Postpartum depression associated with COVID-19 lockdown
Twice as many mothers with babies 6 months or younger reported postpartum depression during the first UK COVID-19–related lockdown, according to a Frontiers in Psychology study yesterday.
University College London (UCL) researchers surveyed 162 London mothers in May and June 2020 (about 1.5 to 3 months into the lockdown) and found that 47.5% met the Edinburgh Postnatal Depression Scale (EPDS) criteria (11 points or higher). That compares with previous research that found a prepandemic baseline of 23% in European mothers.
Mothers discussed four major themes surrounding lockdown: appreciation for the bonding time the nuclear family had, the burden of constant mothering, the inadequacy of virtual contact, and the sadness over lost social opportunities for themselves and their infant. Quantitative data from the survey support this need for social connection, as well: Depression symptoms had a negative association with seeing support system members in person (relative risk ratio [RRR], 0.950 to 0.974) or remotely (RRR, 0.995).
Most mothers reported 11 members in their support system, which on average was 47.8% relatives and 14.7% mommy friends, or women who were at a similar stage in motherhood. On average, women had seen one family member other than their partner, three total support system members, and no mommy friends in the last few weeks. Remote communication, on the other hand, was high.
“Our survey shows that lockdowns leave new mothers more vulnerable to postnatal depression, and that digital solutions might help but they are not the answer,” lead author Sarah Myers, PhD, MPhil, said in a UCL press release. “Policy makers must take this into account as we continue to deal with COVID-19, for the sake of mums, babies, and whole families.”
Mothers were aged 19 to 47 years, with an average of 34.6 years. Half were caring for their first child (50.6%), followed by 40.1% on their second. Mothers who had partners who were unable to help, especially in regards to home schooling, were more likely to report depression symptoms.
May 11 Front Psychol study
May 11 UCL press release
Home-based hospital care shown effective during pandemic
One in five COVID-19 patients enrolled in the Atrium Health Hospital at Home (AH-HaH) program had to be transferred back to a brick-and-mortar facility within 14 days, making the home-based care an “attractive innovation” that could help hospitals manage resources, according to an Annals of Internal Medicine research letter yesterday.
Patients were eligible for the single-center program if they had had a safe living situation and showed clinical stability. At home, they would have 24/7 telephone access to nurses, at least daily visits from paramedics, daily virtual visits with a hospitalist, and therapy treatments such as intravenous fluids, noninvasive oxygen, and respiratory medications.
Of the 391 patients from March to November 2020, 53% were female, 46% were White, and their median age was 56 years. The median length of program enrollment was 3 days, and the 84 patients who required transfer back to a traditional healthcare site (21.5%) did so within a median of 2.2 days. Thirty-three of these required intensive care, 11 needed mechanical ventilation, and 11 died, for an overall 2.8% mortality rate.
Higher oxygen saturation was negatively associated with transfer (odds ratio [OR], 0.87); whereas, higher comorbidities were linked to a higher risk (OR, 1.12). The researchers note that rapid heart rate or respiratory issues such as low oxygen saturation were observed among patients who needed immediate care escalation, but chronic conditions such as diabetes and high blood pressure were more common among patients who needed nonimmediate care escalation.
While neither old age nor obesity was associated with higher transfer risks, the researchers say this could be because doctors were more hesitant to enroll patients with these conditions into the program.
May 11 Ann Intern Med study
UK COVID-19 contact tracing app may have reduced cases 2%
The United Kingdom’s National Health Services app for COVID-19 contact tracing may have reduced England’s and Wale’s cases from 0.8% to 2.3%, or by almost 300,000 to 600,000 patients, according to a study in Nature today.
The app was launched Sep 24, 2020, and through the end of December, 16.5 million people regularly used it, or about 28% of the total population. Besides monitoring proximal exposures, the app also automatically updated any COVID-19 diagnosis test results and sent them to applicable contacts, provided a platform for venues to conduct contact tracing, and gave localized COVID-19 quarantine, symptom, and testing information.
The researchers estimate that 6.02% of individuals who were notified about possible exposures from the app ended up testing positive for COVID-19, which is comparable to the proportion identified via manual contact tracing. Overall, modeling indicates that 284,000 cases were prevented with the app (0.8%; 95% confidence interval [CI], 108,000 to 450,000), while statistical comparisons project the number to be even higher, at 594,000 (2.3%; 95% CI, 317,000 to 914,000).
“This suggests that on average, each confirmed case who consented to notification of their contacts through the app prevented one new case,” the researchers write, adding that the app may have averted 1.5% of deaths (4,200 as estimated by modeling or 8,700 via the statistical comparison approach). “These findings provide evidence for continued development and deployment of such apps in populations that are awaiting full protection from vaccines.”
Still, they caution, “The app is best understood as part of a system of non-pharmaceutical interventions, not in isolation. It is not a substitute for social distancing or face masks: Control of the epidemic requires all available interventions to work together.”
May 12 Nature study
Blood analysis shows cats contact COVID-19 at higher rates than dogs
COVID-19 seroprevalence—or the prevalence of SARS-CoV-2 antibodies in blood—is higher in cats than in dogs and higher in general in pets living with people who have the disease, according to a study yesterday in Emerging Infectious Diseases.
Italian scientists analyzed 198 serum samples, 130 from dogs and 68 from cats, collected during March through June of 2020, as well as 100 serum samples, 65 from dogs and from 35 cats, collected in different regions of Italy before 2019 to use as prepandemic controls.
The researchers detected 14 cases in animals, representing a 16.2% SARS-CoV-2 seroprevalence in cats and 2.3% in dogs. Symptomatic people were more likely to have pets test positive.
“We found the proportion of serologic positivity increased with increasing length of exposure,” the authors said. “We recorded the first SARS-CoV-2–positive animals 10 days after owners’ diagnoses and all 14 seropositive cases were classified as positive after >54 days of exposure.”
The authors said that, among 5 of the 14 positive animals, owners reported that their pets had experienced clinical signs at the same time as their own illnesses.
May 11 Emerg Infect Dis study