Public perception of the appropriateness of COVID-19 management strategies and level of disturbances in daily activities: A focus on educational level.

BACKGROUND: This study investigated the association between public perception of the appropriateness of management strategies implemented during the COVID-19 pandemic and the level of disturbances in daily activities reported by the general population. METHODS: This cross-sectional study used Korea Community Health Survey conducted from August to November 2020. Public perception of COVID-19 management strategies included those implemented by the government (central, city or provincial, and administrative districts), the mass media, regional medical institutions, and neighbors. The subjective level of disturbances in daily activities was measured using a 0-100 numeric rating scale developed by Korea Disease Control and Prevention Agency. Multivariable linear regression analysis was used. A subgroup analysis was conducted based on education level. RESULTS: The present study analyzed 211,353 participants. Compared to individuals who perceived that the management strategies implemented during the pandemic was 'highly appropriate,' those who reported 'mediocre appropriateness' (ß: -1.96, p-value: <0.001) or 'low appropriateness' (ß: -3.60, p-value: 0.010) reported higher levels of subjective disturbances. The appropriateness of measures implemented by the mass media was associated with levels of subjective disturbances felt by individuals of lower education with statistical significance, whereas that applied by the mass media and the government were important in those with higher education. CONCLUSIONS: The findings suggest the importance of public perception of management strategies when implementing containment policies and minimizing its disturbances on daily lives is essential.

Area-level deprivation and handwashing behavior during the COVID-19 pandemic: A multilevel analysis on a nationwide survey in Korea.

This study investigated the association between area deprivation level and performance of handwashing behavior during the COVID-19 pandemic in Korean adults. This study used data from the 2015 Population and Housing Census data to measure area deprivation level. The 2020 Korea Community Health Survey was used for all other variables, including hand hygiene behavior (August through November 2020). The association between area deprivation level and practice of handwashing behavior was examined using multilevel logistic regression analysis. The study population comprised 215,676 adults aged 19 years or above. Compared to the least area deprived group, the most deprived group was more likely to not wash hands after using the restroom (OR 1.43, 95% CI 1.13-1.82), after coming home (OR 1.85, 95% CI 1.43-2.39), and using soap (OR 1.55, 95% CI 1.29-1.84). The findings suggest the importance of considering area deprivation in implementing policies that promote handwashing, particularly during a pandemic.

COVID-19 Prognosis in Association with Antidepressant Use.

INTRODUCTION: Various subtypes of severe acute respiratory syndrome coronavirus 2 and variations among immune systems in different ethnicities need to be considered to understand the outcomes of coronavirus disease 2019 (COVID-19). This study aimed to provide evidence for the association between the use of antidepressants and the severity of COVID-19. METHODS: We used the National Health Information Data-COVID database. Patients with one or more prescriptions of any antidepressant were selected as the exposure group. Detailed analyses were performed to determine the type of medication associated with the prognosis. RESULTS: The use of selective serotonin reuptake inhibitors (SSRIs) was associated with a lower risk of severe outcomes of COVID-19, whereas the use of tricyclic antidepressants (TCAs) increased the risk of poor prognosis of COVID-19. Detailed analyses showed that escitalopram was significantly associated with better clinical outcomes, and nortriptyline was linked to more severe COVID-19 outcomes. CONCLUSION: This study revealed an association between antidepressants and COVID-19 prognosis. SSRIs were significantly associated with a lower risk of severe outcomes, whereas TCAs were related to the poor prognosis of COVID-19.

Perceived social support and depressive symptoms during the COVID-19 pandemic: A nationally-representative study.

