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COVID Increases Risk Of Mental Health Disorders – The ASEAN Post

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Having COVID-19 puts people at a significantly increased chance of developing new mental health conditions, potentially adding to existing crises of suicide and overdoses, according to new research looking at millions of health records in the United States (US) over the course of a year.

The long-term effects of having COVID are still being discovered, and among them is an increased chance of being diagnosed with mental health disorders. They include depression, anxiety, stress and an increased risk of substance use disorders, cognitive decline, and sleep problems – a marked difference from others who also endured the stress of the pandemic but weren’t diagnosed with the virus.

“This is basically telling us that millions and millions of people in the US infected with COVID are developing mental health problems,” said Ziyad Al-Aly, chief of research and development at the VA St Louis Healthcare System and senior author of the paper. “That makes us a nation in distress.”

The higher risk of mental health disorders, including suicidal ideation and opioid use, is particularly concerning, he said.

“This is really almost a perfect storm that is brewing in front of our eyes – for another opioid epidemic two or three years down the road, for another suicide crisis two or three years down the road,” Al-Aly added.

These unfolding crises are “quite a big concern”, said James Jackson, director of behavioural health at Vanderbilt University’s ICU Recovery Center, who was not involved with this study. He is also seeing patients whose previous conditions, including anxiety, depression and opioid use disorder, worsened during the pandemic.

Research like this shows the clear need to follow patients in the weeks and months after even mild COVID diagnoses and to seek quick treatment for any emerging disorders, the experts said. “If we apply attention to it now and nip it in the bud, we could literally save lives,” Al-Aly said.

More than 18 percent of COVID patients developed mental health problems, compared with 12 percent of those who did not have COVID, according to the study published on Wednesday.

The study followed more than 153,000 patients who tested positive for COVID in the Veterans Affairs health system between March 2020 and January 2021, and compared them with other health records: to 5.8 million people who did not test positive in that time, but lived through the same stresses of the pandemic, and with 5.6 million patients seen before the pandemic.

Among all patients who developed new mental health problems during the pandemic, the COVID patients were significantly more likely to develop cognitive problems (80 percent), sleep disorders (41 percent), depression (39 percent), stress (38 percent), anxiety (35 percent) and opioid use disorder (34 percent), compared with those who didn’t have COVID.

The study looked only at patients with no history of mental health diagnoses in the past two years. It compared those hospitalized for COVID versus other illnesses, and compared outcomes to thousands of flu cases. The study also adjusted for factors like demographics, other health conditions and other factors.

The results were all clear: COVID has a marked effect on mental health.

Those with more severe cases of COVID, especially those who need to be hospitalized, tend to be at higher risk. But even those with mild or asymptomatic cases were more likely to receive mental health diagnoses.

“People who were hospitalized had it worse, but the risk in non-hospitalized [patients] is significant and absolutely not trivial – and that represents the majority of people in the US and the world,” Al-Aly said.

The study did have some limitations: most of those analysed were older white men. But controlling for race, gender and age found no changes in risk.

The coronavirus can be found in the brain, other studies have shown. “We can actually see the virus in the amygdala, in the hippocampus – the very centres responsible for regulating our moods, regulating our emotions,” Al-Aly said.

The study adds to other research showing that “mental health issues are a huge concern” after COVID, Jackson said. And the results line up with what he sees among patients.

“We’re learning that COVID may be even more problematic and more impactful than we thought,” Jackson said.

Early treatment of patients facing new or additional mental health challenges after COVID can make a crucial difference, the experts said.

“The idea here is to identify patients’ data early to hopefully reduce this from becoming a much larger problem down the road,” Al-Aly said. “If you leave a disease unattended, it only gets worse.”

But the longer the virus continues circulating, the more long-term problems it may create – adding even greater pressure to health systems.

“The wave of people with mental health disorders is going to be hitting the clinics in the next year or two or three, as a result of COVID and as a result of the pandemic,” Al-Aly said.

And many mental health practitioners don’t accept insurance, creating a large stumbling block for patients, while others have long waiting lists.

“This is a gigantic problem, and I’m not really sure what we’re going to do about it,” Jackson said. “The needs are vastly greater than the resources.”

Jackson has set up peer support groups to offer counselling to patients dealing with long COVID – brain fog, cognitive impairment, memory problems, feelings of inadequacy. The groups are held on Zoom, so patients can join from all over the country.

“We need to pay attention to the long-term consequences of COVID,” Al-Aly said. “If we only pay attention to the short-term consequences, the first 30 days or the first 90 days, we really, really are missing the larger picture.

“The pandemic itself caught the US unprepared, and we’re going to be caught unprepared again for long COVID,” Al-Aly said. “The reality is that COVID is producing long-term consequences, and we cannot just wish it away or sweep it under the rug or not deal with it.”

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Some in B.C. cross U.S. border for their next COVID-19 vaccine – Global News

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Global News Hour at 6 BC

There is evidence of the lengths some British Columbians will go to get a second booster dose of the COVID-19 vaccine — crossing the border to Point Roberts, WA for a shot. The movement comes thanks to the different approach to the fourth shot south of the border. Catherine Urquhart reports.

