the Globe: A Narrative Literature Review.
Fotakis, EA, Kontele, I, Tzoutzou, M, Grammatikopoulou, MG, Arvanitaki, E, Sergentanis, TN, Kotrokois, K, Kornarou, E, Vassilakou, T
Foods (Basel, Switzerland). 2024;(10)
Abstract
Food insecurity comprises a major global public health threat, as its effects are detrimental to the mental, physical, and social aspects of the health and well-being of those experiencing it. We performed a narrative literature review on the magnitude of global food insecurity with a special emphasis on Greece and analyzed the major factors driving food insecurity, taking into consideration also the effect of the COVID-19 pandemic. An electronic search of international literature was conducted in three databases. More than 900 million people worldwide experience severe food insecurity, with future projections showing increasing trends. Within Europe, Eastern and Southern European countries display the highest food insecurity prevalence rates, with Greece reporting a prevalence of moderate or severe food insecurity ranging between 6.6% and 8% for the period 2019-2022. Climate change, war, armed conflicts and economic crises are major underlying drivers of food insecurity. Amidst these drivers, the COVID-19 pandemic had a profound impact on food insecurity levels around the globe, through halting economic growth, disrupting food supply chains and increasing unemployment and poverty. Tackling food insecurity through addressing its key drivers is essential to any progress towards succeeding the Sustainable Development Goal of "Zero Hunger".
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The SABER School Feeding policy tool: a 10-year analysis of its use by countries in developing policies for their national school meals programs.
Schultz, L, Renaud, A, Bundy, DAP, Barry, FBM, Benveniste, L, Burbano de Lara, C, Lo, MM, Neitzel, J, O'Grady, N, Drake, L
Frontiers in public health. 2024;:1337600
Abstract
Since its launch in 2011, 59 governments have used the World Bank's Systems Approach for Better Education Results (SABER) policy tool to design their national school-based health and nutrition programs. This tool guides governments to self-evaluate their education system policies against international benchmarks and identify actionable priorities to strengthen national programs. Thirty-two of the 49 countries in sub-Saharan Africa (65%) have undertaken a SABER review, and globally the approach has been adopted by 68% of the world's low-income countries and 54% of lower-middle-income countries. Analysis of 51 comparable SABER School Feeding surveys suggests that countries with longer established national school meals frameworks tend also to be more advanced in other policy areas, and vice versa. The SABER reviews consistently identify, perhaps predictably, that the weakest policy areas relate to program design, implementation and fiscal space. This analysis also found that the tool had an additional value in tracking the evolution of policies when implemented over several time points, and showed that policy areas become more advanced as national programs mature. These benefits of the tool are particularly relevant to the 98 countries that co-created the global School Meals Coalition in 2021. The Coalition member countries have the specific goal of enhancing coverage and support for the well-being of schoolchildren and adolescents affected by the school closures during the COVID-19 pandemic. The SABER tool has the demonstrated potential to implement, accelerate and track changes in school meals policy and, since it has been previously used by 74% (31/42) of low- and lower-middle-income countries in sub-Saharan Africa, is an already accepted element of the political economies of those countries and so has the potential to be deployed rapidly.
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Cytokine Storm in COVID-19: Insight into Pathological Mechanisms and Therapeutic Benefits of Chinese Herbal Medicines.
Yu, Q, Zhou, X, Kapini, R, Arsecularatne, A, Song, W, Li, C, Liu, Y, Ren, J, Münch, G, Liu, J, et al
Medicines (Basel, Switzerland). 2024;(7)
Abstract
Cytokine storm (CS) is the main driver of SARS-CoV-2-induced acute respiratory distress syndrome (ARDS) in severe coronavirus disease-19 (COVID-19). The pathological mechanisms of CS are quite complex and involve multiple critical molecular targets that turn self-limited and mild COVID-19 into a severe and life-threatening concern. At present, vaccines are strongly recommended as safe and effective treatments for preventing serious illness or death from COVID-19. However, effective treatment options are still lacking for people who are at the most risk or hospitalized with severe disease. Chinese herbal medicines have been shown to improve the clinical outcomes of mild to severe COVID-19 as an adjunct therapy, particular preventing the development of mild to severe ARDS. This review illustrates in detail the pathogenesis of CS-involved ARDS and its associated key molecular targets, cytokines and signalling pathways. The therapeutic targets were identified particularly in relation to the turning points of the development of COVID-19, from mild symptoms to severe ARDS. Preclinical and clinical studies were reviewed for the effects of Chinese herbal medicines together with conventional therapies in reducing ARDS symptoms and addressing critical therapeutic targets associated with CS. Multiple herbal formulations, herbal extracts and single bioactive phytochemicals with or without conventional therapies demonstrated strong anti-CS effects through multiple mechanisms. However, evidence from larger, well-designed clinical trials is lacking and their detailed mechanisms of action are yet to be well elucidated. More research is warranted to further evaluate the therapeutic value of Chinese herbal medicine for CS in COVID-19-induced ARDS.
