Fighting against COVID-19: Latest Advances, Challenges and Methodologies

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Biomedicines biomedicines	4.7	3.7	2013	15.4 Days	CHF 2600
Diagnostics diagnostics	3.6	3.6	2011	20.7 Days	CHF 2600
International Journal of Environmental Research and Public Health ijerph	-	5.4	2004	29.6 Days	CHF 2500
Journal of Clinical Medicine jcm	3.9	5.4	2012	17.9 Days	CHF 2600
Journal of Imaging jimaging	3.2	4.4	2015	21.7 Days	CHF 1800

21 pages, 5195 KiB

Open AccessArticle

Wastewater Monitoring for Infectious Disease: Intentional Relationships between Academia, the Private Sector, and Local Health Departments for Public Health Preparedness

by Jeffrey L. Ram, William Shuster, Lance Gable, Carrie L. Turner, James Hartrick, Adrian A. Vasquez, Nicholas W. West, Azadeh Bahmani and Randy E. David

Int. J. Environ. Res. Public Health 2023, 20(17), 6651; https://doi.org/10.3390/ijerph20176651 - 25 Aug 2023

Cited by 1 | Viewed by 1322

Abstract

The public health emergency caused by the COVID-19 pandemic stimulated stakeholders from diverse disciplines and institutions to establish new collaborations to produce informed public health responses to the disease. Wastewater-based epidemiology for COVID-19 grew quickly during the pandemic and required the rapid implementation [...] Read more.

The public health emergency caused by the COVID-19 pandemic stimulated stakeholders from diverse disciplines and institutions to establish new collaborations to produce informed public health responses to the disease. Wastewater-based epidemiology for COVID-19 grew quickly during the pandemic and required the rapid implementation of such collaborations. The objective of this article is to describe the challenges and results of new relationships developed in Detroit, MI, USA among a medical school and an engineering college at an academic institution (Wayne State University), the local health department (Detroit Health Department), and an environmental services company (LimnoTech) to utilize markers of the COVID-19 virus, SARS-CoV-2, in wastewater for the goal of managing COVID-19 outbreaks. Our collaborative team resolved questions related to sewershed selection, communication of results, and public health responses and addressed technical challenges that included ground-truthing the sewer maps, overcoming supply chain issues, improving the speed and sensitivity of measurements, and training new personnel to deal with a new disease under pandemic conditions. Recognition of our complementary roles and clear communication among the partners enabled city-wide wastewater data to inform public health responses within a few months of the availability of funding in 2020, and to make improvements in sensitivity and understanding to be made as the pandemic progressed and evolved. As a result, the outbreaks of COVID-19 in Detroit in fall and winter 2021–2022 (corresponding to Delta and Omicron variant outbreaks) were tracked in 20 sewersheds. Data comparing community- and hospital-associated sewersheds indicate a one- to two-week advance warning in the community of subsequent peaks in viral markers in hospital sewersheds. The new institutional relationships impelled by the pandemic provide a good basis for continuing collaborations to utilize wastewater-based human and pathogen data for improving the public health in the future. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 312 KiB

Open AccessReview

Principles of Rational COVID-19 Therapy in Pediatrics

by Oksana D. Nemyatykh, Marina A. Maistrenko, Dina D. Demchenko, Igor A. Narkevich, Sergey V. Okovityi and Vladimir N. Timchenko

J. Clin. Med. 2023, 12(14), 4731; https://doi.org/10.3390/jcm12144731 - 17 Jul 2023

Cited by 1 | Viewed by 820

Abstract

The purpose of this review was to conduct a comparative assessment of the concepts of therapy for pediatric patients with COVID-19 in the framework of global clinical practice. A structural analysis of the range of drugs and treatment strategies in the context of [...] Read more.

The purpose of this review was to conduct a comparative assessment of the concepts of therapy for pediatric patients with COVID-19 in the framework of global clinical practice. A structural analysis of the range of drugs and treatment strategies in the context of etiotropic, pathogenetic, and symptomatic therapy has shown that in the global context and in real clinical practice, the etiotropic-pathogenetic approach based on information about the effectiveness of individual medical technologies prevails today. It has been established that eight international nonproprietary/grouping names are present in international practice as means of etiotropic therapy for pediatric patients with COVID-19, and 18 positions are used for pathogenetic therapy. In terms of frequency of occurrence, the leading positions are occupied by remdesivir and the combination of nirmatrelvir with ritonavir, as well as dexamethasone and tocilizumab. The paper emphasizes the relevance of research in the field of evaluating the effectiveness of individual treatment regimens as well as the analysis of the delayed consequences of pathology suffered in childhood under the conditions of using various approaches to pharmacotherapy. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

14 pages, 3162 KiB

Open AccessArticle

Transformative Effect of COVID-19 Pandemic on Magnetic Resonance Imaging Services in One Tertiary Cardiovascular Center

by Tatiana A. Shelkovnikova, Aleksandra S. Maksimova, Nadezhda I. Ryumshina, Olga V. Mochula, Valery K. Vaizov, Wladimir Y. Ussov and Nina D. Anfinogenova

J. Imaging 2023, 9(6), 108; https://doi.org/10.3390/jimaging9060108 - 28 May 2023

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Abstract

The aim of study was to investigate the transformative effect of the COVID-19 pandemic on magnetic resonance imaging (MRI) services in one tertiary cardiovascular center. The retrospective observational cohort study analyzed data of MRI studies (n = 8137) performed from 1 January [...] Read more.

The aim of study was to investigate the transformative effect of the COVID-19 pandemic on magnetic resonance imaging (MRI) services in one tertiary cardiovascular center. The retrospective observational cohort study analyzed data of MRI studies (n = 8137) performed from 1 January 2019 to 1 June 2022. A total of 987 patients underwent contrast-enhanced cardiac MRI (CE-CMR). Referrals, clinical characteristics, diagnosis, gender, age, past COVID-19, MRI study protocols, and MRI data were analyzed. The annual absolute numbers and rates of CE-CMR procedures in our center significantly increased from 2019 to 2022 (p-value < 0.05). The increasing temporal trends were observed in hypertrophic cardiomyopathy (HCMP) and myocardial fibrosis (p-value < 0.05). The CE-CMR findings of myocarditis, acute myocardial infarction, ischemic cardiomyopathy, HCMP, postinfarction cardiosclerosis, and focal myocardial fibrosis prevailed in men compared with the corresponding values in women during the pandemic (p-value < 0.05). The frequency of myocardial fibrosis occurrence increased from ~67% in 2019 to ~84% in 2022 (p-value < 0.05). The COVID-19 pandemic increased the need for MRI and CE-CMR. Patients with a history of COVID-19 had persistent and newly occurring symptoms of myocardial damage, suggesting chronic cardiac involvement consistent with long COVID-19 requiring continuous follow-up. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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23 pages, 10493 KiB

Open AccessArticle

Multiscale Geographically Weighted Regression in the Investigation of Local COVID-19 Anomalies Based on Population Age Structure in Poland

by Mateusz Ciski and Krzysztof Rząsa

Int. J. Environ. Res. Public Health 2023, 20(10), 5875; https://doi.org/10.3390/ijerph20105875 - 19 May 2023

Cited by 1 | Viewed by 1565

Abstract

A growing number of various studies focusing on different aspects of the COVID-19 pandemic are emerging as the pandemic continues. Three variables that are most commonly used to describe the course of the COVID-19 pandemic worldwide are the number of confirmed SARS-CoV-2 cases, [...] Read more.

A growing number of various studies focusing on different aspects of the COVID-19 pandemic are emerging as the pandemic continues. Three variables that are most commonly used to describe the course of the COVID-19 pandemic worldwide are the number of confirmed SARS-CoV-2 cases, the number of confirmed COVID-19 deaths, and the number of COVID-19 vaccine doses administered. In this paper, using the multiscale geographically weighted regression, an analysis of the interrelationships between the number of confirmed SARS-CoV-2 cases, the number of confirmed COVID-19 deaths, and the number of COVID-19 vaccine doses administered were conducted. Furthermore, using maps of the local R² estimates, it was possible to visualize how the relations between the explanatory variables and the dependent variables vary across the study area. Thus, analysis of the influence of demographic factors described by the age structure and gender breakdown of the population over the course of the COVID-19 pandemic was performed. This allowed the identification of local anomalies in the course of the COVID-19 pandemic. Analyses were carried out for the area of Poland. The results obtained may be useful for local authorities in developing strategies to further counter the pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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19 pages, 898 KiB

Open AccessArticle

Evaluating Community Capability to Prevent and Control COVID-19 Pandemic in Shenyang, China: An Empirical Study Based on a Modified Framework of Community Readiness Model

by Xiaojie Zhang, Xiaoyu Liu and Lili Wang

Int. J. Environ. Res. Public Health 2023, 20(5), 3996; https://doi.org/10.3390/ijerph20053996 - 23 Feb 2023

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Abstract

Community plays a crucial role in the successful prevention and control of the COVID-19 pandemic in China. However, evaluation of community capability to fight against COVID-19 is rarely reported. The present study provides a first attempt to assess community capability to combat COVID-19 [...] Read more.

Community plays a crucial role in the successful prevention and control of the COVID-19 pandemic in China. However, evaluation of community capability to fight against COVID-19 is rarely reported. The present study provides a first attempt to assess community capability to combat COVID-19 in Shenyang, the capital city of Liaoning province in Northeast China, based on a modified framework of a community readiness model. We conducted semi-structured interviews with ninety key informants from fifteen randomly selected urban communities to collect the data. The empirical results indicate that the overall level of community capability for epidemic prevention and control in Shenyang was at the stage of preparation. The specific levels of the fifteen communities ranged from the stages of preplanning to preparation to initiation. Concerning the level of each dimension, community knowledge about the issue, leadership, and community attachment exhibited significant disparities between communities, while there were slight differences among communities on community efforts, community knowledge of efforts, and community resources. In addition, leadership demonstrated the highest overall level among all the six dimensions, followed by community attachment and community knowledge of efforts. Community resources displayed the lowest level, followed by community efforts. This study not only extends the application of the modified community readiness model to evaluate community capability of epidemic prevention in the Chinese community context, but also offers practical implications for enhancing Chinese communities’ capabilities to deal with various future public health emergencies. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 1925 KiB

Open AccessArticle

Seroprevalence of Anti-SARS-CoV-2 Antibodies Following the Omicron BA.1 Wave

by Maja Socan, Katarina Prosenc and Maja Mrzel

Int. J. Environ. Res. Public Health 2023, 20(4), 3665; https://doi.org/10.3390/ijerph20043665 - 18 Feb 2023

Cited by 5 | Viewed by 1558

Abstract

We conducted a seroprevalence study using convenient residual sera samples from the Slovenian population collected after the end of the Omicron BA.1 pandemic wave. Serum samples were tested for spike glycoprotein (anti-S) and nucleocapsid protein (anti-N) antibodies. Participants’ data regarding confirmed infection and [...] Read more.

We conducted a seroprevalence study using convenient residual sera samples from the Slovenian population collected after the end of the Omicron BA.1 pandemic wave. Serum samples were tested for spike glycoprotein (anti-S) and nucleocapsid protein (anti-N) antibodies. Participants’ data regarding confirmed infection and vaccination was obtained from national registries. Anti-S antibodies were detected in 2439 (84.1%) of 2899 sera from persons aged 0–90 years, with the lowest prevalence in the 0–17 age group. The proportion of anti-N positives was the lowest in the ≥70 age group. The proportion of anti-N positives was significantly higher among participants with confirmed past infection and among those who had never been vaccinated. In participants who had not been notified as infected and who had never been vaccinated, the seroprevalence of anti-S and anti-N antibodies was 53% and 35.5%, respectively. From the time of serum collection to mid-November 2022, 445 participants (15.3%) tested positive for SARS-CoV-2, with higher odds in seronegative participants, participants in the 40–59 age group, and those without notified previous infection. Vaccination status and gender had no significant effects on infection risk. This study underlines the importance of serosurveys in understanding the development of the pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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8 pages, 1454 KiB

Open AccessArticle

Pleural Effusion in COVID-19 Pneumonia: Clinical and Prognostic Implications—An Observational, Retrospective Study

by Sara Cappelli, Elisabetta Casto, Marta Lomi, Alessandra Pagano, Luciano Gabbrielli, Roberta Pancani, Ferruccio Aquilini, Giulia Gemignani, Laura Carrozzi and Alessandro Celi

J. Clin. Med. 2023, 12(3), 1049; https://doi.org/10.3390/jcm12031049 - 29 Jan 2023

Cited by 2 | Viewed by 2361

Abstract

Background: COVID-19 presents with a wide spectrum of clinical and radiological manifestations, including pleural effusion. The prevalence and prognostic impact of pleural effusion are still not entirely clear. Patients and methods: This is a retrospective, single-center study including a population of consecutive patients [...] Read more.

Background: COVID-19 presents with a wide spectrum of clinical and radiological manifestations, including pleural effusion. The prevalence and prognostic impact of pleural effusion are still not entirely clear. Patients and methods: This is a retrospective, single-center study including a population of consecutive patients admitted to the University Hospital of Cisanello (Pisa) from March 2020 to January 2021 with a positive SARS-CoV-2 nasopharyngeal swab and SARS-CoV-2-related pneumonia. The patients were divided into two populations based on the presence (n = 150) or absence (n = 515) of pleural effusion on chest CT scan, excluding patients with pre-existing pleural effusion. We collected laboratory data (hemoglobin, leukocytes, platelets, C-reactive protein, procalcitonin), worst PaO₂/FiO₂ ratio as an index of respiratory gas exchange impairment, the extent of interstitial involvement related to SARS-CoV-2 pneumonia and data on intensity of care, length of stay and outcome (discharge or death). Results: The prevalence of pleural effusion was 23%. Patients with pleural effusion showed worse gas exchange (p < 0.001), longer average hospital stay (p < 0.001), need for more health care resources (p < 0.001) and higher mortality (p < 0.001) compared to patients without pleural effusion. By multivariate analysis, pleural effusion was found to be an independent negative prognostic factor compared with other variables such as increased C-reactive protein, greater extent of pneumonia and older age. Pleural effusion was present at the first CT scan in most patients (68%). Conclusions: Pleural effusion associated with SARS-CoV-2 pneumonia is a relatively frequent finding that is confirmed to be a negative prognostic factor. Identifying early prognostic factors in an endemic-prone disease such as COVID-19 is necessary to optimize its clinical management. Further clinical studies aimed at better characterizing pleural effusion in these patients will be appropriate in order to clarify its pathogenetic role. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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21 pages, 1838 KiB

Open AccessArticle

T Cells Immunophenotyping and CD38 Overexpression as Hallmarks of the Severity of COVID-19 and Predictors of Patients’ Outcomes

by Nesrin I. Tarbiah, Nuha A. Alkhattabi, Abdullah J. Alsahafi, Hani S. Aljahdali, Husam M. Joharjy, Maryam H. Al-Zahrani, Aliaa M. Sabban, Rana A. Alghamdi, Maha J. Balgoon and Reham A. Khalifa

J. Clin. Med. 2023, 12(2), 710; https://doi.org/10.3390/jcm12020710 - 16 Jan 2023

Cited by 2 | Viewed by 2069

Abstract

Background: By the end of 2019, the COVID-19 pandemic spread all around the world with a wide spectrum of clinical presentations ranging from mild to moderate to severe or critical cases. T cell subtype dysregulation is mostly involved in the immunopathogenic mechanism. The [...] Read more.

Background: By the end of 2019, the COVID-19 pandemic spread all around the world with a wide spectrum of clinical presentations ranging from mild to moderate to severe or critical cases. T cell subtype dysregulation is mostly involved in the immunopathogenic mechanism. The present study aimed to highlight the role of monitoring T cell subtypes and their activation (expression of CD38) in COVID-19 patients compared to healthy subjects and their role in predicting severity and patients’ outcomes. Materials: The study involved 70 adult COVID-19 confirmed cases stratified into three groups: a mild/asymptomatic group, a clinically moderate group, and a clinically severe/critical group. Flow cytometry analysis was used for the assessment of CD3⁺ cells for total T cell count, CD4⁺ cells for helper T cells (Th), CD8⁺ cells for cytotoxic T cells (Tc), CD4⁺CD25⁺ cells for regulatory T cells (T reg), and CD38 expression in CD4⁺ T cells and CD8⁺ T cells for T cell activation. Results: A statistically significant difference was found between COVID-19 cases and healthy controls as regards low counts of all the targeted T cell subtypes, with the lowest counts detected among patients of the severe/critical group. Furthermore, CD38 overexpression was observed in both CD4⁺ and CD8⁺ T cells. Conclusion: Decreased T cell count, specifically CD8⁺ T cell (Tc), with T cell overactivation which was indicated by CD38 overexpression on CD4⁺ and CD8⁺ T cells had a substantial prognostic role in predicting severity and mortality among COVID-19 patients. These findings can provide a preliminary tool for clinicians to identify high-risk patients requiring vigilant monitoring, customized supportive therapy, or ICU admission. Studies on larger patient groups are needed. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 1693 KiB

Open AccessArticle

The Impact of Cooperative Behavior between Social Organizations during the COVID-19 Pandemic Outbreak in Shanghai: A Simulation Approach

by Weipeng Fang, Changwei Qin, Dan Zhou, Jian Yin, Zhongmin Liu and Xianjun Guan

Int. J. Environ. Res. Public Health 2023, 20(2), 1409; https://doi.org/10.3390/ijerph20021409 - 12 Jan 2023

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Abstract

In 2022, a new outbreak of the COVID-19 pandemic created considerable challenges for the Shanghai public health system. However, conventional prevention and control strategies, which only rely on formal organizations, inefficiently decrease the number of infections. Thus, a multi-organization management mode is needed [...] Read more.

In 2022, a new outbreak of the COVID-19 pandemic created considerable challenges for the Shanghai public health system. However, conventional prevention and control strategies, which only rely on formal organizations, inefficiently decrease the number of infections. Thus, a multi-organization management mode is needed for pandemic prevention. In this paper, we applied a stochastic actor-oriented model (SAOM) to analyze how these social organizations cooperate with others and further identify the mechanism that drives them to create a reliable and sustainable cooperative relationship network from the perspective of social network analysis. The model allowed us to assess the effects of the actor’s attributes, the network structure, and dynamic cooperative behavior in RSiena with longitudinal data collected from 220 participants in 19 social organizations. The results indicated that the number of cooperative relationships increased during the pandemic, from 44 to 162, which means the network between social organizations became more reliable. Furthermore, all the hypotheses set in four sub-models were significant (t-ratio < 0.1, overall max t-ratio < 0.25, and e/s > 2). Additionally, the estimated values showed that four factors played a positive role in forming the cooperative relationship network, i.e., all except the “same age group effect (−1.02)”. The results also indicated that the social organizations tend to build relationships with more active actors in the community in every time period. This paper is of great significance regarding the innovation of public health system management and the improvement of Chinese grassroots governance. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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16 pages, 1528 KiB

Open AccessArticle

Examination of Preferences for COVID-19 Vaccines in Hungary Based on Their Properties—Examining the Impact of Pandemic Awareness with a Hybrid Choice Approach

by Zsanett Blaga, Peter Czine, Barbara Takacs, Anna Szilagyi, Reka Szekeres, Zita Wachal, Csaba Hegedus, Gyula Buchholcz, Balazs Varga, Daniel Priksz, Mariann Bombicz, Adrienn Monika Szabo, Rita Kiss, Rudolf Gesztelyi, Dana Diana Romanescu, Zoltan Szabo, Miklos Szucs, Peter Balogh, Zoltan Szilvassy and Bela Juhasz

Int. J. Environ. Res. Public Health 2023, 20(2), 1270; https://doi.org/10.3390/ijerph20021270 - 10 Jan 2023

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Abstract

The COVID-19 pandemic has posed a huge challenge to the world in recent years. The development of vaccines that are as effective as possible and accessible to society offers a promising alternative for addressing the problems caused by this situation as soon as [...] Read more.

The COVID-19 pandemic has posed a huge challenge to the world in recent years. The development of vaccines that are as effective as possible and accessible to society offers a promising alternative for addressing the problems caused by this situation as soon as possible and to restore the pre-epidemic system. The present study investigated the preferences of residents in Hungary’s second-largest city (Debrecen) for the COVID-19 vaccine. To achieve this aim, a discrete choice experiment was conducted with 1011 participants, and the vaccine characteristics included in the design of the experiment were determined by qualitative methods and a pilot survey: (1) country of origin; (2) efficiency; (3) side effect; and (4) duration of protection. During the data collection at three vaccination sites, respondents were asked to choose between three vaccine alternatives and one “no choice” option in eight decision situations. Discrete choice model estimations were performed using a random parameter logit (RPL) specification with the final model extended to include a latent variable measuring pandemic awareness. The results showed that the vaccine with a Chinese country of origin is the least preferred among the respondents, while the Hungarian and the European vaccines are the most preferred. Furthermore, the increase in the vaccine efficiency level increased the respondents’ sense of utility for the vaccine; the short-term side effect was preferred to the long-term one; and the increase in the duration of protection provided by the vaccine increased the respondents’ sense of utility for the vaccine. Based on the parameter estimated for the latent variable, it can be concluded that as the level of pandemic awareness (which is more positive among people with chronic diseases and less important among health workers) increases, the choice of a vaccine option becomes more preferred among respondents compared to the “no choice“. The results of our investigation could contribute towards increasing compliance in the case of the vaccination-rejecting population, not only for COVID-19, but for any kind of vaccination procedure. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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16 pages, 1503 KiB

Open AccessArticle

Rapid Evaluation of the Xpert^® Xpress CoV-2 plus and Xpert^® Xpress CoV-2/Flu/RSV plus Tests

by Lara Dominique Noble, Lesley Erica Scott, Riffat Munir, Mignon Du Plessis, Kim Steegen, Lucia Hans, Puleng Marokane, Pedro Da Silva and Wendy Susan Stevens

Diagnostics 2023, 13(1), 34; https://doi.org/10.3390/diagnostics13010034 - 22 Dec 2022

Cited by 5 | Viewed by 1847

Abstract

The Xpert^® Xpress SARS-CoV-2 and Xpert^® Xpress SARS-CoV-2/Flu/RSV tests were rapidly developed and widely used during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. In response to emerging genetic variability, a new SARS-CoV-2 target (RNA-dependent RNA-polymerase) has been added to [...] Read more.

The Xpert^® Xpress SARS-CoV-2 and Xpert^® Xpress SARS-CoV-2/Flu/RSV tests were rapidly developed and widely used during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. In response to emerging genetic variability, a new SARS-CoV-2 target (RNA-dependent RNA-polymerase) has been added to both tests: Xpert^® Xpress CoV-2 plus and Xpert^® Xpress CoV-2/Flu/RSV plus test. A rapid evaluation of both tests was performed in South Africa, using residual respiratory specimens. Residual respiratory specimens (n = 125) were used to evaluate the Xpert^® Xpress CoV-2 plus test and included 50 genotyped specimens. The Xpert^® Xpress CoV-2/Flu/RSV plus test was assessed using 45 genotyped SARS-CoV-2 specimens, 10 influenza A, 10 influenza B and 20 respiratory syncytial virus specimens. Results were compared to in-country standard-of-care tests. Genotyped specimens tested the performance of the test under pressure from circulating SARS-CoV-2 variants of concern. Reference material was included to assess the test limits and linearity. The Xpert^® Xpress CoV-2 plus test performance compared to reference results across residual respiratory specimens was good (positive percentage agreement (PPA) = 95.2%, negative percentage agreement (NPA) = 95.0%) The Xpert^® Xpress CoV-2/Flu/RSV plus test showed good performance across all residual respiratory specimens (PPA = 100%, NPA = 98.3%). All genotyped variants of concern were detected by both tests. The Xpert^® Xpress CoV-2 plus and Xpert^® Xpress CoV-2/Flu/RSV plus tests can be used to diagnose SARS-CoV-2, and to diagnose and differentiate SARS-CoV-2, influenza A, influenza B and respiratory syncytial virus, respectively. The NPA was lower than the recommended 99%, but was influenced by the low number of negative specimens tested. The variants of concern assessed did not affect test performance. It is recommended that sites perform their own assessments compared to in-country standard-of-care tests. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 952 KiB

Open AccessArticle

Post-Traumatic Growth of Nurses in COVID-19 Designated Hospitals in Korea

by Suk-Jung Han, Ji-Young Chun and Hye-Jin Bae

Int. J. Environ. Res. Public Health 2023, 20(1), 56; https://doi.org/10.3390/ijerph20010056 - 21 Dec 2022

Cited by 7 | Viewed by 1411

Abstract

Background: This descriptive survey aimed to identify the factors affecting the post-traumatic growth (PTG) of nurses in COVID-19 designated hospitals on the basis of a PTG model. Methods: A survey of 250 nurses working at three COVID-19 hospitals in Seoul, South Korea, was [...] Read more.

Background: This descriptive survey aimed to identify the factors affecting the post-traumatic growth (PTG) of nurses in COVID-19 designated hospitals on the basis of a PTG model. Methods: A survey of 250 nurses working at three COVID-19 hospitals in Seoul, South Korea, was conducted from May to July 2021. The collected data were analyzed using the IBM SPSS 25 (IBM Inc., Armonk, NY, USA). Results: The participants in this study were mostly women (92.7%), and the average age and career duration were 32.08 and 7.88 years, respectively. The factors that significantly influenced the participants’ PTG were identified as marriage, religion, self-disclosure, deliberate rumination, meaning in life, and resilience. Conclusions: As new infectious diseases emerge, it is necessary to develop a program that can encourage self-disclosure and deliberate rumination, help nurses discover and pursue meaning in life, and enhance their ability to overcome trauma and promote PTG. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

7 pages, 535 KiB

Open AccessArticle

Evaluating the Value of Anti-SARS-CoV-2 Antibody-Based Tests for COVID-19 Diagnosis

by Xiao-Lu Yu, Jia-Wen Xie, Mao Wang, Mei-Qi Lin, Ya-Wen Zheng and Li-Rong Lin

J. Clin. Med. 2022, 11(24), 7489; https://doi.org/10.3390/jcm11247489 - 17 Dec 2022

Cited by 1 | Viewed by 1225

Abstract

Background: The early detection of COVID-19 patients is fundamental for containing the pandemic. A reverse-transcriptase quantitative polymerase chain reaction (RT-PCR), which detects SARS-CoV-2 RNA, is the gold standard diagnostic test, although it can contribute to false-negative results. Consequently, supplementary diagnostic tests are urgently [...] Read more.

Background: The early detection of COVID-19 patients is fundamental for containing the pandemic. A reverse-transcriptase quantitative polymerase chain reaction (RT-PCR), which detects SARS-CoV-2 RNA, is the gold standard diagnostic test, although it can contribute to false-negative results. Consequently, supplementary diagnostic tests are urgently needed. Methods: To assess the value of anti-SARS-CoV-2 antibody-based tests for confirming COVID-19, a retrospective study was conducted on 3120 inbound overseas travelers who underwent a 14-day government quarantine in Xiamen from August 2020 to October 2020. The diagnostic accuracy of the total antibody that detected the anti-SARS-CoV-2 antibody and the RT-PCR that detected SARS-CoV-2 RNA was determined in comparison to the clinical diagnosis. Results: The COVID-19 positive rate was 3.14% (98/3120). The sensitivity and specificity of the RT-PCR test on the first day of quarantine were 14.29% and 100%, respectively, and the sensitivity and specificity of the total antibody were 93.88% and 99.40%, respectively. The kappa value between an RT-PCR on the first day of quarantine and a clinical diagnosis was 0.24 (95% CI, 0.14–0.35), indicating poor consistency. The kappa value between total antibodies and a clinical diagnosis was 0.88 (95% CI, 0.83–0.93), indicating perfect consistency. There were no differences in the positive rates of an RT-PCR in symptomatic COVID-19 (7.41% (2/27)) and asymptomatic COVID-19 (16.90 (12/71) (p = 0.338). Similarly, the positive rate of the total antibody tests showed no difference in symptomatic COVID-19 (96.30% (26/27)) and asymptomatic COVID-19 (92.96% (66/71)) (p = 0.676). Conclusion: SARS-CoV-2 antibodies are developed by the body in response to an infection or after vaccination; this can easily lead to a missed diagnosis. In the context of low sensitivity for an RT-PCR, SARS-CoV-2 antibody detection is an effective adjunct to RT-PCR detection, which can improve the diagnostic accuracy of COVID-19 and provide an effective complement to the false-negative results of an RT-PCR. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 2029 KiB

Open AccessArticle

Association between COVID-19 Burden, Population Vaccination Status, and Urologic Oncology Surgery Volume: A National Multicenter Cross-Sectional Study

by Ido Amir, Shay Golan, Michael Frumer, Itay A. Sternberg, Omri Schwarztuch Gildor, Azik Hoffman, Reut Shashar, Roy Mano, Ziv Savin, Miki Haifler, Dorit E. Zilberman, Zohar A. Dotan and Barak Rosenzweig

J. Clin. Med. 2022, 11(23), 7071; https://doi.org/10.3390/jcm11237071 - 29 Nov 2022

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Abstract

Initial deleterious effects of the COVID-19 pandemic on urologic oncology surgeries are well described, but the possible influence of vaccination efforts and those of pandemic conditions on surgical volumes is unclear. Our aim was to examine the association between changing vaccination status and [...] Read more.

Initial deleterious effects of the COVID-19 pandemic on urologic oncology surgeries are well described, but the possible influence of vaccination efforts and those of pandemic conditions on surgical volumes is unclear. Our aim was to examine the association between changing vaccination status and COVID-19 burden throughout the pandemic and the volume of urologic oncology surgeries in Israel. This multi-center cross-sectional study included data collected from five tertiary centers between January 2019 and December 2021. All 7327 urologic oncology surgeries were included. Epidemiological data were obtained from the Israeli Ministry of Health database. A rising trend in total urologic oncology surgery volumes was observed with ensuing COVID-19 wave peaks over time (

X^{2}

= 13.184, df = 3, p = 0.004). Total monthly surgical volumes correlated with total monthly hospitalizations due to COVID-19 (R = −0.36, p = 0.015), as well as with the monthly average Oxford Stringency Index (R = −0.31, p = 0.035). The cumulative percent of vaccinations and of new COVID-19 cases per month did not correlate with total monthly urologic surgery volumes. Our study demonstrates the gradual acclimation of the Israeli healthcare system to the COVID-19 pandemic. However, hospitalizations due to COVID-19, as well as restriction stringency, correlate with lower volumes of urologic oncological surgeries, regardless of the population’s vaccination status. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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16 pages, 1701 KiB

Open AccessArticle

An Examination of US COVID-19 Vaccine Distribution in New Jersey, Pennsylvania, and New York

by Ethan Moss, Natasha A. Patterson and Brenda F. Seals

Int. J. Environ. Res. Public Health 2022, 19(23), 15629; https://doi.org/10.3390/ijerph192315629 - 24 Nov 2022

Cited by 1 | Viewed by 1942

Abstract

COVID-19 quickly spread across the United States (US) while communications and policies at all government levels suffered from inconsistency, misinformation, and lack of coordination. In order to explain the discrepancy between availability and population uptake, a case study was conducted analyzing vaccine rollout [...] Read more.

COVID-19 quickly spread across the United States (US) while communications and policies at all government levels suffered from inconsistency, misinformation, and lack of coordination. In order to explain the discrepancy between availability and population uptake, a case study was conducted analyzing vaccine rollout plans, social media, and Health Officer/Other Key Informant interviews in New Jersey, New York, and Pennsylvania. Key research questions included, “What were the barriers and facilitators of early COVID vaccine distribution?” and “What mechanisms in the community emerged to alleviate strains in early vaccination?” Findings from this study revealed that pre-existing emergency preparedness infrastructures and plans developed since the 9/11 tragedy were seemingly abandoned. This caused health departments at all levels of government to make impromptu, non-uniform decisions leading to confusion, vaccine hesitancy, and ultimately low uptake. The results indicate that future vaccine rollout best practices must include evidence-based decision-making, coordinated communications, and outreach to high-priority and vulnerable communities. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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8 pages, 2214 KiB

Open AccessArticle

Characterization of COVID-19-Related Lung Involvement in Patients Undergoing Magnetic Resonance T1 and T2 Mapping Imaging: A Pilot Study

by Giovanni Camastra, Luca Arcari, Federica Ciolina, Massimiliano Danti, Gerardo Ansalone, Luca Cacciotti and Stefano Sbarbati

J. Imaging 2022, 8(12), 314; https://doi.org/10.3390/jimaging8120314 - 23 Nov 2022

Cited by 2 | Viewed by 1333

Abstract

Tissue characterization by mapping techniques is a recent magnetic resonance imaging (MRI) tool that could aid the tissue characterization of lung parenchyma in coronavirus disease-2019 (COVID-19). The aim of the present study was to compare lung MRI findings, including T1 and T2 mapping, [...] Read more.

Tissue characterization by mapping techniques is a recent magnetic resonance imaging (MRI) tool that could aid the tissue characterization of lung parenchyma in coronavirus disease-2019 (COVID-19). The aim of the present study was to compare lung MRI findings, including T1 and T2 mapping, in a group of n = 11 patients with COVID-19 pneumonia who underwent a scheduled cardiac MRI, and a cohort of healthy controls. MRI scout images were used to identify affected and remote lung regions within the patients’ cohort and appropriate regions of interest (ROIs) were drawn accordingly. Both lung native T1 and T2 values were significantly higher in the affected areas of patients with COVID-19 as compared to the controls (1375 ms vs. 1201 ms, p = 0.016 and 70 ms vs. 30 ms, p < 0.001, respectively), whereas no significant differences were detected between the remote lung parenchyma of the COVID-19 patients and the controls (both p > 0.05). When a larger ROI was identified, comprising the whole lung parenchyma within the image irrespective of the affected and remote areas, the COVID-19 patients still retained higher native T1 (1278 ms vs. 1149 ms, p = 0.003) and T2 values (38 ms vs. 34 ms, p = 0.04). According to the receiver operator characteristics curves, the T2 value of the affected region retained the higher accuracy for the differentiation of the COVID-19 patients against the controls (area under the curve 0.934, 95% confidence interval 0.826–0.999). These findings, possibly driven by the ability of MRI tissue mapping to detect ongoing inflammation in the lungs of patients with COVID-19, suggest that T1 and T2 mapping of the lung is a feasible approach in this clinical scenario. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 1131 KiB

Open AccessArticle

Comparative Analysis of In-House RT-qPCR Detection of SARS-CoV-2 for Resource-Constrained Settings

by Yesit Bello-Lemus, Marco Anaya-Romero, Janni Gómez-Montoya, Moisés Árquez, Henry J. González-Torres, Elkin Navarro-Quiroz, Leonardo Pacheco-Londoño, Lisandro Pacheco-Lugo and Antonio J. Acosta-Hoyos

Diagnostics 2022, 12(11), 2883; https://doi.org/10.3390/diagnostics12112883 - 21 Nov 2022

Cited by 2 | Viewed by 2471

Abstract

We developed and standardized an efficient and cost-effective in-house RT-PCR method to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We evaluated sensitivity, specificity, and other statistical parameters by different RT-qPCR methods including triplex, duplex, and simplex assays adapted from the initial World [...] Read more.

We developed and standardized an efficient and cost-effective in-house RT-PCR method to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We evaluated sensitivity, specificity, and other statistical parameters by different RT-qPCR methods including triplex, duplex, and simplex assays adapted from the initial World Health Organization- (WHO) recommended protocol. This protocol included the identification of the E envelope gene (E gene; specific to the Sarvecovirus genus), RdRp gene of the RNA-dependent RNA polymerase (specific for SARS-CoV-2), and RNase P gene as endogenous control. The detection limit of the E and the RdRp genes were 3.8 copies and 33.8 copies per 1 µL of RNA, respectively, in both triplex and duplex reactions. The sensitivity for the RdRp gene in the triplex and duplex RT-qPCR tests were 98.3% and 83.1%, respectively. We showed a decrease in sensitivity for the RdRp gene by 60% when the E gene acquired Ct values > 31 in the diagnostic tests. This is associated with the specific detection limit of each gene and possible interferences in the protocol. Hence, developing efficient and cost-effective methodologies that can be adapted to various health emergency scenarios is important, especially in developing countries or settings where resources are limited. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 2376 KiB

Open AccessArticle

Study of the Deep Processes of COVID-19 in Russia: Finding Ways to Identify Preventive Measures

by Alexander P. Anyutin, Tatiana M. Khodykina, Ekaterina I. Akimova, Elena V. Belova, Ekaterina A. Shashina, Denis V. Shcherbakov, Valentina V. Makarova, Nadezhda N. Zabroda, Anna A. Klimova, Nina A. Ermakova, Tatiana S. Isiutina-Fedotkova, Yury V. Zhernov, Roman V. Polibin and Oleg V. Mitrokhin

Int. J. Environ. Res. Public Health 2022, 19(22), 14714; https://doi.org/10.3390/ijerph192214714 - 09 Nov 2022

Cited by 1 | Viewed by 1272

Abstract

The novel coronavirus disease 2019 (COVID-19) pandemic has had a huge impact on all areas of human life. Since the risk of biological threats will persist in the future, it is very important to ensure mobilization readiness for a prompt response to the [...] Read more.

The novel coronavirus disease 2019 (COVID-19) pandemic has had a huge impact on all areas of human life. Since the risk of biological threats will persist in the future, it is very important to ensure mobilization readiness for a prompt response to the possible emergence of epidemics of infectious diseases. Therefore, from both a theoretical and practical standpoint, it is currently necessary to conduct a thorough examination of the COVID-19 epidemic. The goal of this research is to investigate the underlying processes that led to the COVID-19 pandemic in Russia and to identify ways to improve preventive measures and ensure mobilization readiness for a quick response to potential COVID-19-like pandemics. This research will analyze the daily dynamics of the number of infection cases and the number of new lethal cases of COVID-19. We analyzed the daily number of new cases of COVID-19 infection N(d), the daily number of new lethal cases L(d), their percentage ratio L(d)/N(d) 100% in Russia for 2 years of the pandemic (from the beginning of the pandemic to 23 March 2022), the rate of increase and decrease of these indicators (dN(d)/dd and dL(d)/dd), as well as their spectra created on the basis of wavelet analysis. Wavelet analysis of the deep structure of the N(d) and L(d) wavelet spectra made it possible to identify the presence of internal cycles, the study of which makes it possible to predict the presence of days with the maximum number of infections and new deaths in a pandemic similar to COVID-19 and outline ways and methods for improving preventive measures and measures to ensure mobilization readiness for a rapid response to the potential emergence of pandemics similar to COVID-19. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 299 KiB

Open AccessArticle

COVID-19 Fear and Anxiety among Patients with Chronic Heart Failure: A Cross Sectional Study

by Osama Alkouri, Yousef Khader, Issa M. Hweidi, Muntaha K. Gharaibeh, Mohamad Jarrah, Khaldoun M. Hamdan, Amina Al Marzouqi and Khaldoun Khamaiseh

J. Clin. Med. 2022, 11(21), 6586; https://doi.org/10.3390/jcm11216586 - 07 Nov 2022

Cited by 6 | Viewed by 1643

Abstract

Although the current management of COVID-19 is mainly focused on efficacious vaccine and infection control, the most common psychological reactions (such as fear and anxiety) associated with the COVID-19 pandemic have not been investigated and even neglected in patients with heart failure who [...] Read more.

Although the current management of COVID-19 is mainly focused on efficacious vaccine and infection control, the most common psychological reactions (such as fear and anxiety) associated with the COVID-19 pandemic have not been investigated and even neglected in patients with heart failure who are at greater risk for morbidity and mortality. We assessed COVID-19 related fear and anxiety among patients with heart failure and determined their associated factors. A cross sectional survey was conducted among 300 consecutive patients with heart failure during the period of March 2021–June 2021. Almost 50.7% of patients had fear of COVID-19 and 36.3% had coronavirus anxiety. Age > 55 was significantly associated with increased odds of fear (OR = 2.6) and anxiety (OR = 4.3). Patients with angina were more likely to have fear (OR = 3.0) and anxiety (OR = 2.2) and patients with chronic lung disease were more likely to have fear (OR = 3.0) and anxiety (OR = 3.3). Increased age, having angina, and having chronic lung disease were associated with increased odds of fear of COVID-19 and coronavirus anxiety. Psychological support needs to be integrated in patient care with special attention to physiological risk factors that are associated with COVID-19 comorbidities. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

10 pages, 1701 KiB

Open AccessArticle

Clinical Outcomes and Prevalence of Sarcopenia in Patients with Moderate to Severe COVID-19

by Shuhei Yamamoto, Yasunari Sakai, Keiji Matsumori, Ryuji Osawa, Shun Ito, Daichi Tsukakoshi, Tomoki Ohno, Hiroaki Ohta, Takashi Ichiyama, Masamichi Komatsu, Yosuke Wada, Masayuki Hanaoka, Shota Ikegami and Hiroshi Horiuchi

J. Clin. Med. 2022, 11(21), 6578; https://doi.org/10.3390/jcm11216578 - 06 Nov 2022

Viewed by 1596

Abstract

Background: The purpose of this study was to investigate the effectiveness and clinical outcomes of inpatient rehabilitation for patients with severe COVID-19 in Japan. Methods: Patients with severe COVID-19 who underwent rehabilitation during hospitalization were included. The Medical Research Council (MRC) score and [...] Read more.

