The same storm but not the same boat: Effects of COVID-19 stay-at-home order on mental health in individuals with overweight
TL;DR: The effects of stay‐at‐home orders and social distancing during the coronavirus disease outbreak on mental health and to compare these outcomes between individuals with normal weight and overweight are described.
Abstract: OBJECTIVE: To describe the effects of stay-at-home orders and social distancing during the coronavirus disease (COVID-19) outbreak on mental health and to compare these outcomes between individuals with normal weight and overweight METHODS: This cross-sectional study included 1857 Brazilian adults, who were invited through social media to answer an online questionnaire from 5 May 2020 to 17 May 2020 The instrument included questions related to health behaviour, mental health (anxiety, depression, self-esteem, sadness and stress) and overall health Overweight was defined as body mass index (BMI) ≥ 25 Kg/m(2) Multiple logistic regression was conducted to identify whether overweight is associated with mental health variables RESULTS: Women reported increased anxiety (36 5% vs 22 2%, P < 01), depression (16 2% vs 8 8%, P < 01), low self-esteem (19 8% vs 10 6%, P < 01), sadness (17 7% vs 10 2%, P < 01), and stress (29 5% vs 19 3%, P < 01) relative to men Women with overweight are more likely to report higher feeling of anxiety (OR 1 62, CI 95% 1 22-2 14), depression (OR 1 79, CI 95% 1 25-2 55), low self-esteem (OR 1 82, CI95% 1 28-2 58) and sadness (OR 1 51, CI 95% 1 08-2 10), adjusted for age, social isolation days, educational level, chronic diseases, smoke, alcohol intake and physical activity CONCLUSION: Women, specially those with overweight are more vulnerable to the deleterious effects of stay-at-home orders on mental health during the COVID-19 pandemic
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01 Jan 2020
TL;DR: Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Abstract: Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
4,408 citations
Journal Article•
TL;DR: An influenza epidemic simulation model was adapted to estimate the likelihood of human-to-human transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a simulated Singaporean population and the combined intervention was the most effective, reducing the estimated median number of infections.
Abstract: Summary Background Since the coronavirus disease 2019 outbreak began in the Chinese city of Wuhan on Dec 31, 2019, 68 imported cases and 175 locally acquired infections have been reported in Singapore. We aimed to investigate options for early intervention in Singapore should local containment (eg, preventing disease spread through contact tracing efforts) be unsuccessful. Methods We adapted an influenza epidemic simulation model to estimate the likelihood of human-to-human transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a simulated Singaporean population. Using this model, we estimated the cumulative number of SARS-CoV-2 infections at 80 days, after detection of 100 cases of community transmission, under three infectivity scenarios (basic reproduction number [R0] of 1·5, 2·0, or 2·5) and assuming 7·5% of infections are asymptomatic. We first ran the model assuming no intervention was in place (baseline scenario), and then assessed the effect of four intervention scenarios compared with a baseline scenario on the size and progression of the outbreak for each R0 value. These scenarios included isolation measures for infected individuals and quarantining of family members (hereafter referred to as quarantine); quarantine plus school closure; quarantine plus workplace distancing; and quarantine, school closure, and workplace distancing (hereafter referred to as the combined intervention). We also did sensitivity analyses by altering the asymptomatic fraction of infections (22·7%, 30·0%, 40·0%, and 50·0%) to compare outbreak sizes under the same control measures. Findings For the baseline scenario, when R0 was 1·5, the median cumulative number of infections at day 80 was 279 000 (IQR 245 000–320 000), corresponding to 7·4% (IQR 6·5–8·5) of the resident population of Singapore. The median number of infections increased with higher infectivity: 727 000 cases (670 000–776 000) when R0 was 2·0, corresponding to 19·3% (17·8–20·6) of the Singaporean population, and 1 207 000 cases (1 164 000–1 249 000) when R0 was 2·5, corresponding to 32% (30·9–33·1) of the Singaporean population. Compared with the baseline scenario, the combined intervention was the most effective, reducing the estimated median number of infections by 99·3% (IQR 92·6–99·9) when R0 was 1·5, by 93·0% (81·5–99·7) when R0 was 2·0, and by 78·2% (59·0 −94·4) when R0 was 2·5. Assuming increasing asymptomatic fractions up to 50·0%, up to 277 000 infections were estimated to occur at day 80 with the combined intervention relative to 1800 for the baseline at R0 of 1·5. Interpretation Implementing the combined intervention of quarantining infected individuals and their family members, workplace distancing, and school closure once community transmission has been detected could substantially reduce the number of SARS-CoV-2 infections. We therefore recommend immediate deployment of this strategy if local secondary transmission is confirmed within Singapore. However, quarantine and workplace distancing should be prioritised over school closure because at this early stage, symptomatic children have higher withdrawal rates from school than do symptomatic adults from work. At higher asymptomatic proportions, intervention effectiveness might be substantially reduced requiring the need for effective case management and treatments, and preventive measures such as vaccines. Funding Singapore Ministry of Health, Singapore Population Health Improvement Centre.
