Cross-sectional study of self-report of health issues in patients who had recovered from moderate-severe COVID-19 in Ho Chi Minh City, Vietnam

Original Research

Abstract

Introduction: There is increasing recognition that acute coronavirus disease (COVID-19) can be followed by a period of long-term symptoms (“long COVID” or post-COVID-19 syndrome [PCS]). This study investigated health issues in patients who had recovered from moderate-severe COVID-19 in District 10, Ho Chi Minh City, Vietnam.

Methods: This cross-sectional study utilized a questionnaire and telephone interviews in patients with confirmed COVID-19 who were treated in hospital between July 27 and September 15, 2021. The questionnaire gathered data on demographics, symptoms during acute COVID-19, and symptoms in the post-COVID-19 period. Logistic regression models were used to identify potential contributing factors with health issues after moderate-severe COVID-19. Health issues after moderate-severe COVID-19, similar to post-COVID-19 syndrome, were defined as the appearance of any signs or symptoms that developed during acute illness or after recovery and persisted for ≥12 weeks and could not be explained by any other medical conditions.

Results: Out of 98 individuals who completed the survey, 72 (73.5%) had symptoms after moderate-severe COVID-19. The most common symptoms were hair loss (56.1%), fatigue (42.9%), dyspnea (33.7%), sleep difficulties (26.5%), memory loss (20.4%), persistent cough (12.2%), myalgia (10.2%), muscle weakness (9.2%), palpitation (8.2%), joint pain (8.2%), and persistent sputum (6.1%). Among them, two symptoms - hair loss and fatigue - often co-occurred with dyspnea or sleep difficulties.

Conclusions: This analysis provides the first indication of the relatively high prevalence of health issues in patients who had recovered from moderate-severe COVID-19 in Ho Chi Minh City, Vietnam. This could help the local health system to detect and manage health issues after moderate-severe COVID-19 in the future.

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A case report of COVID-19-associated severe psychotic symptoms and suicidal behavior: a late psychiatric intervention

Case Study

Abstract

A 25-year-old previously healthy female patient experienced new-onset psychosis and showed suicidal behavior after contracting COVID-19. Based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the diagnosis of an acute and transient psychotic disorder (ATPD) was appropriate. Due to poor insight into illness, the patient received an oral solution containing 2 mg/mL haloperidol and fully recovered after the first month of treatment. This is the first case of a COVID-19-associated psychotic episode showing full recovery with late intervention, which occurred nearly 45 days after exhibiting the first psychotic symptoms. Additionally, the patient would require long-term follow-up owing to an ultra-high risk of relapse.

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A cross-sectional survey-based study of the cold and heat pattern of recovering patients after COVID-19 at the University medical center at Ho Chi Minh City branch 3 and students of the faculty of Traditional medicine, University of Medicine and Pharmacy at Ho Chi Minh City.

Original Research

Abstract

Introduction: Due to the surge of the post-COIVD-19 patients, numerous publications were recently presented, including applying Traditional Chinese medicine (TCM) in accelerating recovering pace. However, most TCM studies mainly focused on interventions and their effect on the patients. In the general characteristic of the post-COVID-19 syndrome in TCM, this study identified the relationship between post-COVID-19 syndrome and cold–heat patterns, one of the essential principles of the Eight Principles in TCM.

Method: We established a cross-sectional study on 384 participants at University Medical Centre HCMC - branch No.3 and the faculty of Traditional medicine, UMP, from January 2022 to April 2022 (including outpatients, inpatients, and students). A questionnaire was built to collect data on socio–demography, post-COVID-19 status, and cold-heat patterns. Cold-heat patterns were gathered based on the “Cold and heat patterns identification questionnaire” developed by Yeo M et al. (2016). All eligible participants were free to choose a suitable interview method, including by phone, by URL link, or by face-to-face interview.

Result: We enrolled 384 eligible patients, and 17 samples were removed due to missing. The median age was 33 (24 - 42) and the median BMI was 21.97 (19.78 – 23.88), and females took up to 62%. We found the relationship between gender and cold-heat pattern with post-COVID-19 status (p<0.05).

Conclusion: The relevance of post-COVID-19 status and cold–heat patterns took the first step in comprehensively observing general TCM characteristics of the post-COVID-19 syndrome. 

