Impact of Sensorineural Hearing Loss during the Pandemic of COVID-19 on the Appearance of Depressive Symptoms, Anxiety and Stress.

BACKGROUND: The incidence of hearing loss is constantly increasing and according to the World Health Organization, by 2050, 900 million people will suffer from hearing loss. The main Objective of the study was to determine the differences between the severity of the symptoms of stress, anxiety and depression in participants with varying degrees of sensorineural hearing loss during the COVID-19 pandemic. An additional aim was to examine the extent and manner in which protective face masks impact the communication of people with hearing loss. Matrials and Methods: A cross-sectional study was conducted, which included 160 patients (81 men and 79 women) with bilateral sensorineural hearing loss. The patients' age range was 50 to 80 years. Depending on the degree of hearing loss or pure-tone threshold, the participants were divided into four groups: mild hearing loss, moderate hearing loss, severe hearing loss and profound hearing loss. The research used the Depression, Anxiety and Stress Scale (DASS-21) and a questionnaire in which the participants reported whether surgical face masks (medical three-layer masks) worn by speakers makes communication difficult, to what extent and in what way. RESULTS: The average age of the patients was 67.97 ± 8.16. A significant correlation was found between the degree of hearing loss and communication difficulties caused by the use of protective face masks (p < 0.001). For patients with severe and profound hearing loss, communication is significantly more difficult (50.0% and 45.0% respectively) when the interlocutor wears a face mask. There is a significant correlation between the degree of hearing loss and the way in which communication is made more difficult when the interlocutor wears a face mask (p < 0.001). A statistically significant difference was determined between the degrees of hearing loss in all measured subscales: stress (p = 0.024), anxiety (p = 0.026) and depression (p = 0.016). CONCLUSIONS: We have determined that face masks used during the COVID-19 pandemic significantly hamper communication among the study groups (p = 0.007) and there is a significant correlation between the degree of sensorineural hearing loss and the presence of symptoms in all three DASS-21 subscales, meaning that the symptoms of stress, anxiety and depression were more intense in severe and profound hearing loss.

Importance of a functional measure in the evaluation of patients in a memory clinic: Validation of the Serbian version of the Amsterdam instrumental activities of daily living questionnaire.

INTRODUCTION AND AIM: The Amsterdam instrumental activities of daily living questionnaire (A-IADL-Q) was developed as a sensitive tool in detecting a functional decline in early dementia. The aim of our study was to analyze the validity and reliability of the Serbian translation of the short version of A-IADL-Q in a population of memory clinic patients. MATERIAL AND METHODS: We have included 160 subjects with Alzhemier's disease (AD) dementia, mild cognitive impairment (MCI), or normal cognition (NC). All patients were examined by a neurologist, screened for cognitive impairment (MMSE) and depression, and referred to laboratory testing, neuroimaging examination, and neuropsychological assessment. Informants (close friends or relatives) completed Serbian language versions of the A-IADL-Q -Short version and the Lawton-Brody Instrumental Activities of Daily Living (LB-IADL) scale. Reliability analysis was performed by assessing internal consistency and reproducibility (test-retest reliability). Construct validity was assessed as the impact of gender, аgе, education, diagnosis, cognitive and functional measures on A-IADL-Q scores. RESULTS: The internal consistency of the Serbian version of A-IADL-Q was acceptable (Cronbach's alpha 0.82), Test-retest reliability of the A-IADL-Q was excellent (ICC=0.92, 95% CI 0.84-0.98, p < 0.001). There was no statistically significant difference in A-IADL-Q scores between male and female subjects (t = 1.183; p = 0.241), while the difference was registered between subjects with different education levels (F=12.955; p < 0.001) and diagnosis (F=209.433; p < 0.001). There was a strong and statistically significant correlation between A-IADL-Q and MMSE scores (tau-b= 0.638; p < 0.001) and IADL-Q and LB-ADL scores (tau-b=0.714; p < 0.001). A significant multiple regression model was found (F(4, 155) = 103.692;p < 0.001), which explained 72.1% of the A-IADL-Q score variance with MMSE score and age as significant predictors. CONCLUSION: The Serbian adaptation of the A-IADL-Q-short version is a reliable and valid measure of instrumental activities of daily living in patients with dementia and mild cognitive impairment. This easy-to-administer instrument is useful for the early diagnostics of dementia syndrome in a memory clinic population.