317 citations
TL;DR: Disruption in daily physical activity routine, rather than physical activity level, negatively influences sleep quality during the COVID-19 quarantine.
Abstract: Background: The outbreak of novel coronavirus disease 2019 (COVID-19) has caused a global panic and public concern due to its mortality ratio and lack of treatments/vaccines Reduced levels of physical activity have been reported during the outbreak, affecting the normal daily pattern Objective: To investigate (i) the relationship of physical activity level with sleep quality and (ii) the effects of reduction physical activity levels on sleep quality Methods: A Google form was used to address personal information, COVID-19 personal care, physical activity, and mental health of 1,907 adult volunteers Binary logistic regression was used to verify the association of physical activity parameters and sleep quality Results: Insufficient physical activity levels were a risk factor to have disturbed sleep pattern [OR: 1 28, 95% CI (1 01–1 62)];however, when the BMI was added to the analysis, there was no more statistical difference [OR: 1 23, 95% CI (0 96–1 57)] On the other hand, we found that the reduction of physical activity levels was associated with negative changes in sleep quality [OR: 1 73, 95% CI (1 37–2 18)], regardless all the confounders [OR: 1 30, 95% CI (1 01–1 68)], unless when feeling of depression was added in Model 6 [OR: 1 28, 95% CI (0 99–1 66)] Conclusion: Disruption in daily physical activity routine, rather than physical activity level, negatively influences sleep quality during the COVID-19 quarantine © Copyright © 2020 Diniz, Christofaro, Tebar, Cucato, Botero, Correia, Ritti-Dias, Lofrano-Prado and Prado
33 citations
TL;DR: In this paper, the authors analyzed the association of increased screen time in different devices during the COVID-19 pandemic with consumption and increased desire of alcohol, smoking, and sweetened foods in adults.
Abstract: Background: Elevated screen time has been associated with addictive behaviors, such as alcohol and sugar intake and smoking. Considering the substantial increase in screen time caused by social isolation policies, this study aimed to analyze the association of increased screen time in different devices during the COVID-19 pandemic with consumption and increased desire of alcohol, smoking, and sweetened foods in adults. Methods: A sample of 1,897 adults with a mean age of 37.9 (13.3) years was assessed by an online survey, being composed by 58% of women. Participants were asked whether screen time in television, cell phone, and computer increased during the pandemic, as well as how much time is spent in each device. Closed questions assessed the frequency of alcohol and sweetened food consumption, smoking, and an increased desire to drink and smoke during the pandemic. Educational level, age, sex, feeling of stress, anxiety, depression, and use of a screen device for physical activity were covariates. Binary logistic regression models considered adjustment for covariates and for mutual habits. Results: Increased television time was associated with increased desire to drink (OR = 1.46, 95% CI: 1.12; 1.89) and increased sweetened food consumption (OR = 1.53, 95% CI: 1.18; 1.99), while an increase in computer use was negatively associated with consumption of alcohol (OR = 0.68, 95% CI: 0.53; 0.86) and sweetened foods (OR = 0.78, 95% CI: 0.62; 0.98). Increased cell phone time was associated with increased sweetened food consumption during the pandemic (OR = 1.78, 95% CI: 1.18; 2.67). Participants with increased time in the three devices were less likely to consume sweetened foods for ≥5 days per week (OR = 0.63, 95% CI: 0.39; 0.99) but were twice as likely to have sweetened food consumption increased during pandemic (OR = 2.04, 95% CI: 1.07; 3.88). Conclusion: Increased screen time was differently associated with consumption and desire for alcohol and sweets according to screen devices. Increased time in television and cell phones need to be considered for further investigations of behavioral impairments caused by the pandemic.
23 citations
TL;DR: In this paper, the authors examine the existing literature on the relationships between social isolation, loneliness, mental health, and weight as they relate to the COVID-19 pandemic.
Abstract: Social isolation and loneliness have long been identified as risk factors for poorer physical and mental health and increased mortality. These factors have also been shown to impact dietary behavior and physical activity which play a role in precipitating and maintaining obesity. Less is known about the impact of social isolation resulting from the COVID-19 pandemic in which social distancing is a major component of public health initiatives. This narrative review will examine the existing literature on the relationships between social isolation, loneliness, mental health, and weight as they relate to the COVID-19 pandemic. Individuals with obesity are at very high risk for worsening course of COVID-19, hospitalization, and death. This population may also be more significantly impacted by the dietary and physical activity consequences resulting from lockdown, social distancing, and isolation. The pandemic has led to significant lifestyle disruptions. However, early studies have largely relied upon cross-sectional studies or convenience samples. Future research will need to study the impact more rigorously, particularly among populations at greatest risk.
12 citations
References
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TL;DR: Wang et al. as discussed by the authors used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death, including older age, high SOFA score and d-dimer greater than 1 μg/mL.
