Burden of COVID-19 in Different Countries

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Viruses viruses	4.7	7.1	2009	13.8 Days	CHF 2600
Life life	3.2	2.7	2011	17.5 Days	CHF 2600
International Journal of Environmental Research and Public Health ijerph	-	5.4	2004	29.6 Days	CHF 2500
Healthcare healthcare	2.8	2.7	2013	19.5 Days	CHF 2700
COVID covid	-	-	2021	16.8 Days	CHF 1000

17 pages, 1422 KiB

Open AccessArticle

Alcohol Use of German Adults during Different Pandemic Phases: Repeated Cross-Sectional Analyses in the COVID-19 Snapshot Monitoring Study (COSMO)

by Melanie Koeger, Hannah Schillok, Stephan Voss, Michaela Coenen, Christina Merkel, Caroline Jung-Sievers and On behalf of the COSMO Study Team

Int. J. Environ. Res. Public Health 2022, 19(9), 5489; https://doi.org/10.3390/ijerph19095489 - 01 May 2022

Viewed by 1676

Abstract

There is little evidence on how different COVID-19 pandemic phases influence the alcohol use behaviour of adults. The objective of this study is to investigate alcohol use frequency over different COVID-19 pandemic phases and to identify vulnerable subgroups for risky use behaviour in [...] Read more.

There is little evidence on how different COVID-19 pandemic phases influence the alcohol use behaviour of adults. The objective of this study is to investigate alcohol use frequency over different COVID-19 pandemic phases and to identify vulnerable subgroups for risky use behaviour in the German adult population. Survey waves of 14/15 April 2020 (n = 1032), 23/24 June 2020 (n = 993), and 26/27 January 2021 (n = 1001) from the COVID-19 Snapshot Monitoring (COSMO) were analysed. The mean age was 46 ± 15.3 years in April, 46 ± 15.5 years in June, and 45 ± 15.5 years in January. The gender ratio was mostly equal in each survey wave. Descriptive analyses and univariate and multivariate logistic regression analyses for individuals with increased alcohol use frequency (AUF) were performed. 13.2% in April (lockdown), 11.3% in June (easement), and 8.6% in January (lockdown) of participants showed an increased AUF. Individuals with perceived burden, high frustration levels due to protective measures, and young to middle-aged adults were more likely to increase their AUF during different pandemic phases. In conclusion, unfavourable alcohol behaviour might occur as a potentially maladaptive coping strategy in pandemics. Because of potential negative long-term consequences of problematic alcohol use behaviour on health, public health strategies should consider mental health consequences and target addictive behaviour, while also guiding risk groups towards healthy coping strategies such as physical activities during pandemics/crises. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 1555 KiB

Open AccessArticle

The Impact of COVID-19 on the Mental Well-Being of College Students

by Natalia Sauer, Agnieszka Sałek, Wojciech Szlasa, Tomasz Ciecieląg, Jakub Obara, Sara Gaweł, Dominik Marciniak and Katarzyna Karłowicz-Bodalska

Int. J. Environ. Res. Public Health 2022, 19(9), 5089; https://doi.org/10.3390/ijerph19095089 - 22 Apr 2022

Cited by 9 | Viewed by 3327

Abstract

The COVID-19 pandemic has caused an overall increase in stress and depression in society. The aim of the present research was to evaluate the psychological condition of college students during the COVID-19 pandemic and explore factors influencing their daily functioning. The study focused [...] Read more.