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Acceptance and willingness to pay for COVID-19 vaccines available in Vietnam: an online study during the fourth epidemic wave

Original Research

Abstract

COVID-19 vaccines available in Vietnam have different prices, efficacies, and side effects. We studied acceptance and willingness to pay (WTP) for COVID-19 vaccines in Vietnam, using a self-designed online questionnaire. Respondents were 2093 unvaccinated adults. Multiple regression analyses identified factors associated with vaccine acceptance and WTP. Acceptance of free vaccines was around 90% for the three available in Vietnam (Astra Zeneca, SPUTNIK V, and Pfizer-BioNTech). WTP for the same vaccines was about 70%. Vaccine acceptance was associated with being female and/or chronically ill or undergoing COVID-19-related job changes. WTP was associated variously with family economic status, occupational changes due to COVID-19, chronic disease, and perceived risk of infection. Most respondents were willing to be vaccinated and many were willing to pay for it, depending on personal and family circumstances. Vietnam should budget for free vaccines to support those unable to pay. 

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Multisystem inflammatory syndrome in children following SARS-CoV-2 infection: A case report

Case Study

Abstract

Introduction: COVID-19 in children has a diverse clinical presentation, most of which is asymptomatic or mildly symptomatic. In addition, after 2-6 weeks of being infected with COVID-19, children may have the multisystem inflammatory syndrome in children (MIS-C), which is rare but serious condition, death has also been reported despite active treatment. We describe a severe clinical case of MIS-C treated at our hospital in the early stage of the 4th wave of COVID-19 in Vietnam.

Case report: A six-year-old boy admitted to Thu Duc City Hospital on August 27th, 2021. He had a history of COVID-19, which was diagnosed by a positive RT-PCR SARS CoV-2 test on July 24th, 2021. He had no symptoms and was concentrated quarantine with his family. He was discharged on August 12th, 2021. Four weeks after SARS-CoV-2 infection, he had symptoms such as sustained fever (5 days), stomachache (6 days), erythema multiform (8 days), eye and lip swelling (7 days), edema of hands and feet (10 days), dyspnea (5 days), hepatomegaly and shock. After then, he was diagnosed with MIS-C and treated with intravenous methylprednisolone 2 mg/kg/day (3 days), then tapered 1 mg/kg/day (5 days), maintained with prednisone 1 mg/kg/day for 14 days. The patient had no clinical symptoms, was discharged after 14 days of treatment, and continued treatment with aspirin 3 mg/kg/day and prednisolone 1 mg/kg/day.

Conclusion: The MIS-C manifestation following SARS-CoV2 infection needs prompt attention and treatment. Intravenous immunoglobulin plays an important role in treatment. However, when intravenous immunoglobulin is not available where limited resources, early appropriate use of methylprednisolone may be beneficial. 

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Impact of COVID-19 outbreak on cardiology outpatient visits at a Vietnamese tertiary general hospital

Original Research

Abstract

Background: COVID-19 is a rising health problem that affects not only the infected patients but also the non-COVID-19 group. There is a reduction of non-COVID-19 healthcare services during COVID-19 outbreaks which leads to subsequent increment of mortality. This study aims to investigate the impact of the fourth COVID-19 surge on the cardiology outpatient visits at Nhan dan Gia Dinh hospital.

Method: A retrospective observational study was conducted using extracted data from the healthcare informative system of Nhan dan Gia Dinh hospital. Monthly trends of cardiology outpatient visits between May 1st, 2021 to August 31st, 2021 were compared with those of the previous four months and the same period of the year 2020. The demographic characteristics, diagnoses, and prescription behavior were described.

Results: Non-COVID-19 cardiology outpatient visits showed a stable trend until the beginning of the fourth outbreak, in May 2021 when they dropped drastically by 50%. A reduction of 50% was observed in every diagnosis. There was a substantial decrease in visits from other provinces as well as in the concurrent diagnosis of cancer. No change in the rates of prescribed medications was observed besides the lengthening of the prescription time.

Conclusion: The fourth COVID-19 wave caused a serious impact on cardiology outpatient care which might lead to an adverse prognosis. Though there has been some adaptive modification in prescription, this phenomenon calls for more attention and adequate measurements in the non-COVID-19 population for the later outbreaks. 

