Background : There is a lack of data concerning impact of COVID-19 among older adults (OA) living at long-term care (LTC) centers. This study investigated how COVID-19 has affected this population. The prevalence of and risk factors for post-traumatic stress, depression, and anxiety were investigated. Methods : A semi-structured interview to determine the effect of COVID-19 was conducted to 200 OA at two government LTC centers. The 17-item Post-traumatic Stress Disorder Checklist, the 9-item Patient Health Questionnaire, and the 7-item Generalized Anxiety Disorder Scale were used to evaluate post-traumatic stress, depression, and anxiety, respectively. Results : Most OA reported moderate or severe impact of COVID-19. The most impacted area was financial due to decreased support from outside the center. Seventy percent of OA reported no or mild psychological stress from COVID-19; however, 5.5% had post-traumatic stress, 7.0% had depression, and 12.0% had anxiety. Higher psychological stress from COVID-19 and having respiratory tract infection symptoms were independently associated with post-traumatic stress, depression, and anxiety. Receiving COVID-19 news via social media was independently associated with post-traumatic stress and depression. Having psychiatric comorbidity was independently associated with depression. Conclusions : OA living in LTC centers reported moderate or severe impact from COVID-19, especially financial, but relatively low psychological stress. Psychological stress from COVID-19, having respiratory tract infection symptoms, and receiving COVID-19 news via social media were risk factors for psychological disorders. Limitations : The data reflected the post-outbreak period. There is limitation in the generalizability of the results for other countries with different health care systems.

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Objective: To described the periprocedural electroconvulsive therapy (ECT) management of a patient in the 3rd trimester of pregnancy, the ECT complications, and their treatment. Materials and Methods: A retrospective chart review was conducted of a 26-year-old parturient with bipolar I disorder with psychotic features during the coronavirus disease 2019 (COVID-19) outbreak. Case Report: The patient was admitted and scheduled for ECT. Fifteen ECT sessions (eight on her first admission, and another seven on a second admission) were performed. General anesthesia with endotracheal intubation was conducted after sufficient preoxygenation. Complications were observed: prolonged seizure, decreased fetal heart rate, and hypersecretion. Nonetheless, good outcomes were achieved after treated with thiopental to terminate the seizure, intravenous crystalloid loading and left uterine displacement to stabilize the fetus, and suctioning and an antisialagogue for secretion clearance. Conclusion: In ECT during pregnancy, it can be challenging to apply electrical current, induce anesthesia and airway management to achieve safe patient care and ensure adequate seizure duration. Moreover, the ECT is conducted in a non-operating room setting where equipment may be deficient. A prerequisite is good periprocedural collaboration among members of the multidisciplinary team which include a psychiatrist, an anesthesiologist, and an obstetrics-gynecologist, as well as proper protective equipment to prevent the contamination to the environment. Keywords: Coronavirus disease 2019 (COVID-19); Electroconvulsive therapy (ECT); Multidisciplinary team; Periprocedural management; Pregnancy