The COVID-19 pandemic has caused an overall increase in stress and depression in society. The aim of the present research was to evaluate the psychological condition of college students during the COVID-19 pandemic and explore factors influencing their daily functioning. The study focused on four main aspects such as mental well-being, sexuality, concern about financial status, and trust in medical authorities. The study was based on a specially designed survey. The questionnaire was created using Google Forms and shared on social media sites. A total of 630 students participated in the survey, 17 surveys were excluded due to incomplete data and 613 surveys (97.30%) were considered for the final analysis. During isolation, 68.0% of students experienced fear of missing out (FOMO). A total of 73.4% were frustrated due to spending a lot of time in front of a computer. A significant decrease in motivation to study was reported by 78.1% of the respondents. Students showed significantly different attitudes towards sexuality. Concern about the financial situation was reported by 48.7% of respondents. The state of the Polish economy was of concern to 86.4% of respondents. A total of 74.5% of students declared concern about their career development. During the pandemic, 59.0% of respondents became concerned about their health. The attitude towards vaccination was described as positive by 82.5% of the respondents. The percentage of respondents experiencing negative psychological effects relative to the overall epidemiological situation of COVID-19 is troubling. Given the unexpected length and severity of the pandemic, we suggest that students’ concerns be more thoroughly understood and addressed. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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21 pages, 2298 KiB

Open AccessArticle

Identification of Transcription Factors Regulating SARS-CoV-2 Tropism Factor Expression by Inferring Cell-Type-Specific Transcriptional Regulatory Networks in Human Lungs

by Haonan Tong, Hao Chen and Cranos M. Williams

Viruses 2022, 14(4), 837; https://doi.org/10.3390/v14040837 - 17 Apr 2022

Cited by 3 | Viewed by 2490

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that caused the coronavirus disease 2019 (COVID-19) pandemic. Though previous studies have suggested that SARS-CoV-2 cellular tropism depends on the host-cell-expressed proteins, whether transcriptional regulation controls SARS-CoV-2 tropism factors in human lung cells [...] Read more.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that caused the coronavirus disease 2019 (COVID-19) pandemic. Though previous studies have suggested that SARS-CoV-2 cellular tropism depends on the host-cell-expressed proteins, whether transcriptional regulation controls SARS-CoV-2 tropism factors in human lung cells remains unclear. In this study, we used computational approaches to identify transcription factors (TFs) regulating SARS-CoV-2 tropism for different types of lung cells. We constructed transcriptional regulatory networks (TRNs) controlling SARS-CoV-2 tropism factors for healthy donors and COVID-19 patients using lung single-cell RNA-sequencing (scRNA-seq) data. Through differential network analysis, we found that the altered regulatory role of TFs in the same cell types of healthy and SARS-CoV-2-infected networks may be partially responsible for differential tropism factor expression. In addition, we identified the TFs with high centralities from each cell type and proposed currently available drugs that target these TFs as potential candidates for the treatment of SARS-CoV-2 infection. Altogether, our work provides valuable cell-type-specific TRN models for understanding the transcriptional regulation and gene expression of SARS-CoV-2 tropism factors. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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2 pages, 159 KiB

Open AccessCorrection

Correction: Ntakolia et al. An Explainable Machine Learning Approach for COVID-19’s Impact on Mood States of Children and Adolescents during the First Lockdown in Greece. Healthcare 2022, 10, 149

by Charis Ntakolia, Dimitrios Priftis, Mariana Charakopoulou-Travlou, Ioanna Rannou, Konstantina Magklara, Ioanna Giannopoulou, Konstantinos Kotsis, Aspasia Serdari, Emmanouil Tsalamanios, Aliki Grigoriadou, Konstantina Ladopoulou, Iouliani Koullourou, Neda Sadeghi, Georgia O’Callaghan and Eleni Lazaratou

Healthcare 2022, 10(4), 657; https://doi.org/10.3390/healthcare10040657 - 31 Mar 2022

Cited by 1 | Viewed by 1469

Abstract

Argyris Stringaris was initially included as an author in the original publication [...] Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

17 pages, 2548 KiB

Open AccessArticle

Examining Psychosocial Factors and Community Mitigation Practices to Limit the Spread of COVID-19: Evidence from Nigeria

by Ekundayo Shittu, Funmilayo Adewumi, Nkemdilim Ene, Somto Chloe Keluo-Udeke and Chizoba Wonodi

Healthcare 2022, 10(3), 585; https://doi.org/10.3390/healthcare10030585 - 21 Mar 2022

Cited by 4 | Viewed by 2175

Abstract

We examine the psychosocial factors influencing community adoption of non-pharmaceutical interventions (NPI) to limit the spread of COVID-19. Using data from 990 respondents in communities across Nigeria, we examine the correlation of health behaviors and socioeconomic indicators. We conduct logistic regression to estimate [...] Read more.

