COVID, Volume 3, Issue 9 (September 2023) – 17 articles

We provide policy lessons for governments across Latin America by drawing on an original dataset of daily national and subnational non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic for eight Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Mexico, and Peru. Our analysis offers lessons for health system decision-making at various levels of government and highlights the impact of subnational policy implementation for responding to health crises. However, subnational responses cannot replace coordinated national policy; governments should emphasize the vertical integration of evidence-based policy from national to local levels while tailoring local policies to local conditions as they evolve. Horizontal policy integration across sectors and jurisdictions will also improve coordination at each level of government. The Latin American experiences with policy and politics during the COVID-19 pandemic project glocal health policy recommendations that connect global considerations with local needs. Full article

Institutional quarantine was one of the key public health measures used to control the spread of the Corona Virus Disease 2019 (COVID-19). Institutional quarantine has been associated with several psychosocial and economic risks. However, little is known about the psychosocial and economic risks it poses to affected persons in low-resource countries since it is a relatively new strategy for controlling disease spread in these settings. This article provides insights into the economic and psychosocial risks encountered by affected persons in a low-resource context. Narrative interviews were conducted with 20 adults placed under institutional quarantine to contain the COVID-19 pandemic in Uganda. Individuals confined in institutional quarantine experienced an intricate range of economic and psychosocial risks including loss of livelihood and/or income, financial distress, fear, worry, anger, loneliness, and stigma. The experience of specific risks was shaped by an intersection between individual and contextual factors. However, disregard for economic and social issues and shortcomings in the implementation of institutional quarantine contributed profoundly to the occurrence of risks. Safety nets to address the emergent financial insecurities of quarantined individuals and their families and bridging gaps in the implementation of institutional quarantine may help to minimise the associated economic and psychosocial risks in Uganda and similar contexts. Full article

The emergence of SARS-CoV-2, the virus responsible for the COVID-19 pandemic, has sparked intense research on its spike protein, which is essential for viral entrance into host cells. Viral reproduction and transmission, host immune response regulation, receptor recognition and host cell entrance mechanisms, as well as structural and functional effects have all been linked to mutations in the spike protein. Spike protein mutations can also result in immune evasion mechanisms that impair vaccine effectiveness and escape, and they are linked to illness severity and clinical consequences. Numerous studies have been conducted to determine the effects of these mutations on the spike protein structure and how it interacts with host factors. These results have important implications for the design and development of medicines and vaccines based on spike proteins as well as for the assessment of those products’ efficiency against newly discovered spike protein mutations. This paper gives a general overview of how spike protein mutations are categorized and named. It further looks at the links between spike protein mutations and clinical outcomes, illness severity, unanswered problems, and future research prospects. Additionally, explored are the effects of these mutations on vaccine effectiveness as well as the possible therapeutic targeting of spike protein mutations. Full article

The objective of this study was to explore the potential enhancement of response within GP medical centres in New Zealand when facing heightened healthcare demand during a pandemic. This investigation sheds light on effective crisis management and leadership. By elucidating the contributions of this research, we gain a deeper appreciation of its importance in advancing our understanding of pandemic management. This study has yielded fresh insights and knowledge, beneficial to both academic and real-world applications, particularly concerning the adoption and effects of leadership and management within the healthcare domain amidst crisis situations. Using a multiple case study design, we conducted 86 in-depth interviews with staff from 16 General Practice centres in New Zealand. The critical activities delivered during the first six months of the COVID pandemic to keep New Zealand communities safe during the initial COVID-19 outbreak were (a) leadership in health service planning, including workforce planning, new operational processes, and expansion in the use of Information Communication Technology systems by the GP medical centres; (b) environment disinfection using national guidelines, education and establishment of respiratory clinics and expanding testing sites in GP medical centres; and (c) education and outreach to the patients including the protection of Māori, Pasifika, and remote communities. The decision to adopt a localised response to the pandemic, centralise testing, and better understand local-level needs prompted GP medical centres to communicate and engage early and effectively with patients. This enabled centres to lead and manage the COVID-19 pandemic with greater efficiency in the first six months of the outbreak. The New Zealand government’s “team of 5 million” COVID-compliance campaign program provided clear and persistent communication by the Ministry of Health. This campaign assisted in a better national understanding and compliance with the regulation of the COVID-19 pandemic. The dedication of medical centre managers to forward planning using contingency and accrued funding and setting up Community-Based Assessment Centres and respiratory clinics, including walk-in and outreach services, proved to be highly effective. GP centres led the way in COVID-19 pandemic planning, response, and management. Full article

