Auburn Research Day 2022

Alexandra C. Skoczek, MPH 1 , OMS-II; Patrick W. Ruane, OMS-II 2 ; Cassidy A. Onley, OMS-II 3 ; Torhiana Haydel, MHA, OMS-II 4 ; Maria V. Ortega, OMS-II 4 ; Alexis M. Stoner, PhD, MPH 2 ; H. Dean Sutphin, PhD 3 VCOM – Auburn 1 ; VCOM – Carolinas 2 ; VCOM – Virginia 3 ; VCOM – LA 4 Cl i n i ca l Resea rch | Med i ca l St udent Testimonials from Multinational Medical School Students in the Face of the Covid-19 Pandemic: A Global Health Approach 1

In the midst of the Covid-19 pandemic, countries, and governments around the world have implemented different measures and guidelines for the containment and mitigation of the SARS-CoV-2 virus. In addition to implemented policies and initiatives, social media and personal beliefs have affected medical students’ social, emotional, financial, and academic success both domestically and internationally. As osteopathic medical students focused on the interconnectedness of the mind, body, and spirit, we questioned the impact of the pandemic and global responses on the beliefs and psychological well-being of medical students around the world. Due to differences in global response and media portrayal, it was hypothesized that, international medical students in countries such as El Salvador, Honduras, and the Dominican Republic will be impacted differently regarding Covid-19 policy strictness, social and mental health, financial and academic stability, and overall attitude towards the pandemic than the US medical students. In this prospective qualitative study, United States and international medical students enrolled in the Global Seminar for Health and Environment course were eligible to participate in the study. Participants completed a weekly, non-graded journaling assignment for six weeks that asked open-ended questions about personal beliefs and knowledge, policies and initiatives, global policies and initiatives, and social media presentations. A qualitative thematic analysis was then performed.

International medical students believed that their country's COVID-19 response contained more restrictions than the global response, with the theme being expressed in 17% compared to 1.7% of US responses containing the theme. International students were also more likely to express views on negative mental health impacts as well as economic impacts. The theme “mental health impact” was present in 27.3% of international responses and included responses such as: "My anxiety and panic have risen to such levels that it is hard for me to tolerate casual touch and proximity. I don't remember the last time I hugged a friend." The U.S. responses showed less of a mental health impact and expressed stronger negative views on how COVID-19 was handled in regard to policies and initiatives. While it was not a major theme expressed, the U.S. responses also contained more criticism of the political response to Covid-19. The current study was limited by responses and student participation each week. Future studies aimed at analyzing specific Covid-19 policies around the world and the extent of the pandemic’s impact on mental health may provide greater insight into medical students' beliefs, attitudes, and well-being which have been challenged over the last year. Regardless, it must be acknowledged that the medical school experience has changed for both international and the United States medical students and affected them not only academically but mentally, socially, and financially.

Cl i n i ca l Case Repor t | Med i ca l St udent Pneumatocele-Induced Pneumothorax in a Patient with Post-Covid-19 Pneumonitis: A Case Report

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Kevin O. Wortman II, MS, OMS-IV; Kevin O. Wortman Sr., CCRN, BSN Edward Via College of Osteopathic Medicine-Auburn; Florida Agriculture and Mechanical University

Background: The COVID-19 pandemic has been challenging medical professionals and facilities for over a year now. Much of the literature describes pathologic lung changes and complications associated with SARS-CoV-2, with pneumothorax and pneumatoceles not being uncommon. The Case: We describe a case involving a patient that presented to the emergency department with a pneumothorax. Three weeks prior, the patient was hospitalized for 10 days in acute respiratory distress secondary to SARS-CoV-2 pneumonia, which did not require ventilator support. Follow up imaging revealed a 7 cm (AP) x 4.6 cm (transverse) x 2.5 (cc) cm pneumatocele.

Conclusion: We speculate that antecedent rupture of an unrecognized pneumatocele likely caused lung collapse leading to the patient’s pneumothorax. Therefore, we recommend that patients with post-COVID-19 pneumonitis, especially those given ventilator support, are assessed radiographically before hospital discharge and within two weeks after discharge to discern whether the patient may be at risk for multiple pathological pulmonary events after COVID-19 hospitalization.

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