BACKGROUND: The COVID-19 pandemic and the associated containment policies have led to negative mental health consequences in the general population. AIMS: This study investigated the association between perceived social support and depressive symptoms in Korea. METHODS: Data from the Korea Community Health Survey conducted from August to November 2020 was used for this cross-sectional study. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) and perceived social support was assessed based on the number of contacts that participants had identified as being available in case participants needed isolation due to COVID-19 exposure. This study included the general adult populations aged 19 years and older. The relationship between the perceived social support and depressive symptoms was analyzed using multivariable liner regression analysis. Subgroup analysis was conducted based on income. RESULTS: Analysis of the data obtained from 225,453 participants indicated that PHQ-9 scores were highest in the group with 'no' perceived social support, followed by 'low', 'middle', and 'high' perceived levels of social support. Compared to individuals with 'high' perceived social support, those with 'middle' (ß: .10, p-value <.001), 'low (ß: .07, p-value .010), and 'no' (ß: .34, p-value <.001) perceived levels of social support showed poorer depression scores. The magnitude of the relationship found was particularly strong in the low-income group. CONCLUSIONS: During the COVID-19 pandemic, individuals' depression scores varied according to their perceived level of social support. Strategies that address the need of vulnerable individuals are required to reduce the potentially negative mental health consequences of the pandemic.

Is COVID-19 induced reductions in the level of physical activity associated with increased depressive symptoms in patients with hypertension?

BACKGROUND: Studies have reported that the coronavirus 2019 (COVID-19) outbreak led to reduced levels of physical activity, but this has been rarely studied in patients with hypertension. This study investigated the association between depressive symptoms and changes in physical activity of patients with hypertension during the COVID-19 outbreak. METHODS: Data were from the Korea Community Health Survey (KCHS), conducted between August to November 2020. The KCHS is a nationwide cross-sectional survey that evaluates information on various sociodemographic, economic, and health related variables. Depressive symptoms were measured using the Patient Health Questionnaire-9. Physical activity was measured using a questionnaire inquiring whether participants experienced any changes in physical activity after the pandemic. The association between depressive symptoms and changes in physical activity level were analyzed using a multivariable logistic regression analysis. RESULTS: Out of 55,203 patients, 39.6% responded that they had experienced lower levels of physical activity due to the pandemic and showed increased likelihoods of depressive symptoms (OR 1.33, 95% CI 1.14-1.54) than individuals who responded that they had performed similar levels of physical activity. This tendency was stronger in patients that did not receive treatment for hypertension (OR 2.07, 95% CI 1.02-4.23) than those who did receive treatment with marginal significance (p-value of interaction term: 0.1241). CONCLUSIONS: Decreased levels of physical activity due to the outbreak was experienced by a noticeable proportion of patients with hypertension and was associated with increased likelihoods of depressive symptoms.

Did the increase in sitting time due to COVID-19 lead to obesity in adolescents?

INTRODUCTION: Since adolescent with obesity is closely linked with the incidence of cardiovascular disease, it is important to identify the factors that increase the prevalence of adolescent with obesity and prevent it early. This study aimed to examine which of the demographic and lifestyle factors including sitting hours per week for purposes other than study had the greatest influence on Korean adolescents with obesity during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: We used the Korean Youth Risk Behavior Web-based Survey (KYRBWS) data. The primary outcome was the relationship between sitting hours and obesity during and after the COVID-19 pandemic. Multiple logistic regression analysis was performed to examine which of the demographic and lifestyle factors including sitting hours per week for purposes other than study had the greatest influence on Korean adolescents' obesity status. RESULTS: The prevalence of obesity was significantly higher during the COVID-19 than before the COVID-19 (OR, 1.268, CI:1.232-1.305). There was a significant increase in the OR for sitting hours per week for purposes other than study (OR, 1.021, 95% CI, 1.019-1.024). Compared to low household income, the OR decreased for middle (OR = 0.798, 95% CI:0.77, 0.826) and high-income household students (OR, 0.833, 95% CI: 0.803-0.865). DISCUSSION/CONCLUSION: The results of this study confirmed the relationship between sit-ting hours and obesity in adolescents during the pandemic. To prevent adolescent with obesity, further studies are needed to focus on the importance of promoting health policy in adolescents to avoid the continuous rising of its prevalence and needed to understand whether the increase in obesity rates during the pandemic is a temporary trend.

Is fear of COVID-19 higher in individuals residing in more deprived areas? A nationwide study.

