Siamak Moayedi

Bio: Siamak Moayedi is an academic researcher from University of Maryland, Baltimore. The author has contributed to research in topics: Medicine & Emergency department. The author has an hindex of 9, co-authored 49 publications receiving 234 citations.

The prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic: An umbrella review of meta-analyses.

Abstract: BACKGROUND: Healthcare workers, who are at the forefront of the fight against COVID-19, are particularly susceptible to physical and mental health consequences such as anxiety and depression. The aim of this umbrella review of meta-analyses is to determine the prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic. METHODS: Using relevant keywords, data resources including PubMed, Scopus, Web of Science, Cochrane, ProQuest, Science Direct, Google Scholar and Embase were searched to obtain systematic reviews and meta-analyses reporting the prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic from the beginning of January to the end of October 2020. The random effects model was used for meta-analysis, and the I2 index was employed to assess heterogeneity among studies. Data was analyzed using STATA 14 software. RESULTS: In the primary search, 103 studies were identified, and ultimately 7 studies were included in the umbrella review. The results showed that the overall prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic was 24.94% (95% CI: 21.83-28.05, I2 = 0.0%, P = 0.804) and 24.83% (95% CI: 21.41-28.25, I2 = 0.0%, P = 0.897), respectively. CONCLUSION: This umbrella review shows that the prevalence of anxiety and depression is relatively high among healthcare workers during the COVID-19 pandemic. Healthcare workers should be provided with resources to minimize this risk.

The COVID-19 pandemic and death anxiety in the elderly.

Abstract: The coronavirus disease-2019 (COVID-19) epidemic has affected millions of people around the world and posed serious challenges for the global healthcare systems (Usher, Kim et al 2020; Vardanjani, Ronco et al. 2020). The mortality rate of the disease is directly related to the age of affected individuals such that the highest death tolls have been reported in people over 65 years of age. Eight out of 10 COVID-19-related deaths reported in the United States have been in people 65 years or older (Ioannidis, Axfors et al. 2020). In general, the elderly have a relatively weaker immune system making them more vulnerable to COVID-19. Furthermore, the elderly are more likely to have underlying chronic medical conditions which further render them susceptible to the infection. Therefore, mortality and serious complications are more common among the elderly, especially those with underlying chronic diseases (Meng, Xu et al. 2020; Vardanjani & Moayedi, 2020). Specifically, health conditions such as hypertension, diabetes, and coronary artery and cerebrovascular diseases can exaggerate the risk of serious complications of COVID-19 disease in the elderly (Ioannidis, Axfors et al. 2020). Anxiety is one of the most common psychological problems in the elderly. This is because people face various types of deficiencies and disabilities at this period of life. Studies have shown that elders are more prone to anxiety due to reduced self-confidence, decreased activity and mobility, losing friends, reduced financial and physical independence, and chronic diseases. The most common type of this is death anxiety (Mohammadpour, Sadeghmoghadam et al. 2018; Mokhtari, Moayedi et al. 2020). Death anxiety is a feeling of panic, fear, or great worry caused by thinking of death, being detached from the world, or what that would happen after life. The high prevalence of death anxiety among the elderly is due to the fact that they suffer from many physical problems, chronic diseases, movement disorders, physical disabilities, and dependence on others. Retirement and the ensuing loneliness can also contribute to death anxiety in the elderly (Birgit, Tak et al. 2018; Menzies & Menzies 2020). Traditionally, the United Nation and most researchers have considered some criteria and indicators for defining population ageing, which mainly or in a large part are based on people’s chronological age (i.e. 60 to 65 years or older) and the elderly are defined as people 60 or 65 years of age or older. According to the United Nation, 703 million of the global population have been elders (65 or over) in 2019. As population ageing is spreading fast across the world, the number of elders is expected to double to 1.5 billion by 2050 (Fent, 2008). In addition to physical morbidity and mortality, it is common for confirmed or suspected COVID-19-affected patients to suffer from excessive stress. Confirmed or suspected cases of COVID-19 infection have legitimate fears of the disease prognosis (Li, Yang et al. 2020,) which can contribute to stress and anxiety, especially among the elderly (Meng, Xu et al. 2020). As a result, they may experience loneliness, denial, anxiety, insomnia, and frustration which can reduce their adherence to medical treatments (Li, Yang et al. 2020) and negatively affect their mental health. Additionally, this fear can lead to obsessive-compulsive disorder, suicidal thoughts, depression, alcohol abuse, self-harm behaviours, avoidance, and fear of others (Pragholapati 2020). Isolated individuals with suspected COVID-19 infection may suffer from anxiety due to the uncertainty about their health status and experience obsessive-compulsive symptoms such as recurrent checking of body temperature and hand washing. Moreover, strict quarantine policies can lead to social exclusion, financial losses, discrimination, and shame. Misinformation about COVID-19 may exaggerate public anxiety, fear, isolation, frustration, and irritability (Li, Yang et al. 2020). Prolonged quarantine, boredom, inadequate nutrition, insufficient information, and social stigma are also documented sources of stress during the COVID-19 epidemic (Shojaei & Masoumi 2020). The common anxiety among COVID-19 patients appears to be largely due to the unknown nature and ambiguities about the virus. The inadequate scientific information, the emergence of new clinical symptoms, Correspondence: Mohamad Golitaleb, Basij Square, Arak, Iran, Postal code/P.O. Box: 3848176941. Email: Mohamadgolitaleb@gmail.com, m.golitaleb@arakmu.ac.ir

COVID-19 pandemic and health anxiety among nurses of intensive care units.