The objectives of this study were to (1) investigate the association between human blood type and COVID-19 in both inpatient and longitudinal populations and (2) identify the association between blood type and severity of COVID-19 via presence of cellular biomarkers of severe infection in hospitalized individuals at our institution in South Florida. This study consisted of (1) a single-center retrospective analysis of 669 out of 2741 COVID-19-positive, screened patients seen from 1 January 2020 until 31 March 2021 at the University of Miami Emergency Department (ED) who tested positive for COVID-19 and had a documented ABO blood type and (2) a longitudinal SARS-CoV-2 immunity study (“CITY”) at the University of Miami Miller School of Medicine, consisting of 185 survey participants. In an inpatient setting, blood type appeared to be associated with COVID-19 severity and mortality. Blood type O sustained less risk of COVID-19 mortality, and blood type O- demonstrated less risk of developing COVID-19 pneumonia. Inpatients with O- blood type exhibited less biomarkers of severe infection than did other blood types. In a longitudinal setting, there was no association found between blood type and SARS-CoV-2 infection. Full article

Public market workers may be disproportionally exposed to SARS-CoV-2 due to interactions with shoppers. We aimed to estimate the seroprevalence of SARS-CoV-2 and determine whether occupation or adherence to preventive practices were associated with exposure. From July to December 2021, we longitudinally surveyed two Guatemalan markets twice. We collected blood to detect anti-S IgA, anti-S IgG, and anti-N IgG using ELISA, and a nasopharyngeal swab to detect SARS-CoV-2 using rRT-PCR. We estimated seroprevalences and assessed associations using generalized estimating equations. Of 229 workers, 109 (48%) participated in the first survey and 87 (38%) in the second. At baseline, 77% were female, 64% were aged <40, and 81% were vendors. Overall, the seroprevalence increased between surveys (61% to 89% for anti-S IgA, 53% to 91% for anti-S IgG, and 22% to 29% for anti-N IgG), but the magnitude differed by vaccination status and antibody type. The prevalence of infections decreased from 13% to 1% and most were asymptomatic. Vendor occupation was associated with IgA and IgG anti-S in males but not females. Using a mask was a protective measure. Most market workers had been exposed to SARS-CoV-2, possibly through asymptomatic individuals. Masking is a protective measure to be prioritized during high transmission. Full article

In bioinformatics research, traditional machine-learning methods have demonstrated efficacy in addressing Euclidean data. However, real-world data often encompass non-Euclidean forms, such as graph data, which contain intricate structural patterns or high-order relationships that elude conventional machine-learning approaches. Representation learning seeks to derive valuable data representations from enhancing predictive or analytic tasks, capturing vital patterns and structures. This method has proven particularly beneficial in bioinformatics and biomedicine, as it effectively handles high-dimensional and sparse data, detects complex biological patterns, and optimizes predictive performance. In recent years, graph representation learning has become a popular research topic. It involves the embedding of graphs into a low-dimensional space while preserving the structural and attribute information of the graph, enabling better feature extraction for downstream tasks. This study extensively reviews representation learning advancements, particularly in the research of representation methods since the emergence of COVID-19. We begin with an analysis and classification of neural-network-based language model representation learning techniques as well as graph representation learning methods. Subsequently, we explore their methodological innovations in the context of COVID-19, with a focus on the domains of drugs, public health, and healthcare. Furthermore, we discuss the challenges and opportunities associated with graph representation learning. This comprehensive review presents invaluable insights for researchers as it documents the development of COVID-19 and offers experiential lessons to preempt future infectious diseases. Moreover, this study provides guidance regarding future bioinformatics and biomedicine research methodologies. Full article

