Protocol for a systematic review of interventions targeting mental health, cognition or psychological well-being among individuals with long COVID

Introduction
For some people, COVID-19 infection leads to negative health impacts that can last into the medium or long term. The long-term sequelae of COVID-19 infection, or ‘long COVID’, negatively affects not only physical health, but also mental health, cognition or psychological well-being. Complex, integrated interventions are recommended for long COVID, including psychological components; however, the effectiveness of such interventions has yet to be critically evaluated. This protocol describes a systematic review to be conducted of scientific literature reporting on clinical trials of interventions to promote mental health, cognition or psychological well-being among individuals with long COVID.

Methods and analysis
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be followed. A health sciences librarian will identify the relevant literature through comprehensive systematic searches of Medline, Embase, APA PsycINFO, Cumulative Index to Nursing and Allied Health Literature, medRxiv, PsyArXiv, China National Knowledge Internet and WANFANG Data databases, as well as The Cochrane Central Register of Controlled Trials, clinicaltrials.gov and the WHO International Clinical Trials Registry Platform. Studies will be selected through a title and abstract review, followed by a full-text review using inclusion and exclusion criteria. Data extracted will include intervention descriptions and efficacy metrics. Data will be narratively synthesised; if the data allow, a meta-analysis will be conducted. Risk of bias assessment will be conducted using the Cochrane Risk of Bias 2.0 tool.

Ethics and dissemination
Ethical approval for systematic reviews is not required. As researchers and clinicians respond to the new clinical entity that long COVID represents, this review will synthesise a rapidly emerging evidence base describing and testing interventions to promote mental health, cognition or psychological well-being. Results will therefore be disseminated through an open-access peer-reviewed publication and conference presentations to inform research and clinical practice.

Prospero registration number
CRD42022318678

Leggi
Settembre 2022

Protocol for a pragmatic feasibility randomised controlled trial of peer coaching for adults with long-term conditions: PEER CONNECT

Introduction
Patients with low levels of knowledge, skills and confidence to manage their health and well-being (activation) are more likely to have unmet health needs, delay seeking healthcare and need emergency care. National Health Service England estimates that this may be applicable to 25%–40% of patients with long-term health conditions. Volunteer peer coaching may support people to increase their level of activation. This form of intervention may be particularly effective for people with low levels of activation.

Methods and analysis
This single site, two-arm randomised controlled trial has been designed to assess the feasibility of conducting a definitive trial of volunteer peer health and well-being coaching for people with long-term health conditions (multiple sclerosis, rheumatic diseases or chronic pain) and low activation. Feasibility outcomes include recruitment and retention rates, and intervention adherence. We will measure patient activation, mental health and well-being as potential outcomes for a definitive trial. These outcomes will be summarised descriptively for each time point by allocated group and help to inform sample size calculation for the definitive trial. Criteria for progression to a full trial will be used.

Ethics and dissemination
Ethical approval has been granted by the London – Surrey Research Ethics Committee, reference 21/LO/0715. Results from this feasibility trial will be shared directly with participants, presented at local, regional and national conferences and published in an open-access journal.

Trial registration number
ISRCTN12623577.

Leggi
Settembre 2022

Perceived stress and associated factors among pregnant women during COVID-19 pandemic period in Northwest Ethiopia, 2020: a cross-sectional study

Objective
This study aimed to determine the prevalence and associated factors of perceived stress among pregnant women during the COVID-19 pandemic period in Northwest Ethiopia.

Method
A cross-sectional study.

Setting
University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.

Participants
A total of 415 pregnant women were recruited by using a systematic random sampling technique from 28 April 2020 to 12 June 2020.

Measurement
The required data were collected through face-to-face interviews. The Perceived Stress Scale was used to assess perceived stress. The Edinburgh Postnatal Depression Scale and Oslo Social Support Scale 3 were used for associated factors. The data were analysed by using SPSS V.20. We also included sociodemographic, obstetrical and gynaecology, substance use and intimate partner-related factors. Logistic regression analysis was used to identify associated factors with perceived stress. Bivariate and multivariable logistic regression analyses were used to identify the effect of each independent variable with the outcome variable. A p value of less than 0.05 was considered to be statistically significant.

