Background: This study aims to explore differences of psychological impact and influencing factors that affected Taiwanese healthcare workers (HCW) during the first and second wave of COVID-19. Methods: a cross sectional survey of first-line HCW during November 2021 to February 2022: 270 paper questionnaires were issued and the valid response rate was 86% (231). For statistical analysis, descriptive statistics, Pearson correlation, and multivariate linear regression were used. Results: regardless of the wave of the pandemic, nearly 70% of HCW had anxiety, nearly 60% felt depressed, half of them suffered from insomnia, and one in three felt insufficient social support, which means a high level of loneliness. With an increased number of infected patients during the second wave, HCW felt significant changes of workload and schedule, with higher concern over risk of infection, and these factors induced higher levels of anxiety, but they manifested better satisfaction over public health policies and information provided by hospitals and governments. Changes of working schedules or duties positively relate to levels of anxiety and insomnia. The risk of infection causes anxiety, depression, and insomnia. Workplace relationships significantly relate to depression and loneliness. A negative family support causes an adverse psychological impact. Conclusions: the pandemic has a negative psychological impact on HCW. Early recognition of significant influencing factors, providing psychological support and therapy, are helpful strategies for reducing the adverse psychological effects.

a b s t r a c tTakotsubo cardiomyopathy is a recognized cardiac syndrome that mimics acute coronary syndrome, without occlusion of the coronary artery. This syndrome is usually triggered by emotional or physical stress. Acute infection as a trigger condition is rarely reported. We report a case of an elderly woman who experienced chest pains with ST-segment elevation on electrocardiography, and who was later confirmed to have this cardiac syndrome by cardiac catheterization in coexistence with shock status related to suspected acute infection.

a b s t r a c tThe management of acute coronary syndrome (ACS) and heart failure (HF) in centenarians is specially challenging because these patients suffer from multiple comorbidities, altered anatomy, physiology, and response to medications compared with younger patients. Unfortunately, there are no specific guidelines for this age group. We herein report an experience of treating a woman 101 years of age with ACS and HF, had a complex coronary angiographic procedure, and proved to have coronary artery disease with the involvement of multiple vessels. Due to the very high risk of being treated surgically or by transcatheter coronary interventions, the clinical course became stable with multidisciplinary conservative medical treatment, which resulted in survival and maintenance of quality of life.

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