The value of D-dimer assessments in ICU patients with COVID-19 for the prediction of pulmonary embolism (PE) is unclear. The present study had two purposes: 1. To assess the specificity of elevated absolute D-dimer values for PE on admission to the ICU. 2. To assess the specificity of a D-dimer increment for the development of PE during an ICU stay. D-dimer values were paired with the results of a CT pulmonary angiogram (CTPA) and compared in patients with and without PE on admission. In patients without PE on initial imaging and available repeat CTPA during an ICU stay, D-dimer increments between initial and repeat imaging of patients developing PE during an ICU stay were compared with those with persistently no PE. On admission, D-dimers in patients with PE were higher than those in patients without PE (median 850 vs. 6060 μg/L; p < 0.0001). Using a cut-off of 9000 μg/L, the specificity for predicting PE was 100% (CI 95.3–100%). Delta D-dimer during an ICU stay was greater in patients with PE (median 7983 vs. 3815 μg/L; p < 0.005). Using a cut-off of 8000 μg/L, specificity was 100% (CI 79.4–100%). Strongly elevated D-dimer values on admission and marked increases in D-dimer during ICU stays have a high specificity for predicting pulmonary embolism in critically ill COVID-19 patients. Full article

This paper highlights curriculum and policy reforms and innovations in a Higher Education (HE) institution in response to undergraduate student perspectives about the phenomenon of the COVID-19 restrictions imposed by the New Zealand government (2020–2022). The advent of the coronavirus pandemic precipitated unexpected and unprecedented changes in HE learning and in the pedagogy required for undergraduate students. Consequently, HE institutions have had to be agile, resulting in ‘emergency’ adaptations to curriculum practice and policy implementation. This paper discusses triggers for change, reactions to restrictions, strategic measures, and the emergence of a ‘new normal’ from an undergraduate student perspective. Local and global concerns about student participation in undergraduate study (in Sport and Recreation), sport, and physical activity during restricted periods prompted the researchers to investigate the challenges these young people faced. Student voice was collected through semi-structured interviews and focus groups, collected post lockdown periods. Research findings, elicited from lecturers using a collaborative auto-ethnographical method, along with interpretative analysis (hermeneutic phenomenology) of students’ perspectives about the four pillars of lifestyle, active lives, learning, and livelihood provide insights about the impact of unexpected curriculum and policy change for HE students in New Zealand. This research provides real-time data to inform recommendations on policy and practice in HE institutions, to enhance student wellbeing in times of crises, like the COVID-19 pandemic. Full article

The utilization of gene selection techniques is crucial when dealing with extensive datasets containing limited cases and numerous genes, as they enhance the learning processes and improve overall outcomes. In this research, we introduce a hybrid method that combines the binary reptile search algorithm (BRSA) with the LASSO regression method to effectively filter and reduce the dimensionality of a gene expression dataset. Our primary objective was to pinpoint genes associated with COVID-19 by examining the GSE149273 dataset, which focuses on respiratory viral (RV) infections in individuals with asthma. This dataset suggested a potential increase in ACE2 expression, a critical receptor for the SARS-CoV-2 virus, along with the activation of cytokine pathways linked to COVID-19. Our proposed BRSA method successfully identified six significant genes, including ACE2, IFIT5, and TRIM14, that are closely related to COVID-19, achieving an impressive maximum classification accuracy of 87.22%. By conducting a comparative analysis against four existing binary feature selection algorithms, we demonstrated the effectiveness of our hybrid approach in reducing the dimensionality of features, while maintaining a high classification accuracy. As a result, our hybrid approach shows great promise for identifying COVID-19-related genes and could be an invaluable tool for other studies dealing with very large gene expression datasets. Full article

Pandemic restrictions and reduced social opportunities led to increased loneliness in affected countries. Considering that stressful situations activate the attachment system and engage various coping strategies, the present study explored the role of attachment dimensions and coping styles in perceived social isolation and the subsequent effect on emotional distress. Data were collected using an online survey between the third and fourth waves in Romania during the second year of the pandemic. Correlational analyses presented significant relationships between all variables measured. Regression analysis showed that attachment insecurity could predict up to half of the variance in loneliness and one-third of emotional distress. Coping styles that predicted both loneliness and emotional distress were problem-focused and socially supported coping, though the effect was minimal. Emotion-focused coping presented a protective role against loneliness. Finally, mediation analysis revealed how loneliness fully mediated the relationship between insecure attachment styles and emotional distress. Further implications for research on loneliness and pandemic resilience are discussed. Full article

