Differential mortality in COVID-19 patients from India and western countries

Background and aimsCOVID-19 disease has been associated with disproportionate mortality amongst world population. We try to elucidate various reasons for lower mortality rate in the Indian subcontinent due to COVID-19 pandemic.MethodWe carried out a comprehensive review of the literature using suitable keywords such as ‘COVID-19’, ‘Pandemics’, ‘disease outbreaks’ and ‘India’ on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the month of May 2020 during the current COVID-19 pandemic and assessed mortality data.ResultsThe mortality observed in Indian and south Asian subcontinent is lower than in the west.Multifactorial reasons indicated for this differential mortality due to COVID-19 have been described in the current literature.ConclusionsThe effects of COVID-19 on the health of racial and ethnic minority groups are still emerging with disproportionate burden of illness and death amongst some black and ethnic minority groups. Overall the current COVID-19 related mortality appears to be lower in the health and resource challenged populous Indian subcontinent. Further scientific studies would be helpful to understand this disparity in mortality due to COVID-19 in the world population.     

Impact of COVID-19 outbreak on lifestyle behaviour: A review of studies published in India

Background and aimsThe entire globe is undergoing an unprecedented challenge of COVID-19 which has affected the lifestyle behaviour of individuals. The present review is an attempt to summarize the effect of pandemic COVID-19 on lifestyle behaviour among the Indian population.MethodsA review was carried out to summarize the effect of pandemic COVID-19 on lifestyle behaviour focusing on changes in dietary or eating behaviour, stress, sleep pattern, and level of physical activity among the Indian population. Literature searches were conducted in PubMed and Google Scholar from inception till October 2020 to identify all relevant studies.ResultsA total of 11 studies (n = 5957, age group 18–70 years, comprising both genders) consisting of 1 hospital and 10 community based, were included in the present review. A change in lifestyle behaviour was observed due to COVID-19. Psychosocial or any kind of mental stress among the participants was found to be prevalent. Weight gain and decline in physical activity were also observed. Not only sleep quantity but sleep quality was also found to be affected due to COVID-19.ConclusionThe present review indicates the need for lifestyle behaviour programmes via using the platform of E-media and also for the dissemination of health education.     

Massive covidization of research citations and the citation elite

Massive scientific productivity accompanied the COVID-19 pandemic. We evaluated the citation impact of COVID-19 publications relative to all scientific work published in 2020 to 2021 and assessed the impact on scientist citation profiles. Using Scopus data until August 1, 2021, COVID-19 items accounted for 4% of papers published, 20% of citations received to papers published in 2020 to 2021, and >30% of citations received in 36 of the 174 disciplines of science (up to 79.3% in general and internal medicine). Across science, 98 of the 100 most-cited papers published in 2020 to 2021 were related to COVID-19; 110 scientists received ≥10,000 citations for COVID-19 work, but none received ≥10,000 citations for non–COVID-19 work published in 2020 to 2021. For many scientists, citations to their COVID-19 work already accounted for more than half of their total career citation count. Overall, these data show a strong covidization of research citations across science, with major impact on shaping the citation elite.

