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      An Assessment of the Novel COVISTRESS Questionnaire: COVID-19 Impact on Physical Activity, Sedentary Action and Psychological Emotion

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          Abstract

          Globally the COVID-19 pandemic outbreak has triggered an economic downturn and a rise in unemployment. As a result, global communities have had to face physical, health, psychological and socio-economical related stressors. The purpose of this study was to assess and report the impact of isolation and effect of coronavirus on selected psychological correlates associated with emotions. Following ethical approval, a mixed methods observational study was conducted using the validated COVISTRESS questionnaire. Two observational study scenarios were evaluated namely “Prior” to the COVID-19 outbreak and “Currently”, i.e., during the COVID-19 pandemic. 10,121 participants from 67 countries completed the COVISTRESS questionnaire. From the questionnaire responses only questions that covered the participant’s occupation; sociodemographic details, isolation and impact of coronavirus were selected. Further analyses were performed on output measures that included leisure time, physical activity, sedentary time and emotions. All output measures were evaluated using the Visual Analogue Scale (VAS) with an intensity ranging from 0–100. Descriptive statistics, Wilcoxon signed-rank test and Spearman correlational analysis were applied to the leisure time, physical activity, sedentary time and emotional feeling datasets; p = 0.05 was set as the significance level. Both males and females displayed similar output measures. The Wilcoxon signed rank test showed significant differences with respect to “Prior” COVID-19 and “Currently” for sedentary activity (Z = −40.462, p < 0.001), physical activity (Z = −30.751, p < 0.001) and all other emotional feeling output measures. A moderate correlation between “Prior” COVID-19 and “Currently” was observed among the Males (r = 0.720) in comparison to the Females (r = 0.639) for sedentary activity while weaker correlations (r < 0.253) were observed for physical activity and emotional feeling measurements, respectively. Our study reported incremental differences in the physical and psychological output measures reported, i.e., “Prior” COVID-19 and “Currently”. “Prior” COVID-19 and “Currently” participants increased their sedentary habits by 2.98%, and the level of physical activity reduced by 2.42%, depression levels increased by 21.62%, anxiety levels increased by 16.71%, and stress levels increased by 21.8%. There were no correlations (r) between leisure, physical activity and sedentary action (i.e., “Prior” = −0.071; “Currently” = −0.097); no correlations (r) between leisure physical activity and emotion (i.e., −0.071 > r > 0.081) for “Prior”; and poor correlations (r) between leisure, physical activity and sedentary action (i.e., −0.078 > r > 0.167) for “Current”. The correlations (r) between sedentary action and emotion for “Prior” and “Currently” were (−0.100 > r > 0.075) and (−0.040 > r > 0.041) respectively. The findings presented here indicate that the COVISTRESS project has created awareness in relation to the physical and psychological impact resulting from the COVID-19 pandemic. The findings have also highlighted individual distress caused by COVID-19 and associated health consequences for the global community.

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          Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

          In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
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            Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

            Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
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              Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

              Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                19 October 2020
                October 2020
                : 9
                : 10
                : 3352
                Affiliations
                [1 ]Faculty of Sports Science, Ningbo University, Ningbo 315211, China; guyaodong@ 123456hotmail.com (Y.G.); jsbaker@ 123456hkbu.edu.hk (J.S.B.)
                [2 ]Institute for Clinical Exercise & Health Science, School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire G72 0LH, Scotland, UK
                [3 ]Department of Biomedical Engineering, University of Strathclyde, Glasgow G11XQ, UK
                [4 ]Department of Sport Medicine and Functional Exploration, University Hospital CHU G. Montpied, INRA, UNH, CRNH Auvergne, Clermont Auvergne University, Clermont-Ferrand, F-63000 Clermont-Ferrand, France; mduclos@ 123456chu-clermontferrand.fr
                [5 ]Sports and Motor Performance Department, Faculty of Physical Education and Sports, National University of Physical Education and Sports, 060057 Bucharest, Romania; constanta.urzeala@ 123456unefs.ro
                [6 ]LaPSCo, Catech, Université Clermont Auvergne, CNRS, F-63000 Clermont-Ferrand, France; mickael.berthon@ 123456uca.fr
                [7 ]Health and Physical Education Program, Indiana University of Pennsylvania, Bloomington, IN 47405-1006, USA; kskulik@ 123456iup.edu
                [8 ]Department of Teaching Staff Training, Faculty of Physical Education and Sports, National University of Physical Education and Sports, 060057 Bucharest, Romania; aurabota@ 123456ymail.com
                [9 ]Laboratory of Metabolic Adaptations to Exercise under Physiological and Pathological conditions (AME2P), Université Clermont Auvergne, CRNH Auvergne, F-63000 Clermont-Ferrand, France; david.thivel@ 123456uca.fr
                [10 ]Department of Exercise Physiology, University of Isfahan, 8174673441 Isfahan, Iran; will.fivb@ 123456yahoo.com
                [11 ]Department of Sport, Physical Education and Health, Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong 999077, Hong Kong, China
                [12 ]Biostatistics Unit, DRCI, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France; nandant@ 123456chu-clermontferrand.fr (N.A.); bpereira@ 123456chu-clermontferrand.fr (B.P.)
                [13 ]Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France; krouffiac@ 123456chu-clermontferrand.fr
                [14 ]Physiological and Psychosocial Stress, LaPSCo, CNRS, Preventive and Occupational Medicine, WittyFit, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; maelysclinchamps@ 123456gmail.com (M.C.); frederic.dutheil@ 123456uca.fr (F.D.)
                Author notes
                [* ]Correspondence: u.ugbolue@ 123456uws.ac.uk ; Tel.: +44-(0)1698-283100 (ext. 8284)
                [†]

