Impact of long COVID-19 on posttraumatic stress disorder as modified by health literacy: an observational study in Vietnam.

BACKGROUND: The prevalence of posttraumatic stress disorder (PTSD) has increased, particularly among individuals who have recovered from coronavirus disease 2019 (COVID-19) infection. Health literacy is considered a "social vaccine" that helps people respond effectively to the pandemic. We aimed to investigate the association between long COVID-19 and PTSD, and to examine the modifying role of health literacy in this association. METHODS: A cross-sectional study was conducted at 18 hospitals and health centers in Vietnam from December 2021 to October 2022. We recruited 4,463 individuals who had recovered from COVID-19 infection for at least 4 weeks. Participants provided information about their sociodemographics, clinical parameters, health-related behaviors, health literacy (using the 12-item short-form health literacy scale), long COVID-19 symptoms and PTSD (Impact Event Scale-Revised score of 33 or higher). Logistic regression models were used to examine associations and interactions. RESULTS: Out of the study sample, 55.9% had long COVID-19 symptoms, and 49.6% had PTSD. Individuals with long COVID-19 symptoms had a higher likelihood of PTSD (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.63-2.12; p<0.001). Higher health literacy was associated with a lower likelihood of PTSD (OR, 0.98; 95% CI, 0.97-0.99; p=0.001). Compared to those without long COVID-19 symptoms and the lowest health literacy score, those with long COVID-19 symptoms and a 1-point health literacy increment had a 3% lower likelihood of PTSD (OR, 0.97; 95% CI, 0.96-0.99; p=0.001). CONCLUSION: Health literacy was found to be a protective factor against PTSD and modified the negative impact of long COVID-19 symptoms on PTSD.

Predictive value of the sFlt-1 and PlGF in women at risk for preeclampsia in the south of Vietnam.

BACKGROUND: It has been suggested that soluble fms-like tyrosine kinase receptor-1 (sFlt-1) and placental growth factor (PlGF) play potential roles in preeclampsia diagnosis. Nevertheless, studies on the use of sFlt-1, PlGF, and sFlt-1/PlGF ratio in predicting preeclampsia have found contradictory results. Thus, more studies in different populations are needed. OBJECTIVES: This study aims to (i) examine the associations between sFlt-1, PlGF, or sFlt-1/PlGF ratio at gestational ages of 24-28 weeks and subsequent preeclampsia, and (ii) estimate predictive values of these markers in southern Vietnamese women. METHODS: We used a nested case-control design from a cohort of 490 pregnant women who were at risk of preeclampsia. The total sample size for statistical analysis consisted of 30 cases and 67controls. Levels of sFlt-1 and PlGF were quantified by using a fully automated electrochemiluminescence immunoassay platform (Elecsys®/Cobas®). RESULTS: The median of sFlt-1 concentration was not statistically different between case and control groups. The median PlGF concentration was lower (349.7 pg/ml versus 534.6 pg/ml, P < .001) and the median sFlt-1/PlGF ratio was higher in the preeclampsia group (4.3 versus 1.9, P < .001). After adjusting for maternal age, gestational age, nullipara, and body mass index, the odds of preeclampsia in women with an sFlt-1/PlGF ratio in the fourth quartile were 10 times greater than in women with an sFlt-1/PlGF ratio in the other quartiles (95% confidence interval, 3.2-31.4; P < .001). CONCLUSIONS: This study contributes to the literature that sFlt-1/PlGF ratio measured at gestational weeks 24-28 in southern Vietnamese women can separate preeclamptic from normotensive cases.