Results
A total of 415 pregnant women participated in the study with response rate of 98.57%. The prevalence of perceived stress is found to be 13.7% (95% CI=10.4% to 17.1%). According to the multivariable logistic regression result, being a student (adjusted OR (AOR)=9.67, 95% CI=2.739 to 34.183), being at the first and third trimesters of gestational age (AOR=3.56, 95% CI=1.065 to 11.885; AOR=4.80, 95% CI=1.851 to 14.479, respectively), and having antenatal depression (AOR=3.51, 95% CI=1.628 to 7.563) were factors positively associated with perceived stress.

Conclusion
The prevalence of perceived stress among pregnant people was relatively high. This study recommends that all pregnant people should be screened and treated for perceived stress particularly during the first and third trimesters. Emphasis should be given to early detection and treatment of antenatal depression. Pregnant students must be strongly evaluated and intervened for perceived stress.

Leggi
Settembre 2022

How do care environments shape healthcare? A synthesis of qualitative studies among healthcare workers during the COVID-19 pandemic

Objective
To investigate how care is shaped through the material practices and spaces of healthcare environments during the COVID-19 pandemic.

Design
Critical interpretive synthesis (CIS) of qualitative research.

Participants
Studies included qualitative research investigating the experiences of healthcare workers involved in the care of individuals during the COVID-19 pandemic.

Results
134 articles were identified in the initial sampling frame with 38 studies involving 2507 participants included in the final synthesis. Three themes were identified in the analysis: (1) the hospital transformed, (2) virtual care spaces and (3) objects of care. Through the generation of these themes, a synthesising argument was developed to demonstrate how material spaces and practices of healthcare shape care delivery and to provide insights to support healthcare providers in creating enabling and resilient care environments.

Conclusions
The findings of this study demonstrate how healthcare environments enable and constrain modes of care. Practices of care are shaped through the materiality of spaces and objects, including how these change in the face of pandemic disruption. The implication is that the healthcare environment needs to be viewed as a critical adaptive element in the optimisation of care. The study also develops a versatile and coherent approach to CIS methods that can be taken up in future research.

Leggi
Settembre 2022

Parents and teachers attitudes to and experiences of the implementation of COVID-19 preventive measures in primary and secondary schools following reopening of schools in autumn 2020: a descriptive cross-sectional survey

Objective
To assess implementation and ease of implementation of control measures in schools as reported by staff and parents.

Design
A descriptive cross-sectional survey.

Setting
Staff and parents/guardians of the 132 primary schools and 19 secondary schools participating in COVID-19 surveillance in school kids (sKIDs and sKIDsPLUS Studies).

Main outcome measure
Prevalence of control measures implemented in schools in autumn 2020, parental and staff perception of ease of implementation.

Results
In total, 56 of 151 (37%) schools participated in this study, with 1953 parents and 986 staff members completing the questionnaire. Most common measures implemented by schools included regular hand cleaning for students (52 of 56, 93%) and staff (70 of 73, 96%), as reported by parents and staff, respectively, and was among the easiest to implement at all times for students (57%) and even more so, for staff (78%). Maintaining 2-metre distancing was less commonly reported for students (24%–51%) as it was for staff (81%–84%), but was one of the most difficult to follow at all times for students (25%) and staff (16%) alike. Some measures were more commonly reported by primary school compared to secondary school parents, including keeping students within the same small groups (28 of 41, 68% vs 8 of 15, 53%), ensuring the same teacher for classes (29 of 41, 71% vs 6 of 15, 40%). On the other hand, wearing a face covering while at school was reported by three-quarters of secondary school parents compared with only parents of 4 of 41 (10%) primary schools. Other measures such as student temperature checks (5%–13%) and advising staff work from home if otherwise healthy (7%–15%) were rarely reported.