We examine the psychosocial factors influencing community adoption of non-pharmaceutical interventions (NPI) to limit the spread of COVID-19. Using data from 990 respondents in communities across Nigeria, we examine the correlation of health behaviors and socioeconomic indicators. We conduct logistic regression to estimate the relationship between mask wearing as a health-seeking NPI with demographic and socioeconomic variables. We estimate separate models in the sensitivity robustness checks with other NPIs and control for differences across sex, age, education, number in household, and the presence of a student in the respondent’s household. A crucial finding is that health-seeking NPI behaviors are statistically significantly affected in different ways by the menu of socioeconomic indicators. The control for age, sex, education, and household size indicates that there is intersectionality of how these factors influence specific mitigation practices. We find that women are more likely to engage in mask wearing, hand washing, and use of hand sanitizers and tissues than men, and the provision of palliatives and access to family supplies significantly enhances community mitigation. Palliatives and access to family supplies enhance most health-seeking behaviors. The implication for pandemic mitigation policy is that minimizing incidence rates requires having responsive initiatives such as information updates on pandemic progression. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 811 KiB

Open AccessArticle

The Influence of Research Follow-Up during COVID-19 Pandemic on Mental Distress and Resilience: A Multicenter Cohort Study of Treatment-Resistant Depression

by Pham Thi Thu Huong, Chia-Yi Wu, Ming-Been Lee, Wei-Chieh Hung, I-Ming Chen and Hsi-Chung Chen

Int. J. Environ. Res. Public Health 2022, 19(6), 3738; https://doi.org/10.3390/ijerph19063738 - 21 Mar 2022

Viewed by 2091

Abstract

Background: During the COVID-19 outbreak, patients with mental disorders have faced more negative psychological consequences than the public. For people with treatment-resistant depression (TRD), it is unclear whether research engagement would protect them from the deterioration of their symptoms. The study aimed to [...] Read more.

Background: During the COVID-19 outbreak, patients with mental disorders have faced more negative psychological consequences than the public. For people with treatment-resistant depression (TRD), it is unclear whether research engagement would protect them from the deterioration of their symptoms. The study aimed to examine if chronic depressive patients would have improved resilience and mental distress levels after follow-up interviews during an observation period under COVID-19. Methods: The study was nested within a three-year prospective cohort study. A two-group comparison design was conducted, i.e., the follow-up group with regular research interviews every three months after baseline assessment and the control group with one assessment-only interview. The two groups were compared with demographics, psychosocial, and suicide information. Results: Baseline assessments were not significantly different in sociodemographic variables, suicide risks, mental distress, and resilience between groups. Significant differences were detected in resilient coping and mental distress levels (p < 0.05). The follow-up group (n = 46) experienced a higher level of resilient coping (37% vs. 25%) and lower level of mental distress (47.8% vs. 64.7%) than the control group (n = 68). Conclusions: Findings highlight under universal government strategy against COVID-19, TRD patients receiving regular research follow-ups exhibited better resilience and less mental distress than those without regular support from healthcare providers. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 894 KiB

Open AccessSystematic Review

Global Health Governance and Health Equity in the Context of COVID-19: A Scoping Review

by Wafa Abu El Kheir-Mataria, Hassan El-Fawal, Shahjahan Bhuiyan and Sungsoo Chun

Healthcare 2022, 10(3), 540; https://doi.org/10.3390/healthcare10030540 - 15 Mar 2022

Cited by 5 | Viewed by 3443

Abstract

Background: Health equity is an important aspect of responsible governance. COVID-19 exposed existing shortfalls of Global Health Governance (GHG). A considerable amount of related literature is produced. This scoping review aims at mapping the present knowledge and at identifying research gaps. Methods: This [...] Read more.

