Mental Health Disorders and Coping Strategies in Healthcare Workers during the COVID-19 Pandemic: An Analytical Cross-Sectional Study in Southeastern Mexico.

Mental health disorders are relatively common in the general population and were already an important issue for the healthcare sector before COVID-19. COVID-19, being a worldwide crucial event and evidently a great stressor has increased both the prevalence and incidence of these. Therefore, it is evident that COVID-19 and mental health disorders are closely related. Moreover, several coping strategies exist to endure said disorders such as depression and anxiety, which are used by the population to confront stressors, and healthcare workers are not the exception. This was an analytical cross-sectional study, conducted from August to November 2022, via an online survey. Prevalence and severity of depression, anxiety, and stress were assessed via the DASS-21 test, and coping strategies were assessed via the CSSHW test. The sample consisted of 256 healthcare workers and of those, 133 (52%) were males with a mean age of 40.4 ± 10.35, and 123 (48%) were females with a mean age of 37.28 ± 9.33. Depression was prevalent in 43%, anxiety in 48%, and stress in 29.7%. Comorbidities were a significant risk factor for both depression and anxiety with an OR of 10.9 and 4.18, respectively. The psychiatric background was a risk factor for depression with an OR of 2.17, anxiety with an OR of 2.43, and stress with an OR of 3.58. The age difference was an important factor in the development of depression and anxiety. The maladaptive coping mechanism was prevalent in 90 subjects and was a risk factor for depression (OR of 2.94), anxiety (OR of 4.46) and stress (OR of 3.68). The resolution coping mechanism was a protective factor for depression (OR of 0.35), anxiety (OR of 0.22), and stress (OR of 0.52). This study shows that mental health disorders are highly prevalent among healthcare workers in Mexico and that coping strategies are associated with their prevalence. It also implies that not only occupations, age, and comorbidities might affect mental health, but also the way patients confront reality and the behavior and decisions they take towards stressors.

Clinical and Virological Features of SARS-CoV-2 Variants during the Four Waves of the Pandemic in the Mexican Southeast.

We conducted a retrospective study using a population of patients who were hospitalized at Dr. Juan Graham Casasus Hospital in Villahermosa (Tabasco, Mexico) and had a positive RT-PCR test for SARS-CoV-2 between June 2020 and January 2022. We analyzed all medical records, including demographic data, SARS-CoV-2 exposure history, underlying comorbidities, symptoms, signs at admission, laboratory findings during the hospital stay, outcome, and whole-genome sequencing data. Finally, the data were analyzed in different sub-groups according to distribution during waves of the COVID-19 pandemic regarding Mexican reports from June 2020 to January 2022. Of the 200 patients who tested positive via PCR for SARS-CoV-2, only 197 had samples that could be sequenced. Of the samples, 58.9% (n = 116) were males and 41.1% (n = 81) females, with a median age of 61.7 ± 17.0 years. Comparisons between the waves of the pandemic revealed there were significant differences in the fourth wave: the age of patients was higher (p = 0.002); comorbidities such as obesity were lower (p = 0.000), while CKD was higher (p = 0.011); and hospital stays were shorter (p = 0.003). The SARS-CoV-2 sequences revealed the presence of 11 clades in the study population. Overall, we found that adult patients admitted to a third-level Mexican hospital had a wide range of clinical presentations. The current study provides evidence for the simultaneous circulation of SARS-CoV-2 variants during the four pandemic waves.

Prevalence and Risk Factors of Adverse Effects and Allergic Reactions after COVID-19 Vaccines in a Mexican Population: An Analytical Cross-Sectional Study.

Vaccinations have helped to control the COVID-19 pandemic; however, few studies focus on the adverse effects and allergic reactions of these vaccines and fewer have a scope in the Latin American population. The objective of this study was to assess the associations between vaccinations, sex, age, allergic reactions, and adverse effects. This was an analytical cross-sectional study conducted between 1 July and 1 October 2022. The sample consisted of 443 surveyed participants, with a total of 1272 COVID-19 vaccine doses. Seven vaccines (Pfizer BioNTech, Oxford-AstraZeneca, CanSino, Moderna, Johnson and Johnson, Sinovac, and Sputnik V) were evaluated. A total of 12.6% of those surveyed had at least one allergic reaction posterior to vaccination, and females had a greater chance of developing one (p < 0.001, OR 3.1). The most common allergic reaction was chest pain, and Pfizer-BioNTech and Oxford-AstraZeneca were associated with the onset of allergic reactions (p < 0.005). A total of 54.6% of those surveyed developed adverse effects, the most common of which were myalgia, fever, cephalea, asthenia or adynamia, and arthralgia; moreover, older age was associated with the onset of adverse effects (p < 0.5). This study concludes that the BNT162b2 (Pfizer BioNTech) and ChAdOX1 nCOV-19 (Oxford-AstraZeneca) vaccines are strongly associated with the onset of allergic reactions, with ORs of 1.6 (CI 95%, 1.18 to 2.3) and 1.87 (CI 95%, 1.35 to 2.6), respectively. In addition, females have a greater chance of developing allergic reactions associated with COVID-19 vaccinations, and there was a relation found between older age and a greater prevalence of comorbidities, adverse effects after vaccination, and COVID-19 infection after vaccination.

