Evidence suggests that acute severe coronavirus disease 2019 (COVID-19) may be associated with neuropsychiatric symptoms. This is a case report of a patient who had recently been infected with COVID-19 and had no history of psychiatric disorders presenting a few days after inpatient discharge from COVID-19 treatment with acute onset of psychosis and manic symptoms. This case illustrates the psychiatric presentation, possible causes, and management of post-COVID-19 psychosis.
COVID-19 ; Psychotic Disorders ; Mania

Introduction: COVID-19 survivors with mental health issues are more likely to have a lower quality of life, reduced work productivity, social troubles, and other health issues. However, information on the mental health of COVID-19 survivors is scarce. Therefore, we aimed to determine the COVID-19 survivors’ mental health status in the form of depression and its associated factors. Methods: This cross-sectional study was conducted in Malaysia, during the nationwide lockdown. Data were collected using an online questionnaire. Socio-demographic variables, comorbidities, self-perception of health, information on the person’s acute condition during COVID-19 infection, symptoms and duration of symptoms postCOVID, and state of depression were gathered. The Patient Health Questionnaire 9 was used to assess depression. Factors associated with mild to severe depression were analysed using multivariable logistic regression analyses. Results: A total of 732 COVID-19 survivors responded to the survey. The respondents were mainly females and of younger age (in their 20s and 30s). One-third of the participants perceived themselves as having poor health. One in five participants reported having Long COVID. Slightly less than half (47.3%) of the respondents had mild to severe depression (total PHQ-9 score of 5-27). In the multivariable analysis, being female (aOR: 1.68; 95% CI: 1.08,2.62), of younger age (20s – aOR: 3.26; 95% CI: 1.47, 7.25; 30s – aOR: 2.08; 95% CI: 1.05, 4.15; and 40s – aOR: 2.43; 95% CI: 1.20, 4.90; compared to those in their 50s and above), being overweight/obese (aOR: 1.83; 95% CI: 1.18, 2.83), having Long COVID (aOR: 2.45; 95% CI: 1.45, 4.16) and perceived poorer health (aOR: 4.54; 95% CI: 2.89, 7.13) Conclusion Females, younger age groups, being overweight/obese, having Long COVID and perceiving themselves to be in poor health were factors associated with higher odds of mild to severe depression.
COVID-19

Background: The spread of COVID-19 was inevitable and has not spared small and isolated communities, including the community of Perhentian Island in Besut District, Terengganu. Managing clusters in small islands can be difficult, given the limited resources. This study explores the characteristics of COVID-19 cases and the experience of outbreak containment at Perhentian Island. Methodology: A retrospective study involving record review of COVID-19 cases and at-risk individuals registered under Perhentian Cluster were retrieved from the Besut District Health Office COVID-19 online registry from the 16thAugust2021 until 6thOctober 2021. All notified cases and close contacts who fulfilled the inclusion criteria were extracted and analysed using descriptive statistics. Results: A total of 1,093 community members of Perhentian Island were screened of which 170 (15.5%) tested positive for COVID-19, while 923 (84.5%) tested negative. Among individuals who tested positive, the majority were adults (52.4%), male (51.8%), Malays (98.8%), and villagers (96.5%). Clinical characteristics were categorized into: asymptomatic (55.9%), had no known medical comorbidities (90.6%), low-risk groups (87.1%), vaccinated (57.6%), and admitted to PKRC (97.1%) for treatment. Multiple agencies were involved in the outbreak containment of the Perhentian Cluster, working collectively and in good coordination. Conclusion The outbreak was attributed to community gatherings and close interactions among villagers. Prompt actions, targeted planning, and inter-agency collaboration were the key factors in successful containment of further spread of COVID-19 in Perhentian Island.
COVID-19

The pandemic outbreak caused by COVID-19 has been spreading throughout the world including Indonesia. The high number of infection cases and deaths due to Covid-19 and the lack of experience in managing corpses (post mortem) caused by COVID-19 disease creates defiance for forensic practitioners and the general public. Indonesia has extra challenges because there are still people who refuse to bury corpses known to be COVID-19 victims in their areas. This paper reviews and summarizes the experience of how to deal with a corpse case with COVID-19 including how to bury such a corpse hence providing a perspective view for the future.
COVID-19

