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New Insights into COVID-19: Epidemiology, Prevention, Diagnosis, and Treatment of SARS-CoV-2, and New Variants

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Coronaviruses (CoV) and COVID-19 Pandemic".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 11416

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Dr. Emanuele Amodio

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Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
Interests: public health; epidemiology; infectious diseases; vaccination; vaccine effectiveness; communicable diseases
Special Issues, Collections and Topics in MDPI journals

Dr. Dario Genovese

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Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
Interests: public health; epidemiology; immunology; infectious diseases; vaccination; vaccine effectiveness; communicable diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The coronavirus disease 2019 (COVID-19) has certainly had an incomparable health, social, and economic impact on a global scale. Since its first detection in Wuhan, China, in December 2019, the epidemic spread so rapidly to countries around the world that the World Health Organization (WHO) had to declare the pandemic status a few months later, on 11 March 2020. SARS-CoV-2 infection may determine a broad clinical spectrum that ranges from asymptomatic infection to distinct clinical manifestations, namely asthenia, fever, chills, cough, shortness of breath, sore throat, diarrhea, dysgeusia, loss of appetite, dysosmia, and respiratory symptoms. Much attention was focused on the spread of this viral infection: after several months, it was the advent of COVID-19 vaccines that significantly controlled both the spread and the severity of SARS-CoV-2-infection-related outcomes.

The COVID-19 pandemic, unfortunately, was complicated by SARS-CoV-2 genetic evolution, an adaptive response to human hosts’ defenses that progressively contributed to the selection of different variants. Some of these variants have been defined by the WHO as variants of concern (VOCs) because of their greater transmissibility or virulence and, secondarily, due to the reduced neutralizing activity of the antibodies produced both from natural infection and vaccination. As a result, the effectiveness of COVID-19 vaccines against SARS-CoV-2 infection and COVID-19 may have been altered.

Accordingly, the aim of the Special Issue is to provide an updated scenery of the COVID-19 pandemic, exploring the general epidemiology of this continuously evolving virus, establishing and evaluating disease diagnosis, treatment, and prevention and control strategies, assessing the impact of public health interventions, including communication strategies, inspecting the impact of VOC among SARS-CoV-2 infected subjects, and evaluating the effectiveness over time of COVID-19 vaccines.

We look forward to receiving contributions on these topics.

Dr. Emanuele Amodio
Dr. Dario Genovese
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

COVID-19
coronavirus
SARS-CoV-2
viral infections
pandemic
public health
epidemiology
vaccine effectiveness
variants
variants of concern
long-COVID
diagnosis
testing
prevention
treatment
recovery

Published Papers (8 papers)

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11 pages, 245 KiB

Open AccessArticle

The Impact of COVID-19 Infection on Trauma Patients in South Korea

by Myungjin Jang, Mina Lee, Woosung Choi and Kangkook Choi

Healthcare 2023, 11(23), 3064; https://doi.org/10.3390/healthcare11233064 - 29 Nov 2023

Viewed by 733

Abstract

Background: The COVID-19 pandemic has significantly affected societies worldwide, including the medical healthcare system and trauma care. This study explores the impact of COVID-19 infection on trauma patients in South Korea, a country with effective pandemic management. Methods: A retrospective cohort study of 4206 trauma patients from June 2020 to May 2022 was conducted. Patients were categorized into COVID-19-positive and COVID-19-negative groups. Various clinical parameters, complications, and mortality rates were analyzed. Results: COVID-19-positive patients exhibited higher rates of complications, such as pressure sores (8.8% vs. 2.3%, p < 0.001), surgical site infections (2.4% vs. 0.8%, p = 0.044), and pneumonia (8.8% vs. 4.1%, p = 0.007). There was no significant difference in mortality between COVID-19-positive and -negative groups (4% vs. 5.6%, p = 0.439). Factors influencing mortality included COVID-19 status, age, Glasgow Coma Scale, Injury Severity Score, and transfusion status. Conclusion: COVID-19 positivity may have adverse clinical effects on trauma patients, but the impact varies based on public health factors. Additional studies in different contexts are crucial to elucidate these complexities. Full article

(This article belongs to the Special Issue New Insights into COVID-19: Epidemiology, Prevention, Diagnosis, and Treatment of SARS-CoV-2, and New Variants)