Side effects of the Pfizer BioNTech vaccine in health workers of a hospital in the southeast of Mexico.

INTRODUCTION: The goal of this study was to evaluate the side effects of application of the Pfizer BioNTech vaccine on the workers at a Mexican hospital. METHODOLOGY: A cross-sectional study was carried out, in which 1351 workers from a tertiary care center in the Mexican southeast were included. Sociodemographic data, comorbidities, and side effects after the Pfizer BioNTech vaccine were obtained through an online survey. The variables were analyzed through descriptive statistics. The presence or absence of side effects was analyzed through the Chi-square test or t-test, as appropriate. The result was considered statistically significant at p < 0.05. RESULTS: A total of 1351 health workers participated in the online survey. The mean age was 37.8 ± 10.9 years and 56.4% were women. Among them, 8.2% suffered from high blood pressure. In addition, 76.7% manifested pain in the application area. The presence of side effects was associated with the female gender (p < 0.01). Side effects were more prevalent in younger age (37.2 ± 10.7) than older age (41.5 ± 10.8) (p < 0.01). There was no association with the presence of comorbidities (p > 0.05). CONCLUSIONS: The data suggest that pain in the application area is the most frequent side effect among workers in a Mexican hospital who received the Pfizer BioNTech vaccine against COVID-19. In addition, we observed sialorrhea as a side effect in the studied population and this had not previously been reported. The highest number of adverse events occurred between 24 to 72 hours after application.

Different Clinical Presentations of Human Rhinovirus Species Infection in Children and Adults in Mexico.

Background: Human rhinoviruses (HRVs) are a common cause of influenza-like illness, with the ability to infect the upper and lower respiratory tracts. In this study we aim to describe the clinical and molecular features of HRV infection in Mexican children and adults. Methods: We performed a hospital-based, 4-year multicenter prospective observational cohort study of patients with influenza-like illness. Participants who tested positive for HRV were included. We described demographic, clinical, and laboratory characteristics and the association between HRV types, illness severity, and clinical outcomes. Results: Of the 5662 subjects recruited, 1473 (26%) had HRV; of those, 988 (67.1%) were adults (≥18 years) and 485 (32.9%) were children. One hundred sixty-seven (11.33%) samples were sequenced; 101 (60.5%) were rhinovirus species A (HRV-A), 22 (13.2%) were rhinovirus species B (HRV-B), and 44 (26.3%) were rhinovirus species C (HRV-C). Among children and adults, 30.5% and 23.5%, respectively, were hospitalized (non-intensive care unit [ICU]). The odds of HRV-C are higher than HRV-A for participants in the ICU (compared to outpatient) and when platelets, lymphocytes, white blood cells, and lactate dehydrogenase are increased. The odds of HRV-C are higher than HRV-A and HRV-B with shortness of breath. The odds of HRV-A are higher than HRV-B, and the odds of HRV-B are higher than HRV-C, when mild symptoms like muscle ache and headache occur. Conclusions: Rhinoviruses are a common cause of influenza-like illness. It is necessary to improve the surveillance, testing, and species identification for these viruses to understand different clinical presentations and risk factors associated with worse outcomes. Clinical Trials Registration. NCT01418287.

Fluoxetine modulates the pro-inflammatory process of IL-6, IL-1ß and TNF-α levels in individuals with depression: a systematic review and meta-analysis.

Clinical evidence suggests that inflammation is a key factor to understand the causes of depressive symptoms. Fluoxetine is one of the main first-line medications used for depression, and it is hypothesized that it participates in the decrease of pro-inflammatory cytokines. Hence, our aim was to perform a meta-analysis and systematic review to understand the interaction of fluoxetine in the IL-1ß, IL-6 and TNF-α inflammatory process. Studies identified in PubMed and Scopus databases were used to perform a meta-analysis via the Comprehensive software. Standardized mean difference (SMD) was used as a summary statistic. The analysis included a total of 292 individuals with major depressive disorder who received fluoxetine for a period longer than 6 weeks; additionally, IL-1ß, IL-6 or TNF-α levels were measured at the end of the antidepressant treatment. The findings were significant revealed decreased levels of the cytokines studied. In conclusion, the pooled data suggest that fluoxetine treatment improved depressive symptomatology by the modulation of pro-inflammatory process such as IL-1ß, IL-6 or TNF-α.