Background: The purpose of this study was to investigate the effectiveness and clinical outcomes of inpatient rehabilitation for patients with severe COVID-19 in Japan. Methods: Patients with severe COVID-19 who underwent rehabilitation during hospitalization were included. The Medical Research Council (MRC) score and short physical performance battery (SPPB), such as physical function assessment and the intensive care unit (ICU) mobility scale, the functional status score for the ICU, and Barthel index as activities of daily living (ADLs) were evaluated at admission and discharge or transfer from the hospital. The correlation between SPPB at discharge and each factor at admission were also analyzed. Furthermore, the prevalence of sarcopenia was evaluated by defining SPPB of <9 points at discharge as sarcopenia. Results: The median age of the total of 23 patients was 59 years (interquartile range (IQR): 47–67), 73.9% were male, and the median PaO₂/FiO₂ at admission was 172.0 (IQR: 123.0–209.0). All physical function and ADL parameters were significantly improved from the time of admission to discharge (p = 0.014 for the MRC score and p < 0.001 for all others). Moreover, SPPB at discharge significantly correlated with WBC (Spearman’s rho = −0.473, p = 0.041), C-reactive protein (Spearman’s rho = −0.468, p = 0.044), and exhibited a significant trend with PaO₂/FiO₂ (Spearman’s rho = 0.429, p = 0.067) and age (Spearman’s rho = 0.409, p = 0.083). Although the median Barthel index at discharge was 90 points, 47% of patients had sarcopenia as defined by an SPPB of <9 points. Conclusions: Early rehabilitation for patients with severe COVID-19 improved physical function and ADLs during hospitalization. However, 47% of patients had the same level of sarcopenia at discharge. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 961 KiB

Open AccessArticle

Lung Ultrasound as a Triage Method in Primary Care for Patients with Suspected SARS-CoV-2 Pneumonia

by María Belén Guzmán-García, Alicia Mohedano-Moriano, Jaime González-González, José Manuel Morales-Cano, Ricardo Campo-Linares, César Lozano-Suárez, Tyrone Paul Estrada-Álvarez, Mª Mar Romero-Fernández, Esther Vanesa Aguilar-Galán and Juan José Criado-Álvarez

J. Clin. Med. 2022, 11(21), 6420; https://doi.org/10.3390/jcm11216420 - 29 Oct 2022

Cited by 5 | Viewed by 1693

Abstract

Background: Currently, there are few studies that have analyzed the benefits of using lung ultrasound in the field of primary care, including in homes and nursing homes, for patients with suspected COVID-19 pneumonia and subsequent follow-ups. The aim of this study was to [...] Read more.

Background: Currently, there are few studies that have analyzed the benefits of using lung ultrasound in the field of primary care, including in homes and nursing homes, for patients with suspected COVID-19 pneumonia and subsequent follow-ups. The aim of this study was to demonstrate that lung ultrasound is a useful technique for triaging these patients. Methods: An observational and retrospective study of individuals who presented with clinical suspicion of SARS-CoV-2 pneumonia was carried out during the months of March to June 2020 in Health Center number 2 of Ciudad Real and in homes of patients and nursing homes belonging to the Health Service of Castilla-La Mancha (Spain). Results: A total of 209 patients, of whom 86 (41.1%) were male, were included in the study. The most frequent ultrasound findings were bilateral B-lines, with a right predominance, specifically in the posterobasal region. Additionally, there was a statistical significance (p < 0.05) correlation between pathological positivity on lung ultrasound and PCR and chest X-ray positivity. When calculating the sensitivity and specificity of ultrasound and X-ray, ultrasound had a sensitivity of 93%, and X-ray had a sensitivity of 75%. Conclusion: Due to its high sensitivity and negative predictive value, lung ultrasound is very useful as a triage tool for patients with suspected SARS-CoV-2 pneumonia. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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19 pages, 2533 KiB

Open AccessReview

Modeling COVID-19 Transmission Dynamics: A Bibliometric Review

by Gour Gobinda Goswami and Tahmid Labib

Int. J. Environ. Res. Public Health 2022, 19(21), 14143; https://doi.org/10.3390/ijerph192114143 - 29 Oct 2022

Cited by 6 | Viewed by 2760

Abstract

A good amount of research has evolved just in three years in COVID-19 transmission, mortality, vaccination, and some socioeconomic studies. A few bibliometric reviews have already been performed in the literature, especially on the broad theme of COVID-19, without any particular area such [...] Read more.

A good amount of research has evolved just in three years in COVID-19 transmission, mortality, vaccination, and some socioeconomic studies. A few bibliometric reviews have already been performed in the literature, especially on the broad theme of COVID-19, without any particular area such as transmission, mortality, or vaccination. This paper fills this gap by conducting a bibliometric review on COVID-19 transmission as the first of its kind. The main aim of this study is to conduct a bibliometric review of the literature in the area of COVID-19 transmission dynamics. We have conducted bibliometric analysis using descriptive and network analysis methods to review the literature in this area using RStudio, Openrefine, VOSviewer, and Tableau. We reviewed 1103 articles published in 2020–2022. The result identified the top authors, top disciplines, research patterns, and hotspots and gave us clear directions for classifying research topics in this area. New research areas are rapidly emerging in this area, which needs constant observation by researchers to combat this global epidemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 862 KiB

Open AccessArticle

Appealing to Individual Fears or Social Norms: How Can the Public Be Persuaded to Accept COVID-19 Vaccination through Risk Communication?

by Fangfei Wang, Sifan Zhang and Lei Lei

Int. J. Environ. Res. Public Health 2022, 19(21), 13737; https://doi.org/10.3390/ijerph192113737 - 22 Oct 2022

Viewed by 1369

Abstract

In the context of the COVID-19 pandemic, improving the public’s understanding of the increased efficacy and safety of the COVID-19 vaccines through scientific risk communication campaigns, promoting the public’s acceptance and willingness to receive COVID-19 vaccines, and forming collective actions at the social [...] Read more.

In the context of the COVID-19 pandemic, improving the public’s understanding of the increased efficacy and safety of the COVID-19 vaccines through scientific risk communication campaigns, promoting the public’s acceptance and willingness to receive COVID-19 vaccines, and forming collective actions at the social level will deeply impact on the effect of COVID-19 prevention in various countries, which is also a key factor that governments need to address urgently. Previous research on risk communication has mostly focused on microscopic perspectives of how to stimulate individual self-protection behaviors by awakening threat and efficacy perceptions; however, a lack of observation of social collective actions means there is a risk of failure regarding COVID-19 epidemic reduction and prevention. In this regard, this study was based on the issue of vaccination in the context of the COVID-19 epidemic through a highly regulated and controlled research experiment in China (n = 165), which was designed to examine the impact of two risk communication frameworks, appealing to individual fears and appealing to social norms, on the public’s acceptance and recommendations of COVID-19 vaccines, thus outlining the path of action from individual protection to collective epidemic prevention. Both the “fear appeals” framework and the “social norms” framework were found to have a positive effect on the Chinese public’s vaccination acceptance. Specifically, social norms information may increase vaccination acceptance by enhancing the public’s perceptions of social responsibility, while fear appeals information may reduce their perceptions of threat and social pressure to get the vaccine. Female and highly educated groups were more likely to refuse to recommend vaccination after reading the risk communication information. These results can be a useful supplement to the theory and practice of risk communication. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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19 pages, 802 KiB

Open AccessArticle

Assessment of Adult Patients with Long COVID Manifestations Suspected as Cardiovascular: A Single-Center Experience

by Alon Shechter, Dana Yelin, Ili Margalit, Merry Abitbol, Olga Morelli, Ashraf Hamdan, Mordehay Vaturi, Alon Eisen, Alex Sagie, Ran Kornowski and Yaron Shapira

J. Clin. Med. 2022, 11(20), 6123; https://doi.org/10.3390/jcm11206123 - 18 Oct 2022

Cited by 4 | Viewed by 1643

Abstract

Background: Persistent symptoms affect a subset of coronavirus disease 2019 (COVID-19) survivors. Some of these may be cardiovascular (CV)-related. Objective: To assess the burden of objective CV morbidity among, and to explore the short-term course experienced by, COVID-19 patients with post-infectious [...] Read more.

Background: Persistent symptoms affect a subset of coronavirus disease 2019 (COVID-19) survivors. Some of these may be cardiovascular (CV)-related. Objective: To assess the burden of objective CV morbidity among, and to explore the short-term course experienced by, COVID-19 patients with post-infectious symptomatology suspected as CV. Methods: This was a single-center, retrospective analysis of consecutive adult patients with new-onset symptoms believed to be CV following recovery from COVID-19, who had been assessed at a dedicated ‘Cardio’-COVID clinic between June 2020 and June 2021. All participants were followed for 1 year for symptomatic course and the occurrence of new CV diagnoses and major adverse cardiovascular events (MACE). Results: A total of 96 patients (median age 54 (IQR, 44–64) years, 52 (54%) females) were included in the final analysis. Initial visits occurred within a median of 142 days after the diagnosis of acute COVID. Nearly all (99%) patients experienced a symptomatic acute illness, which was graded as severe in 26 (27%) cases according to the National Institutes of Health (NIH) criteria. Long-COVID symptoms included mainly dyspnea and fatigue. While the initial work-up was mostly normal, 45% of the 11 cardiac magnetic resonance studies performed revealed pathologies. New CV diagnoses were made in nine (9%) patients and mainly included myocarditis that later resolved. An abnormal spirometry was the only variable associated with these. No MACE were recorded. Fifty-two (54%) participants felt that their symptoms improved. No association was found between CV morbidity and symptomatic course. Conclusions: In our experience, long-COVID symptoms of presumed CV origin signified actual CV disease in a minority of patients who, irrespective of the final diagnosis, faced a fair 1-year prognosis. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 654 KiB

Open AccessArticle

Knowledge, Attitudes, and Practices Survey among Nursing Care Workers Involved in Caring for Older Adults during the Early Stage of the COVID-19 Pandemic in Japan

by Dan Kambayashi, Toshie Manabe, Masayoshi Hirohara and Hiroyasu Akatsu

Int. J. Environ. Res. Public Health 2022, 19(20), 12993; https://doi.org/10.3390/ijerph192012993 - 11 Oct 2022

Cited by 1 | Viewed by 2017

Abstract

Background: As Japan undergoes population aging, nursing care workers play an important role in supporting older adults in the community, which has been particularly critical during COVID-19 pandemic. However, the knowledge, attitudes, and practices (KAP) among nursing care workers regarding COVID-19 have not [...] Read more.

Background: As Japan undergoes population aging, nursing care workers play an important role in supporting older adults in the community, which has been particularly critical during COVID-19 pandemic. However, the knowledge, attitudes, and practices (KAP) among nursing care workers regarding COVID-19 have not been fully elucidated. Methods: A self-administered questionnaire survey was conducted in June 2020 among 481 nursing care workers in the nursing care facilities in Aichi, Japan. We assessed COVID-19-related KAP scores of nursing care workers, and compared them by age, sex, and years of experience. Results: A total of 481 nursing care workers responded to the survey. Out of a maximum of 10 points, the mean (standard deviations) knowledge, attitude, and practice scores were 6.86 (1.45), 7.11 (1.42), and 7.40 (1.89), respectively. Comparisons between the KAP scores revealed significantly higher knowledge scores among older workers (p < 0.001) and significantly higher knowledge scores (p = 0.002) and practice scores (p = 0.033) among workers with more than 20 years of working experience. Conclusions: The findings revealed that older age and a longer duration of experience were associated with higher COVID-19-related knowledge and practice scores. To better support older adults, it is essential to improve the education system for care workers and to provide environments for delivering necessary information rapidly. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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21 pages, 1645 KiB

Open AccessArticle

Causes of Stress among Healthcare Professionals and Successful Hospital Management Approaches to Mitigate It during the COVID-19 Pandemic: A Cross-Sectional Study

by Lourdes Herraiz-Recuenco, Laura Alonso-Martínez, Susanne Hannich-Schneider and Jesús Puente-Alcaraz

Int. J. Environ. Res. Public Health 2022, 19(19), 12963; https://doi.org/10.3390/ijerph191912963 - 10 Oct 2022

Cited by 11 | Viewed by 2531

Abstract

The outbreak of the COVID-19 pandemic posed an immediate challenge to the management of hospitals in Germany and elsewhere. The risk of stress for front-line healthcare professionals forced occupational health and safety units to adopt a variety of protective measures, not all of [...] Read more.

The outbreak of the COVID-19 pandemic posed an immediate challenge to the management of hospitals in Germany and elsewhere. The risk of stress for front-line healthcare professionals forced occupational health and safety units to adopt a variety of protective measures, not all of which have been thoroughly validated. The main objective of the present analysis is to assess what the most important sources of stress were and which of the protective measures applied to counteract stress among healthcare staff had the greatest impact. A better understanding of these factors will improve hospital management and worker safety in a future health crisis situation and may also prove to be beneficial in non-crisis situations. For this purpose, in 2020, an exploratory, cross-sectional and quantitative study using a questionnaire created for this purpose was carried out on a total of 198 professionals—133 nurses and 65 physicians—at the Klinikum Mittelbaden Balg hospital in Baden-Baden, Germany, during the first wave of the pandemic. Statistical analyses showed that nurses suffer more stress than physicians and that stress is higher among professionals in critical care and emergency units than in units that are less exposed to infected patients. It was also found that measures such as salary incentives, encouragement of work in well-integrated teams, and perceived support from hospital management mitigate stress. These findings highlight the importance of support measures from management and superiors. Knowing the actual effectiveness of the measures applied by management and the factors mentioned above could help to protect healthcare professionals in the event of another pandemic or similar situations and may still be of value in dealing with the continuing COVID-19 pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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16 pages, 1886 KiB

Open AccessSystematic Review

Inhaled Nitric Oxide for Clinical Management of COVID-19: A Systematic Review and Meta-Analysis

by Jaber S. Alqahtani, Abdulelah M. Aldhahir, Shouq S. Al Ghamdi, Salma AlBahrani, Ibrahim A. AlDraiwiesh, Abdullah A. Alqarni, Kamaluddin Latief, Reynie Purnama Raya and Tope Oyelade

Int. J. Environ. Res. Public Health 2022, 19(19), 12803; https://doi.org/10.3390/ijerph191912803 - 06 Oct 2022

Cited by 9 | Viewed by 2478

Abstract

Background: Severe COVID-19 is associated with hypoxemia and acute respiratory distress syndrome (ARDS), which may predispose multiorgan failure and death. Inhaled nitric oxide (iNO) is a clinical vasodilator used in the management of acute respiratory distress syndrome (ARDS). This study evaluated the response [...] Read more.

Background: Severe COVID-19 is associated with hypoxemia and acute respiratory distress syndrome (ARDS), which may predispose multiorgan failure and death. Inhaled nitric oxide (iNO) is a clinical vasodilator used in the management of acute respiratory distress syndrome (ARDS). This study evaluated the response rate to iNO in patients with COVID-19-ARDS. Method: We searched Medline and Embase databases in May 2022, and data on the use of iNO in the treatment of ARDS in COVID-19 patients were synthesized from studies that satisfied predefined inclusion criteria. A systematic synthesis of data was performed followed by meta-analysis. We performed the funnel plot and leave-one-out sensitivity test on the included studies to assess publication bias and possible exaggerated effect size. We compared the effect size of the studies from the Unites States with those from other countries and performed meta-regression to assess the effect of age, year of publication, and concomitant vasodilator use on the effect size. Results: A total of 17 studies (including 712 COVID-19 patients) were included in this systematic review of which 8 studies (involving 265 COVID-19 patients) were subjected to meta-analysis. The overall response rate was 66% (95% CI, 47–84%) with significantly high between-studies heterogeneity (I2 = 94%, p < 0.001). The funnel plot showed publication bias, although the sensitivity test using leave-one-out analysis showed that removing any of the study does not remove the significance of the result. The response rate was higher in the Unites States, and meta-regression showed that age, year of publication, and use of concomitant vasodilators did not influence the response rate to iNO. Conclusion: iNO therapy is valuable in the treatment of hypoxemia in COVID-19 patients and may improve systemic oxygenation in patients with COVID-19-ARDS. Future studies should investigate the mechanism of the activity of iNO in COVID-19 patients to provide insight into the unexplored potential of iNO in general ARDS. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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26 pages, 17562 KiB

Open AccessArticle

Influence of the Demographic, Social, and Environmental Factors on the COVID-19 Pandemic—Analysis of the Local Variations Using Geographically Weighted Regression

by Krzysztof Rząsa and Mateusz Ciski

Int. J. Environ. Res. Public Health 2022, 19(19), 11881; https://doi.org/10.3390/ijerph191911881 - 20 Sep 2022

Cited by 3 | Viewed by 1522

Abstract

As the COVID-19 pandemic continues, an increasing number of different research studies focusing on various aspects of the pandemic are emerging. Most of the studies focus on the medical aspects of the pandemic, as well as on the impact of COVID-19 on various [...] Read more.

As the COVID-19 pandemic continues, an increasing number of different research studies focusing on various aspects of the pandemic are emerging. Most of the studies focus on the medical aspects of the pandemic, as well as on the impact of COVID-19 on various areas of life; less emphasis is put on analyzing the influence of socio-environmental factors on the spread of the pandemic. In this paper, using the geographically weighted regression method, the extent to which demographic, social, and environmental factors explain the number of cases of SARS-CoV-2 is explored. The research was performed for the case-study area of Poland, considering the administrative division of the country into counties. The results showed that the demographic factors best explained the number of cases of SARS-CoV-2; the social factors explained it to a medium degree; and the environmental factors explained it to the lowest degree. Urban population and the associated higher amount and intensity of human contact are the most influential factors in the development of the COVID-19 pandemic. The analysis of the factors related to the areas burdened by social problems resulting primarily from the economic exclusion revealed that poverty-burdened areas are highly vulnerable to the development of the COVID-19 pandemic. Using maps of the local R² it was possible to visualize how the relationships between the explanatory variables (for this research—demographic, social, and environmental factors) and the dependent variable (number of cases of SARS-CoV-2) vary across the study area. Through the GWR method, counties were identified as particularly vulnerable to the pandemic because of the problem of economic exclusion. Considering that the COVID-19 pandemic is still ongoing, the results obtained may be useful for local authorities in developing strategies to counter the pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 1275 KiB

Open AccessArticle

The Effect of Short Treatment with Nigella Sativa on Symptoms, the Cluster of Differentiation (CD) Profile, and Inflammatory Markers in Mild COVID-19 Patients: A Randomized, Double-Blind Controlled Trial

by Khalid A. Bin Abdulrahman, Abdullah Omar Bamosa, Abdullah I. Bukhari, Intisar Ahmad Siddiqui, Mostafa A. Arafa, Ashfaq A. Mohsin, Mamdouh Faleh Althageel, Majed Owed Aljuaeed, Ibrahim Mohammed Aldeailej, Abdulaziz Ibrahim Alrajeh, Kamel Mohamed Aldosari, Najat Ahmed Hawsawi, Khalid Ibrahim Zawbaee and Saad Mohammed Alsurayea

Int. J. Environ. Res. Public Health 2022, 19(18), 11798; https://doi.org/10.3390/ijerph191811798 - 19 Sep 2022

Cited by 2 | Viewed by 5554

Abstract

The current study investigated the impact of different doses of Nigella sativa seeds on the symptoms, the cluster of differentiation profile group, and inflammatory markers of mild COVID-19 cases. Methods: The study was a double-blind placebo-controlled clinical trial. Patients with mild and asymptomatic [...] Read more.

The current study investigated the impact of different doses of Nigella sativa seeds on the symptoms, the cluster of differentiation profile group, and inflammatory markers of mild COVID-19 cases. Methods: The study was a double-blind placebo-controlled clinical trial. Patients with mild and asymptomatic SARS-CoV-2 infection patients were randomly subdivided into seven subgroups: Group (GP) 1: received charcoal capsules as a control group, and GP 2: received three capsules of whole Nigella sativa seeds daily, two capsules in the morning and one in the evening; GP 3: received three capsules of whole Nigella sativa seeds every 12 h, GP 4: received five capsules in the morning and four capsules of whole Nigella sativa seeds in the evening, GP 5: received one capsule of Nigella sativa powder every 12 h; GP 6: received two capsules of Nigella sativa powder every 12 h; GP 7: received three capsules of Nigella sativa powder every 12 h; all treatment course was for ten days. Inflammatory parameters were assessed before and after interventions. Results: 262 subjects were included in the final analysis. No significant difference was detected regarding age, gender, and nationality. No significant differences were detected between the inflammatory marker in all groups. The WBCs showed a significant difference between before and after the intervention. While for procalcitonin, a significant difference was demonstrated in groups 1,4, and 6. Conclusions: The current randomized clinical trial did not reveal a significant effect of ten days of treatment with various doses of Nigella sativa on symptoms, differentiation profile, and inflammatory markers of patients with COVID-19. As a natural product, the effect of Nigella sativa on disease requires weeks to manifest itself. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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Graphical abstract

20 pages, 1358 KiB

Open AccessArticle

Risk, Obligation, and Public Noncompliance with Mobility Directives in China during the COVID-19 Pandemic

by Chunhui Zheng, Jia Zhang, Lili Qian and Yuling Zhang

Int. J. Environ. Res. Public Health 2022, 19(18), 11505; https://doi.org/10.3390/ijerph191811505 - 13 Sep 2022

Viewed by 1315

Abstract

Human mobility greatly increases the risk of epidemic transmission. This study examines the psychological mechanism of individuals’ noncompliance with public health directives and their choice to travel amidst threats through two rounds of surveys (N = 1473 in total) in China at different [...] Read more.

Human mobility greatly increases the risk of epidemic transmission. This study examines the psychological mechanism of individuals’ noncompliance with public health directives and their choice to travel amidst threats through two rounds of surveys (N = 1473 in total) in China at different stages of the COVID-19 pandemic. This research revealed the relative strength of the motivating and impeding factors that determined behavioral intention. In subtle internal conflicts, maladaptive responses (e.g., wishful thinking, denial, fatalism) were identified as a significant factor in negotiating risk-related constraints and encouraging risky travel behavior. Interestingly, both those who traveled amidst threats and those who did not travel agreed that they had social obligations for epidemic prevention. The results demonstrated that obligation could have an indirect negative impact on behavioral intention only via attitude. By unveiling the psychological mechanism of individuals’ noncompliance with health directives and travel during the pandemic, this study can aid in the development of appropriate operational strategies to manage population mobility during crises. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 625 KiB

Open AccessArticle

How Work-Family Conflict Influenced the Safety Performance of Subway Employees during the Initial COVID-19 Pandemic: Testing a Chained Mediation Model

by Jingyu Zhang, Yao Fu, Zizheng Guo, Ranran Li and Qiaofeng Guo

Int. J. Environ. Res. Public Health 2022, 19(17), 11056; https://doi.org/10.3390/ijerph191711056 - 03 Sep 2022

Cited by 4 | Viewed by 1800

Abstract

This study examined the impact of work-family conflict on subway employees’ safety performance during the initial wave of the COVID-19 pandemic. We proposed a chain mediation model in which job burnout and affective commitment play mediating roles in this process. Using questionnaire data [...] Read more.

This study examined the impact of work-family conflict on subway employees’ safety performance during the initial wave of the COVID-19 pandemic. We proposed a chain mediation model in which job burnout and affective commitment play mediating roles in this process. Using questionnaire data from 632 Chinese subway employees during February 2020, structural equation modeling analyses were performed. The analyses showed that work-family conflict had a significant negative impact on subway employee safety performance. Moreover, job burnout completely mediated the influence of work-family conflict on safety performance, while affective commitment only partially mediated the influence of job burnout on safety performance. These findings suggest the important role played by Work-Family balance during the pandemic and contribute to a deeper understanding of the inner mechanisms. We also discussed several practical implications for organizations to reduce the negative impact of work-family conflict on safety performance. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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16 pages, 3550 KiB

Open AccessReview

The Supporting Role of Combined and Sequential Extracorporeal Blood Purification Therapies in COVID-19 Patients in Intensive Care Unit

by Federico Nalesso, Federica L. Stefanelli, Valentina Di Vico, Leda Cattarin, Irene Cirella, Giuseppe Scaparrotta, Francesco Garzotto and Lorenzo A. Calò

Biomedicines 2022, 10(8), 2017; https://doi.org/10.3390/biomedicines10082017 - 19 Aug 2022

Cited by 1 | Viewed by 2231

Abstract

Critical clinical forms of COVID-19 infection often include Acute Kidney Injury (AKI), requiring kidney replacement therapy (KRT) in up to 20% of patients, further worsening the outcome of the disease. No specific medical therapies are available for the treatment of COVID-19, while supportive [...] Read more.

Critical clinical forms of COVID-19 infection often include Acute Kidney Injury (AKI), requiring kidney replacement therapy (KRT) in up to 20% of patients, further worsening the outcome of the disease. No specific medical therapies are available for the treatment of COVID-19, while supportive care remains the standard treatment with the control of systemic inflammation playing a pivotal role, avoiding the disease progression and improving organ function. Extracorporeal blood purification (EBP) has been proposed for cytokines removal in sepsis and could be beneficial in COVID-19, preventing the cytokines release syndrome (CRS) and providing Extra-corporeal organ support (ECOS) in critical patients. Different EBP procedures for COVID-19 patients have been proposed including hemoperfusion (HP) on sorbent, continuous kidney replacement therapy (CRRT) with adsorbing capacity, or the use of high cut-off (HCO) membranes. Depending on the local experience, the multidisciplinary capabilities, the hardware, and the available devices, EBP can be combined sequentially or in parallel. The purpose of this paper is to illustrate how to perform EBPs, providing practical support to extracorporeal therapies in COVID-19 patients with AKI. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 496 KiB

Open AccessArticle

STANDARD M10 SARS-CoV-2 Assay for Rapid Detection of SARS-CoV-2: Comparison of Four Real-Time PCR Assays

by Seri Jeong, Nuri Lee, Su Kyung Lee, Eun-Jung Cho, Jungwon Hyun, Min-Jeong Park, Wonkeun Song and Hyun Soo Kim

Diagnostics 2022, 12(8), 1998; https://doi.org/10.3390/diagnostics12081998 - 18 Aug 2022

Cited by 5 | Viewed by 1732

Abstract

The demand for assays that can rapidly and accurately detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains high. We evaluated the performance of two rapid real-time reverse transcription polymerase chain reaction (RT-qPCR) assays (STANDARD M10 SARS-CoV-2 and Xpert Xpress SARS-CoV-2) against conventional [...] Read more.

The demand for assays that can rapidly and accurately detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains high. We evaluated the performance of two rapid real-time reverse transcription polymerase chain reaction (RT-qPCR) assays (STANDARD M10 SARS-CoV-2 and Xpert Xpress SARS-CoV-2) against conventional RT-qPCR assays (STANDARD M nCoV and Allplex SARS-CoV-2) for detecting SARS-CoV-2. A total of 225 swab samples were collected and tested using the four assays. The STANDARD M10 SARS-CoV-2 assay showed 97.4% positive percent agreement (PPA) and 100.0% negative percent agreement (NPA) compared to the STANDARD M nCoV assay and Allplex SARS-CoV-2 assay. STANDARD M10 exhibited high performance except in samples with low viral loads (cycle threshold (Ct) > 30). Xpert Xpress showed PPA and NPA of 100.0% compared to the two conventional RT-qPCR assays. The kappa coefficient (Κ) showed nearly almost perfect agreement between each assay and conventional RT-qPCR assays. The correlations of Ct values between the two rapid RT-qPCR and conventional RT-qPCR assays were >0.8, indicating strong correlations. All included assays could detect SARS-CoV-2 variants, such as the Alpha, Beta, and Gamma variants. The recently developed STANDARD M10 has a shorter turnaround time and random-access detection on automated devices, thereby facilitating efficient testing in emergency settings. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 941 KiB

Open AccessArticle

Self-Reported Periodontal Disease and Its Association with SARS-CoV-2 Infection

by Israel Guardado-Luevanos, Ronell Bologna-Molina, José Sergio Zepeda-Nuño, Mario Isiordia-Espinoza, Nelly Molina-Frechero, Rogelio González-González, Mauricio Pérez-Pérez and Sandra López-Verdín

Int. J. Environ. Res. Public Health 2022, 19(16), 10306; https://doi.org/10.3390/ijerph191610306 - 18 Aug 2022

Cited by 5 | Viewed by 1725

Abstract

Introduction: Knowledge of the oral manifestations associated with SARS-CoV-2 infection, the new coronavirus causing the COVID-19 pandemic, was hindered due to the restrictions issued to avoid proximity between people and to stop the rapid spread of the disease, which ultimately results in [...] Read more.

Introduction: Knowledge of the oral manifestations associated with SARS-CoV-2 infection, the new coronavirus causing the COVID-19 pandemic, was hindered due to the restrictions issued to avoid proximity between people and to stop the rapid spread of the disease, which ultimately results in a hyperinflammatory cytokine storm that can cause death. Because periodontal disease is one of the most frequent inflammatory diseases of the oral cavity, various theories have emerged postulating periodontal disease as a risk factor for developing severe complications associated with COVID-19. This motivated various studies to integrate questions related to periodontal status. For the present work, we used a previously validated self-report, which is a useful tool for facilitating epidemiological studies of periodontal disease on a large scale. Methodology: A blinded case-control study with participants matched 1:1 by mean age (37.7 years), sex, tobacco habits and diseases was conducted. After the diagnostic samples for SARS-CoV-2 detection were taken in an ad hoc location at Guadalajara University, the subjects were interviewed using structured questionnaires to gather demographic, epidemiological and COVID-19 symptom information. The self-reported periodontal disease (Self-RPD) questionnaire included six questions, and subjects who met the criteria with a score ≥ 2 were considered to have periodontal disease. Results: In total, 369 participants were recruited, with 117 participants included in each group. After indicating the subjects who had self-reported periodontal disease, a statistically significant difference (p value ≤ 0.001) was observed, showing that self-reported periodontal disease (n = 95, 85.1%) was higher in SARS-CoV-2-positive individuals than in controls (n = 66, 56.4%), with an OR of 3.3 (1.8–6.0) for SARS-CoV-2 infection in people with self-reported periodontal disease. Cases reported a statistically higher median of symptoms (median = 7.0, Q₁= 5.5, Q₃ = 10.0) than controls (p value ≤ 0.01), and cases with positive self-RPD had a significantly (p value ≤ 0.05) higher number of symptoms (median = 8.0, Q₁ = 6.0, Q₃ = 10.0) in comparison with those who did negative self-RPD (median = 6.0, Q₁ = 5.0, Q₃ = 8.0). Conclusions: According to this study, self-reported periodontal disease could be considered a risk factor for SARS-CoV-2 infection, and these individuals present more symptoms. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 863 KiB

Open AccessArticle

Vaccination against SARS-CoV-2 in Haemodialysis Patients: Spike’s Ab Response and the Influence of BMI and Age

by Pedro Ponce, Ricardo Peralta, Carla Felix, Carla Pinto, Bruno Pinto and João Fazendeiro Matos

Int. J. Environ. Res. Public Health 2022, 19(16), 10091; https://doi.org/10.3390/ijerph191610091 - 15 Aug 2022

Cited by 2 | Viewed by 1458

Abstract

Patients with chronic kidney disease (CKD-5D) in dialysis have been associated with higher rates of SARS-CoV-2 infection. Objective: To identify the CKD-5D patients’ immune system behavior regarding the Pfizer-BioNTech (BNT162b2 mRNA) vaccine (Comirnaty©). This was a multicenter study carried out in 38 dialysis [...] Read more.

Patients with chronic kidney disease (CKD-5D) in dialysis have been associated with higher rates of SARS-CoV-2 infection. Objective: To identify the CKD-5D patients’ immune system behavior regarding the Pfizer-BioNTech (BNT162b2 mRNA) vaccine (Comirnaty©). This was a multicenter study carried out in 38 dialysis units in NephroCare Portugal. Eligible patients from two cohorts—one composed of completely vaccinated patients with Comirnaty© (vaccinated group) against a second cohort of patients who recovered from SARS-CoV-2 infection (control group)—were selected through representative sampling for each cohort. Humoral response was assessed at 3 (t0) and 6 months (t1) after complete vaccination and, in the control group, 6 months after COVID-19 recovery. In the vaccinated group, at t0, the median anti-Spike IgG level was 1120 AU/mL and, at t1, all participants’ antibody level decreased to a median of 455 AU/mL. In the control group, the median serum SARS-CoV-2 antibodies level was 1836 AU/mL. In the vaccinated group, at t0, patients < 70 years presented a significantly (p = 0.002) higher level of anti-Spike IgG titres. In contrast, older patients from the control group presented a significantly (p = 0.038) higher IgG. No correlation was found between age and anti-Spike IgG antibodies level in any of the studied groups. Patients with a higher body mass index showed a greater immune response in both the vaccinated and control group, although without significance. We concluded that, in the vaccinated group, elderly patients developed a lower immune response than younger patients and the levels of anti-Spike IgG antibodies declined faster between t0 and t1, while in the control group, the oldest and overweight patients developed the best humoral response. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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15 pages, 6309 KiB

Open AccessArticle

Application of Machine Learning in Hospitalized Patients with Severe COVID-19 Treated with Tocilizumab

by Antonio Ramón, Marta Zaragozá, Ana María Torres, Joaquín Cascón, Pilar Blasco, Javier Milara and Jorge Mateo

J. Clin. Med. 2022, 11(16), 4729; https://doi.org/10.3390/jcm11164729 - 12 Aug 2022

Cited by 3 | Viewed by 2431

Abstract

Among the IL-6 inhibitors, tocilizumab is the most widely used therapeutic option in patients with SARS-CoV-2-associated severe respiratory failure (SRF). The aim of our study was to provide evidence on predictors of poor outcome in patients with COVID-19 treated with tocilizumab, using machine [...] Read more.

Among the IL-6 inhibitors, tocilizumab is the most widely used therapeutic option in patients with SARS-CoV-2-associated severe respiratory failure (SRF). The aim of our study was to provide evidence on predictors of poor outcome in patients with COVID-19 treated with tocilizumab, using machine learning (ML) techniques. We conducted a retrospective study, analyzing the clinical, laboratory and sociodemographic data of patients admitted for severe COVID-19 with SRF, treated with tocilizumab. The extreme gradient boost (XGB) method had the highest balanced accuracy (93.16%). The factors associated with a worse outcome of tocilizumab use in terms of mortality were: baseline situation at the start of tocilizumab treatment requiring invasive mechanical ventilation (IMV), elevated ferritin, lactate dehydrogenase (LDH) and glutamate-pyruvate transaminase (GPT), lymphopenia, and low PaFi [ratio between arterial oxygen pressure and inspired oxygen fraction (PaO₂/FiO₂)] values. The factors associated with a worse outcome of tocilizumab use in terms of hospital stay were: baseline situation at the start of tocilizumab treatment requiring IMV or supplemental oxygen, elevated levels of ferritin, glutamate-oxaloacetate transaminase (GOT), GPT, C-reactive protein (CRP), LDH, lymphopenia, and low PaFi values. In our study focused on patients with severe COVID-19 treated with tocilizumab, the factors that were weighted most strongly in predicting worse clinical outcome were baseline status at the start of tocilizumab treatment requiring IMV and hyperferritinemia. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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8 pages, 617 KiB

Open AccessBrief Report

Factors Associated with Burnout among Resident Physicians Responding to the COVID-19 Pandemic: A 2-Month Longitudinal Observation Study

by Teressa R. Ju, Emilia E. Mikrut, Alexandra Spinelli, Anne-Marie Romain, Elizabeth Brondolo, Varuna Sundaram and Cynthia X. Pan

Int. J. Environ. Res. Public Health 2022, 19(15), 9714; https://doi.org/10.3390/ijerph19159714 - 07 Aug 2022

Cited by 4 | Viewed by 1588

Abstract

Background: Burnout during residency may be a function of intense professional demands and poor work/life balance. With the onset of the COVID-19 pandemic, NYC hospital systems were quickly overwhelmed, and trainees were required to perform beyond the usual clinical duties with less supervision [...] Read more.

Background: Burnout during residency may be a function of intense professional demands and poor work/life balance. With the onset of the COVID-19 pandemic, NYC hospital systems were quickly overwhelmed, and trainees were required to perform beyond the usual clinical duties with less supervision and limited education. Objective: The present longitudinal study examined the effects of COVID-19 caseload over time on burnout experienced by resident physicians and explored the effects of demographic characteristics and organizational and personal factors as predictors of burnout severity. Methods: This study employed a prospective design with repeated measurements from April 2020 to June 2020. Participants were surveyed about their well-being every 5 days. Predictors included caseload, sociodemographic variables, self-efficacy, hospital support, perceived professional development, meaning in work, and postgraduate training level. Results: In total, 54 resident physicians were recruited, of whom 50% reported burnout on initial assessment. Periods of higher caseload were associated with higher burnout. PGY-3 residents reported more burnout initially but appeared to recover faster compared to PGY-1 residents. Examined individually, higher self-efficacy, professional development, meaningful work, and hospital support were associated with lower burnout. When all four predictors were entered simultaneously, only self-efficacy was associated with burnout. However, professional development, meaningful work, and hospital support were associated with self-efficacy. Conclusion: Burnout among residency is prevalent and may have implications for burnout during later stages of a physician’s career. Self-efficacy is associated with lower burnout and interventions to increase self-efficacy and the interpersonal factors that promote self-efficacy may improve physician physical and emotional well-being. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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17 pages, 687 KiB

Open AccessArticle

COVID-19 Lockdown in New Zealand: Perceived Stress and Wellbeing among International Health Students Who Were Essential Frontline Workers

by Anita Jagroop-Dearing, Griffin Leonard, Syed M. Shahid and Ondene van Dulm

Int. J. Environ. Res. Public Health 2022, 19(15), 9688; https://doi.org/10.3390/ijerph19159688 - 06 Aug 2022

Cited by 2 | Viewed by 1859

Abstract

This study examined the stresses and wellbeing of international postgraduate health and nursing students at a tertiary education institute in New Zealand who were mainly essential frontline healthcare workers during the COVID-19 lockdown. Quantitative and qualitative data were collected by purposeful sampling ( [...] Read more.

This study examined the stresses and wellbeing of international postgraduate health and nursing students at a tertiary education institute in New Zealand who were mainly essential frontline healthcare workers during the COVID-19 lockdown. Quantitative and qualitative data were collected by purposeful sampling (n = 43). The study utilised a cross-sectional survey, along with the Short Form of Cohen’s Perceived Stress Scale (PSS-10), adapted for the COVID-19 lockdown, and followed by semi-structured individual interviews. This study is the first in New Zealand to demonstrate that, with a mean PSS-10 score of 21.7 (±7.1), international health students experienced higher than optimal levels of stress, with supporting qualitative data identifying four themes for the sources of stress: (1) familial relationships, (2) essential work, (3) finances, and (4) study. However, these students coped because of the extensive support provided by their education institute and employers. These students played a critical role in the pandemic’s response and made a significant public health contribution by working in the frontline of the COVID-19 outbreak. Considering the global shortage of healthcare workers and understanding the key challenges, means of coping and support provisions, as we have here, offer insights for building and maintaining a resilient and resourceful health workforce through international health and nursing students in New Zealand and elsewhere. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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15 pages, 859 KiB

Open AccessArticle

Market Women’s Perspectives on Coronavirus Disease 2019 (COVID-19): The Case of Ghana and South Africa

by Ebenezer Kwabena Frimpong, Peter Yamoah, Ebenezer Wiafe, Patrick Hulisani Demana and Moliehi Matlala

Int. J. Environ. Res. Public Health 2022, 19(15), 9658; https://doi.org/10.3390/ijerph19159658 - 05 Aug 2022

Cited by 5 | Viewed by 1600

Abstract

Globally, countries are still battling health challenges and the negative economic stress on the citizenry caused by COVID-19. This study explored the perspectives of market women in Ghana and South Africa on COVID-19. Data collection was executed in both Ghana and South Africa [...] Read more.

Globally, countries are still battling health challenges and the negative economic stress on the citizenry caused by COVID-19. This study explored the perspectives of market women in Ghana and South Africa on COVID-19. Data collection was executed in both Ghana and South Africa between March 2021 and December 2021. Employing semi-structured questionnaires, face-to-face interviews were conducted. Most of the market women in Ghana described COVID-19 as a global pandemic, while market women in South Africa described the disease as the deadly flu. There were similarities in the perceived signs and symptoms of COVID-19. Market women in both countries specifically observed that not adhering to the safety protocols was the major mode of transmission. Lemon, garlic and ginger were the most common foodstuffs used by the market women to fight COVID-19. To prevent COVID-19 at their places of work, market women stressed the importance of observing the safety protocols. An overwhelming majority of market women in both countries bemoaned the negative impact of COVID-19 on their businesses and suggested the need for financial assistance from their respective governments. The findings are intended to assist policymakers in both Ghana and South Africa to implement interventional projects to assist women whom the literature suggests are the most vulnerable during pandemics such as COVID-19. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 702 KiB

Open AccessArticle

Soluble RAGE as a Prognostic Marker of Worsening in Patients Admitted to the ICU for COVID-19 Pneumonia: A Prospective Cohort Study

by Emmanuel Besnier, Valéry Brunel, Caroline Thill, Perrine Leprêtre, Jérémy Bellien, Zoe Demailly, Sylvanie Renet, Fabienne Tamion and Thomas Clavier

J. Clin. Med. 2022, 11(15), 4571; https://doi.org/10.3390/jcm11154571 - 05 Aug 2022

Viewed by 1405

Abstract

Background: The different waves of SARS-CoV-2 infection have strained hospital resources and, notably, intensive care units (ICUs). Identifying patients at risk of developing a critical condition is essential to correctly refer patients to the appropriate structure and to spare limited resources. The soluble [...] Read more.

