• COVID-19
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Crises test the resilience of public service organizations. Healthcare providers must respond and innovate within tight constraints to address challenges. Presenting COVID-19 as a knowable unknown (black swan event), we adopt information processing theory to investigate how healthcare providers and their suppliers address information asymmetry to support decision-making. Building on primary and secondary datasets, we demonstrate managers were innovating internal structural responses. For black swan events, in-house ‘intelligent clients’ are intrinsic not only in managing information uncertainty associated with early stages of the crisis, but also in addressing information equivocality and joint decision-making with other organizations associated with implementing solutions.

Initial reports early on in the pandemic in 2020 indicate a high incidence of acute kidney injury (AKI) in coronavirus disease 2019 (COVID-19). There is a need to better understand risk factors for AKI in patients with COVID-19. It is also unclear if AKI in patients with COVID-19 differs from AKI due to other causes. More data are required to clarify if COVID-19 is an independent risk factor for AKI and how COVID-19-associated AKI may differ from AKI due to other causes. We, therefore, sought to review the published evidence about the reported relationship between COVID-19, AKI, and outcomes. We performed a systematic search via PubMed and EMBASE using key words "COVID-19" and "AKI" to identify relevant observational studies, case series, and cohort studies published between March 2020 and April 2021. We also manually examined the reference lists of included studies and reviewed the AKI reports published in general medicine journals such as BMJ, Lancet, NEJM, and JAMA. The prevalence of AKI in hospitalized patients with COVID-19 differed across various regions of the world. Initial reports from China where cases of COVID-19 began initially have shown a much lower prevalence compared to those from Europe and North America, especially in critically ill patients in the intensive care unit with acute respiratory distress syndrome. The various components of severe acute respiratory syndrome-associated AKI appear in large parts to be similar to sepsis-induced AKI. However, affinity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) specifically to the angiotensin-converting enzyme 2 receptors located on podocytes and endothelial cells of the kidney also points toward the direct cytotoxic effects of the virus on the kidney. Numerous mechanisms likely occur simultaneously and hence more treatment approaches need to be streamlined based on pathophysiology. Although data from published literature regarding previous SARS coronaviruses can give some useful insights, we will know more going forward about the nature of kidney injury associated with COVID-19 virus as well as optimum-specific therapeutic management.

This study aimed to evaluate the frequency of isolation of Staphylococcus aureus from different pathological samples processed in the Microbiology Laboratory of the National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, Romania, between 1 January 2017 and 31 December 2022, aiming to establish the ratio of methicillin-resistant to methicillin-susceptible Staphylococcus aureus strains and the antibiotic resistance pattern of isolated microorganisms. The data of isolates originating from routine diagnostic tasks were analyzed retrospectively using laboratory data from the microbiology department. Up to 39.11% of Staphylococcus aureus strains were resistant to oxacillin (MRSA), with 49.97% resistance to erythromycin and 36.06% inducible resistance to clindamycin. Resistance rates to ciprofloxacin, rifampicin, gentamicin, and trimethoprim-sulfamethoxazole were 9.98%, 5.38%, 5.95%, and 0.96%, respectively. There was no resistance to vancomycin. Between 2017 and 2022, the percentage of MRSA strains decreased from 41.71% to 33.63%, sharply increasing to 42.42% in 2021 (the year of the COVID-19 pandemic, when the percentage of strains isolated from lower respiratory tract infections was higher than that of strains isolated from wounds or blood, as in previous years). This study showed a high percentage of MRSA strains (39.11% overall) with a higher proportion of these strains isolated from the blood (42.49%) compared to other clinical specimens.

