COVID, Volume 4, Issue 4 (April 2024) – 11 articles

Since 2019, the SARS-CoV-2 virus has caused a global pandemic, resulting in widespread infections and ongoing mutations. Analyzing these mutations is essential for predicting future impacts. Unlike influenza mutations, SARS-CoV-2 mutations displayed distinct selective patterns that were concentrated in the spike protein and small ORFs. In contrast to the gradual accumulation seen in influenza mutations, SARS-CoV-2 mutations lead to the abrupt emergence of new variants and subsequent outbreaks. This phenomenon may be attributed to their targeted cellular substances; unlike the influenza virus, which has mutated to evade acquired immunity, SARS-CoV-2 appeared to mutate to target individuals who have not been previously infected. The Omicron variant, which emerged in late 2021, demonstrates significant mutations that set it apart from previous variants. The rapid mutation rate of SARS-CoV-2 has now reached a level comparable to 30 years of influenza variation. The most recent variant, JN.1, exhibits a discernible trajectory of change distinct from previous Omicron variants. Full article

Students’ and teachers’ acceptance of the COVID-19 vaccination may help boost the uptake of the vaccines in the general population because teachers and students serve as a source of information and campaign mechanisation for vaccination. This review aimed to map evidence on the prevalence and predictors of COVID-19 vaccine acceptance and hesitancy among teachers and students. After removing duplicates, a search in several databases (Dimensions, PubMed Central, JSTOR, Google Scholar, Google, the WHO Library, and HINARI) produced 2060 records. Through screening based on the inclusion criteria, 27 records were used for this review. A relatively high prevalence of vaccine hesitancy was found among teachers and students. Teachers and students in countries such as China, Egypt, the USA, and India however, reported relatively low levels of COVID-19 vaccine acceptance. Vaccine hesitancy depends on perceived adverse effects, safety, efficacy, and benefits among teachers and students, with male teachers and male students being more likely to accept the COVID-19 vaccine than their female counterparts. Moreover, we found that vaccine acceptance could result from trust in the healthcare system and pharmaceutical companies, sources of COVID-19 information, and trust in healthcare providers. Public health experts, academics, other scientists, and health practitioners are required to take a more distinctive, multidisciplinary, and structured approach that focused on communicating effective evidence-based information to combat misinformation concerning COVID-19 vaccines. Full article

The sudden lockdown and social isolation caused by the COVID-19 pandemic substantially affected the physical and psychological aspects of our lives. This study used a sequential explanatory research design to explore how human–animal interactions (HAI) can reduce stress and improve quality of life (QOL) for employees working from home during the period. A total of 770 respondents took part in the quantitative portion of this study, comprised of 385 pet owners and 385 non-pet owners, with ten individuals randomly selected for the qualitative phase. The pet owners group was predominantly female, with 28.57% of the total sample with a mean age of 33.67 and a standard deviation (SD) of 9.46. In contrast, the majority of non-pet owners were male, making up 32.46% of the group with an average age of 29.57 and SD of 6.42. The HAI scale, work stress questionnaire, and the WHOQOL-BREF tests were utilized to evaluate the variables of this research. The results indicated significant differences in stress levels between the two independent groups. However, there were no significant differences in the overall QOL within the groups, except in the social domain. More importantly, our research showed that HAI had a buffering effect on stress and QOL among pet owners. Our research has important implications for understanding the importance of owning pets in enhancing personal welfare. These results are helpful for public health policies and endeavors to aid individuals and communities during periods of crises such as a pandemic. Full article