Abstract: Coronavirus disease 2019 (COVID-19) is a new human infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus has spread to most countries around the world. Simultaneous with its rapid outbreak, the global healthcare system has been overwhelmed (Usher, Bhullar et al. 2020; Vardanjani, Moayedi et al. 2020).The global state of emergency caused by COVID-19 has put tremendous pressure on nursing services. High work burden, insufficient resources and excessive work environment stressors can adversely affect intensive care unit (ICU) nurses’ mental health (Pappa, Ntella et al. 2020). If these stressors are not effectively addressed, they may not only weaken immune their system and increase the risk of COVID-19 infection, but can negatively affect the quality and safety of medical services (Shen, Zou et al. 2020). Considering that the International Council of Nurses has recognized a main role for nurses in combating COVID-19 (Millar 2020), improving nurses’ mental health is essential to control the pandemic (Millar 2020). Increased workload, physical burnout, inadequate personal protective equipment, infection risk and frequent difficult ethical decisions regarding care priorities have led to severe psychological stresses in healthcare workers. Nurses in particular are disproportionately affected because they spend more time caring of COVID-19 patients compared with other health providers (Liu, Han et al. 2020; Pappa, Ntella et al. 2020). Studies have reported a high prevalence of anxiety in health staff caring of COVID-19 (Pappa, Ntella et al. 2020). A recent Chinese study found that one-sixth of health personnel suffered from psychological problems amid the outbreak of COVID-19, of whom only 35% sought treatment (Liu, Han et al. 2020), nurses working in ICUs at baseline experience difficult working conditions and heavy responsibilities such as long and continuous care of critically ill and dying patients. Consequently, these nurses are exposed to the highest levels of stress during this pandemic (Jamshidian, Kiani et al. 2018). In one study, the prevalence of anxiety in nurses caring of COVID-19 patients in ICUs was reported as 17.6% (Liu, Han et al. 2020). Nurses are exposed to various stressors due to the nature of their job. These include prolong and continuous confronting with critically ill and dying patients and feeling a high degree of responsibility. These events and their consequent destructive psychological and physiological effects can lead to more adverse consequences such as various diseases, absenteeism, reduced performance, impaired emotional function, decreased productivity, increased risk of anxiety, which endanger humans’ lives. Beside these, the nurses working in ICUs are at higher risk of being infected with COVID19 due to a more special working environment and working with more severely ill patients who are under mechanical ventilation and require conducting dangerous and invasive procedures such as suctioning airways secretions and oral cavity, that increase the risk of transmission of COVID-19. (Millar 2020; Pappa, Ntella et al. 2020; Shanafelt, Ripp et al. 2020).Health anxiety is one of the important factors contributing to the higher levels of stress in ICU nurses (Jamshidian, Kiani et al. 2018). Health anxiety is a cognitive disorder caused by misconceptions about disease symptoms and physical manifestations resulting from a person’s beliefs about his/her illness or health (Fergus, Kelley et al. 2016; Jamshidian, Kiani et al. 2018). Health anxiety is associated with four specific misconceptions: The assumption of having the disease, fear of the disease, incapability to cope with the disease and the inadequacy of medical treatments (Taylor & Asmundson 2004). This form of anxiety is more common in less experienced and often younger nurses. Severe health anxiety may lead to depression, headaches, insomnia, and even suicidal thoughts (Janzen Claude, Hadjistavropoulos et al. 2014; Taylor & Asmundson 2004).The most important factor leading to health anxiety in health personnel, especially nurses, amid the COVID-19 pandemic is the high rate of healthcare worker infection and mortality. In Italy, 10% of health personnel contracted and 3% of them died of the Correspondence: Mohamad Golitaleb, Basij Square, Postal code/ P.O. Box: 3848176941, Arak, Iran. Emails: Mohamadgolitaleb@gmail.com, m.golitaleb@arakmu.ac.ir Financial disclosure: None. Declaration of competing interest: None.