The COVID-19 pandemic resulted in a massive mobilization of researchers across science to address a new major challenge (1). It is estimated that ∼4% of the scientific literature published in 2020 to 2021 was related to COVID-19 (2): over 720,000 different scientists published over 210,000 relevant publications based on items indexed in Scopus as of August 1, 2021 (2). COVID-19–related published items exceeded 440,000 by the end of 2021 according to the WHO database (https://search.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/; last accessed December 25, 2021).This shift of the research enterprise and massive production of COVID-19–related publications (“covidization”) may have had implications for citations to recent scientific work. In most scientific disciplines, most papers get few, if any, citations in the first year, and citations appear gradually, spread over many years, with citation half-lives that typically exceed 5 y for most scientific fields and may exceed 10 y for some fields (3–5). The half-life of the citation pattern for COVID-19 work is still unknown, given the short-term follow-up for the COVID-19 published papers. However, the hundreds of thousands of COVID-19 publications likely have drawn citations largely from other very recently published COVID-19 work. Conversely, for non–COVID-19 work, citations from very recent papers (<1 to 2 y old) are expected to have been a minority. Therefore, it is likely that a large share of citations to very recent work in 2020 and 2021 reflect citations to COVID-19 papers. The extent and distribution of such a COVID-19–enriched pattern of recent citations is worth studying for their implications in understanding the evolving cultural norms. Citations of more recent papers may represent reliance on less vetted, more tentative knowledge. Reliance on less-mature knowledge may be more susceptible to reversal, and a number of high-profile retractions have unnerved the scientific world in the COVID-19 era (6).Moreover, the massive COVID-19 literature and its citations may have had a major impact on the careers of many scientists. The possibility of receiving a large number of citations could be highly appealing to researchers whose careers are influenced by reputation and citation metrics. If covidization of research heralds a new approach to receiving citations, it may change the incentives of scientists motivated by the lure of such scientific rewards. This, in turn, may shift the work of young scientists away from more “gradualist” fields toward COVID-19. The appeal of working on COVID-19, in other words, may extend beyond its health challenges, skewing an important alignment between the burden of disease and interest by scientists.Here, we compare scientists’ acquisition of citations for COVID-19 and similarly recent non–COVID-19 work, characterize the profiles of scientists that had extraordinary boosts to their citation profiles, and assess whether COVID-19 citations correlated with overall career impact, or whether they had an independent impact in generating a new citation elite. We addressed these questions using comprehensive data from Scopus (7) from 2020 to 2021.     

Analyzing Indian general public’s perspective on anxiety,stress and trauma during Covid-19 - A machine learning study of 840,000 tweets

Background and aimsEver since COVID-19 was declared a pandemic by WHO in late March 2020, more and more people began to share their opinions online about the anxiety, stress, and trauma they suffered because of the pandemic. However, very few studies were conducted to analyze the general public’s perception of what causes stress, anxiety, and trauma during COVID-19. This study focuses particularly on understanding Indian citizens.MethodsBy using Machine learning techniques, particularly Natural language processing, this study focuses on understanding the attitude of Indian citizens while discussing the anxiety, stress, and trauma created because of COVID-19 and the major reasons that cause it. We used Tweets as data for this study. We have used 840,000 tweets for this study.ResultsOur sentiment analysis study revealed the interesting fact that, even while discussing about the stress, anxiety, and trauma caused by COVID-19, most of the tweets were in neutral sentiments. Death and Lockdown caused by the COVID-19 were the two most important aspects that cause stress, anxiety, and Trauma among Indian citizens.ConclusionIt is important for policymakers and health professionals to understand common citizen’s perspectives of what causes them stress, anxiety, and trauma to formulate policies and treat the patients. Our study shows that Indian citizens use social media to share their opinions about COVID-19 and as a coping mechanism in unprecedented time.     

COVID-19 and applications of smartphone technology in the current pandemic

BackgroundWith restrictions on face to face clinical consultations in the COVID-19 pandemic and the challenges faced by health care systems in delivering patient care, alternative information technologies like telemedicine and smartphone are playing a key role.AimsWe assess the role and applications of smartphone technology as an extension of telemedicine in provide continuity of care to our patients and surveillance during the current COVID-19 pandemic.MethodsWe have done a comprehensive review of the literature using suitable keywords on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the first week of May 2020.ResultsThrough the published literature on this topic, we discuss role, common applications and its support in extended role of telemedicine technology in several aspects of current COVID-19 pandemic.ConclusionSmartphone technology on its own and as extension of telemedicine has significant applications in the current COVID-19 pandemic. As the smartphone technology further evolves with fifth generation cellular network expansion, it is going to play a key role in future of health medicine, patient referral, consultation, ergonomics and many other extended applications of health care.     

Covid-19 pandemic,diabetes and glycemic control: Results of a retrospective cohort study of 230.000 persons with diabetes in tuscany

Background and aimsThe COVID-19 pandemic affected the processes of routine care for chronic patients due to disrupted delivery care. The aim of the present study is to verify the COVID-19 pandemic effects on diabetes control and management.Methods and resultsThe study was designed as a retrospective observational study, performed on two cohorts of patients with diabetes in 2019 and 2020. Data used for the analyses were gathered from administrative and laboratory databases, which do not include any sensible information on COVID-19. The Tuscany Regional Health Agency is data controller for current administrative databases and has been working to produce available information for policy decision-making.In 2020, in comparison with 2019, a relevant reduction of the number of patients measuring HbA1c was observed during the March–April lockdown, and again during the second pandemic wave in Autumn. A similar pattern was observed for specialist visits for diabetes, for which the introduction of televisits only partly compensated for the reduction of traditional office visits. The number of patients receiving drugs for diabetes each week in 2020 was very similar to 2019. The mean HbA1c values and the proportion of HbA1c values > 8% for each week, were higher during the 2020 Spring and Autumn lockdown.ConclusionCOVID-19 pandemic negatively impacts diabetes management, reducing specialist visits and HbA1c determinations during the first and second pandemic wave. Despite a satisfactory continuity in pharmacological treatment, short-term impairment of average glycemic control was detected, particularly in Autumn.     

