Depression, anxiety, and stress during the sanitary emergency of COVID-19 in southeastern México

Abstract: Aim: Evaluate the level of depression, anxiety, and stress; and identify the factors associated with these psychological responses during the third phase of the COVID-19 health emergency in a sample of Mexican population. Methods: An online cross-sectional survey was conducted. We performed bivariate and multivariate analyses to identify factors associated with depression, anxiety, and stress. Results: We included 997 individuals with a mean age of 35.3 ± 12.9 years; 18.9% of the participants presented symptoms of depression, 21.7% symptoms of anxiety and 14.1% symptoms of stress. Respondents were more likely to present depression if they were <40 years old (OR 1.73), not having a religion (OR 1.71), if they were currently unemployed (OR 1.54). Factors associated with anxiety were age<40 years old (OR 1.73) and having recent contact with suspected or diagnosed patients with COVID-19 (OR 1.54). Self-perception of insufficient knowledge about COVID-19 disease was associated with stress (OR 1.55). Declaring not feeling safe of COVID-19 infection was associated with depression (OR 2.03), anxiety (OR 1.90), and stress (OR 1.75). Conclusions: The damage to mental health caused by the COVID-19 pandemic is evident; health personnel must pay attention to their psychological state and well-being to take appropriate measures.

Resumen: Objetivo: Evaluar el nivel de depresión, ansiedad y estrés; e identificar los factores asociados a estas respuestas psicologicas durante la tercera fase de la emergencia sanitaria COVID-19 en una muestra de población mexicana. Métodos: Se realizó un estudio transversal en línea. Mediante análisis bivariado y multivariado identificamos factores asociados con depresión, ansiedad y estrés. Resultados: Participaron 997 individuos con una edad media de 35,3 ± 12,9 años; el 18,9% de los participantes presentó síntomas de depresión; 21,7%, ansiedad; y 14,1%, estrés. Los encuestados tenían más probabilidades de presentar depresión si tenían <40 años (OR 1,73), si no tenían religión (OR 1,71) y no tenían empleo (OR 1,54). Los factores asociados con la ansiedad fueron edad <40 años (OR 1,73) y contacto reciente con pacientes sospechosos o diagnosticados de COVID-19 (OR 1,54). La autopercepción de conocimiento insuficiente sobre la enfermedad se asoció a estrés (OR 1,55). Declarar no sentirse seguro ante el contagio se asoció con depresión (OR 2,03); ansiedad (OR 1,90); y estrés (OR 1,75). Conclusiones: El daño a la salud mental causado por la pandemia COVID-19 es evidente; el personal de salud debe prestar atención a su estado psicológico y bienestar para tomar las medidas adecuadas.

Resumo: Objetivo: Avaliar o nível de depressão, ansiedade e estresse; e identificar os fatores associados a essas respostas psicológicas durante a terceira fase da emergência sanitária da COVID-19 em uma amostra da população mexicana. Métodos: Foi realizado um estudo transversal on-line. Através da análise bivariada e multivariada identificamos fatores associados à depressão, ansiedade e estresse. Resultados: 997 indivíduos com idade média de 35,3 ± 12,9 anos participaram; 18,9% dos participantes apresentaram sintomas de depressão; 21,7%, ansiedade; e 14,1%, estresse. Os respondentes tinham maior probabilidade de depressão se tivessem <40 anos (OR 1,73), não tivessem religião (OR 1,71) e estivessem desempregados (OR 1,54). Os fatores associados à ansiedade foram idade <40 anos (OR 1,73) e contato recente com pacientes suspeitos ou diagnosticados com COVID-19 (OR 1,54). O conhecimento insuficiente autopercebido sobre a doença estava associado ao estresse (OR 1,55). O relato de não se sentir seguro contra infecção estava associado à depressão (OR 2,03); ansiedade (OR 1,90); e estresse (OR 1,75). Conclusões: Os danos à saúde mental causados pela pandemia da COVID-19 são evidentes; os profissionais da saúde devem prestar atenção ao seu estado psicológico e bem-estar a fim de tomar as medidas apropriadas.

MMP-2 salivary activity in type 2 diabetes mellitus patients.

BACKGROUND: Type 2 diabetes mellitus (T2DM) and periodontitis are chronic inflammatory diseases with a bidirectional relationship. The uncontrolled levels of glucose in T2DM patients change the pathophysiology and balance of inflammatory mediators. Matrix Metalloproteinase-2 (MMP-2) is a zinc-dependent endopeptidase that is responsible for tissue remodeling and degradation of the extracellular matrix in periodontal tissue. Therefore, the uncontrolled levels of glucose in T2DM could lead to an imbalance in MMP-2 activity in saliva, favoring the development of periodontitis. METHODS: Ninety-seven T2DM patients from Hospital Dr. Donato Alarcon were included in the study. Following clinical examination, the patients were classified into four groups according to the presence and degree of periodontal disease and glycemic control. Blood and whole saliva samples (WSS) were collected from each patient. Blood samples were used for Hba1c and polymorphonuclear cells count determination, while WSS were used to determine MMP-2 activity, TIMP-1 and nitrite. MMP-2 activity was determined by zymography. TIMP-1 were determined by Western blotting, and nitric oxide (NO) levels were determined by the Griess method. RESULTS: Of the 97 patients with T2DM, 66 had periodontitis of different severities: 18 patients had mild periodontitis, 15 had moderate and 33 had severe. Salivary MMP-2 activity, HbA1c and TIMP-1 were positively correlated with the severity of periodontitis. On the other hand, the increase in HbA1c was negatively correlated with MMP-2 activity and quantity of TIMP-1 but was positively correlated with nitrite levels. CONCLUSIONS: T2DM with glycemic uncontrol conditions, distinct clinical alterations in periodontal tissue were identified, including a decrease in the gingival redness, increased the clinical attachment loss and imbalance of MMP-2/TIMP-1, as the possible causes of disorders promoting the progression of periodontitis. Accelerated periodontitis development with poor glycemic uncontrol likely results from the altered response of host defenses and decreased activity of polymorphonuclear cells. Taken together, these findings identify MMP-2 as a promising molecular market for periodontitis.