Estudio preliminar de un enjuague bucal de solución salina como muestra diagnóstica para SARS-CoV-2 / Preliminary study of a saline mouthwash as a diagnostic sample for SARS-CoV-2

Resumen Objetivo: Evaluar la utilidad de un enjuague bucal con solución salina (EBSS) como muestra diagnóstica para la detección de SARS-CoV-2 en pacientes ambulatorios. Material y métodos: Este fue un estudio prospectivo realizado en el Hospital Regional de Alta Especialidad "Dr. Juan Graham Casasús", se seleccionaron 34 muestras aleatorias pareadas EBSS/MNF (enjuague bucal con solución salina/muestra (clínica) de la nasofaringe) que se recolectaron durante la visita al centro de evaluación ambulatoria de dicho hospital. Las muestras se analizaron mediante la reacción en cadena de la polimerasa con transcripción inversa en tiempo real (RT-PCR) y se calculó la concordancia entre EBSS y MNF, la sensibilidad y especificidad del EBSS. Resultados: De las 34 muestras pareadas EBSS/MNF, 14 fueron positivas para SARS- CoV-2; 4 muestras de EBSS y 10 muestras de MNF. Los resultados concordantemente positivos en las muestras pareadas EBSS/MNF fueron 3 y las medias de CT de cada gen (RdRp, N, E) no mostraron diferencia significativa entre las muestras. Se observaron 8 discordancias entre los dos tipos de muestras (7 individuos dieron positivo por MNF y 1 por EBSS). La concordancia observada entre EBSS y MNF fue aceptable (coeficiente kappa 0.31). La sensibilidad de EBSS fue de 30% con una especificidad del 95.8%. Conclusiones: La sensibilidad de EBSS no es comparable con la sensibilidad de MNF para la detección de SARS-CoV-2, pero nuestros datos sugieren al EBSS como una herramienta no invasiva, permite la autocolección y no requiere personal de salud capacitado para su muestreo: asimismo, esta muestra podría ser alternativa ante la escasez de hisopos y medios de transporte viral. Además, el EBSS puede tener beneficio para poblaciones remotas, vulnerables o facilitar las pruebas a un gran número de individuos.

Abstract Objective: To assess the usefulness of a saline mouth rinse (SMR) as a diagnostic tool for the detection of SARS-CoV-2 in outpatients. Method: This was a prospective study carried out at the Hospital Regional de Alta Especialidad "Dr. Juan Graham Casasús", 34 SMR/SNP (saline mouth rinse/sample (clinical) of nasopharyngeal) randomized paired samples were selected and collected in the outpatient clinic. The samples were analyzed by real-time reverse transcription polymerase chain reaction (RT-PCR) and the concordance between SMRs and SNP samples and the sensitivity and specificity of SMR were calculated. Results: Out of the 34 SMR/SNP paired samples, 14 samples were positive for SARS- CoV-2; 4 SMR samples and 10 SNP samples. We found 3 positive concordant results in the SMRs/SNP paired samples, the mean CT for each gene (RdRp, N, E) did not show a significant difference between the samples. Eight discrepancies were observed between the two types of samples (7 individuals were positive by SNP and 1 for SMR). The concordance observed between SMR and SNP was acceptable (kappa coefficient 0.31). The sensitivity of EBSS was 30% with a specificity of 95.8%. Conclusions: The SMR sensitivity is not comparable with SNP sensitivity for SARS- CoV-2 detection, but our data suggest SMR as a non-invasive tool that allows self- collection, and it does not require health trained personnel for its collection. Also, this sample could be an alternative to the lack of swabs and/or viral transportation media. Additionally, SMR may be of benefit in remote and vulnerable populations, and/or to facilitate the screening of SARS-CoV-2 in a large number of individuals.

Spontaneous Pneumomediastinum in nCOVID-19 infection: a case report / Pneumomediastino espontáneo en la infección por nCOVID-19: un reporte de caso

Spontaneous pneumomediastinum (SP) is a clinical entity characterized by the presence of interstitial air in the mediastinum. The purpose of this study was to further examine a rare SP case in a 60-year-old male, with COVID-19. In conclusion, SP is an uncommon complication in COVID-19, and the recognition of clinical characteristics is crucial since early identification plays a significant role in the maintenance or recovery of the disease..(Au)

El neumomediastino espontáneo (NE) es una entidad clínica caracterizada por la presencia de aire intersticial en el mediastino. El propósito de este estudio fue examinar más a fondo un caso raro de NE en un hombre de 60 años con COVID-19. En conclusión, el NE es una complicación poco común de COVID-19 y el reconocimiento de las características clínicas es crucial, ya que su identificación temprana juega un papel importante en el mantenimiento y recuperación de la enfermedad..(Au)