Excess diabetes-related deaths: The role of comorbidities through different phases of the COVID-19 pandemic

Background and aimsDiabetes confers an excess risk of death to COVID-19 patients. Causes of death are now available for different phases of the pandemic, encompassing different viral variants and COVID-19 vaccination. The aims of the present study were to update multiple causes of death data on diabetes-related mortality during the pandemic and to estimate the impact of common diabetic comorbidities on excess mortality.Methods and resultsDiabetes-related deaths in 2020–2021 were compared with the 2018–2019 average; furthermore, age-standardized rates observed during the pandemic were compared with expected figures obtained from the 2008–2019 time series through generalized estimating equation models. Changes in diabetes mortality associated with specific comorbidities were also computed. Excess diabetes-related mortality was +26% in 2020 and +18% in 2021, after the initiation of the vaccination campaign. The presence of diabetes and hypertensive diseases was associated with the highest mortality increase, especially in subjects aged 40–79 years, +41% in 2020 and +30% in 2021.ConclusionThe increase in diabetes-related deaths exceeded that observed for all-cause mortality, and the risk was higher when diabetes was associated with hypertensive diseases. Notably, the excess mortality decreased in 2021, after the implementation of vaccination against COVID-19.     

Early COVID-19 pandemic’s toll on tuberculosis services,WHO European Region,January to June 2020

BackgroundEssential health services, including for tuberculosis (TB), are being affected by public health and social measures (PHSM) introduced to control COVID-19. In many settings, TB resources, facilities and equipment are being redirected towards COVID-19 response.AimWe sought to assess the COVID-19 pandemic’s impact on TB services in the World Health Organization (WHO) European Region.MethodsThe fifty-three European Region Member States were asked to report qualitative and quantitative data in quarter one and two (Q1 and Q2) 2020. TB notifications were triangulated with the severity score on domestic movement restrictions to assess how they may have influenced TB detection.ResultsTwenty-nine countries reported monthly TB notifications for the first half of 2019 and 2020. TB notifications decreased by 35.5% during Q2 2020 compared with Q2 2019, which is six-fold more than the average annual decrease of 5.1% documented during 2015–2019. The number of patients enrolled in rifampicin-resistant/multidrug-resistant TB treatment also decreased dramatically in Q2 2020, by 33.5%. The highest movement restriction severity score was observed between April and May 2020, which coincided with the highest observed decrease in TB notifications.ConclusionA decrease in TB detection and enrolment to treatment may cause increases in TB burden and threatens the Region’s ability to reach the TB targets of the 2030 Sustainable Development Goals, still this might be mitigated with rapid restoration of TB services and the implementation of targeted interventions during periods with severe PHSM in place, such as those introduced in response to the COVID-19 pandemic.     

Epidemiological findings on interventional cardiology procedures during the COVID-19 pandemic: A multi-center study

BackgroundThe rates of in-hospital mortality following percutaneous interventional procedures (PIP) during the COVID-19 pandemic period compared to the non-pandemic period has not been reported so far.MethodsWe retrospectively enrolled all consecutive patients admitted for PIP across five centers from February 2020 to May 2020.ResultsA total of 4092 PIP were performed during the reference periods. The total number of procedures dropped from 2380 to 1712 (28.0% reduction). Overall in-hospital mortality increased from 1.1% in 2019, to 2.6% in 2020 (63% relative increase).ConclusionDuring the COVID-19 pandemic, in-hospital all-cause mortality significantly increased in patients admitted for cardiological PIP.     