18 pages, 1687 KiB

Open AccessArticle

The Epidemiological Analysis of COVID-19 Outbreaks in Nursing Homes during the Period of Omicron Variant Predominance

by Jeffrey Che-Hung Tsai, Ying-Ying Chang, Chiann-Yi Hsu, Hui-Ju Chen, Feng-Tse Chan and Zhi-Yuan Shi

Healthcare 2023, 11(21), 2868; https://doi.org/10.3390/healthcare11212868 - 31 Oct 2023

Viewed by 858

Abstract

Background: The main purpose of this study was to evaluate the epidemic trend and risk factors associated with COVID-19 outbreaks in nursing homes during the period of Omicron variant predominance. Methods: The study analyzed the risk factors associated with SARS-CoV-2 infection and death among the 327 residents and 129 healthcare workers (HCWs) in three hospital-affiliated nursing homes through a multivariate Cox regression model. Results: The rates of receiving a COVID-19 booster dose were 70.3% for the residents and 93.0% for the healthcare workers (HCWs), respectively. A number of asymptomatic individuals, including 54 (16.5%) residents and 15 (11.6%) HCWs, were detected through mass screening surveillance tests. The COVID-19 infection rates during the outbreaks were 41.6% among residents and 48.1% among HCWs, respectively. The case fatality rate among residents was 10.3%. None of the HCWs were hospitalized or died. The multivariate Cox regression model showed that the risk of COVID-19 infection increased in males (HR 2.46; 95% CI 1.47–4.11; p = 0.001), Barthel index ≥ 61 (HR 1.93; 95% CI 1.18–3.17; p = 0.009), and dementia (HR 1.61; 95% CI 1.14–2.27; p = 0.007). The risk of COVID-19 death increased with pneumonia (HR 11.03; 95% CI 3.02–40.31; p < 0.001), hospitalization (HR 7.18; 95% CI 1.97–26.25; p = 0.003), and admission to an intensive care unit (HR 8.67; 95% CI 2.79–26.89; p < 0.001). Conclusions: This study highlighted the high infection rates with a substantial proportion of asymptomatic infections for both residents and HCWs, as well as a high case fatality rate for the residents among nursing homes during the Omicron epidemic period. We suggest implementing mass screening through regular surveillance testing as an effective strategy for early detection of COVID-19 and for preventing transmission during an epidemic period. Pneumonia is the primary risk associated with COVID-19 death. Early detection and prompt treatment of pneumonia for vulnerable residents in nursing homes are crucial to protect them from potential mortality. Full article

(This article belongs to the Special Issue New Insights into COVID-19: Epidemiology, Prevention, Diagnosis, and Treatment of SARS-CoV-2, and New Variants)

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14 pages, 1104 KiB

Open AccessArticle

Prognostic Value of Routine Biomarkers in the Early Stage of COVID-19

by Andrea Mihajlović, David Ivanov, Borislav Tapavički, Milica Marković, Dragana Vukas, Ana Miljković, Dejana Bajić, Isidora Semnic, Maja Bogdan, Dea Karaba Jakovljević, Stanislava Nikolić, Danijel Slavić and Dajana Lendak

Healthcare 2023, 11(15), 2137; https://doi.org/10.3390/healthcare11152137 - 26 Jul 2023

Viewed by 1033

Abstract

Various biomarkers like certain complete blood cell count parameters and the derived ratios including neutrophil–lymphocyte ratio are commonly used to evaluate disease severity. Our study aimed to establish if baseline levels of complete blood cell count-derived biomarkers and CRP, measured before any treatment which can interfere with their values, could serve as a predictor of development of pneumonia and the need for hospitalization requiring oxygen therapy. We retrospectively analyzed the laboratory data of 200 consecutive patients without comorbidities, who denied usage of medications prior to blood analysis and visited a COVID-19 ambulance between October and December 2021. Multivariate regression analysis extracted older age, elevated CRP and lower eosinophil count as significant independent predictors of pneumonia (p = 0.003, p = 0.000, p = 0.046, respectively). Independent predictors of hospitalization were higher CRP (p = 0.000) and lower platelet count (p = 0.005). There was no significant difference in the neutrophil–lymphocyte and platelet–lymphocyte ratios between examined groups. Individual biomarkers such as platelet and eosinophil count might be better in predicting the severity of COVID-19 than the neutrophil–lymphocyte and platelet–lymphocyte ratios. Full article

