COVID

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

The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19 vaccination uptake and hesitancy and its associated factors among HCWs in Tanzania. We employed a convergent-parallel mixed-methods design among 1368 HCWs across health facilities in seven geographical zones in Tanzania in 2021. We collected quantitative data by using an interviewer-administered questionnaire and qualitative data, using in-depth interviews and focus group discussions. Participants in the quantitative aspect were conveniently selected whereas those in the qualitative aspect were purposively selected based on their role in patient care, management, and vaccine provision. Stata software version 16.1 was used in the analysis of quantitative data and thematic analysis for the qualitative data. Multiple logistic regression was used to assess the determinants of COVID-19 vaccine uptake. The median age of 1368 HCWs was 33, and the interquartile range was 28–43 years; 65.6% were aged 30+ years, and 60.1% were females. Over half (53.4%) of all HCWs received the COVID-19 vaccine, 33.6% completely refused, and 13% chose to wait. HCWs aged 40+ years, from lower-level facilities (district hospitals and health centers), who worked 6+ years, and with perceived high/very high risk of COVID-19 infection had significantly higher odds of vaccine uptake. The qualitative data revealed misinformation and inadequate knowledge about COVID-19 vaccine safety and efficacy as the key barriers to uptake. Nearly half of all HCWs in Tanzania are still unvaccinated against COVID-19. The predominance of contextual influence on COVID-19 vaccine uptake calls for interventions to focus on addressing contextual determinants, focusing on younger HCWs’ population, short working duration, those working at different facility levels, and providing adequate vaccine knowledge. Full article

Background: Stress and depression are common mental health concerns among college students. Factors related to weight status and stigma are associated with poor mental health outcomes. We sought to describe the prevalence of weight dissatisfaction in relation to stress and depression among college students (n = 551). Methods: A cross-sectional study was conducted via a convenient sample between December 2020 and February 2021. Mean differences in the Perceived Stress Scale-10 scores and Center for Epidemiologic Studies Depression Scale scores were examined using a one-way analysis of variance. Associations between stress, depression, and weight dissatisfaction were measured by logistic regression. Results: Weight dissatisfied (75.1%) students had significantly higher mean depression scores compared to weight satisfied. The weight dissatisfied students were 1.05 times more likely to be depressed compared to those who were weight satisfied. Significant mean differences in stress and/or depression were found for weight dissatisfied students by gender, race, parental status, marital status, residence, and U.S. citizenship. Weight dissatisfaction was higher than that reported in the literature, possibly due to the influence of social isolation during the COVID-19 pandemic. Conclusions: Strategies to reduce the prevalence of weight dissatisfaction for improved mental health should be explored, particularly efforts to reduce weight stigmatization and expand access to mental health care. Full article

The occurrence of breakthrough infections with SARS-CoV-2 in vaccinated individuals argues against abandoning mitigation efforts such as social distancing. Some public health messages, however, promote vaccination by increasing psychological distress, which interferes with social distancing. Prosocial messages present an alternative approach that may avoid this problem. Accordingly, the present study examined the relation of pandemic mitigation with scores on prosocial personality traits (i.e., altruism, sympathy, and trust) and vaccination intentions. Regression analyses indicated that while vaccination intentions increased significantly with an increase in trust, distancing increased significantly with increases in altruism and sympathy. Because older adults are much more vulnerable to COVID-19 than younger adults, these findings reveal an altruistic paradox, in which older adults, perhaps the most altruistic portion of the population, may be dependent on the altruistic behavior of younger adults, who may be the least altruistic portion. The challenge for public health messaging will be to motivate younger adults to take the consequences of their mitigation decisions for others into account. Full article