Background: The different waves of SARS-CoV-2 infection have strained hospital resources and, notably, intensive care units (ICUs). Identifying patients at risk of developing a critical condition is essential to correctly refer patients to the appropriate structure and to spare limited resources. The soluble form of RAGE (sRAGE), the endoplasmic stress response and its surrogates, GRP78 and VEGF-A, may be interesting markers. Methods: This was a prospective monocenter cohort study of adult patients admitted to the ICU for severe COVID-19 pneumonia. The plasma levels of sRAGE, GRP78 and VEGF-A were measured within the first 24 h. Patients were classified as critical if they further needed vasopressor therapy, renal replacement therapy, or invasive mechanical ventilation, or died during their ICU stay, and were otherwise classified as not critical. Results: A total of 98 patients were included and 39 developed a critical condition. Critical patients presented higher sRAGE (626 [450–1043] vs. 227 [137–404] pg/mL, p < 0.0001), interleukin-6 (43 [15–112] vs. 11 [5–20] pg/mL, p < 0.0001), troponin T (17 [9–39] vs. 10 [6–18] pg/mL, p = 0.003) and NT-pro-BNP (321 [118–446] vs. 169 [63–366] pg/mL, p = 0.009) plasma levels. No difference was observed for VEGF-A and GRP78. The variables independently associated with worsening in the ICU were sRAGE (1.03 [1.01–1.05] per 10 pg/mL) and age (1.7 [1.2–2.4] per 5 years). An sRAGE value of 449.5 pg/mL predicted worsening with a sensitivity of 77% and a specificity of 80%. Conclusion: sRAGE may allow the identification of patients at risk of developing a critical form of COVID-19 pneumonia, and thus may be useful to correctly refer patients to the appropriate structure of care. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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6 pages, 312 KiB

Open AccessBrief Report

Religious Fundamentalism, Delusions, and Conspiracy Beliefs Related to the COVID-19 Pandemic

by Małgorzata Sobol, Marcin Zajenkowski and Konrad S. Jankowski

Int. J. Environ. Res. Public Health 2022, 19(15), 9597; https://doi.org/10.3390/ijerph19159597 - 04 Aug 2022

Cited by 4 | Viewed by 1613

Abstract

The widespread COVID-19 conspiracy theories are a problem in dealing with the pandemic, as their proponents tend not to adhere to public health regulations. The aim of this study was to analyse the relationships between religious fundamentalism, delusions, compliance with public health regulations, [...] Read more.

The widespread COVID-19 conspiracy theories are a problem in dealing with the pandemic, as their proponents tend not to adhere to public health regulations. The aim of this study was to analyse the relationships between religious fundamentalism, delusions, compliance with public health regulations, and religion-related conspiracy beliefs about the COVID-19 pandemic. The participants were 570 internet users aged 18–60. They responded to questions regarding sociodemographic variables, compliance with public health regulations, conspiracy beliefs concerning COVID-19, as well as the Revised Religious Fundamentalism Scale, and the Delusions Scale. The results indicated that people exhibiting more conspiracy beliefs were less likely to comply with public health regulations concerning the COVID-19 pandemic and showed more religious fundamentalism. Additionally, there was an indirect effect of religious fundamentalism on conspiracy beliefs through delusions. The results suggest that when formulating epidemiological messages, it is worth paying attention to the importance of rational thinking. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

12 pages, 822 KiB

Open AccessArticle

Continuous Positive Airway Pressure in Elderly Patients with Severe COVID-19 Related Respiratory Failure

by Elisa Ceriani, Annalisa Pitino, Dejan Radovanovic, Emanuele Salvi, Maddalena Matone, Thomas Teatini, Antonio Gidaro, Giovanni Tripepi, Pierachille Santus, Mercedes Gori and Chiara Cogliati

J. Clin. Med. 2022, 11(15), 4454; https://doi.org/10.3390/jcm11154454 - 30 Jul 2022

Viewed by 1364

Abstract

The elderly population represents a high percentage of patients hospitalized for COVID-19 pneumonia and severe respiratory failure, for whom CPAP may be a treatment option. The aim of this study was to describe the CPAP support modalities and to explore factors associated with [...] Read more.

The elderly population represents a high percentage of patients hospitalized for COVID-19 pneumonia and severe respiratory failure, for whom CPAP may be a treatment option. The aim of this study was to describe the CPAP support modalities and to explore factors associated with CPAP failure. In this retrospective study, 110 consecutive patients aged ≥ 75 years were enrolled. Median frailty score, baseline partial arterial pressure of oxygen to fraction of inspired oxygen ratio (P/F), and respiratory rate (RR) were 5, 108, and 30 cycles/min, respectively. Of the 110 patients that began CPAP treatment, 17 patients died within 72 h from baseline, while in 2 patients, CPAP was withdrawn for clinical improvement. Thus, of the 91 patients still on CPAP at day 3, 67% of them needed continuous CPAP delivery. Patients with RR ≥ 30 and with frailty score ≥ 5 had an odds ratio of continuous CPAP needing of 3 and 4, respectively. Patients unable to tolerate CPAP-free periods demonstrated higher mortality risk as compared to those able to tolerate intermittent CPAP (OR: 6.04, 95% CI 2.38–16.46, p < 0.001). The overall in-hospital mortality was 63.6%. Delirium occurred in 59.1%, with a mortality rate in this subgroup of 83.1%. In a time-varying Cox model, the hazard ratio of death was 2.9 in patients with baseline RR ≥ 30 cycle/min, 2.4 in those with baseline P/F < 100. In the same model, the hazard ratio of death was 20 in patients with delirium and a frailty score < 5 and 8.8 in those without delirium and with frailty ≥ 5, indicating a competitive effect between these two variables on the death risk. Conclusions: Respiratory impairment, frailty, and delirium predict treatment failure, with the latter two factors demonstrating a competitive effect on mortality risk. CPAP support may represent a feasible therapeutic option in elderly patients, although chances of a therapeutic benefit are markedly reduced in case of severe respiratory impairment, very frail baseline condition or delirium occurrence. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 3250 KiB

Open AccessArticle

Predicting COVID-19 Infections in Eswatini Using the Maximum Likelihood Estimation Method

by Sabelo Nick Dlamini, Wisdom Mdumiseni Dlamini and Ibrahima Socé Fall

Int. J. Environ. Res. Public Health 2022, 19(15), 9171; https://doi.org/10.3390/ijerph19159171 - 27 Jul 2022

Viewed by 1607

Abstract

COVID-19 country spikes have been reported at varying temporal scales as a result of differences in the disease-driving factors. Factors affecting case load and mortality rates have varied between countries and regions. We investigated the association between socio-economic, weather, demographic and health variables [...] Read more.

COVID-19 country spikes have been reported at varying temporal scales as a result of differences in the disease-driving factors. Factors affecting case load and mortality rates have varied between countries and regions. We investigated the association between socio-economic, weather, demographic and health variables with the reported cases of COVID-19 in Eswatini using the maximum likelihood estimation method for count data. A generalized Poisson regression (GPR) model was fitted with the data comprising 15 covariates to predict COVID-19 risk in the whole of Eswatini. The results show that the variables that were key determinants in the spread of the disease were those that included the proportion of elderly above 55 years at 98% (95% CI: 97–99%) and the proportion of youth below the age of 35 years at 8% (95% CI: 1.7–38%) with a pseudo R-square of 0.72. However, in the early phase of the virus when cases were fewer, results from the Poisson regression showed that household size, household density and poverty index were associated with reported COVID-19 cases in the country. We then produced a disease-risk map of predicted COVID-19 in Eswatini using variables that were selected by the regression model at a 5% significance level. The map could be used by the country to plan and prioritize health interventions against COVID-19. The identified areas of high risk may be further investigated to find out the risk amplifiers and assess what could be done to prevent them. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 1217 KiB

Open AccessArticle

Cross-Cultural Adaptation and Validation of the Fear of COVID-19 Scale for Chinese University Students: A Cross-Sectional Study

by Wanqiu Yang, Peng Li, Yubo Huang, Xiao Yang, Wei Mu, Wangwei Jing, Xiaohong Ma and Xiangyang Zhang

Int. J. Environ. Res. Public Health 2022, 19(14), 8624; https://doi.org/10.3390/ijerph19148624 - 15 Jul 2022

Cited by 5 | Viewed by 1625

Abstract

Background: fear of COVID-19 is widespread among the population, especially among college students because of their increased exposure to the media information overload of the COVID-19 outbreak. The Fear of COVID-19 scale (FCV-19 S) is a relatively short instrument used to evaluate fears [...] Read more.

Background: fear of COVID-19 is widespread among the population, especially among college students because of their increased exposure to the media information overload of the COVID-19 outbreak. The Fear of COVID-19 scale (FCV-19 S) is a relatively short instrument used to evaluate fears surrounding the COVID-19 pandemic. However, the validity and reliability of the Fear of COVID-19 Scale have not been fully investigated in Chinese university student groups. Objectives: this study assessed the cross-cultural adaptability and reliability of the FCV-19S for Chinese university students. Methods: a Chinese version of Fear of COVID-19 Scale (C-FCV-19S) was generated using the translation-backward translation method. Psychometric properties of the C-FCV-19S, including internal consistency, split-half reliability, construct reliability, convergent validity, and diagnostic accuracy, were evaluated. The Patient Health Questionnaire (PHQ) and Generalized Anxiety Disorder Questionnaire (GAD-7) scales were also used to evaluate participants for depression and anxiety. Results: the C-FCV-19S has acceptable internal consistency (Cronbach’s alpha: 0.872) and satisfactory split-half reliability (correlation coefficient: 0.799). Using the exploratory factor analysis (EFA), we examined the construct reliability (KMO = 0.920). The confirmatory factor analysis (CFA) confirmed that the bifactor model of scale (including general factor, factor1: the awareness of COVID-19 and physiological arousal, factor 2: fear-related thinking) had a good fit index (χ2/df =6.18, RMSEA= 0.067, SRMR = 0.028, GFI = 0.986, TLI = 0.970 and CFI= 0.988). Using depression-positive and anxiety-positive scores as reference criteria, we found that the areas under the curve were 0.70 and 0.68, respectively, and that the optimal cutoff scores of the C-FCV-19S was 17.5 (sensitivity: 66.3% and 58.7%, respectively). Conclusions: the validity and reliability of C-FCV-19S are satisfactory, and the optimal cutoff point was 17.5. The C-FCV-19S can be applied adopted in Chinese university students. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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7 pages, 1425 KiB

Open AccessCommentary

Misleading Meta-Analyses during COVID-19 Pandemic: Examples of Methodological Biases in Evidence Synthesis

by Erand Llanaj and Taulant Muka

J. Clin. Med. 2022, 11(14), 4084; https://doi.org/10.3390/jcm11144084 - 14 Jul 2022

Cited by 2 | Viewed by 2708

Abstract

Not all evidence is equal. Evidence-based public health and medicine emanate from the principle that there is a hierarchy of evidence, with systematic reviews and meta-analyses (SRMAs) being at the top, as the highest level of evidence. Despite this, it is common in [...] Read more.

Not all evidence is equal. Evidence-based public health and medicine emanate from the principle that there is a hierarchy of evidence, with systematic reviews and meta-analyses (SRMAs) being at the top, as the highest level of evidence. Despite this, it is common in literature to find SRMAs with methodological issues that can distort the results and can thus have serious public health or clinical implications. During the Coronavirus Disease 2019 (COVID-19) pandemic, the importance of evidence and the way in which evidence was produced was stress tested and revealed a wide array of methodological biases that might have led to misleading conclusions and recommendations. We provide a critical examination of methodological biases in selected SRMAs on COVID-19, which have been widely used to guide or justify some pharmaceutical and nonpharmaceutical interventions with high public health and clinical significance, such as mask wearing, asymptomatic transmission, and ivermectin. Through these selected examples, we highlight the need to address biases related to the methodological quality and relevance of study designs and effect size computations and considerations for critical appraisal of available data in the evidence synthesis process for better quality evidence. Such considerations help researchers and decision makers avoid misleading conclusions, while encouraging the provision of the best policy recommendations for individual and public health. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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8 pages, 689 KiB

Open AccessArticle

Von Willebrand Factor and ADAMTS-13 Are Associated with the Severity of COVID-19 Disease

by Nataliya Dolgushina, Elena Gorodnova, Olga Beznoshenco, Andrey Romanov, Irina Menzhinskaya, Lyubov Krechetova and Gennady Sukhikh

J. Clin. Med. 2022, 11(14), 4006; https://doi.org/10.3390/jcm11144006 - 11 Jul 2022

Cited by 7 | Viewed by 1313

Abstract

Coagulopathy in COVID-19 patients is presumably based on systemic hypercoagulation with the inflammatory response. As a result of endothelial dysfunction, tissue factor and von Willebrand factor (vWF) are released into the blood stream, which leads to prothrombinase activation. The vWF/ADAMTS-13 ratio can be [...] Read more.

Coagulopathy in COVID-19 patients is presumably based on systemic hypercoagulation with the inflammatory response. As a result of endothelial dysfunction, tissue factor and von Willebrand factor (vWF) are released into the blood stream, which leads to prothrombinase activation. The vWF/ADAMTS-13 ratio can be used for monitoring the severity of the disease. This observational prospective study included 141 patients with COVID-19. In patients with mild COVID-19 (group 1), the assessment was performed on the 3rd–7th day of illness (point 1) and 14–28 days after recovery (point 2). In patients with moderate (groups 2) and severe (group 3) COVID-19, the assessment was performed during hospitalization (point 1) and after 14 days (point 2). The vWF:RCo/ADAMTS-13:activity (point 1), vWF/ADAMTS-13 (point 2) and vWF:RCo/ADAMTS-13:activity (point 2) ratios were significantly higher in patients with moderate and severe COVID-19. Moreover, in these patients, both ratios increased after recovery (point 2), which is a negative prognostic factor of thrombotic complications. Thus, COVID-19 is characterized by a decrease in the concentration and activity of ADAMTS-13 metalloproteinase, especially in patients with the severe form of COVID-19. A decrease in ADAMTS-13 activity results in an increase in vWF concentration and activity so the ratio of vWF to ADAMTS-13 changes significantly. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 601 KiB

Open AccessReview

Postacute Laryngeal Injuries and Dysfunctions in COVID-19 Patients: A Scoping Review

by Jérôme R. Lechien and Stéphane Hans

J. Clin. Med. 2022, 11(14), 3989; https://doi.org/10.3390/jcm11143989 - 09 Jul 2022

Cited by 9 | Viewed by 1538

Abstract

Objective: To investigate post-acute laryngeal injuries and dysfunctions (PLID) in coronavirus disease 2019 (COVID-19) patients. Methods: Three independent investigators performed a systematic review of the literature studying PLID in patients with a history of COVID-19. The review was performed according to the Preferred [...] Read more.

Objective: To investigate post-acute laryngeal injuries and dysfunctions (PLID) in coronavirus disease 2019 (COVID-19) patients. Methods: Three independent investigators performed a systematic review of the literature studying PLID in patients with a history of COVID-19. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Epidemiological, clinical, hospitalization features, laryngeal diseases, and voice outcomes were extracted from the included papers. Results: Eight papers met our inclusion criteria (393 patients) corresponding to five uncontrolled prospective and three retrospective studies. The most prevalent PLID were vocal fold dysmotility (65%), vocal fold edema (35%), muscle tension dysphonia (21%), and laryngopharyngeal reflux (24%). Posterior glottic stenosis (12%), granuloma (14%), and posterior glottic diastasis (12%) were the most common injuries. Most patients with PLID were obese and had a history of intensive care unit hospitalization, and orotracheal intubation. The delay between the discharge and the laryngology office consultation ranged from 51 to 122 days. The mean duration of intubation ranged from 10 to 34 days. Seventy-eight (49%) intubated patients were in the prone position. The proportion of patients requiring surgical treatment ranged from 39% to 70% (mean = 48%). There was an important heterogeneity between studies about inclusion, exclusion criteria, and outcomes. Conclusions: COVID-19 appeared to be associated with PLID, especially in patients with a history of intubation. However, future controlled studies are needed to evaluate if intubated COVID-19 patients reported more frequently PLID than patients who were intubated for other conditions. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 531 KiB

Open AccessArticle

The Association between the Sense of Coherence and the Self-Reported Adherence to Guidelines during the First Months of the COVID-19 Pandemic in Israel

by Anne Marie Novak, Adi Katz, Michal Bitan and Shahar Lev-Ari

Int. J. Environ. Res. Public Health 2022, 19(13), 8041; https://doi.org/10.3390/ijerph19138041 - 30 Jun 2022

Cited by 2 | Viewed by 1408

Abstract

(1) Background: Social distancing became a central strategy employed to limit the spread of the SARS-CoV-2 virus. We explore self-reported adherence (SRA) and factors associated with SRA among Israeli adults at the end of the first national lockdown in Israel. (2) Methods: We [...] Read more.

(1) Background: Social distancing became a central strategy employed to limit the spread of the SARS-CoV-2 virus. We explore self-reported adherence (SRA) and factors associated with SRA among Israeli adults at the end of the first national lockdown in Israel. (2) Methods: We conducted a cross-sectional consumer panel survey of 820 Israeli adults aged 18 to 70 in May and June 2020. We collected data on the SRA to the social distancing measures, sociodemographic variables, perceptions of pandemic-related danger and of protection provided by the social distancing measures, as well as Sense of Coherence (SoC). (3) Results: 60% of respondents reported complying with 7 measures. Higher SoC was associated with higher SRA (p = 0.04), and was related to income, marital status, age, profession, and education. The SRA was higher among Jews than Arabs (Jews: Mean = 10.5, SD = 4.5; Arabs: Mean = 9.1, SD = 4.1, p < 0.001) and among males (Males: Mean = 10.8, SD = 4.7; Females: Mean = 9, SD = 4.1; p = 0.003). SoC, perception of protection and perception of danger were associated with higher SRA (p = 0.42, p < 0.001 and p = 0.005 respectively). Single people reported higher levels of SRA than people in relationships (Partnered: Mean = 9.7, SD = 4.2, Non-partnered: Mean = 10.9, SD = 4.7, p = 0.033). (4) Conclusions: At the time of exit from the first lockdown, compliance with social distancing measures was high, with Jewish, single and male Israelis more likely to adhere to the guidelines. We identified the populations at risk for non-adherence and associated factors, reporting for the first time the correlation between SoC and SRA. Further research is needed to assess the role of these factors in Jewish and Arab populations. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 472 KiB

Open AccessArticle

Searching for Factors Influencing the Severity of the Symptoms of Long COVID

by Alicja Mińko, Agnieszka Turoń-Skrzypińska, Aleksandra Rył, Natalia Tomska, Zuzanna Bereda and Iwona Rotter

Int. J. Environ. Res. Public Health 2022, 19(13), 8013; https://doi.org/10.3390/ijerph19138013 - 30 Jun 2022

Cited by 6 | Viewed by 2174

Abstract

COVID-19 is a highly contagious respiratory disease. Infection with the virus can occur with differing symptom severity, from mild and moderate to severe cases, but the long-term consequences of infection have not been fully identified or studied. Long COVID is defined as occurring [...] Read more.

COVID-19 is a highly contagious respiratory disease. Infection with the virus can occur with differing symptom severity, from mild and moderate to severe cases, but the long-term consequences of infection have not been fully identified or studied. Long COVID is defined as occurring in individuals with a history of probable or confirmed SARS-CoV-2 infection, and symptoms persisting for at least two months within three months of onset that cannot be explained by an alternative diagnosis. The purpose of this study was to look for factors that influence the type and severity of Long COVID symptoms. In total, 932 individuals with a history of COVID-19 were qualified for the study using an original questionnaire based on the COVID-19 Yorkshire Rehab Screen (C19-YRS) questionnaire. Older adults were more likely to report problems with mobility (p < 0.001) and in performing daily activities (p = 0.014). Those with a higher BMI showed significantly more symptoms such as dyspnea at rest (p < 0.001) and on exertion (p < 0.001), feelings of chronic fatigue (p = 0.023), problems with mobility (p < 0.001), and in performing daily activities (p = 0.002). The data show that those with Long COVID should receive multidisciplinary help including additional medical and psychological support. Particular attention should be paid to elderly and obese persons, who should be included in rehabilitation programs after COVID-19 in the first place. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 5557 KiB

Open AccessArticle

Evaluation of Respiratory Particle Emission during Otorhinolaryngological Procedures in the Context of the SARS-CoV-2 Pandemic

by Reinhard Veltrup, Stefan Kniesburges, Michael Döllinger, Sebastian Falk and Sarina K. Mueller

Diagnostics 2022, 12(7), 1603; https://doi.org/10.3390/diagnostics12071603 - 30 Jun 2022

Cited by 1 | Viewed by 1522

Abstract

Understanding the risk of infection by routine medical examination is important for the protection of the medical personnel. In this study we investigated respiratory particles emitted by patients during routine otolaryngologic procedures and assessed the risks for the performing physician. We developed two [...] Read more.

Understanding the risk of infection by routine medical examination is important for the protection of the medical personnel. In this study we investigated respiratory particles emitted by patients during routine otolaryngologic procedures and assessed the risks for the performing physician. We developed two experimental setups to measure aerosol and droplet emission during rigid/flexible laryngoscopy, rhinoscopy, pharyngoscopy, otoscopy, sonography and patient interview for subjects with and without masks. A high-speed-camera setup was used to detect ballistic droplets (approx. > 100 µm) and an aerosol-particle-sizer was used to detect aerosol particles in the range of 0.3 µm to 10 µm. Aerosol particle counts were highly increased for coughing and slightly increased for heavy breathing in subjects without masks. The highest aerosol particle counts occurred during rigid laryngoscopy. During laryngoscopy and rhinoscopy, the examiner was exposed to increased particle emission due to close proximity to the patient’s face and provoked events such as coughing. However, even during sonography or otoscopy without a mask, aerosol particles were expelled close to the examiner. The physician’s exposure to respiratory particles can be reduced by deliberate choice of examination technique depending on medical indication and the use of appropriate equipment for the examiners and the patients (e.g., FFP2 masks for both). Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 778 KiB

Open AccessArticle

Evaluation of a Follow-Up Health Consultation Program for Patients with Coronavirus Disease 2019 in Korea: Using the Context–Input–Process–Product Model

by Keun-Mi Lee, Hae-Jin Ko, Geon Ho Lee, Yun-A Kim, Seung-Pil Jung and A-Sol Kim

Int. J. Environ. Res. Public Health 2022, 19(13), 7996; https://doi.org/10.3390/ijerph19137996 - 29 Jun 2022

Viewed by 1593

Abstract

Beyond physical pain, patients with coronavirus disease 2019 (COVID-19) experience psychological anxiety during and after quarantine, often facing negative perceptions when returning to their communities. This study evaluated a health consultation program in Korea for post-quarantine patients with COVID-19, designed to help them [...] Read more.

Beyond physical pain, patients with coronavirus disease 2019 (COVID-19) experience psychological anxiety during and after quarantine, often facing negative perceptions when returning to their communities. This study evaluated a health consultation program in Korea for post-quarantine patients with COVID-19, designed to help them return to their communities. The program was conducted from 9 March to 5 June 2020, in Daegu, Korea. In total, 20 doctors and 504 recovered patients were surveyed via questionnaire. The survey, comprising open-ended questions rated on a five-point Likert scale, was based on the Context–Input–Process–Product program evaluation model. Reliability was assessed, and descriptive statistics were obtained. A regression analysis was performed on factors affecting product (output) areas. As a main result, both doctors and recovered patients evaluated the program positively. The mean program effectiveness score was 4.00 in the doctors’ evaluations and 3.95 in the patients’ evaluations. Moreover, the input and process variables affected the product. This first-of-its-kind health consultation program proved to be an effective practical intervention for patients returning to the community after an infectious disease; it also highlights aspects that could increase satisfaction in systemized subsequent programs, with input and process areas for patients and doctors. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 1627 KiB

Open AccessArticle

SARS-CoV-2 Viral Load Analysis at Low and High Altitude: A Case Study from Ecuador

by Esteban Ortiz-Prado, Katherine Simbaña-Rivera, Raul Fernandez-Naranjo, Jorge Eduardo Vásconez, Aquiles R. Henriquez-Trujillo, Alexander Paolo Vallejo-Janeta, Ismar A. Rivera-Olivero, Tannya Lozada, Gines Viscor and Miguel Angel Garcia-Bereguiain

Int. J. Environ. Res. Public Health 2022, 19(13), 7945; https://doi.org/10.3390/ijerph19137945 - 28 Jun 2022

Cited by 6 | Viewed by 1984

Abstract

SARS-CoV-2 has spread throughout the world, including remote areas such as those located at high altitudes. There is a debate about the role of hypobaric hypoxia on viral transmission and COVID-19 incidence. A descriptive cross-sectional analysis of SARS-CoV-2 infection and viral load among [...] Read more.

SARS-CoV-2 has spread throughout the world, including remote areas such as those located at high altitudes. There is a debate about the role of hypobaric hypoxia on viral transmission and COVID-19 incidence. A descriptive cross-sectional analysis of SARS-CoV-2 infection and viral load among patients living at low (230 m) and high altitude (3800 m) in Ecuador was completed. Within these two communities, the total number of infected people at the time of the study was 108 cases (40.3%). The COVID-19 incidence proportion at low altitude was 64% while at high altitude was 30.3%. The mean viral load from those patients who tested positive was 3,499,184 copies/mL (SD = 23,931,479 copies/mL). At low altitude (Limoncocha), the average viral load was 140,223.8 copies/mL (SD = 990,840.9 copies/mL), while for the high altitude group (Oyacachi), the mean viral load was 6,394,789 copies/mL (SD = 32,493,469 copies/mL). We found no statistically significant differences when both results were compared (p = 0.056). We found no significant differences across people living at low or high altitude; however, men and younger populations had higher viral load than women older populations, respectively. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 695 KiB

Open AccessArticle

COVID-19 Vaccination Campaign among the Health Workers of Fondazione Policlinico Universitario Agostino Gemelli IRCCS: A Cost–Benefit Analysis

by Mario Cesare Nurchis, Alberto Lontano, Domenico Pascucci, Martina Sapienza, Eleonora Marziali, Francesco Castrini, Rosaria Messina, Luca Regazzi, Francesco Andrea Causio, Andrea Di Pilla, Giuseppe Vetrugno, Gianfranco Damiani and Patrizia Laurenti

Int. J. Environ. Res. Public Health 2022, 19(13), 7848; https://doi.org/10.3390/ijerph19137848 - 26 Jun 2022

Cited by 5 | Viewed by 2144

Abstract

Vaccinations generate health, economic and social benefits in both vaccinated and unvaccinated populations. The aim of this study was to conduct a cost–benefit analysis to estimate the costs and benefits associated with the COVID-19 vaccination campaign for health workers in Fondazione Policlinico Universitario [...] Read more.

Vaccinations generate health, economic and social benefits in both vaccinated and unvaccinated populations. The aim of this study was to conduct a cost–benefit analysis to estimate the costs and benefits associated with the COVID-19 vaccination campaign for health workers in Fondazione Policlinico Universitario Agostino Gemelli IRCCS (FPG). The analysis included 5152 healthcare workers who voluntarily received the Pfizer–BioNTech COVID-19 vaccine, divided into physicians, nurses and other health workers. Data about vaccine cost, administration and materials were derived from administrative databases of the FPG from 28 December 2020 to 31 March 2021. The costs associated with the COVID-19 vaccination campaign amounted to EUR 2,221,768, while the benefits equaled EUR 10,345,847. The benefit-to-cost ratio resulted in EUR 4.66, while the societal return on investment showed a ratio of EUR 3.66. The COVID-19 vaccination campaign for health workers in FPG has high social returns and it strengthens the need to inform and update decision-making about the economic and social benefits associated with a vaccination campaign. Health economic evaluations on vaccines should always be considered by decision-makers when considering the inclusion of a new vaccine into the national program. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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7 pages, 437 KiB

Open AccessCommunication

The Detection of SARS-CoV2 Antigen in Wastewater Using an Automated Chemiluminescence Enzyme Immunoassay

by Supranee Thongpradit, Somsak Prasongtanakij, Supanart Srisala, Suwannee Chanprasertyothin, Ekawat Pasomsub and Boonsong Ongphiphadhanakul

Int. J. Environ. Res. Public Health 2022, 19(13), 7783; https://doi.org/10.3390/ijerph19137783 - 24 Jun 2022

Cited by 2 | Viewed by 1730

Abstract

The SARS-CoV-2 virus, which is driving the current COVID-19 epidemic, has been detected in wastewater and is being utilized as a surveillance tool to establish an early warning system to aid in the management and prevention of future pandemics. qPCR is the method [...] Read more.

The SARS-CoV-2 virus, which is driving the current COVID-19 epidemic, has been detected in wastewater and is being utilized as a surveillance tool to establish an early warning system to aid in the management and prevention of future pandemics. qPCR is the method usually used to detect SARS-CoV-2 in wastewater. There has been no study using an immunoassay that is less laboratory-intensive than qPCR with a shorter turnaround time. Therefore, we aimed to evaluate the performance of an automated chemiluminescence enzyme immunoassay (CLEIA) for SARS-CoV-2 antigen in wastewater. The CLEIA assay achieved 100% sensitivity and 66.7% specificity in a field-captured wastewater sample compared to the gold standard RT-qPCR. Our early findings suggest that the SARS-CoV-2 antigen can be identified in wastewater samples using an automated CLEIA, reducing the turnaround time and improving the performance of SARS-CoV-2 wastewater monitoring during the pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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2 pages, 176 KiB

Open AccessComment

Single-Breath Counting Test to Start Non-Invasive Respiratory Support in COVID-19 Patients: Early Detection and the Eternal Dilemma. Comment on Longhitano et al. Single-Breath Counting Test Predicts Non-Invasive Respiratory Support Requirements in Patients with COVID-19 Pneumonia. J. Clin. Med. 2022, 11, 179

by Stefano Oldani, Serena Bensai and Antonio M. Esquinas

J. Clin. Med. 2022, 11(13), 3588; https://doi.org/10.3390/jcm11133588 - 22 Jun 2022

Viewed by 1089

Abstract

We have read this study, in which the predictive role of a single-breath counting test (SBCT) to foresee the need of non-invasive respiratory strategies (NIRS) in patients with COVID-19 has been explored, with great interest [...] Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

15 pages, 408 KiB

Open AccessReview

COVID-19—What Price Do Children Pay? An Analysis of Economic and Social Policy Factors

by Stephanie Lange, Claire-Marie Altrock, Emily Gossmann, Jörg M. Fegert and Andreas Jud

Int. J. Environ. Res. Public Health 2022, 19(13), 7604; https://doi.org/10.3390/ijerph19137604 - 21 Jun 2022

Cited by 6 | Viewed by 2085

Abstract

Numerous studies have addressed the indirect consequences of the COVID-19 pandemic for children such as social isolation or increases in reported child maltreatment. Research on the economic and sociopolitical consequences is scarce as they can only be evaluated with a time lag. To [...] Read more.

Numerous studies have addressed the indirect consequences of the COVID-19 pandemic for children such as social isolation or increases in reported child maltreatment. Research on the economic and sociopolitical consequences is scarce as they can only be evaluated with a time lag. To improve our understanding of future, long-term developments in the context of the COVID-19 pandemic, we gathered findings from the still unexploited empirical literature on the aftermath of earlier pandemics, epidemics, and other infectious disease outbreaks. On top of this, we scrutinized research on past economic crises to interpret the link between changes in the economy and the health of children. Many of the side effects of battling the spread of the current pandemic, such as school closures, the stigma of infection, or conflicts about vaccines, are not novel and have already been documented in connection with previous infectious disease outbreaks. Results highlight that changes in the financial situation of families and socio-political challenges affect the situation and daily routine of children and youth in the long term. In consequence, the already pronounced socioeconomic inequalities will likely further increase. On top of this, due to reduced revenues, child protective services are likely to face challenges in the availability of human and financial resources. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

13 pages, 631 KiB

Open AccessArticle

Behavioral Intention and Its Predictors toward COVID-19 Booster Vaccination among Chinese Parents: Applying Two Behavioral Theories

by Meng Zhou, Li Liu, Shu-Yan Gu, Xue-Qing Peng, Chi Zhang, Qi-Feng Wu, Xin-Peng Xu and Hua You

Int. J. Environ. Res. Public Health 2022, 19(12), 7520; https://doi.org/10.3390/ijerph19127520 - 20 Jun 2022

Cited by 11 | Viewed by 1889

Abstract

The booster vaccination of COVID-19 is being implemented in most parts of the world. This study used behavioral psychology to investigate the predictors of parents’ intentions regarding the COVID-19 booster vaccination for their children. This is a cross-sectional study with a self-designed questionnaire [...] Read more.

The booster vaccination of COVID-19 is being implemented in most parts of the world. This study used behavioral psychology to investigate the predictors of parents’ intentions regarding the COVID-19 booster vaccination for their children. This is a cross-sectional study with a self-designed questionnaire based on two behavioral theories—protective motivation theory (PMT) and theory of planned behavior (TPB). A stratified multi-stage sampling procedure was conducted in Nanjing, China, and multivariable regression analyses were applied to examine the parents’ intentions. The intention rate was 87.3%. The response efficacy (ORa = 2.238, 95% CI: 1.360–3.682) and response cost (ORa = 0.484, 95% CI: 0.319–0.732) in the PMT, were significant psychological predictors of parents’ intentions, and so were the attitude (ORa = 2.619, 95% CI: 1.480–4.636) and behavioral control (ORa = 3.743, 95% CI: 2.165–6.471) in the TPB. The findings of crucial independent predictors in the PMT and TPB constructs inform the evidence-based formulation and implementation of strategies for booster vaccination in children. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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8 pages, 687 KiB

Open AccessArticle

Impact of COVID-19 by Pandemic Wave among Patients with Gastroenterology Symptoms in the Emergency Departments at a Medical Center in Taiwan

by Tony Kuo, Chun-Hao Liu, Cheng-Yu Chien and Chung-Cheng Yeh

Int. J. Environ. Res. Public Health 2022, 19(12), 7516; https://doi.org/10.3390/ijerph19127516 - 20 Jun 2022

Cited by 2 | Viewed by 1408

Abstract

The COVID-19 pandemic has affected emergency department (ED) usage. This study examines changes in the number of ED visits for gastrointestinal (GI) bleeding and nonemergency GI conditions, such as acute gastroenteritis (AGE) and constipation, before the pandemic and at the peak and slack [...] Read more.

The COVID-19 pandemic has affected emergency department (ED) usage. This study examines changes in the number of ED visits for gastrointestinal (GI) bleeding and nonemergency GI conditions, such as acute gastroenteritis (AGE) and constipation, before the pandemic and at the peak and slack periods of the pandemic in Taiwan. This retrospective observational study was conducted at a referral medical center in northern Taiwan. We recorded the number of weekly ED visits for GI bleeding, AGE, and constipation from 2019 to 2021. We then compared the baseline period (calendar weeks 4–18 and 21–31, 2019) with two peak pandemic periods (period 1, calendar weeks 4–18, 2020; period 2, calendar weeks 21–31, 2021) and their corresponding slack periods. The decline in the number of ED visits during the two peak pandemic periods for GI bleeding (−18.4% and −30.2%) were not as substantial as for AGE (−64.1% and −76.7%) or for constipation (−44.4% and −63.6%), but GI bleeding cases were still significantly lower in number relative to the baseline. During the slack period, the number of ED visits for all three diagnoses rebounded but did not exceed the baseline. Our study revealed that there was a significant decline of GI complaint during the pandemic. This phenomenon was more prominent in nonemergency complaints (AGE and constipation) and less prominent in serious complaints (GI bleeding). Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 1986 KiB

Open AccessArticle

Usefulness of Hospital Admission Chest X-ray Score for Predicting Mortality and ICU Admission in COVID-19 Patients

by Trieu-Nghi Hoang-Thi, Duc-Tuan Tran, Hai-Dang Tran, Manh-Cuong Tran, Tra-My Ton-Nu, Hong-Minh Trinh-Le, Hanh-Nhi Le-Huu, Nga-My Le-Thi, Cong-Trinh Tran, Nhat-Nam Le-Dong and Anh-Tuan Dinh-Xuan

J. Clin. Med. 2022, 11(12), 3548; https://doi.org/10.3390/jcm11123548 - 20 Jun 2022

Cited by 1 | Viewed by 1718

Abstract

We aimed to investigate the performance of a chest X-ray (CXR) scoring scale of lung injury in prediction of death and ICU admission among patients with COVID-19 during the 2021 peak pandemic in HCM City, Vietnam. CXR and clinical data were collected from [...] Read more.

We aimed to investigate the performance of a chest X-ray (CXR) scoring scale of lung injury in prediction of death and ICU admission among patients with COVID-19 during the 2021 peak pandemic in HCM City, Vietnam. CXR and clinical data were collected from Vinmec Central Park-hospitalized patients from July to September 2021. Three radiologists independently assessed the day-one CXR score consisting of both severity and extent of lung lesions (maximum score = 24). Among 219 included patients, 28 died and 34 were admitted to the ICU. There was a high consensus for CXR scoring among radiologists (κ = 0.90; CI95%: 0.89–0.92). CXR score was the strongest predictor of mortality (tdAUC 0.85 CI95% 0.69–1) within the first 3 weeks after admission. A multivariate model confirmed a significant effect of an increased CXR score on mortality risk (HR = 1.33, CI95%: 1.10 to 1.62). At a threshold of 16 points, the CXR score allowed for predicting in-hospital mortality and ICU admission with good sensitivity (0.82 (CI95%: 0.78 to 0.87) and 0.86 (CI95%: 0.81 to 0.90)) and specificity (0.89 (CI95%: 0.88 to 0.90) and 0.87 (CI95%: 0.86 to 0.89)), respectively, and can be used to identify high-risk patients in needy countries such as Vietnam. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 837 KiB

Open AccessReview

How COVID-19 Affects Lung Transplantation: A Comprehensive Review

by Jiri Vachtenheim, Jr., Rene Novysedlak, Monika Svorcova, Robert Lischke and Zuzana Strizova

J. Clin. Med. 2022, 11(12), 3513; https://doi.org/10.3390/jcm11123513 - 18 Jun 2022

Viewed by 2119

Abstract

Lung transplant (LuTx) recipients are at a higher risk of developing serious illnesses from COVID-19, and thus, we have closely reviewed the consequences of the COVID-19 pandemic on lung transplantation. In most transplant centers, the overall LuTx activity significantly declined and led to [...] Read more.

Lung transplant (LuTx) recipients are at a higher risk of developing serious illnesses from COVID-19, and thus, we have closely reviewed the consequences of the COVID-19 pandemic on lung transplantation. In most transplant centers, the overall LuTx activity significantly declined and led to a specific period of restricting lung transplantation to urgent cases. Moreover, several transplant centers reported difficulties due to the shortage of ICU capacities. The fear of donor-derived transmission generated extensive screening programs. Nevertheless, reasonable concerns about the unnecessary losses of viable organs were also raised. The overall donor shortage resulted in increased waiting-list mortality, and COVID-19-associated ARDS became an indication of lung transplantation. The impact of specific immunosuppressive agents on the severity of COVID-19 varied. Corticosteroid discontinuation was not found to be beneficial for LuTx patients. Tacrolimus concentrations were reported to increase during the SARS-CoV-2 infection, and in combination with remdesivir, tacrolimus may clinically impact renal functions. Monoclonal antibodies were shown to reduce the risk of hospitalization in SOT recipients. However, understanding the pharmacological interactions between the anti-COVID-19 drugs and the immunosuppressive drugs requires further research. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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31 pages, 3190 KiB

Open AccessArticle

Associations between COVID-19 Pandemic, Lockdown Measures and Human Mobility: Longitudinal Evidence from 86 Countries

by Md. Mokhlesur Rahman and Jean-Claude Thill

Int. J. Environ. Res. Public Health 2022, 19(12), 7317; https://doi.org/10.3390/ijerph19127317 - 14 Jun 2022

Cited by 16 | Viewed by 2850

Abstract

Recognizing an urgent need to understand the dynamics of the pandemic’s severity, this longitudinal study is conducted to explore the evolution of complex relationships between the COVID-19 pandemic, lockdown measures, and social distancing patterns in a diverse set of 86 countries. Collecting data [...] Read more.

Recognizing an urgent need to understand the dynamics of the pandemic’s severity, this longitudinal study is conducted to explore the evolution of complex relationships between the COVID-19 pandemic, lockdown measures, and social distancing patterns in a diverse set of 86 countries. Collecting data from multiple sources, a structural equation modeling (SEM) technique is applied to understand the interdependencies between independent variables, mediators, and dependent variables. Results show that lockdown and confinement measures are very effective to reduce human mobility at retail and recreation facilities, transit stations, and workplaces and encourage people to stay home and thereby control COVID-19 transmission at critical times. The study also found that national contexts rooted in socioeconomic and institutional factors influence social distancing patterns and severity of the pandemic, particularly with regard to the vulnerability of people, treatment costs, level of globalization, employment distribution, and degree of independence in society. Additionally, this study portrayed a mutual relationship between the COVID-19 pandemic and human mobility. A higher number of COVID-19 confirmed cases and deaths reduces human mobility and the countries with reduced personal mobility have experienced a deepening of the severity of the pandemic. However, the effect of mobility on pandemic severity is stronger than the effect of pandemic situations on mobility. Overall, the study displays considerable temporal changes in the relationships between independent variables, mediators, and dependent variables considering pandemic situations and lockdown regimes, which provides a critical knowledge base for future handling of pandemics. It has also accommodated some policy guidelines for the authority to control the transmission of COVID-19. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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42 pages, 50533 KiB

Open AccessArticle

Electrostatic Spray Disinfection Using Nano-Engineered Solution on Frequently Touched Surfaces in Indoor and Outdoor Environments

by Tanya Purwar, Shamya Dey, Osama Zaid Ali Al-Kayyali, Aaron Floyd Zalar, Ali Doosttalab, Luciano Castillo and Victor M. Castano

Int. J. Environ. Res. Public Health 2022, 19(12), 7241; https://doi.org/10.3390/ijerph19127241 - 13 Jun 2022

Cited by 4 | Viewed by 2286

Abstract

The COVID-19 pandemic has resulted in high demand for disinfection technologies. However, the corresponding spray technologies are still not completely optimized for disinfection purposes. There are important problems, like the irregular coverage and dripping of disinfectant solutions on hard and vertical surfaces. In [...] Read more.