Introduction: With changes in treatments, precautions, and the virus itself, the continued evaluation of post-COVID-19 patient rehabilitation needs is essential. Methods: Demographics, comorbidities, functional assessments, quality of life, and rehabilitation outcomes for 98 patients admitted to inpatient rehabilitation during New York’s most recent major COVID-19 hospitalization surge were analyzed. Patients were contacted at 6 months to evaluate functional improvement, post-COVID-19 symptoms, vaccination status, and quality of life. Results: Inpatient rehabilitation addressed significant limitations in lung capacity, mobility, and self-care. Median mobility scores improved significantly from admission (16) to discharge (34) and follow-up (42). Sixty-six percent of patients reported overall quality of life improvement during their rehabilitation stay; at follow-up, a more modest percentage (35%) reported additional gains. Continued improvement in supplemental oxygen use was observed in 49% of patients who completed the follow-up assessment. Consistent with previous studies on severe disease, post-COVID-19 condition features were exhibited by 86% of patients at follow-up; vaccinated individuals displayed fewer symptoms associated with post-COVID-19 condition than their unvaccinated counterparts. Conclusions: Individuals recovering from severe COVID-19, including previously ventilated patients, made significant functional and quality of life gains during inpatient rehabilitation. While functional independence continued to improve post-discharge, patients exhibited greater improvement from admission to discharge than from discharge to 6-month follow-up. Inpatient rehabilitation represents a crucial component for recovery from severe COVID-19. Full article

False positive reactive plasmin reagin (RPR) reactivity following a COVID-19 vaccine has been reported, and it is therefore conceivable that individuals who receive frequent coronavirus disease 2019 (COVID-19) vaccinations may exhibit durable RPR responses. Here, we sought to investigate the extent to which repeated mRNA COVID-19 vaccines can elicit chronic false RPR reactivity in a longitudinal cohort. Participants (n = 119) in an IRB-approved (#20201026), longitudinal SARS-CoV-2 cohort study were screened for RPR reactivity via manual RPR card assays. Samples with reactive results underwent additional testing, including follow-on RPR screening at additional timepoints, confirmatory fluorescent treponemal antibody (FTA-ABS) testing and anti-nuclear antibody (ANA) testing. Medical histories were collected. We observed (n = 2) screen-positive RPR results (1.7% [2/119]) following booster vaccination, for which two individuals exhibited chronic, vaccine-induced RPR reactivity for up to 9 months following booster vaccination. Both participants were ANA-negative. It is imperative for clinicians to be mindful of the potential immunologic interference of COVID-19 vaccines with standard infectious disease assays, including RPR testing. Detailed medical histories and clinical contexts, including recent vaccination, should be reviewed prior to proceeding with distressing and invasive workups. Full article

The emergence of novel pathogens is a well-known epidemiological risk; however, the unexpected emergence of a truly novel coronavirus-mediated pandemic due to SARS-CoV-2 underscored the significance of understanding this contagion. The pandemic, due to novel coronavirus, termed COVID-19, caused unprecedented social, economic, and educational disruptions on a scale never seen before. In addition to social protocols, safe, effective, and affordable vaccines were developed within months, the cornerstone of the mitigation of this pandemic. We present an overview of the evolution of the pandemic from a historical perspective and describe its biology and behavior, especially the immunological aspects of the disease. We further provide an overview of therapeutics, treatment, and vaccine development to mitigate SARS-CoV-2. It is critical to understand the transmission mechanism of the disease to control and mitigate its progression. We describe cohort studies to identify secondary and tertiary syndromes. The transmission characteristics help its diagnosis and detection. During the pandemic, a lot of emphasis was placed on personal protection equipment. It is now concluded that the virus particles are spread by aerosol dispersion. While the recommended distance may not have been sufficient, the use of personal protective equipment and social distancing was helpful in close-quarters environments. Such protocols, in conjunction with safe and effective vaccines and personal hygiene, are among the safe practices. While we learn from our experience, this review provides a holistic overview of the pandemic and encapsulates the event in a historical context. In doing so, we hope to understand the SARS-CoV-2 virus and take sufficient precautionary measures to mitigate consequences during any subsequent similar pandemics. In addition to a wide-spectrum automated analytics system introduced by the authors earlier, we propose the use of artificial intelligence in conjunction with data analytics to minimize the risk of speculatively diagnosing agents incorrectly by employing a novel concept of cloud-based presumptive diagnosis. Full article

