Although the current management of COVID-19 is mainly focused on efficacious vaccine and infection control, the most common psychological reactions (such as fear and anxiety) associated with the COVID-19 pandemic have not been investigated and even neglected in patients with heart failure who are at greater risk for morbidity and mortality. We assessed COVID-19 related fear and anxiety among patients with heart failure and determined their associated factors. A cross sectional survey was conducted among 300 consecutive patients with heart failure during the period of March 2021–June 2021. Almost 50.7% of patients had fear of COVID-19 and 36.3% had coronavirus anxiety. Age > 55 was significantly associated with increased odds of fear (OR = 2.6) and anxiety (OR = 4.3). Patients with angina were more likely to have fear (OR = 3.0) and anxiety (OR = 2.2) and patients with chronic lung disease were more likely to have fear (OR = 3.0) and anxiety (OR = 3.3). Increased age, having angina, and having chronic lung disease were associated with increased odds of fear of COVID-19 and coronavirus anxiety. Psychological support needs to be integrated in patient care with special attention to physiological risk factors that are associated with COVID-19 comorbidities.

Objective: This study aims to evaluate the association between polycystic ovary syndrome (PCOS) phenotypes A and D with primary and secondary pregnancy outcomes among PCOS vs non-PCOS patients after in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Methods: A retrospective cohort design using data of eligible women aged 20– 40 years who had their first IVF treatment. The data were obtained from medical records. The women were either diagnosed with PCOS according to Rotterdam Criteria, namely phenotypes A and D or non-PCOS. Pregnancy outcome including (1) the rate of biochemical pregnancy and (2) ongoing clinical pregnancy and (3) the rate of miscarriage were measured. Furthermore, secondary outcome data were collected on (1) the number of oocytes retrieved, (2) the number and percentage of mature oocytes, (3) fertilization rate, (4) the percentage of grade 1 embryos on day 3 and (5) the percentage of grade 1 embryos on day 5. Results: A sample of 149 women was analyzed. For secondary pregnancy outcomes, PCOS women in groups A and D have lower oocyte maturity rate and lower fertilization oocyte ratio, as well as fewer grade 1 oocytes on day 3 in comparison to the control. Primary pregnancy outcomes have significantly lower values among PCOS women in group A with respect to biochemical pregnancy and ongoing clinical pregnancy and higher miscarriage rates in comparison to group D and the control group. Finally, group D and control did not differ significantly in the primary pregnancy outcomes. Conclusion: Patients with phenotype D have better IVF outcomes in comparison to phenotype A. Phenotype A, affects the IVF outcomes negatively possibly due to hyperandrogenism.

Background and Objectives: The neuroendocrine system plays a crucial role in regulating various bodily functions, including reproduction, with evidence suggesting its significant involvement in male fertility and sperm development. Vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase activating polypeptide (PACAP) are expressed in both male and female reproductive tissues, influencing penile erection and regulating steroidogenesis in males. Therefore, our study aimed to compare the protein levels of VIP and PACAP in seminal plasma between healthy controls and sub-fertile patients. Additionally, we sought to correlate the levels of these biomarkers with clinical, functional, and laboratory findings in the participants. Materials and Methods: The study included a total of 163 male participants for analysis. The participants were further stratified into subgroups of fertile and sub-fertile men of four subgroups according to the 2021 WHO guidelines. Seminal plasma concentrations of the neuropeptides VIP and PACAP were measured using human enzyme-linked immunosorbent assay technique. Results: The findings showed statistically significant differences in total sperm count, sperm concentration, total motility, and vitality (p < 0.001) between the fertile group and the sub-fertile group. Specifically, significant differences found between healthy males and oligoasthenospermic patients (p = 0.002), and between asthenospermic and oligoasthenospermic patients (p = 0.039). An ROC analysis showed associated sensitivity and specificity values of 62.2% and 55.6%, respectively, to PACAP seminal levels differentiated between sub-fertile patients from fertile males (p = 0.028). No significant difference in seminal levels of VIP was found between the sub-fertile and fertile groups. Conclusions: Previous research leads to the point of PACAP active involvement in spermatogenesis. In accordance to our study, in human semen samples, we have seen a significance change in PACAP levels amongst patients with low sperm count or with both low sperm count and low motility, hinting at its contribution and acting as a possible factor in this complex process. Thus, alterations in the levels or actions of these neuropeptides have been associated with certain reproductive disorders in males.