Background: Most undergraduate dental students were concerned regarding the transmission of the COVID-19 virus through their profession. This dread and anxiety may be attributable to a lack of comprehension regarding the necessary precautions and protocols to implement to ensure safety and limit potential infection threat. This study aims to assess COVID-19-related knowledge, attitudes, and practices (KAP) among undergraduate dental students at the Faculty of Dentistry, Universiti Malaya. Methods: A cross-sectional study design was used, involving 166 respondents who were undergraduate dental students from years II to IV. Data collection was achieved using a pre-tested web-based questionnaire. Descriptive and inferential analyses, including independent t-tests and one-way analysis of variance (ANOVA) tests, evaluated the KAP differences related to demographic factors. Results: There were no statistically significant differences in mean KAP associated with demographic factors such as gender, place of residence, and year of study (p > 0.05). Conclusions Dental students at the Faculty of Dentistry, Universiti Malaya, Malaysia, had adequate knowledge of COVID-19 in light of the country’s quarantine status and pandemic context.
COVID-19

BACKGROUND

Persistent symptoms following SARS-CoV-2 infection have increasingly been reported globally, although currently there are no available local epidemiological data on this. This study aimed to determine the prevalence, common manifestations, and clinical predictors of post COVID-19 condition among the pediatric population.

A cross-sectional analytical study adapting the ISARIC (International Severe Acute Respiratory and Emerging Infection Consortium) Global COVID 19 – pediatric survey questionnaire was done. There were 356 patients with confirmed SARS-CoV-2 infection (RNA detected by RT-PCR/GeneXpert). Out of the 189 with complete data and who responded, 3 were excluded due to deaths during the acute infection. A total of 186 children aged 0-18 years old were enrolled and children of the same age group having SARS-CoV-2 negative result were included as control in 1:1 ratio. Univariate and multivariate regression analyses were performed to identify variables associated with post COVID-19 symptoms.

The prevalence of post COVID-19 condition was 15%. The most common presenting symptoms during the acute infection were fever and cough, while the common post COVID-19 symptoms included persistent cough (65%), rhinorrhea (55%) and loss of taste (3%). In the univariate analysis, the age group 5-11 years (OR 13.83, p value < 0.05) and hospitalization (OR 2.37, p value < 0.05) were statistically correlated with persisting symptoms. However, multivariate logistic regression analysis showed that hospitalization (aOR 4.1, p value < 0.05) was the only factor significantly associated with the persistence of symptoms.

Children less than 11 years old and male sex have a higher prevalence of persistent symptoms following acute COVID-19 infection. The age group 5-11 years old was identified as a clinical predictor of post COVID-19 condition along with those who were hospitalized.

BACKGROUND

COVID-19 pandemic led to a dramatic loss of human life worldwide and presented an unprecedented challenge to public health. One of the solutions in addressing the problem was mass vaccination in order to attain herd immunity. However, most people were hesitant to be vaccinated particularly due to their fear of the adverse events; hence the goal of this study was to determine the possible adverse events (AEs) experienced during administration of CoronaVac^TM COVID-19 Vaccine.

The objective of the study was to monitorthe occurrence of adverse events within one hour, two to 24 hours, and 25 to 72 hours after administration of the first and second dose of CoronaVac^TM COVID-19 Vaccine in a tertiary government hospital in Pangasinan.

This cross-sectional study was done from February to April 2021 at Region 1 Medical Center. Employees who received the two doses of Sinovac-CoronaVac^TM vaccine and gave their informed consent were included in the study. Participants were monitored closely for adverse events within 30 minutes following administration of the vaccine and were instructed to report any local and systemic AEs to the Hospital Epidemiology Center Office. Individuals were also followed up through telephone to investigate the occurrence of any complaints after 24 to 72 hours.

A total of 353 participants who received the complete doses of CoronaVac^TM were included in the study. The incidence of AEs was higher after the first dose compared with the second dose. After the first dose of CoronaVac^TM 12.5% reported AEs after the 1st hour, 14.2% two to 24 hours after the vaccine, and 1.4% on the 25^th hour up to the 72^nd hour. Pain on injection site was the most common adverse event during the first hour (8.2%). On the 2nd hour up to 24 hours, headache, and myalgia (14.2%) were more evident. Headache was reported in 1.1% of the participants after 25-72 hours of vaccination. After the second dose, only one participant reported multiple AEs such as fatigue, headache, rash and retroorbital pain (1, 0.7%).

In this study, 28.1% of the participants experienced adverse events afterthe first dose of CoronaVac^TM vaccine. AEs were higher after the first dose (28.1%) compared with the second dose (0.3%). Injection site pain was the most common adverse event during the first hour, then headache and myalgia during the 2^nd hour up to 24 hours, and headache on the 25^th – 72^nd hour after vaccination. Only one participant reported several AEs after the 2^nd dose of the vaccine.

