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Background:
Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associatedwith worse outcomes. However, AKI among hospitalized patients with COVID19 in the United States is not well described.
Methods:
This retrospective, observational study involved a review of data from electronic health records of patients aged >= 18 years with laboratory-confirmed COVID-19 admitted to the Mount Sinai Health System from February 27 to May 30, 2020. We describe the frequency of AKI and dialysis requirement, AKI recovery, and adjusted odds ratios (aORs) with mortality.
Results:
Of 3993 hospitalized patients with COVID-19, AKI occurred in 1835 (46%) patients; 347 (19%) of the patientswith AKI required dialysis. The proportionswith stages 1, 2, or 3 AKIwere 39%, 19%, and 42%, respectively. A total of 976 (24%) patients were admitted to intensive care, and 745 (76%) experienced AKI. Of the 435 patients with AKI and urine studies, 84% had proteinuria, 81% had hematuria, and 60% had leukocyturia. Independent predictors of severe AKI were CKD, men, and higher serum potassium at admission. In-hospital mortality was 50% among patients with AKI versus 8% among those without AKI (aOR, 9.2; 95% confidence interval, 7.5 to 11.3). Of survivors with AKI who were discharged, 35% had not recovered to baseline kidney function by the time of discharge. An additional 28 of 77 (36%) patients who had not recovered kidney function at discharge did so on posthospital follow-up.
Conclusions:
AKI is common among patients hospitalized with COVID-19 and is associated with high mortality. Of all patients with AKI, only 30% survived with recovery of kidney function by the time of discharge.
Background: As the COVID-19 pandemic continues to spread across the globe, the search for an effective medication to treat the symptoms of COVID-19 continues as well. It would be desirable to identify a medication that is already in use for another condition and whose side effect profile and safety data are already known and approved.
Objective: The objective of this study was to evaluate the effect of different medications on typical COVID-19 symptoms by using data from an online surveillance survey.
Methods: Between early April and late-July 2020, a total of 3654 individuals in Lower Saxony, Germany, participated in an online symptom-tracking survey conducted through the app covid-nein-danke.de. The questionnaire comprised items on typical COVID-19 symptoms, age range, gender, employment in patient-facing healthcare, housing status, postal code, previous illnesses, permanent medication, vaccination status, results of reverse transcription polymerase chain reaction (RT-PCR) and antibody tests for COVID-19 diagnosis, and consequent COVID-19 treatment if applicable. Odds ratio estimates with corresponding 95% CIs were computed for each medication and symptom by using logistic regression models.
Results: Data analysis suggested a statistically significant inverse relationship between typical COVID-19 symptoms self-reported by the participants and self-reported statin therapy and, to a lesser extent, antihypertensive therapy. When COVID-19 diagnosis was based on restrictive symptom criteria (ie, presence of 4 out of 7 symptoms) or a positive RT-PCR test, a statistically significant association was found solely for statins (odds ratio 0.28, 95% CI 0.1-0.78).
Conclusions: Individuals taking statin medication are more likely to have asymptomatic COVID-19, in which case they may be at an increased risk of transmitting the disease unknowingly. We suggest that the results of this study be incorporated into symptoms-based surveillance and decision-making protocols in regard to COVID-19 management. Whether statin therapy has a beneficial effect in combating COVID-19 cannot be deduced based on our findings and should be investigated by further study.
COVID-19
(2021)
We investigate how the economic consequences of the pandemic and the government-mandated measures to contain its spread affect the self-employed — particularly women — in Germany. For our analysis, we use representative, real-time survey data in which respondents were asked about their situation during the COVID-19 pandemic. Our findings indicate that among the self-employed, who generally face a higher likelihood of income losses due to COVID-19 than employees, women are about one-third more likely to experience income losses than their male counterparts. We do not find a comparable gender gap among employees. Our results further suggest that the gender gap among the self-employed is largely explained by the fact that women disproportionately work in industries that are more severely affected by the COVID-19 pandemic. Our analysis of potential mechanisms reveals that women are significantly more likely to be impacted by government-imposed restrictions, e.g., the regulation of opening hours. We conclude that future policy measures intending to mitigate the consequences of such shocks should account for this considerable variation in economic hardship.
During COVID-19, various public institutions tried to shape citizens’ behaviour to slow the spread of the pandemic. How did their authority affect citizens’ support of public measures taken to combat the spread of COVID-19? The article makes two contributions. First, it presents a novel conceptualisation of authority as a source heuristic. Second, it analyses the authority of four types of public institutions (health ministries, universities, public health agencies, the WHO) in two countries (Germany and the UK), drawing on novel data from a survey experiment conducted in May 2020. On average, institutional endorsements seem to have mattered little. However, there is an observable polarisation effect where citizens who ascribe much expertise to public institutions support COVID-19 measures more than the control group. Furthermore, those who ascribe little expertise support them less than the control group. Finally, neither perception of biases nor exposure to institutions in public debates seems consistently to affect their authority.
