Impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists

Abstract

Objectives: To evaluate the impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists during the month of April 2020. Materials and Methods: A 39-question, web-based survey was sent to all urologist members of the Brazilian Society of Urology. We assessed socio-demographic, professional, health and behavior parameters. The primary goal was to evaluate changes in urologists' clinical practice and income after two months of COVID-19. We also looked at geographical differences based on the incidence rates of COVID-19 in different states. Results: Among 766 urologists who completed the survey, a reduction ≥ 50% of patient visits, elective and emergency surgeries was reported by 83.2%, 89.6% and 54.8%, respectively. An income reduction of ≥ 50% was reported by 54.3%. Measures to reduce costs were implemented by most. Video consultations were performed by 38.7%. Modifications in health and lifestyle included weight gain (32.9%), reduced physical activity (60.0%), increased alcoholic intake (39.9%) and reduced sexual activity (34.9%). Finally, 13.5% of Brazilian urologists were infected with SARS-CoV-2 and about one third required hospitalization. Urologists from the highest COVID-19 incidence states were at a higher risk to have a reduction of patient visits and nonessential surgeries (OR=2.95, 95% CI 1.86-4.75; p< 0.0001) and of being infected with SARS-CoV-2 (OR=4.36 95%CI 1.74-10.54, p=0.012). Conclusions: COVID-19 produced massive disturbances in Brazilian urologists' practice, with major reductions in patient visits and surgical procedures. Distressing consequences were also observed on physicians' income, health and personal lives. These findings are probably applicable to other medical specialties.

Global Impact of COVID-19 on Weight and Weight-Related Behaviors in the Adult Population: A Scoping Review

“…Out of the 19 articles included in this scoping review [ 2 , 3 , 4 , 5 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], four explored changes in all three domains, namely weight, diet and exercise [ 2 , 4 , 5 , 24 ], three explored changes in both weight and diet and weight and exercise, three explored changes in both diet and exercise [ 22 , 23 , 24 ], and the rest explored each domain exclusively ( Table 2 , Figure 1 ). A summary of the impact of COVID-19 on the overall change in perceived weight status, dietary behaviors, physical activity behaviors, sedentary behaviors and other lifestyle behaviors are shown in Table 2 .…”

“…Eleven out of 19 articles mentioned changes in weight where ten articles mentioned weight gain that ranged from 12.8% to 48.6% and six articles mentioned weight loss that ranged from 13.9–19.4% ( Table 3 ) [ 2 , 3 , 4 , 5 , 18 , 19 , 21 , 25 , 26 , 28 , 29 ]. Two articles reported the combined proportion of participants who lost weight and did not perceive a change in weight [ 3 , 25 ].…”

“…Physical activity was evaluated in terms of the overall level of activity and types of activities (i.e., walking, jogging, swimming, cycling, sports, weight lifting, and leisure-time activities). Four studies reported a higher proportion of respondents who increased rather than decreased physical activity (36–47%) [ 2 , 17 , 22 , 24 ] while seven studies reported the opposite in terms of proportion (35–70%) [ 3 , 4 , 5 , 16 , 21 , 28 , 30 ] mean duration (57.9 ± 34.5 to 51.1 ± 37.7 min/week (min/w)) [ 18 ] or metabolic equivalent task (median = 3006 to 1483.8 MET–min/w, median difference 1168.5 MET–min/w) [ 20 ]. Four studies reported a significant increase in sedentary behaviors, including increased sitting time (42.6% to 46%), TV watching, using electronics and social media [ 16 , 17 , 28 , 30 ].…”

“…Our scoping review found only 19 studies that examined COVID-19 related changes in weight and weight-related behaviors with mixed conclusions [ 2 , 3 , 4 , 5 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. Moreover, all the studies were understandably conducted online due to the COVID-19 precautionary measures and derived from self-reports, which could have introduced risks of bias and inaccuracies in the study findings.…”

“…Other well-established predictors of weight gain were supported, including decreased physical activity, increased sedentary behavior and higher baseline BMI. However, there were mixed findings in terms of the proportion of respondents who increased versus decreased physical activity [ 2 , 3 , 4 , 5 , 16 , 17 , 21 , 22 , 24 , 28 , 30 ]. Therefore, while COVID-19 measures are to be in place for the next few years before they can be reasonably eradicated or be safe enough for the measures to be removed, health authorities could implement health promotion strategies to remind the citizens to be mindful of their total consumption (not only to eat more healthy foods) and stay physically active.…”