Influencia de la pandemia COVID-19 sobre la epidemiología de la bronquiolitis aguda

IntroductionThe COVID-19 pandemic has changed the circulation of some viruses associated with acute bronchiolitis. We analyzed the epidemiology of bronchiolitis admissions during the COVID-19 pandemic compared with 8 previous epidemic seasons.MethodsAn observational and ambispective study was performed, including infants admitted with bronchiolitis in a tertiary hospital during 2 periods: COVID-19 pandemic (15th March 2020 to 3 rd August 2021) and pre-pandemic (1st September 2012 to 14th March 2020). Demographic, clinical data and etiologies were collected.ResultsFive hundred ten patients were hospitalized with bronchiolitis: 486 in the pre-pandemic period with an average of 61 admissions per season vs. 24 during the pandemic, observing a 60.7% reduction in bronchiolitis admissions. During the pandemic, bronchiolitis outbreak was delayed until spring–summer 2021. Respiratory syncytial virus was the most frequent etiological agent in both periods.ConclusionWe observed a change in the seasonality of bronchiolitis during the pandemic COVID-19, possibly influenced by control measures against SARS-CoV-2.     

Global research on vitamin D and coronavirus disease 2019: A bibliometric and visualized study

Background and aim:Vitamin D play a substantial role in immune function, but little is known about its prevention in coronavirus disease 2019 (COVID-19). A detail bibliometric analysis of the published scientific literature indexed in Web of Science on vitamin D as a therapeutic option for the COVID-19 patients’ treatment is lacking. Thus, the current study was conducted to determine the key bibliometric indices and plot the global research on vitamin D and COVID-19.Methods:The Web of Science Core Collection database was utilized to retrieve publications on vitamin D and COVID-19. A Boolean search strategy was applied and the obtained data were exported to Microsoft Excel to generate relevant graphs. Furthermore, VOSviewer software version 1.6.17 for Windows was used to generate co-authorship countries, bibliographic coupling sources and co-occurrence keyword network visualization mapping. In addition, RStudio and Bibliometric online tool were used to generate WordCloud and thematic map, and intercountries relation map, respectively.Results:A total of 818 publications on vitamin D and COVID-19 were included in the final analysis. These publications were cited 10,713 times, with an H-index of 50. The number of publications and citations score from 2020 to November 2021 increased from 317 (2423 citations) to 501 (8290 citations). Delanghe JR and Speeckaert MM were the most prolific authors with 13 publications each. The most productive journal was Nutrients (n = 63). The most studied research area is nutrition dietetics. The most widely used author keywords were COVID-19 (n = 444), Vitamin D (n = 312), and SARS-CoV-2 (n = 190). The National Institute of Health and US Department of Health and Human Services were the leading funding agencies. Harvard University was the most active institution with 25 publications. The United States of America was the highly contributing and influential country in terms of publications (n = 203) and total link strength (n = 185).Conclusion:It was concluded that an increasing trend in the number of publications on vitamin D and COVID-19 has been observed. Significantly, the majority of the research has been conducted in developed countries. Most importantly, over the time, the direction of research has been changed and the recent trend topics are vitamin D deficiency, risk and infection, and vitamin D supplementation based on KeyWords Plus. The use of vitamin D supplement is one of the promising therapeutic options for COVID-19 treatment. Therefore, the current study not only highlight the global research trends but also provide standard bibliographic information for future studies.     

Integrating emerging technologies into COVID-19 contact tracing: Opportunities,challenges and pitfalls

Background and aimsWith no approved vaccines for treating COVID-19 as of August 2020, many health systems and governments rely on contact tracing as one of the prevention and containment methods. However, there have been instances when the infected person forgets his/her contact-persons and does not have their contact details. Therefore, this study aimed at analyzing possible opportunities and challenges of integrating emerging technologies into COVID-19 contact tracing.MethodsThe study applied literature search from Google Scholar, Science Direct, PubMed, Web of Science, IEEE and WHO COVID-19 reports and guidelines analyzed.ResultsWhile the integration of technology-based contact tracing applications to combat COVID-19 and break transmission chains promise to yield better results, these technologies face challenges such as technical limitations, dealing with asymptomatic individuals, lack of supporting ICT infrastructure and electronic health policy, socio-economic inequalities, deactivation of mobile devices’ WIFI, GPS services, interoperability and standardization issues, security risks, privacy issues, political and structural responses, ethical and legal risks, consent and voluntariness, abuse of contact tracing apps, and discrimination.ConclusionIntegrating emerging technologies into COVID-19 contact tracing is seen as a viable option that policymakers, health practitioners and IT technocrats need to seriously consider in mitigating the spread of coronavirus. Further research is also required on how best to improve efficiency and effectiveness in the utilisation of emerging technologies in contact tracing while observing the security and privacy of people in fighting the COVID-19 pandemic.     