1. Background: Some reports have suggested that as many as one-half of all hospital inpatients identified as COVID-19-positive during the Omicron BA.1 variant-driven wave were incidental cases admitted primarily for reasons other than their viral infections. To date, however, there are no prospective longitudinal studies of a representative panel of hospitals based on pre-established criteria for determining whether a patient was, in fact, admitted as a result of the disease. 2. Materials and Methods: To fill this gap, we developed a formula to estimate the fraction of incidental COVID-19 hospitalizations that relies on measurable, population-based parameters. We applied our approach to a longitudinal panel of 164 counties throughout the United States, covering a 4-week interval ending in the first week of January 2022. 3. Results: Within this panel, we estimated that COVID-19 incidence was rising exponentially at a rate of 9.34% per day (95% CI, 8.93–9.87). Assuming that only one-quarter of all Omicron BA.1 infections had been reported by public authorities, we further estimated the aggregate prevalence of active SARS-CoV-2 infection during the first week of January to be 3.45%. During the same week, among 250 high-COVID-volume hospitals within our 164-county panel, an estimated one in four inpatients was COVID-positive. Based upon these estimates, we computed that 10.6% of such COVID-19-positive hospitalized patients were incidental infections. Across individual counties, the median fraction of incidental COVID-19 hospitalizations was 9.5%, with an interquartile range of 6.7 to 12.7%. 4. Conclusion: Incidental COVID-19 infections appear to have been a nontrivial fraction of all COVID-19-positive hospitalized patients during the Omicron BA.1 wave. In the aggregate, however, the burden of patients admitted for complications of their viral infections was far greater. Full article

In the context of new therapeutic protocols and vaccines developed in the past 3 years, coronavirus 2019 (COVID-19) continues to exert an important impact on the healthcare systems worldwide. Age and a history of cardiovascular or respiratory diseases remain relevant in terms of prognosis for all COVID-19 patients, independent of the viral strain, by conveying a worse outcome and increased rates of in-hospital mortality. Previous studies reported heterogenous cardiovascular manifestations in COVID-19 patients from acute myocarditis or myopericarditis, acute coronary syndromes, stress cardiomyopathy, de novo arrhythmias to pulmonary embolism, or in some rare cases, endocarditis. In this review, we assessed the potential acute, in-hospital and long-term cardiac complications in patients diagnosed with COVID-19. Full article

Introduction: The Coronavirus disease of 2019 (COVID-19) is a catastrophic emerging global health threat caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has a wide range of complications and sequelae. It is devastating in developing countries, causing serious health and socioeconomic crises as a result of the increasingly overburdened healthcare system. This study was conducted to determine the prevalence of SARS-CoV-2 infection in Ethiopia. Methods: Electronic databases, such as PubMed, Google Scholar, Web of Science, Research Gate, Embase, and Scopus were thoroughly searched from March to April 2022 to identify relevant studies. The quality of the included studies was evaluated using the Newcastle-Ottawa Quality scale for cross-sectional studies. STATA-12 was used for analysis. A random-effects model was used to compute the pooled prevalence of SARS-CoV-2 infection. The heterogeneity was quantified by using the I² value. Subgroup analysis was done for sex, age of study subjects, population type, diagnostic methods, and publication year. Publication bias was assessed using a funnel plot and Egger’s test. A sensitivity analysis was also done. Result: 11 studies consisting of 35,376 study participants (15,759 male and 19,838 female) were included in this systematic review and meta-analysis. The pooled prevalence of SARS-CoV-2 was 8.83%. There was substantial heterogeneity, with an I² value of 99.3%. The pooled prevalence of SARS-CoV-2 was higher in males (9.27%) than in females (8.8%). According to the publication year, a higher prevalence was obtained in 2021 (12.69%). Similarly, it was higher in the population of specific groups (16.65%) than in the general population (5.75%). Conclusion: the national pooled prevalence of SARS-CoV-2 infection in the Ethiopian population was 8.83%. This indicates that the burden of COVID-19 is still high, which urges routine screening and appropriate treatment. Full article