Background: Health equity is an important aspect of responsible governance. COVID-19 exposed existing shortfalls of Global Health Governance (GHG). A considerable amount of related literature is produced. This scoping review aims at mapping the present knowledge and at identifying research gaps. Methods: This scoping review is based on the Joanna Briggs Institute’s guideline for standardized methods and PRISMA-ScR guidelines for reporting. Documents published from December 2019 to October 2021 were searched using PubMed, Scopus, Google Scholar, World cat, and WHO-Global Index Medicus. Two reviewers screened and reviewed eligible studies in three stages: duplicates identification and elimination, title and abstract screening, and full-text assessment. Data was charted and results were classified into conceptual categories. Analysis was done in three stages: open descriptive coding, focused thematic analysis, and frequency, commonality and significance analysis. Results: forty-nine studies met the inclusion criteria. Areas of research were grouped into seven themes: “human rights and inequities”, “solidarity, collaboration and partnership”, “GHG structure change”, “political and economic power and finance”, “approaches to address inequity”, “law and regulations”, and “private investment and public-private partnerships (PPPs) in GHG”. The highest number of papers were in the first theme, “human rights and inequities”. However, the themes are interrelated. Authors who contributed to research were mostly affiliated to developed countries indicating a gap in knowledge and expertise in developing countries. Conclusion: Through this scoping review we found that the seven themes are interconnected. Disciplinary collaboration in research relating GHG to health inequities is solicited. Collaboration in research, information sharing, and research capacity development are in needed in developing countries. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 286 KiB

Open AccessArticle

Quality of Life among Caregivers of Patients Diagnosed with Major Chronic Disease during COVID-19 in Saudi Arabia

by Mohammed Aljuaid, Namrah Ilyas, Eman Altuwaijri, Haddel Albedawi, Ohoud Alanazi, Duaa Shahid and Wadi Alonazi

Healthcare 2022, 10(3), 523; https://doi.org/10.3390/healthcare10030523 - 13 Mar 2022

Cited by 7 | Viewed by 3128

Abstract

Quality of life (QoL) is considered one of the measures of health outcomes. Limited research studies have assessed family caregivers’ QoL, especially among patients diagnosed with chronic disease. This study measures the QoL of caregivers who guardian patients diagnosed with cardiovascular disease, diabetes, [...] Read more.

Quality of life (QoL) is considered one of the measures of health outcomes. Limited research studies have assessed family caregivers’ QoL, especially among patients diagnosed with chronic disease. This study measures the QoL of caregivers who guardian patients diagnosed with cardiovascular disease, diabetes, cancer, and/or other diseases during the COVID-19 pandemic. Participants were primary caregivers who were supporting, in the last six months, individuals diagnosed with one of the previously mentioned chronic diseases. This included caregivers of patients admitted to a tertiary hospital from January 2021 to July of the same year (n = 1081); all participants completed the World Health Organization Quality of Life Assessment tool (WHOQOL-BREF) questionnaire. Caregivers of patients with cancer reported the highest mean level of QoL, followed by diabetes, cardiovascular diseases, then other different diseases (M = 3.80; M = 3.38; M = 3.37; and M = 2.51, respectively). A chi-square test of independence was performed to examine the relationship between the QoL of the four groups and their behaviors (i.e., caregivers’ psychological onuses and physical actions/reactions). The relation between these variables was significant, X² (3, n = 1081) = 8.9, p = 0.001. The Kruskal–Wallis test indicated significant differences among the four groups (p ≤ 0.001). While the overall results of the QoL level of participants were low, a major recommendation of this study was to incorporate a QoL assessment to caregivers of chronically ill patients. Regular psychological and physical health check-ups of caregivers should be mandated in the healthcare system. Research studies should consider investigating and identifying the factors affecting health outcomes and positive developments which have a great impact on the wellbeing of both caregivers and patients on personal, organizational, and national levels. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