The COVID-19 pandemic has resulted in high demand for disinfection technologies. However, the corresponding spray technologies are still not completely optimized for disinfection purposes. There are important problems, like the irregular coverage and dripping of disinfectant solutions on hard and vertical surfaces. In this study, we highlight two major points. Firstly, we discuss the effectiveness of the electrostatic spray deposition (ESD) of nanoparticle-based disinfectant solutions for systematic and long-lasting disinfection. Secondly, we show that, based on the type of material of the substrate, the effectiveness of ESD varies. Accordingly, 12 frequently touched surface materials were sprayed using a range of electrostatic spray system parameters, including ion generator voltage, nozzle spray size and distance of spray. It was observed that for most cases, the surfaces become completely covered with the nanoparticles within 10 s. Acrylic, Teflon, PVC, and polypropylene surfaces show a distinct effect of ESD and non-ESD sprays. The nanoparticles form a uniform layer with better surface coverage in case of electrostatic deposition. Quantitative variations and correlations show that 1.5 feet of working distance, an 80

μ

m spray nozzle diameter and an ion generator voltage of 3–7 kV ensures a DEF (differential electric field) that corresponds to an optimized charge-to-mass ratio, ensuring efficient coverage of nanoparticles. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 756 KiB

Open AccessArticle

SARS-CoV-2 Risk Quantification Model and Validation Based on Large-Scale Dutch Test Events

by Bas Kolen, Laurens Znidarsic, Andreas Voss, Simon Donders, Iris Kamphorst, Maarten van Rijn, Dimitri Bonthuis, Merit Clocquet, Maarten Schram, Rutger Scharloo, Tim Boersma, Tim Stobernack and Pieter van Gelder

Int. J. Environ. Res. Public Health 2022, 19(12), 7238; https://doi.org/10.3390/ijerph19127238 - 13 Jun 2022

Viewed by 1606

Abstract

In response to the outbreak of SARS-CoV-2, many governments decided in 2020 to impose lockdowns on societies. Although the package of measures that constitute such lockdowns differs between countries, it is a general rule that contact between people, especially in large groups of [...] Read more.

In response to the outbreak of SARS-CoV-2, many governments decided in 2020 to impose lockdowns on societies. Although the package of measures that constitute such lockdowns differs between countries, it is a general rule that contact between people, especially in large groups of people, is avoided or prohibited. The main reasoning behind these measures is to prevent healthcare systems from becoming overloaded. As of 2021 vaccines against SARS-CoV-2 are available, but these do not guarantee 100% risk reduction and it will take a while for the world to reach a sufficient immune status. This raises the question of whether and under which conditions events like theater shows, conferences, professional sports events, concerts, and festivals can be organized. The current paper presents a COVID-19 risk quantification method for (large-scale) events. This method can be applied to events to define an alternative package of measures replacing generic social distancing. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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16 pages, 316 KiB

Open AccessArticle

Jordan’s Pandemic Influenza Preparedness (PIP): A Reflection on COVID-19 Response

by Khalid A. Kheirallah, Mohammed Al-Nusair, Shahed Aljabeiti, Nadir Sheikali, Abdallah Alzoubi, Jomana W. Alsulaiman, Abdel-Hameed Al-Mistarehi, Hamed Alzoubi, Ayman Ahmad Bani Mousa and Mohammed Z. Allouh

Int. J. Environ. Res. Public Health 2022, 19(12), 7200; https://doi.org/10.3390/ijerph19127200 - 12 Jun 2022

Cited by 2 | Viewed by 2021

Abstract

The COVID-19 pandemic made it clear to the world that better preparedness for future pandemics is paramount. This study aims to explore how the 2018 Jordan’s Pandemic Influenza Preparedness (PIP) assessment plan (conducted utilizing a standardized tool of the CDC National Inventory of [...] Read more.

The COVID-19 pandemic made it clear to the world that better preparedness for future pandemics is paramount. This study aims to explore how the 2018 Jordan’s Pandemic Influenza Preparedness (PIP) assessment plan (conducted utilizing a standardized tool of the CDC National Inventory of Core Capabilities for Pandemic Influenza Preparedness and Response) reflected on the initial COVID-19 response. A qualitative, single intrinsic case study design, utilizing interpretivist approach, was utilized to interview subject-matter experts and explore the potential reflection of PIP assessment on COVID-19 response. Utilizing a mini-Delphi approach, the interviews aimed at generating an in-depth understanding of how the Jordan’s PIP risk assessment reflects on the country’s response to COVID-19. The following 12 core capabilities, along with their reflections on COVID-19, were assessed: country planning, research and use of findings, communications, epidemiologic capability, laboratory capability, routine influenza surveillance, national respiratory disease surveillance, outbreak response, resources for containment, community-based interventions to prevent the spread of influenza, infection control (IC), and health sector pandemic response. Jordan’s experience and preparedness for influenza may have served as a crucial guide to establishing success in COVID-19 control and mitigation. Surveillance, outbreak, and research activities were very well established in Jordan’s PIP, whereas surge capacity in human capital and health facility were identified as two high-risk areas. However, the limitation in these two areas was met during the COVID-19 response. Still, human capital suffered fatigue, and there was an evident lack of laboratory testing plans when COVID-19 cases increased. Jordan’s experience with PIP may have served as a guide for establishing successful COVID-19 control and mitigation. The established PIP principles, systems, and capacities seem to have reflected well on fighting against COVID-19 in terms of more efficient utilization of available surveillance, laboratory, outbreak management, and risk communications. This reflection facilitated a better mitigation and control of COVID-19. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

12 pages, 1082 KiB

Open AccessArticle

Clinical (BMI and MRI) and Biochemical (Adiponectin, Leptin, TNF-α, and IL-6) Effects of High-Intensity Aerobic Training with High-Protein Diet in Children with Obesity Following COVID-19 Infection

by Gopal Nambi, Mshari Alghadier, Tamer E. Elnegamy, Reem M. Basuodan, Reem M. Alwhaibi, Arul Vellaiyan, Naif A. Nwihadh, Osama R. Aldhafian, Anju Verma, Shahul Hameed Pakkir Mohamed, Mohamed Faisal Chevidikunnan and Fayaz Khan

Int. J. Environ. Res. Public Health 2022, 19(12), 7194; https://doi.org/10.3390/ijerph19127194 - 11 Jun 2022

Cited by 3 | Viewed by 2445

Abstract

Objective: To find the clinical and biochemical effects of high-intensity aerobic training with a high-protein diet in children with obesity following COVID-19 infection. Methods: By using the block randomization method, the eligible participants were randomized into two groups. The first group received high-intensity [...] Read more.

Objective: To find the clinical and biochemical effects of high-intensity aerobic training with a high-protein diet in children with obesity following COVID-19 infection. Methods: By using the block randomization method, the eligible participants were randomized into two groups. The first group received high-intensity aerobic training with a high-protein diet (Group A; n = 38) and the second group were allowed to do regular physical activities and eat a regular diet (Group B; n = 38) for 8 weeks. Clinical (basal metabolic index (BMI) and muscle-mass-cross-sectional area (CSA)) and biochemical (Adiponectin, leptin, TNF-α, and IL-6) measures were measured at baseline, on the 8th week, and at 6-months follow-up. Results: Baseline demographic and clinical attributes show homogenous presentation among the study groups (p > 0.05). After eight weeks of intervention, and at the end of 6-months follow-up, the basal metabolic index (BMI) (6.3) (CI 95% 4.71 to 7.88), mid-arm CSA (17) (CI 95% 14.70 to 19.29), mid-thigh CSA (13.10) (CI 95% 10.60 to 15.59), mid-calf CSA (11.3) (CI 95% 9.30 to 13.29), adiponectin (−1.9) (CI 95% −2.13 to −1.66), leptin (5.64) (CI 95% 5.50 to 5.77), TNF-α (0.5) (CI 95% 0.42 to 0.57), and IL-6 (0.21) (CI 95% 0.18 to 0.23) showed more improvement (p < 0.001) in Group A than Group B (p > 0.05). Conclusion: Overall, this trial found that high-intensity aerobic training with a high-protein diet decreased the BMI percentile and muscle mass (arm, thigh, and calf), and positively altered the biochemical variables in children with obesity. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 678 KiB

Open AccessArticle

The Influence of SARS-CoV-2 Pandemic on TMJ Disorders, OSAS and BMI

by Sabina Saccomanno, Stefano Saran, Martina De Luca, Rodolfo Francesco Mastrapasqua, Luca Raffaelli and Luca Levrini

Int. J. Environ. Res. Public Health 2022, 19(12), 7154; https://doi.org/10.3390/ijerph19127154 - 10 Jun 2022

Cited by 6 | Viewed by 2067

Abstract

The pandemic of the 21st century had a significant influence on the lives of the world population in a negative way. This situation determined a change of lifestyle; it caused the necessity of social isolation for a great number of people. In fact, [...] Read more.

The pandemic of the 21st century had a significant influence on the lives of the world population in a negative way. This situation determined a change of lifestyle; it caused the necessity of social isolation for a great number of people. In fact, people tended to avoid crowded environments, social events, to reduce medical checks and sports activities, favoring sedentary life because of fear of the virus. This social attitude brought a high level of stress that worsened many health conditions. This study has the aim of evaluating the possible influence of the pandemic on temporomandibular joint (TMJ) disorders, obstructive sleep apnea syndrome (OSAS) and body mass index (BMI). An anonymized survey, available in two languages (Italian and English), was given to 208 patients from different private dental practices. In this questionnaire, the patients shared experiences about their life during the pandemic. The article highlighted that during this health emergency, there was an increase in body weight in the considered sample. This brought a worsening of OSAS in 65% of patients with a previous diagnosis. Eventually, an increase in TMJ disorders and orofacial pain was reported. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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24 pages, 4333 KiB

Open AccessArticle

How Much Do We Care about Teacher Burnout during the Pandemic: A Bibliometric Review

by Valentina Gómez-Domínguez, Diego Navarro-Mateu, Vicente Javier Prado-Gascó and Teresa Gómez-Domínguez

Int. J. Environ. Res. Public Health 2022, 19(12), 7134; https://doi.org/10.3390/ijerph19127134 - 10 Jun 2022

Cited by 17 | Viewed by 6492

Abstract

In this study, a descriptive bibliometric analysis of the scientific production was performed in the Web of Science on burnout and/or stress in teachers in pandemic situations. The aim of the study was to analyse the scientific production on stress and burnout in [...] Read more.

In this study, a descriptive bibliometric analysis of the scientific production was performed in the Web of Science on burnout and/or stress in teachers in pandemic situations. The aim of the study was to analyse the scientific production on stress and burnout in teachers during the COVID-19 pandemic. A total of 75 documents from 33 journals with 3947 cited references were considered, with 307 researchers from 35 countries publishing at least one article. The country with the most publications was the USA, followed by China and Spain. The USA was the country with the most collaborations. A total of 184 institutions published documents, and the universities with the most records were Christopher Newport and Columbia, although the American University of Sharjah and Cape Breton University had a higher overall citation coefficient. Of the 33 journals that have published on the subject, Frontiers in Psychology and the International Journal of Environmental Research and Public Health stood out in terms of the number of articles, and they were also listed in this order with regard to their impact factor. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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21 pages, 4323 KiB

Open AccessArticle

Assessment of Smell and Taste Disturbances among COVID-19 Convalescent Patients: A Cross-Sectional Study in Armenia

by Karine Melkumyan, Darshan Shingala, Syuzanna Simonyan, Hrag Torossian, Karen Mkrtumyan, Karen Dilbaryan, Garri Davtyan, Erik Vardumyan and Konstantin Yenkoyan

J. Clin. Med. 2022, 11(12), 3313; https://doi.org/10.3390/jcm11123313 - 09 Jun 2022

Cited by 1 | Viewed by 2762

Abstract

Background and Objectives: Neurological manifestations of Coronavirus Disease 2019 (COVID-19) such as olfactory and gustatory disturbance have been reported among convalescent COVID-19 patients. However, scientific data on the prevalence of smell and taste disturbance are lacking. Therefore, we present findings on the degree [...] Read more.

Background and Objectives: Neurological manifestations of Coronavirus Disease 2019 (COVID-19) such as olfactory and gustatory disturbance have been reported among convalescent COVID-19 patients. However, scientific data on the prevalence of smell and taste disturbance are lacking. Therefore, we present findings on the degree of smell and taste disturbances among the Armenian population. Methods: Study participants were randomly recruited and then categorized into two groups based on their course of the disease. A cross-sectional study was performed to assess participants’ sensitivity to smell triggered by the olfactory and the trigeminal nerves; their ability to differentiate between various odors; and to evaluate their gustatory perception. Results: The smell test revealed that the degree of olfactory nerve disturbance was different by 30.7% in those participants of the early group as compared to those of the late group, and the degree of trigeminal nerve disturbance was different by 71.3% in the early group as compared to the late group. A variation of the differentiating ability among the participants of the early and late groups was detected. Gustatory disturbances for all flavors were also found to be different in both the groups. A moderate positive correlation (0.51) was found between the overall sensitivity of smell and the ability to differentiate between various odors as cumulatively stimulated by both the olfactory and trigeminal nerves. Also, a moderate positive correlation (0.33) was found between headache and smell sensitivity through the olfactory nerve and a high negative correlation (−0.71) was found between headache and smell sensitivity through the trigeminal nerve. Conclusion: Pathological changes in the olfactory and trigeminal perceptive abilities caused disturbances in smell sensation, with the trigeminal nerve being more affected. The capacity to differentiate fragrances did not improve with time and the disturbance severity of bitter taste perception was higher among the study participants. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 336 KiB

Open AccessArticle

Perceived Satisfaction with Online Study during COVID-19 Lockdown Correlates Positively with Resilience and Negatively with Anxiety, Depression, and Stress among Slovenian Postsecondary Students

by Branko Gabrovec, Špela Selak, Nuša Crnkovič, Katarina Cesar and Andrej Šorgo

Int. J. Environ. Res. Public Health 2022, 19(12), 7024; https://doi.org/10.3390/ijerph19127024 - 08 Jun 2022

Cited by 10 | Viewed by 1911

Abstract

Background: The purpose of this study is to fill the research gap regarding the influence of satisfaction with distance learning on the correlates of mental health during the COVID-19 pandemic. Methods: An online cross-sectional study was conducted in February and March 2021, involving [...] Read more.

Background: The purpose of this study is to fill the research gap regarding the influence of satisfaction with distance learning on the correlates of mental health during the COVID-19 pandemic. Methods: An online cross-sectional study was conducted in February and March 2021, involving 4661 postsecondary students. Five validated instruments—PHQ-9 (depression), GAD-7 (anxiety), PSS-4 (stress), CD-RISC-10 (resilience) and SAT-5 (satisfaction with online study)—were used in the present study. Findings: The correlations between anxiety, depression, and stress were so high that they were almost inextricably linked. Both satisfaction with online learning and psychological resilience were negatively correlated with anxiety, depression, and stress. Satisfaction with online learning was also negatively correlated with psychological resilience. Females showed higher levels of vulnerability to anxiety, depression, and stress, and exhibited lower levels of psychological resilience than males. Conclusion: Home-based distance-learning during the COVID-19-induced lockdown had a significant impact on students’ mental health. Low satisfaction with distance learning can lead to the development of anxiety and depression symptoms, increase stress, and decrease the psychological resilience of postsecondary students; therefore, it is critical that educational institutions focus on implementing interventions that promote students’ satisfaction with distance learning, and their psychological resilience, to protect their mental health. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

10 pages, 347 KiB

Open AccessArticle

COVID-19, Long COVID Syndrome, and Mental Health Sequelae in a Mexican Population

by Jesús Maximiliano Granados Villalpando, Humberto Azuara Forcelledo, Jorge Luis Ble Castillo, Alejandro Jiménez Sastré, Isela Esther Juárez Rojop, Viridiana Olvera Hernández, Fernando Enrique Mayans Canabal and Crystell Guadalupe Guzmán Priego

Int. J. Environ. Res. Public Health 2022, 19(12), 6970; https://doi.org/10.3390/ijerph19126970 - 07 Jun 2022

Cited by 8 | Viewed by 2635

Abstract

The COVID-19 pandemic is currently a worldwide threat and concern, not only because of COVID-19 itself but its sequelae. The aim of this study was to evaluate whether a relation between COVID-19, Long COVID, and the prevalence of mental health disorders exist. A [...] Read more.

The COVID-19 pandemic is currently a worldwide threat and concern, not only because of COVID-19 itself but its sequelae. The aim of this study was to evaluate whether a relation between COVID-19, Long COVID, and the prevalence of mental health disorders exist. A total of 203 people from Tabasco were included in this study, answering a survey integrated by three dominions: General and epidemiological data, the DASS-21 test (to determine the presence of signs or symptoms suggestive of depression, anxiety, and/or stress) and an exploratory questionnaire about Long COVID syndrome. A descriptive and inferential statistical analysis was made via Microsoft Excel and Graphpad Prism software, evaluating differences through the Mann–Whitney U test and considering p < 0.05 as statistically significant. Of the 203 people surveyed, 96 (47.29%) had had COVID-19 and 107 (52.71%) had not; from the ones that had COVID-19, 29 (30.21%) presented mental health disorders and 88 (91.66%) presented at least one symptom or sign of Long COVID syndrome; meanwhile, 31 (32.29%) presented 10 or more symptoms or signs. From the comparison between the population with previous mental health disorders and COVID-19 and those without background disorders or COVID-19, the results were the following: 27.58% vs. 16.82% presented severe depression, 48.27% vs. 17.75% presented severe anxiety, and 27.58% vs. 20.56% presented severe stress. A high prevalence of mental health effects was observed in patients without COVID-19 and increased in the population with Long COVID syndrome and previous mental health disorders. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

16 pages, 340 KiB

Open AccessArticle

Better Understanding Adult COVID-19 Vaccination Hesitancy and Refusal: The Influence of Broader Beliefs about Vaccines

by John Boyle, Glen Nowak, Rachel Kinder, Ronaldo Iachan and James Dayton

Int. J. Environ. Res. Public Health 2022, 19(11), 6838; https://doi.org/10.3390/ijerph19116838 - 02 Jun 2022

Cited by 8 | Viewed by 2103

Abstract

Published surveys in the United States provide much evidence that COVID-19 vaccination is influenced by disease and vaccine-related risk perceptions. However, there has been little examination of whether individual’s general beliefs about vaccines are also related to COVID-19 vaccination, especially among unvaccinated adults. [...] Read more.

Published surveys in the United States provide much evidence that COVID-19 vaccination is influenced by disease and vaccine-related risk perceptions. However, there has been little examination of whether individual’s general beliefs about vaccines are also related to COVID-19 vaccination, especially among unvaccinated adults. This study used an August 2021 national survey of 1000 U.S. adults to examine whether general beliefs about vaccines were associated with COVID-19 vaccination status. In addition, it used multivariate analyses to assess the relative contribution of individual vaccine beliefs to current vaccine status independently of COVID-19-specific attitudes and experiences, and demographics. The findings indicated that, collectively, general vaccine beliefs mattered more than demographics, COVID-19-specific risk perceptions, confidence in government, or trust in public health agencies in COVID-19 vaccination status. Overall, the findings affirm the importance of vaccine education and communication efforts that help people understand why vaccines are needed, how vaccine safety is established and monitored, and how vaccines provide protection from infectious diseases. To achieve success among vaccine-hesitant individuals, communication strategies should target vaccine beliefs that most influence vaccination outcomes. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

9 pages, 412 KiB

Open AccessArticle

Comparison of the Characteristics and Outcomes of COVID-19 Patients Treated by a Hospital-at-Home Service in Japan during the Alpha and Delta Waves

by Ryota Inokuchi, Xueying Jin, Masao Iwagami, Yu Sun, Ayaka Sakamoto, Masatoshi Ishikawa and Nanako Tamiya

J. Clin. Med. 2022, 11(11), 3185; https://doi.org/10.3390/jcm11113185 - 02 Jun 2022

Cited by 3 | Viewed by 1749

Abstract

Coronavirus infections occurred in repeated waves caused by different variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the number of patients increasing during each wave. A private after-hours house-call (AHHC) service provides hospital-at-home (HaH) services to patients in Japan requiring oxygen [...] Read more.

Coronavirus infections occurred in repeated waves caused by different variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the number of patients increasing during each wave. A private after-hours house-call (AHHC) service provides hospital-at-home (HaH) services to patients in Japan requiring oxygen when hospital beds are in short supply. This retrospective study aimed to compare the characteristics of COVID-19 patients treated by the AHHC service during the COVID-19 waves caused by the Alpha (March–June 2021) and Delta (July–December 2021) SARS-CoV-2 variants. All patients with COVID-19 treated by the AHHC service from March to December 2021 while awaiting hospitalization were included. The data were collected from medical records and follow-up telephone interviews. The AHHC service treated 55 and 273 COVID-19 patients during the Alpha and Delta waves, respectively. The patients treated during the Delta wave were significantly younger than those treated during the Alpha wave (median: 63 years and 47 years, respectively; p < 0.001). Disease severity did not differ significantly between the two waves, but the crude case-fatality rate was significantly higher during the Alpha wave (10/55, 18.2%) than during the Delta wave (4/273, 1.4%; p < 0.001). The patient characteristics and outcomes differed between the Alpha and Delta waves. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 259 KiB

Open AccessArticle

The Long-Term Effect of COVID-19 Disease Severity on Risk of Diabetes Incidence and the Near 1-Year Follow-Up Outcomes among Postdischarge Patients in Wuhan

by Jun Zhang, Tingting Shu, Rui Zhu, Fengwen Yang, Boli Zhang and Xuefeng Lai

J. Clin. Med. 2022, 11(11), 3094; https://doi.org/10.3390/jcm11113094 - 30 May 2022

Cited by 10 | Viewed by 1991

Abstract

We assessed the nearly 1-year health consequences following discharge and related risk factors of COVID-19 infection and further explored the long-term effect of COVID-19 disease severity on the risk of diabetes incidence. This prospective study included 248 COVID-19 patients discharged from Wuhan Hospital [...] Read more.

We assessed the nearly 1-year health consequences following discharge and related risk factors of COVID-19 infection and further explored the long-term effect of COVID-19 disease severity on the risk of diabetes incidence. This prospective study included 248 COVID-19 patients discharged from Wuhan Hospital of Traditional Chinese Medicine who were followed up between 1 March and 10 June 2021. Logistic regression models were used to evaluate risk factors. The top ten symptoms were shortness of breath (30.3%), sore or dry throat (25.7%), cough (23.2%), expectoration (23.2%), body pain (22.3%), chest tightness (20.8%), palpitations (17.8%), sleep difficulties (17.0%), fatigue (16.6%), and anxiety (15.3%). Hypertension was associated with fatigue (OR = 2.51, 95% CI: 1.08, 5.80), shortness of breath (OR = 2.34, 95% CI: 1.16, 4.69), palpitations (OR = 2.82, 95% CI: 1.26, 6.31), expectoration (OR = 2.08, 95% CI: 1.01, 4.30), and sore or dry throat (OR = 2.71, 95% CI: 1.30, 5.65). Diabetes was associated with palpitations (OR = 3.22, 95% CI: 1.18, 8.81). Critical illness was associated with an increased risk of diabetes incidence after discharge (OR = 2.90, 95% CI: 1.07, 7.88), which seemed more evident in males. Long COVID-19 symptoms were common at 1-year postdischarge; hypertension and diabetes could be projected as potential risk factors. We are among the first researchers to find that critical illness is associated with incident diabetes after discharge. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

13 pages, 917 KiB

Open AccessArticle

Concerns of Home Isolating COVID-19 Patients While Receiving Care via Telemedicine during the Pandemic in the Northern Thailand: A Qualitative Study on Text Messaging

by Kanokporn Pinyopornpanish, Nopakoon Nantsupawat, Nida Buawangpong, Suphawita Pliannuom, Tanat Vaniyapong and Wichuda Jiraporncharoen

Int. J. Environ. Res. Public Health 2022, 19(11), 6591; https://doi.org/10.3390/ijerph19116591 - 28 May 2022

Cited by 4 | Viewed by 2037

Abstract

As there were strict limits on contact between health professionals and patients during the COVID-19 pandemic, telemedicine increased in importance with regard to improving the provision of health care and became the preferred method of care. This study aims to determine the topics [...] Read more.

As there were strict limits on contact between health professionals and patients during the COVID-19 pandemic, telemedicine increased in importance with regard to improving the provision of health care and became the preferred method of care. This study aims to determine the topics of concern expressed by individuals with COVID-19 receiving care at home via teleconsultation. The qualitative study was conducted using secondary data of chat messages from 213 COVID-19 patients who had consented to online consultation with the health care team. The messages were sent during the home isolation period, which was between 29th October and 20th December 2021. Thematic analysis was used to analyze the data. All patients had consented to the use of their data. A small majority of the patients were female (58.69%). The average age was 32.26 ± 16.92 years. A total of 475 questions were generated by 150 patients during the isolation period. Nearly thirty percent (29.58%) never asked any questions. From the analysis, the questions could be divided into three themes including: (1) complex care system; (2) uncertainty about self-care and treatment plan with regard to lack of knowledges and skills; and (3) concern about recovery and returning to the community after COVID-19 infection. In conclusion, there were enquiries about many aspects of medical care during home isolation, detailed answers from professionals were useful for the self-care of patients and to provide guidance for their future health behavior. The importance of the service being user friendly and accessible to all became increasingly evident. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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17 pages, 738 KiB

Open AccessReview

The Impact of Physical Activity on Mental Health during COVID-19 Pandemic in China: A Systematic Review

by Mengfei Li, Qianhui Wang and Jing Shen

Int. J. Environ. Res. Public Health 2022, 19(11), 6584; https://doi.org/10.3390/ijerph19116584 - 28 May 2022

Cited by 18 | Viewed by 3053

Abstract

The outbreak and spread of novel coronavirus disease (COVID-19) in 2019 was a public health emergency of global concern. As an important health behavior, physical activity (PA) and its impact on mental health have been increasingly explored during the epidemic period. The keywords [...] Read more.

The outbreak and spread of novel coronavirus disease (COVID-19) in 2019 was a public health emergency of global concern. As an important health behavior, physical activity (PA) and its impact on mental health have been increasingly explored during the epidemic period. The keywords and references were searched on PubMed, Web of Science, Scopus, Cochrane Library, EBSCO, and CNKI since the inception of an electronic bibliographic database until October 2021. A total of 2979 articles were identified, of which 23 were eligible for inclusion to examine the relationship between PA and mental health during the COVID-19 epidemic. Residents with regular PA, high-intensity PA, and PA duration of 30–60 min or more per day were associated with a lower risk of anxiety, depression, and negative emotions. In contrast, residents with no exercise and physical inactivity were more likely to have anxiety, depression, sleep disturbances, and lower subjective well-being. In addition, the dose–response curve between PA and negative emotions indicated a U-shaped relationship, and there were urban–rural differences in the relationship between emotional status and the levels of PA in adolescents. The findings have significant implications for addressing mental health issues during the current pandemic and future pandemics. Future studies adopting an experimental study design, conducting objective PA measures, and focusing on the vulnerable subpopulations are warranted to further explore the association of PA on mental health during the COVID-19 pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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20 pages, 15792 KiB

Open AccessArticle

Evaluation of the Microbiological Effectiveness of Three Accessible Mask Decontamination Methods and Their Impact on Filtration, Air Permeability and Physicochemical Properties

by Roberta Lordelo, José Rafael S. Botelho, Paula V. Morais, Hermínio C. de Sousa, Rita Branco, Ana M. A. Dias and Marco S. Reis

Int. J. Environ. Res. Public Health 2022, 19(11), 6567; https://doi.org/10.3390/ijerph19116567 - 27 May 2022

Cited by 2 | Viewed by 1825

Abstract

The need to secure public health and mitigate the environmental impact associated with the massified use of respiratory protective devices (RPD) has been raising awareness for the safe reuse of decontaminated masks by individuals and organizations. Among the decontamination treatments proposed, in this [...] Read more.

The need to secure public health and mitigate the environmental impact associated with the massified use of respiratory protective devices (RPD) has been raising awareness for the safe reuse of decontaminated masks by individuals and organizations. Among the decontamination treatments proposed, in this work, three methods with the potential to be adopted by households and organizations of different sizes were analysed: contact with nebulized hydrogen peroxide (H₂O₂); immersion in commercial bleach (NaClO) (sodium hypochlorite, 0.1% p/v); and contact with steam in microwave steam-sanitizing bags (steam bag). Their decontamination effectiveness was assessed using reference microorganisms following international standards (issued by ISO and FDA). Furthermore, the impact on filtration efficiency, air permeability and several physicochemical and structural characteristics of the masks, were evaluated for untreated masks and after 1, 5 and 10 cycles of treatment. Three types of RPD were analysed: surgical, KN95, and cloth masks. Results demonstrated that the H₂O₂ protocol sterilized KN95 and surgical masks (reduction of >6 log10 CFUs) and disinfected cloth masks (reduction of >3 log10 CFUs). The NaClO protocol sterilized surgical masks, and disinfected KN95 and cloth masks. Steam bags sterilized KN95 and disinfected surgical and cloth masks. No relevant impact was observed on filtration efficiency. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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15 pages, 3924 KiB

Open AccessArticle

Individual Stress Burden and Mental Health in Health Care Workers during the COVID-19 Pandemic: Moderating and Mediating Effects of Resilience

by Jonas Schmuck, Nina Hiebel, Milena Kriegsmann-Rabe, Juliane Schneider, Julia-Katharina Matthias, Yesim Erim, Eva Morawa, Lucia Jerg-Bretzke, Petra Beschoner, Christian Albus, Kerstin Weidner, Lukas Radbruch, Eberhard Hauschildt and Franziska Geiser

Int. J. Environ. Res. Public Health 2022, 19(11), 6545; https://doi.org/10.3390/ijerph19116545 - 27 May 2022

Cited by 7 | Viewed by 2451

Abstract

Introduction: The COVID-19 pandemic generated a significant burden on the German health care system, affecting the mental health of health care workers (HCW) in particular. Resilience may serve as an essential protective factor for individuals’ well-being. Objective: Our objective was to identify demographic [...] Read more.

Introduction: The COVID-19 pandemic generated a significant burden on the German health care system, affecting the mental health of health care workers (HCW) in particular. Resilience may serve as an essential protective factor for individuals’ well-being. Objective: Our objective was to identify demographic and work-related correlates of individual resilience and to investigate the association between pandemic-related stress, resilience and mental health using different resilience models. Methods: Our sample comprised 1034 German HCW in different medical professions who completed an online survey from 20 April to 1 July 2020. Resilience was assessed using the Resilience Scale-5 (RS-5). The pandemic-related self-reported stress burden was captured by a single item, while depression and anxiety symptoms were measured with the PHQ-2 and GAD-2, respectively. Additionally, various sociodemographic and work-related factors were assessed. Results: Overall, we found high levels of resilience in the sample compared to a German sample before the pandemic, which were significantly associated only with the older age of participants and having children in both univariate and multivariate analyses. Regarding mechanisms of resilience, moderation analysis revealed that low individual resilience and high pandemic-related stress burden independently contributed to both anxiety and depression symptoms while resilience additionally moderated the relationship between stress burden and anxiety symptoms. The link between self-reported stress burden and mental health symptoms was also partially mediated by individual resilience. Conclusion: Taken together, the findings based on the present sample during the COVID-19 pandemic suggest that resilience plays a central role in the mental health of healthcare workers and that resilience-building interventions should be expanded, especially with a focus on younger employees. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 1663 KiB

Open AccessArticle

Lung Ultrasound Improves Outcome Prediction over Clinical Judgment in COVID-19 Patients Evaluated in the Emergency Department

by Paolo Bima, Emanuele Pivetta, Denise Baricocchi, Jacopo Davide Giamello, Francesca Risi, Matteo Vesan, Michela Chiarlo, Giuliano De Stefano, Enrico Ferreri, Giuseppe Lauria, Stefano Podio, Peiman Nazerian, Franco Aprà, Enrico Lupia, Fulvio Morello and On behalf of the CODED Study Investigators

J. Clin. Med. 2022, 11(11), 3032; https://doi.org/10.3390/jcm11113032 - 27 May 2022

Cited by 4 | Viewed by 1281

Abstract

In the Emergency Department (ED), the decision to hospitalize or discharge COVID-19 patients is challenging. We assessed the utility of lung ultrasound (LUS), alone or in association with a clinical rule/score. This was a multicenter observational prospective study involving six EDs (NCT046291831). From [...] Read more.

In the Emergency Department (ED), the decision to hospitalize or discharge COVID-19 patients is challenging. We assessed the utility of lung ultrasound (LUS), alone or in association with a clinical rule/score. This was a multicenter observational prospective study involving six EDs (NCT046291831). From October 2020 to January 2021, COVID-19 outpatients discharged from the ED based on clinical judgment were subjected to LUS and followed-up at 30 days. The primary clinical outcome was a composite of hospitalization or death. Within 393 COVID-19 patients, 35 (8.9%) reached the primary outcome. For outcome prognostication, LUS had a C-index of 0.76 (95%CI 0.68–0.84) and showed good performance and calibration. LUS-based classification provided significant differences in Kaplan–Meier curves, with a positive LUS leading to a hazard ratio of 4.33 (95%CI 1.95–9.61) for the primary outcome. The sensitivity and specificity of LUS for primary outcome occurrence were 74.3% (95%CI 59.8–88.8) and 74% (95%CI 69.5–78.6), respectively. The integration of LUS with a clinical score further increased sensitivity. In patients with a negative LUS, the primary outcome occurred in nine (3.3%) patients (p < 0.001 vs. unselected). The efficiency for rule-out was 69.7%. In unvaccinated ED patients with COVID-19, LUS improves prognostic stratification over clinical judgment alone and may support standardized disposition decisions. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 1922 KiB

Open AccessArticle

Explainable Vision Transformers and Radiomics for COVID-19 Detection in Chest X-rays

by Mohamed Chetoui and Moulay A. Akhloufi

J. Clin. Med. 2022, 11(11), 3013; https://doi.org/10.3390/jcm11113013 - 26 May 2022

Cited by 20 | Viewed by 4122

Abstract

The rapid spread of COVID-19 across the globe since its emergence has pushed many countries’ healthcare systems to the verge of collapse. To restrict the spread of the disease and lessen the ongoing cost on the healthcare system, it is critical to appropriately [...] Read more.

The rapid spread of COVID-19 across the globe since its emergence has pushed many countries’ healthcare systems to the verge of collapse. To restrict the spread of the disease and lessen the ongoing cost on the healthcare system, it is critical to appropriately identify COVID-19-positive individuals and isolate them as soon as possible. The primary COVID-19 screening test, RT-PCR, although accurate and reliable, has a long turn-around time. More recently, various researchers have demonstrated the use of deep learning approaches on chest X-ray (CXR) for COVID-19 detection. However, existing Deep Convolutional Neural Network (CNN) methods fail to capture the global context due to their inherent image-specific inductive bias. In this article, we investigated the use of vision transformers (ViT) for detecting COVID-19 in Chest X-ray (CXR) images. Several ViT models were fine-tuned for the multiclass classification problem (COVID-19, Pneumonia and Normal cases). A dataset consisting of 7598 COVID-19 CXR images, 8552 CXR for healthy patients and 5674 for Pneumonia CXR were used. The obtained results achieved high performance with an Area Under Curve (AUC) of 0.99 for multi-class classification (COVID-19 vs. Other Pneumonia vs. normal). The sensitivity of the COVID-19 class achieved 0.99. We demonstrated that the obtained results outperformed comparable state-of-the-art models for detecting COVID-19 on CXR images using CNN architectures. The attention map for the proposed model showed that our model is able to efficiently identify the signs of COVID-19. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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3 pages, 229 KiB

Open AccessComment

Health Perception among Female COVID-19 Patients. Comment on Fernández-de-las-Peñas et al. Female Sex Is a Risk Factor Associated with Long-Term Post-COVID Related-Symptoms but Not with COVID-19 Symptoms: The LONG-COVID-EXP-CM Multicenter Study. J. Clin. Med. 2022, 11, 413

by Blanca Ayuso García, Eva Romay Lema and Ramón Rabuñal Rey

J. Clin. Med. 2022, 11(11), 2999; https://doi.org/10.3390/jcm11112999 - 26 May 2022

Cited by 6 | Viewed by 1337

Abstract

We read with interest the original paper by Fernández-de-las-Peñas et al. [...] Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

11 pages, 1537 KiB

Open AccessArticle

How Seasonality and Control Measures Jointly Determine the Multistage Waves of the COVID-19 Epidemic: A Modelling Study and Implications

by Yangcheng Zheng and Yunpeng Wang

Int. J. Environ. Res. Public Health 2022, 19(11), 6404; https://doi.org/10.3390/ijerph19116404 - 25 May 2022

Cited by 7 | Viewed by 1775

Abstract

The current novel Coronavirus Disease 2019 (COVID-19) is a multistage epidemic consisting of multiple rounds of alternating outbreak and containment periods that cannot be modeled with a conventional single-stage Suspected-Exposed-Infectious-Removed (SEIR) model. Seasonality and control measures could be the two most important driving [...] Read more.

The current novel Coronavirus Disease 2019 (COVID-19) is a multistage epidemic consisting of multiple rounds of alternating outbreak and containment periods that cannot be modeled with a conventional single-stage Suspected-Exposed-Infectious-Removed (SEIR) model. Seasonality and control measures could be the two most important driving factors of the multistage epidemic. Our goal is to formulate and incorporate the influences of seasonality and control measures into an epidemic model and interpret how these two factors interact to shape the multistage epidemic curves. New confirmed cases will be collected daily from seven Northern Hemisphere countries and five Southern Hemisphere countries from March 2020 to March 2021 to fit and validate the modified model. Results show that COVID-19 is a seasonal epidemic and that epidemic curves can be clearly distinguished in the two hemispheres. Different levels of control measures between different countries during different seasonal periods have different influences on epidemic transmission. Seasonality alone cannot cause the baseline reproduction number R₀ to fall below one and control measures must be taken. A superposition of a high level of seasonality and a low level of control measures can lead to a dramatically rapid increase in reported cases. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 1918 KiB

Open AccessArticle

Do They Really Work? Quantifying Fabric Mask Effectiveness to Improve Public Health Messaging

by Charles Freeman, Reuben Burch, Lesley Strawderman, Catherine Black, David Saucier, Jaime Rickert, John Wilson, Holli Seitz and Jeffrey Stull

Int. J. Environ. Res. Public Health 2022, 19(11), 6372; https://doi.org/10.3390/ijerph19116372 - 24 May 2022

Cited by 2 | Viewed by 2470

Abstract

The purpose of this study is to compare masks (non-medical/fabric, surgical, and N95 respirators) on filtration efficiency, differential pressure, and leakage with the goal of providing evidence to improve public health messaging. Masks were tested on an anthropometric face filtration mount, comparing both [...] Read more.

The purpose of this study is to compare masks (non-medical/fabric, surgical, and N95 respirators) on filtration efficiency, differential pressure, and leakage with the goal of providing evidence to improve public health messaging. Masks were tested on an anthropometric face filtration mount, comparing both sealed and unsealed. Overall, surgical and N95 respirators provided significantly higher filtration efficiency (FE) and differential pressure (dP). Leakage comparisons are one of the most significant factors in mask efficiency. Higher weight and thicker fabric masks had significantly higher filtration efficiency. The findings of this study have important implications for communication and education regarding the use of masks to prevent the spread of COVID-19 and other respiratory illnesses, specifically the differences between sealed and unsealed masks. The type and fabric of facial masks and whether a mask is sealed or unsealed has a significant impact on the effectiveness of a mask. Findings related to differences between sealed and unsealed masks are of critical importance for health care workers. If a mask is not completely sealed around the edges of the wearer, FE for this personal protective equipment is misrepresented and may create a false sense of security. These results can inform efforts to educate health care workers and the public on the importance of proper mask fit. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 1797 KiB

Open AccessArticle

Comparative Clinical Characteristics, Laboratory Findings, and Outcomes of Hypoxemic and Non-Hypoxemic Patients Treated at a Makeshift COVID-19 Unit in Bangladesh: A Retrospective Chart Analysis

by Monira Sarmin, Mustafa Mahfuz, Lubaba Shahrin, Nusrat Jahan Shaly, Shamsun Nahar Shaima, Shamima Sharmin Shikha, Didarul Haque Jeorge, Shoeb Bin Islam, Mohammod Jobayer Chisti and Tahmeed Ahmed

J. Clin. Med. 2022, 11(11), 2968; https://doi.org/10.3390/jcm11112968 - 24 May 2022

Cited by 3 | Viewed by 1383

Abstract

Background: Starting on 31 December 2019, from Wuhan City, China, Coronavirus disease 2019 (COVID-19) caused a global pandemic by 11 March 2020. Bangladesh detected its first case on 8 March 2020, only 66 days later the detection of the first case in China. [...] Read more.

Background: Starting on 31 December 2019, from Wuhan City, China, Coronavirus disease 2019 (COVID-19) caused a global pandemic by 11 March 2020. Bangladesh detected its first case on 8 March 2020, only 66 days later the detection of the first case in China. We aimed to describe the epidemiology, clinical features, laboratory characteristics, and outcomes of Bangladeshi COVID-19 patients. Methods: This retrospective chart analysis compared Bangladeshi COVID-19 patients with hypoxemia compared to those without hypoxemia treated in a makeshift COVID-19 unit of icddr,b. Results: By March 2021, 207 remained in-patient. Nineteen patients (9.2%) died, whereas 10 (4.8%) were referred to different facilities for definitive care. Out of 207 in-patients, 88 patients required oxygen therapy. Multivariable logistic regression identified age (1.07 (1.02–1.13)), dyspnea (3.56 (1.06–11.96)), high CRP (1.13 (1.03–1.25)), and lymphopenia (6.18 (1.81–21.10)) as the independent predictors for hypoxemia in patients hospitalized for COVID 19 (for all, p < 0.05). Conclusion: Older age, dyspnea, high CRP, and lymphopenia are simple, but important, clinical and laboratory parameters. These may help clinicians to identify COVID-19 patients early who are at risk of fatal hypoxemia. Close monitoring, and prompt and aggressive treatment of these patients would curb their morbidity and mortality, especially in resource-limited settings. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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17 pages, 2666 KiB

Open AccessArticle

Long-Term Characteristics of Severe COVID-19: Respiratory Function, Functional Capacity, and Quality of Life

by Ukbe Sirayder, Deniz Inal-Ince, Busra Kepenek-Varol and Cihangir Acik

Int. J. Environ. Res. Public Health 2022, 19(10), 6304; https://doi.org/10.3390/ijerph19106304 - 23 May 2022

Cited by 18 | Viewed by 2630

Abstract

Recovery from pneumonia takes around 3–6 months in individuals with severe COVID-19. In order to detect the isolated damage caused by COVID-19, the 6-month period must pass after the recoveries. However, to our knowledge, no published study analyzes a comprehensive evaluation of individuals [...] Read more.

