COVID, Volume 3, Issue 6 (June 2023) – 9 articles

Objective: To analyze the spatial pattern of the incidence of COVID-19 in association with social determinants of health (SDH) in the Northeast Region of Brazil during the first year of the pandemic. Methods: We conducted an ecological analytical study that included notifications made between 27 March 2020 and 27 March 2021. The data analysis used two global regression models: the ordinary least squares (OLS) and spatial lag model and the geographically weighted multiscale regression model (GWMSR). Results: We observed that the Gini index, illiteracy rate, percentages of people living below the poverty line, people in households who were vulnerable to poverty, and dependent elderly people are predictors of a higher incidence of COVID-19 in Northeast Brazil. Conclusions: Results of this study may contribute to generating new hypotheses for studies focusing on the syndemic process and for the formulation of intersectoral public policies targeting the population at greatest vulnerability to minimize the impact of the disease. Full article

Real-time RT-PCR is used as a gold standard method for the diagnosis of COVID-19. Since real-time RT PCR is nucleic acid-based, it is a highly sensitive and specific test. However, this test takes 4–8 h to generate results and, in emergency settings, this delay may prove fatal for certain patients. The frequent surge in COVID cases increases patient load in emergency settings. Thus, a nucleic acid-based rapid POC test is required that can generate results quickly as well as being comparable to real-time RT-PCR. In this study, comparison of real-time RT-PCR was carried out using the rapid nucleic acid-based LAMP method. Nasopharyngeal swabs were taken in duplicate from patients visiting the kiosk and were analyzed for the presence of the SARS-CoV-2 virus by both real-time RT-PCR and LAMP techniques ID NOW(bbott). Out of 14 positive and 31 negative samples tested by real-time RT-PCR, 13 samples were identified as positive and 31 were observed as negative with the LAMP-based test. Hence, the sensitivity and specificity of this method were found to be 92.9% and 93.5%, respectively. Therefore, LAMP-based point-of-care testing has the potential to be used in hospital emergency settings for quick diagnosis of critically ill patients, and the information generated here will further draw the attention of policymakers toward such nucleic acid-based rapid tests. Full article

SARS-CoV-2, a single stranded positive RNA-virus, emerged in 2019 and caused a global pandemic. Some infected patients develop severe complications, such as acute respiratory distress syndrome (ARDS) and pulmonary fibrosis. The mechanisms leading to lung fibrosis in the context of COVID-19 are still unclear. However, there are correlations between this condition and certain inflammatory mediators that are elevated in the plasma of patients. This study addressed the question of whether SARS-CoV-2 spike protein was able to directly activate immune cells to produce inflammatory and fibrogenic cytokines, independent of viral infection. By stimulating peripheral blood mononuclear cells (PBMC) from healthy blood donors through different formulations of SARS-CoV-2 spike protein, the expression of fibrogenic and inflammatory cytokines was measured. The spike protein induced a significantly increased expression of IL-1β and IL-6 mRNA in PBMC. Both cytokines are important players in the COVID-19 cytokine storm, in ARDS and in the development of pulmonary fibrosis. Different receptors with an affinity to the spike protein may be involved. However, the exact mechanism on how the spike protein leads to a higher cytokine expression in PBMC needs further investigation. Full article

The aim of this qualitative research, conducted in Spring 2021, was to identify the inconveniences and the psychological and social impact of 10 days of home isolation, required by law, in non-hospitalised COVID-19 patients in Greece and to improve management. Thirty-seven semi-structured telephone interviews were conducted, audio-recorded, and transcribed verbatim. Thematic analysis identified four key emergent themes, i.e., everyday life during self-isolation, psychological issues, social issues, and information and guidance. Food provisioning was of particular concern. Solidarity was expressed to individuals in need. Isolation was not always viable due to space constraints and the necessity to care for sick family members. Fear of transmission to vulnerable groups, hospitalisation, irreversible complications, and death as well as anxiety, insecurity, guilt, and alienation were articulated. COVID-19 disrupted the normal functioning of families and led to revision of interpersonal relationships. Patients avoided re-integration in society due to the transmitter stigma and to limit the risk of infection spread in the community. Over-information promoted fear. Mild illness raised doubts about information validity. Primary care provided monitoring and psychological support. Home isolation caused disruption in various aspects of participants’ life, ranging from logistic problems to dealing with the psychological burden of isolation and illness. Primary care could play a central role in supporting patients. Full article

Early in the SARS-CoV-2 pandemic, polymerase chain reaction (PCR) testing was reserved for symptomatic patients. However, many infections were asymptomatic or mildly symptomatic. Positive serologic antibody (Ab) testing is theorized to be a marker of prior infection, allowing for identification of the true burden of the disease and the establishment of links between outbreaks. The objective was to assess serologic testing in subjects after PCR testing and compare seropositivity rates of household vs. non-household close contacts. We identified subjects who were PCR-positive between March 2020 and May 2021. Index cases and close contacts then underwent serologic testing for IgG against the SARS-CoV-2 nucleocapsid N-protein. One hundred and thirteen subjects underwent serologic testing with a sensitivity of 65.0%, specificity of 78.9%, positive predictive value of 92.9%, and negative predictive value of 34.9%. Index cases comprised 20.5% of subjects, and 73.9% were seropositive (p = 0.01). Close contacts included 72% household contacts and 28% non-household contacts. One seropositive case had no prior PCR and four were PCR negative. No statistical difference existed in seropositivity between household and non-household contact (53.1% vs. 43.8%, p = 0.4). Testing for IgG against SARS-CoV-2 N-protein may identify previously unrecognized infections in the community. Seropositivity rates of household vs. non-household contacts were not significantly different, and >50% of household contacts were seropositive. Full article

