Adverse Skin Reactions to Personal Protective Equipment Among Healthcare Workers in Oman During the Coronavirus Disease 2019 Pandemic.

Background During the coronavirus disease 2019 (COVID-19) pandemic, healthcare workers (HCWs) were required to use personal protective equipment (PPE) for unusually prolonged periods of time in order to protect themselves. This study was conducted to assess the prevalence of adverse skin reactions to PPE among HCWs from occupational and domestic exposure in Oman. Methods This was a cross-sectional study that used a self-administered questionnaire, modified based on the Nordic Occupational Skin Questionnaire, and was conducted in different categories of healthcare facilities in Oman from September to December 2020. This study involved 431 different categories of HCWs. Stata statistical software, version 12 (StataCorp, College Station, TX), was used to analyze the data, with a P value <0.05 indicating statistical significance. Results Findings indicated that 58.24% of HCWs reported new skin symptoms since the pandemic started, compared to 33.41% of HCWs who had skin symptoms before the pandemic (P<0.001). From the multivariate analysis, being female (odds ratio, or OR, 3.512; 95% confidence interval, or CI: 2.193-5.625), allergic rhinitis diagnosis (OR 2.420; 95% CI: 1.097-5.347), history of skin symptoms (OR 3.166; 95% CI: 1.856-5.400), and total glove use time (OR 1.160; 95% CI: 1.078-1.247) were associated with an increased risk of acquiring new skin symptoms. Conclusion This study demonstrates that there is some association between the prolonged use of PPE during an event such as a pandemic and a previous history of allergic rhinitis and skin symptoms. This study also emphasizes the importance of appropriate protective skin care before and after the use of PPE.

Cutaneous Manifestations of COVID-19: An Experience From Oman.

OBJECTIVES: To identify the cutaneous manifestations in COVID-19 disease in Oman. METHODS: The study was conducted in two phases with initial cross-sectional data collection with subsequent telemedical investigations of late skin manifestations including confirmed COVID-19 patients evaluated at Al-Nahdha Hospital and local health centers in Muscat from March 22 to June 2, 2020. RESULTS: The total number of patients included in the study was 374. Cutaneous manifestations were observed in 1.87% (n=7) of patients at presentation with an additional 1.6% (n=5) on follow-up. The types of skin reactions included maculopapular rash (n=6), urticaria (n=2), transient pruritic erythema (n=1), pruritic palmoplantar erythema (n=1), pustular eruption (n=1) and flare-up of atopic dermatitis (n=1). CONCLUSIONS: The low percentage of skin lesions is not contradicting previous data and it might just reflect under-reporting of skin rash in the context of the presence of more severe symptoms in our sample population. Skin lesions can still be utilized to treat patients as suspected cases until proven otherwise as it can be a silent clue in asymptomatic patients.

Prevalence and Determinants of Immediate and Long-Term PTSD Consequences of Coronavirus-Related (CoV-1 and CoV-2) Pandemics among Healthcare Professionals: A Systematic Review and Meta-Analysis.

BACKGROUND: The COVID-19 pandemic continues to rise. In order to control the COVID-19 pandemic, healthcare professionals have been subjected to increased exposure to work stress. In this systematic review, we aimed at investigating the prevalence and determinants of immediate and long-term post-traumatic stress disorder (PTSD) effects on healthcare professionals by the COVID-19 (SARS CoV-2) and SARS-2003 (SARS CoV-1) pandemics. METHODS: This systematic review was conducted according to the recommendations of the Protocols for Systemic Review and Meta-Analysis (PRISMA) statement. Only studies reporting the prevalence of PTSD (frequency, percentage) and related risk factors (adjusted odds ratio (OR)) in healthcare professionals (HCPs) during the SARS CoV-2 and SARS CoV-1 pandemics were included. The following databases were screened: Medline, Embase, PsychINFO, and Health Psychosocial Instrument (HaPI). RESULTS: Six of eight studies reported PTSD symptoms among healthcare professionals during the COVID-19 pandemic in China (three), Singapore (one), India (one), and the United States of America (USA) (two), while two studies reported symptoms during the SARS-2003 pandemic in China (one) and Singapore (one). Sample sizes ranged from 263 to 5062 with a combined total of 10,074 participants. All of the studies self-reported the level of exposure to coronaviruses (CoV-1 and CoV-2) and severity of PTSD. Seven studies reported the prevalence of immediate PTSD and determinants, while one study reported delayed-onset PTSD (3 years after CoV-1 pandemic). Determinants of immediate PTSD were reported for the CoV-2 pandemic, while those for long-term PTSD were reported for the CoV-1 pandemic. CONCLUSIONS: A comprehensive understanding of the prevalence and determinants of immediate or long-term pandemic PTSD for healthcare workers can improve prevention, diagnosis, and management. Rigorous research measuring the prevalence of PTSD and its associated risk factors (adjusted OR) for the CoV-2 pandemic are envisaged. Although strategies to resolve immediate PTSD are key, long-term PTSD must not be overlooked.