                The COVISTRESS network is headed by Pr. Frédéric Dutheil—CHU Clermont-Ferrand, Occupational and Environmental Medicine, 58 rue Montalembert, 63000 Clermont-Ferrand, France. Members of the research group are Nicolas Andant, Maélys Clinchamps, Stéphanie Mestres, Cécile Miele, Valentin Navel, Lénise Parreira, Bruno Pereira, Karine Rouffiac—CHU Clermont-Ferrand, France; Yves Boirie, Jean-Baptiste Bouillon-Minois, Martine Duclos, Maria Livia Fantini, Jeannot Schmidt, Stéphanie Tubert-Jeannin—Université Clermont Auvergne/CHU Clermont-Ferrand, France; Mickael Berthon, Pierre Chausse, Michael Dambrun, Sylvie Droit-Volet, Julien Guegan, Serge Guimond, Laurie Mondillon, Armelle Nugier, Pascal Huguet—Université Clermont Auvergne, CNRS, LAPSCO, France; Samuel Dewavrin—WittyFit, France; Fouad Marhar—CHU Toulouse, France; Geraldine Naughton, Amanda Benson—Swinburne University, Australia; Claus Lamm—University of Vienna, Austria; Vicky Drapeau—Université de Laval, Canada; Raimundo Avilés Dorlhiac—Universidad Finis Terrae, Chile; Benjamin Bustos—Universidad de Los Andes, Chile; Gu Yaodong—Ningbo University, China; Haifeng Zhang—Hebei Normal University, China; Peter Dieckmann—Copenhagen Academy for Medical Education and Simulation (CAMES), Denmark; Julien Baker, Binh Quach, Jiao Jiao, Yanping Duan, Gemma Gao, Wendy Y J Huang, Ka Lai Kelly Lau, Chun-Qing Zhang, Hong Kong Baptist University, China; Hijrah Nasir, Indonesia; Perluigi Cocco, Rosamaria Lecca, Monica Puligheddu, Michela Figorilli, Università di Cagliari, Italia; Morteza Charkhabi, Reza Bagheri—University of Isfahan, Iran; Daniela Pfabigan—University of Oslo, Norway; Peter Dieckmann, University of Stavanger, Norway; Samuel Antunes, David Neto, Pedro Almeida—Ordem dos Psicólogos Portugueses, ISPA-Instituto Universitário, Portugal; Maria João Gouveia—ISPA-Instituto Universitário, Portugal; Pedro Quinteiro—William James Center for Research, ISPA-Instituto Universitário; Constanta Urzeala—UNEFS, Romania; Benoit Dubuis—UNIGE, Switzerland; Juliette Lemaignen—Fondation INARTIS, Switzerland; Andy Liu—University of Taipei, Taiwan; Foued Saadaoui, King Abdulaziz University, Tunisia; Ukadike Chris Ugbolue, University of the West of Scotland, United Kingdom; Keri Kulik—Indiana University of Pennsylvania, USA; Kuan-chou Chen, National Taiwan University of Sport, Department of Sport Management, Taiwan.

                Author information
                https://orcid.org/0000-0002-7158-386X
                https://orcid.org/0000-0003-1977-5722
                https://orcid.org/0000-0003-2187-9440
                https://orcid.org/0000-0002-9093-7897
                https://orcid.org/0000-0003-3778-7161
                https://orcid.org/0000-0003-4756-6928
                Article
                jcm-09-03352
                10.3390/jcm9103352
                7603364
                33086648
                66a59a2b-1c58-4dd3-951f-ee2afa46fd53
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 06 September 2020
                : 09 October 2020
                Categories
                Article

                covid-19,severe acute respiratory syndrome coronavirus 2 (sars-cov-2),depression,anxiety,stress,distress

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