Conclusions
Variable implementation of infection control measures was reported, with some easier to implement (hand hygiene) than others (physical distancing).

Leggi
Settembre 2022

Effectiveness and safety of fibrinolytic therapy in critically ill patients with COVID-19 with ARDS: protocol for a prospective meta-analysis

Introduction
The use of fibrinolytic therapy has been proposed in severe acute respiratory distress syndrome (ARDS). During the COVID-19 pandemic, anticoagulation has received special attention due to the frequent findings of microthrombi and fibrin deposits in the lungs and other organs. Therefore, the use of fibrinolysis has been regarded as a potential rescue therapy in these patients. In this prospective meta-analysis, we plan to synthesise evidence from ongoing clinical trials and thus assess whether fibrinolytic therapy can improve the ventilation/perfusion ratio in patients with severe COVID-19-caused ARDS as compared with standard of care.

Methods and analysis
This protocol was registered in PROSPERO. All randomised controlled trials and prospective observational trials that compare fibrinolytic therapy with standard of care in adult patients with COVID-19 and define their primary or secondary outcome as improvement in oxygenation and/or gas exchange, or mortality will be considered eligible. Safety outcomes will include bleeding event rate and requirement for transfusion. Our search on 25 January 2022 identified five eligible ongoing clinical trials. A formal search of MEDLINE (via PubMed), Embase, CENTRAL will be performed every month to identify published results and to search for further trials that meet our eligibility criteria.

Dissemination
This could be the first qualitative and quantitative synthesis summarising evidence of the efficacy and safety of fibrinolytic therapy in critically ill patients with COVID-19. We plan to publish our results in peer-reviewed journals.

PROSPERO registration number
CRD42021285281.

Leggi
Settembre 2022

Assessing the short, intermediate and long-term health effects of COVID-19 on the survivors in Zambia: a prospective quantitative study protocol

Introduction
Little is known about the clinical course of COVID-19 following mild symptoms, and how the disease affects the survivors over time. Moreover, information on the severity of the long-term health effects as well as the associated risk factors is scant. This study aims to determine the short, intermediate and long-term health effects of COVID-19 on the survivors and the associated risk factors.

Methods and analysis
We propose conducting a 24-month prospective quantitative study in 10 health facilities (2 specialist, 3 regional, 2 mission and 3 subdistrict hospitals) from Lusaka and Southern Province of Zambia. Health facilities will be those which served as COVID-19 treatment centres during the third wave (June–August 2021). Study participants will comprise a randomly selected cohort of 450 COVID-19 survivors who had mild or no symptoms (80%) and severe cases (20%). Using a questionnaire, respondent demographic, clinical and laboratory data will be collected at baseline and at a 3-month interval for 18 months using a questionnaire. Respondents’ medical records will be reviewed and data collected using a checklist. Descriptive statistics will be computed to summarise respondents’ characteristics and clinical outcomes. Bivariate analysis (X2 and t-test) will be conducted to test the association between respondent characteristics and clinical outcomes. Multivariate logistic regression analysis will be run to determine the risk factors for short, intermediate and long-term health effects; adjusted ORs will be computed to test the strength of the association (p

Leggi
Settembre 2022

Characterising persons diagnosed with HIV as either recent or long-term using a cross-sectional analysis of recent infection surveillance data collected in Malawi from September 2019 to March 2020

Objectives
In Malawi, a recent infection testing algorithm (RITA) is used to characterise infections of persons newly diagnosed with HIV as recent or long term. This paper shares results from recent HIV infection surveillance and describes distribution and predictors.

Setting
Data from 155 health facilities in 11 districts in Malawi were pooled from September 2019 to March 2020.

Participants
Eligible participants were ≥13 years, and newly diagnosed with HIV. Clients had RITA recent infections if the rapid test for recent infection (RTRI) test result was recent and viral load (VL) ≥1000 copies/mL; if VL was

Leggi
Settembre 2022