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"High prevalence of burnout syndrome among medical and nonmedical residents during the COVID-19 pandemic","Background: Since the beginning of the COVID-19 pandemic, health professionals have been working under extreme conditions, increasing the risk of physical and mental illness. We evaluated the prevalence of burnout and its associated factors among postgraduate student residents in health professions during the global health crisis. Methods : Healthcare residents were recruited from all across Brazil between July and September 2020 through digital forms containing instruments for assessing burnout (Oldenburg Burnout Inventory (OLBI)), resilience (brief resilient coping scale (BRCS)) and anxiety, stress and depression (depression, anxiety and stress scale (DASS-21) and Patient Health Questionnaire (PHQ-9)). Additionally, the relationships between burnout and chronic diseases, autonomy and educational adequacy in the residency programme, personal protective equipment (PPE), workload and care for patients with COVID-19 were evaluated. The chi-square test , Students t test, Pearsons correlation test and logistic regression were performed. Results : A total of 1,313 participants were included: mean (standard deviation) age, 27.8 (4.4) years; female gender, 78.1%; white race, 59.3%; and physicians, 51.3%. The overall prevalence of burnout was 33.4%. The odds (odds ratio [95% confidence interval]) of burnout were higher in the presence of pre-existing diseases (1.76 [ 1.26-2 .47]) and weekly work > 60 h (1.36 [1.03-1.79]) and were lower in the presence of high resilience (0.84 [0.81-0.88]), autonomy (0.87 [0.81-0.93]), and educational structure (0.77 [0.73-0.82]), adequate availability of PPE (0.72 [0.63-0.83]) and non-white race (0.63 [0.47-0.83]). Burnout was correlated with anxiety (r = 0.47; p < 0.05), stress (r: 0.58; p < 0.05) and depression (r: 0.65; p < 0.05). Conclusions : We observed a high prevalence of burnout among residents during the COVID-19 pandemic. Individual characteristics and conditions related to the work environment were associated with a higher or lower occurrence of the syndrome.","Rebeca da Nóbrega Lucena Pinho; ThaÃs Ferreira Costa; Nayane Miranda Silva; Adriana Ferreira Barros-Areal; André de Matos Salles; Andrea Pedrosa Ribeiro Alves Oliveira; Carlos Henrique Reis Esselin Rassi; Ciro Martins Gomes; Dayde Lane Mendonça da Silva; Fernando Araújo Rodrigues de Oliveira; Isadora Jochims; Ivan Henrique Ranulfo Vaz Filho; Lucas Alves de Brito Oliveira; Marta Alves Rosal; Marta Pinheiro Lima; Mayra Veloso Ayrimoraes Soares; PatrÃcia Shu Kurizky; Viviane Cristina Uliana Peterle; Ana Paula Monteiro Gomides; Licia Maria Henrique da Mota; Cleandro Pires de Albuquerque; Cezar Kozak Simaan; Veronica Moreira Amado","https://medrxiv.org/cgi/content/short/2022.04.12.22273783","20220416","","medRxiv","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2022-04-17","",30218,""
"The effect of antidepressants on severity of COVID-19 in hospitalized patients: A systematic review and meta-analysis","Introduction: Clinical depression and the subsequent low immunity is a comorbidity that can act as a risk factor for severity of COVID-19 cases. Antidepressants such as SSRI and SNRI are associated with immune-modulatory effects, which dismiss inflammatory response and reduce lung tissue damage. The current systematic review and meta-analysis aims to evaluate the effect of antidepressant drugs on prognosis and severity of COVID-19 in hospitalized patients. Methods: A systematic search was carried out in PubMed/Medline, EMBASE, and Scopus up to January 16, 2022. The following keywords were used: ""COVID-19"", ""SARS-CoV-2"", ""2019-nCoV"", ""SSRI"", ""SNRI"", ""TCA"", ""MAOI"", and ""Antidepressant"". The pooled risk ratio (RR) with 95% CI was assessed using a fixed or random-effect model. We considered P < 0.05 as statistically significant for publication bias. Data were analyzed by Comprehensive Meta-Analysis software, Version 2.0 (Biostat, Englewood, NJ). Results: Twelve studies were included in our systematic review. Three of them were experimental with 1751, and nine of them were observational with 290,950 participants. Seven out of twelve articles revealed the effect of antidepressants on reducing severity of COVID-19. SSRI medications, including Fluvoxamine, Escitalopram, Fluoxetine, and Paroxetine and also among the SNRI drugs Venlafaxine are also reasonably associated with reduced risk of intubation or death. There were four studies showing no significant effect and one study showing the negative effect of antidepressants on prognosis of covid-19. The meta-analysis on clinical trials showed that fluvoxamine could significantly decrease the severity outcomes of COVID-19 (RR: 0.745; 95% CI: 0.580-0.956) Conclusions: Most of the evidence supports that the use of antidepressant medications, mainly Fluvoxamine may decrease the severity and improve the outcome in hospitalizes patients with sars-cov-2. Some studies showed contradictory findings regarding the effects of antidepressants on severity of COVID-19. Further experimental studies should be conducted to clarify the effects of antidepressants on severity of COVID-19.","Hosein Nakhaee; Reza Bayati; Mohammad Rahmanian; Amir Ghaffari Jolfayi; MOEIN ZANGIABADIAN; Sakineh Rakhshanderou","https://medrxiv.org/cgi/content/short/2022.04.11.22273709","20220416","","medRxiv","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2022-04-17","",30219,""