Alimohamad Asghari, MD. Professor of otolaryngology, Skull base research center, The five senses institute, Abstract Background

Aim To validate a questionnaire to assess stress and burnout in healthcare workers during COVID-19 pandemic. Subjects and methods In this study, content validity, Cronbach's alpha, and test-retest reliability method were utilized among 60 HCWs to evaluate the validity, internal consistency, and reliability of the questionnaire respectively. The final questionnaire was composed of four parts asking for the background information, questions about the stress caused by the COVID-19, the Depression, Anxiety and Stress Scale -21 (DASS-21), and six questions from the Copenhagen Burnout Inventory (CBI). Results The CVR of 46 questions was equal to 1, making them acceptably valid (CVR > 0.78), so that the items could be arranged into a final questionnaire. Moreover, all items could successfully attain CVI values above 0.79, confirming the content validity of the questionnaire. The Cronbach's alpha was between 0.80-0.95 for different sections of questionaire, confirming the stable reliability and high repeatability of the questionnaire. ConclusionThe results of this study showed that the DASS-21 offers adequate levels of validity and reliability for assessing the stress, anxiety, and depression among the HCWs engaged with the COVID-19 pandemic. Moreover, the six items adapted from the Copenhagen burnout inventory (CBI) were found to provide a good instrument for investigating the job burnout among the HCWs at Masih Daneshvari Hospital during the outbreak of the COVID-19 epidemic.

Background:The occurrence of anosmia/hyposmia during novel Coronavirus disease 2019 may indicate a relationship between coincidence of olfactory dysfunction and coronavirus disease 2019 . This study aimed to assess the frequency of self-reported anosmia/hyposmia during COVID-19 epidemic in Iran.Methods: This population-based cross sectional study was performed through an online questionnaire from March 12 to 17, 2020. Cases from all provinces of Iran voluntarily participated in this study. Patients completed a 33-item patient-reported online questionnaire, including smell and taste dysfunction and their comorbidities, along with their basic characteristics and past medical histories. The inclusion criteria were self-reported anosmia/hyposmia during the past 4 weeks, from the start of COVID-19 epidemic in Iran.Results: A total of 10 069 participants aged 32.5±8.6 (7-78) years took part in this study, of them 71.13% women and 81.68% nonsmokers completed the online questionnaire. The correlation between the number of olfactory disorders and reported COVID-19 patients in all provinces up to March 17, 2020 was highly significant (Spearman correlation coefficient = 0.87, P< 0.001). A sudden onset of olfactory dysfunction was reported in 76.24% of the participations and persistent anosmia in 60.90% from the start of COVID-19 epidemic. In addition, 80.38% of participants reported concomitant olfactory and gustatory dysfunctions.Conclusion: An outbreak of olfactory dysfunction occurred in Iran during the COVID-19 epidemic. The exact mechanisms by which anosmia/hyposmia occurred in patients with COVID-19 call for further investigations.

The findings suggest that the sensitivity of the ULBT and TMD for predicting difficult intubations may not be significantly different, but the specificity of the ULBT is significantly higher. The positive predictive value of the ULBT was significantly higher than that of TMD, signifying that a positive ULBT is more predictive of a difficult airway than is a positive TMD.