Mental health impacts of COVID-19 on healthcare workers in the Eastern Mediterranean Region: a multi-country study.

BACKGROUND: Healthcare workers (HCWs) fighting against the COVID-19 pandemic are under incredible pressure, which puts them at risk of developing mental health problems. This study aimed to determine the prevalence of depression, anxiety, and stress among HCWs responding to COVID-19 and its associated factors. METHODS: A multi-country cross-sectional study was conducted during July-August 2020 among HCWs responding to COVID-19 in nine Eastern Mediterranean Region (EMR) countries. Data were collected using an online questionnaire administered using KoBo Toolbox. Mental problems were assessed using the Depression, Anxiety, and Stress Scale (DASS-21). RESULTS: A total of 1448 HCWs from nine EMR countries participated in this study. About 51.2% were male and 52.7% aged ≤ 30 years. Of all HCWs, 57.5% had depression, 42.0% had stress, and 59.1% had anxiety. Considering the severity, 19.2%, 16.1%, 26.6% of patients had severe to extremely severe depression, stress, and anxiety, respectively. Depression, stress, anxiety, and distress scores were significantly associated with participants' residency, having children, preexisting psychiatric illness, and being isolated for COVID-19. Furthermore, females, those working in a teaching hospital, and specialists had significantly higher depression and stress scores. Married status, current smoking, diabetes mellitus, having a friend who died with COVID-19, and high COVID-19 worry scores were significantly associated with higher distress scores. CONCLUSIONS: Mental problems were prevalent among HCWs responding to COVID-19 in EMR. Therefore, special interventions to promote mental well-being among HCWs responding to COVID-19 need to be immediately implemented.

Impact of COVID-19 lockdown on physical activity behavior among students in Somalia.

Background: Due to the worldwide reach of the COVID-19 pandemic, authorities across the globe deemed it essential to enforce exceptional containment measures. Maintaining physical activity (PA) during this time was only feasible through engaging in activities at home. Therefore, this study focused on elucidating the levels of PA and well-being among Somali students in the aftermath of the lockdown measures implemented by governments at the onset of the COVID-19 pandemic. Methods: This study was conducted in Somalia among undergraduate students studying at Somali International University. A total of 1266 students were included in the present study. An online survey was utilized to measure participant PA behavior. The assessment of PA was conducted in the aftermath of the COVID-19 pandemic, utilizing the Godin Leisure questionnaire. The study showed that 85.8% of the study participants (n = 1086) were between the ages of 17 and 22. More than half of the participants (58.7%, n = 743) were female and had no other employment (57.3%, n = 743). Results: Jogging was the most frequently reported PA (57.3%, n = 726), and PA level was on average 59.7 minutes per day (SD = 25.9). Also, most of the study participants were in their last year (82.1%). In the regression analysis, age, gender, academic year, and work status were significant predictors of being physically active after the COVID-19 pandemic. Conclusion: Factors affecting PA after the COVID-19 pandemic include age, gender, academic year, and work status. Males, younger individuals, and those who engage in outdoor exercise are more likely to be physically active. Once the COVID-19 restrictions were relaxed, undergraduate students in Somalia were physically active. A high level of PA appears to be advantageous for public health. Universities in Somalia should uphold school policies that promote an active lifestyle among students, aiming to maintain or enhance the existing level of PA.

Cardiovascular risk factors and clinical outcomes of patients hospitalized with COVID-19 pneumonia in Somalia.

Background: Coronavirus disease-2019 (COVID-19) is a potentially life-threatening illness with no established treatment. Cardiovascular risk factors (CRFs) exacerbate COVID-19 morbidity and mortality. Objective: To determine the prevalence of CRF and clinical outcomes of patients hospitalized with COVID-19 in a tertiary hospital in Somalia. Methods: We reviewed the medical records of patients aged 18 years or older with a real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 hospitalized at the De Martino Hospital in Mogadishu, Somalia, between March and July 2020. Results: We enrolled 230 participants; 159 (69.1%) males, median age was 56 (41-66) years. In-hospital mortality was 19.6% (n = 45); 77.8% in the intensive care unit (ICU) compared with 22.2%, in the general wards (p < 0.001). Age ⩾ 40 years [odds ratio (OR): 3.6, 95% confidence interval (CI): 1.2-10.6, p = 0.020], chronic heart disease (OR: 9.3, 95% CI: 2.2-38.9, p = 0.002), and diabetes mellitus (OR: 3.2, 95% CI: 1.6-6.2, p < 0.001) were associated with increased odds of mortality. Forty-three (18.7%) participants required ICU admission. Age ⩾ 40 years (OR: 7.5, 95% CI: 1.7-32.1, p = 0.007), diabetes mellitus (OR: 3.2, 95% CI: 1.6-6.3, p < 0.001), and hypertension (OR: 2.5, 95% CI: 1.2-5.2, p = 0.014) were associated with ICU admission. For every additional CRF, the odds of admission into the ICU increased threefold (OR: 2.7, 95% CI: 1.2-5.2, p < 0.001), while the odds of dying increased twofold (OR: 2.1, 95% CI: 1.3-3.2, p < 0.001). Conclusions: We report a very high prevalence of CRF among patients hospitalized with COVID-19 in Somalia. Mortality rates were unacceptably high, particularly among those with advanced age, underlying chronic heart disease, and diabetes.