(This article belongs to the Special Issue New Insights into COVID-19: Epidemiology, Prevention, Diagnosis, and Treatment of SARS-CoV-2, and New Variants)

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12 pages, 485 KiB

Open AccessArticle

Public Anxiety, Attitudes, and Practices towards COVID-19 Infection in the Eastern Province of Saudi Arabia: A Cross-Sectional Study

by Mahmoud Mohamed Berekaa, Abdulaziz Abdulrahman AlMulla, Munthir Mohammed AlMoslem, Khalid Saif AlSahli, Mohammed Tawfiq AlJassim, Abdulmalik Salman AlSaif and Salman Ali AlQuwayi

Healthcare 2023, 11(14), 2083; https://doi.org/10.3390/healthcare11142083 - 21 Jul 2023

Viewed by 843

Abstract

Coronavirus disease 2019, or COVID-19, still has a terrifying potential due to its continuous genetic variation. Although vaccines have been created, adherence to preventive measures remains a privileged choice to tackle the pandemic. This study aims to investigate the anxiety, attitudes, and practices (KAPs) towards COVID-19 infection in the Eastern Province of Saudi Arabia. In this cross-sectional study, data were collected from 400 participants via an online self-structured questionnaire. Anxiety, attitude, and practice scores were calculated by summing the points of the statements under the corresponding domain multiplied by 100 over 12, 21, or 15, respectively. Chi-square and one-way analysis of variance were used to investigate the relationships between vaccination, anxiety, attitude, practice scores, and demographic characteristics. More than half of the participants were female (58.5%; mean age of 29.5 years; the majority in the age groups of <20 years and 21–30 years). Only 21.5% of the participants were suffering from or previously had chronic diseases. Notably, 22.3% of the male participants were vaccinated (p = 0.000). The old age groups (41–50 years and >50 years) were more vaccinated (16.3% and 24.1%, respectively, p = 0.000), as well as the unemployed (36.4%; p = 0.000). The mean scores of anxiety, attitude, and practice were 66.8, 72.3, and 85.2, respectively. Females had an anxiety score of 68.5% (p = 0.008) and a higher attitude score of 68.5% (p = 0.008). Infected male participants had a lower practice score of 80% (p = 0.038), while females recorded higher practice scores (85.7 ± 11.6). The results highlight the importance of reliable communication from health representatives and legislators in educating the public and promoting their knowledge about non-therapeutic interventions. Efficient intervention approaches are required to fill the gap during the implementation of non-therapeutic measures. Also, it is recommended that awareness programs, during COVID-19 or any other similar pandemics, should be tailored to target Eastern Province inhabitants, especially males. Full article

(This article belongs to the Special Issue New Insights into COVID-19: Epidemiology, Prevention, Diagnosis, and Treatment of SARS-CoV-2, and New Variants)

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16 pages, 857 KiB

Open AccessArticle

Clinical Features and Treatment Outcomes of COVID-19 Admissions in the Can Tho City Hospital of Tuberculosis and Respiratory Diseases, Vietnam: A Hospital-Based Observational Study

by Hung Do Tran, Tran Thanh Hung, Tran Hoang Thuy Phuong, Le Thanh Tam, Hung Gia Tran and Phuoc Huu Le

Healthcare 2023, 11(11), 1632; https://doi.org/10.3390/healthcare11111632 - 02 Jun 2023