Recovery from pneumonia takes around 3–6 months in individuals with severe COVID-19. In order to detect the isolated damage caused by COVID-19, the 6-month period must pass after the recoveries. However, to our knowledge, no published study analyzes a comprehensive evaluation of individuals with severe COVID-19 after 6 months. We aimed to evaluate long-term consequences of severe COVID patients by comparing respiratory function, functional capacity, quality of life, fatigue, and balance 6 months after the intensive care unit (ICU) discharge with healthy individuals. Method: 26 post-COVID adult patients and 26 healthy individuals (control group) were included in this study. Physical characteristics of both groups and patients’ ICU data, including APACHE II scores, were recorded. Lung function, respiratory, and peripheral muscle strength were measured. The lower limit of normal (LLN) cutoff points for forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁) were calculated. A 6-minute walk test (6MWT) was used to assess functional capacity. Time Up and Go test (TUG) with a stadiometer was performed for balance evaluation. Quality of life was evaluated using Nottingham Health Profile (NHP) and St George Respiratory Questionnaire (SGRQ). Results: Percent predicted FVC and FEV₁, 6MWT distance, change in oxygen saturation (SpO₂) during 6MWT, were lower and NHP, SGRQ, FSS scores and TUG findings were higher in the COVID group than the control group (p < 0.05). The FVC of nine individuals and the FEV₁ value of seven individuals in the COVID-19 group were below the LLN values. A moderate correlation was found between ICU length of stay and APACHE II scores with FVC, FEV₁, 6MWT distance, and change in SpO₂ values in the COVID-19 patients (p < 0.05). Conclusion: Respiratory function, functional capacity, quality of life, and fatigue levels of the individuals with severe COVID-19 infection are impaired at 6 months after ICU discharge. Impaired lung function might be associated with severe inflammation, which starts during the acute infection process and the fibrous tissue during the healing process, impairing lung compliance and diffusion capacity. Infiltration of coronavirus and inflammatory cytokines into the cerebrum and muscle might have increased fatigue and decreased functional capacity. Overall, our study suggests that severe COVID patients need post-discharge care even after 6 months of recovery. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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17 pages, 5161 KiB

Open AccessArticle

Understanding COVID-19 Halal Vaccination Discourse on Facebook and Twitter Using Aspect-Based Sentiment Analysis and Text Emotion Analysis

by Ali Feizollah, Nor Badrul Anuar, Riyadh Mehdi, Ahmad Firdaus and Ainin Sulaiman

Int. J. Environ. Res. Public Health 2022, 19(10), 6269; https://doi.org/10.3390/ijerph19106269 - 21 May 2022

Cited by 7 | Viewed by 2531

Abstract

The COVID-19 pandemic introduced unprecedented challenges for people and governments. Vaccines are an available solution to this pandemic. Recipients of the vaccines are of different ages, gender, and religion. Muslims follow specific Islamic guidelines that prohibit them from taking a vaccine with certain [...] Read more.

The COVID-19 pandemic introduced unprecedented challenges for people and governments. Vaccines are an available solution to this pandemic. Recipients of the vaccines are of different ages, gender, and religion. Muslims follow specific Islamic guidelines that prohibit them from taking a vaccine with certain ingredients. This study aims at analyzing Facebook and Twitter data to understand the discourse related to halal vaccines using aspect-based sentiment analysis and text emotion analysis. We searched for the term “halal vaccine” and limited the timeline to the period between 1 January 2020, and 30 April 2021, and collected 6037 tweets and 3918 Facebook posts. We performed data preprocessing on tweets and Facebook posts and built the Latent Dirichlet Allocation (LDA) model to identify topics. Calculating the sentiment analysis for each topic was the next step. Finally, this study further investigates emotions in the data using the National Research Council of Canada Emotion Lexicon. Our analysis identified four topics in each of the Twitter dataset and Facebook dataset. Two topics of “COVID-19 vaccine” and “halal vaccine” are shared between the two datasets. The other two topics in tweets are “halal certificate” and “must halal”, while “sinovac vaccine” and “ulema council” are two other topics in the Facebook dataset. The sentiment analysis shows that the sentiment toward halal vaccine is mostly neutral in Twitter data, whereas it is positive in Facebook data. The emotion analysis indicates that trust is the most present emotion among the top three emotions in both datasets, followed by anticipation and fear. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 247 KiB

Open AccessArticle

Assessment of the Diagnostic Performance of a Novel SARS-CoV-2 Antigen Sealing Tube Test Strip (Colloidal Gold) as Point-of-Care Surveillance Test

by Alessandro Medoro, Sergio Davinelli, Serena Voccola, Gaetano Cardinale, Daniela Passarella, Nicola Marziliano and Mariano Intrieri

Diagnostics 2022, 12(5), 1279; https://doi.org/10.3390/diagnostics12051279 - 21 May 2022

Cited by 6 | Viewed by 2252

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant outbreaks have highlighted the need of antigen-detecting rapid diagnostic tests (Ag-RDTs) that can be used at the point-of-care (POC). Although many Ag-RDTs have been approved for SARS-CoV-2 detection, studies demonstrating the clinical performance of Ag-RDTs [...] Read more.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant outbreaks have highlighted the need of antigen-detecting rapid diagnostic tests (Ag-RDTs) that can be used at the point-of-care (POC). Although many Ag-RDTs have been approved for SARS-CoV-2 detection, studies demonstrating the clinical performance of Ag-RDTs against variants of concern, especially the new Omicron variant, are limited. The aim of this study was to evaluate the diagnostic sensitivity and specificity of the AMAZING COVID-19 Antigen Sealing Tube Test Strip (Colloidal Gold) in 584 early symptomatic and asymptomatic participants (age range 0–90 years). The performance of this Ag-RDT was assessed by comparing its results with reverse transcription RT-PCR (rRT-PCR). One hundred twenty positive samples were also analyzed with rRT-PCR to discriminate Omicron and Delta/Kappa variants (72.50% Omicron; 27.50% Delta/Kappa). Overall, the Ag-RDT showed high positive and negative percent values of 92.52% (95% CI, 86.61–95.95%) and 98.05% (95% CI, 96.41–98.95%), respectively, as well as an overall diagnostic accuracy of 96.92% (95% CI, 95.17–98.16%). Taken together, these data indicate that this inexpensive and simple-to-use Ag-RDT presents excellent analytical performance and can reliably detect Omicron and Delta/Kappa variants. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

16 pages, 1820 KiB

Open AccessArticle

Health Communication through Positive and Solidarity Messages Amid the COVID-19 Pandemic: Automated Content Analysis of Facebook Uses

by Angela Chang, Xuechang Xian, Matthew Tingchi Liu and Xinshu Zhao

Int. J. Environ. Res. Public Health 2022, 19(10), 6159; https://doi.org/10.3390/ijerph19106159 - 19 May 2022

Cited by 7 | Viewed by 2625

Abstract

The COVID-19 outbreak has caused significant stress in our lives, which potentially increases frustration, fear, and resentful emotions. Managing stress is complex, but helps to alleviate negative psychological effects. In order to understand how the public coped with stress during the COVID-19 pandemic, [...] Read more.

The COVID-19 outbreak has caused significant stress in our lives, which potentially increases frustration, fear, and resentful emotions. Managing stress is complex, but helps to alleviate negative psychological effects. In order to understand how the public coped with stress during the COVID-19 pandemic, we used Macao as a case study and collected 104,827 COVID-19 related posts from Facebook through data mining, from 1 January to 31 December 2020. Divominer, a big-data analysis tool supported by computational algorithm, was employed to identify themes and facilitate machine coding and analysis. A total of 60,875 positive messages were identified, with 24,790 covering positive psychological themes, such as “anti-epidemic”, “solidarity”, “hope”, “gratitude”, “optimism”, and “grit”. Messages that mentioned “anti-epidemic”, “solidarity”, and “hope” were the most prevalent, while different crisis stages, key themes and media elements had various impacts on public involvement. To the best of our knowledge, this is the first-ever study in the Chinese context that uses social media to clarify the awareness of solidarity. Positive messages are needed to empower social media users to shoulder their shared responsibility to tackle the crisis. The findings provide insights into users’ needs for improving their subjective well-being to mitigate the negative psychological impact of the pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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17 pages, 1143 KiB

Open AccessArticle

Costs of Employee Stewardship Behaviors for Employees in the Work-to-Family Penetration Context during the COVID-19 Pandemic

by Chen Qian, Xinran Gu and Lei Wang

Int. J. Environ. Res. Public Health 2022, 19(10), 6117; https://doi.org/10.3390/ijerph19106117 - 18 May 2022

Cited by 1 | Viewed by 1719

Abstract

Drawing on the work–home resources model, our aim in this study was to explore the negative effects of employee stewardship behavior on work–family conflict (WFC) through work-to-family border permeation (WFBP) for employees. A conditional process model linking employee stewardship behavior (ESB), family-supportive supervisor [...] Read more.

Drawing on the work–home resources model, our aim in this study was to explore the negative effects of employee stewardship behavior on work–family conflict (WFC) through work-to-family border permeation (WFBP) for employees. A conditional process model linking employee stewardship behavior (ESB), family-supportive supervisor behavior (FBBS), work-to-family border permeation (WFBP), family support, and work–family conflict (WFC) was developed. Longitudinal data collected at two different time points from 323 employees of three internet companies in south China were examined. The results revealed that WFBP mediates the impact of ESB on WFC. Family-supportive supervisor behavior substantially weakens the relationship between ESB and WFBP and the indirect effect of WFBP. Similarly, family support undermines the relationship between WFBP and WFC and the indirect effect of WFBP. Employee-level stewardship and blurred work–family boundaries have been common phenomena in contemporary China, especially during the COVID-19 pandemic. This study is among the first to focus on the negative impacts of employee stewardship behaviors on the employee, especially on their family, from a Chinese context. These findings also increase our understanding of the effects of ESB and provide some new insights into how to mitigate WFC. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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8 pages, 307 KiB

Open AccessArticle

Lessons We Have Learned Regarding Seroprevalence in High and Low SARS-CoV-2 Contexts in Greece before the Omicron Pandemic Wave

by Ourania S. Kotsiou, George D. Vavougios, Dimitrios Papagiannis, Elena Matsiatsiou, Dimitra Avgeri, Evangelos C. Fradelos, Dimitra I. Siachpazidou, Garifallia Perlepe, Angeliki Miziou, Athanasios Kyritsis, Eudoxia Gogou, Serafim Kalampokas, Georgios Kalantzis, Vaios S. Kotsios and Konstantinos I. Gourgoulianis

Int. J. Environ. Res. Public Health 2022, 19(10), 6110; https://doi.org/10.3390/ijerph19106110 - 17 May 2022

Cited by 1 | Viewed by 1761

Abstract

Background: Antibody seroprevalence in rural communities remains poorly investigated. We compared the SARS-CoV-2 seroprevalence in two Greek communities in June and July 2021 after the end of the Delta-driven pandemic wave that started in November 2020. One community was affected worse than the [...] Read more.

Background: Antibody seroprevalence in rural communities remains poorly investigated. We compared the SARS-CoV-2 seroprevalence in two Greek communities in June and July 2021 after the end of the Delta-driven pandemic wave that started in November 2020. One community was affected worse than the other. Methods: The SARS-CoV-2 IgG II Quant method (Architect, Abbott, IL, USA) was used for antibody testing. Results: We found a high rate of SARS-CoV-2 seropositivity in both communities, approaching 77.5%. In the area with a higher burden of COVID-19, Malesina, seropositivity was achieved with vaccine-acquired and naturally acquired immunity, whereas in the low-burden context of Domokos, the high rates of seropositivity were achieved mainly with vaccination. Previously infected individuals were less likely to be vaccinated than previously uninfected adults. The antibody titers were significantly higher in previously infected, vaccinated participants than in unvaccinated ones. In total, 4% and 10% of the unvaccinated population were diagnosed seropositive for the first time while not knowing about the previous infection. Age and gender did not impact antibody titers in high- or low-burden contexts. Conclusions: Before the Omicron pandemic wave, herd immunity was reached in different contexts in Greece. Higher antibody titers were measured in infected vaccinated individuals than in infected unvaccinated ones. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

18 pages, 540 KiB

Open AccessReview

Efficacy and Safety of Extracorporeal Membrane Oxygenation in Patients under Mechanical Ventilation with COVID-19 and Severe Acute Respiratory Distress Syndrome: A Health Technology Assessment

by Carlos J. Toro-Huamanchumo, Maribel M. Castro-Reyes, Verónica Peralta, Julissa E. Venancio-Huerta, Pablo R. Puescas-Sanchez and Eric R. Peña-Sanchez

Int. J. Environ. Res. Public Health 2022, 19(10), 6080; https://doi.org/10.3390/ijerph19106080 - 17 May 2022

Viewed by 2181

Abstract

We aimed to assess the efficacy and safety of extracorporeal membrane oxygenation (ECMO) in patients under mechanical ventilation with COVID-19 and severe acute respiratory distress syndrome (ARDS). A systematic review of the literature published in PubMed, Cochrane Library and LILACS databases, was performed. [...] Read more.

We aimed to assess the efficacy and safety of extracorporeal membrane oxygenation (ECMO) in patients under mechanical ventilation with COVID-19 and severe acute respiratory distress syndrome (ARDS). A systematic review of the literature published in PubMed, Cochrane Library and LILACS databases, was performed. A manual search was also conducted using the reference lists of the studies included in the full-text assessment, as well as a grey-literature search on Google. Additionally, websites of state institutions and organizations developing clinical practice guidelines and health technology assessments were reviewed. The ClinicalTrials.gov website was screened along with the websites of the International Clinical Trial Registry Platform and the National Registry of Health Research Projects of the Peruvian National Institute of Health. No restrictions were applied in terms of language, time, or country. A total of 13 documents were assessed, which included 7 clinical practice guidelines, 3 health technology assessments, 1 systematic review, 1 randomized clinical trial, and 1 observational study. A critical appraisal was conducted for each document. After this, we considered that the currently available evidence is insufficient for a conclusion supporting the use of ECMO in patients under mechanical ventilation with severe ARDS associated to COVID-19 in terms of mortality, safety, and quality of life. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 348 KiB

Open AccessArticle

The Role of Moral Distress on Physician Burnout during COVID-19

by Caitlin A. J. Powell and John P. Butler

Int. J. Environ. Res. Public Health 2022, 19(10), 6066; https://doi.org/10.3390/ijerph19106066 - 17 May 2022

Cited by 6 | Viewed by 1911

Abstract

The purpose of this study was to explore the role of moral distress on physician burnout during COVID-19. Physicians in the US were interviewed between February and March 2021; 479 responded to our survey. The results indicated that moral distress was a key [...] Read more.

The purpose of this study was to explore the role of moral distress on physician burnout during COVID-19. Physicians in the US were interviewed between February and March 2021; 479 responded to our survey. The results indicated that moral distress was a key mediator in explaining the relationship between perceived organizational support, medical specialization, emotional labor, and coping with burnout. Results did not support increased burnout among female physicians, and contracting COVID-19 likewise did not play a role in burnout. Our findings suggest that physician burnout can be mitigated by increasing perceived organizational support; likewise, physicians who engaged in deep emotional labor and problem-focused coping tended to fare better when it came to feelings of moral distress and subsequent burnout. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

13 pages, 1607 KiB

Open AccessArticle

Health-Promoting Quality of Life at Work during the COVID-19 Pandemic: A 12-Month Longitudinal Study on the Work-Related Sense of Coherence in Acute Care Healthcare Professionals

by Joana Berger-Estilita, Sandra Abegglen, Nadja Hornburg, Robert Greif and Alexander Fuchs

Int. J. Environ. Res. Public Health 2022, 19(10), 6053; https://doi.org/10.3390/ijerph19106053 - 16 May 2022

Cited by 9 | Viewed by 5575

Abstract

(1) Background: During a pandemic, the wellbeing of healthcare professionals is crucial. We investigated the long-term association of the Work-related Sense of Coherence (Work-SoC) and the evolution of psychological health symptoms of acute care healthcare professionals during the first year of the COVID-19 [...] Read more.

(1) Background: During a pandemic, the wellbeing of healthcare professionals is crucial. We investigated the long-term association of the Work-related Sense of Coherence (Work-SoC) and the evolution of psychological health symptoms of acute care healthcare professionals during the first year of the COVID-19 pandemic. (2) Methods: This longitudinal observational study enrolled 520 multinational healthcare professionals, who completed an online survey every three months from April 2020 to April 2021. Mixed linear models examined the associations between Work-SOC and COVID-19-related anxiety, perceived vulnerability, depressiveness, and psychological trauma symptomatology. (3) Results: Healthcare professionals with a higher Work-SoC reported lower levels of COVID-19-related anxiety, perceived vulnerability, depressiveness, and psychological trauma symptomatology in April 2020 than healthcare professionals with an average or lower Work-SoC, but the levels increased to higher values in April 2021. Healthcare professionals with a lower Work-SoC reported higher levels of depressiveness and psychological trauma symptomatology in April 2020 but lower levels in April 2021. (4) Conclusions: Healthcare professionals with higher levels of Work-related Sense of Coherence might be protected against variations in psychological symptoms for about three months, but this protection seems to decrease as the pandemic continues, resulting in mental health deterioration. In contrast, healthcare professionals with a lower Work-SoC might be protected at later stages of the pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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20 pages, 9745 KiB

Open AccessArticle

Research on the Design Strategy of Healing Products for Anxious Users during COVID-19

by Fan Wu, Yang-Cheng Lin and Peng Lu

Int. J. Environ. Res. Public Health 2022, 19(10), 6046; https://doi.org/10.3390/ijerph19106046 - 16 May 2022

Cited by 5 | Viewed by 1937

Abstract

With the spread of COVID-19 worldwide, various travel restrictions are becoming a significant trigger for anxiety. Although healing products could relieve anxiety, few scholars have proposed a practical design strategy. Therefore, we offer a design strategy for healing products that includes three phases: [...] Read more.

With the spread of COVID-19 worldwide, various travel restrictions are becoming a significant trigger for anxiety. Although healing products could relieve anxiety, few scholars have proposed a practical design strategy. Therefore, we offer a design strategy for healing products that includes three phases: preparation, analysis, and verification. In Phase 1, 20 people with moderate or high anxiety are invited to rate 100 samples. Then, FCM is used to obtain representative samples. In Phase 2, a three-layer diagram (incl. the upper, middle, and lower layers) of healing products is obtained using the evaluation grid method. Subsequently, the middle layer is considered evaluation criteria. Additionally, 18 items in the lower layer are considered design guidelines. In Phase 3, we invite two teams to develop innovative designs based on design guidelines and personal experience, generating four alternatives. Finally, four alternatives and four healing commodities are evaluated using grey relation analysis and perceptual questionnaires. The consistency of both evaluations could confirm the validity of the evaluation criteria. The alternatives generated based on the design guidelines are better than other alternatives, demonstrating the effectiveness of the design guidelines. The design strategy is beneficial for developing and evaluating healing products to alleviate people’s anxiety during COVID-19. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 1143 KiB

Open AccessArticle

Effectiveness of Intermediate Respiratory Care Units as an Alternative to Intensive Care Units during the COVID-19 Pandemic in Catalonia

by Marina Galdeano Lozano, Julio César Alfaro Álvarez, Núria Parra Macías, Rosario Salas Campos, Sarah Heili Frades, Josep Maria Montserrat, Antoni Rosell Gratacós, Jorge Abad Capa, Olga Parra Ordaz and Francesc López Seguí

Int. J. Environ. Res. Public Health 2022, 19(10), 6034; https://doi.org/10.3390/ijerph19106034 - 16 May 2022

Cited by 2 | Viewed by 1913

Abstract

Objectives: During the COVID-19 pandemic, the risk of collapse for the health system created great difficulties. We will demonstrate that intermediate respiratory care units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important for patients with SARS-CoV-2 pneumonia. [...] Read more.

Objectives: During the COVID-19 pandemic, the risk of collapse for the health system created great difficulties. We will demonstrate that intermediate respiratory care units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important for patients with SARS-CoV-2 pneumonia. Methods: A prospective observational study of patients with COVID-19 admitted to the ICU of a tertiary hospital. Sociodemographic data, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was subsequently analyzed. Results: 991 patients were admitted, 56 to the IRCU (from a of 81 admitted to the critical care unit). Mean age was 65 years (SD 12.8), Barthel index 75 (SD 8.3), Charlson comorbidity index 3.1 (SD 2.2), HTN 27%, COPD 89% and obesity 24%. A significant relationship (p < 0.05) with higher mortality was noted for the following parameters: fever greater than or equal to 39 °C [OR 5.6; 95% CI (1.2–2.7); p = 0.020], protocolized pharmacological treatment [OR 0.3; 95% CI (0.1–0.9); p = 0.023] and IOI [OR 3.7; 95% CI (1.1–12.3); p = 0.025]. NIMV had less of a negative impact [OR 1.8; 95% CI (0.4–8.4); p = 0.423] than IOI. The total cost of the IRCU amounted to €66,233. The cost per day of stay in the IRCU was €164 per patient. The total cost avoided was €214,865. Conclusions: The pandemic has highlighted the importance of IRCUs in facilitating the management of a high patient volume. The treatment carried out in IRCUs is effective and efficient, reducing both admissions to and stays in the ICU. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 378 KiB

Open AccessArticle

Determinants of Quality of Life in the COVID-19 Pandemic Situation among Persons Using Psychological Help at Various Stages of the Pandemic

by Joanna Chwaszcz, Michał Wiechetek, Rafał P. Bartczuk, Iwona Niewiadomska and Patrycja Wośko

Int. J. Environ. Res. Public Health 2022, 19(10), 6023; https://doi.org/10.3390/ijerph19106023 - 16 May 2022

Cited by 1 | Viewed by 1544

Abstract

This article presents the results of three surveys conducted during the initial stage of the COVID-19 pandemic, in March 2020 and in late June/early July 2020, when pandemic restrictions were in force. The surveys covered patients who had used psychological assistance before the [...] Read more.

This article presents the results of three surveys conducted during the initial stage of the COVID-19 pandemic, in March 2020 and in late June/early July 2020, when pandemic restrictions were in force. The surveys covered patients who had used psychological assistance before the pandemic. two were cross-sectional and one was longitudinal. The first survey involved 270 people (age: M = 29.59, SD = 10.74, women 79.3%), and the second one covered 117 subjects (age: M = 29.40, SD = 11.49, women 85.5%). The third, longitudinal, survey covered 83 subjects (age: M = 26.61, SD = 7.17, women 89.2%). In our research we used the Conservation of Resources Evaluation questionnaire, the abbreviated version of the Coping Orientation to Problems Experienced, the WHO Quality of Life Scale, and a questionnaire for collecting sociodemographic information. Our analysis of the quality-of-life correlates in the two cross-sectional studies leads to an observation that for people using psychological help, the constant determinants of quality of life during a pandemic are high gain in resources and little loss of resources. In the first phase of the pandemic, active strategies were not linked to the sense of quality of life. This sense, however, was diminished by a number of negative strategies, such as denial, venting, substance use, restraint, and self-blame. After 3 months of the ongoing pandemic, perceived quality of life was positively correlated with strategies related to seeking instrumental support and active coping. this most likely points to a process of adapting to a difficult situation. The results of our longitudinal surveys demonstrate increasing escapism. Our attempt at explaining which factors determined the quality of life after 3 months of the ongoing pandemic showed that the crucial factors are: a sense of quality of life before the occurrence of the pandemic, changes in the distribution of resilience-oriented resources, changed frequency of using passive strategies, and active ways of coping—but only after 3 months into the pandemic. The results thus obtained can be used both in prevention and in work with persons affected by the negative consequences of the COVID-19 pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

11 pages, 367 KiB

Open AccessArticle

Clinical and Socio-Demographic Variables Associated with the Diagnosis of Long COVID Syndrome in Youth: A Population-Based Study

by Eugene Merzon, Margaret Weiss, Beth Krone, Shira Cohen, Gili Ilani, Shlomo Vinker, Avivit Cohen-Golan, Ilan Green, Ariel Israel, Tzipporah Schneider, Shai Ashkenazi, Abraham Weizman and Iris Manor

Int. J. Environ. Res. Public Health 2022, 19(10), 5993; https://doi.org/10.3390/ijerph19105993 - 15 May 2022

Cited by 23 | Viewed by 9747

Abstract

This study examines the demographic, clinical and socioeconomic factors associated with diagnosis of long COVID syndrome (LCS). Data of 20,601 COVID-19-positive children aged 5 to 18 years were collected between 2020 and 2021 in an Israeli database. Logistic regression analysis was used to [...] Read more.

This study examines the demographic, clinical and socioeconomic factors associated with diagnosis of long COVID syndrome (LCS). Data of 20,601 COVID-19-positive children aged 5 to 18 years were collected between 2020 and 2021 in an Israeli database. Logistic regression analysis was used to evaluate the adjusted odds ratio for the characteristics of the COVID-19 infection and pre-COVID-19 morbidities. Children with LCS were significantly more likely to have been severely symptomatic, required hospitalization, and experienced recurrent acute infection within 180 days. In addition, children with LCS were significantly more likely to have had ADHD, chronic urticaria, and allergic rhinitis. Diagnosis of LCS is significantly associated with pre-COVID-19 ADHD diagnosis, suggesting clinicians treating ADHD children who become infected with COVID-19 remain vigilant for the possibility of LCS. Although the risk of severe COVID-19 infection and LCS in children is low, further research on possible morbidity related to LCS in children is needed. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

11 pages, 2141 KiB

Open AccessArticle

Risk Factors Associated with Mortality among Patients with COVID-19: Analysis of a Cohort of 1213 Patients in a Tertiary Healthcare Center

by Carlos Alfonso Romero-Gameros, Guadalupe Vargas-Ortega, Mario Enrique Rendón-Macias, Carlos Fredy Cuevas-García, Tania Colín-Martínez, Luis Alejandro Sánchez-Hurtado, Lourdes Josefina Balcázar-Hernández, Iván Emilio De la Cruz-Rodríguez, Enid Karina Pérez-Dionisio, Perla Michelle Retana-Torres, Elsy Sarahí García-Montesinos, Mayra Alejandra López-Moreno, Marielle Intriago-Alor, Salomón Waizel-Haiat and Baldomero González-Virla

J. Clin. Med. 2022, 11(10), 2780; https://doi.org/10.3390/jcm11102780 - 14 May 2022

Cited by 4 | Viewed by 2102

Abstract

The presence of cardio-metabolic and respiratory comorbidities, immunosuppression, and chronic kidney disease have been associated with an increase in mortality from COVID-19. The objective of this study is to establish the risk factors associated with 30-day mortality in a cohort of hospitalized patients [...] Read more.

The presence of cardio-metabolic and respiratory comorbidities, immunosuppression, and chronic kidney disease have been associated with an increase in mortality from COVID-19. The objective of this study is to establish the risk factors associated with 30-day mortality in a cohort of hospitalized patients with COVID-19. This paper conducts a retrospective and analytical study of patients hospitalized for COVID-19 in a tertiary care center. A Cox proportional hazard analysis was performed to estimate the association of comorbidities with 30-day mortality. A total of 1215 patients with a median age of 59 years were included. In the adjusted Cox proportional hazards regression model, hypothyroidism, D-dimer ≥ 0.8 μg/mL, LHD ≥ 430 IU/L, CRP ≥ 4.83 ng/mL, and triglycerides ≥ 214 mg/dL were associated with an increased risk of death. The presence of a history of hypothyroidism and biomarkers (D-dimer, lactic dehydrogenase, CRP, and triglycerides) were associated with an increase in mortality in the studied cohort. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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15 pages, 3016 KiB

Open AccessArticle

Emergency Medical Services Calls Analysis for Trend Prediction during Epidemic Outbreaks: Interrupted Time Series Analysis on 2020–2021 COVID-19 Epidemic in Lazio, Italy

by Antonio Vinci, Amina Pasquarella, Maria Paola Corradi, Pelagia Chatzichristou, Gianluca D’Agostino, Stefania Iannazzo, Nicoletta Trani, Maria Annunziata Parafati, Leonardo Palombi and Domenico Antonio Ientile

Int. J. Environ. Res. Public Health 2022, 19(10), 5951; https://doi.org/10.3390/ijerph19105951 - 13 May 2022

Cited by 5 | Viewed by 1998

Abstract

(1) Background: During the COVID-19 outbreak in the Lazio region, a surge in emergency medical service (EMS) calls has been observed. The objective of present study is to investigate if there is any correlation between the variation in numbers of daily EMS calls, [...] Read more.

(1) Background: During the COVID-19 outbreak in the Lazio region, a surge in emergency medical service (EMS) calls has been observed. The objective of present study is to investigate if there is any correlation between the variation in numbers of daily EMS calls, and the short-term evolution of the epidemic wave. (2) Methods: Data from the COVID-19 outbreak has been retrieved in order to draw the epidemic curve in the Lazio region. Data from EMS calls has been used in order to determine Excess of Calls (ExCa) in the 2020–2021 years, compared to the year 2019 (baseline). Multiple linear regression models have been run between ExCa and the first-order derivative (D’) of the epidemic wave in time, each regression model anticipating the epidemic progression (up to 14 days), in order to probe a correlation between the variables. (3) Results: EMS calls variation from baseline is correlated with the slope of the curve of ICU admissions, with the most fitting value found at 7 days (R² 0.33, p < 0.001). (4) Conclusions: EMS calls deviation from baseline allows public health services to predict short-term epidemic trends in COVID-19 outbreaks, and can be used as validation of current data, or as an independent estimator of future trends. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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20 pages, 1680 KiB

Open AccessReview

An Effective Mechanism for the Early Detection and Containment of Healthcare Worker Infections in the Setting of the COVID-19 Pandemic: A Systematic Review and Meta-Synthesis

by Yueli Mei, Xiuyun Guo, Zhihao Chen and Yingzhi Chen

Int. J. Environ. Res. Public Health 2022, 19(10), 5943; https://doi.org/10.3390/ijerph19105943 - 13 May 2022

Cited by 3 | Viewed by 1908

Abstract

The COVID-19 pandemic has exposed healthcare workers (HCWs) to serious infection risks. In this context, the proactive monitoring of HCWs is the first step toward reducing intrahospital transmissions and safeguarding the HCW population, as well as reflecting the preparedness and response of the [...] Read more.

The COVID-19 pandemic has exposed healthcare workers (HCWs) to serious infection risks. In this context, the proactive monitoring of HCWs is the first step toward reducing intrahospital transmissions and safeguarding the HCW population, as well as reflecting the preparedness and response of the healthcare system. As such, this study systematically reviewed the literature on evidence-based effective monitoring measures for HCWs during the COVID-19 pandemic. This was followed by a meta-synthesis to compile the key findings, thus, providing a clearer overall understanding of the subject. Effective monitoring measures of syndromic surveillance, testing, contact tracing, and exposure management are distilled and further integrated to create a whole-process monitoring workflow framework. Taken together, a mechanism for the early detection and containment of HCW infections is, thus, constituted, providing a composite set of practical recommendations to healthcare facility leadership and policy makers to reduce nosocomial transmission rates while maintaining adequate staff for medical services. In this regard, our study paves the way for future studies aimed at strengthening surveillance capacities and upgrading public health system resilience, in order to respond more efficiently to future pandemic threats. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 1262 KiB

Open AccessArticle

Effects of Population Knowledge, Perceptions, Attitudes, and Practices on COVID-19 Infection Prevention and Control in NUST

by Caitlin Bosch, Edwig Hauwanga, Beauty E. Omoruyi, Benjamin I. Okeleye, Vincent I. Okudoh and Yapo G. Aboua

Int. J. Environ. Res. Public Health 2022, 19(10), 5918; https://doi.org/10.3390/ijerph19105918 - 13 May 2022

Viewed by 1823

Abstract

The global COVID-19 pandemic has had a major impact on the education sector of most countries. One of the basic CDC prevention guidelines is the implementation of non-pharmaceutical interventions (NPIs) to protect the health of students and staff members to curve the spread [...] Read more.

The global COVID-19 pandemic has had a major impact on the education sector of most countries. One of the basic CDC prevention guidelines is the implementation of non-pharmaceutical interventions (NPIs) to protect the health of students and staff members to curve the spread of COVID-19. The current study aimed to examine the knowledge, perceptions, attitudes, and practices of students at the Namibia University of Technology toward the COVID-19 pandemic. A cross-sectional descriptive survey was conducted using a closed-ended questionnaire. Data were collected from full-time students who were on campus during the COVID-19 pandemic between 29 January to 14 February 2021. The average knowledge about the modes of transmission, protective measures, and clinical symptoms ranged from 78% to 96%. About 31% of student respondents believed the virus was created in a laboratory, and 47% believed the vaccine has negative side effects and therefore, refused to take it. The three main sources of information about COVID-19 were social media (75%), television (63%), and friends and family (50%). The students had an overall positive attitude towards the implementation of NPIs. However, the importance of vaccine safety must be emphasized. Lockdowns should be lifted gradually to reduce the amount of time students are spending on online content. Reopening of classrooms for face-to-face study will bring unquestionable benefits to students and the wider economy. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 1497 KiB

Open AccessArticle

SARS-CoV-2 Vaccination Rate and SARS-CoV-2 Infection of Health Care Workers in Aerosol-Generating Medical Disciplines

by Anna Muzalyova, Alanna Ebigbo, Maria Kahn, Stephan Zellmer, Albert Beyer, Jonas Rosendahl, Johannes Zenk, Bilal Al-Nawas, Roland Frankenberger, Juergen Hoffmann, Christoph Arens, Frank Lammert, Claudia Traidl-Hoffmann, Helmut Messmann and Christoph Roemmele

J. Clin. Med. 2022, 11(10), 2751; https://doi.org/10.3390/jcm11102751 - 12 May 2022

Cited by 2 | Viewed by 1298

Abstract

Healthcare workers (HCW) who perform aerosol-generating procedures (AGP) are at high risk of SARS-CoV-2 infection. Data on infection rates and vaccination are limited. A nationwide, cross-sectional study focusing on AGP-related specialties was conducted between 3 May 2021 and 14 June 2021. Vaccination rates [...] Read more.

Healthcare workers (HCW) who perform aerosol-generating procedures (AGP) are at high risk of SARS-CoV-2 infection. Data on infection rates and vaccination are limited. A nationwide, cross-sectional study focusing on AGP-related specialties was conducted between 3 May 2021 and 14 June 2021. Vaccination rates among HCW, perception of infection risk, and infection rates were analyzed, focusing on the comparison of gastrointestinal endoscopy (GIE) and other AGP-related specialties (NON-GIE), from the beginning of the pandemic until the time point of the study. Infections rates among HCW developed similarly to the general population during the course of the pandemic, however, with significantly higher infections rates among the GIE specialty. The perceived risk of infection was distributed similarly among HCW in GIE and NON-GIE (91.7%, CI: 88.6–94.4 vs. 85.8%, CI: 82.4–89.0; p < 0.01) with strongest perceived threats posed by AGPs (90.8%) and close patient contact (70.1%). The very high vaccination rate (100–80%) among physicians was reported at 83.5%, being significantly more frequently reported than among nurses (56.4%, p < 0.01). GIE had more often stated very high vaccination rate compared with NON-GIE (76.1% vs. 65.3%, p < 0.01). A significantly higher rate of GIE was reported to have fewer concerns regarding infection risk after vaccination than NON-GIE (92.0% vs. 80.3%, p < 0.01). Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 557 KiB

Open AccessArticle

Sponge Whirl-Pak Sampling Method and Droplet Digital RT-PCR Assay for Monitoring of SARS-CoV-2 on Surfaces in Public and Working Environments

by Davide Cardinale, Maria Tafuro, Andrea Mancusi, Santa Girardi, Federico Capuano, Yolande Thérèse Rose Proroga, Federica Corrado, Jacopo Luigi D’Auria, Annachiara Coppola, Giuseppe Rofrano, Palmiero Volzone, Pio Galdi, Sabato De Vita, Alfonso Gallo, Elisabetta Suffredini, Biancamaria Pierri, Pellegrino Cerino and Maria Morgante

Int. J. Environ. Res. Public Health 2022, 19(10), 5861; https://doi.org/10.3390/ijerph19105861 - 11 May 2022

Cited by 4 | Viewed by 1798

Abstract

The SARS-CoV-2 can spread directly via saliva, respiratory aerosols and droplets, and indirectly by contact through contaminated objects and/or surfaces and by air. In the context of COVID-19 fomites can be an important vehicle of virus transmission and contribute to infection risk in [...] Read more.

The SARS-CoV-2 can spread directly via saliva, respiratory aerosols and droplets, and indirectly by contact through contaminated objects and/or surfaces and by air. In the context of COVID-19 fomites can be an important vehicle of virus transmission and contribute to infection risk in public environments. The aim of the study was to analyze through surface sampling (sponge method) the presence of SARS-CoV-2 in public and working environments, in order to evaluate the risk for virus transmission. Seventy-seven environmental samples were taken using sterile sponges in 17 animal farms, 4 public transport buses, 1 supermarket and 1 hotel receptive structure. Furthermore, 246 and 93 swab samples were taken in the farms from animals and from workers, respectively. SARS-CoV-2 detection was conducted by real-time RT-PCR and by digital droplet RT-PCR (dd RT-PCR) using RdRp, gene E and gene N as targets. None of the human and animal swab samples were positive for SARS-CoV-2, while detection was achieved in 20 of the 77 sponge samples (26%) using dd RT-PCR. Traces of the RdRp gene, gene E and gene N were found in 17/77 samples (22%, average concentration 31.2 g.c./cm², range 5.6 to 132 g.c./cm²), 8/77 samples (10%, average concentration 15.1 g.c./cm², range 6 to 36 g.c./cm²), and in 1/77 (1%, concentration 7.2 g.c./cm²). Higher detection rates were associated with sampling in animal farms and on public transport buses (32% and 30%) compared to the supermarket (21%) and the hotel (no detection). The result of the study suggests that the risk of contamination of surfaces with SARS-CoV-2 increases in environments in which sanitation strategies are not suitable and/or in highly frequented locations, such as public transportation. Considering the analytical methods, the dd RT-PCR was the only approach achieving detection of SARS-CoV-2 traces in environmental samples. Thus, dd RT-PCR emerges as a reliable tool for sensitive SARS-CoV-2 detection. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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15 pages, 358 KiB

Open AccessArticle

Job Satisfaction Level of Safety and Health Manager in Construction Industry: Pandemic Period

by Won Choi, Sang-joon Lee, Woo-je Lee, Eun-mi Beak and Ki-youn Kim

Int. J. Environ. Res. Public Health 2022, 19(10), 5858; https://doi.org/10.3390/ijerph19105858 - 11 May 2022

Cited by 2 | Viewed by 1819

Abstract

In a widespread social turmoil such as the Pandemic, job groups with high turnover rates and high job stress, such as the construction industry, will have a greater adverse impact than the general job group. This is to be used as basic data [...] Read more.

In a widespread social turmoil such as the Pandemic, job groups with high turnover rates and high job stress, such as the construction industry, will have a greater adverse impact than the general job group. This is to be used as basic data in preparing management plans by identifying the factors that hinder job stress and job satisfaction of construction workers. In this study, during the Pandemic period (1 September 2021 to 31 December 2021), a survey was conducted on job stress and job satisfaction among safety and health managers working at construction sites. The overall job satisfaction of workers in the construction industry was grasped by analyzing the level of correlation and the mutual influence on job stress, job satisfaction, general characteristics, and work-related characteristics. As a result, in terms of work characteristics, it was found that the smaller the working period in the current position, the more positive the job satisfaction was (p < 0.01). In addition, it was found that job satisfaction increased significantly when there was a promotion opportunity (p < 0.001). The construction industry is a job group with high basic job stress and low job satisfaction. In addition, it was evaluated that job stress increased during the pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

12 pages, 679 KiB

Open AccessArticle

The Impact of Different Ventilatory Strategies on Clinical Outcomes in Patients with COVID-19 Pneumonia

by Rihards P. Rocans, Agnese Ozolina, Denise Battaglini, Evita Bine, Janis V. Birnbaums, Anastasija Tsarevskaya, Sintija Udre, Marija Aleksejeva, Biruta Mamaja and Paolo Pelosi

J. Clin. Med. 2022, 11(10), 2710; https://doi.org/10.3390/jcm11102710 - 11 May 2022

Viewed by 2047

Abstract

Introduction: The aim was to investigate the impact of different ventilator strategies (non-invasive ventilation (NIV); invasive MV with tracheal tube (TT) and with tracheostomy (TS) on outcomes (mortality and intensive care unit (ICU) length of stay) in patients with COVID-19. We also assessed [...] Read more.

Introduction: The aim was to investigate the impact of different ventilator strategies (non-invasive ventilation (NIV); invasive MV with tracheal tube (TT) and with tracheostomy (TS) on outcomes (mortality and intensive care unit (ICU) length of stay) in patients with COVID-19. We also assessed the impact of timing of percutaneous tracheostomy and other risk factors on mortality. Methods: The retrospective cohort included 868 patients with severe COVID-19. Demographics, MV parameters and duration, and ICU mortality were collected. Results: MV was provided in 530 (61.1%) patients, divided into three groups: NIV (n = 139), TT (n = 313), and TS (n = 78). Prevalence of tracheostomy was 14.7%, and ICU mortality was 90.4%, 60.2%, and 30.2% in TT, TS, and NIV groups, respectively (p < 0.001). Tracheostomy increased the chances of survival and being discharged from ICU (OR 6.3, p < 0.001) despite prolonging ICU stay compared to the TT group (22.2 days vs. 10.7 days, p < 0.001) without differences in survival rates between early and late tracheostomy. Patients who only received invasive MV had higher odds of survival compared to those receiving NIV in ICU prior to invasive MV (OR 2.7, p = 0.001). The odds of death increased with age (OR 1.032, p < 0.001), obesity (1.58, p = 0.041), chronic renal disease (1.57, p = 0.019), sepsis (2.8, p < 0.001), acute kidney injury (1.7, p = 0.049), multiple organ dysfunction (3.2, p < 0.001), and ARDS (3.3, p < 0.001). Conclusions: Percutaneous tracheostomy compared to MV via TT significantly increased survival and the rate of discharge from ICU, without differences between early or late tracheostomy. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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8 pages, 638 KiB

Open AccessArticle

Age-Dependent Biomarkers for Prediction of In-Hospital Mortality in COVID-19 Patients

by Eugene Feigin, Tal Levinson, Asaf Wasserman, Shani Shenhar-Tsarfaty, Shlomo Berliner and Tomer Ziv-Baran

J. Clin. Med. 2022, 11(10), 2682; https://doi.org/10.3390/jcm11102682 - 10 May 2022

Cited by 7 | Viewed by 1479

Abstract

Background: Several biomarkers and models have been proposed to predict in-hospital mortality among COVID-19 patients. However, these studies have not examined the association in sub-populations. The present study aimed to identify the association between the two most common inflammatory biomarkers in the emergency [...] Read more.