Vaccines have been identified as a crucial strategy to control the spread of COVID-19 and reduce its impact. However, there are concerns about the acceptance of vaccines within African, Caribbean, and Black (ACB) communities. Based on a community sample of ACB people in Ottawa, Ontario (n = 375), the current study aimed to use logistic regression analysis and identify factors associated with COVID-19 vaccine willingness. A multivariate analysis shows that ACB people who believed that the ACB population is at a higher risk for COVID-19 were more likely to be willing to receive the vaccine compared to those who did not (OR = 1.79, p < 0.05). ACB people who had received at least one dose of the COVID-19 vaccine were more likely to be willing to receive it in the future (OR = 2.75, p < 0.05), and trust in government COVID-19 information was also positively associated with vaccine willingness (OR = 3.73, p < 0.01). In addition, English-speaking respondents were more willing to receive the vaccine compared to French-speaking respondents (OR = 3.21, p < 0.01). In terms of socioeconomic status, ACB people with a post-graduate degree (OR = 2.21, p < 0.05) were more likely to report vaccine willingness compared to those without a bachelor’s degree. Based on these findings, we discuss implications for policymakers and directions for future research. Full article

(1) Background: Data on COVID-19 outcomes and disease course as a function of different medications used to treat cardiovascular disease and chronic kidney disease (CKD), as well as the presence of different comorbidities in primarily Black cohorts, are lacking. (2) Methods: We conducted a retrospective medical chart review on 327 patients (62.6% Black race) who were admitted to the Detroit Medical Center, Detroit, MI. Group differences (CKD vs. non-CKD) were compared using the Pearson χ² test. We conducted univariate and multivariate regression analyses for factors contributing to death during hospitalization due to COVID-19 (primary outcome) and ICU admission (secondary outcome), adjusting for age, sex, different medications, and comorbidities. A sub-analysis was also completed for CKD patients. (3) Results: In the fully adjusted model, a protective effect of ACEi alone, but not in combination with ARB or CCB, for ICU admission was found (OR = 0.400, 95% CI [0.183–0.874]). Heart failure was significantly associated with the primary outcome (OR = 4.088, 95% CI [1.1661–14.387]), as was COPD (OR = 3.747, 95% CI [1.591–8.828]). (4) Conclusions: Therapeutic strategies for cardiovascular disease and CKD in the milieu of different comorbidities may need to be tailored more prudently for individuals with COVID-19, especially Black individuals. Full article

Accurate prediction of SARS-CoV-2 infection based on symptoms can be a cost-efficient tool for remote screening in healthcare settings with limited SARS-CoV-2 testing capacity. We used a machine learning approach to determine self-reported symptoms that best predict a positive SARS-CoV-2 test result in physician trainees from a large healthcare system in New York. We used survey data on symptoms history and SARS-CoV-2 testing results collected retrospectively from 328 physician trainees in the Mount Sinai Health System, over the period 1 February 2020 to 31 July 2020. Prospective data on symptoms reported prior to SARS-CoV-2 test results were available from the employee health service COVID-19 registry for 186 trainees and analyzed to confirm absence of recall bias. We estimated the associations between symptoms and IgG antibody and/or reverse transcriptase polymerase chain reaction test results using Bayesian generalized linear mixed effect regression models adjusted for confounders. We identified symptoms predicting a positive SARS-CoV-2 test result using extreme gradient boosting (XGBoost). Cough, chills, fever, fatigue, myalgia, headache, shortness of breath, diarrhea, nausea/vomiting, loss of smell, loss of taste, malaise and runny nose were associated with a positive SARS-CoV-2 test result. Loss of taste, myalgia, loss of smell, cough and fever were identified as key predictors for a positive SARS-CoV-2 test result in the XGBoost model. Inclusion of sociodemographic and occupational risk factors in the model improved prediction only slightly (from AUC = 0.822 to AUC = 0.838). Loss of taste, myalgia, loss of smell, cough and fever are key predictors for symptom-based screening of SARS-CoV-2 infection in healthcare settings with remote screening and/or limited testing capacity. Full article

