Longitudinal Assessment of Mental Health Consequences of the COVID-19 Pandemic Long-Term Exposure on Health Care Workers from a North West Italian Hospital.

OBJECTIVE: To assess individual variation in anxiety, stress disorder, depression, insomnia, burnout, and resilience in health care workers (HCWs), 12 and 18 months after the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. METHODS: Prospective longitudinal study. RESULTS: A total of 207 HCWs (74% female, 46% physicians, 44% nurses) answered; 50% scored over the cut-off for anxiety (GAD-7), 66% for PCL-C, 41% for depression (PHQ-9), 25% for ISI, and 15% started sleep inducers; 52% showed emotional exhaustion (EE), 68% detachment (DE), 39% professional efficacy (EF) at MBI; 27% completed the follow-up questionnaire 6 months later, showing a significant reduction in nearly all scores (GAD-7 median 11[5-15] vs 7[4-12] (P < 0.001); PCL-C 43[30-58] vs 37[24-50] (P < 0.05); PHQ-9 10[4-16] vs 6[3-12] (P < 0.001); ISI 10[4-15] vs 7[5-12](NS); MBI EE 25[16-35] vs 23 [15-31] (NS), DE 13[8-17] vs 12[8-17], EF 29[25-34] vs 30[25-34]. Living in a flat (OR 2.27 [1.10-4.81], high-intensity-of-care working (2.83 [1.15-7.16] increased risk of anxiety (GAD-7); age between 31-40 y (OR 2.8 [1.11-7.68], being a nurse (OR 3.56 [1.59-8.36] and high-intensity-of-care working (OR 8.43 [2.92-26.8] increased risk of pathological stress (PCL-C). CONCLUSIONS: Nearly half of HCWs showed psychological distress, especially nurses, women, and the youngest. A mandatory job change, increasing intensity of care, working in a COVID-19 department, and being infected were negative factors; having a partner and living in a detached house were protective. Six months later, all the psychological domains showed individual improvement.

Efficacy and safety of long-term entecavir therapy in a European population.

BACKGROUND: Therapy in chronic hepatitis B (chronic hepatitis B) patients aims at improving their survival by preventing disease progression to cirrhosis and its complications. Entecavir (ETV) is currently a first line therapeutic agent recommended for the treatment of CHB. Our aim was to evaluate the long term outcome of a cohort of CHB patients treated with ETV. METHODS: Thirty-four patients treated with ETV for at least 6 months were included in this study. The virologic response was determined by the dosage of serum HBV-DNA, HBsAg, HBeAg, anti-HBs and anti-HBe antibodies. Death, acute pancreatitis, lactic acidosis and kidney function impairment were considered as major adverse events. RESULTS: The median period of treatment was 55 months (range 15-81). Thirty-three (97%) patients responded to the therapy after a mean time of 14.7 weeks (4-60); of these, 29 (85.3%) maintained the HBV-DNA negativity in serum, while 4 patients (11.8%) had a breakthrough. The remaining patient did not respond. Seroconversion to anti-HBs and anti-HBe was not observed, although 2 patients lost the e and the s antigen, respectively. Baseline alanine aminostransferase (ALT) levels in serum were altered in 18 patients (52.9%), and returned to normal levels during the follow-up, with a reduction of 87.7 IU/L (P<0.0001). A case (3.4%) of hepatocellular carcinoma was observed after 24 months. No major adverse events were recorded. CONCLUSIONS: ETV is effective in suppressing viral replication as well as in normalizing serum ALT levels, without anti-HBs seroconversion. Finally, ETV is a safe drug, substantially free of major side effects.