Background: Several biomarkers and models have been proposed to predict in-hospital mortality among COVID-19 patients. However, these studies have not examined the association in sub-populations. The present study aimed to identify the association between the two most common inflammatory biomarkers in the emergency department and in-hospital mortality in subgroups of patients. Methods: A historical cohort study of adult patients who were admitted to acute-care hospital between March and December 2020 and had a diagnosis of COVID-19 infection. Data on age, sex, Charlson comorbidity index, white blood cell (WBC) count, C-reactive protein (CRP), and in-hospital mortality were collected. Discrimination ability of each biomarker was observed and the CHAID method was used to identify the association in subgroups of patients. Results: Overall, 762 patients (median age 70.9 years, 59.7% males) were included in the study. Of them, 25.1% died during hospitalization. In-hospital mortality was associated with higher CRP (median 138 mg/L vs. 85 mg/L, p < 0.001), higher WBC count (median 8.5 vs. 6.6 K/µL, p < 0.001), and higher neutrophil-to-lymphocyte ratio (NLR) (median 9.2 vs. 5.4, p < 0.001). The area under the ROC curve was similar among all biomarkers (WBC 0.643, NLR 0.677, CRP 0.646, p > 0.1 for all comparisons). The CHAID method revealed that WBC count was associated with in-hospital mortality in patients aged 43.1–66.0 years (<11 K/µL: 10.1% vs. 11+ K/µL: 27.9%), NLR in patients aged 66.1–80 years (≤8: 15.7%, >8: 43.3%), and CRP in patients aged 80.1+ years (≤47 mg/L: 18.8%, 47.1–149 mg/L: 43.1%, and 149.1+: 71.7% mortality). Conclusions: WBC, NLR, and CRP present similar discrimination abilities. However, each biomarker should be considered as a predictor for in-hospital mortality in different age groups. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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18 pages, 937 KiB

Open AccessArticle

Long-Lasting Olfactory Dysfunction in Hospital Workers Due to COVID-19: Prevalence, Clinical Characteristics, and Most Affected Odorants

by María Luisa Delgado-Losada, Jaime Bouhaben, Claudia Ruiz-Huerta, Marcelle V. Canto and Alice Helena Delgado-Lima

Int. J. Environ. Res. Public Health 2022, 19(9), 5777; https://doi.org/10.3390/ijerph19095777 - 09 May 2022

Cited by 2 | Viewed by 2085

Abstract

Hospital workers have increased exposure risk of healthcare-associated infections due to the frontline nature of their work. Olfactory dysfunction is highly prevalent. The objectives for this investigation are to study the prevalence of long-lasting olfactory dysfunction associated with COVID-19 infection in hospital workers [...] Read more.

Hospital workers have increased exposure risk of healthcare-associated infections due to the frontline nature of their work. Olfactory dysfunction is highly prevalent. The objectives for this investigation are to study the prevalence of long-lasting olfactory dysfunction associated with COVID-19 infection in hospital workers during the first pandemic wave, to identify clinical characteristics and associated symptomatology, and to analyze how many patients with COVID-19 infection had developed olfactory dysfunction during infection and maintained a reduced olfactory function for approximately 10 weeks after diagnosis. Between June and July of 2020, a cross-sectional study was carried out at the Hospital Central de la Cruz Roja San José and Santa Adela in Madrid, Spain. One hundred sixty-four participants were included, of which 110 were patient-facing healthcare staff and 54 were non-patient-facing healthcare staff. Participants were split into three groups, according to COVID-19 diagnosis and presence of COVID-19 related olfactory symptomatology. Participants were asked to complete a structured online questionnaire along with Sniffin’ Stick Olfactory Test measurements. In this study, 88 participants were confirmed for COVID-19 infection, 59 of those participants also reported olfactory symptomatology. The prevalence of COVID-19 infection was 11.35%, and the prevalence for olfactory dysfunction was 67.05%. Olfactory dysfunction associated with COVID-19 infection leads to long-lasting olfactory loss. Objective assessment with Sniffin’ Stick Olfactory Test points to odor identification as the most affected process. Lemon, liquorice, solvent, and rose are the odors that are worst recognized. Mint, banana, solvent, garlic, coffee, and pineapple, although they are identified, are perceived with less intensity. The findings of this study confirmed a high prevalence of SARS-CoV-2 infection among the hospital workers. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 614 KiB

Open AccessArticle

Streamlining Patient Management of Suspected COVID-19 Patients in the Emergency Department: Incorporation of Pulmonary CT Angiography into the Triaging Algorithm

by Benedikt M. Schaarschmidt, David Fistera, Yan Li, Margarete Konik, Johannes Haubold, Johannes Grueneisen, Oliver Witzke, Michael Forsting, Carola Holzner and Lale Umutlu

Diagnostics 2022, 12(5), 1183; https://doi.org/10.3390/diagnostics12051183 - 09 May 2022

Cited by 1 | Viewed by 1413

Abstract

Purpose: To evaluate the use of pulmonary computed tomography (CT) angiography during initial admission at an emergency department (ED), to identify COVID-19 patients with accompanying pulmonary embolism (PE) and its impact on clinical management. Methods: We performed a retrospective analysis of COVID-19 patients [...] Read more.

Purpose: To evaluate the use of pulmonary computed tomography (CT) angiography during initial admission at an emergency department (ED), to identify COVID-19 patients with accompanying pulmonary embolism (PE) and its impact on clinical management. Methods: We performed a retrospective analysis of COVID-19 patients that underwent pulmonary CT angiography at the ED. CT scans were evaluated for the presence and extent of PE and for imaging changes suspicious of COVID-19. Patients were subdivided into two groups: (1) Group A consisted of patients with proven COVID-19 based on real-time polymerase chain reaction (RT-PCR), and (2) Group B of patients suspected for COVID-19, comprising patients positive on RT-PCR and/or COVID-19-suspicious CT findings. To assess the differences between patients with and without pulmonary embolism, Fisher’s exact test was used. Results: A total of 308 patients were admitted to the ED for diagnostic work-up of dyspnea and suspected COVID-19, and 95 patients underwent pulmonary CT angiography. PE was detected in 13.6% (3/22) of patients in Group A and 20.7% (6/29) in Group B. No significant differences were observed between patients with and without PE concerning hospitalization (Group B: 100% (6/6) vs. 91.3% (21/23)), the necessity of oxygen therapy (Group B: 66% (4/6) vs. 43.5% (10/23)), and death (Group B: 33% (2/6) vs. 4.3% (1/23) p > 0.05, respectively). Conclusions: In 20.7% of COVID-19 patients, PE was detected upon admission to the ED. Although the incorporation of early pulmonary CT angiography in patients suspicious of COVID-19 may be beneficial to identify concomitant PE, further studies are necessary to corroborate these findings. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 557 KiB

Open AccessArticle

Acute Pulmonary Artery Thrombosis despite Anticoagulation in Patients with COVID-19 Pneumonia: A Single-Center Retrospective Cohort Study

by Cristian-Mihail Niculae, Ana-Maria-Jennifer Anghel, Eliza-Daniela Militaru, Laura-Georgiana Tîrlescu, Mihai Lazar and Adriana Hristea

J. Clin. Med. 2022, 11(9), 2633; https://doi.org/10.3390/jcm11092633 - 07 May 2022

Cited by 6 | Viewed by 2269

Abstract

(1) Background: We aimed to describe the clinical and imaging characteristics of patients diagnosed with pulmonary artery thrombosis (PAT) despite receiving anticoagulation with low-molecular-weight heparin (LMWH). (2) Methods: We retrospectively studied all hospitalized COVID-19 adult patients diagnosed with PAT between March 2020 and [...] Read more.

(1) Background: We aimed to describe the clinical and imaging characteristics of patients diagnosed with pulmonary artery thrombosis (PAT) despite receiving anticoagulation with low-molecular-weight heparin (LMWH). (2) Methods: We retrospectively studied all hospitalized COVID-19 adult patients diagnosed with PAT between March 2020 and December 2021, who received LMWH for ≥72 h until the diagnosis of PAT. Acute PAT was confirmed by a CT pulmonary angiogram. (3) Results: We included 30 severe and critical COVID-19 patients. Median age was 62 (54–74) years, with 83.3% males, and comorbidities seen in 73.3%. PAT was diagnosed despite prophylactic (23.3%), intermediate (46.6%) or therapeutic (30%) doses of LMWH for a median time of 8 (4.7–12) days. According to their Wells score, 80% of patients had a low probability of pulmonary embolism diagnosis. PAT was localized in the lower lobes of the lungs in 76.6% of cases with 33.3% having bilateral involvement, with the distal, peripheral arteries being the most affected. At the PAT diagnosis we found a worsening of respiratory function, with seven patients progressing to mechanical ventilation (p = 0.006). The in-hospital mortality was 30%. (4) Conclusions: PAT should be considered in patients with severe and critical COVID-19, mainly in elderly male patients with comorbidities, irrespective of Wells score and LMWH anticoagulation. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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22 pages, 1557 KiB

Open AccessArticle

SARS-CoV-2 Droplet and Airborne Transmission Heterogeneity

by Marta Baselga, Antonio Güemes, Juan J. Alba and Alberto J. Schuhmacher

J. Clin. Med. 2022, 11(9), 2607; https://doi.org/10.3390/jcm11092607 - 06 May 2022

Cited by 7 | Viewed by 9347

Abstract

The spread dynamics of the SARS-CoV-2 virus have not yet been fully understood after two years of the pandemic. The virus’s global spread represented a unique scenario for advancing infectious disease research. Consequently, mechanistic epidemiological theories were quickly dismissed, and more attention was [...] Read more.

The spread dynamics of the SARS-CoV-2 virus have not yet been fully understood after two years of the pandemic. The virus’s global spread represented a unique scenario for advancing infectious disease research. Consequently, mechanistic epidemiological theories were quickly dismissed, and more attention was paid to other approaches that considered heterogeneity in the spread. One of the most critical advances in aerial pathogens transmission was the global acceptance of the airborne model, where the airway is presented as the epicenter of the spread of the disease. Although the aerodynamics and persistence of the SARS-CoV-2 virus in the air have been extensively studied, the actual probability of contagion is still unknown. In this work, the individual heterogeneity in the transmission of 22 patients infected with COVID-19 was analyzed by close contact (cough samples) and air (environmental samples). Viral RNA was detected in 2/19 cough samples from patient subgroups, with a mean Ct (Cycle Threshold in Quantitative Polymerase Chain Reaction analysis) of 25.7 ± 7.0. Nevertheless, viral RNA was only detected in air samples from 1/8 patients, with an average Ct of 25.0 ± 4.0. Viral load in cough samples ranged from 7.3 × 10⁵ to 8.7 × 10⁸ copies/mL among patients, while concentrations between 1.1–4.8 copies/m³ were found in air, consistent with other reports in the literature. In patients undergoing follow-up, no viral load was found (neither in coughs nor in the air) after the third day of symptoms, which could help define quarantine periods in infected individuals. In addition, it was found that the patient’s Ct should not be considered an indicator of infectiousness, since it could not be correlated with the viral load disseminated. The results of this work are in line with proposed hypotheses of superspreaders, which can attribute part of the heterogeneity of the spread to the oversized emission of a small percentage of infected people. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 544 KiB

Open AccessArticle

Epidemiology, Clinical Presentation and Treatment of Non-Hepatic Hyperammonemia in ICU COVID-19 Patients

by Nardi Tetaj, Giulia Valeria Stazi, Maria Cristina Marini, Gabriele Garotto, Donatella Busso, Silvana Scarcia, Ilaria Caravella, Manuela Macchione, Giada De Angelis, Rachele Di Lorenzo, Alessandro Carucci, Alessandro Capone, Andrea Antinori, Fabrizio Palmieri, Gianpiero D’Offizi, Fabrizio Taglietti, Stefania Ianniello, Paolo Campioni, Francesco Vaia, Emanuele Nicastri, Enrico Girardi, Luisa Marchioni and on behalf of ICU COVID-19 Study Group Show full author list Hide full author list

J. Clin. Med. 2022, 11(9), 2592; https://doi.org/10.3390/jcm11092592 - 05 May 2022

Viewed by 2148

Abstract

(1) Background: Although COVID-19 is largely a respiratory disease, it is actually a systemic disease that has a wide range of effects that are not yet fully known. The aim of this study was to determine the incidence, predictors and outcome of non-hepatic [...] Read more.

(1) Background: Although COVID-19 is largely a respiratory disease, it is actually a systemic disease that has a wide range of effects that are not yet fully known. The aim of this study was to determine the incidence, predictors and outcome of non-hepatic hyperammonemia (NHH) in COVID-19 in intensive care unit (ICU); (2) Methods: This is a 3-month prospective observational study in a third-level COVID-19 hospital. The authors collected demographic, clinical, severity score and outcome data. Logistic regression analyses were performed to identify predictors of NHH; (3) Results: 156 COVID-19 patients were admitted to the ICU. The incidence of NHH was 12.2% (19 patients). The univariate analysis showed that invasive mechanical ventilation had a 6.6-fold higher risk (OR 6.66, 95% CI 0.86–51.6, p = 0.039) for NHH, while in the multiple regression analysis, there was a 7-fold higher risk for NHH—but it was not statistically significant (OR 7.1, 95% CI 0.90–56.4, p = 0.062). Demographics, clinical characteristics and mortality in the ICU at 28 days did not show a significant association with NHH. (4) Conclusions: The incidence of NHH in ICU COVID-19 patients was not low. NHH did not appear to significantly increase mortality, and all patients with non-hepatic hyperammonemia were successfully treated without further complications. However, the pathogenesis of NHH in ICU patients with COVID-19 remains a topic to be explored with further research. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 1262 KiB

Open AccessArticle

SARS-CoV-2 RNA Detection on Environmental Surfaces in a University Setting of Central Italy

by Anna Casabianca, Chiara Orlandi, Giulia Amagliani, Mauro Magnani, Giorgio Brandi and Giuditta Fiorella Schiavano

Int. J. Environ. Res. Public Health 2022, 19(9), 5560; https://doi.org/10.3390/ijerph19095560 - 03 May 2022

Cited by 8 | Viewed by 1589

Abstract

The transmission of SARS-CoV-2 occurs through direct contact (person to person) and indirect contact by means of objects and surfaces contaminated by secretions from individuals with COVID-19 or asymptomatic carriers. In this study, we evaluated the presence of SARS-CoV-2 RNA on surfaces made [...] Read more.

The transmission of SARS-CoV-2 occurs through direct contact (person to person) and indirect contact by means of objects and surfaces contaminated by secretions from individuals with COVID-19 or asymptomatic carriers. In this study, we evaluated the presence of SARS-CoV-2 RNA on surfaces made of different materials located in university environments frequented by students and staff involved in academy activity during the fourth pandemic wave (December 2021). A total of 189 environmental samples were collected from classrooms, the library, computer room, gym and common areas and subjected to real-time PCR assay to evaluate the presence of SARS-CoV-2 RNA by amplification of the RNA-dependent RNA polymerase (RdRp) gene. All samples gave a valid result for Internal Process Control and nine (4.8%) tested very low positive for SARS-CoV-2 RNA amplification with a median Ct value of 39.44 [IQR: 37.31–42.66] (≤1 copy of viral genome). Our results show that, despite the prevention measures implemented, the presence of infected subjects cannot be excluded, as evidenced by the recovery of SARS-CoV-2 RNA from surfaces. The monitoring of environmental SARS-CoV-2 RNA could support public health prevention strategies in the academic and school world. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 371 KiB

Open AccessArticle

Factors Affecting Preventive Health Behaviors against COVID-19 in Nursing Students: A Cross-Sectional Study

by Young-Mi Jung and Na-Young Kim

Int. J. Environ. Res. Public Health 2022, 19(9), 5496; https://doi.org/10.3390/ijerph19095496 - 01 May 2022

Cited by 6 | Viewed by 1651

Abstract

This study was conducted to identify factors affecting preventive health behaviors and to provide basic data for developing coronavirus disease 2019 (COVID-19) prevention and education programs. The participants were 218 students enrolled in two nursing colleges located near Gyeongsang and Jeolla province, Republic [...] Read more.

This study was conducted to identify factors affecting preventive health behaviors and to provide basic data for developing coronavirus disease 2019 (COVID-19) prevention and education programs. The participants were 218 students enrolled in two nursing colleges located near Gyeongsang and Jeolla province, Republic of Korea. Data were collected in December 2020 and analyses were conducted using t- and Scheffé tests, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression with the SPSS/WIN 25.0 program (IBM Corp., Armonk, NY, USA). The factors affecting preventive health behaviors were fear of infection (β = 0.26, p < 0.001), perceived benefits of COVID-19 infection control (β = 0.20, p = 0.002), educational needs concerning COVID-19 infection control (β = 0.18, p = 0.004), and perceived barriers to COVID-19 infection control (β = 0.16, p = 0.011). To improve preventive health behaviors of nursing students against COVID-19, effective and practical education is required, and a systematic infection prevention education program should be developed considering the fear of COVID-19 infection and the perceived benefits and barriers in infection control. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

11 pages, 1356 KiB

Open AccessArticle

The Psychological Experience of COVID-19 Vaccination and Its Impact on the Willingness to Receive Booster Vaccines among the Chinese Population: Evidence from a National Cross-Sectional Study

by Yudong Miao, Yi Li, Wanliang Zhang, Jian Wu, Jianqin Gu, Meiyun Wang, Wei Wei, Beizhu Ye, Chengyuan Miao, Clifford Silver Tarimo and Wenyong Dong

Int. J. Environ. Res. Public Health 2022, 19(9), 5464; https://doi.org/10.3390/ijerph19095464 - 29 Apr 2022

Cited by 10 | Viewed by 2251

Abstract

The purpose of this study was to assess the psychological experience of COVID-19 basic vaccination, the willingness to receive booster vaccines, and to determine their relationships among Chinese people. Between 6 August 2021 and 9 August 2021, a research firm performed a national [...] Read more.

The purpose of this study was to assess the psychological experience of COVID-19 basic vaccination, the willingness to receive booster vaccines, and to determine their relationships among Chinese people. Between 6 August 2021 and 9 August 2021, a research firm performed a national cross-sectional online survey among Chinese individuals (aged over 18), using the snowball sampling approach, with 26,755 participants. Factor analysis and binary logistic regression were used to evaluate the existing associations. The overall COVID-19 vaccination psychological experience score of the participants was 25.83 (25.78~25.89; scores ranged from 7–35). A total of 93.83% (95%CI = 93.54~94.12) of respondents indicated a willingness to receive booster vaccines. After classifying psychological experiences associated with COVID-19 vaccination into positive and negative experiences and adjusting for confounding factors, for the former, the willingness to receive booster vaccines for participants with the highest scores of 13–15 was 3.933 times higher (OR = 3.933, 95%CI = 3.176~4.871) than participants who obtained scores of 3–9, and for the latter, the willingness to receive booster vaccines for participants with the highest scores of 19–20 was 8.871 times higher (OR = 8.871, 95%CI = 6.240~12.612) than participants who obtained scores of 4–13. Our study suggests that a good psychological experience with vaccination is positively associated with an increased willingness to receive booster vaccines. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 667 KiB

Open AccessArticle

Development and Psychometric Properties of the Health Belief Scales toward COVID-19 Vaccine: A Cross-Sectional Study in North-Eastern Poland

by Karol Konaszewski, Jolanta Muszyńska, Sebastian Binyamin Skalski and Janusz Surzykiewicz

Int. J. Environ. Res. Public Health 2022, 19(9), 5424; https://doi.org/10.3390/ijerph19095424 - 29 Apr 2022

Cited by 3 | Viewed by 1570

Abstract

In the study, we evaluated the psychometric properties of the Health Belief Scales Toward COVID-19 Vaccine, including the structure, reliability and validity of the scale. Psychometric properties were assessed on a general sample of 472 Polish participants aged between 19 and 69 years [...] Read more.

In the study, we evaluated the psychometric properties of the Health Belief Scales Toward COVID-19 Vaccine, including the structure, reliability and validity of the scale. Psychometric properties were assessed on a general sample of 472 Polish participants aged between 19 and 69 years (M = 25.43). The procedure consisted of completing the Health Belief Scales Toward COVID-19 Vaccine, the World Health Organization’s 5-item Well-being Index (WHO-5) and demographic questions. The presented research results obtained using the measure indicate that it can be considered to be a reliable and valid research tool. A four-factor solution demonstrated a good fit to the data: χ2/df = 3.90, RMSEA = 0.079, AGFI = 0.913, GFI = 0.951, CFI = 0.960, TLI = 0.941. The reliability measures for the overall index of the Health Belief Scales Toward COVID-19 Vaccine were: Cronbach’s α = 0.88 and McDonald’s ω = 0.87. The Health Belief Scales Toward COVID-19 Vaccine total score correlated negatively and weakly with the WHO-5 score. The Health Belief Scales Toward COVID-19 Vaccine proved to be a valid and a reliable tool to assess attitudes towards vaccination in four dimensions consistent with the HBM. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 359 KiB

Open AccessArticle

Compliance with Standard Precaution and Its Relationship with Views on Infection Control and Prevention Policy among Chinese University Students during the COVID-19 Pandemic

by Winnie Lai Sheung Cheng, Enid Wai Yung Kwong, Regina Lai Tong Lee, Anson Chui Yan Tang and Lokki Lok Ki Wong

Int. J. Environ. Res. Public Health 2022, 19(9), 5327; https://doi.org/10.3390/ijerph19095327 - 27 Apr 2022

Cited by 4 | Viewed by 1791

Abstract

Background: COVID-19 has placed tremendous pressure on the global public health system and has changed daily life. Aim: To examine the relationships between the perceived threat, perceived stress, coping responses and infection control practices towards the COVID-19 pandemic among university students in China. [...] Read more.

Background: COVID-19 has placed tremendous pressure on the global public health system and has changed daily life. Aim: To examine the relationships between the perceived threat, perceived stress, coping responses and infection control practices towards the COVID-19 pandemic among university students in China. Methods: Using a cross-sectional survey, 4392 students were recruited from six universities in two regions of China. Methods: Data were collected via an online platform using self-reported questionnaires. Hierarchical multiple regression analyses were performed to predict the variables on COVID-19 infection control practices. Results: Pearson correlation coefficients showed a significant negative relationship between perceived stress and COVID-19 infection control practices. A significant positive relationship was observed between wishful thinking and empathetic responding, and infection control practices. Hierarchical multiple regression analyses revealed that gender, geographical location, perceived stress and emotion-focused and relationship-focused coping responses were predictors of COVID-19 infection control practices. Conclusions: The findings suggest that university students displayed moderate levels of stress, using wishful thinking and empathetic responses as coping strategies. Counselling services should therefore emphasise reassurance and empathy. Male university students tended to be less compliant with social distancing. Both counselling and public health measures should recognise the importance of gender differences. Nurses should integrate these findings into future health programme planning and interventions. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

13 pages, 276 KiB

Open AccessArticle

Influence of the COVID-19 Pandemic on Adherence to Orally Administered Antineoplastics

by Amparo Talens, Elsa López-Pintor, Marta Bejerano, Mercedes Guilabert, María Teresa Aznar, Ignacio Aznar-Lou and Blanca Lumbreras

J. Clin. Med. 2022, 11(9), 2436; https://doi.org/10.3390/jcm11092436 - 26 Apr 2022

Cited by 1 | Viewed by 1468

Abstract

Background: Several factors can influence adherence to orally administered antineoplastics, including fear or anxiety resulting from situations such as the COVID-19 pandemic. The aim of this study was to analyse the influence of these patients’ experiences on adherence to orally administered antineoplastics. Methods: [...] Read more.

Background: Several factors can influence adherence to orally administered antineoplastics, including fear or anxiety resulting from situations such as the COVID-19 pandemic. The aim of this study was to analyse the influence of these patients’ experiences on adherence to orally administered antineoplastics. Methods: Cross-sectional study in four hospitals including >18 year old cancer patients receiving orally administered antineoplastics during the first half of 2021. Data were collected from medical records and through telephone interviews. Adherence was assessed through the prescription refill records and pill counts. Patients’ fear resulting from the pandemic was assessed by means of a structured questionnaire using a 5-point Likert-type scale. Results: Our sample compr BARCELONAised 268 patients (54% men) with a mean age of 64 years (SD 12). More than 15% had experienced afraid and 5% had experienced a dangerous situation when attending hospital, 17% felt they had received less care, and 30% preferred telepharmacy. Adherence measured by pill count was 69.3% and 95.5% according to prescription refill records. Patients who had experienced fear or anxiety when attending hospital were less adherent (aOR 0.47, 95% CI 0.23–0.96, p = 0.039). Conclusion: The fear experienced by some patients has affected adherence to treatment. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

18 pages, 4769 KiB

Open AccessArticle

Maximization of the Minicircle DNA Vaccine Production Expressing SARS-CoV-2 RBD

by Cathy Ventura, Dalinda Eusébio, Ana M. Gonçalves, Jorge Barroca-Ferreira, Diana Costa, Zhengrong Cui, Luís A. Passarinha and Ângela Sousa

Biomedicines 2022, 10(5), 990; https://doi.org/10.3390/biomedicines10050990 - 25 Apr 2022

Cited by 2 | Viewed by 2885

Abstract

Nucleic acid vaccines have been proven to be a revolutionary technology to induce an efficient, safe and rapid response against pandemics, like the coronavirus disease (COVID-19). Minicircle DNA (mcDNA) is an innovative vector more stable than messenger RNA and more efficient in cell [...] Read more.

Nucleic acid vaccines have been proven to be a revolutionary technology to induce an efficient, safe and rapid response against pandemics, like the coronavirus disease (COVID-19). Minicircle DNA (mcDNA) is an innovative vector more stable than messenger RNA and more efficient in cell transfection and transgene expression than conventional plasmid DNA. This work describes the construction of a parental plasmid (PP) vector encoding the receptor-binding domain (RBD) of the S protein from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the use of the Design of Experiments (DoE) to optimize PP recombination into mcDNA vector in an orbital shaker. First, the results revealed that host cells should be grown at 42 °C and the Terrific Broth (TB) medium should be replaced by Luria Broth (LB) medium containing 0.01% L-arabinose for the induction step. The antibiotic concentration, the induction time, and the induction temperature were used as DoE inputs to maximize the % of recombined mcDNA. The quadratic model was statistically significant (p-value < 0.05) and presented a non-significant lack of fit (p-value > 0.05) with a suitable coefficient of determination. The optimal point was validated using 1 h of induction, at 30 °C, without the presence of antibiotics, obtaining 93.87% of recombined mcDNA. Based on these conditions, the production of mcDNA was then maximized in a mini-bioreactor platform. The most favorable condition obtained in the bioreactor was obtained by applying 60% pO₂ in the fermentation step during 5 h and 30% pO₂ in the induction step, with 0.01% L-arabinose throughout 5 h. The yield of mcDNA-RBD was increased to a concentration of 1.15 g/L, when compared to the orbital shaker studies (16.48 mg/L). These data revealed that the bioreactor application strongly incremented the host biomass yield and simultaneously improved the recombination levels of PP into mcDNA. Altogether, these results contributed to improving mcDNA-RBD biosynthesis to make the scale-up of mcDNA manufacture simpler, cost-effective, and attractive for the biotechnology industry. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 782 KiB

Open AccessArticle

Fatigue Is a Major Symptom at COVID-19 Hospitalization Follow-Up

by Søren Sperling, Andreas Fløe, Steffen Leth, Charlotte Hyldgaard, Tina Gissel, Ayfer Topcu, Lars Kristensen, Lene Dahl Sønderskov, Johannes Martin Schmid, Søren Jensen-Fangel and Elisabeth Bendstrup

J. Clin. Med. 2022, 11(9), 2411; https://doi.org/10.3390/jcm11092411 - 25 Apr 2022

Cited by 10 | Viewed by 2235

Abstract

Persistent symptoms after hospitalization with COVID-19 are common, but the frequency and severity of these symptoms are insufficiently understood. We aimed to describe symptoms and pulmonary function after hospitalization with COVID-19. Patients hospitalized with COVID-19 in Central Denmark Region were invited for follow-up [...] Read more.

Persistent symptoms after hospitalization with COVID-19 are common, but the frequency and severity of these symptoms are insufficiently understood. We aimed to describe symptoms and pulmonary function after hospitalization with COVID-19. Patients hospitalized with COVID-19 in Central Denmark Region were invited for follow-up 3 months after discharge. Clinical characteristics, patient reported outcomes (Fatigue Assessment Scale (FAS), anxiety and depression (HADS)), symptoms, pulmonary function test and 6-min walk test were collected. We included 218 patients (mean age 59.9 (95% CI: 58.2, 61.7), 59% males). Fatigue, dyspnea and impaired concentration were the most prevalent symptoms at follow-up. Using FAS, 47% reported mild-to-moderate fatigue and 18% severe fatigue. Mean HADS was 7.9 (95% CI: 6.9, 8.9). FAS was correlated to HADS (β = 0.52 (95% CI: 0.44, 0.59, p < 0.001)). Mean DLCO was 80.4% (95% CI: 77.8, 83.0) and 45% had DLCO ˂ 80%. Mean DLCO was significantly reduced in patients treated in the ICU (70.46% (95% CI 65.13, 75.79)). The highest FAS and HADS were seen in patients with the shortest period of hospitalization (2.1 days (95% CI: 1.4, 2.7)) with no need for oxygen. In conclusion, fatigue is a common symptom after hospitalization for COVID-19 and ICU treatment is associated to decreased diffusion capacity. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 1816 KiB

Open AccessArticle

Predictors of Submaximal Exercise Test Attainment in Adults Reporting Long COVID Symptoms

by Roman Romero-Ortuno, Glenn Jennings, Feng Xue, Eoin Duggan, John Gormley and Ann Monaghan

J. Clin. Med. 2022, 11(9), 2376; https://doi.org/10.3390/jcm11092376 - 23 Apr 2022

Cited by 10 | Viewed by 2957

Abstract

Adults with long COVID often report intolerance to exercise. Cardiopulmonary exercise testing (CPET) has been used in many settings to measure exercise ability but has been conducted in a few long COVID cohorts. We conducted CPET in a sample of adults reporting long [...] Read more.

Adults with long COVID often report intolerance to exercise. Cardiopulmonary exercise testing (CPET) has been used in many settings to measure exercise ability but has been conducted in a few long COVID cohorts. We conducted CPET in a sample of adults reporting long COVID symptoms using a submaximal cycle ergometer protocol. We studied pre-exercise predictors of achieving 85% of the age-predicted maximum heart rate (85%HRmax) using logistic regression. Eighty participants were included (mean age 46 years, range 25–78, 71% women). Forty participants (50%) did not reach 85%HRmax. On average, non-achievers reached 84% of their predicted 85%HRmax. No adverse events occurred. Participants who did not achieve 85%HRmax were older (p < 0.001), had more recent COVID-19 illness (p = 0.012) with higher frequency of hospitalization (p = 0.025), and had been more affected by dizziness (p = 0.041) and joint pain (p = 0.028). In the logistic regression model including age, body mass index, time since COVID-19, COVID-19-related hospitalization, dizziness, joint pain, pre-existing cardiopulmonary disease, and use of beta blockers, independent predictors of achieving 85%HRmax were younger age (p = 0.001) and longer time since COVID-19 (p = 0.008). Our cross-sectional findings suggest that exercise tolerance in adults with long COVID has potential to improve over time. Longitudinal research should assess the extent to which this may occur and its mechanisms. ClinicalTrials.gov identifier: NCT05027724 (TROPIC Study). Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 3654 KiB

Open AccessArticle

Fine-Tuning BERT Models to Classify Misinformation on Garlic and COVID-19 on Twitter

by Myeong Gyu Kim, Minjung Kim, Jae Hyun Kim and Kyungim Kim

Int. J. Environ. Res. Public Health 2022, 19(9), 5126; https://doi.org/10.3390/ijerph19095126 - 22 Apr 2022

Cited by 8 | Viewed by 2643

Abstract

Garlic-related misinformation is prevalent whenever a virus outbreak occurs. With the outbreak of COVID-19, garlic-related misinformation is spreading through social media, including Twitter. Bidirectional Encoder Representations from Transformers (BERT) can be used to classify misinformation from a vast number of tweets. This study [...] Read more.

Garlic-related misinformation is prevalent whenever a virus outbreak occurs. With the outbreak of COVID-19, garlic-related misinformation is spreading through social media, including Twitter. Bidirectional Encoder Representations from Transformers (BERT) can be used to classify misinformation from a vast number of tweets. This study aimed to apply the BERT model for classifying misinformation on garlic and COVID-19 on Twitter, using 5929 original tweets mentioning garlic and COVID-19 (4151 for fine-tuning, 1778 for test). Tweets were manually labeled as ‘misinformation’ and ‘other.’ We fine-tuned five BERT models (BERT_BASE, BERT_LARGE, BERTweet-base, BERTweet-COVID-19, and BERTweet-large) using a general COVID-19 rumor dataset or a garlic-specific dataset. Accuracy and F1 score were calculated to evaluate the performance of the models. The BERT models fine-tuned with the COVID-19 rumor dataset showed poor performance, with maximum accuracy of 0.647. BERT models fine-tuned with the garlic-specific dataset showed better performance. BERTweet models achieved accuracy of 0.897–0.911, while BERT_BASE and BERT_LARGE achieved accuracy of 0.887–0.897. BERTweet-large showed the best performance with maximum accuracy of 0.911 and an F1 score of 0.894. Thus, BERT models showed good performance in classifying misinformation. The results of our study will help detect misinformation related to garlic and COVID-19 on Twitter. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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19 pages, 1082 KiB

Open AccessArticle

Will Macau’s Restaurants Survive or Thrive after Entering the O2O Food Delivery Platform in the COVID-19 Pandemic?

by Fan Cheong and Rob Law

Int. J. Environ. Res. Public Health 2022, 19(9), 5100; https://doi.org/10.3390/ijerph19095100 - 22 Apr 2022

Cited by 11 | Viewed by 2914

Abstract

COVID-19 presents a formidable challenge to global tourism. One of the emergency measures adopted by the Macau restaurant industry has been to increase its revenue by joining an online-to-offline (O2O) platform. Nevertheless, are there any risks that follow these opportunities? This article aims [...] Read more.

COVID-19 presents a formidable challenge to global tourism. One of the emergency measures adopted by the Macau restaurant industry has been to increase its revenue by joining an online-to-offline (O2O) platform. Nevertheless, are there any risks that follow these opportunities? This article aims to explore whether any risks follow these opportunities, which could extend the literature. Study 1 explores the key factors that customers focus on by analyzing the content of customer reviews published on the Aomi platform through Python. Results show that brand credibility, freshness, and taste remained prominent in the customers’ dining experience. Packaging, delivery quality, and hygiene emerged as new factors due to the COVID-19 pandemic and the popularity of the O2O platform. Customers and staff continued to participate in service interactions through these online channels. Meanwhile, Study 2 contributes to the present understanding of O2O services in restaurants by interviewing catering professionals, and the results highlight how restaurateurs adopt their strategies on O2O platforms. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 315 KiB

Open AccessArticle

Do Contextual and Demographic Factors Help Malaysian Nurses Prepare in Dealing with the COVID-19 Pandemic?

by Bee Seok Chua, Getrude Cosmas, Norkiah Arsat and Walton Wider

Int. J. Environ. Res. Public Health 2022, 19(9), 5097; https://doi.org/10.3390/ijerph19095097 - 22 Apr 2022

Cited by 1 | Viewed by 1582

Abstract

As of 11 October 2020, Sabah comprised a quarter of all COVID19 cases reported in Malaysia since the start of the pandemic last January 2020. In this pandemic, nurses serve in vital roles to mitigate the effects of COVID-19. This study aims to [...] Read more.

As of 11 October 2020, Sabah comprised a quarter of all COVID19 cases reported in Malaysia since the start of the pandemic last January 2020. In this pandemic, nurses serve in vital roles to mitigate the effects of COVID-19. This study aims to explore the nurses’ preparedness in managing the COVID-19 outbreak situation in Sabah, Malaysia, examining the contextual (e.g., participated in an actual major disaster event) and demographic factors (e.g., age and working experience that may influence nurses’ preparedness for managing the COVID-19 pandemic). A total of 317 nurses in Sabah, Malaysia were involved in this study. The Emergency Preparedness Information Questionnaire (EPIQ) contained 41 items and was used to assess civilian nurses’ perceived familiarity with 9 competency dimensions of preparedness. The mean scores of nurses’ preparedness indicated a moderate level of nurses’ preparedness in managing the COVID-19 pandemic (mean ranging from 2.89 to 3.79). The results indicated that there was a significant difference between the nurses who actively participate in an actual major disaster event and who were not active in a total of preparedness and all dimensions (t = 2.79, df = 285, p = 0.006) (except in familiarity with decontamination and familiarity with special populations), across working experience (F(2,291) = 5.09, p = 0.007) (except familiarity with Incident Command System and role), and age among nurses ((F(3,290) = 2.68, p = 0.047)) (total of preparedness, familiarity with ethical issues in triage, epidemiology, and surveillance, and psychological issues). Overall, this study has made a significant theoretical contribution, as well as in clinical implications in the field of nursing practice, by addressing the impact of contextual and demographic factors on nurses’ preparedness in managing the COVID-19 outbreak situation. This study will help nurses to understand the skills, abilities, knowledge, and actions needed to respond, mitigate, and prepare for emergencies during pandemics and disasters. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

17 pages, 336 KiB

Open AccessArticle

Student and Nature Interactions and Their Impact on Mental Health during the COVID-19 Pandemic

by Jonah E. Trevino, Muntazar Monsur, Carol S. Lindquist and Catherine R. Simpson

Int. J. Environ. Res. Public Health 2022, 19(9), 5030; https://doi.org/10.3390/ijerph19095030 - 21 Apr 2022

Cited by 10 | Viewed by 3167

Abstract

Passive and active interactions with nature reduce stress, anxiety, and depression. Populations that experience increased stress often have fewer interactions with nature due to many factors. More recently, the COVID-19 pandemic has created a new stressor for all populations due to sickness, isolation, [...] Read more.

Passive and active interactions with nature reduce stress, anxiety, and depression. Populations that experience increased stress often have fewer interactions with nature due to many factors. More recently, the COVID-19 pandemic has created a new stressor for all populations due to sickness, isolation, financial burdens, or other factors. University students were particularly impacted due to the change to online modalities, which isolated them from other students. To assess if any negative or other consequences were experienced and if nature factors could mitigate them, we examined how plant interactions affected university students (N = 353) in an online learning environment. Two modified Depression Anxiety Stress Surveys (DASS; Depression Anxiety Stress and Academic Stress, DASA) were administered over two semesters in 2020 to survey students on these interactions with nature. During the two semesters, most students experienced extremely severe self-reported mental health adversities. Further correlations between DASA scores and responses about nature interactions, home environments, plant exposure, and plant access showed that outdoor interactions were positively related to better self-reported mental health scores. However, the concerning and lingering effects of the pandemic were evidenced in our research as DASA scores increased across the two semesters. Nevertheless, going outdoors and interacting with nature brings some benefits that lessen the severity of depression, anxiety, and stress. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

12 pages, 860 KiB

Open AccessArticle

Effectiveness of Tocilizumab in Patients with Severe or Critical Lung Involvement in COVID-19: A Retrospective Study

by Daniel Chober, Bogusz Aksak-Wąs, Katarzyna Bobrek-Lesiakowska, Anna Budny-Finster, Ewa Hołda, Joanna Mieżyńska-Kurtycz, Grzegorz Jamro and Miłosz Parczewski

J. Clin. Med. 2022, 11(9), 2286; https://doi.org/10.3390/jcm11092286 - 20 Apr 2022

Cited by 7 | Viewed by 2037

Abstract

Introduction: Acute lung injury is associated with dysfunctional immune response to SARS-CoV-2. This leads to CRS, which require immunomodulatory treatments aiming to limit the excessive production of cytokines. The literature so far indicates the effectiveness of tocilizumab in patients with COVID-19-associated pneumonia, but [...] Read more.

Introduction: Acute lung injury is associated with dysfunctional immune response to SARS-CoV-2. This leads to CRS, which require immunomodulatory treatments aiming to limit the excessive production of cytokines. The literature so far indicates the effectiveness of tocilizumab in patients with COVID-19-associated pneumonia, but there is no clear evidence of its effectiveness in patients with at least 50% lung involvement; therefore, we aimed to bridge this gap in knowledge. Materials and methods: Longitudinal data for 4287 patients with confirmed COVID-19 infection were collected between 1st March 2020 and 16th of January 2022. In total, 182 cases with lung involvement >50% and biochemical indicators of cytokine release storm (Il-6 >100 pg/mL) were selected and analyzed using non-parametric statistics and multivariate Cox models. Results: Among the 182 included patients, 100 (55%) were treated with TCZ, while 82 (45%) did not receive TCZ. The groups were balanced regarding demographics, lung involvement and biochemical markers. Overall mortality in the group was 63.1%. Mortality in the TCZ group was 58.0% compared to 69.5% (n = 57) in the non-TCZ group (p = 0.023). In multivariate Cox proportional hazards models, intravenous administration of tocilizumab was associated with lower probability of ICU admission (HR: 0333 (CI: 0.159–0.700, p = 0.004)) and lower mortality (HR: 0.57306 (CI: 0.354–0.927, p = 0.023)). Conclusions: Tocilizumab is effective as a treatment in the most severely ill patients, in whom the level of lung involvement by the inflammatory process can exceed 50% with coexisting biochemical indices of cytokine storm (Il-6 > 100 pg/mL). Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 245 KiB

Open AccessArticle

Comparison of Clinical Features and Outcomes between SARS-CoV-2 and Non-SARS-CoV-2 Respiratory Viruses Associated Acute Respiratory Distress Syndrome: Retrospective Analysis

by Manbong Heo, Jong Hwan Jeong, Sunmi Ju, Seung Jun Lee, Yi Yeong Jeong, Jong Deog Lee and Jung-Wan Yoo

J. Clin. Med. 2022, 11(8), 2246; https://doi.org/10.3390/jcm11082246 - 17 Apr 2022

Cited by 6 | Viewed by 1881

Abstract

Although a few studies comparing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and non-SARS-CoV-2 respiratory viruses have been reported, clinical features and outcomes comparing SARS-CoV-2 and non-SARS-CoV-2 respiratory viruses associated acute respiratory distress syndrome (ARDS) are still lacking. We retrospectively identified patients with [...] Read more.