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Effectiveness of Omega-3 Fatty Acid Supplementation in Improving the Metabolic and Inflammatory Profiles of Mexican Adults Hospitalized with COVID-19.
Rodríguez-Vera, D, Salazar, JR, Soriano-Ursúa, MA, Guzmán-Pérez, J, Vergara-Castañeda, A, Muñoz-Durán, H, Ramírez-Velez, GL, Vivar-Sierra, A, Naranjo-Navarro, CR, Meza-Meneses, PA, et al
Diseases (Basel, Switzerland). 2024;(1)
Abstract
BACKGROUND AND OBJECTIVES The development of severe COVID-19 is related to the preexistence of comorbidities and an inadequate nutritional status. The latter is a critical factor for the development of infection and the progression of the disease. Notably, optimal nutrition impacts immune system function, as malnutrition is related to high cytokine levels in the late phase of the disease, correlating with a poor prognosis. In this sense, omega-3 fatty acids (O3FAs) have anti-inflammatory properties that may reduce morbidity and mortality from COVID-19 infection. O3FAs are linked to a better prognosis in COVID-19 patients. MATERIALS AND METHODS In this randomized, double-blind clinical trial, we evaluate the administration of O3FAs to unvaccinated Mexican patients for two weeks starting after the first two hours of hospitalization. RESULTS The findings support the notion that O3FAs (in a dose high enough to satisfy human physiological requirements in a short time, one capsule of 1.4 g O3FAs daily) exert a comprehensive multi-systemic modulatory influence, affecting inflammatory and metabolic pathways. Significant perturbations in biomarkers, including absolute neutrophil count, hematocrit, and platelet indices, underscore the compound's anti-inflammatory effect. Concurrently, the intervention modulates pivotal metabolic and hepatic parameters, attenuating cardiovascular risk profiles and expediting patient convalescence. These multifarious effects are likely orchestrated through intricate biochemical mechanisms and are subject to individual variations predicated on metabolic factors. CONCLUSIONS The results of this trial support the notion that O3FA supplementation has beneficial effects on COVID-19 patients with moderate presentation by regulating metabolism and limiting inflammation.
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Psychological profile of Chinese peritoneal dialysis patients during the Omicron pandemic in 2022.
Qiu, J, Zhang, C, Xie, J, Lin, S, Ren, H, Huang, X, Xu, T
BMC psychology. 2024;(1):109
Abstract
OBJECTIVE The aim of this study was to determine the psychological status of peritoneal dialysis (PD) patients who were blocked during the 2022 Omic Pandemic in Shanghai. METHODS This was an observational and cross-sectional study. We selected 172 PD patients from the peritoneal dialysis center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, during the quarantine of the Omicron pandemic in Shanghai from April to May 2022. General data and biochemical indices were collected. The Kidney Disease Quality of Life (SF-36) questionnaire was used to evaluate the psychological state of the patients during the quarantine. RESULTS According to the assessment of the SF-36 scale, the physiological and psychological health status of PD patients was better than that before quarantine (P < 0.05). According to the comparison of biochemical indices, the high-density lipoprotein, total cholesterol and body mass index (BMI) levels were lower in patients after quarantine than before quarantine, while the blood phosphorus, blood calcium and haemoglobin levels were greater after quarantine (P < 0.05). Logistic regression analysis revealed that health changes were positively correlated with age of penetration (years) (OR = 1.031, 95% CI = 1.005-1.058); however, physiological function was negatively correlated with sex (OR = 0.198, 95% CI = 0.044-0.899). Energy was significantly positively correlated with closed-loop time (OR = 1.063, 95% CI = 1.001-1.128) (P < 0.05). There were no significant differences in biochemical indices or quality of life between APD patients and non-APD patients (P > 0.05). According to the results of the abstract independent sample T test, when comparing the various dimensions of the SF-36 scale, for the dimensions of physiological function, pain and energy, the PD patients were better than the HD patients were (P < 0.05). Similarly, for the dimension of physiological function, the HD patients were better than the PD patients were (P < 0.05). During the quarantine period from April to May in Shanghai, the infection rate of PD patients was lower than usual (P < 0.05). CONCLUSIONS During the Omicron pandemic in Shanghai in 2022, PD patients exhibited relatively stable psychological and physiological states and a low infection rate. Compared with HD patients, PD patients had better adaptability. Especially in the context of the COVID-19 pandemic, peritoneal dialysis has more advantages.