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Unknown hepatitis in children: Will it become a pandemic too? – CGTN

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03:56

The number of cases of a mysterious acute hepatitis in children continues to increase worldwide, with most cases occurring in Europe. As of May 10, 348 suspected cases had been reported in at least 20 countries. Information and data have pointed to an adenovirus called adenovirus-41 (HAdV-41) as the possible culprit. Does it have anything to do with COVID? Will it become a pandemic? How do we protect ourselves from it?

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Study tracks hospital readmission risk for COVID-19 patients in Alberta, Ontario – CBC.ca

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A new study offers a closer look at possible factors that may lead to some hospitalized COVID-19 patients being readmitted within a month of discharge.

At roughly nine per cent, researchers say the readmission rate is similar to that seen for other ailments, but socio-economic factors and sex seem to play a bigger role in predicting which patients are most likely to suffer a downturn when sent home.

Research published Monday in the Canadian Medical Association Journal looked at 46,412 adults hospitalized for COVID-19 in Alberta and Ontario during the first part of the pandemic. About 18 per cent — 8,496 patients — died in hospital between January 2020 and October 2021, which was higher than the norm for other respiratory tract infections.

Among those sent home, about nine per cent — 2,759 patients — returned to hospital within 30 days of leaving, while two per cent — 712 patients — died. The deaths include patients who returned to hospital.

The combined rate of readmission or death was similar in each province, at 9.9 per cent or 783 patients in Alberta, and 10.6 per cent or 2,390 patients in Ontario.

For those wondering if the patients were discharged too soon, the report found most spent less than a month in hospital and patients who stayed longer were actually readmitted at a slightly higher rate.

“We initially wondered, ‘Were people being sent home too early?’ … and there was no association between length of stay in hospital and readmission rates, which is reassuring,” co-author Dr. Finlay McAlister, a professor of general internal medicine at the University of Alberta, said from Edmonton.

“So it looked like clinicians were identifying the right patients to send home.”

Examining the peaks

Craig Jenne, an associate professor of microbiology, immunology and infectious diseases at the University of Calgary who was not involved in the research, said the study suggests that the health-care system was able to withstand the pressures of the pandemic. 

“We’ve heard a lot about how severe this disease can be and there was always a little bit of fear that, because of health-care capacity, that people were perhaps rushed out of the system,” Jenne said. “There was a significant increase in loss of life but this wasn’t due to system processing of patients.

“Care was not sacrificed despite the really unprecedented pressure put on staff and systems during the peaks of those early waves.” 

The study also provides important insight on the power of vaccines in preventing severe outcomes, Jenne said.

Of all the patients admitted with COVID-19 in both provinces, 91 per cent in Alberta and 95 per cent in Ontario were unvaccinated, the study found.

The report found readmitted patients tended to be male, older, and have multiple comorbidities and previous hospital visits and admissions. They were also more likely to be discharged with home care or to a long-term care facility.

McAlister also found socio-economic status was a factor, noting that hospitals traditionally use a scoring system called LACE to predict outcomes by looking at length of stay, age, comorbidities and past emergency room visits, but “that wasn’t as good a predictor for post-COVID patients.”

“Including things like socio-economic status, male sex and where they were actually being discharged to were also big influences. It comes back to the whole message that we’re seeing over and over with COVID: that socio-economic deprivation seems to be even more important for COVID than for other medical conditions.”

McAlister said knowing this could help transition co-ordinators and family doctors decide which patients need extra help when they leave the hospital.

‘Deprivation’ indicators

On its own, LACE had only a modest ability to predict readmission or death but adding variables including the patient’s neighbourhood and sex improved accuracy by 12 per cent, adds supporting co-author Dr. Amol Verma, an internal medicine physician at St. Michael’s Hospital in Toronto.

The study did not tease out how much socio-economic status itself was a factor, but did look at postal codes associated with so-called “deprivation” indicators like lower education and income among residents.

Readmission was about the same regardless of neighbourhood, but patients from postal codes that scored high on the deprivation index were more likely to be admitted for COVID-19 to begin with, notes Verma.

Verma adds that relying on postal codes does have limitations in assessing socio-economic status since urban postal codes can have wide variation in their demographic. He also notes the study did not include patients without a postal code.

McAlister said about half of the patients returned because of breathing difficulties, which is the most common diagnosis for readmissions of any type.

He suspected many of those problems would have been difficult to prevent, suggesting “it may just be progression of the underlying disease.”

Looking at readmissions is just the tip of the iceberg.-Dr. Finlay McAlister-Dr. Finlay McAlister

It’s clear, however, that many people who appear to survive COVID are not able to fully put the illness behind them, he added.

“Looking at readmissions is just the tip of the iceberg. There’s some data from the [World Health Organization] that maybe half to two-thirds of individuals who have had COVID severe enough to be hospitalized end up with lung problems or heart problems afterwards, if you do detailed enough testing,” he said.

“If you give patients quality of life scores and symptom questionnaires, they’re reporting much more levels of disability than we’re picking up in analyses of hospitalizations or emergency room visits.”

The research period pre-dates the Omicron surge that appeared in late 2021 but McAlister said there’s no reason to suspect much difference among today’s patients.

He said that while Omicron outcomes have been shown to be less severe than the Delta variant, they are comparable to the wild type of the novel coronavirus that started the pandemic.

“If you’re unvaccinated and you catch Omicron it’s still not a walk in the park,” he said.

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