BACKGROUND: This study investigated the association between various types of coronavirus disease 2019 (COVID-19)-related fear and the level of area deprivation in Korea. METHODS: Different types of COVID-19-related fear were examined, namely fear of infection, fear of dying from infection, fear of public criticism, fear of a family member getting infected and fear of economic loss. The level of area deprivation was measured based on the Area Deprivation Index, which was calculated based on population census data. The association between various types of COVID-19-related fear and the level of area deprivation was analyzed using multivariable logistic regression analysis. RESULTS: This study included 199 859 individuals from the 253 administrative divisions in South Korea. Findings indicated that fear was most common in individuals residing in the most deprived areas, followed by those in the mediocre and least deprived areas (fear of infection: odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01-1.09; fear of dying from infection: OR 1.23, 95% CI 1.19-1.28; fear of public criticism: OR 1.20, 95% CI 1.15-1.24; fear of a family member getting infected: OR 1.12, 95% CI 1.07-1.18). CONCLUSIONS: The findings suggest the need to monitor and account for area deprivation in managing the psychological health effects of the COVID-19 crisis.

Does having various types of fear related to COVID-19 disrupt individuals' daily life?: Findings from a nationwide survey in Korea.

OBJECTIVES: Unexpected changes in daily routines caused by the coronavirus disease 2019 (COVID-19) pandemic may affect psychological health. This study investigated the association between various types of COVID-19-related fear and the subjective level of disturbance in daily activities experienced by individuals. METHODS: This cross-sectional study used the Korea Community Health Survey conducted from August through November 2020. COVID-19-related fear included fear of infection, death, public criticism, family members getting infected, and economic loss. The subjective level of disruption in daily activities was measured using a 0-100 numeric rating scale developed by the Korea Disease Control and Prevention Agency. Multivariable linear regression was used to analyze the associations between the independent and dependent variables. A subgroup analysis was performed based on income level. RESULTS: Participants who reported fear of infection (ß=-3.37, p<0.001), death (ß=-0.33, p=0.030), public criticism (ß=-1.63, p<0.001), a family member getting infected (ß=-1.03, p<0.001), and economic loss (ß=-3.52, p<0.001) experienced more disturbances in daily activities. The magnitude of this association was most significant in the lowest-income group. CONCLUSIONS: Individuals reporting COVID-19-related fear experienced higher levels of subjective disruption in daily activities.

The Ability to Rest at Home During COVID-19 Symptom Manifestation and Depressive Symptoms: Evidence From Korea.

OBJECTIVE: This study investigated the association between ability to rest at home in times of coronavirus disease 2019 (COVID-19) symptom manifestation and depressive symptoms. METHODS: The 2020 Korea Community Health Survey data were used. The presence of depressive symptoms was determined using the Patient Health Questionnaire-9. The relationship between depressive symptoms and ability to rest at home was examined using logistic regression analysis. Additional analysis was performed on the reasons for the inability to stay at home. RESULTS: Depressive symptoms were more common in participants who could not rest at home if symptoms manifested (4.1%) than those who could rest at home (2.7%). Participants who could not rest at home (OR 1.53, 95% CI 1.34-1.74) were more likely to have depressive symptoms, particularly when they had to report to work (OR 1.50, 95% CI 1.30-1.74) or purchase daily necessities (OR 2.40, 95% CI 1.15-5.03). CONCLUSION: Inability to rest at home in the case of COVID-19 symptom manifestation was associated with depressive symptoms. The findings suggest the need to address the identified vulnerable groups to mitigate the mental health consequences of the pandemic.

Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to evaluate the impact of COVID-19 on pregnant women. We searched for qualified studies in PubMed, Embase, and Web of Science. The clinical characteristics of pregnant women with COVID-19 and their infants were reported as means and proportions with 95% confidence interval. Eleven studies involving with 9032 pregnant women with COVID-19 and 338 infants were included in the meta-analysis. Pregnant women with COVID-19 have relatively mild symptoms. However, abnormal proportions of laboratory parameters were similar or even increased, compared to general population. Around 30% of pregnant women with COVID-19 experienced preterm delivery, whereas the mean birth weight was 2855.9 g. Fetal death and detection of SARS-CoV-2 were observed in about 2%, whereas neonatal death was found to be 0.4%. In conclusion, the current review will serve as an ideal basis for future considerations in the treatment and management of COVID-19 in pregnant women.