The influence of the COVID-19 pandemic on patients with chronic inflammatory demyelinating polyradiculoneuropathy.

OBJECTIVES: At a time of global health crisis, fear, anxiety, and stress levels increase. The effects of protracted social isolation, and media related misinformation's about the coronavirus disease 2019 (COVID-19) resulting in increased fear/stress related to the insufficiently known illness. The aim was to assess the influence of the COVID-19 health crisis on patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). METHODS: A cross-sectional study on 29 adult CIDP patients was performed. The Medical Research Council scale was used to evaluate muscle strength. The degree of functional disability was measured using the Inflammatory Neuropathy Cause and Treatment disability scale. The overall quality of life (QoL) was self-estimated on a 0-100 numeric rating scale. We also used a specifically designed 22-question-survey about COVID-19. RESULTS: Regarding the COVID-19 pandemic, 62% of CIDP patients were concerned. The daily activities of 55% of patients were negatively influenced by the pandemic. During the COVID-19 outbreak, 21% of patients reported their CIDP got worse. In 39% of CIDP patients, the influence of the pandemic on CIDP therapy was reported (reducing the dose or time interval or even discontinuation). The mean value of the self-estimated QoL was 64 ± 19. Independent predictors of worse QoL were age of patients (beta = -0.35, p < 0.05) and fear of the COVID-19 (beta = -0.34, p < 0.05). CONCLUSION: The COVID-19 pandemic has a significant impact on CIDP patients. Besides the direct influence of the virus and fear of the virus, restrictive measures can indirectly harm the patients with CIDP.

Quality of sleep and fatigue in patients with the relapsing-remitting multiple sclerosis during the coronavirus disease-2019 pandemic.

ОBJECTIVE: Sleep disturbances and fatigue are frequent symptoms in multiple sclerosis patients. The aim was to assess the quality of sleep (QoS) and fatigue in patients with the relapsing-remitting multiple sclerosis (RRMS), during the coronavirus disease-2019 (COVID-19) pandemic. METHODS: The study included 67 patients with RRMS and 85 healthy control subjects. RRMS patients, who were tested in first half of 2019, were retested in April and May 2020, during the COVID-19 pandemic. We collected sociodemographic and clinical data, and also used the following questionnaires: Pittsburgh sleep quality index (PSQI), Fatigue Severity Scale (FSS), and Multiple Sclerosis Quality of Life-54 Instrument (MSQOL-54). RESULTS: The FSS score and PSQI global score were significantly higher in patients with RRMS than in the control group (p < 0.01). We noticed a statistically significant difference between the results obtained a year ago and the results during the COVID-19 pandemic in PSQI global score (p < 0.01) and all subscores. Higher disability status was an independent predictor of the worse PSQI scores. CONCLUSION: During the COVID-19 outbreak worse QoS were noticed in RRMS patients than in healthy individuals. Also, QoS of RRMS patients is more affected during the COVID-19 pandemic than in regular circumstances. High levels of sleep disturbance and fatigue in RRMS patients correlates with worse life quality, female gender, lower educational level and partner status. The results of the present study provide evidence in support of regular screening and monitoring of fatigue and QoS in this patient population, especially during the pandemic states.

Quality of sleep and health-related quality of life among health care professionals treating patients with coronavirus disease-19.