Background: COVID-19 patients with DM have increased mortality and severity of the disease. Although telemedicine helps to minimize the impact of COVID-19 on the DM standard of care, it is increasingly evident that COVID-19 has a significant impact on DM standards of care, especially in areas where telemedicine is not available. Objective: The study aimed to assess the impact of COVID-19 on patients with diabetes standard of care in the Jazan region, Saudi Arabia. Methods: A cross-sectional study using an online pretested questionnaire targeted adult diabetic patients living in the Jazan region between December 2021 to March 2022. The participants were selected through a random sampling method. They completed self-administered questionnaires that included demographic variables. Results: A total of 258 study subjects participated in this study. In comparison to DM standards of care before and during COVID-19, there was no clinically significant difference in medication compliance, blood glucose checking, or experiencing blood glucose extrusion. However, with the spread of the corona pandemic and the closure of clinics, the percentage of those who have difficulty controlling blood sugar levels has increased to 22%, despite the availability of telemedicine. Conclusion: DM standards of care have not been affected and were not statistically significant, which could be explained by the rapid adoption of telemedicine during the lockdown. However, as corona spread participants had difficulty controlling blood sugar levels. This indicates that governmental multidisciplinary work limits the COVID-19 impact; however, further work is still needed to ensure that DM care is not compromised.

Resumo Objetivou-se verificar a adesão às medidas de prevenção em idosos com maior predisposição a formas graves de COVID-19 e sua associação e interação com o apoio social. Trata-se de um estudo transversal realizado em amostra de 3.477 participantes do inquérito telefônico do Estudo Longitudinal da Saúde dos Idosos Brasileiros (iniciativa ELSI-COVID-19), que informaram ter saído de casa na semana anterior à realização do inquérito. A adesão foi aferida pela frequência com que saiu de casa, necessidade de sair de casa, uso de máscara e higienização das mãos. As análises basearam-se no modelo Poisson com variância robusta. Idade ≥ 65 anos, hipertensão, diabetes e obesidade foram considerados fatores predisponentes para formas graves de COVID-19. O apoio social incluiu o arranjo domiciliar e a conexão social na pandemia. Aproximadamente 46% apresentaram melhor adesão, que foi associada positivamente ao número de fatores predisponentes para formas graves. O apoio social não foi associado à adesão e não modificou essa associação, após ajustamentos. Conclui-se que a adesão às medidas de prevenção, que deveria ser estendida a todos, está concentrada nos idosos com maior predisposição a formas graves de COVID-19, independentemente do apoio social.

Background: Aggressive quarantine and lockdown measures were implemented as protective public health actions during the coronavirus disease 2019 (COVID-19) pandemic. Assessing the psychological effects associated with these measures is an important attempt to inform local policymakers in an early stage. Yet little is known about these effects, specifically depression, among the Palestinians. This study aimed to assess the prevalence and predictors of depression among the Palestinian community during this pandemic.Materials and methods: A cross-sectional web-based survey throughout social media (Facebook and Instagram) was carried out using an anonymous online questionnaire. The validated and standardized depression, anxiety, and stress scale (DASS) was used to measure depression severity. A snowball technique recruiting the general public living in Palestine was conducted. Data were collected between 6 and 16 April 2020, which corresponded to the middle interval of strict massive lockdown in Palestine on 22 March to 5 May 2020. Multinomial logistic regression model was developed to predict depression severity.Results: About 2,819 respondents filled out the questionnaire. Depression prevalence was (57.5%; n = 1,621). Out of them, 66% had mild/moderate severity, and 34% had severe/extremely severe degree. Depression severity was negatively associated with age {mild/moderate degree [OR (95% CI) = 0.98 (0.97–0.99)] and severe/extremely severe [OR (95% CI) = 0.96 (0.94–0.97)]} degrees compared with normal degree. Males were significantly less likely to have higher depression than females {mild/moderate degree [OR (95% CI) = 0.69 (0.57–0.85)] and severe/extremely severe [OR (95% CI) = 0.52 (0.40–0.86)]} degree. However, those who reported having inadequate food supply and lesser monthly incomes were more likely to have a higher degree of depression as compared with normal degree. Single persons were significantly more likely to have mild/moderate depression than those in a relationship [OR (95% CI) = 1.31 (1.05–1.64)].Conclusions: High depression prevalence (57.5%) among the Palestinian community during the COVID-19 pandemic is a growing public health concern. It is essential to provide psychological counseling and treatment during and after the pandemic for the targeted people at high risk (young age/female gender) who were affected psychologically. Strategic long-term policy to address pandemic ramifications, including depression, by implementing comprehensive interventions taking into account socioeconomic disparities, vulnerability, and inequities, is crucial to emerge from this crisis in Palestine.