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Daily routine disruptions and psychiatric symptoms amid COVID-19: a systematic review and meta-analysis of data from 0.9 million individuals in 32 countries.
Liu, H, Tao, TJ, Chan, SKY, Ma, JCH, Lau, AYT, Yeung, ETF, Hobfoll, SE, Hou, WK
BMC medicine. 2024;(1):49
Abstract
BACKGROUND There is currently a deficit of knowledge about how to define, quantify, and measure different aspects of daily routine disruptions amid large-scale disasters like COVID-19, and which psychiatric symptoms were more related to the disruptions. This study aims to conduct a systematic review and meta-analysis on the probable positive associations between daily routine disruptions and mental disorders amid the COVID-19 pandemic and factors that moderated the associations. METHODS PsycINFO, Web of Science, PubMed, and MEDLINE were systematically searched up to April 2023 (PROSPERO CRD42023356846). Independent variables included regularity, change in frequency, and change in capability of different daily routines (i.e., physical activity, diet, sleep, social activities, leisure activities, work and studies, home activities, smoking, alcohol, combined multiple routines, unspecified generic routines). Dependent variables included symptoms and/or diagnoses of mental disorders (i.e., depression, anxiety, post-traumatic stress disorder, and general psychological distress). RESULTS Fifty-three eligible studies (51 independent samples, 910,503 respondents) were conducted in five continents. Daily routine disruptions were positively associated with depressive symptoms (r = 0.13, 95% CI = [0.06; 0.20], p < 0.001), anxiety symptoms (r = 0.12, 95% CI = [0.06; 0.17], p < 0.001), and general psychological distress (r = 0.09, 95% CI = [0.02; 0.16], p = 0.02). The routine-symptom associations were significant for physical activity, eating, sleep, and smoking (i.e., type), routines that were defined and assessed on regularity and change in capability (i.e., definition and assessment), and routines that were not internet-based. While the positive associations remained consistent across different sociodemographics, they were stronger in geo-temporal contexts with greater pandemic severity, lower governmental economic support, and when the routine-symptom link was examined prospectively. CONCLUSIONS This is one of the first meta-analytic evidence to show the positive association between daily routine disruptions and symptoms of mental disorders among large populations as COVID-19 dynamically unfolded across different geo-temporal contexts. Our findings highlight the priority of behavioral adjustment for enhancing population mental health in future large-scale disasters like COVID-19.
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Association between COVID-19 and the incidence of type 1 diabetes in Portugal - a registry study.
