COVID, Volume 2, Issue 9 (September 2022) – 11 articles

Volunteer tourists, often foreigners, collect essential data in wildlife conservation projects worldwide. Due to the COVID-19 pandemic, international tourism activities reduced drastically, forcing many conservation projects to shut down. Using a nine-year (2013–2021) case study in Indonesia, we examine how local and foreign tourists construct the meaning of their volunteer experiences in the light of COVID-19. We aim to highlight the potential benefits of local volunteer tourism to face the travel limitations posed by COVID-19, and to show an example of how conservation projects can overcome the challenges of the current and potential future pandemics. We recruited 117 volunteers (49 Indonesians, 68 foreign; 73 females, 44 males; mean age: 24.2 ± SD 4.7) that collected 50.8% of the total amount of data collected by the project over the same period. Of the 117 volunteers, 81 of them (38 Indonesians, 43 foreigners) filled in a feedback form at the end of their stay. Via logistic regressions, we found that Indonesian volunteers declared more positive feedback on the logistics at the research station (p = 0.047). Via Bayesian structural equation models, we found that Indonesian volunteers reported significantly more frequently than foreign volunteers that they learned new skills (89% Credible Interval = 0.017–0.351) and that they gained personal wisdom, growth and maturity (89% Credible Interval = 0.891–1.003) from the volunteer experience. The volunteer program evolved from being 100% foreign volunteers in 2013 to 100% Indonesian volunteers by 2020 at the peak of the pandemic, which helped maintain the continuity of the research and conservation activities. We presented the positive implications of shifting towards local volunteer tourists in a long-term conservation project. We suggest that promoting local volunteer tourism through training new generations of nationals in conservation projects is key to guarantee the persistence of such initiatives in the post-COVID-19 Era. Full article

Coronaviruses are neurotropic viruses capable of entering the brain through various mechanisms and generating an important inflammatory response that is capable of triggering neuropsychiatric manifestations. Several reports describe the appearance of different conditions, such as sleep problems, anxiety and depression disorders, acute psychotic disorders, encephalitis, and delirium, among others, associated with COVID-19 infection. We performed a literature review in PubMed, Springer, Nature, MDPI, and other scientific journals on the relationship between COVID-19 infection with the development and aggravation of neuropsychiatric manifestations explained by molecular changes secondary to SARS-CoV-2 where it was found that there is a relationship between the virus and the development of these manifestations. Prospective neuropsychiatric follow-up of people exposed to SARS-CoV-2 at different points in their lives, as well as their neuroimmunological status, is necessary to fully understand the long-term impact of COVID-19 on mental health. It is required to identify the risk of developing neuropsychiatric problems due to COVID-19 infection to provide better medical care from a multidisciplinary team and improve the prognosis of these patients as well as the treatment of long-term sequelae. Full article

Cases of multisystem inflammatory syndrome in children (MIS-C-like disease), have rarely been reported in neonates. A 33-week gestational age twin B female neonate presented with respiratory distress, tachycardia, and abdominal distention at 15 days of age. Echocardiogram found reduced left ventricular ejection fraction to 33%. Cardiac enzyme levels were all elevated: creatine kinase-MB 6.1 ng/mL (normal 0–4.5 ng/mL), troponin-T 170 ng/L (normal < 14 ng/L) and NT-proBNP > 35,000 pg/mL (normal 250.0 to 3987.0 pg/mL). Multiplex PCR of nasopharyngeal swab material was negative for respiratory pathogens. Serological tests revealed negative anti-spike SARS-CoV-2 IgM but positive anti-nucleocapsid SARS-CoV-2 IgG in both the mother and the patient. The mother provided a history of COVID-19 during pregnancy at 19 weeks gestation. The patient was diagnosed with neonatal multisystem inflammatory syndrome (MIS-N) and successfully treated with intravenous immunoglobulin (two doses of 1 gm/kg/dose) and methylprednisolone (2 mg/kg/day for 5 days then tapered off). She later developed coronary vessel (LMCA and RCA) dilation. The non-identical twin A did not develop MIS-N, suggesting a role of host genetic background. Newborn infants born to SARS-CoV-2-infected mothers at any time during pregnancy should be closely monitored for MIS-N. The optimal treatment approaches to this syndrome and the prognosis require further study. Full article