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Relationship between Asian-BMI classification and radiographic severity index in hospitalized COVID-19 patients

Original Research

Abstract

Introduction: Obesity is acknowledged to be a significant risk factor for mortality in patients with COVID-19. At primary healthcare center, early stratification of high-risk patients is critical in order to provide effective management. There is limited research available in Vietnam concerning the relationship between obesity as defined by Asian- standards and pulmonary damage. Our goal was to find the correlation between the obesity status index by Asian-standardized BMI and the severity of lung injury on chest radiographs patients with COVID-19 in the Vietnamese field hospital.

Methods: A total of 279 confirmed COVID-19 patients (118 males and 161 females) patients were recruited in our study. Two internal medicine physicians independently evaluated chest X-rays using the Brixia score system to assess the severity of lung disease, then agreed. The probability of Brixia scores per chest X-ray film was modeled using Poisson regression with gender and Asian-standardized BMI as predictors.

Results: The study revealed that the median age of our study was 59 years, and the mean BMI was 24.6 ± 3.4 kg/m2. The Pearson correlation between the Brixia score and the BMI was 0.25 with a p-value < 0.05. Both men and women showed that the obese group had the highest Brixia scores. There was a statistically significant difference between Brixia scores of male patients between the normal and obese groups (p-value =0.0446). Poisson regression showed that as the BMI increased, the probability of a higher Brixia score also increased.

Conclusions: According to the findings, the higher the BMI value of a patient, the higher the Brixia score for chest X-rays. This result was recorded in both genders, but more significantly in men. 

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Knowledge, attitudes, and behaviors towards COVID-19 prevention: a cross-sectional study at University Medical Center in Ho Chi Minh City, Vietnam

Original Research

Abstract

Introduction: The COVID-19 pandemic has spread around the world that severely affects people's life and the health system of countries. Enhancing the population’s awareness and prevention behaviors are crucial. This study aims to assess the knowledge, attitudes, and behaviors regarding COVID-19 prevention of outpatients and visitors at the University Medical Center in Ho Chi Minh City (UMC).

Methods: A cross-sectional study was conducted on 765 participants who were conveniently selected when they arrived at UMC between March 2021 and April 2021. A questionnaire was developed based on guidelines of Viet Nam Ministry of Health (Viet Nam MOH), World Health Organization (WHO), and other prior studies to evaluate the general knowledge regarding COVID-19 disease, disease prevention, attitude, and behaviors on prevention methods.

Results: The results showed low proportions of participants who had good knowledge of COVID-19 disease (29.15%) and prevention measures (38.17%) that were in contrast with a high percentage of positive attitudes (89.08%). There were 22.09% of participants were identified as good preventive behaviors based on seven surveyed measures. An association between prevention knowledge and prevention behaviors was observed when participants with good knowledge showed 2.15 times-higher odds of good behaviors (95%CI: 1.52, 3.04, p-value<0.001) compared to those with insufficient knowledge. Gender, occupation, accommodation, living with family or friends, comorbidities, and history of COVID-19 -related isolation were associated with good behaviors (adjusted p-value <0.05).

Conclusions: The percentage of knowledge and the compliance rate for COVID-19 prevention measures is low, and there is a positive association between prevention knowledge and good behaviors. Therefore, communication programs to improve the community's knowledge and to increase good practice rates are necessary and urgent. 

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Emergence of telemedicine during COVID-19 pandemic: drawing upon an underrated modality in Vietnam

Review

Abstract

In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic. In Vietnam, the incidence rate started climbing in May 2021, reaching an all-time high of 9,000 cases per day, and is projected to increase even further. Direct patient contact, as has always been the case in conventional medical practice, now constitutes significant transmission risk during the height of COVID-19. Healthcare workers, while accounting for a minor proportion of the population, are two to three times more likely to contract COVID-19, especially those who provide outpatient care or home-based service. The pandemic has led to a significant increase in the adoption of telemedicine, as hospitals are overwhelmed with critically ill patients, demand for healthcare soars, and transmission risk remains serious. With appropriate attention and further advancement of Vietnam's telehealth infrastructure, telemedicine will become an indispensable weapon to combat COVID-19 and an important modality of medical care during and after the pandemic. 

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Effective and safe profile of mini-pulse corticosteroid among COVID-19 inpatients: a case series

Case Study

Abstract

Background: The COVID-19 epidemic has spanned four waves in Vietnam, the most recent and also the most deadly of which began in April 2021.