Although a few studies comparing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and non-SARS-CoV-2 respiratory viruses have been reported, clinical features and outcomes comparing SARS-CoV-2 and non-SARS-CoV-2 respiratory viruses associated acute respiratory distress syndrome (ARDS) are still lacking. We retrospectively identified patients with SARS-CoV-2 (November 2020 to January 2022) and non-SARS-CoV-2 respiratory viruses associated ARDS (February 2015 to November 2020) at a single tertiary hospital. Their clinical data were obtained by medical record review. All viral infections were confirmed by RT-PCR. Thirty-one SARS-CoV-2 and seventy-one patients with non-SARS-CoV-2 respiratory viruses associated ARDS patients were identified. Influenza (62%) was the most common in non-SARS-CoV-2 respiratory viruses associated ARDS patients. Patients with SARS-CoV-2 were more likely to be female and had higher body mass index, lower clinical frailty, APACHE II, and SOFA score than those with non-SARS-CoV-2 respiratory viruses. All patients with SARS-CoV-2 were treated with corticosteroids and used more high-flow nasal oxygen than those with non-SARS-CoV-2 respiratory viruses. The concomitant respiratory bacterial infection was significantly higher in non-SARS-CoV-2 respiratory viruses than SARS-CoV-2. Although there were no significant differences in the 28-, 60-day, and in-hospital mortality rates between SARS-CoV-2 and non-SARS-CoV-2 respiratory viruses associated ARDS, the duration of mechanical ventilation and length of hospital stay were significantly longer in patients with SARS-CoV-2 than those with non-SARS-CoV-2 respiratory viruses. Although the severity of illness and the concomitant bacterial infection rate were lower in patients with SARS-CoV-2 associated ARDS, mortality rates did not differ from non-SARS-CoV-2 respiratory viruses associated ARDS. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

15 pages, 1759 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on Maternal Well-Being during Pregnancy

by Rosalia Pascal, Francesca Crovetto, Irene Casas, Lina Youssef, Cristina Trilla, Marta Larroya, Alex Cahuana, David Boada, Maria Foraster, Elisa Llurba, Jordi Sunyer, Fàtima Crispi, Eduard Gratacos and María Dolores Gómez-Roig

J. Clin. Med. 2022, 11(8), 2212; https://doi.org/10.3390/jcm11082212 - 15 Apr 2022

Cited by 3 | Viewed by 1923

Abstract

The outbreak of a pandemic has negative psychological effects. We aimed to determine the impact of the SARS-CoV-2 pandemic during pregnancy and identify the risk factors for maternal well-being. A multicenter, prospective, population-based study was carried out that included women (n = [...] Read more.

The outbreak of a pandemic has negative psychological effects. We aimed to determine the impact of the SARS-CoV-2 pandemic during pregnancy and identify the risk factors for maternal well-being. A multicenter, prospective, population-based study was carried out that included women (n = 1320) who were pregnant during the SARS-CoV-2 pandemic in Barcelona (Spain) compared against a pre-pandemic cohort (n = 345). Maternal well-being was assessed using the validated World Health Organization Well-Being Index Questionnaire (WHO-5 Index). Pregnant women attended during the COVID-19 pandemic showed worst WHO-5 well-being scores (median (IQR) of 56 (36–72) for the pandemic cohort vs. 64 (52–76) for the pre-pandemic cohort p < 0.001), with 42.8% of women presenting a poor well-being score vs. 28% for the pre-pandemic cohort (p < 0.001). Presence of a previous psychiatric disorder (OR 7.1; 95% CI 2.6–19, p < 0.001), being in the third trimester of pregnancy (OR 1.7; 95% CI 1.5–2, p < 0.001), or requiring hospital admission for COVID-19 (OR 4.7; 95% CI 1.4–16.7, p = 0.014), significantly contributed to low maternal well-being during the COVID-19 pandemic (multivariate analysis). Being infected by SARS-CoV-2 was not associated with a lower well-being score. We conclude that, during the COVID-19 pandemic, there were higher rates of poor maternal well-being; the infection of SARS-CoV-2 itself did not worsen maternal well-being, but other factors as psychiatric disorders, being in the third trimester of pregnancy or hospital admission for COVID-19 disease did. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 470 KiB

Open AccessReview

Mini Review: Co-Existing Diseases and COVID-19—A One Way Ticket?

by Mantė Eidininkienė, Jelena Cesarskaja, Simona Talačkaitė, Vilma Traškaitė-Juškevičienė and Andrius Macas

Int. J. Environ. Res. Public Health 2022, 19(8), 4738; https://doi.org/10.3390/ijerph19084738 - 14 Apr 2022

Cited by 3 | Viewed by 1786

Abstract

Background and aims. Many patients with SARS-CoV-2 virus infection have various comorbidities. Their presence in the background of coronavirus has a tendency to worsen the course of the disease and increase the risk of unfavorable outcomes. Understanding the interactions between SARS-CoV-2 and [...] Read more.

Background and aims. Many patients with SARS-CoV-2 virus infection have various comorbidities. Their presence in the background of coronavirus has a tendency to worsen the course of the disease and increase the risk of unfavorable outcomes. Understanding the interactions between SARS-CoV-2 and the most common comorbidities is key to the successful management of these patients. Methods. We systematically searched Medline, Springer and Elsevier databases and accessed the full text on SARS-CoV-2 virus infection and the following conditions: cardiovascular, renal, immunosuppression, metabolic disorder and hematological in order to prepare a narrative review on this topic. Results. Patients with underlying cardiovascular diseases are more likely to suffer from severe forms of COVID-19. Cardiovascular diseases were also noted as the most frequent comorbidities among coronavirus patients. Metabolic syndrome and its components have been identified as the second most common comorbidity among fatal cases of COVID-19. Infected patients with acute kidney injury also show a higher mortality rate among the others. Immunocompromised patients, such as organ recipients and cancer and hematologic patients, develop more severe forms of COVID-19 and are at higher risk of admission to ICUs and requiring mechanical ventilation. Higher mortality rates among those patients have also been observed. Conclusions. Based on recent studies, patients with co-existing diseases are at higher risk for severe courses of COVID-19 virus infection and unfavorable outcomes. Cardiovascular diseases, metabolic syndrome and immunosuppressive and kidney diseases in the presence of coronavirus may lead to longer and more aggressive treatment in the ICU and increased mortality rate. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 2085 KiB

Open AccessArticle

Differences in Puberty of Girls before and during the COVID-19 Pandemic

by Clariano Pires de Oliveira Neto, Rossana Santiago de Sousa Azulay, Ana Gregória Ferreira Pereira de Almeida, Maria da Glória Rodrigues Tavares, Luciana Helena Gama Vaz, Ianik Rafaela Lima Leal, Monica Elinor Alves Gama, Marizélia Rodrigues Costa Ribeiro, Gilvan Cortês Nascimento, Marcelo Magalhães, Wellyandra Costa dos Santos, Alexandre Nogueira Facundo, Manuel dos Santos Faria and Débora Cristina Ferreira Lago

Int. J. Environ. Res. Public Health 2022, 19(8), 4733; https://doi.org/10.3390/ijerph19084733 - 14 Apr 2022

Cited by 18 | Viewed by 3319

Abstract

In the COVID-19 pandemic, there was an increase in consultations for precocious puberty. We aim to analyze differences in female puberty before and during the COVID-19 pandemic. A cross-sectional analytical study was designed at the Pediatric Endocrinology Clinic of the University Hospital of [...] Read more.

In the COVID-19 pandemic, there was an increase in consultations for precocious puberty. We aim to analyze differences in female puberty before and during the COVID-19 pandemic. A cross-sectional analytical study was designed at the Pediatric Endocrinology Clinic of the University Hospital of the Federal University of Maranhão in São Luis, Brazil. We included 55 girls with precocious puberty, 22 who started puberty during the pandemic and 33 who started puberty before the pandemic. Clinical, anthropometric, laboratory and imaging variables were compared between groups. Statistics were performed to determine if there was a statistical difference between the groups. Girls with puberty during the pandemic had higher Z-scores for weight (1.08 ± 1.29 versus 0.69 ± 0.83; p = 0.04), lower ovarian volume (1.88 ± 0.95 versus 3.15 ± 2.31; p = 0.01), and smaller differences between thelarche noticed by the parents and the diagnosis (6.63 ± 5.21 versus 12.15 ± 9.96; p = 0.02). The association between precocious puberty during the pandemic with higher Z-scores for weight, lower ovarian volume, and a reduction in the time between the perception of pubertal findings by parents and the diagnosis suggests the influence of the pandemic on the normal time of puberty. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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7 pages, 739 KiB

Open AccessBrief Report

Placental Ultrasonographical Findings during SARS-CoV-2 Infection

by Sotirios Sotiriou, Athina A. Samara, Iokasti-Apostolia Tsiamalou, Christos Donoudis, Eleni Seviloglou, Chara Skentou, Antonios Garas and Alexandros Daponte

Diagnostics 2022, 12(4), 974; https://doi.org/10.3390/diagnostics12040974 - 13 Apr 2022

Cited by 2 | Viewed by 1696

Abstract

Infection with SARS-CoV-2 virus (COVID-19) during pregnancy has been associated with several complications. Increasing evidence suggests that COVID-19 infection leaves tell-tale signs of placental injury. During ultrasound examination and placental evaluation of COVID-19 infected pregnancies, we recorded signs of placental involvement, with findings [...] Read more.

Infection with SARS-CoV-2 virus (COVID-19) during pregnancy has been associated with several complications. Increasing evidence suggests that COVID-19 infection leaves tell-tale signs of placental injury. During ultrasound examination and placental evaluation of COVID-19 infected pregnancies, we recorded signs of placental involvement, with findings indicating malperfusion, chorangiosis, deciduitis, and subchorionitis. Early detection of placental damage through the use of specific ultrasound findings could indicate which pregnancies are at increased risk for complications. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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15 pages, 2650 KiB

Open AccessArticle

Strong Cellular Immune Response, but Not Humoral, against SARS-CoV-2 in Oncohematological Patients with Autologous Stem Cell Transplantation after Natural Infection

by Lorena Vigón, Adrián Sánchez-Tornero, Sara Rodríguez-Mora, Javier García-Pérez, Magdalena Corona de Lapuerta, Lucía Pérez-Lamas, Guiomar Casado-Fernández, Gemma Moreno, Montserrat Torres, Elena Mateos, María Aránzazu Murciano-Antón, José Alcamí, Mayte Pérez-Olmeda, Javier López-Jiménez, Valentín García-Gutiérrez, Mayte Coiras and on behalf of Multidisciplinary Group of Study of COVID-19 (MGS-COVID)

J. Clin. Med. 2022, 11(8), 2137; https://doi.org/10.3390/jcm11082137 - 11 Apr 2022

Cited by 2 | Viewed by 1842

Abstract

Oncohematological patients show a low immune response against SARS-CoV-2, both to natural infection and after vaccination. Most studies are focused on the analysis of the humoral response; therefore, the information available about the cellular immune response is limited. In this study, we analyzed [...] Read more.

Oncohematological patients show a low immune response against SARS-CoV-2, both to natural infection and after vaccination. Most studies are focused on the analysis of the humoral response; therefore, the information available about the cellular immune response is limited. In this study, we analyzed the humoral and cellular immune responses in nine individuals who received chemotherapy for their oncohematological diseases, as well as consolidation with autologous stem cell transplantation (ASCT), after being naturally infected with SARS-CoV-2. All individuals had asymptomatic or mild COVID-19 and were not vaccinated against SARS-CoV-2. These results were compared with matched healthy individuals who also had mild COVID-19. The humoral response against SARS-CoV-2 was not detected in 6 of 9 oncohematological individuals prior to ASCT. The levels of antibodies and their neutralization capacity decreased after ASCT. Conversely, an enhanced cytotoxic activity against SARS-CoV-2-infected cells was observed after chemotherapy plus ASCT, mostly based on high levels of NK, NKT, and CD8+TCRγδ+ cell populations that were able to produce IFNγ and TNFα. These results highlight the importance of performing analyses not only to evaluate the levels of IgGs against SARS-CoV-2, but also to determine the quality of the cellular immune response developed during the immune reconstitution after ASCT. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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20 pages, 2399 KiB

Open AccessArticle

QUCoughScope: An Intelligent Application to Detect COVID-19 Patients Using Cough and Breath Sounds

by Tawsifur Rahman, Nabil Ibtehaz, Amith Khandakar, Md Sakib Abrar Hossain, Yosra Magdi Salih Mekki, Maymouna Ezeddin, Enamul Haque Bhuiyan, Mohamed Arselene Ayari, Anas Tahir, Yazan Qiblawey, Sakib Mahmud, Susu M. Zughaier, Tariq Abbas, Somaya Al-Maadeed and Muhammad E. H. Chowdhury

Diagnostics 2022, 12(4), 920; https://doi.org/10.3390/diagnostics12040920 - 07 Apr 2022

Cited by 17 | Viewed by 4263

Abstract

Problem—Since the outbreak of the COVID-19 pandemic, mass testing has become essential to reduce the spread of the virus. Several recent studies suggest that a significant number of COVID-19 patients display no physical symptoms whatsoever. Therefore, it is unlikely that these patients will [...] Read more.

Problem—Since the outbreak of the COVID-19 pandemic, mass testing has become essential to reduce the spread of the virus. Several recent studies suggest that a significant number of COVID-19 patients display no physical symptoms whatsoever. Therefore, it is unlikely that these patients will undergo COVID-19 testing, which increases their chances of unintentionally spreading the virus. Currently, the primary diagnostic tool to detect COVID-19 is a reverse-transcription polymerase chain reaction (RT-PCR) test from the respiratory specimens of the suspected patient, which is invasive and a resource-dependent technique. It is evident from recent researches that asymptomatic COVID-19 patients cough and breathe in a different way than healthy people. Aim—This paper aims to use a novel machine learning approach to detect COVID-19 (symptomatic and asymptomatic) patients from the convenience of their homes so that they do not overburden the healthcare system and also do not spread the virus unknowingly by continuously monitoring themselves. Method—A Cambridge University research group shared such a dataset of cough and breath sound samples from 582 healthy and 141 COVID-19 patients. Among the COVID-19 patients, 87 were asymptomatic while 54 were symptomatic (had a dry or wet cough). In addition to the available dataset, the proposed work deployed a real-time deep learning-based backend server with a web application to crowdsource cough and breath datasets and also screen for COVID-19 infection from the comfort of the user’s home. The collected dataset includes data from 245 healthy individuals and 78 asymptomatic and 18 symptomatic COVID-19 patients. Users can simply use the application from any web browser without installation and enter their symptoms, record audio clips of their cough and breath sounds, and upload the data anonymously. Two different pipelines for screening were developed based on the symptoms reported by the users: asymptomatic and symptomatic. An innovative and novel stacking CNN model was developed using three base learners from of eight state-of-the-art deep learning CNN algorithms. The stacking CNN model is based on a logistic regression classifier meta-learner that uses the spectrograms generated from the breath and cough sounds of symptomatic and asymptomatic patients as input using the combined (Cambridge and collected) dataset. Results—The stacking model outperformed the other eight CNN networks with the best classification performance for binary classification using cough sound spectrogram images. The accuracy, sensitivity, and specificity for symptomatic and asymptomatic patients were 96.5%, 96.42%, and 95.47% and 98.85%, 97.01%, and 99.6%, respectively. For breath sound spectrogram images, the metrics for binary classification of symptomatic and asymptomatic patients were 91.03%, 88.9%, and 91.5% and 80.01%, 72.04%, and 82.67%, respectively. Conclusion—The web-application QUCoughScope records coughing and breathing sounds, converts them to a spectrogram, and applies the best-performing machine learning model to classify the COVID-19 patients and healthy subjects. The result is then reported back to the test user in the application interface. Therefore, this novel system can be used by patients in their premises as a pre-screening method to aid COVID-19 diagnosis by prioritizing the patients for RT-PCR testing and thereby reducing the risk of spreading of the disease. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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13 pages, 341 KiB

Open AccessArticle

Perceived Stress and Coping Behavior of Nurses Caring for Critical Patients with COVID-19 Outbreak in Taiwan: A Mixed-Methods Study

by Shu-Yen Lee, Kai-Jo Chiang, Yi-Jiun Tsai, Chi-Kang Lin, Yun-Ju Wang, Chou-Ping Chiou and Hsueh-Hsing Pan

Int. J. Environ. Res. Public Health 2022, 19(7), 4258; https://doi.org/10.3390/ijerph19074258 - 02 Apr 2022

Cited by 10 | Viewed by 2352

Abstract

Severe pneumonia with novel pathogens, also called COVID-19, caused a pandemic in Taiwan as well as in the rest of the world in May 2021. Nurses are under great stress when caring for critically ill patients with COVID-19. This study aimed to explore [...] Read more.

Severe pneumonia with novel pathogens, also called COVID-19, caused a pandemic in Taiwan as well as in the rest of the world in May 2021. Nurses are under great stress when caring for critically ill patients with COVID-19. This study aimed to explore the perceived stress and coping behaviors of nurses caring for critically ill patients with COVID-19 using a mixed-methods approach. We recruited 85 nurses from a special intensive care unit (ICU) of a medical center in Taiwan between May and June 2021. To gather data, we used a questionnaire on basic characteristics, the perceived stress scale (PSS-14), and the brief coping orientation to problems experienced inventory (B-COPE), then conducted a qualitative interview. The results showed that the average perceived stress level among nurses was 25.4 points, and most of them perceived moderate stress. The top three coping behaviors practiced by the nurses were active coping, planning, and acceptance. Nurses who received less perceived support from their friends or families and who had shorter working experience in nursing had significantly higher stress levels. The qualitative results revealed that the nurses’ perceived stress came from fear, worry, and the increased burden caused by caring for critical patients with COVID-19. Coping behaviors included rest, seeking support, and affirmative fighting. Based on these findings, it is suggested that the support nurses receive from their families is an important predictor of perceived stress. Therefore, it is suggested that nurses be provided with more support in dealing with stress caused by caring for critical patients with COVID-19 in special ICUs. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

16 pages, 2727 KiB

Open AccessArticle

Soluble Angiotensin-Converting Enzyme 2 as a Prognostic Biomarker for Disease Progression in Patients Infected with SARS-CoV-2

by Noelia Díaz-Troyano, Pablo Gabriel-Medina, Stephen Weber, Martin Klammer, Raquel Barquín-DelPino, Laura Castillo-Ribelles, Angels Esteban, Manuel Hernández-González, Roser Ferrer-Costa, Tomas Pumarola and Francisco Rodríguez-Frías

Diagnostics 2022, 12(4), 886; https://doi.org/10.3390/diagnostics12040886 - 01 Apr 2022

Cited by 9 | Viewed by 2012

Abstract

Predicting disease severity in patients infected with SARS-CoV-2 is difficult. Soluble angiotensin-converting enzyme 2 (sACE2) arises from the shedding of membrane ACE2 (mACE2), which is a receptor for SARS-CoV-2 spike protein. We evaluated the predictive value of sACE2 compared with known biomarkers of [...] Read more.

Predicting disease severity in patients infected with SARS-CoV-2 is difficult. Soluble angiotensin-converting enzyme 2 (sACE2) arises from the shedding of membrane ACE2 (mACE2), which is a receptor for SARS-CoV-2 spike protein. We evaluated the predictive value of sACE2 compared with known biomarkers of inflammation and tissue damage (CRP, GDF-15, IL-6, and sFlt-1) in 850 patients with and without SARS-CoV-2 with different clinical outcomes. For univariate analyses, median differences between biomarker levels were calculated for the following patient groups (classified by clinical outcome): RT-PCR-confirmed SARS-CoV-2 positive (Groups 1–4); RT-PCR-confirmed SARS-CoV-2 negative following previous SARS-CoV-2 infection (Groups 5 and 6); and ‘SARS-CoV-2 unexposed’ patients (Group 7). Median levels of CRP, GDF-15, IL-6, and sFlt-1 were significantly higher in hospitalized patients with SARS-CoV-2 compared with discharged patients (all p < 0.001), whereas levels of sACE2 were significantly lower (p < 0.001). ROC curve analysis of sACE2 provided cut-offs for predicting hospital admission (≤0.05 ng/mL (positive predictive value: 89.1%) and ≥0.42 ng/mL (negative predictive value: 84.0%)). These findings support further investigation of sACE2, as a single biomarker or as part of a panel, to predict hospitalization risk and disease severity in patients with SARS-CoV-2 infection. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 337 KiB

Open AccessArticle

Exploring Factors Contributing to the Smoking Behaviour among Hong Kong Chinese Young Smokers during COVID-19 Pandemic: A Qualitative Study

by Katherine-Ka-Wai Lam, Ka-Yan Ho, Cynthia-Sau-Ting Wu, Man-Nok Tong, Lai-Ngo Tang and Yim-Wah Mak

Int. J. Environ. Res. Public Health 2022, 19(7), 4145; https://doi.org/10.3390/ijerph19074145 - 31 Mar 2022

Cited by 5 | Viewed by 2171

Abstract

COVID-19 has significant impacts on young smokers in their smoking behaviors. This qualitative study summarises the lived experience of young smokers during COVID-19. Moreover, through their lived experience, we aim to understand how the COVID-19 pandemic influence tobacco use behaviours in this population. [...] Read more.

COVID-19 has significant impacts on young smokers in their smoking behaviors. This qualitative study summarises the lived experience of young smokers during COVID-19. Moreover, through their lived experience, we aim to understand how the COVID-19 pandemic influence tobacco use behaviours in this population. A purposive sampling of 48 smokers aged between 17–25 years old is individually interviewed for 30 to 45 min. All interviews are transcribed in verbatim and analysed by two researchers separately using Colaizzi’s method of descriptive phenomenology. The results reveal the following six important themes, which could explain the mixed pattern of smoking behaviour changes in young smokers: (1) perceptions of COVID-19 and its association with smoking, (2) more time at home, (3) taking masks off to smoke, (4) the effects of COVID-19 on smokers’ financial status and academic performance, (5) reduced social gatherings, and (6) restricted access to tobacco products. To conclude, this pandemic and the anti-pandemic measures, i.e., mask mandates, stay-at-home and work-from-home orders, and class suspension, result in both new obstacles and new advantages for smoking cessation among young people. More studies should be performed to monitor any transition of tobacco products and the trajectory of use in this population during this pandemic, thus informing public health policy making. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

15 pages, 611 KiB

Open AccessArticle

Healthcare Workers’ Acceptance of COVID-19 Vaccination in Russia

by Nikolay I. Briko, Vladimir A. Korshunov, Alla Ya Mindlina, Roman V. Polibin, Maksim O. Antipov, Alexey I. Brazhnikov, Yurii E. Vyazovichenko, Ekaterina V. Glushkova, Kirill S. Lomonosov, Alena V. Lomonosova, Platon D. Lopukhov, Artem A. Pozdnyakov, Tatiana S. Saltykova, Nikolay V. Torchinsky, Natalia N. Tsapkova, Olga P. Chernyavskaya and Arseny V. Shamis

Int. J. Environ. Res. Public Health 2022, 19(7), 4136; https://doi.org/10.3390/ijerph19074136 - 31 Mar 2022

Cited by 11 | Viewed by 1773

Abstract

During the COVID-19 pandemic, the problem of the population’s adherence to vaccination has become significantly aggravated around the world. This study is aimed at evaluating healthcare workers’ (HCWs) acceptance of COVID-19 vaccination in Russia. A cross-sectional multicenter study was carried out by interviewing [...] Read more.

During the COVID-19 pandemic, the problem of the population’s adherence to vaccination has become significantly aggravated around the world. This study is aimed at evaluating healthcare workers’ (HCWs) acceptance of COVID-19 vaccination in Russia. A cross-sectional multicenter study was carried out by interviewing HCWs in Russia using an electronic questionnaire and snowball sampling. The analysis included 85,216 questionnaires from 81 out of 85 regions of Russia. Statistical analysis was performed using SPSS v.22. The results indicated that 35.0% (CI 95%, 34.7–35.3) of HCWs were ready to get COVID-19 vaccination. The acceptance level was 42.4% (41.8–42.9) for all physicians and 31.3% (30.9–31.6) for nursing staff. A total of 29.4% (29.1–29.7) of HCWs were willing to recommend COVID-19 vaccination to patients: 38.5% (38.0–39.1) of physicians, and 24.7% (24.4–25.1) of nursing staff. Acceptance of COVID-19 vaccination is higher among HCWs dealing with infectious diseases and involved in vaccination. The low acceptance of HCWs toward vaccination against COVID-19 can be explained by the low level of awareness of HCWs in these issues. Additional educational programs are needed for HCWs, both for physicians and nurses, using all possible forms and methods of education. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 733 KiB

Open AccessArticle

The Relationship between Exercise and Mental Health Outcomes during the COVID-19 Pandemic: From the Perspective of Hope

by Yingying Yao, Jianqiao Chen, Dan Dong, Yi Feng and Zhihong Qiao

Int. J. Environ. Res. Public Health 2022, 19(7), 4090; https://doi.org/10.3390/ijerph19074090 - 30 Mar 2022

Cited by 6 | Viewed by 4650

Abstract

The unexpected outbreak of COVID-19 triggered fear and anxiety in the general population. Exercise was one of the most widely promoted methods to improve body function when socially restricted. This study aims to examine the role of exercise in relieving stressful mental health [...] Read more.

The unexpected outbreak of COVID-19 triggered fear and anxiety in the general population. Exercise was one of the most widely promoted methods to improve body function when socially restricted. This study aims to examine the role of exercise in relieving stressful mental health outcomes (anxiety and depressive symptoms) during the COVID-19 pandemic and explore the underlying mechanism from the perspective of hope, using a combination of goal-directed planning (pathways) and motivation (agency). A cross-sectional online survey recruiting 2390 Chinese participants was conducted during the COVID-19 pandemic in China. A series of questions and scales, including the self-designed exercise questionnaire, the Adult Dispositional Hope Scale, the Generalized Anxiety Disorder Scale-7 and the Patient Health Questionnaire-9, were used to measure exercise, hope, anxiety symptoms and depressive symptoms, respectively. A structural equation model was constructed to test the hypothesis that exercise benefits mental health outcomes through the mediating role of hope. Our results showed that exercise relieved stressful mental health outcomes via three paths: one direct path (β = −0.077, 95% CI = (−0.138, −0.017), p < 0.01), one indirect path through hope of pathways thinking (β = −0.046, 95% CI = (−0.064, −0.027), p < 0.001) and another indirect path through hope of agency thinking (β = −0.060, 95% CI = (−0.081, −0.039), p < 0.001). Our results showed that exercise could alleviate stressful mental health outcomes by promoting both hope of pathway thinking and agency thinking. It provided practical insights into psychological prevention and intervention by means of exercise during the COVID-19 pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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17 pages, 1026 KiB

Open AccessArticle

COVID-19 Health Crisis Workloads and Screening for Psychological Impact in Nursing Home Staff: A Qualitative and Quantitative Survey

by Nesrine Tebbeb, Fanny Villemagne, Thomas Prieur, Solène Dorier, Emmanuel Fort, Thomas Célarier, Luc Fontana, Nathalie Barth and Carole Pélissier

Int. J. Environ. Res. Public Health 2022, 19(7), 4061; https://doi.org/10.3390/ijerph19074061 - 29 Mar 2022

Cited by 6 | Viewed by 2345

Abstract

Background: Nursing homes were particularly affected by the COVID-19 pandemic. The purpose of this study was to evaluate qualitatively and quantitatively with the use of a self-reported questionnaire as a tool for screening for mental disorders in nursing home staff. Methods: A multicenter [...] Read more.

Background: Nursing homes were particularly affected by the COVID-19 pandemic. The purpose of this study was to evaluate qualitatively and quantitatively with the use of a self-reported questionnaire as a tool for screening for mental disorders in nursing home staff. Methods: A multicenter epidemiological study was conducted in 12 nursing homes in France with 1117 nursing home staff eligible. Socio-demographic, occupational, and medical data were collected by anonymous self-reported questionnaire using validated scales to assess anxiety/depressive symptoms (HAD scale) and post-traumatic stress disorder (PCL-5). A total of 12 semi-structured interviews were conducted to assess acceptance and expectations for the use of the questionnaire. Results: The participation rate was 34.5%. Data from 373 questionnaires were included in the analysis. The questionnaire was well accepted by the participants and met their wishes for prevention action. The sample was 82% female. More than half reported a feeling of powerlessness and lack of time or staffing. The prevalence of anxiety symptoms was 22%, depressive symptoms 10%, and post-traumatic stress 7%. Conclusions: This study underlines the interest in screening for mental disorders by self-reported questionnaire and deploying preventive actions in the workplace to reduce stress and facilitate the reconciliation of family and working life in this context of the pandemic. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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20 pages, 4062 KiB

Open AccessArticle

Evolution of Responses to COVID-19 and Epidemiological Characteristics in South Korea

by Junhwi Jeon, Changyong Han, Tobhin Kim and Sunmi Lee

Int. J. Environ. Res. Public Health 2022, 19(7), 4056; https://doi.org/10.3390/ijerph19074056 - 29 Mar 2022

Cited by 11 | Viewed by 2288

Abstract

The characteristics of COVID-19 have evolved at an accelerated rate over the last two years since the first SARS-CoV-2 case was discovered in December 2019. This evolution is due to the complex interplay among virus, humans, vaccines, and environments, which makes the elucidation [...] Read more.

The characteristics of COVID-19 have evolved at an accelerated rate over the last two years since the first SARS-CoV-2 case was discovered in December 2019. This evolution is due to the complex interplay among virus, humans, vaccines, and environments, which makes the elucidation of the clinical and epidemiological characteristics of COVID-19 essential to assess ongoing policy responses. In this study, we carry out an extensive retrospective analysis on infection clusters of COVID-19 in South Korea from January 2020 to September 2021 and uncover important clinical and social factors associated with age and regional patterns through the sophisticated large-scale epidemiological investigation using the data provided by the Korea Disease Control and Prevention Agency (KDCA). Epidemiological data of COVID-19 include daily confirmed cases, gender, age, city of residence, date of symptom onset, date of diagnosis, and route of infection. We divide the time span into six major periods based on the characteristics of COVID-19 according to various events such as the rise of new variants, vaccine rollout, change of social distancing levels, and other intervention measures. We explore key features of COVID-19 such as the relationship among unlinked, asymptomatic, and confirmed cases, serial intervals, infector–infectee interactions, and age/region-specific variations. Our results highlight the significant impact of temporal evolution of interventions implemented in South Korea on the characteristics of COVID-19 transmission, in particular, that of a high level of vaccination coverage in the senior-aged group on the dramatic reduction of confirmed cases. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 1104 KiB

Open AccessArticle

Evaluation of BNT162b2 Vaccine Effectiveness in Galicia, Northwest Spain

by Jacobo Pardo-Seco, Narmeen Mallah, Luis Ricardo López-Pérez, Juan Manuel González-Pérez, Benigno Rosón, María Teresa Otero-Barrós, Carmen Durán-Parrondo, Carmen Rodríguez-Tenreiro, Irene Rivero-Calle, Alberto Gómez-Carballa, Antonio Salas and Federico Martinón-Torres

Int. J. Environ. Res. Public Health 2022, 19(7), 4039; https://doi.org/10.3390/ijerph19074039 - 29 Mar 2022

Cited by 3 | Viewed by 2559

Abstract

Investigating vaccine effectiveness (VE) in real-world conditions is crucial, especially its variation across different settings and populations. We undertook a test-negative control study in Galicia (Northwest Spain) to assess BNT162b2 effectiveness against acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as well as COVID-19 [...] Read more.

Investigating vaccine effectiveness (VE) in real-world conditions is crucial, especially its variation across different settings and populations. We undertook a test-negative control study in Galicia (Northwest Spain) to assess BNT162b2 effectiveness against acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as well as COVID-19 associated hospitalization, intensive care unit (ICU) admission and mortality. A total of 44,401 positive and 817,025 negative SARS-CoV-2 test results belonging to adults were included. Adjusted odds ratios of vaccination and their 95% confidence interval (CI) were estimated using multivariate logistic-regression models. BNT162b2 showed high effectiveness in reducing SARS-CoV-2 infections in all age categories, reaching maximum VE ≥ 14 days after administering the second dose [18–64 years: VE = 92.9% (95%CI: 90.2–95.1); 65–79 years: VE = 85.8% (95%CI: 77.3–91.9), and ≥80 years: VE = 91.4% (95%CI: 87.9–94.1)]. BNT162b2 also demonstrated effectiveness in preventing COVID-19 hospitalization for all age categories, with VE more pronounced for those aged ≥80 years [VE = 60.0% (95%CI: 49.4–68.3)]. Moreover, there was a considerable reduction in ICU admission [VE = 88.0% (95%CI: 74.6–95.8)] and mortality [VE = 38.0% (95%CI: 15.9–55.4)] in the overall population. BNT162b2 showed substantial protection against SARS-CoV-2 infections and COVID-19 severity. Our findings would prove useful for systematic reviews and meta-analysis on COVID-19 VE. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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19 pages, 870 KiB

Open AccessArticle

Characteristic Immune Dynamics in COVID-19 Patients with Cardiac Dysfunction

by Filipe André Gonzalez, Miguel Ângelo-Dias, Catarina Martins, Rui Gomes, Jacobo Bacariza, Antero Fernandes, Luís Miguel Borrego and EchoCrit Group

J. Clin. Med. 2022, 11(7), 1880; https://doi.org/10.3390/jcm11071880 - 28 Mar 2022

Cited by 3 | Viewed by 1792

Abstract

Background: We aimed to explore immune parameters in COVID-19 patients admitted to the intensive care unit (ICU) to identify distinctive features in patients with cardiac injury. Methods: A total of 30 COVID-19 patients >18 years admitted to the ICU were studied on days [...] Read more.

Background: We aimed to explore immune parameters in COVID-19 patients admitted to the intensive care unit (ICU) to identify distinctive features in patients with cardiac injury. Methods: A total of 30 COVID-19 patients >18 years admitted to the ICU were studied on days D1, D3 and D7 after admission. Cardiac function was assessed using speckle-tracking echocardiography (STE). Peripheral blood immunophenotyping, cardiac (pro-BNP; troponin) and inflammatory biomarkers were simultaneously evaluated. Results: Cardiac dysfunction (DYS) was detected by STE in 73% of patients: 40% left ventricle (LV) systolic dysfunction, 60% LV diastolic dysfunction, 37% right ventricle systolic dysfunction. High-sensitivity cardiac troponin (hs-cTn) was detectable in 43.3% of the patients with a median value of 13.00 ng/L. There were no significant differences between DYS and nDYS patients regarding mortality, organ dysfunction, cardiac (including hs-cTn) or inflammatory biomarkers. Patients with DYS showed persistently lower lymphocyte counts (median 896 [661–1837] cells/µL vs. 2141 [924–3306] cells/µL, p = 0.058), activated CD3 (median 85 [66–170] cells/µL vs. 186 [142–259] cells/µL, p = 0.047) and CD4 T cells (median 33 [28–40] cells/µL vs. 63 [48–79] cells/µL, p = 0.005), and higher effector memory T cells (TEM) at baseline (CD4%: 10.9 [6.4–19.2] vs. 5.9 [4.2–12.8], p = 0.025; CD8%: 15.7 [7.9–22.8] vs. 8.1 [7.7–13.7], p = 0.035; CD8 counts: 40 cells/µL [17–61] vs. 10 cells/µL [7–17], p = 0.011) than patients without cardiac dysfunction. Conclusion: Our study suggests an association between the immunological trait and cardiac dysfunction in severe COVID-19 patients. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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30 pages, 5995 KiB

Open AccessArticle

Development of a Machine Learning Based Web Application for Early Diagnosis of COVID-19 Based on Symptoms

by Charlyn Nayve Villavicencio, Julio Jerison Macrohon, Xavier Alphonse Inbaraj, Jyh-Horng Jeng and Jer-Guang Hsieh

Diagnostics 2022, 12(4), 821; https://doi.org/10.3390/diagnostics12040821 - 27 Mar 2022

Cited by 9 | Viewed by 3738

Abstract

Detecting the presence of a disease requires laboratory tests, testing kits, and devices; however, these were not always available on hand. This study proposes a new approach in disease detection using machine learning algorithms by analyzing symptoms experienced by a person without requiring [...] Read more.

Detecting the presence of a disease requires laboratory tests, testing kits, and devices; however, these were not always available on hand. This study proposes a new approach in disease detection using machine learning algorithms by analyzing symptoms experienced by a person without requiring laboratory tests. Six supervised machine learning algorithms such as J48 decision tree, random forest, support vector machine, k-nearest neighbors, naïve Bayes algorithms, and artificial neural networks were applied in the “COVID-19 Symptoms and Presence Dataset” from Kaggle. Through hyperparameter optimization and 10-fold cross validation, we attained the highest possible performance of each algorithm. A comparative analysis was performed according to accuracy, sensitivity, specificity, and area under the ROC curve. Results show that random forest, support vector machine, k-nearest neighbors, and artificial neural networks outweighed other algorithms by attaining 98.84% accuracy, 100% sensitivity, 98.79% specificity, and 98.84% area under the ROC curve. Finally, we developed a web application that will allow users to select symptoms currently being experienced, and use it to predict the presence of COVID-19 through the developed prediction model. Based on this mechanism, the proposed method can effectively predict the presence or absence of COVID-19 in a person immediately without using laboratory tests, kits, and devices in a real-time manner. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 353 KiB

Open AccessArticle

COVID-19 Lockdown in Patients with Chronic Diseases: A Cross-Sectional Study

by Mathieu Boulin, Amélie Cransac-Miet, Marc Maynadié, Fabienne Volot, Catherine Creuzot-Garcher, Jean-Christophe Eicher, Frédéric Chagué, Eléa Ksiazek, Guillaume Beltramo, Philippe Bonniaud, Thibault Moreau, Bernard Bonnotte, Edith Sales-Wuillemin, Agnès Soudry-Faure, Marianne Zeller and Yves Cottin

Int. J. Environ. Res. Public Health 2022, 19(7), 3957; https://doi.org/10.3390/ijerph19073957 - 26 Mar 2022

Cited by 5 | Viewed by 2044

Abstract

Background: We aimed to investigate the impact of the first COVID-19 lockdown on medication adherence, physician access, lifestyle behaviours, and mental health in patients with chronic conditions. Methods: A cross-sectional phone survey was conducted in 1274 housebound adults recruited from 8 regional chronic [...] Read more.

Background: We aimed to investigate the impact of the first COVID-19 lockdown on medication adherence, physician access, lifestyle behaviours, and mental health in patients with chronic conditions. Methods: A cross-sectional phone survey was conducted in 1274 housebound adults recruited from 8 regional chronic disease cohorts (CLEO CD study: NCT04390126). Results: Medication adherence was 97%; 305 (41%) patients declared that at least one scheduled visit with a physician was missed during the first lockdown. The main changes in lifestyle behaviours were deterioration in sleep time (duration and/or quality; 71%), increase in screen time (46%), and decrease in physical activity (46%). Nineteen percent experienced psychological distress (Kessler-6 score ≥ 5). An urban living place (OR, 1.76 vs. rural; 95% CI, 1.32–2.33; p = 10⁻⁴), worse self-reported mental health (OR, 1.62 vs. about the same or better; 95% CI, 1.17–2.25; p = 0.003), and a K6 score ≥ 5 (OR, 1.52 vs. <5; 95% CI, 1.05–2.21; p = 0.03) were independent factors associated with at least one unhealthy behaviour. Conclusions: Encouraging results were observed in terms of medication adherence. Caution is needed in chronic disease patients living in urban places as well as those presenting psychological distress and worse self-reported mental health to reduce unhealthy behaviours. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

9 pages, 283 KiB

Open AccessArticle

Urinary Tract Infections in Hospitalized COVID-19 Patients, What’s Up, Doc?

by Beatriz Díaz Pollán, Gladys Virginia Guedez López, Paloma María García Clemente, María Jiménez González, Silvia García Bujalance and María Rosa Gómez-Gil Mirá

J. Clin. Med. 2022, 11(7), 1815; https://doi.org/10.3390/jcm11071815 - 25 Mar 2022

Cited by 7 | Viewed by 2347

Abstract

The SARS-CoV-2 pandemic might have increased the risks of healthcare-associated infections (HAIs); however, several studies of HAI such as urinary tract infections (UTIs) and catheter-associated urinary tract infections (CAUTIs) have shown contradictory results. The aim of this study is to assess the clinical [...] Read more.