Background: Vaccine hesitancy is a complex challenge that demands a comprehensive approach, one that not only acknowledges legitimate concerns within communities but also actively confronts misinformation. In this context, this study aimed to investigate the prevalence of belief in conspiracy theories about COVID-19 vaccines among Brazilians, seeking to understand the factors associated with this behavior. Method: Utilizing a national online survey conducted between May and August 2020, with a sample of 4247 participants, we conducted multivariate analysis to identify the independent determinants of this adherence, calculating adjusted prevalence ratios (APRs) and their 95% confidence intervals. Results: It was revealed that 27.7% of participants believed in at least one conspiracy theory. Factors associated with a higher level of adherence included agreement with at least one piece of COVID-19 misinformation on social media (APR: 3.65; 95% CI: 3.07–4.34), lack of difficulty accessing leisure activities during the pandemic (APR: 3.11; 95% CI: 1.85–5.24), age 50 years or older (APR: 1.70; 95% CI: 1.49–1.94), absence of difficulty accessing protective measures (APR: 1.47; 95% CI: 1.26–1.72), use of face masks (APR: 1.62; 95% CI: 1.33–1.97), non-use of at least one traditional media source for information (APR: 1.47; 95% CI: 1.26–1.72), female gender (APR: 1.41; 95% CI: 1.25–1.60), and age between 30 and 49 years (APR: 1.35; 95% CI: 1.19–1.52). Conclusions: Our findings highlight that it is crucial to recognize that vaccine hesitancy is not merely an isolated phenomenon but often rooted in a complex interplay of social, cultural, psychological, and political factors. There is a need for multifaceted strategies to combat vaccine hesitancy, effectively address conspiracy theories, and consider the various factors associated with their prevalence. Full article

This study compared the psychosocial health between Black/African Americans and other ethnic groups during the COVID-19 pandemic. Using self-report questionnaires, data were collected at three time points from April 2020 to January 2022, controlling for education and employment status. Surprisingly, Black/African American participants consistently reported lower psychological distress compared to their counterparts. However, they initially reported lower quality of life, which improved over time, eventually surpassing that of the other groups by January 2022. These findings suggest resilience among Black/African Americans despite historical marginalization. Socioeconomic factors and historical context may have influenced these disparities, highlighting the need for targeted interventions to support marginalized communities during crises. Full article

Identifying determinants of vaccination uptake is critical for public and community health. The population became divided in regard to preventative measures and vaccinations during the COVID-19 pandemic. In addition, there are varying opinions on decisions to vaccinate children against childhood diseases and COVID-19. Recent findings suggest that the COVID-19 pandemic has exacerbated existing vaccine hesitancy. Here, we assess vaccine hesitancy in parents by identifying predictors of vaccine acceptance by parents during the COVID-19 pandemic using a survey given to parents in South Carolina. Knowledge about COVID-19 and vaccinations affects vaccination intentions. Age, education, gender, and politics were also found to predict parents’ decisions about vaccinating their kids. Understanding potential barriers to vaccine acceptance will aid healthcare providers and public health entities to better reach the community. Full article

Post-COVID syndrome, also known as long COVID, includes a range of symptoms that persist for months or even years after initial infection such as fatigue, shortness of breath, joint pain, chest pain, muscle aches, and heart palpitations, among others. In addition, long COVID is related with new-onset diseases such as diabetes mellitus. The association between SARS-CoV-2 infections and the development of diabetes mellitus is complex and not fully understood. Therefore, the objective of this article was to summarize the state of the art in possible mechanisms involved in the development of diabetes mellitus in the post-COVID-19 era, particularly the impact of SARS-CoV-2 variants on molecular mimicry, the role of viral m6A RNA methylation, and the potential associations between these factors. A better understanding of the combinatorial effects of these mechanisms is paramount for both clinicians and researchers alike because it could help tailor more effective treatment strategies, enhance patient care, and guide future research efforts. Full article

Contact tracing is a method used to control the spread of a pandemic. The objectives of this research are to conduct an empirical review and content analysis to identify the environmental factors causing the spread of the pandemic and to propose an ontology-based big data architecture to collect these factors for prediction. No research studies these factors as a whole in pandemic prediction. The research method used was an empirical study and content analysis. The keywords contact tracking, pandemic spread, fear, hygiene measures, government policy, prevention programs, pandemic programs, information disclosure, pandemic economics, and COVID-19 were used to archive studies on the pandemic spread from 2019 to 2022 in the EBSCOHost databases (e.g., Medline, ERIC, Library Information Science & Technology, etc.). The results showed that only 84 of the 588 archived studies were relevant. The risk perception of the pandemic (n = 14), hygiene behavior (n = 7), culture (n = 12), and attitudes of government policies on pandemic prevention (n = 25), education programs (n = 2), business restrictions (n = 2), technology infrastructure, and multimedia usage (n = 24) were the major environmental factors influencing public behavior of pandemic prevention. An ontology-based big data architecture is proposed to collect these factors for building the spread prediction model. The new method overcomes the limitation of traditional pandemic prediction model such as Susceptible-Exposed-Infected-Recovered (SEIR) that only uses time series to predict epidemic trend. The big data architecture allows multi-dimension data and modern AI methods to be used to train the contagion scenarios for spread prediction. It helps policymakers to plan pandemic prevention programs. Full article

