Topic Editors

1. Molecular Imaging and Neuropathology Division, Columbia University and New York State Psychiatric Institute, New York, NY 10032, USA
2. New York State Psychiatric Institute, New York, NY 10032, USA
Department of Signal Theory, Telematics and Communications, University of Granada, 18071 Granada, Spain
Informatics Building School of Informatics, University of Leicester, Leicester LE1 7RH, UK

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

Abstract submission deadline
closed (31 December 2022)
Manuscript submission deadline
closed (31 March 2023)
Viewed by
369407

Topic Information

Dear Colleagues,

The 2019–20 coronavirus pandemic is an ongoing coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was declared a Public Health Emergency of International Concern and recognized as a pandemic by the World Health Organization. The outbreak of COVID-19 has rapidly spread to most countries in the world. There have been more than 351 million confirmed cases and 5.5 million deaths worldwide.

The scientific community must play a leading role to fight against COVID-19, and it is our obligation to step forward to assist in the eradication of COVID-19. For this purpose, it is important to find mechanisms, methodologies, models, techniques and/or systems capable of helping during the various stages of this pandemic: evolution, early diagnosis, prevention of spread, isolation measures, etc. Particularly, Artificial intelligence (AI) plays a vital role in fighting COVID-19. For example, AI techniques can help develop vaccines & targeted drugs for COVID-19. In epidemiology, AI can provide tracking and prediction of the spread speed of infected territories and areas to assist policymakers in making appropriate decisions. The visualization technology provides a global overview for policymakers. AI methods are efficient in making fast and accurate diagnoses of COVID-19 using trained models based on routine CT or X-ray. Wearable sensors with AI can monitor abnormality for home-based mild COVID-19 patients. AI can analyze human behavioral data to improve individual or community quarantine and social control policies. AI can help predict the protein structures of the coronavirus. AI can utilize the emotional data in the mental health of COVID-19 patients to help cope with self-quarantined people. AI can manage medical resources (e.g., face masks, ventilator, et al.) supply chain.

We are seeking contributions that report the Latest Advances, Challenges and Methodologies for Fighting against COVID-19. Investigations on mathematical models built on the pandemic prevalence and incidence are also welcome. Submissions should clarify the substantive improvements on work that has already been published, accepted for publication, or submitted in parallel to other conferences or journals.

Topics of interest include, but are not limited to, the following:

  • Data-driven AI for fighting COVID-19
  • Explainable AI for fighting COVID-19
  • Trustworthy AI for fighting COVID-19
  • Evolutionary AI for fighting COVID-19
  • Deep learning for fighting COVID-19
  • Multi-agent for fighting COVID-19
  • Multimodal fusion for fighting COVID-19
  • Feature extraction, selection, reduction, and optimization
  • Prediction and forecast for fighting COVID-19
  • Wearable systems to fighting against COVID-19
  • Statistical studies of future trends of COVID-19
  • Medical images analysis for fighting against COVID-19
  • Computer-aided systems for fighting against COVID-19
  • Machine learning models, methods, and theories

Prof. Dr. Zhengchao Dong
Prof. Dr. Juan Manuel Gorriz
Prof. Dr. Yudong Zhang
Topic Editors

Keywords

  • artificial intelligence
  • COVID-19
  • computed tomography
  • prevention and control
  • diagnostic test
  • epidemic dynamics
  • healthcare and infection
  • mathematical modeling
  • gene mutation
  • pandemic
  • pattern recognition
  • precision medicine
  • public health
  • SARS-CoV-2
  • vaccine
  • rehabilitation
  • risk and survival
  • SARS-CoV-2
  • social distancing
  • socioeconomic impacts
  • antiviral strategy
  • targeted drug
  • therapeutics
  • trustworthy AI
  • respiratory virus

Participating Journals

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

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Published Papers (162 papers)