This paper examines the subjective realities of female students in higher education as they navigated their well-being and active lives during the COVID-19 pandemic. Drawing upon Merleau-Ponty’s phenomenological framework, which confronts an often-neglected dimension of our experience—the lived body and the phenomenal world—we aim to inform the development of targeted support and interventions to address the specific needs of female students, in future pandemic times. By exploring how three female students studying sport and recreation in higher education perceived their experiences, this article seeks to shed light on the unique challenges faced by these women in maintaining physical activity, coping with isolation and a change in social networks, and managing their mental health in the context of the pandemic. Understanding these subjective realities (such as isolation, restricted physical activity, and loss of social connections) and interpreting the three students’ lived habitats, their bodily responsiveness, and their spontaneity ensures that their experience is heard, and appropriate future support can be given. Full article

This prospective study sought to characterise the educational experiences, mental health, and behavioural functioning of Australian children with a pre-existing learning difficulty or specific learning disorder (SLD) during the COVID-19 pandemic. The study also evaluated the potential role of parent psychological distress as a risk factor for poorer child functioning in this high-risk population. Using a prospective longitudinal design, the study involved 58 parents of children and adolescents with a pre-existing learning difficulty or specific learning disorder (M age = 11.9 years; range 7–17 years) who were initially referred to a state-wide diagnostic centre for specific learning disorders in Melbourne, Victoria, Australia. Child outcomes were assessed using the COVID-19 Wellbeing and Mental Health Survey (a modified version of the CoRonavIruS Health Impact Survey [CRISIS] tool), the Strengths and Difficulties Questionnaire (SDQ), and the Emotional Distress Scale from the Patient-Reported Outcomes Measurement Information System (PROMIS). Parents’ mental health was assessed using the CRISIS tool and the Kessler Psychological Distress Scale (K10). In keeping with initial predictions, a large proportion of parents expressed significant disruption to child educational experience and routines, including challenges related to child engagement in remote learning platforms during COVID-19. Compared to pre-pandemic mental health symptom ratings, children experienced significantly higher symptoms of worry, negative thoughts, loneliness, agitation, and aggression during the pandemic period (all p < 0.05). As expected, higher levels of parent distress predicted greater child worry symptoms (p = 0.003) and more frequent child behavioural difficulties (p = 0.004). These results help elucidate the specific psychological and educational challenges faced by children with pre-existing learning difficulty or SLD during the COVID-19 pandemic. Family-centred intervention and/or supports may help to address the unique educational and psychological needs of young people with pre-existing learning differences and their families during future global pandemics. Full article

Background: When schools reopened for face-to-face classroom instruction following the COVID-19 pandemic, teachers faced many professional challenges. Most studies examining teachers’ psychosocial condition after school reopening predominantly focused on negative aspects of their emotional well-being, leaving a gap in the understanding of the potential positive effects. This study is grounded in the theory of post-traumatic growth, which suggests that growth and development can occur alongside difficulties. Objectives: The purpose of this study was to shed light on the lesser explored associations between resilience, social support, and post-traumatic growth among teachers after the COVID-19 pandemic. It also examined the differences in post-traumatic growth between teachers in special education and those in general education. Methods: The participants in this cross-sectional study were recruited by convenience sampling. A self-report online survey was used to collect data from 208 Israeli teachers during November 2022. Results: Most of the participants (79.4%) reported experiences of post-traumatic growth during the pandemic. The findings revealed that post-traumatic growth exhibited a positive association with social support (r = 0.23, p < 0.001) and resilience (r = 0.18, p < 0.001). The multiple regression model was significant, explaining 14.5% of the variance in post-traumatic growth [F(4.202) = 8.58, p < 0.001]. Finally, special education teachers exhibited higher levels of post-traumatic growth than general education teachers (t = −2.36, p < 0.05). Conclusions: Social support for teachers must be provided during and after traumas caused by crises and pandemics similar to COVID-19. Intervention programs and ongoing training should offer effective tools to help teachers balance their professional and personal lives. Promoting positive changes in teacher well-being must be a priority in the education system. Full article