Forced to stay at home
(2022)
The effects of COVID-19-related lockdowns on deterioration of mental health and use of exercise to remediate such effects has been well documented in numerous populations. However, it remains unknown how lockdown restrictions impacted individuals differently and who was more likely to change their exercise behavior and experience negative well-being. The current study examined exercise dependence as a risk factor and its impact on exercise behavior and mood during the initial COVID-19 lockdowns on a global scale in 11,898 participants from 17 countries. Mixed effects models revealed that reducing exercise behavior was associated with a stronger decrease in mood for individuals at risk of exercise dependence compared to individuals at low risk of exercise dependence. Participants at high risk and exercising more prior to the pandemic reported the most exercise during lockdown. Effects of lowered mood were most pronounced in participants with high risk of exercise dependence who reported greater reduction in exercise frequency during lockdown. These results support recent etiological evidence for exercise dependence and add to a growing body of literature documenting mental health effects related to COVID-19.
In response to strong revenue and income losses facing a large share of self-employed individuals during the COVID-19 pandemic, the German federal government introduced a €50bn emergency-aid program. Based on real-time online-survey data comprising more than 20,000 observations, we analyze the impact of this program on the confidence to survive the crisis. We investigate how the digitalization level of self-employed individuals influences the program’s effectiveness. Employing propensity score matching, we find that the emergency-aid program had only moderately positive effects on the confidence of self-employed to survive the crisis. However, self-employed whose businesses were highly digitalized, benefitted much more from the state aid than those whose businesses were less digitalized. This only holds true for those self-employed, who started the digitalization processes already before the crisis. Taking a regional perspective, we find suggestive evidence that the quality of the regional broadband infrastructure matters in the sense that it increases the effectiveness of the emergency-aid program. Our findings show the interplay between governmental support programs, the digitalization levels of entrepreneurs, and the regional digital infrastructure. The study helps public policy to improve the impact of crisis-related policy instruments, ultimately increasing the resilience of small firms in times of crises.
Boredom has been identified as one of the greatest psychological challenges when staying at home during quarantine and isolation. However, this does not mean that the situation necessarily causes boredom. On the basis of 13 explorative interviews with bored and non-bored persons who have been under quarantine or in isolation, we explain why boredom is related to a subjective interpretation process rather than being a direct consequence of the objective situation. Specifically, we show that participants vary significantly in their interpretations of staying at home and, thus, also in their experience of boredom. While the non-bored participants interpret the situation as a relief or as irrelevant, the bored participants interpret it as a major restriction that only some are able to cope with.
The coronavirus disease of 2019 (COVID-19) pandemic has forced most academics to work from home. This sudden venue change can affect academics' productivity and exacerbate the challenges that confront universities as they face an uncertain future. In this paper, we identify factors that influence academics' productivity while working from home during the mandate to self-isolate. From analyzing results from a global survey we conducted, we found that both personal and technology-related factors affect an individual's attitude toward working from home and productivity. Our results should prove valuable to university administrators to better address the work-life challenges that academics face.
We present the first systematic literature review on stress and burnout in K-12 teachers during the COVID-19 pandemic. Based on a systematic literature search, we identified 17 studies that included 9,874 K-12 teachers from around the world. These studies showed some indication that burnout did increase during the COVID-19 pandemic. There were, however, almost no differences in the levels of stress and burnout experienced by K-12 teachers compared to individuals employed in other occupational fields. School principals' leadership styles emerged as an organizational characteristic that is highly relevant for K-12 teachers' levels of stress and burnout. Individual teacher characteristics associated with burnout were K-12 teachers' personality, self-efficacy in online teaching, and perceived vulnerability to COVID-19. In order to reduce stress, there was an indication that stress-management training in combination with training in technology use for teaching may be superior to stress-management training alone. Future research needs to adopt more longitudinal designs and examine the interplay between individual and organizational characteristics in the development of teacher stress and burnout during the COVID-19 pandemic and beyond.
We present the first systematic literature review on stress and burnout in K−12 teachers during the COVID-19 pandemic. Based on a systematic literature search, we identified 17 studies that included 9,874 K−12 teachers from around the world. These studies showed some indication that burnout did increase during the COVID-19 pandemic. There were, however, almost no differences in the levels of stress and burnout experienced by K−12 teachers compared to individuals employed in other occupational fields. School principals' leadership styles emerged as an organizational characteristic that is highly relevant for K−12 teachers' levels of stress and burnout. Individual teacher characteristics associated with burnout were K−12 teachers' personality, self-efficacy in online teaching, and perceived vulnerability to COVID-19. In order to reduce stress, there was an indication that stress-management training in combination with training in technology use for teaching may be superior to stress-management training alone. Future research needs to adopt more longitudinal designs and examine the interplay between individual and organizational characteristics in the development of teacher stress and burnout during the COVID-19 pandemic and beyond.