Bjerregaard-Andersen, M, Da Silva, J, Diogo, R, Claro, AR, Ferro, I, Romana, A, Rocha, P, Sá, B, Lobarinhas, G, Rolim, S, et al
BMC endocrine disorders. 2024;(1):145
Abstract
BACKGROUND Viral respiratory infections may precipitate type 1 diabetes (T1D). A possible association between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, and the incidence of T1D is being determined. This study was carried out using Portuguese registries, aiming at examining temporal trends between COVID-19 and T1D. METHODS Hospital data, comparing the incidence before and during the COVID-19 pandemic, from children and young adults diagnosed with new-onset T1D, was acquired beginning in 2017 and until the end of 2022. Data was obtained from nine different Portuguese hospital units. The impact of the COVID-19 pandemic, beginning in March 2020, was assessed comparing the annual numbers of new-onset T1D cases. The annual median levels of glucose, glycated hemoglobin (HbA1c) and fasting C-peptide at T1D diagnosis were compared. The annual number of diabetic ketoacidosis (DKA) episodes among new T1D cases was also assessed at two centers. RESULTS In total, data from 574 newly diagnosed T1D patients was analyzed, including 530 (92.3%) children. The mean ages for child and adult patients were 9.1 (SD 4.4) and 32.8 (SD 13.6) years, respectively. 57.8% (331/573) were male, one patient had unknown sex. The overall median (25-75 percentiles) levels of glucose, HbA1c and fasting C-peptide at diagnosis were 454 mg/dL (356-568), 11.8% (10.1-13.4) and 0.50 µg/L (0.30-0.79), respectively. DKA at T1D diagnosis was present in 48.4% (76/157). For eight centers with complete 2018 to 2021 data (all calendar months), no overall significant increase in T1D cases was observed during the COVID-19 pandemic, i.e. 90 cases in 2018, 90 cases in 2019, 112 in 2020 and 100 in 2021 (P for trend = 0.36). Two of the centers, Faro (CHUA) and Dona Estefânia (CHULC) hospitals, did however see an increase in T1D from 2019 to 2020. No significant changes in glucose (P = 0.32), HbA1c (P = 0.68), fasting C-peptide (P = 0.20) or DKA frequency (P = 0.68) at the time of T1D diagnosis were observed over the entire study period. CONCLUSION The T1D incidence did not increase significantly, when comparing the years before and during the COVID-19 pandemic, nor did key metabolic parameters or number of DKA episodes change.
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Randomized Controlled Trials for Post-COVID-19 Conditions: A Systematic Review.
Motilal, S, Rampersad, R, Adams, M, Goon Lun, S, Ramdhanie, A, Ruiz, T, Shah, A, Wilkinson, A, Lewis, J
Cureus. 2024;(8):e67603
Abstract
Post-coronavirus disease 2019 (COVID-19) syndrome or condition (PCS) is defined as new onset symptoms for at least three months following COVID-19 infection that has persisted for at least two months. Given the global sequelae of COVID-19, there is an urgent need for effective PCS interventions. The aim of this study was to systematically review all interventions for PCS tested in randomized controlled trials. In this International Prospective Register of Systematic Reviews (PROSPERO) registered (CRD42023415835) systematic review, PubMed, Google Scholar, and ClinicalTrials.gov databases were searched between 1st January 2020 and 30th April 2023. Inclusion criteria were (1) randomized controlled trials that tested interventions for (2) PCS as defined above. Studies were independently reviewed, and final decisions regarding extracted data and risk of bias were made by consensus. Trial findings were summarized qualitatively. The review included 23 trials with 1,916 subjects (mean age 44.9, 25.8% males) from 10 countries. The predominant symptom or function targeted by the interventions were general long COVID-19 symptoms (35%), fatigue (30%), breathlessness (17%), olfactory (17%), and brain function (9%). Overall, the majority of trials (74%) were at high risk of bias. A range of interventions were identified, including physical therapies, dietary and regenerative treatments, electrical stimulation, and digital wellness programs with variable effects. While a diverse range of interventions for PCS have been tested, their effectiveness varies, with threats to validity in most studies. Trials focusing on PCS mental health disorders, musculoskeletal complaints, and children are needed. Well-designed RCTs are needed to establish definitive interventions for PCS.
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The Influence of Probiotic Lactobacilli on COVID-19 and the Microbiota.
Taufer, CR, da Silva, J, Rampelotto, PH
Nutrients. 2024;(9)
Abstract
This comprehensive review explores the potential of using lactobacilli as a probiotic in the management of COVID-19. Our findings suggest that lactobacilli show promise in reducing the risk of death, gastrointestinal and overall symptoms, and respiratory failure, as well as in lowering cytokines and inflammatory markers associated with the disease. The molecular mechanisms by which lactobacilli protect against COVID-19 and other viral infections may be related to the reduction in inflammation, modulation of the immune response, and direct interaction with viruses to produce antiviral substances. However, the selected studies demonstrate the presence of mixed findings for various clinical, biochemical, hematological, and immunological parameters, which may be attributed to methodological differences among studies. We highlight the importance of clearly describing randomization processes to minimize bias and caution against small sample sizes and inappropriate statistical tests that could lead to errors. This review offers valuable insights into the therapeutic potential of lactobacilli in the context of COVID-19 and identifies avenues for further research and applications. These findings hold promise for the development of novel approaches to managing COVID-19 and warrant further investigation into the potential benefits of lactobacilli in combating the disease.