SARS-CoV-2 damages not only the lungs, but also the liver and kidney. Most critically ill COVID-19 patients have liver and kidney dysfunctions. The early identification of patients with COVID-19 who will develop severe or critical disease symptoms is important for delivering proper and early treatment. This research studies the correlation of liver and kidney function indexes and COVID-19 outcomes. Electronic medical record data from 391 patients diagnosed with COVID-19 in the COVID-19 Department, Galilee Medical Center, Nahariya, Israel were collected. Epidemiological, clinical, laboratory, and imaging variables were analyzed. The liver and kidney enzyme indexes were measured upon admission and discharge. A correlation between laboratory levels and severity and mortality of COVID-19 patients was undertaken. This study included 391 COVID-19 patients, 258 mild patients and 133 severe patients. Multivariate stepwise regression analyses and discriminant analyses were used to identify and validate powerful predictors. The main outcome was death or invasive ventilation. Three factors, namely higher urea nitrogen (BUN) and IL-6, and lower albumin levels, were the most powerful predictors of mortality, and classified the results (survival vs. death) correctly in 85% of cases (diagnostic accuracy) with a sensitivity of 88% and a specificity 55%. Compared with mild patients, severe patients had lower albumin (ALB), higher alanine aminotransferase (ALT), aspartate aminotransferase (AST) and BUN (all p < 0.001). COVID-19 patients, especially severe patients, have damage to liver and kidney function. BUN, IL-6 and albumin are factors predicting mortality while fibrinogen and AST could be independent factors for predicting the severity of COVID-19. Full article

Introduction: COVID-19, in combination with steroid treatment, is known to propagate hyperglycemia in diabetic patients. The purpose of this study was to establish a new insulin protocol for diabetic patients with COVID-19 on the dexamethasone protocol for better glycemic control. Research Design and Methods: This was a retrospective cohort study conducted at NYU Langone Long Island Hospital from 1 July 2020 to 1 July 2021. Eligible cases had to meet the following inclusion criteria: age of 18 years or greater, history of or new-onset diabetes, diagnosis of COVID-19 and receiving the 10 day dexamethasone treatment, length of stay of at least 3 days with a minimum of 48 h of glucose monitoring, and requiring basal and prandial insulin with correction during hospital stay. Data were collected using the hospital’s electronic record system. The total basal, prandial, and daily doses of insulin on the day at which glycemic control was achieved, or if glycemic control was not achieved by the discharge date, then on the completion date of the dexamethasone treatment, were collected and assessed. Results: A total of 145 patient cases were analyzed. About 46% of patients achieved glycemic control. The average insulin dose required was 0.67 (0.61–0.74) unit/kg. The mean total dose of insulin was 59 units. The mean total basal dose was 21 units. The mean total prandial dose was 38 units. The average prandial doses were higher than the basal doses for all participants. Conclusions: Diabetic patients with COVID-19 on dexamethasone should be initiated on at least 0.6–0.7 u/kg of insulin to achieve glycemic control. Full article

The COVID-19 pandemic prompted global public health restrictions that impacted Canadians in multiple ways. The effects of the pandemic are well examined in specific populations and in researcher-defined areas (e.g., mental health, physical activity, social connections, and financial impacts). Few studies explore the complex perspectives of adults who experienced and were impacted by the pandemic. The purpose of this study was to understand Canadian adults’ perspectives of pandemic impacts over time. Methods: A sample of 347 Canadian adults were recruited during the first six months of the COVID-19 pandemic to respond to open-ended questions about the pandemic’s impacts, administered every two weeks between April 2020 and January 2021. The responses were amalgamated into epochs, defined by dates that paralleled infection rates and public health responses in Canada. Qualitative thematic analysis identified major themes for each epoch and changes in themes over time. Results: The participants predominately reported adverse impacts of the pandemic during each epoch assessed, particularly with respect to mental health, future-oriented worry, activity restrictions, and social, and employment disruptions. Key concerns were potentially driven by changes in infection rates and public health policy changes. Conclusions: The COVID-19 pandemic impacted individuals in predominantly negative and complex ways that varied over time with public health responses. Findings from the present study may direct future pandemic responses to mitigate adverse effects to best prevent infection while preserving wellbeing. Full article