20,189 citations
TL;DR: A review of the psychological impact of quarantine using three electronic databases is presented in this article, where the authors report negative psychological effects including post-traumatic stress symptoms, confusion, and anger.
10,370 citations
TL;DR: This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID-19 in the New York City area and assesses outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy, and death.
Abstract: Importance There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19). Objective To describe the clinical characteristics and outcomes of patients with COVID-19 hospitalized in a US health care system. Design, Setting, and Participants Case series of patients with COVID-19 admitted to 12 hospitals in New York City, Long Island, and Westchester County, New York, within the Northwell Health system. The study included all sequentially hospitalized patients between March 1, 2020, and April 4, 2020, inclusive of these dates. Exposures Confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample among patients requiring admission. Main Outcomes and Measures Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy, and death. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected. Results A total of 5700 patients were included (median age, 63 years [interquartile range {IQR}, 52-75; range, 0-107 years]; 39.7% female). The most common comorbidities were hypertension (3026; 56.6%), obesity (1737; 41.7%), and diabetes (1808; 33.8%). At triage, 30.7% of patients were febrile, 17.3% had a respiratory rate greater than 24 breaths/min, and 27.8% received supplemental oxygen. The rate of respiratory virus co-infection was 2.1%. Outcomes were assessed for 2634 patients who were discharged or had died at the study end point. During hospitalization, 373 patients (14.2%) (median age, 68 years [IQR, 56-78]; 33.5% female) were treated in the intensive care unit care, 320 (12.2%) received invasive mechanical ventilation, 81 (3.2%) were treated with kidney replacement therapy, and 553 (21%) died. As of April 4, 2020, for patients requiring mechanical ventilation (n = 1151, 20.2%), 38 (3.3%) were discharged alive, 282 (24.5%) died, and 831 (72.2%) remained in hospital. The median postdischarge follow-up time was 4.4 days (IQR, 2.2-9.3). A total of 45 patients (2.2%) were readmitted during the study period. The median time to readmission was 3 days (IQR, 1.0-4.5) for readmitted patients. Among the 3066 patients who remained hospitalized at the final study follow-up date (median age, 65 years [IQR, 54-75]), the median follow-up at time of censoring was 4.5 days (IQR, 2.4-8.1). Conclusions and Relevance This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID-19 in the New York City area.
7,282 citations
"The same storm but not the same boa..." refers background in this paper
...Overweight status has been associated with increased risks of biological health-related complications by COVID 19.(11,15) Noteworthy, individuals with obesity are more likely to present with adverse mental health problems....
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TL;DR: The findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
Abstract: Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
6,656 citations
"The same storm but not the same boa..." refers background in this paper
...The 2019 new coronavirus disease (COVID-19) pandemic is the largest outbreak in decades.(1) With the lack of specific pharmacological treatment and vaccine options to prevent the spread of COVID-19, both “stay-at-home” measures and social isolation has been proposed by the World Health Organization in order to flatten the curve of COVID-19 infection and reduce the spread of the virus....
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...Evidence demonstrates telemedicine including psychosocial interventions, particularly cognitive behavioural therapy via telephone or videoconference, can improve quality of life, depression, and anxiety in clinical populations.(1,18) Even with insufficient data for the effectiveness of eHealth interventions for individuals with overweight, this can be considerate as alternative strategy during the COVID-19 pandemic....
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01 Jan 2011
TL;DR: Overweight or obesity in adolescents has reache epidemic proportions in the USA and other industr alized countries and these conditions, although lumped together in research and in commentarie reflect adolescents’ being toward the heavier point a continuum that would range from underweight morbidly obese.
Abstract: e w id r as e, se er t st al h r Overweight or obesity in adolescents has reache epidemic proportions in the USA and other industr alized countries. These conditions, although ofte lumped together in research and in commentarie reflect adolescents’ being toward the heavier point a continuum that would range from underweight morbidly obese. The terms may be used interchang ably, but there is no doubt that, in the US a considerable percentage of adolescents suffer fro too much body fat. The prevalence of obesity (bod mass index [BMI] >95th percentile) among adole cents aged 12–19 years is now one in six (17.6%); an one in three (34.9%) US adolescents are overweight obese (BMI>85th percentile) (Story et al. 2009). Oth industrialized countries, such as Canada, Japa Germany, and China also are beginning to experien increasing problems related to obesity (Cornette 2008 Being on the overweight side of the weight continuu means being afflicted with a serious, chronic disea that can cause substantial harm to adolescents’ curre and future health. Although terms may be used loosely, individua only are formally deemed obese by physicians. The are some rules of thumb and formulas that often a used, especially in social science studies, but physician diagnose whether adolescents are obese. Discussion measurements tends to focus on that diagnos A diagnosis of obesity typically involves using a bod mass index (BMI). BMI is a measure of weight propo tionate to height, which is deemed a useful measure the amount of body fat. Although there are other mo precise ways to measure excess fat, experts now recom mend using BMI because it is easily obtained, strong
2,963 citations