Viewed by 1337

Abstract

Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is among the top global health crises. As confirmed by the Vietnam Ministry of Health on 25th January 2023, Vietnam had a cumulative total of more than 11.52 million COVID-19 patients, including 10.61 million recoveries and 43,186 deaths. Objectives: This study aimed to describe the clinical and subclinical characteristics, treatment progress, and outcomes of 310 cases of SARS-CoV-2 infection. Methods: A total of 310 patients with medical records of SARS-CoV-2 were admitted to Can Tho City Hospital of Tuberculosis and Lung Diseases, Can Tho city, Vietnam, between July 2021 and December 2021. Demographic and clinical data, including laboratory examinations, of all the patients were collected and analyzed. Results: The median duration of hospital stay was 16.4 ± 5.3 days. There were 243 (78.4%) patients with clinical symptoms of COVID-19 and 67 (21.6%) patients without clinical symptoms. The common symptoms included cough (71.6% of 310 patients), fever (35.4%), shortness of breath (22.6%), sore throat (21.4%), loss of smell/taste (15.6%), and diarrhea (14.4%). Regarding treatment outcomes, 92.3% of the patients were discharged from the hospital, 1.9% of the patients suffered a more severe illness and were transferred to a higher-level hospital, and 5.8% of the patients died. The RT-PCR results were negative in 55.2% of the patients, and 37.1% of the patients had positive RT-PCR results with Ct values of >30 on the discharge/transfer day. Multivariate logistic regression analyses showed that comorbidity and decreased blood pH were statistically significantly related to the treatment outcomes of the patients with COVID-19 (p < 0.05). Conclusions: This study provides useful information (i.e., the clinical characteristics and treatment outcomes) on the COVID-19 pandemic in Vietnam during its biggest outbreak; the information may be used for reference and for making improvements in the handling of future health crises. Full article

(This article belongs to the Special Issue New Insights into COVID-19: Epidemiology, Prevention, Diagnosis, and Treatment of SARS-CoV-2, and New Variants)

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10 pages, 1306 KiB

Open AccessArticle

Effectiveness of mRNA Vaccine Booster against SARS-CoV-2 Infection and COVID-19 in the Adult Population during the First Three Months of the Omicron Wave in Sicily

by Giuseppe Vella, Dario Genovese, Miriam Belluzzo, Luca Mazzeo, Vincenzo Pisciotta and Emanuele Amodio

Healthcare 2023, 11(3), 305; https://doi.org/10.3390/healthcare11030305 - 19 Jan 2023

Cited by 2 | Viewed by 2108

Abstract

Background: In Italy, the administration of the COVID-19 vaccine booster dose started on 27 September 2021, supported by clinical trials corroborating its efficacy. Given the paucity of real-world effectiveness data, this study aims to estimate the vaccine effectiveness of the booster dose against SARS-CoV-2 infection, severe disease, and death in the adult Sicilian population. Methods: This retrospective cohort study was carried out from 1 January to 31 March 2022 and included all residents in Sicily aged ≥ 18 years without previous SARS-CoV-2 infection and with a complete mRNA vaccine primary cycle. The cohort was split into two groups (booster and primary cycle) matched by age, gender, vaccine type, and month of completion of the primary vaccination cycle. Results: 913,382 subjects were observed in the study: 456,690 (50%) were vaccinated with two doses and 456,692 (50%) with three doses. There were 43,299 cases of SARS-CoV-2 among the two-doses vaccinees (9.5%) and 10,262 (2.2%) among the three-doses counterpart. Vaccine effectiveness in the booster cohort was 76.5% and 74.4% against SARS-CoV-2 infection, 85.7% and 79.7% against severe disease, and 84.1% and 73.1% against intubation or death, for BNT162b2 and mRNA-1273, respectively. Conclusions: This study confirmed the remarkable efficacy profile of the SARS-CoV-2 vaccine booster dose against infection, severe disease, and death attributable to the virus. Overall, the results of this study provide important real-world data to support the continued roll-out of the COVID-19 booster dose and have the potential to inform public health policy and guide decisions on vaccination strategies in countries around the world. Full article

(This article belongs to the Special Issue New Insights into COVID-19: Epidemiology, Prevention, Diagnosis, and Treatment of SARS-CoV-2, and New Variants)

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14 pages, 294 KiB

Open AccessArticle

Evaluation of 34 Cytokines and Vitamin D Status Reveal A Sexually-Dimorphic Active Immune Response to SARS-CoV-2

by Osama E. Amer, Shaun Sabico, Eman Sheshah, Naif H Alotaibi, Dara A. Aldisi, Mushira A. Enani, Naji J. Aljohani, Naemah Alshingetti, Suliman Y. Alomar, Syed D. Hussain, Abdullah M. Alnaami, Mohamed A. Elsaid and Nasser M. Al-Daghri

Healthcare 2022, 10(12), 2571; https://doi.org/10.3390/healthcare10122571 - 19 Dec 2022