Objective: Cognitive dysfunction is one of the most frequently reported symptoms in post-acute sequelae of COVID-19 (PASC) and has become a common reason for neuropsychological referral. While data are emerging, we aimed to address possible cross-cultural patterns of neuropsychological outcomes that remain underexplored. Methods: In this cross-sectional, retrospective study, we characterize the cognitive performance, demographic makeup, and clinical characteristics of 84 PASC patients (M_age = 57 years) referred for neuropsychological evaluation to three USA sites and one in Germany. Neuropsychological data (mean demographically adjusted z-scores and frequencies of impairment) were examined across six cognitive domains. Independent t-tests compared performances of previously hospitalized and non-hospitalized patients. Results: Patients were assessed on average seven months post-COVID-19 infection. The majority were women and non-hospitalized. Mean cognitive performance was within the normative range, but high variability existed within and between sites. Deficits were generally mild and most frequent in processing speed (range across sites: 9–57% of patients), executive functioning (range across sites: 4–43% of patients) and attention/working memory (range across sites: 0–43% of patients). Hospitalized patients showed greater cognitive impairment than those not requiring hospitalization. Mood symptoms and fatigue/sleep disturbance were more frequent than objective cognitive impairments. At the time of assessment, most patients were unable to return to work. Conclusions: Cognitive performance in clinically referred PASC patients was, overall, within the normative range. Mild deficits were most frequent in time-based attentional/executive tasks. Other factors, such as affective symptoms and fatigue, were frequent and may significantly impact functioning, perhaps more than cognition. Further work with larger samples and longitudinal measures is needed to clarify the impact of COVID-19 on cognitive function and psychiatric distress. Full article

Coronavirus disease 2019 (COVID-19) contact tracing and malaria reactive case detection (RACD) are effective strategies for disease control. The emergence of the COVID-19 pandemic and the global attention COVID-19 has received in the recent past and present has hampered malaria control efforts. Among these are difficulties in finding and treating malaria-infected individuals in hypoendemic settings in the community, due to lockdown restrictions by countries. It is common knowledge that malaria cases that cannot be identified remain untreated. To sustain the gains made in malaria control, we proposed a two-pronged hybrid approach for COVID-19 contact tracing and malaria RACD in communities with COVID-19 and malaria coinfections. Such an approach would equally factor the burden of malaria cases and COVID-19 to support an effective strategy for responding to current and future pandemics. Full article

The COVID-19 pandemic has affected the outcomes of ST-elevation myocardial infarction (STEMI) patients in most countries. We aimed to retrospectively assess the admissions, treatments, complications, and mortality of STEMI patients in the northeast of Slovenia during the first (March–May 2020) and second waves (October–December 2020) of the COVID-19 pandemic and to compare them with data from 2019 (March–October). Comparing 2019 and both waves of the COVID-19 pandemic, we observed nonsignificant differences in the number of STEMI admissions, baseline characteristics, use of primary percutaneous coronary intervention (PCI) within the first 3 (40.5%* vs. 38.7% vs. 25%*, *p = 0.074) or 6 h, TIMI III flow after primary PCI, and hospital complications, as well as significant increases in hospital heart failure (23.3% vs. 42%, p = 0.015) and mitral regurgitation in the second wave (10% vs. 26.9%, p = 0.008) of the pandemic and a nonsignificant increase in hospital mortality (8.9% vs. 9.4% vs. 13.6%) during both waves of the pandemic. We conclude that, due to the increased severity of the COVID-19 pandemic in the second wave, there were longer delays to primary PCI in STEMI patients, resulting in significantly increased hospital heart failure and non-significantly increased hospital mortality. Full article

Background: In response to the COVID-19 pandemic, the US states of New York and New Jersey instituted a “lockdown” that closed schools and most businesses except for essential services. The public was urged to remain at home. The 78-day lockdown period extended from 22 March 2020 to 6 June 2020. We sought to evaluate the impact of COVID-19 lockdown on continuously recorded physical activity in our patients with congenital heart disease with implanted cardiac rhythm management (CRM) devices—pacemakers (PPM), defibrillators (ICD) and implantable loop recorders (ILR) enabled with accelerometers that translate motion into a measure of active hours/day. Methods: All patients from our congenital CRM database with accelerometer-enabled devices who had stable cardiac status residing in NY and NJ were included. Forty-one patients met the inclusion criteria; the median age was 29.6 years (range 7–60); 54% female; 23 ICD, 15 PPM and 3 ILR. The patient activity was averaged for the 2 months prior to lockdown, during the lockdown, and the 2 months afterward. Paired t-tests were used to compare activity before and during lockdown, and before and after lockdown. Each patient served as his/her own control. Results: Active hours/day decreased by a mean of 32% (±27%) from baseline (p < 0.001). A total of 32 patients experienced a decline, 6 had no change and 3 had an increase. Active hours rebounded after lockdown and were unchanged compared to pre-lockdown levels. Conclusions: The COVID-19 lockdown in NY/NJ during the Spring of 2020 resulted in a significant drop in active hours/day in children and adults with congenital heart disease. Active hours/day rebounded to baseline after restrictions were lifted. Full article