The Prevalence of Post-traumatic Stress Disorder Among Health Care Workers During the COVID-19 Pandemic: An Umbrella Review and Meta-Analysis

Abstract: Introduction: Frontline health care workers (HCWs) have had an increased risk of developing health problems during the COVID-19 pandemic. In addition to physical illness, they have experienced mental health challenges, including post-traumatic stress disorder (PTSD). The aim of this study is to investigate the prevalence of PTSD among HCWs during the COVID-19 pandemic via an umbrella review and meta-analysis. Methods: This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to perform a systematic literature search using various medical databases (Web of science, PubMed, Scopus, Cochrane, ProQuest, Science Direct, Embase, and Google scholar). The search included all articles published through the first of January 2020 the end of March 2021. The systematic review and meta-analysis studies that reported the prevalence of PTSD among health care workers were included in the study, and studies that reported the prevalence of PTSD in normal people or other epidemics were excluded. The random effects model was used to perform a meta-analysis, and the I2 index was used to evaluate heterogeneity among studies. Publication bias was assessed using the Egger test. Data was analyzed using STATA (version 14) software. Results: The initial literature search yielded 145 studies. After excluding duplicates and assessing the quality of the studies, eight studies were selected for meta-analysis. The results showed that the overall prevalence of PTSD among HCWs during the COVID-19 pandemic was 13.52% (95% CI: 9.06-17.98, I2= 65.5%, p= 0.008). Conclusion: There is a high prevalence of PTSD among frontline HCWs during the COVID-19 pandemic. It is important to invest in efforts to screen HCWs for mental health disorders such as PTSD and provide them with mental health support.

Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems

Abstract: Urinary tract infections (UTIs) are common in pregnant women and pose a great therapeutic challenge, since the risk of serious complications in both the mother and her child is high. Pregnancy is a state associated with physiological, structural and functional urinary tract changes which promote ascending infections from the urethra. Unlike the general population, all pregnant women should be screened for bacteriuria with urine culture, and asymptomatic bacteriuria must be treated in every case that is diagnosed, as it is an important risk factor for pyelonephritis in this population. The antibiotic chosen should have a good maternal and fetal safety profile. In this paper, current principles of diagnosis and management of UTI in pregnancy are reviewed, and the main problems and controversies are identified and discussed.

MicroRNAs Expression Profiles in Cardiovascular Diseases

Abstract: The current search for new markers of cardiovascular diseases (CVDs) is explained by the high morbidity and mortality still observed in developed and developing countries due to cardiovascular events. Recently, microRNAs (miRNAs or miRs) have emerged as potential new biomarkers and are small sequences of RNAs that regulate gene expression at posttranscriptional level by inhibiting translation or inducing degradation of the target mRNAs. Circulating miRNAs are involved in the regulation of signaling pathways associated to aging and can be used as novel diagnostic markers for acute and chronic diseases such as cardiovascular pathologies. This review summarizes the biogenesis, maturation, and stability of miRNAs and their use as potential biomarkers for coronary artery disease (CAD), myocardial infarction (MI), and heart failure (HF).

The prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic: An umbrella review of meta-analyses.

Abstract: BACKGROUND: Healthcare workers, who are at the forefront of the fight against COVID-19, are particularly susceptible to physical and mental health consequences such as anxiety and depression. The aim of this umbrella review of meta-analyses is to determine the prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic. METHODS: Using relevant keywords, data resources including PubMed, Scopus, Web of Science, Cochrane, ProQuest, Science Direct, Google Scholar and Embase were searched to obtain systematic reviews and meta-analyses reporting the prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic from the beginning of January to the end of October 2020. The random effects model was used for meta-analysis, and the I2 index was employed to assess heterogeneity among studies. Data was analyzed using STATA 14 software. RESULTS: In the primary search, 103 studies were identified, and ultimately 7 studies were included in the umbrella review. The results showed that the overall prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic was 24.94% (95% CI: 21.83-28.05, I2 = 0.0%, P = 0.804) and 24.83% (95% CI: 21.41-28.25, I2 = 0.0%, P = 0.897), respectively. CONCLUSION: This umbrella review shows that the prevalence of anxiety and depression is relatively high among healthcare workers during the COVID-19 pandemic. Healthcare workers should be provided with resources to minimize this risk.

Intensive care nurses' experiences during the COVID-19 pandemic: A qualitative study.

Abstract: Background Because of the COVID-19 pandemic, health care systems worldwide are working under challenging conditions. Patients, who are seriously ill, require intensive care admission. In fighting COVID-19, nurses are frontline health care workers and, as such, have a great responsibility providing needed specialized patient care in intensive care units (ICU). However, working conditions and emotional factors have an impact on the quality of the care provided. Aim The purpose of the present study was to explore and describe the experiences and perceptions of nurses working in an ICU during the COVID-19 global pandemic. Study design Qualitative research was undertaken, using an empirical approach and inductive content analysis techniques. Methods The selected population consisted of ICU nurses from a tertiary teaching hospital in Spain. Data were obtained via semi-structured videocall interviews from Apr 12th to Apr 30th, 2020. Subsequently, transcribed verbatims were analysed using the template analysis model of Brooks. Findings A total of 17 nurses comprised the final sample after data saturation. Four main themes emerged from the analysis and 13 subthemes: "providing nursing care," "psychosocial aspects and emotional lability," "resources management and safety" and "professional relationships and fellowship." Conclusion Providing health care by intensive care nursing professionals, during the COVID-19 pandemic, has shown both strong and weak points in the health care system. Nursing care has been influenced by fear and isolation, making it hard to maintain the humanization of the health care. Relevance to clinical practice Implications for practice include optimizing resource management (human and material), providing psychological support, and adequate training for ICU nurses, as well as high-quality protocols for future emergency situations.