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21 pages, 5195 KiB  
Article
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 1278
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
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14 pages, 312 KiB  
Review
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 799
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
14 pages, 3162 KiB  
Article
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
Viewed by 1517
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
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23 pages, 10493 KiB  
Article
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 1530
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
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19 pages, 898 KiB  
Article
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
Viewed by 1515
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
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14 pages, 1925 KiB  
Article
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 1526
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
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8 pages, 1454 KiB  
Article
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 1 | Viewed by 2304
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
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21 pages, 1838 KiB  
Article
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 2042
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
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12 pages, 1693 KiB  
Article
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
Viewed by 1688
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
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16 pages, 1528 KiB  
Article
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
Viewed by 1593
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
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16 pages, 1503 KiB  
Article
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 1807
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
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13 pages, 952 KiB  
Article
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 1375
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
7 pages, 535 KiB  
Article
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 1204
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
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12 pages, 2029 KiB  
Article
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
Viewed by 1226
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 (X2 = 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
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16 pages, 1701 KiB  
Article
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 1910
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
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8 pages, 2214 KiB  
Article
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 1307
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
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9 pages, 1131 KiB  
Article
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 2446
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
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14 pages, 2376 KiB  
Article
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 1248
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
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12 pages, 299 KiB  
Article
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 1610
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
10 pages, 1701 KiB  
Article
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 1565
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
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11 pages, 961 KiB  
Article
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 1653
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
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19 pages, 2533 KiB  
Review
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 2707
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
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13 pages, 862 KiB  
Article
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 1329
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
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19 pages, 802 KiB  
Article
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 1610
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
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13 pages, 654 KiB  
Article
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 1978
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
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21 pages, 1645 KiB  
Article
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 2482
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
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16 pages, 1886 KiB  
Systematic 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 2430
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
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26 pages, 17562 KiB  
Article
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 1473
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
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14 pages, 1275 KiB  
Article
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 5456
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
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20 pages, 1358 KiB  
Article
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 1289
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
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14 pages, 625 KiB  
Article
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 1772
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
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16 pages, 3550 KiB  
Review
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 2197
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
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10 pages, 496 KiB  
Article
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 1691
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
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9 pages, 941 KiB  
Article
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 1659
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
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10 pages, 863 KiB  
Article
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 1433
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
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15 pages, 6309 KiB  
Article
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 2388
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
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8 pages, 617 KiB  
Brief 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 1560
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
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17 pages, 687 KiB  
Article
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 1834
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
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15 pages, 859 KiB  
Article
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 1554
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
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11 pages, 702 KiB  
Article
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 1374
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
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6 pages, 312 KiB  
Brief 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 1584
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
12 pages, 822 KiB  
Article
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 1331
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
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12 pages, 3250 KiB  
Article
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 1576
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
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13 pages, 1217 KiB  
Article
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 1593
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
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7 pages, 1425 KiB  
Commentary
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 2681
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
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8 pages, 689 KiB  
Article
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 1286
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
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12 pages, 601 KiB  
Review
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 1517
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
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13 pages, 531 KiB  
Article
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 1375
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
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11 pages, 472 KiB  
Article
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 2138
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
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14 pages, 5557 KiB  
Article
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 1490
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
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10 pages, 778 KiB  
Article
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 1560
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
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10 pages, 1627 KiB  
Article
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 1952
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
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10 pages, 695 KiB  
Article
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 2113
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
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7 pages, 437 KiB  
Communication
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 1704
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
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2 pages, 176 KiB  
Comment
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 1073
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
15 pages, 408 KiB  
Review
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 2025
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
13 pages, 631 KiB  
Article
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 1857
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
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8 pages, 687 KiB  
Article
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 1383
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
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13 pages, 1986 KiB  
Article
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 1695
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
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14 pages, 837 KiB  
Review
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 2077
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
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31 pages, 3190 KiB  
Article
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 2810
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
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42 pages, 50533 KiB  
Article
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 2233
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 μm 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
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11 pages, 756 KiB  
Article
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 1572
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
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16 pages, 316 KiB  
Article
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 1990
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
12 pages, 1082 KiB  
Article
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 2400
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
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9 pages, 678 KiB  
Article
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 2035
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
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24 pages, 4333 KiB  
Article
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 6268
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
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21 pages, 4323 KiB  
Article
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 2741
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
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11 pages, 336 KiB  
Article
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 1878
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
10 pages, 347 KiB  
Article
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 2601
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
16 pages, 340 KiB  
Article
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 2072
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
9 pages, 412 KiB  
Article
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 1718
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
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11 pages, 259 KiB  
Article
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 1971
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
13 pages, 917 KiB  
Article
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 2012
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
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17 pages, 738 KiB  
Review
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 2995
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
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20 pages, 15792 KiB  
Article
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 1796
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
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15 pages, 3924 KiB  
Article
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 2331
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
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11 pages, 1663 KiB  
Article
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 1261
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
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13 pages, 1922 KiB  
Article
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 4064
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
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3 pages, 229 KiB  
Comment
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 1326
Abstract
We read with interest the original paper by Fernández-de-las-Peñas et al. [...] Full article
11 pages, 1537 KiB  
Article
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 1749
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
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13 pages, 1918 KiB  
Article
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 2429
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
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12 pages, 1797 KiB  
Article
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 1360
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
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17 pages, 2666 KiB  
Article
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 2558
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
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17 pages, 5161 KiB  
Article
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 6 | Viewed by 2492
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
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10 pages, 247 KiB  
Article
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 2233
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
16 pages, 1820 KiB  
Article
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 2518
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
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17 pages, 1143 KiB  
Article
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 1690
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
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8 pages, 307 KiB  
Article
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 1730
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
18 pages, 540 KiB  
Review
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 2145
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
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10 pages, 348 KiB  
Article
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 5 | Viewed by 1893
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
13 pages, 1607 KiB  
Article
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 5541
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
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20 pages, 9745 KiB  
Article
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 1886
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
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11 pages, 1143 KiB  
Article
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 1885
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
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14 pages, 378 KiB  
Article
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 1512
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 longitudina