Challenges of routine diabetes care during COVID-19 era: A systematic search and narrative review

BackgroundThe world is facing the current COVID-19 pandemic. The pandemic response is affecting routine health care provision all over the world. We aimed to review the relevant literature and highlight challenges in the provision of routine care for patients with diabetes during the COVID-19 outbreak.MethodsWe systematically searched PubMed, ScienceDirect, and Embase databases up till August 13, 2020 and retrieved relevant articles published on difficulties on routine diabetes management during the COVID-19 pandemic.ResultsThrough our reading of the recent literature discussing the difficulties of routine healthcare provision for patients with diabetes amid the COVID-19 pandemic, we have identified nine themes as follows: lockdown of standard outpatient clinics, decreased inpatient capacity, staff shortage, medicine shortage, unaffordable medicine, delayed care seeking, limited self-care practice, transport difficulties, and undiagnosed cases/events.ConclusionDiabetes management during lockdown is particularly challenging. This review specified a summary of difficulties of diabetes care during COVID-19 pandemic. Healthcare policy makers as well as healthcare providers could take advantage of the results of this review to mitigate the adverse effect of the crisis on provision of routine care for diabetes as well as other chronic conditions.     

Excesso de Mortalidade Hospitalar por Doenças Cardiovasculares no Brasil Durante o Primeiro Ano da Pandemia de COVID-19

Background:The COVID-19 pandemic has had an impact on mortality from several diseases worldwide, especially cardiovascular diseases (CVD). Brazil is a continent-sized country with significant differences in the health care structure between its federative units.Objective:Analyze in-hospital mortality from CVDs in the Brazilian public health system during the first year of the COVID-19 pandemic (2020).Methods:This is an ecological study analyzing the absolute number of in-hospital deaths and the rate of in-hospital mortality in Brazil, its macro-regions, and federative units. Data were obtained from the Hospital Information System of the Brazilian Ministry of Health. To analyze excess mortality, the P-score was used. It compares the events observed with those expected for a given place and period. The P-score was corrected by the joinpoint regression model, with a 95% confidence interval and 5% significance level.Results:There were 93,104 in-hospital deaths due to CVD in Brazil in 2020, representing 1,495 fewer deaths (P score: −1.58) than expected. The central-west region had a positive P-score, with a 15.1% increase in the number of deaths. Ten federative units showed a greater number of deaths in 2020. There was also a 13.3% excess in-hospital mortality at the country level, and an excess in-hospital mortality in all macro-regions.Conclusions:There was a decrease in the absolute number of in-hospital deaths, as well as an increase in in-hospital mortality from CVD in Brazil, in 2020, after the COVID-19 pandemic onset.     

Pitfalls in telemedicine consultations in the era of COVID 19 and how to avoid them

Background and aimsWith restrictions on face to face clinical consultations in the COVID-19 pandemic, Telemedicine has become an essential tool in providing continuity of care to patients. We explore the common pitfalls in remote consultations and strategies that can be adopted to avoid them.MethodsWe have done a comprehensive review of the literature using suitable keywords on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the first week of May 2020 including ‘COVID-19’, ‘telemedicine’ and ‘remote consultations’.ResultsTelemedicine has become an integral part to support patient’s clinical care in the current COVID-19 pandemic now and will be in the future for both primary and secondary care. Common pitfalls can be identified and steps can be taken to prevent them.ConclusionTelemedicine it is going to play a key role in future of health medicine, however, telemedicine technology should be applied in appropriate settings and situations. Suitable training, enhanced documentations, communication and observing information governance guidelines will go a long way in avoiding pitfalls associated with remote consultations.     

