Faculty of Medicine

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Comorbid Conditions in a Cohort of Inpatients with SARS-CoV-2 and their Association with In-Hospital Mortality During the Early Phases of the Pandemic
(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2023-12-01)
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Cibrev, Dragan
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Chamurovski, Nikola
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Introduction: Studies determined that age and associated comorbidities are associated with worse outcomes for COVID-19 patients. The aim of the present study is to examine previous electronic health records of SARS-CoV-2 patients to identify which chronic conditions are associated with in-hospital mortality in a nationally representative sample. Materials and Methods: The actual study is a cross-sectional analysis of SARS-CoV-2 infected patients who were treated in repurposed hospitals. The study includes a cohort of patients treated from 06-11-2020 to 15-03-2021 for COVID-19 associated pneumonia. To examine the presence of comorbidities, electronic health records were examined and analyzed. Results: A total of 1486 in-patients were treated in the specified period, out of which 1237 met the criteria for case. The median age of the sample was 65 years. The overall in-hospital mortality in the sample was 25.5%, while the median length of stay was 11 days. From whole sample, 16.0% of the patients did not have established diagnoses in their electronic records, while the most prevalent coexisting condition was arterial hypertension (62.7%), followed by diabetes mellitus (27.3%). The factors of age, male gender, and the number of diagnoses showed a statistically significant increase in odds ratio (OR) for in-hospital mortality. The presence of chronic kidney injury was associated with the highest increase of OR (by 3.37) for in-hospital mortality in our sample. Conclusion: The study reaffirms the findings that age, male gender, and the presence of comorbidities are associated with in-hospital mortality in COVID-19 treated and unvaccinated patients. Our study suggests that chronic kidney injury showed strongest association with the outcome, when adjusted for age, gender, and coexisting comorbidities.
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COVID-19 and young people, understanding the impact
(Macedonian Association of Anatomists and Morphologists, 2023)
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Chepreganova Cangovska, Tatjana
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Zorchec, Danijela
COVID-19 has impacted individuals of all age groups, including young people. Although young individuals generally experience milder symptoms and better outcomes, they are still susceptible to contracting and transmitting the virus. While they may have lower infection rates, it is crucial for young people to adhere to preventive measures as they can still spread the virus, potentially affecting vulnerable populations. The pandemic and related measures have also had an impact on the mental health of young people, with increased stress, isolation, and changes in social interactions leading to feelings of anxiety, depression, and loneliness. The closure of schools and the shift to remote learning have presented challenges in terms of education and social development. It is essential for young people to stay informed, follow guidelines, and prioritize their physical and mental well-being during these challenging times.
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Associations of burnout with job demands/resources during the pandemic in health workers from Southeast European countries
(Frontiers Media SA, 2023-10-24)
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Atanasovska, Aneta
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Bislimovska, Dragana
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Brborović, Hana
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Brborović, Ognjen
Introduction: Despite several studies assessing job demands and burnout in countries from the Southeast European (SEE) region, there is still a lack of data about the psychological impact of the pandemic on health workers (HWs). Aims: The present study aimed to demonstrate and compare levels of burnout dimensions in HWs from SEE countries and to reveal the burnout–job demands/resources relationships in these workers during the pandemic. Materials and methods: During the autumn of 2020, this online multicentric cross-sectional survey studied a large group (N = 4.621) of HWs working in SEE countries. The Maslach Burnout Inventory was used for the measurement of burnout dimensions. We analyzed the job demands by using the Hospital Experience Scale. Remuneration and relationships with superiors were measured using the Questionnaire sur les Ressources et Contraintes Professionnelles (English version). Results: A series of ANOVA comparisons of means revealed the countries in which respondents showed higher mean values of emotional exhaustion (Bosnia and Herzegovina, Bulgaria, Croatia, Moldova, Montenegro, and North Macedonia) and the countries in which respondents showed lower mean values of this burnout dimension (Israel and Romania) (Welch F = 17.98, p < 0.001). We also found differences among HWs from different countries in job demands and job resources. The testing of hierarchical regression models, which have been controlled for certain confounding factors, clearly revealed that emotional exhaustion was predicted by job demands (R2 = 0.37) and job resources (R2 = 0.16). Conclusion: Preventive measures for the improvement of mental health in HWs during the pandemic and beyond have to take into account the differences between countries regarding the country context and current scientific knowledge. A modified stress test should be implemented in hospitals regarding future shocks that might include new pandemics, terrorism, catastrophes, or border conflicts.