Increased mortality has been observed in patients who develop acute kidney injury (AKI) in the setting of coronavirus disease 2019 (COVID-19), which has led to the approval of extracorporeal kidney support by the FDA. We analyzed the existing literature to compare the efficacy and therapeutic benefits of various extracorporeal modalities for the oXiris membranes and CytoSorb cartridge in high-flow continuous kidney replacement therapy (HFCKRT). AKI due to COVID-19 is mediated by a state of systemic inflammation (cytokine storm syndrome), leading to multiple organ dysfunction. Although there is no consensus on a protocol for providing kidney support therapy, clinically oriented studies have shown the capacities of oXiris and CytoSorb filters to effectively filter out pro-inflammatory components, leading to improved clinical outcomes in critically ill patients. In this review, we study the development of cytokine storm syndrome, important clinical evidence regarding the roles of various adsorption techniques in kidney support therapy in this setting, and a protocol influenced by FDA recommendations for oXiris and CytoSorb membranes. Full article

Introduction: The purpose of this study was to analyze hospital capacities in terms of hospital beds and staffing in the United States and explore the trends of hospital capacities during the Omicron variant emergence. Methods: Using data collected by the United States Department of Health and Human Services, this study examined hospitalization rates from 15 December 2021 to 13 February 2022. Graphical trends were plotted for visualization of hospital bed usage and coronavirus disease 2019 (COVID-19) inpatient cases. A Pearson correlation test was used to explore the relationship between critical staffing shortage and COVID-19 death cases. Descriptive statistics of all hospital data were calculated. Results: At the peak of the Omicron variant surge, approximately one-third of the adult intensive care unit beds were used for COVID-19 patients in the United States. The total number of COVID-19 death cases increased as the number of hospitals with critical staffing shortages increased (p < 0.05). Discussion: This study can inform hospital administrators and public health policymakers on how to modify the use of existing hospital and human resources as the continually evolving pandemic taxes hospital capacity. Future studies need to be conducted to determine the long-term trend and how the COVID-19 pandemic continues to change rapidly. Full article

In response to the COVID-19 pandemic, restrictive non-pharmaceutical policy interventions (NPIs), with the goals of reducing interactions and travel for people in different households, were introduced. In the U.S., each state had jurisdiction over the NPI policy imposed, resulting in myriad policy decisions. The aggregate impacts of these decisions are known; however, the individual impacts are not fully understood. We disaggregated the NPIs imposed during the first three months of the epidemic (1 March and 7 June 2020) using panel data regression analysis. Vehicular travel reduction as a proxy for NPI impacts on traffic was regressed against stay-at-home orders, business closures, school closures, and gathering bans. The results show that school closures and full closures of non-essential businesses were correlated with the largest impacts in reducing vehicle trips compared to when they are not in place. Stay-at-home orders had about half the impact of school closures compared to when they were not in place. Gathering bans had the least impact. In the U.S., decisions that target businesses were the most effective in reducing vehicle traffic. There was heterogeneity in how people responded to these restrictions. This study can be used in epidemiology models and inform decision-makers on policies that work best. Full article

Most transmittable diseases appear in a specific season and the effect of climate on COVID-19 is of special interest. This study aimed to investigate the relationship between climatic variables and the R₀ of COVID-19 cases in a list of areas in different latitudes around the world. The daily confirmed cases of COVID-19 and climatic data of each area per day from January 2020 to March 2021 were utilized in the study. The GWR and MLR methods were used to identify the relationship between the R₀ of COVID-19 cases and climatic variables. The MLR results showed a significant (p-value < 0.05) weak inverse relationship between the R₀ of COVID-19 cases and wind speed, but a positive significant (p-value < 0.01) relationship with precipitation. This implies that lower COVID-19 cases were recorded with high wind speed and low precipitation. Based on GWR, the R₀ of COVID-19 infection assessed against air temperature, rh, and precipitation was found to be statistically significant using the Monte Carlo p-value test, and the effect of climatic variables on COVID-19 infection appears to vary geographically. However, besides climatic variables, many socioeconomic factors could influence the virus’s transmission and will need to be considered in future studies. Full article