The SARS-CoV-2 pandemic might have increased the risks of healthcare-associated infections (HAIs); however, several studies of HAI such as urinary tract infections (UTIs) and catheter-associated urinary tract infections (CAUTIs) have shown contradictory results. The aim of this study is to assess the clinical features of UTIs and bacterial isolates from urine samples of hospitalized COVID-19 patients. We conducted a retrospective observational study including 87 COVID-19 patients with UTIs admitted to our centre. Bacterial UTIs presented were 87: 9 (10.3%) community-acquired UTIs (coinfection group) and 78 (89.6%) hospital-acquired UTIs (superinfection group). In the coinfection group, the most frequent type was non-CAUTI with 5 (55.5%) patients; however, the most frequent UTI in the superinfection group was CAUTI, with 53 (67.9%) patients. The median number of days of hospitalization in coinfected patients was lower than superinfection patients: 13 (IQR 11, 23) vs. 34 days (IQR 23, 47) p < 0.006. All UTI patients admitted to ICU, 38 (43.7%), belonged to the superinfection group. The mortality rate was 26.4% (23/87), 22/23 in the superinfection group. The most common microorganisms were E. coli 27 (28.4%), E. faecalis 25 (26.3%) and E. faecium 20 (21.1%). There was an increased incidence of E. faecalis and E. faecium in UTIs as well as hospital-acquired UTIs. This can be related to urethral catheterization during hospitalization, UCI admissions and the number of days of hospitalization. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

15 pages, 868 KiB

Open AccessArticle

Promoting COVID-19 Vaccination Using the Health Belief Model: Does Information Acquisition from Divergent Sources Make a Difference?

by Xiaodong Yang, Lai Wei and Zhiyue Liu

Int. J. Environ. Res. Public Health 2022, 19(7), 3887; https://doi.org/10.3390/ijerph19073887 - 24 Mar 2022

Cited by 11 | Viewed by 3976

Abstract

As a promising approach to stop the escalation of the pandemic, COVID-19 vaccine promotion is becoming a challenging task for authorities worldwide. The purpose of this study was to identify the effective sources for disseminating information on the COVID-19 vaccine to promote individuals’ [...] Read more.

As a promising approach to stop the escalation of the pandemic, COVID-19 vaccine promotion is becoming a challenging task for authorities worldwide. The purpose of this study was to identify the effective sources for disseminating information on the COVID-19 vaccine to promote individuals’ behavioral intention to take the vaccine. Based on the Health Belief Model (HBM), this study illustrated the mechanism of how COVID-19 information acquisition from different sources was transformed into vaccination intentions via health beliefs. Using an online survey in China, the structural equation model results revealed that perceived benefits and cues to action were positively associated with COVID-19 vaccination intentions, and perceived barriers were negatively related to the intentions. However, perceived susceptibility and perceived severity had no significant relationships with the intentions. Moreover, the findings unveiled differences in the effects of acquiring information via multiple sources among traditional media, new media, and interpersonal interactions. Notably, new media and interpersonal interactions were more salient in promoting vaccination intention via health beliefs, compared with traditional media. The findings from this study will benefit health officials in terms of utilizing different information sources in vaccine programs. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 1405 KiB

Open AccessArticle

Rapid Antigen Test LumiraDx^TM vs. Real Time Polymerase Chain Reaction for the Diagnosis of SARS-CoV-2 Infection: A Retrospective Cohort Study

by Anna Maria Cattelan, Lolita Sasset, Federico Zabeo, Anna Ferrari, Lucia Rossi, Maria Mazzitelli, Silvia Cocchio and Vincenzo Baldo

Int. J. Environ. Res. Public Health 2022, 19(7), 3826; https://doi.org/10.3390/ijerph19073826 - 23 Mar 2022

Cited by 9 | Viewed by 2649

Abstract

Background: Real time reverse transcription polymerase chain reaction (real time RT-PCR) testing is the gold standard for the diagnosis of SARS-CoV-2 infections. However, to expand the testing capacity, new SARS-CoV-2 rapid antigen tests (Ag-RDTs) have been implemented. Ag-RDTs are more rapid, but less [...] Read more.

Background: Real time reverse transcription polymerase chain reaction (real time RT-PCR) testing is the gold standard for the diagnosis of SARS-CoV-2 infections. However, to expand the testing capacity, new SARS-CoV-2 rapid antigen tests (Ag-RDTs) have been implemented. Ag-RDTs are more rapid, but less reliable in terms of sensitivity, and real-life data on their performance in comparison with the real time RT-PCR test are lacking. Methods: We aimed at assessing the diagnostic performance of the third-generation antigenic swab LumiraDx™ compared with real time RT-PCR in a retrospective cohort study at the Infectious Diseases Unit of Padua. All of the patients who were consecutively tested for SARS-CoV-2 in our centre (by both real time RT-PCR and Ag-RTD LumiraDx^TM) from 19 January to 30 May 2021, were included. Cycle-threshold (Ct) values of positive real time RT-PCR were recorded as well as the number of days from symptoms’ onset to testing. Results: Among the 282 patients included, 80.9% (N = 228) tested positive to real time RT-PCR, and among these, 174 tested positive also to LumiraDx™. Compared with real time RT-PCR, which is considered as the gold standard for the assessment of the presence/absence of SARS-CoV-2 infection, LumiraDx™ showed an overall sensitivity of 76.3% and specificity of 94.4%. Sensitivity increased to 91% when testing was performed <10 days from symptoms’ onset, and to 95% when considering Ct < 25. Multivariable binomial logistic regression showed that false negative LumiraDx™ results were significantly associated with high Ct values, and with further testing from symptoms’ onset. Conclusions: The results of our study suggested that the LumiraDx™ SARS-CoV-2 antigen assay may be appropriate for the detection of SARS-CoV-2 infection, especially in its early phase when the test largely meets the performance requirements of the European Centre for Disease Prevention and Control (ECDC). Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 6421 KiB

Open AccessArticle

Global Trends and Research Hotspots in Long COVID: A Bibliometric Analysis

by Hongxia Jin, Lu Lu and Haojun Fan

Int. J. Environ. Res. Public Health 2022, 19(6), 3742; https://doi.org/10.3390/ijerph19063742 - 21 Mar 2022

Cited by 11 | Viewed by 3197

Abstract

Long COVID is a condition distinguished by long-term sequelae that occur or persist after the convalescence period of COVID-19. During the COVID-19 pandemic, more and more people who tested positive for SARS-CoV-2 experienced long COVID, which attracted the attention of researchers. This study [...] Read more.

Long COVID is a condition distinguished by long-term sequelae that occur or persist after the convalescence period of COVID-19. During the COVID-19 pandemic, more and more people who tested positive for SARS-CoV-2 experienced long COVID, which attracted the attention of researchers. This study aims to assess the pattern of long COVID research literature, analyze the research topics, and provide insights on long COVID. In this study, we extracted 784 publications from Scopus in the field of long COVID. According to bibliometric analysis, it is found that: developed countries in Europe and America were in leading positions in terms of paper productivity and citations. The International Journal of Environmental Research and Public Health and the Journal of Clinical Medicine were leading journals in the perspective of publications count, and Nature Medicine had the highest number of citations. Author Greenhalgh T has the highest number of papers and citations. The main research topics were: pathophysiology, symptoms, treatment, and epidemiology. The causes of long COVID may be related to organ injury, inflammation, maladaptation of the angiotensin-converting enzyme 2 (ACE2) pathway, and mental factors. The symptoms are varied, including physical and psychological symptoms. Treatment options vary from person to person. Most patients developed at least one long-term symptom. Finally, we presented some possible research opportunities. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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12 pages, 41750 KiB

Open AccessReview

Efficacy of Pre-Procedural Mouthwashes against SARS-CoV-2: A Systematic Review of Randomized Controlled Trials

by Alvaro Garcia-Sanchez, Juan-Francisco Peña-Cardelles, Steve Ruiz, Flor Robles, Esther Ordonez-Fernandez, Angel-Orión Salgado-Peralvo, James Balloch and Jacob C. Simon

J. Clin. Med. 2022, 11(6), 1692; https://doi.org/10.3390/jcm11061692 - 18 Mar 2022

Cited by 9 | Viewed by 3163

Abstract

The oral mucosa is one of the first sites to be affected by the SARS-CoV-2. For this reason, healthcare providers performing aerosol-generating procedures (AGPs) in the oral cavity are at high risk of infection with COVID-19. The aim of this systematic review is [...] Read more.

The oral mucosa is one of the first sites to be affected by the SARS-CoV-2. For this reason, healthcare providers performing aerosol-generating procedures (AGPs) in the oral cavity are at high risk of infection with COVID-19. The aim of this systematic review is to verify whether there is evidence in the literature describing a decrease in the salivary viral load of SARS-CoV-2 after using different mouthwashes. An electronic search of the MEDLINE database (via PubMed), Web of Science, SCOPUS, and the Cochrane library database was carried out. The criteria used were those described by the PRISMA^® Statement. Randomized controlled trial studies that have used mouthwashes as a form of intervention to reduce the viral load in saliva were included. The risk of bias was analyzed using the Joanna Briggs Institute Critical Appraisal Tool. Ultimately, eight articles were included that met the established criteria. Based on the evidence currently available in the literature, PVP-I, CHX and CPC present significant virucidal activity against SARS-CoV-2 in saliva and could be used as pre-procedural mouthwashes to reduce the risk of cross-infection. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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14 pages, 2289 KiB

Open AccessArticle

Can Digital Transformation Promote the Rapid Recovery of Cities from the COVID-19 Epidemic? An Empirical Analysis from Chinese Cities

by Jiaojiao Liu, Shuai Liu, Xiaolin Xu and Qi Zou

Int. J. Environ. Res. Public Health 2022, 19(6), 3567; https://doi.org/10.3390/ijerph19063567 - 17 Mar 2022

Cited by 14 | Viewed by 2918

Abstract

Background: Digital transformation has become a key intervention strategy for the global response to the COVID-19 epidemic, and digital technology is helping cities recover from the COVID-19 epidemic. However, the effects of urban digital transformation on the recovery from the COVID-19 epidemic still [...] Read more.

Background: Digital transformation has become a key intervention strategy for the global response to the COVID-19 epidemic, and digital technology is helping cities recover from the COVID-19 epidemic. However, the effects of urban digital transformation on the recovery from the COVID-19 epidemic still lack mechanism analyses and empirical testing. This study aimed to explain the theoretical mechanism of urban digital transformation on the recovery from the COVID-19 epidemic and to test its effectiveness using an empirical analysis. Methods: This study, using a theoretical and literature-based analysis, summarizes the impact mechanisms of urban digital transformation on the recovery of cities from the COVID-19 epidemic. A total of 83 large- and medium-sized cities from China are included in the empirical research sample, covering most major cities in China. The ordinary least squares (OLS) method is adopted to estimate the effect of China’s urban digitalization level on population attraction in the second quarter of 2020. Results: The theoretical analysis found that urban digital transformation improves the ability of cities to recover from the COVID-19 epidemic by promoting social communication, collaborative governance, and resilience. The main findings of the empirical analysis show that the digital level of a city has a significant positive effect on urban population attraction (p < 0.001). Conclusions: A positive relationship was found between urban digital transformation and the rapid recovery of cities from the COVID-19 epidemic. Digital inventions for social communication, collaborative governance, and urban resilience are an effective way of fighting the COVID-19 emergency. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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20 pages, 3398 KiB

Open AccessArticle

A Simple Method to Quantify Outward Leakage of Medical Face Masks and Barrier Face Coverings: Implication for the Overall Filtration Efficiency

by Silvia Chiera, Alessandro Cristoforetti, Luca Benedetti, Giandomenico Nollo, Luca Borro, Lorenzo Mazzei and Francesco Tessarolo

Int. J. Environ. Res. Public Health 2022, 19(6), 3548; https://doi.org/10.3390/ijerph19063548 - 16 Mar 2022

Cited by 17 | Viewed by 3036

Abstract

Face masking proved essential to reduce transmission of COVID-19 and other respiratory infections in indoor environments, but standards and literature do not provide simple quantitative methods for quantifying air leakage at the face seal. This study reports an original method to quantify outward [...] Read more.

Face masking proved essential to reduce transmission of COVID-19 and other respiratory infections in indoor environments, but standards and literature do not provide simple quantitative methods for quantifying air leakage at the face seal. This study reports an original method to quantify outward leakage and how wearing style impacts on leaks and filtration efficiency. The amount of air leakage was evaluated on four medical masks and four barrier face coverings, exploiting a theoretical model and an instrumented dummy head in a range of airflows between 30 and 160 L/min. The fraction of air leaking at the face seal of the medical masks and barrier face coverings ranged from 43% to 95% of exhaled air at 30 L/min and reduced to 10–85% at 160 L/min. Filter breathability was the main driver affecting both leak fraction and total filtration efficiency that varied from 5% to 53% and from 15% to 84% at 30 and 160 L/min, respectively. Minor changes were related to wearing style, supporting indications on the correct mask use. The fraction of air leaking from medical masks and barrier face coverings during exhalation is relevant and varies according to design and wearing style. The use of highly breathable filter materials reduces air leaks and improve total filtration efficiency. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 835 KiB

Open AccessArticle

Chest X-ray Does Not Predict the Risk of Endotracheal Intubation and Escalation of Treatment in COVID-19 Patients Requiring Noninvasive Respiratory Support

by Tommaso Pettenuzzo, Chiara Giraudo, Giulia Fichera, Michele Della Paolera, Martina Tocco, Michael Weber, Davide Gorgi, Silvia Carlucci, Federico Lionello, Sara Lococo, Annalisa Boscolo, Alessandro De Cassai, Laura Pasin, Marco Rossato, Andrea Vianello, Roberto Vettor, Nicolò Sella and Paolo Navalesi

J. Clin. Med. 2022, 11(6), 1636; https://doi.org/10.3390/jcm11061636 - 16 Mar 2022

Viewed by 1658

Abstract

Forms of noninvasive respiratory support (NIRS) have been widely used to avoid endotracheal intubation in patients with coronavirus disease-19 (COVID-19). However, inappropriate prolongation of NIRS may delay endotracheal intubation and worsen patient outcomes. The aim of this retrospective study was to assess whether [...] Read more.

Forms of noninvasive respiratory support (NIRS) have been widely used to avoid endotracheal intubation in patients with coronavirus disease-19 (COVID-19). However, inappropriate prolongation of NIRS may delay endotracheal intubation and worsen patient outcomes. The aim of this retrospective study was to assess whether the CARE score, a chest X-ray score previously validated in COVID-19 patients, may predict the need for endotracheal intubation and escalation of respiratory support in COVID-19 patients requiring NIRS. From December 2020 to May 2021, we included 142 patients receiving NIRS who had a first chest X-ray available at NIRS initiation and a second one after 48–72 h. In 94 (66%) patients, the level of respiratory support was increased, while endotracheal intubation was required in 83 (58%) patients. The CARE score at NIRS initiation was not predictive of the need for endotracheal intubation (odds ratio (OR) 1.01, 95% confidence interval (CI) 0.96–1.06) or escalation of treatment (OR 1.01, 95% CI 0.96–1.07). In conclusion, chest X-ray severity, as assessed by the CARE score, did not allow predicting endotracheal intubation or escalation of respiratory support in COVID-19 patients undergoing NIRS. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 2968 KiB

Open AccessArticle

Reusability of P3 Facial Filter in a Pandemic Emergency: A 3D Analysis of Filter Microstructure with X-ray Microtomography Images after Dry Heat and UV Sterilization Procedures

by Luca Borro, Massimiliano Raponi, Andrea Del Fattore, Franco Zanini, Francesca di Lillo, Adriano Contillo, Veronica Bordonaro, Eleonora Di Piazza, Alberto E. Tozzi and Aurelio Secinaro

Int. J. Environ. Res. Public Health 2022, 19(6), 3435; https://doi.org/10.3390/ijerph19063435 - 14 Mar 2022

Cited by 1 | Viewed by 1737

Abstract

Objective: Our goal is to evaluate the effects of heat and ultraviolet (UV) irradiation on P3 facial respirator microstructure. Intervention: P3 facial filters were exposed to dry heat and UV sterilization procedures. Methods: P3 facial filter samples underwent a standardized sterilization process based [...] Read more.

Objective: Our goal is to evaluate the effects of heat and ultraviolet (UV) irradiation on P3 facial respirator microstructure. Intervention: P3 facial filters were exposed to dry heat and UV sterilization procedures. Methods: P3 facial filter samples underwent a standardized sterilization process based on dry heat and UV irradiation techniques. We analyzed critical parameters of internal microstructure, such as fiber thickness and porosity, before and after sterilization, using 3D data obtained with synchrotron radiation-based X-ray computed microtomography (micro-CT). The analyzed filter has two inner layers called the “finer” and “coarser” layers. The “finer” layer consists of a dense fiber network, while the “coarser” layer has a less compact fiber network. Results: Analysis of 3D images showed no statistically significant differences between the P3 filter of the controls and the dry heat/UV sterilized samples. In particular, averages fiber thickness in the finer layer of the control and the 60° dry heated and UV-irradiated sample groups was almost identical. Average fiber thickness for the coarser layer of the control and the 60° dry heated and UV-irradiated sample groups was very similar, measuring 19.33 µm (±0.47), 18.33 µm (±0.47), and 18.66 µm (±0.47), respectively. There was no substantial difference in maximum fiber thickness in the finer layers and coarser layers. For the control group samples, maximum thickness was on average 11.43 µm (±1.24) in the finer layer and 59.33 µm (±6.79) in the coarser layer. Similarly, the 60° dry heated group samples were thickened 12.2 µm (±0.21) in the finer layer and 57.33 µm (±1.24) in the coarser layer, while for the UV-irradiated group, the mean max thickness was 12.23 µm (±0.90) in the finer layer and 58.00 µm (±6.68) in the coarser layer. Theoretical porosity analysis resulted in 74% and 88% for the finer and coarser layers. The finer layers’ theoretical porosity tended to decrease in dry heat and UV-irradiated samples compared with the respective control samples. Conclusions: Dry heat and UV sterilization processes do not substantially alter the morphometry of the P3 filter samples’ internal microstructure, as studied with micro-CT. The current study suggests that safe P3 filter facepiece reusability is theoretically feasible and should be further investigated. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 264 KiB

Open AccessArticle

Mental Health and Quality of Life for Disaster Service Workers in a Province under COVID-19

by Ji-Won Na, Chan-Mo Yang, Sang-Yeol Lee and Seung-Ho Jang

J. Clin. Med. 2022, 11(6), 1600; https://doi.org/10.3390/jcm11061600 - 14 Mar 2022

Cited by 2 | Viewed by 2036

Abstract

Objective: Healthcare workers and disaster service workers have been reported to be vulnerable to mental health problems during outbreaks of infectious diseases such as the COVID-19 pandemic. This study aimed to investigate the psychosocial characteristics of disaster service workers in charge of COVID-19-related [...] Read more.

Objective: Healthcare workers and disaster service workers have been reported to be vulnerable to mental health problems during outbreaks of infectious diseases such as the COVID-19 pandemic. This study aimed to investigate the psychosocial characteristics of disaster service workers in charge of COVID-19-related work and also identify the factors affecting their quality of life. Methods: From June 2020 to June 2021, a survey was conducted of 526 disaster service workers in charge of COVID-19-related work. This included those working in public health care centers (PHC), 119 rescue and emergency medical services (119 REMS), public servants of city hall (PS), and police officers. The Korean version of the Fear of COVID-19 Scale, Patient Health Questionnaire-15, Hospital Anxiety and Depression Scale, Insomnia Severity Index, Connor–Davidson Resilience Scale, and World Health Organization quality of life assessment instrument brief form were used. A one-way ANOVA was conducted, and a stepwise regression analysis was carried out to determine the factors affecting quality of life. Results: Regarding quality of life, 119 REMS (180.64 ± 26.20) scored significantly higher than PHC (165.76 ± 23.73) and PS (163.90 ± 23.60), while police officers (176.87 ± 23.17) scored significantly higher than PS (163.90 ± 23.60) (F = 12.373, p < 0.001). Resilience (β = 0.897, p < 0.01) was the most significant explanatory variable, and together with insomnia (β = 0.154, p < 0.01), depression (β = −0.152, p < 0.01), and COVID-19 anxiety (β = −0.057, p < 0.01) accounted for 91.8% of the explanatory variance with regard to quality of life. Discussion: Quality of life was found to be negatively correlated with insomnia, depression, and COVID-19 anxiety while being positively correlated with resilience. Therefore, active interventions are needed to improve the resilience of disaster service workers. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

7 pages, 312 KiB

Open AccessProject Report

Sex Differences between Medical Students in the Assessment of the Fear of COVID-19

by Maria del Carmen Trapp, Brandt J. Wiskur, Joy H. Suh, Michael W. Brand, Katrin G. Kuhn and Julio Rojas

Int. J. Environ. Res. Public Health 2022, 19(6), 3372; https://doi.org/10.3390/ijerph19063372 - 13 Mar 2022

Cited by 1 | Viewed by 2172

Abstract

Background: Differing expressions of the fear of COVID-19 between men and women can potentially increase both immediate and long-term physical health risks. We predicted that women students would express greater fear of COVID-19. Methods: We used an Internet-delivered Fear of COVID-19 Scale (FCV-19S) [...] Read more.

Background: Differing expressions of the fear of COVID-19 between men and women can potentially increase both immediate and long-term physical health risks. We predicted that women students would express greater fear of COVID-19. Methods: We used an Internet-delivered Fear of COVID-19 Scale (FCV-19S) to assess fear among men (n = 100) and women (n = 272) from a larger population of academic medical center members (n = 1761). Sex differences in emotional and physical symptoms were assessed as subcategories within fear scores. Results: Women reported greater fear of COVID-19 than men (p < 0.001). Women reported greater emotional fear (p < 0.001) on specific scale items (thinking of COVID-19, watching news stories about COVID-19, and losing sleep due to fear of contracting COVID-19). Discussion/Conclusions: These results provide a better understanding of how fear of COVID-19 can differ based on sex and how that fear may be expressed differently through emotional and physical symptoms. This information will inform academic health centers of COVID-19 prevention and management policies that may include a gender-specific focus. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

11 pages, 730 KiB

Open AccessArticle

Radiological Findings Increased the Successful of COVID-19 Diagnosis in Hospitalized Patients Suspected of Respiratory Viral Infection but with a Negative First SARS-CoV-2 RT-PCR Result

by Margarita L Martinez-Fierro, Carolina González-Fuentes, Dagoberto Cid-Guerrero, Samantha González Delgado, Santiago Carrillo-Martínez, Edgar Fernando Gutierrez-Vela, Juan Yadid Calzada-Luévano, Maria R. Rocha-Pizaña, Jacqueline Martínez-Rendón, Maria E. Castañeda-López and Idalia Garza-Veloz

Diagnostics 2022, 12(3), 687; https://doi.org/10.3390/diagnostics12030687 - 11 Mar 2022

Cited by 2 | Viewed by 2158

Abstract

SARS-CoV-2 is the etiological agent of COVID-19 and may evolve from asymptomatic disease to fatal outcomes. Real-time reverse-transcription polymerase chain reaction (RT-PCR) screening is the gold standard to diagnose severe accurate respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but this test is not 100% [...] Read more.

SARS-CoV-2 is the etiological agent of COVID-19 and may evolve from asymptomatic disease to fatal outcomes. Real-time reverse-transcription polymerase chain reaction (RT-PCR) screening is the gold standard to diagnose severe accurate respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but this test is not 100% accurate, as false negatives can occur. We aimed to evaluate the potential false-negative results in hospitalized patients suspected of viral respiratory disease but with a negative previous SARS-CoV-2 RT-PCR and analyze variables that may increase the success of COVID-19 diagnosis in this group of patients. A total of 55 hospitalized patients suspected of viral respiratory disease but with a previous negative RT-PCR result for SARS-CoV-2 were included. All the participants had clinical findings related to COVID-19 and underwent a second SARS-CoV-2 RT-PCR. Chest-computed axial tomography (CT) was used as an auxiliary tool for COVID-19 diagnosis. After the second test, 36 patients (65.5%) were positive for SARS-CoV-2 (COVID-19 group), and 19 patients (34.5%) were negative (controls). There were differences between the groups in the platelet count and the levels of D-dimer, procalcitonin, and glucose (p < 0.05). Chest CT scans categorized as COVID-19 Reporting and Data System 5 (CO-RADS 5) were more frequent in the COVID-19 group than in the control group (91.7% vs. 52.6%; p = 0.003). CO-RADS 5 remained an independent predictor of COVID-19 diagnosis in a second SARS-CoV-2 screening (p = 0.013; odds ratio = 7.0, 95% confidence interval 1.5–32.7). In conclusion, chest CT classified as CO-RADS 5 was an independent predictor of a positive second SARS-CoV-2 RT-PCR, increasing the odds of COVID-19 diagnosis by seven times. Based on our results, in hospitalized patients with a chest CT classified as CO-RADS 5, a second SARS-CoV-2 RT-PCR test should be mandatory when the first one is negative. This approach could increase SARS-CoV-2 detection up to 65% and could allow for isolation and treatment, thus improving the patient outcome and avoiding further contagion. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 247 KiB

Open AccessBrief Report

Characteristics and Outcomes of COVID-19-Related Hospitalization among PLWH

by Roberta Gagliardini, Alessandra Vergori, Patrizia Lorenzini, Stefania Cicalini, Carmela Pinnetti, Valentina Mazzotta, Annalisa Mondi, Ilaria Mastrorosa, Marta Camici, Simone Lanini, Marisa Fusto, Jessica Paulicelli, Maria Maddalena Plazzi, Luisa Marchioni, Chiara Agrati, Anna Rosa Garbuglia, Pierluca Piselli, Emanuele Nicastri, Fabrizio Taglietti, Fabrizio Palmieri, Gianpiero D’Offizi, Enrico Girardi, Francesco Vaia and Andrea Antinori Show full author list Hide full author list

J. Clin. Med. 2022, 11(6), 1546; https://doi.org/10.3390/jcm11061546 - 11 Mar 2022

Cited by 8 | Viewed by 1768

Abstract

Background: There is conflicting evidence for how HIV influences COVID-19 infection. The aim of this study was to compare characteristics at presentation and the clinical outcomes of people living with HIV (PLWH) versus HIV-negative patients (non-PLWH) hospitalized with COVID-19. Methods: Primary endpoint: time [...] Read more.

Background: There is conflicting evidence for how HIV influences COVID-19 infection. The aim of this study was to compare characteristics at presentation and the clinical outcomes of people living with HIV (PLWH) versus HIV-negative patients (non-PLWH) hospitalized with COVID-19. Methods: Primary endpoint: time until invasive ventilation/death. Secondary endpoints: time until ventilation/death, time until symptoms resolution. Results: A total of 1647 hospitalized patients were included (43 (2.6%) PLWH, 1604 non-PLWH). PLWH were younger (55 vs. 61 years) and less likely to be with PaO₂/FiO₂ < 300 mmHg compared with non-PLWH. Among PLWH, nadir of CD4 was 185 (75–322) cells/μL; CD4 at COVID-19 diagnosis was 272 cells/μL (127–468) and 77% of these were virologically suppressed. The cumulative probability of invasive mechanical ventilation/death at day 15 was 4.7% (95%CI 1.2–17.3) in PLWH versus 18.9% (16.9–21.1) in non-PLWH (p = 0.023). The cumulative probability of non-invasive/invasive ventilation/death at day 15 was 20.9% (11.5–36.4) in PLWH versus 37.6% (35.1–40.2) in non-PLWH (p = 0.044). The adjusted hazard ratio (aHR) of invasive mechanical ventilation/death of PLWH was 0.49 (95% CI 0.12–1.96, p = 0.310) versus non-PLWH; similarly, aHR of non-invasive/invasive ventilation/death of PLWH was 1.03 (95% CI 0.53–2.00, p = 0.926). Conclusion: A less-severe presentation of COVID-19 at hospitalization was observed in PLWH compared to non-PLWH; no difference in clinical outcomes could be detected. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

14 pages, 1579 KiB

Open AccessArticle

Isolation of Functional SARS-CoV-2 Antigen-Specific T-Cells with Specific Viral Cytotoxic Activity for Adoptive Therapy of COVID-19

by Estéfani García-Ríos, Alejandra Leivas, Francisco J. Mancebo, Laura Sánchez-Vega, Diego Lanzarot, José María Aguado, Joaquín Martínez-López, María Liz Paciello and Pilar Pérez-Romero

Biomedicines 2022, 10(3), 630; https://doi.org/10.3390/biomedicines10030630 - 09 Mar 2022

Cited by 2 | Viewed by 3788

Abstract

In order to demonstrate the feasibility of preparing clinical-grade SARS-CoV-2-specific T-cells from convalescent donors and the ability of these cells to neutralize the virus in vitro, we used blood collected from two COVID-19 convalescent donors (before and after vaccination) that was stimulated with [...] Read more.

In order to demonstrate the feasibility of preparing clinical-grade SARS-CoV-2-specific T-cells from convalescent donors and the ability of these cells to neutralize the virus in vitro, we used blood collected from two COVID-19 convalescent donors (before and after vaccination) that was stimulated with specific SARS-CoV-2 peptides followed by automated T-cell isolation using the CliniMacs Prodigy medical device. To determine cytotoxic activity, HEK 293T cells were transfected to express the SARS-CoV-2 M protein, mimicking SARS-CoV-2 infection. We were able to quickly and efficiently isolate SARS-CoV-2-specific T lymphocytes from both donors before and after they received the Pfizer-BioNTech vaccine. Althoughbefore vaccination, the final product contained up to 7.42% and 30.19% of IFN-γ+ CD3+ T-cells from donor 1 and donor 2, respectively, we observed an enrichment of the IFN-γ+ CD3+ T-cells after vaccination, reaching 70.47% and 42.59%, respectively. At pre-vaccination, the isolated SARS-CoV-2-specific T-cells exhibited cytotoxic activity that was significantly higher than that of unstimulated controls (donor 2: 15.41%, p-value 3.27 × 10⁻³). The cytotoxic activity of the isolated SARS-CoV-2-specific T-cells also significantly increased after vaccination (donor 1: 32.71%, p-value 1.44 × 10⁻⁵; donor 2: 33.38%, p-value 3.13 × 10⁻⁶). In conclusion, we demonstrated that SARS-CoV-2-specific T-cells can quickly and efficiently be stimulated from the blood of convalescent donors using SARS-CoV-2-specific peptides followed by automated isolation. Vaccinated convalescent donors have a higher percentage of SARS-CoV-2-specific T-cells and may be more suitable as donors. Although further studies are needed to assess the clinical utility of the functional isolated SARS-CoV-2-specific T-cells in patients, previous studies using the same stimulation and isolation methods applied to other pathologies support this idea. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 589 KiB

Open AccessArticle

Characteristics Associated with the Dual Behavior of Mask Wearing and Vaccine Acceptance: A Pooled Cross-Sectional Study among Adults in Saskatchewan

by Ali Bukhari, Daniel A. Adeyinka, Jessica McCutcheon, Natalie Kallio and Nazeem Muhajarine

Int. J. Environ. Res. Public Health 2022, 19(6), 3202; https://doi.org/10.3390/ijerph19063202 - 09 Mar 2022

Cited by 3 | Viewed by 2229

Abstract

While the dual behavior of consistent mask wearing and vaccine acceptance represents an effective method of protecting oneself and others from COVID-19, research has yet to directly examine its predictors. A total of 3347 responses from a pooled cross-sectional survey of adults living [...] Read more.

While the dual behavior of consistent mask wearing and vaccine acceptance represents an effective method of protecting oneself and others from COVID-19, research has yet to directly examine its predictors. A total of 3347 responses from a pooled cross-sectional survey of adults living in Saskatchewan, Canada, were analyzed using a multinomial logistic regression model. The outcome variable was the combined behavior of mask-wearing and vaccine intention in four combinations, while covariates consisted of socio-demographic factors, risk of exposure to coronavirus, mitigating behaviors, and perceptions of COVID-19. Those who were 65 years and older, financially secure, consistently practiced social distancing and had no or very few contacts with people outside their households, were concerned about spreading the virus, and perceived they would be seriously sick if infected were likely to engage in both mask wearing and vaccine acceptance, rather than one or the other, with adjusted odds ratios ranging from 2.24 to 27.54. Further, within mask wearers, these factors were associated in a graded manner with vaccine intent. By describing the characteristics of those who engage in both mask wearing and vaccine acceptance, these results offer a specific set of characteristics for public health authorities to target and, therefore, contribute to the rapidly evolving body of knowledge on protective factors for COVID-19. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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11 pages, 1213 KiB

Open AccessCommunication

Evaluation of FAST COVID-19 SARS-CoV-2 Antigen Rapid Test Kit for Detection of SARS-CoV-2 in Respiratory Samples from Mildly Symptomatic or Asymptomatic Patients

by Immacolata Polvere, Serena Voccola, Silvia D'Andrea, Lucrezia Zerillo, Romualdo Varricchio, Jessica Raffaella Madera, Romania Stilo, Pasquale Vito and Tiziana Zotti

Diagnostics 2022, 12(3), 650; https://doi.org/10.3390/diagnostics12030650 - 07 Mar 2022

Cited by 9 | Viewed by 3539

Abstract

Molecular tests are the gold standard to diagnose severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but are associated with a diagnostic delay, while antigen detection tests can generate results within 20 min even outside a laboratory. In order to evaluate the accuracy [...] Read more.

Molecular tests are the gold standard to diagnose severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but are associated with a diagnostic delay, while antigen detection tests can generate results within 20 min even outside a laboratory. In order to evaluate the accuracy and reliability of the FAST COVID-19 SARS-CoV-2 Antigen Rapid Test Kit (Ag-RDT), two respiratory swabs were collected simultaneously from 501 patients, with mild or no coronavirus disease 2019 (COVID-19)-related symptoms, and analyzed with both the Reverse Transcriptase-quantitative Polymerase Chain Reaction (RT-qPCR) and the FAST COVID-19 SARS-CoV-2 Antigen Rapid Test. Results were then compared to determine clinical performance in a screening setting. We measured a precision of 97.41% (95% CI 92.42–99.15%) and a recall of 98.26% (95% CI 93.88–99.25%), with a specificity of 99.22% (95% CI 97.74–99.74%), a negative predictive value of 99.48% (95% CI 97.98–99.87%), and an overall accuracy of 99.00% (95% CI 97.69–99.68%). Concordance was described by a Kappa coefficient of 0.971 (95% CI 0.947–0.996). Considering short lead times, low cost, and opportunities for decentralized testing, the Ag-RDT test can enhance the efforts to control SARS-CoV-2 spread in several settings. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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16 pages, 2286 KiB

Open AccessArticle

Impact of Face-to-Face Teaching in Addition to Electronic Learning on Personal Protective Equipment Doffing Proficiency in Student Paramedics: Randomized Controlled Trial

by Ludivine Currat, Mélanie Suppan, Birgit Andrea Gartner, Emmanuel Daniel, Mathieu Mayoraz, Stephan Harbarth, Laurent Suppan and Loric Stuby

Int. J. Environ. Res. Public Health 2022, 19(5), 3077; https://doi.org/10.3390/ijerph19053077 - 05 Mar 2022

Cited by 5 | Viewed by 3634

Abstract

Personal protective equipment doffing is a complex procedure that needs to be adequately performed to prevent health care worker contamination. During the COVID-19 pandemic, junior health care workers and students of different health care professions who had not been trained to carry out [...] Read more.

Personal protective equipment doffing is a complex procedure that needs to be adequately performed to prevent health care worker contamination. During the COVID-19 pandemic, junior health care workers and students of different health care professions who had not been trained to carry out such procedures were often called upon to take care of infected patients. To limit direct contact, distance teaching interventions were used, but different trials found that their impact was rather limited. We therefore designed and carried out a randomized controlled trial assessing the impact of adding a face-to-face intervention using Peyton’s four-step approach to a gamified e-learning module. Sixty-five student paramedics participated in this study. The proportion of doffing sequences correctly performed was higher in the blended learning group (33.3% (95%CI 18.0 to 51.8) versus 9.7% (95%CI 2.0 to 25.8), p = 0.03). Moreover, knowledge and skill retention four to eight weeks after the teaching intervention were also higher in this group. Even though this study supports the use of a blended learning approach to teach doffing sequences, the low number of student paramedics able to adequately perform this procedure supports the need for iterative training sessions. Further studies should determine how often such sessions should be carried out. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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15 pages, 2599 KiB

Open AccessArticle

Adverse Events Associated with BNT162b2 and AZD1222 Vaccines in the Real World: Surveillance Report in a Single Italian Vaccine Center

by Maria Costantino, Carmine Sellitto, Valeria Conti, Graziamaria Corbi, Francesco Marongiu, Giovanni Genovese, Giuseppina Moccia, Mario Capunzo, Anna Borrelli, Pasquale Pagliano, Mario Farroni, Grazia Maria Lombardi, Maria Giovanna Elberti, Amelia Filippelli and Francesco De Caro

J. Clin. Med. 2022, 11(5), 1408; https://doi.org/10.3390/jcm11051408 - 04 Mar 2022

Cited by 7 | Viewed by 7480

Abstract

Aim: Despite huge efforts in developing specific drugs, vaccination represents the only effective strategy against COVID-19. Efficacy and safety of the COVID-19 vaccines were established during clinical trials. Nonetheless, it is very important to perform continuous surveillance. This observational study aimed to report [...] Read more.

Aim: Despite huge efforts in developing specific drugs, vaccination represents the only effective strategy against COVID-19. Efficacy and safety of the COVID-19 vaccines were established during clinical trials. Nonetheless, it is very important to perform continuous surveillance. This observational study aimed to report potential Adverse Events Following Immunization (AEFI) following the first dose of two different COVID-19 vaccines, BNT162b2 and AZD1222. Methods and Results: Subjects who underwent vaccination at the vaccine center of the University Hospital of Salerno, Italy, were interviewed using an ad hoc questionnaire. AZD-vac group (n = 175) who received AZD1222 had a higher number of AEFI than the BNT-vac group (n = 1613) who received BNT162b2 (83% vs. 42%). The most frequent AEFI associated with AZD1222 and BNT162b2 were fever and pain at the injection site, respectively. The AZD-vac group used drugs to contrast AEFI more frequently than the BNT-vac group. In the BNT-vac group, there was a higher incidence of AEFI in women than in men (26.2% vs. 15.8%, p = 0.01), while no gender-related difference was observed in the AZD-vac group. Conclusions: AZD1222 and BNT162b2 vaccines show a good safety profile. Based on our results and literature data, there are no reasons to justify the reluctance that persists towards immunization. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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9 pages, 3530 KiB

Open AccessReview

Povidone-Iodine as a Pre-Procedural Mouthwash to Reduce the Salivary Viral Load of SARS-CoV-2: A Systematic Review of Randomized Controlled Trials

by Alvaro Garcia-Sanchez, Juan-Francisco Peña-Cardelles, Esther Ordonez-Fernandez, María Montero-Alonso, Naresh Kewalramani, Angel-Orión Salgado-Peralvo, Dániel Végh, Angélica Gargano, Gabriela Parra, Lourdes-Isabela Guerra-Guajardo and Wataru Kozuma

Int. J. Environ. Res. Public Health 2022, 19(5), 2877; https://doi.org/10.3390/ijerph19052877 - 01 Mar 2022

Cited by 14 | Viewed by 3789

Abstract

The use of pre-procedural rinses has been investigated to reduce the number of viral particles and bacteria in aerosols, potentially decreasing the risk of cross-infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during medical and dental procedures. This review aims to confirm [...] Read more.

The use of pre-procedural rinses has been investigated to reduce the number of viral particles and bacteria in aerosols, potentially decreasing the risk of cross-infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during medical and dental procedures. This review aims to confirm whether there is evidence in the literature describing a reduction in salivary load of SARS-CoV-2 when povidone-iodine (PVP-I) is used as a pre-intervention mouthwash. An search of the MEDLINE, Embase, SCOPUS, and the Cochrane library databases was conducted. The criteria used followed the PRISMA^® Statement guidelines. Randomized controlled trials investigating the reduction of salivary load of SARS-CoV-2 using PVP-I were included. Ultimately, four articles were included that met the established criteria. According to the current evidence, PVP-I is effective against SARS-CoV-2 in saliva and could be implemented as a rinse before interventions to decrease the risk of cross-infection in healthcare settings. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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10 pages, 255 KiB

Open AccessArticle

The Impact of Tocilizumab on Radiological Changes Assessed by Quantitative Chest CT in Severe COVID-19 Patients

by Ana-Maria-Jennifer Anghel, Cristian-Mihail Niculae, Eliza-Daniela Manea, Mihai Lazar, Mara Popescu, Anca-Cristina Damalan, Adela-Abigaela Bel, Iulia-Maria Nedelcu, Raluca-Elena Patrascu and Adriana Hristea

J. Clin. Med. 2022, 11(5), 1247; https://doi.org/10.3390/jcm11051247 - 25 Feb 2022

Cited by 11 | Viewed by 2423

Abstract

(1) Background: We aimed to analyze the characteristics associated with the in-hospital mortality, describe the early CT changes expressed quantitatively after tocilizumab (TOC), and assess TOC timing according to the oxygen demands. (2) Methods: We retrospectively studied 101 adult patients with severe COVID-19, [...] Read more.

(1) Background: We aimed to analyze the characteristics associated with the in-hospital mortality, describe the early CT changes expressed quantitatively after tocilizumab (TOC), and assess TOC timing according to the oxygen demands. (2) Methods: We retrospectively studied 101 adult patients with severe COVID-19, who received TOC and dexamethasone. The lung involvement was assessed quantitatively using native CT examination before and 7–10 days after TOC administration. (3) Results: The in-hospital mortality was 17.8%. Logistic regression analysis found that interstitial lesions above 50% were associated with death (p = 0.01). The other variables assessed were age (p = 0.1), the presence of comorbidities (p = 0.9), the oxygen flow rate at TOC administration (p = 0.2), FiO₂ (p = 0.4), lymphocyte count (p = 0.3), and D-dimers level (p = 0.2). Survivors had a statistically significant improvement at 7–10 days after TOC of interstitial (39.5 vs. 31.6%, p < 0.001), mixt (4.3 vs. 2.3%, p = 0.001) and consolidating (1.7 vs. 1.1%, p = 0.001) lesions. When TOC was administered at a FiO₂ ≤ 57.5% (oxygen flow rate ≤ 13 L/min), the associated mortality was significantly lower (4.3% vs. 29.1%, p < 0.05). (4) Conclusions: Quantitative imaging provides valuable information regarding the extent of lung damage which can be used to anticipate the in-hospital mortality. The timing of TOC administration is important and FiO₂ could be used as a clinical predictor. Full article

(This article belongs to the Topic Fighting against COVID-19: Latest Advances, Challenges and Methodologies)

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