Evusheld is a combination injection of tixagevimab and cilgavimab and is indicated for the pre-exposure prophylaxis of COVID-19 in adults and adolescents aged 12 years and older. Its use has been advocated for immunosuppressed individuals, such as blood cancer patients, although uptake varies significantly between countries. Despite extensive use internationally, there has been limited analysis of potential psychological benefits that vulnerable patients might gain from receiving this prophylactic medication. In this study we have quantified four key psychological health parameters in blood cancer patients who received Evusheld (EQ5D-3L quality of life score, DSM5 Agoraphobia score, Duke’s Social Support Index and the hospital anxiety and depression score) and compared their responses with a control group of patients who did not receive Evusheld. We show that patients who opted for treatment had higher baseline markers of psychological stress and ill-health compared with non-treated individuals but that treatment with Evusheld significantly improved the psychological health of recipients and increased the level of physical social/work interactions over that of control patients. Although there are limitations with this small study, the findings strongly suggest that Evusheld prophylaxis can provide significant psychological benefits for vulnerable blood cancer patients who have significant anxiety about COVID-19 infection. Full article

COVID-19 is an infectious disease caused by SARS-CoV-2. This virus presents high levels of mutation and transmissibility, which contributed to the emergence of the pandemic. Our study aimed to analyze, in silico, the genomic diversity of SARS-CoV-2 strains in Bahia State by comparing patterns in variability of strains circulating in Brazil with the first isolated strain NC_045512 (reference sequence). Genomes were collected using GISAID, and subsequently aligned and compared using structural and functional genomic annotation. A total of 744 genomes were selected, and 20,773 mutations were found, most of which were of the SNP type. Most of the samples presented low mutational impact, and of the samples, the P.1 (360) lineage possessed the highest prevalence. The most prevalent epitopes were associated with the ORF1ab protein, and in addition to P.1, twenty-one other lineages were also detected during the study period, notably B.1.1.33 (78). The phylogenetic tree revealed that SARS-CoV-2 variants isolated from Bahia were clustered closely together. It is expected that the data collected will help provide a better epidemiological understanding of the COVID-19 pandemic (especially in Bahia), as well as helping to develop more effective vaccines that allow less immunogenic escape. Full article

To verify the role played by burnout in the prediction of alcohol consumption, considering the integration of the theory of job demands-resources (JD-R) and sociocognitive theory (SCT), we developed an analytical model in which self-efficacy and depression act as mediators of this relationship. A cross-sectional online survey was taken by 3856 workers enrolled in various public agencies of the Mexican Health Ministry during the COVID-19 pandemic in Mexico. The results indicate that of the three dimensions of burnout, only depersonalization predicts alcohol consumption; however, self-efficacy regulates the effect of emotional exhaustion and achievement dissatisfaction on alcohol consumption. Similarly, the three components of burnout have indirect effects through depression, suggesting that depression and self-efficacy mediate the relationship between burnout and alcohol consumption. Burnout alone cannot explain alcohol consumption, but when depression is present, burnout increases the predisposition to consume alcohol; when self-efficacy is present, the probability of alcohol consumption decreases. Full article

In developing in vitro diagnostic (IVD) tests, in particular at-home/over-the-counter (OTC) tests, one of the generally accepted exclusion criteria in IVD clinical trial protocols has been that of subjects with prior knowledge of their positive status, due to potential bias. With COVID-19 antigen tests now widely available, it is common for individuals to test themselves at home with an antigen test if they have symptoms associated with COVID-19, flu, or the common cold. These subjects would be excluded from participation in COVID-19-related clinical trials (i.e., COVID-19 alone or any multiplex tests that include COVID-19). This study compiled the results of four clinical trials to assesses whether potential bias (positive or negative) exists in at-home antigen COVID-19 testing if someone has a prior diagnostic COVID-19 result. The results clearly demonstrated that knowledge of prior COVID-19 diagnostic results did not affect the accuracy of the test result interpretations nor the clinical performance of the at-home antigen test products. This is an important finding that supports the inclusion of these subjects in future COVID-19 diagnostic clinical trials and the FDA’s recommendation of serial antigen testing to improve antigen test performance. Full article