The COVID-19 pandemic unnerved the global population in 2019 and has continued to evolve ever since. Throughout this time, investigations concerning the health of the groups most susceptible to this virus, including the elderly, those with compromised immunity or chronic diseases, and pregnant women, have taken place. Numerous articles have been formulated on the effects of COVID-19 infection on maternal, fetal, and neonatal health, but there are many controversies that still exist within the current literature. Even three years later, it is not fully understood how a maternal infection or vaccination of COVID-19 can impact pregnancy and the fetus, and these topics require further investigation and conclusive results. The aim of this article is to explain the risks for a mother and the neonate, during and after pregnancy, with the emergence of the COVID-19 pandemic. Additionally, this report presents the current state of the literature on whether vaccination during pregnancy is more beneficial or harmful. Finally, this review examines studies regarding the exacerbation of the effects of COVID-19 on pregnancies in various organ systems, particularly the cardiovascular system, in relevance to pre-existing and emerging conditions and the ethnicity of the mother. Full article

Extraversion, of the Big Five personality traits, has been identified as the most socially relevant of the traits with respect to positive COVID-19 coping—yet relevant research is found conflicting. Studies assessing this discrepancy have not situated the influence of extraversion within a geographical and historical context. Thus, a likely contributor has been missed. Furthermore, extraversion is based on other-directed learning with respect to COVID-19 coping, and this has not been considered regarding its contrast to self-directed learning. To provide context, an examination of high-ranking Google Scholar results on extraversion and COVID-19 coping from different countries during the pandemic’s various waves is undertaken, including the introduction of vaccines as a factor in decreasing COVID-19’s perceived threat. These are then examined for relationships regarding public opinion. Following, extraversion is compared with other-directed learning and differentiated from self-directed learning. An understanding is thus presented for assessing when extraversion will be an effective personality trait for positive COVID-19 coping and when it will not. Extraversion’s effect is found inherently inconsistent for identifying positive COVID-19 coping because of its dependence on other-directed learning. The conclusion: stability in positive COVID-19 coping is contingent on personal values that guide self-directed learning rather than extraversion’s other-directed learning. Full article

The COVID-19 pandemic has had a devastating impact on the world at large with over 750 million cases and almost 7 million deaths reported thus far. Of those, over 100 million cases and 1 million deaths have occurred in the United States of America (USA). The mental health of the general population has been impacted by several aspects of the pandemic including lockdowns, media sensationalism, social isolation, and spread of the disease. In this paper, we examine the associations that social isolation and COVID-19 infection and related death had with the prevalence of anxiety and depression in the general population of the USA in a state-by-state multiple time-series analysis. Vector Error Correction Models are estimated and we subsequently evaluated the coefficients of the estimated models and calculated their impulse response functions for further interpretation. We found that COVID-19 incidence was positively associated with anxiety across the studied period for a majority of states. Variables related to social isolation had a varied effect depending on the state being considered. Full article

Background: Chronic obstructive pulmonary disease (COPD) is the most prevalent long-term respiratory condition. Patients with COPD experience detrimental effects of COVID-19 infection. Objective: To figure out whether COPD is a risk factor influencing the progression of COVID-19 and to explore the clinical value of laboratory biomarkers to assess the severity of COVID-19 in patients with COPD comorbidity. Methods: In total, 1572 participants aged 35 to 70 years were enrolled to a tertiary hospital in Bangladesh between March 2022 and October 2022. Participants were categorized into four groups: (1) control, (2) COPD, (3) COVID-19, and (4) COVID-19 with COPD, and blood levels of clinical laboratory markers were assessed to analyze how these markers differ among the study groups. Results: COVID-19 patients with COPD had a significantly lower level of sodium (131.81 ± 2.8 mmol/L) and calcium (1.91 ± 0.28 mmol/L), and a significantly higher level of NT-proBNP (568.45 ± 207.40 pg/mL), bilirubin (1.34 ± 0.54 mg/dL), fibrinogen (577.27 ± 145.24 mg/dL), D-dimer (2.97 ± 2.25 μg/mL), C-reactive protein (71.08 ± 62.42 mg/L), interleukin-6 (166.47 ± 174.39 pg/mL), and procalcitonin (0.25 ± 0.30 ng/mL) compared to other study groups patients (p < 0.0001). In addition, the GOLD 4 group demonstrated significantly altered clinical parameters among COVID-19 patients with COPD. Furthermore, NT-proBNP, interleukin 6, D-dimer, C-reactive protein, and fibrinogen demonstrated excellent diagnostic performance in predicting disease severity among the COVID-19 patients with COPD, with a cut-off value of 511.2 pg/mL, 51.375 pg/mL, 1.645 μg/mL, 40.2 mg/L, and 510 mg/dL, respectively. Our results also indicate that inflammatory markers had significant positive correlations with the biochemical and coagulation markers in the COVID-19 patients suffering with COPD (p < 0.0001). Conclusions: NT-proBNP, interleukin 6, D-dimer, C-reactive protein, and fibrinogen are the most potential parameters for differentiating severe cases of COVID-19. Full article