Cited by 4 | Viewed by 1594

Abstract

Background: Several observational studies have inconsistently demonstrated that vitamin D deficiency is a risk factor for coronavirus disease-19 (COVID-19) infection and severity. Discrepancies in results may partially be explained by the individuals’ immune profiles, which are modulated, in varying degrees, by vitamin D status and sex hormones. Methods: In this study we evaluated the differences and associations of serum levels of 25(OH)D with 34 cytokines in 220 adults (82 controls (41 males; 41 females) and 138 SARS-CoV-2 patients (79 males and 59 females)) with and without COVID-19. Results: Serum 25(OH)D levels were significantly lower in the SARS-CoV-2 group than in the controls. Serum IP-10, MCP-1, CRP, IFNγ, IL-10, IL-13, IL-17α, IL-23, and IL-6 were significantly higher in COVID-19 patients compared to controls. Serum levels of VEGF, IFNγ, IL-13, and IL-5 were significantly higher in male patients than in females. 25(OH)D was significantly correlated with EFG (R = 0.39, p < 0.05) and IL-15 (R = 0.39, p < 0.05) in male patients, while it was inversely correlated with CRP (R = −0.51, p < 0.05) in female patients. Conclusions: Altered levels of cytokines, chemokines, and vitamin D were observed in SARS-CoV-2 adult patients. These expressions were sexually dimorphic and thus highlight the sex-specific nature of the active immune response following SARS-CoV-2 infection. Full article

(This article belongs to the Special Issue New Insights into COVID-19: Epidemiology, Prevention, Diagnosis, and Treatment of SARS-CoV-2, and New Variants)

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16 pages, 1521 KiB

Open AccessSystematic Review

Environmental Factors Influencing the Dynamics and Evolution of COVID-19: A Systematic Review on the Study of Short-Term Ozone Exposure

by Irina-Maria Popescu, Luminita Mirela Baditoiu, Sandhya Rani Reddy, Akhila Nalla, Emilian Damian Popovici, Madalin-Marius Margan, Mariana Anghel, Sorina Maria Denisa Laitin, Ana-Olivia Toma, Alexandra Herlo, Roxana Manuela Fericean, Nina Baghina and Andrei Anghel

Healthcare 2023, 11(19), 2670; https://doi.org/10.3390/healthcare11192670 - 01 Oct 2023

Cited by 1 | Viewed by 882

Abstract

The potential influence of environmental factors, particularly air pollutants such as ozone (O₃), on the dynamics and progression of COVID-19 remains a significant concern. This study aimed to systematically review and analyze the current body of literature to assess the impact of short-term ozone exposure on COVID-19 transmission dynamics and disease evolution. A rigorous systematic review was conducted in March 2023, covering studies from January 2020 to January 2023 found in PubMed, Web of Science, and Scopus. We followed the PRISMA guidelines and PROSPERO criteria, focusing exclusively on the effects of short-term ozone exposure on COVID-19. The literature search was restricted to English-language journal articles, with the inclusion and exclusion criteria strictly adhered to. Out of 4674 identified studies, 18 fulfilled the inclusion criteria, conducted across eight countries. The findings showed a varied association between short-term ozone exposure and COVID-19 incidence, severity, and mortality. Some studies reported a higher association between ozone exposure and incidence in institutional settings (OR: 1.06, 95% CI: 1.00–1.13) compared to the general population (OR: 1.00, 95% CI: 0.98–1.03). The present research identified a positive association between ozone exposure and both total and active COVID-19 cases as well as related deaths (coefficient for cases: 0.214; for recoveries: 0.216; for active cases: 0.467; for deaths: 0.215). Other studies also found positive associations between ozone levels and COVID-19 cases and deaths, while fewer reports identified a negative association between ozone exposure and COVID-19 incidence (coefficient: −0.187) and mortality (coefficient: −0.215). Conversely, some studies found no significant association between ozone exposure and COVID-19, suggesting a complex and potentially region-specific relationship. The relationship between short-term ozone exposure and COVID-19 dynamics is complex and multifaceted, indicating both positive and negative associations. These variations are possibly due to demographic and regional factors. Further research is necessary to bridge current knowledge gaps, especially considering the potential influence of short-term O₃ exposure on COVID-19 outcomes and the broader implications on public health policy and preventive strategies during pandemics. Full article

(This article belongs to the Special Issue New Insights into COVID-19: Epidemiology, Prevention, Diagnosis, and Treatment of SARS-CoV-2, and New Variants)

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