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PHYSICAL INACTIVITY BEFORE AND DURING COVID 19 PANDEMIC
(Antrophological Society of Serbia- Nis, 2021)
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While physical activity is beneficial factor for overall health, physical inactivity is even more harmful for somatic and mental health. The modern public health policies are addressed to preventive strategy and increasing the socioeconomic and environmental conditions for people to be more active. According the WHO statistics, 23% of adult world population are not sufficiently active. Adolescent population is significantly more vulnerable regarding the sedentary life style, 81% of adolescent, between 11 an 17 years, do not reach the criteria of recommended dose of physical activity. The level of physical inactivity is dependent of economic development of the country, ethnicity, race, gender, age and other factors. Epidemiological restrictions recommended during the COVID 19 pandemic were mainly designed towards physical distancing and limited movements of people. The most countries banned unnecessary (or all) outdoor activities which affected people’s physical activity i.e promotes sedentary behavior. The great number of studies reported increases of physical inactivity and its influence on various medical conditions. Covid pandemic restrictions have detrimental effect on physical behavior, and its causes are multifactorial. The physical inactivity level adopted during the pandemic period was higher than before the restricted period.
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Young people and COVID-19 in our country
(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/ Sciendo, 2022)
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Pop-Jordanova Nada
The current COVID-19 pandemic has raised significant mental health consequences across the world. Even though healthcare workers provide psychological services, the mental health of the overall population often is cause for concern. Psychosocial stressors of the population play a critical role in impacting both the spread of the disease and the occurrence of emotional distress and psychological disorder, during and after an infectious disease outbreak. The inability to plan, to anticipate future events, and to exert control, at least partially, over external variables inevitably generate stress and tension. Subsequently, this condition can generate more or less discomfort depending on the subjective evaluation of the individual, an evaluation which is influenced by the indi vidual’s stable personality traits. In fact, subjective experiences are never unique: stimuli endowed with the same stressful power do not necessarily cause these reactions in different individuals, while stressful conditions of varying degrees can induce the same response in different people. The aim of this research was to evaluate some aspects of mental health using answers related to this pan demic of a group young people, selected by chance. Results showed important changes in quality of life, insecurity, changes in mood and behaviour as well as not optimistic view for the future life. Discussion confirmed similar finding about young people opinions from other counties. Additionally, some mediating measures are proposed.
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Insight in the Current Progress in the Largest Clinical Trials for Covid-19 Drug Management (As of January 2021)
(Macedonian Academy of Sciences and Arts/Sciendo, 2021-04-23)
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Ridova Nevenka
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Stojanoska, Tatjana
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Abstract The outbreak of the COVID-19 pandemic has generated the largest global health crisis of the 21st century, evolving into accelerating socioeconomic disruption. In spite of all rapidly and widely emerging scientific data on epidemiology, diagnosis, prevention and treatment of the COVID-19 disease, severe acute respiratory coronavirus 2 (SARS-CoV-2) is continuing to propagate in lack of definitive and specific therapeutic agents. Current therapeutic strategies are mainly focused on viral inhibition by antiviral drugs and hampering the exuberant immune response of the host by immunomodulatory drugs. In this review, we have studied the reports of the largest clinical trials intended to COVID-19 treatment published during the first year of the pandemics. In general, these results concentrate on seven therapeutic options: remdesivir, chloroguine/hydroxychloroquine, lopinavir-ritonavir combination, corticosteroids, tocilizumab, convalescent plasma and monoclonal antibodies. In line with the reviewed data, as of January 2021, most of the evidence support the use of remdesivir in hospitalized patients with moderate and severe forms of the disease and provide reliable data on the substantial beneficial effect of corticosteroids in patients requiring supplemental oxygen. Moreover, preliminary RECOVERY trial results have demonstrated the efficacy of tociluzumab in the treatment of critically ill patients. The reports presenting the outcomes of the other immune-based therapies under investigation are enthusiastically awaited.

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