COVID-19 is a highly contagious disease that caused a worldwide pandemic in 2020. Medical students are public advocates for COVID-19 vaccination to achieve herd immunity. Our objective is to ascertain the level of knowledge, attitude, and practice toward COVID-19 immunisation among medical students in Malaysia. The online study included four public universities in Peninsular Malaysia: Universiti Putra Malaysia, International Islamic University Malaysia, Universiti Sains Malaysia and Universiti Sains Islam Malaysia. Data collected include sociodemographic characteristics, history of COVID-19 infection, knowledge, attitude and practice towards COVID-19 immunisation. Analytical statistics were analysed with IBM Statistical Package Statistical Package for the Social Science (SPSS) v27.0 using Pearson chi-square or Fisher’s exact test (significant if p < 0.05). From the total of 427 respondents, 60.2% had good knowledge whereby clinical students 67.0% had a higher proportion of good knowledge as compared to preclinical students 53.5% (p = 0.004). Respondents in the age group of 21 to 24 years old (p < 0.001) and 25 to 29 years old (p = 0.016), and Indian ethnicity (p = 0.006) were more likely to have good knowledge. Respondents registered in Malaysia’s National COVID-19 vaccination program were considered as having a positive attitude (n = 264, 61.8%). A vaccination rate of 100% was observed. In conclusion, 60.2% of medical students had good knowledge, 61.8% had a positive attitude and 100% were vaccinated in these four public medical schools in Malaysia. Sociodemographic factors (age group and Indian ethnicity) have an association with only good knowledge but none with the level of attitude and practice towards COVID-19 immunisation.
COVID-19

The Coronavirus disease (COVID-19) imparted unprecedented negative impact worldwide since it was declared as a global pandemic in 2020 due to its high infectivity and mortality rate. Consequently, those who have been infected with COVID-19 experienced significant amount of social stigma which resulting in deterioration of mental well being. Hence, this study aimed to translate the Explanatory Model Interview Catalogue Stigma Scale (EMIC-SS) into Malay and investigate the reliability and validity of the Malay version (EMIC-SS-M) among COVID-19 survivors in Malaysia. Initially, concurrent translation and back translation of the EMIC-SS was conducted followed by the assessment of its face and content validity. Then, the EMIC-SS-M was administered to 219 COVID-19 survivors recruited from three targeted centers for assessment of its reliability (internal consistency) and validity (convergent and discriminant validity, exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]). The EMIC-SS-M reported an acceptable internal consistency with Cronbach’s α of 0.727, while its domains reported acceptable Cronbach’s α ranged from 0.708 to 0.795. EFA and CFA confirmed that the EMIC-SS-M consisted of 15 items in 4 domains. The EMIC-SS-M exhibited good psychometric properties and ready for use to assess stigma among COVID 19 survivors in Malaysia. It can be adapted for use to assess stigma in other disease conditions among the Malaysian population in future studies.
COVID-19

Background: During the COVID-19 outbreak, studies indicated that neonates born to COVID-19-positive mothers are susceptible to adverse outcomes. However, limited research explored the link between maternal COVID-19 severity and perinatal outcomes. Objectives: To determine the characteristics and outcomes of newborns born to COVID-19 positive mothers and its association with maternal COVID-19 severity. Methodology: This was a cross-sectional study conducted in a tertiary hospital which involved a retrospective chart review of mother-newborn dyads who delivered between June 1, 2020, and December 31, 2022. Results: One hundred forty COVID-19 infected mothers and their respective newborns (143) were included in the study. Majority of mothers were 18 - 30 yrs. old, multigravida, multiparous, delivered by normal spontaneous delivery (NSD) and were asymptomatic. Only 3.6 % have severe COVID-19. Neonatal outcome was generally good in both non-infected and COVID-19 infected newborns. Most were term, with normal birthweights, appropriate for gestational age (AGA), with good APGAR scores. Hyperbilirubinemia is a common morbidity (15%). There is a higher prevalence of preterm births, low birthweight, low APGAR score in the 5th minute of life, respiratory distress syndrome (RDS), neonatal sepsis, neonatal intensive care unit (NICU) admission and mortality among neonates born to mothers with severe COVID-19, but there is no statistically significant association between maternal COVID - 19 severity and neonatal outcome except for APGAR score on the 5th minute of life. Conclusion Most COVID-19-infected pregnant women were asymptomatic and neonatal outcomes were generally favorable. Maternal COVID-19 severity did not substantially contribute to adverse neonatal outcomes.
COVID-19 ; Infant, Newborn