Methods: We reported on a group of University Medical Center Ho Chi Minh City patients who were diagnosed with SARS-CoV-2 infection and were suitable for mini-pulse corticosteroid therapy with 125 mg of methylprednisolone twice daily for at least three days. Demographics, clinical, laboratory, and outcome data were gathered by electronic medical report. We also compared laboratory data before and after the start of mini-pulse corticosteroid therapy, as well as between the discharged and deceased groups.

Results: We gathered data on 25 patients. The average age was 61.5 ± 11.9 years, and 52% of them were male. Dyspnea was the most prevalent chief complaint. Almost all of them had at least one co-morbidity, with hypertension being the most common; all of them were put on oxygen supplementation, and 44% were started on mini-pulse corticosteroid while using a high-flow nasal cannula. Eighty-four (21%) reacted well and were discharged, whereas sixteen (4%) worsened and died. The deceased group was older than the discharged group (69.8 ± 3.1 vs. 59.9 ± 12.4, p =.005).

Conclusion: Our findings suggest that methylprednisolone at a mini-pulse dosage might be an effective and safe treatment option for COVID-19 inpatients in the inflammatory stage. 

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Knowledge, attitude and practice towards Covid-19 pandemic of pharmacy students in University of Medicine and Pharmacy at Ho Chi Minh city, Vietnam

Original Research

Abstract

Introduction: The rapid increase of infected cases and fatalities during the COVID-19 pandemic has created a huge health crisis to the world and Vietnam in particular. Health professionals were put under massive pressure in preventing pandemic. This study was conducted to assess the knowledge, attitude and practice (KAP) during the COVID-19 disease through an online survey as well as related infection control practices among pharmacy students in the University of Medicine and Pharmacy at Ho Chi Minh City (UMP).

Methods: The cross-sectional study was conducted based on the data obtained from an online questionnaire. Correlation analysis was performed using statistical tests and linear regression model for practice. The total study sample, chosen based on the inclusion and exclusion criteria was taken from pharmacy students in UMP during the study period.

Results: A scale of KAP towards COVID-19 was developed with 43 questions and received 1,089 responses. We acknowledged that the awareness and practice of these students were at a good level (with a mean score of 8.37±0.77 and 8.46±1.33, respectively) and the attitude was optimistic with a mean score of 6.22±0.68. Related factors to practice included gender (p=0.005), year of study (p=0.013); to knowledge included the time spent in university (p=0.040); to attitude included social distancing (p=0.024). Multivariable regression analysis showed that practice is related with male gender (β=-0.254; p=0.001), the first 3 school years (β = 0.173; p=0.020), knowledge score (β =0.154; p=0.003).

Conclusions: Based on a constructive scale, the study noted students' knowledge-attitude-practice towards COVID-19 at a good level. School year and knowledge scores positively affected practice scores, while male students had a negative effect.

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Factors Relating to Preventive Practices of Health Science Students during the Early Stage of the COVID-19 Pandemic

Original Research

Abstract

Objectives: We assessed the factors relating to the prevention of the Novel Coronavirus Disease (COVID-19) for students at the University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. 

Methods: A cross-sectional study was performed in February and March 2020. A 21 item self-administered questionnaire on the knowledge, attitude, and practices regarding COVID-19 was collected from students of the first to the sixth year using the strategy of simple random sampling. The aim was to establish factors that relate to practices using Odds ratio (OR) and 95% confidence interval (95% CI) which were estimated by the logistic regression model, p-value <0.05 shows a significant difference.

Results: Of the 551 students, 41.0% recorded responses indicating good practices toward prevention measures, while around half the students reported that they did not wash their hands for 20 full seconds (50.5%). The overall rate of good knowledge and positive attitude was 49.0% and 26.1%, respectively. When adjusted for all variables in the logistic regression model, a positive overall attitude was associated with good overall preventive practice; AOR = 1.72 (95% CI: 1.16 – 2.55). Furthermore, students mainly accessed information via social media and television (95.8% and 85.8%, respectively).

Conclusions: There were only 41.0% recorded responses indicating good practices toward prevention measures. Besides, knowledge and attitudes about COVID-19 among students were inadequate. Further health education interventions should be focused to change bad hand-washing habits via mass media messages.

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