Acute pancreatitis in children hospitalized with COVID-19

BackgroundLimited data exists on the association or prevalence of pancreatitis in children with COVID-19.MethodsThis is a retrospective study of pediatric patients admitted to a large health system in New York (Northwell Health System) from March 1, 2020–June 1, 2020 during the COVID-19 pandemic.Results8159 pediatric patients were admitted to our healthcare system during the study period, of which 112 were diagnosed with COVID-19 (1.37%). Thirteen were diagnosed with pancreatitis for a point prevalence of 0.16% (13/8159) for all patients admitted. Of the thirteen patients admitted with pancreatitis, two patients were COVID-19 positive for a point prevalence of 1.8% (2/112) among COVID-19 patients compared to 0.14% (11/8047) in the non-COVID-19 population.ConclusionsThis study shows that pancreatitis can occur in pediatric patients with COVID-19 and may be more common in the COVID-19 population.     

Redefining diabetic foot disease management service during COVID-19 pandemic

Background & aimsDiabetic Foot Disease (DFD) management had to be redefined during COVID-19. We aim to evaluate the impact of this on diabetic foot care services and the strategies adopted to mitigate them.MethodsWe have performed a comprehensive review of the literature using suitable keywords on the Search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the first two weeks of May 2020. We have reviewed how the diabetic foot service in the hospital and community setting has been affected by the current Coronavirus outbreak.ResultsWe found considerable disruption in diabetic foot service provisions both in the primary care and in the hospital settings. Social distancing and shielding public health guidelines have impacted the delivery of diabetic foot services.ConclusionAs the COVID-19 pandemic spreads worldwide, health care systems are facing the tough challenges in delivering diabetic foot service to patients. Public health guidelines and the risk of virus transmission have resulted in reconfiguration of methods to support and manage diabetic foot patients including remote consultations.     

COVID-19 mortality,excess mortality,deaths per million and infection fatality ratio,Belgium, 9 March 2020 to 28 June 2020

BackgroundCOVID-19 mortality, excess mortality, deaths per million population (DPM), infection fatality ratio (IFR) and case fatality ratio (CFR) are reported and compared for many countries globally. These measures may appear objective, however, they should be interpreted with caution.AimWe examined reported COVID-19-related mortality in Belgium from 9 March 2020 to 28 June 2020, placing it against the background of excess mortality and compared the DPM and IFR between countries and within subgroups.MethodsThe relation between COVID-19-related mortality and excess mortality was evaluated by comparing COVID-19 mortality and the difference between observed and weekly average predictions of all-cause mortality. DPM were evaluated using demographic data of the Belgian population. The number of infections was estimated by a stochastic compartmental model. The IFR was estimated using a delay distribution between infection and death.ResultsIn the study period, 9,621 COVID-19-related deaths were reported, which is close to the excess mortality estimated using weekly averages (8,985 deaths). This translates to 837 DPM and an IFR of 1.5% in the general population. Both DPM and IFR increase with age and are substantially larger in the nursing home population.DiscussionDuring the first pandemic wave, Belgium had no discrepancy between COVID-19-related mortality and excess mortality. In light of this close agreement, it is useful to consider the DPM and IFR, which are both age, sex, and nursing home population-dependent. Comparison of COVID-19 mortality between countries should rather be based on excess mortality than on COVID-19-related mortality.     

Prevalence of Burnout among Internal Medicine and Primary Care Physicians before and during the COVID-19 Pandemic in Japan

Objective To evaluate the change in the prevalence of burnout during the COVID-19 pandemic among internists and primary care physicians in Japan, and to identify factors associated with the exacerbation of burnout among these populations during this period. Methods This was a cross-sectional study based on two web-based surveys conducted in January 2020 (before the declaration of the COVID-19 pandemic) and June 2020 (during the pandemic). The participants were internists and primary care physicians of the Japanese Chapter of the American College of Physicians. The main outcome was the change in the prevalence of burnout between before and during the “first wave” of the pandemic. We also examined factors associated with the exacerbation of burnout during this period. Results Among the 283 respondents in the first survey and 322 in the second survey, 98 (34.6%) and 111 (34.5%) reported symptoms of burnout, respectively. In June 2020, 82 respondents (25.5%) reported that their level of burnout exacerbated compared to January 2020. Only the experience of self-quarantine was associated with the exacerbation of burnout [odds ratio (OR) 3.12; 95% confidence interval (CI) 1.49-6.50; p=0.002], while being a woman, being a resident physician, and an experience of having worked in a prefecture under a state of emergency were not. Conclusions No marked change in the prevalence of burnout among internists and primary care physicians in Japan was observed during the COVID-19 pandemic as a whole. However, self-quarantine was associated with the exacerbation of the burnout level.