BACKGROUND: Health care professionals exposed to coronavirus disease 2019 (COVID-19) are facing high levels of stress. AIM: The aim was to evaluate the quality of sleep (QoS) and health-related quality of life (HRQoL), among health care professionals treating patients with COVID-19, as well as quantifying the magnitude of symptoms of depression and levels of anxiety. METHODS: We included 201 health care professionals in a cross-sectional, web-based study by applying 7-item Generalized Anxiety Disorder (GAD-7) Scale, Zung Self-rating Depression Scale, 36-item Health Survey of the Medical Outcomes Study Short Form (SF36), Pittsburgh Sleep Quality Index (PSQI) and additional survey constructed for the purpose of the study. RESULTS: Health care workers who treated COVID-19 patients were more afraid of becoming infected or of transmitting the infection to a family member with a significantly low self-assessment of their mental status. Poor QoS and HRQoL correlated with high health anxiety and severe depressive symptoms and several demographic characteristics. Multiple linear regression analysis showed that higher scores on GAD-7 (beta = .71, p < .01) and lower scores on mental health (MH) subscale on SF36 questionnaire (beta = -.69; p < .01) were independent predictors of the higher PSQI score (adjusted R2 = .61, p < .01 for overall model). Higher scores on GAD-7 (beta = .68, p < .01) and worse self-perceived mental status (beta = .25; p < .05) were independent predictors of the lower SF36 scores (adjusted R2 = .73, p < .01 for overall model). CONCLUSION: The major MH burden of health care professionals treating infected patients during the COVID-19 pandemic indicates that they need psychological support.

The Impact of the Coronavirus Disease-2019 Pandemic on the Psychological Status and Quality of Life of Myasthenia Gravis Patients.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) is the largest pandemic of our times. We wanted to investigate the impact of COVID-19 pandemic on the psychological status, quality of life (QoL) and quality of sleep (QoS) of myasthenia gravis (MG) patients. METHODS: Data on the epidemiological and clinical characteristics of MG were collected. We used a self-designed questionnaire (consisting of 12 questions), a revised 15-item Myasthenia Gravis Quality of Life Questionnaire (MGQOL15r), a 36-item health survey of the Medical Outcomes Study Short Form (SF36), Pittsburgh sleep quality index (PSQI), Hamilton scales for the assessment of anxiety (HAM-A), and depression (HAMD) were used. We reassessed patients who were tested three years ago using the same questionnaires. RESULTS: The study included 64 MG patients. We noticed a statistically significant difference between the results obtained three years ago and the results from April 2020 in PSQI scores (P < 0.01). MGQOL15r, SF36, and PSQI scores correlate with severe clinical manifestation, high scores on HAM-A and HAM-D (P < 0.01). Higher scores on HAM-D and fear that MG symptoms will be worse if the patient gets an upper respiratory infection were independent predictors of the lower SF36 scores. Regarding MGQOL15r-independent predictors of the higher score were higher scores on HAM-D. CONCLUSIONS: There is a significant impact of the COVID-19 epidemic on the psychological status and especially on the quality of sleep of MG patients. Healthcare organizations need to provide professional therapeutic advice and psychosocial support for this population of patients during the pandemic.

Psychological status of patients with relapsing-remitting multiple sclerosis during coronavirus disease-2019 outbreak.

BACKGROUND: The coronavirus disease 2019 (COVID-19) is a global health emergency. The aim was to investigate the impact of COVID-19 pandemic on the psychological status of patients with relapsing-remitting multiple sclerosis (RRMS). METHODS: Data on the socio-demographic and clinical characteristics of 95 RRMS patients were collected. We used a self-designed questionnaire, the Multiple Sclerosis Quality of Life-54 Instrument (MSQOL-54), Hamilton scales for the assessment of anxiety (HAM-A), and depression (HAM-D). Patients who were tested one year ago were reassessed using the same questionnaires during the COVID-19 outbreak. Group of 99 healthy individuals (HC) were tested, using the same questionnaires. RESULTS: The main concerns in RRMS patients were that someone that they know could be infected with COVID-19 (78.5%), or could die due to the infection (33.8%), and the lack of specific treatment options (25.8%). The main concerns about the RRMS status were that their disease would be worse if they get infected with COVID-19 (36.4%), that they would experience some difficulties in drug availability (43.6%), that they could not go to the hospital as usual (72.4%). Results on all questionnaires were worse in RRMS patients than in HC (p<0.01). We noticed a statistically significant difference between the results obtained a year ago and the results from April 2020 in HAM-A (p<0.05). CONCLUSIONS: There is an impact of the COVID-19 pandemic on the psychological status of RRMS patients. Healthcare organizations need to provide professional therapeutic advice and psychosocial support for this population of patients during the pandemic.