Unmasking the Truth of Health Care Workers' Well-being During the COVID-19 Pandemic.

BACKGROUND: Burnout is a well-documented multifactorial phenomenon that affects up to 47% of intensive care unit staff at some point in their career. The literature highlights increased rates of anxiety, depression, and posttraumatic stress disorder among staff as a result of the COVID-19 pandemic. LOCAL PROBLEM: Following the second and, at the time of writing, largest surge of the COVID-19 pandemic, concern for staff 's mental health prompted a hospital-wide study to assess depression, anxiety, posttraumatic stress disorder, and alcohol misuse and to determine the use and effectiveness of employee resources. METHODS: Through REDCap, 212 intensive care unit employees were surveyed with validated screening tools for depression, anxiety, posttraumatic stress disorder, and alcohol misuse. The use and perceived effectiveness of hospital initiatives were assessed. RESULTS: A total of 212 surveys were evaluated. Among respondents, 54% experienced mild anxiety, more than 50% screened positive for mild depression, and 37% screened positive for posttraumatic stress disorder. Most employees (74.5%) were aware of at least 1 resource; 37% knew of the COVID-19 newsletter, one of the top resources highlighted in the survey. Perceived effectiveness of resources ranged from 0.9% (disaster helpline) to 82.5% (prayers, readings, and the on-call chaplain-all "somewhat helpful"). The results correlate with the progressive trend of increased mental health concerns among intensive care unit employees. Survey results prompted an expansion of hospital resources. CONCLUSIONS: COVID-19 has brought unique mental health challenges and stressors to intensive care unit staff. By adapting and expanding resources, hospitals can improve staff resiliency and mitigate some mental health concerns with the aim of decreasing the overall psychological impact of the pandemic.

Dyspnea With Unilateral Pulmonary Ground Glass Opacities and Cavitary Lesions.

CASE PRESENTATION: A 62-year-old man presented with a 3-month history of shortness of breath and a dry cough. He had a medical history of hypertension (without use of angiotensin-converting enzyme inhibitors), hyperlipidemia, depression, and 10-pack-years of cigarette smoking several decades ago. He was a limousine driver and denied any history of occupational high-risk exposures. The patient denied significant weight gain or weight loss, night sweats, fevers, hemoptysis, chest pain, or palpitations. He had a normal physical examination. Pulmonary function studies with a hemoglobin level of 12.9 gm/dL revealed normal spirometry, normal lung volumes, and moderately low diffusion capacity (56% of predicted). A 6-minute walk test showed mild desaturation (97% to 92% after 432 m). Stress echo revealed ejection fraction of 60% with no regional wall motion abnormalities, no evidence of impaired diastolic filling, estimated peak pulmonary artery pressure 35 to 40 mm Hg, and no valvular abnormalities with desaturation to 87% during the test. Extensive rheumatologic, infectious disease, and hypercoagulability workup were unremarkable. BAL was negative for malignancy, infection, or eosinophilic lung disease.

The Efficacy of Bamlanivimab in Reducing Emergency Department Visits and Hospitalizations in a Real-world Setting.

Bamlanivimab, a monoclonal antibody targeting the spike protein of severe acute respiratory syndrome coronavirus 2, is available for ambulatory treatment of coronavirus disease 2019 (COVID-19). This real-world study confirms the efficacy of bamlanivimab in reducing hospital admissions and emergency department visits among high-risk outpatients with mild to moderate COVID-19 illness and reveals a trend toward improved mortality.

COVID-19 Pneumonia in Patients on Chronic Hydroxychloroquine Therapy: Three Cases of COVID-19 Pneumonia.

Hydroxychloroquine has gained popularity as a potential preventative and treatment of COVID-19 pneumonia due to its in vitro activity against the virus. These three cases of COVID-19 pneumonia of varying severities occurred in the setting of chronic hydroxychloroquine use. These cases argue against the use of hydroxychloroquine as a preventative or therapeutic option for COVID-19 pneumonia.