9 pages, 414 KiB

Open AccessViewpoint

Emerging SARS-CoV-2 Variants, Inequitable Vaccine Distribution, and Implications for COVID-19 Control in Sub-Saharan Africa

by Grant Murewanhema, Tafadzwa Dzinamarira, Innocent Chingombe, Munyaradzi Paul Mapingure, Solomon Mukwenha, Itai Chitungo, Helena Herrera, Roda Madziva, Solwayo Ngwenya and Godfrey Musuka

COVID 2022, 2(3), 341-349; https://doi.org/10.3390/covid2030023 - 10 Mar 2022

Cited by 4 | Viewed by 2792

Abstract

Since the onset of the COVID-19 pandemic, four SARS-CoV-2 variants of concern have emerged, which have shifted the clinical and epidemiological characteristics of the disease. Of concern is the impact of the emerging variants on COVID-19 vaccination programmes, with vaccination perceived as a [...] Read more.

Since the onset of the COVID-19 pandemic, four SARS-CoV-2 variants of concern have emerged, which have shifted the clinical and epidemiological characteristics of the disease. Of concern is the impact of the emerging variants on COVID-19 vaccination programmes, with vaccination perceived as a key global pandemic control strategy. Variants of concern can reduce the effectiveness of the currently available vaccines, shift herd immunity thresholds, and promote wider vaccine inequities as richer countries hoard vaccines for booster shots for their populations without accounting for the needs of the underdeveloped countries of sub-Saharan Africa. Currently, Africa lags far behind the rest of the world, with most sub-Saharan Africa countries still to reach 50% vaccination of their eligible populations against global herd immunity thresholds of 70–90%. As long as the vaccination gap between sub-Saharan Africa and the rest of the world persists, SARS-CoV-2 will most likely persist as a significant global health threat, with continued emergence of variants of concern. Therefore, strategies to ensure wider reach of different types of vaccines on the African continent are urgently required alongside fighting vaccine hesitancy and logistical barriers to access for the marginalized populations. Sub-Saharan Africa must look for opportunities to manufacture vaccines on the continent and enhance genomic sequencing capacity as key pandemic-control strategies. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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27 pages, 1625 KiB

Open AccessArticle

The Well-Being of the German Adult Population Measured with the WHO-5 over Different Phases of the COVID-19 Pandemic: An Analysis within the COVID-19 Snapshot Monitoring Study (COSMO)

by Fang-Yi Tsai, Hannah Schillok, Michaela Coenen, Christina Merkel, Caroline Jung-Sievers and on behalf of the COSMO Study Group

Int. J. Environ. Res. Public Health 2022, 19(6), 3236; https://doi.org/10.3390/ijerph19063236 - 09 Mar 2022

Cited by 8 | Viewed by 2577

Abstract

The aim of this study is to evaluate factors associated with the subjective well-being (SWB) and suspected depression measured with WHO-5 among German adults during different phases of the COVID-19 pandemic. Survey data were analyzed from the COVID-19 Snapshot Monitoring (COSMO) study, which [...] Read more.

The aim of this study is to evaluate factors associated with the subjective well-being (SWB) and suspected depression measured with WHO-5 among German adults during different phases of the COVID-19 pandemic. Survey data were analyzed from the COVID-19 Snapshot Monitoring (COSMO) study, which collected data from 972, 1013, and 973 participants in time point 1 (19–20 May 2020), time point 2 (15–16 September 2020), and time point 3 (21–22 December 2020), respectively. Descriptive analyses and logistic regression analyses to identify the factors associated with suspected depression (WHO-5 ≤ 50) were conducted. Data showed that the mean WHO-5 scores in three time points were 56.17, 57.27, and 53.93, respectively. The risk of suspected depression was increased by about 1.5 times for females, 2.5–3 times among 18–24 year-olds compared to ages above 65 years, 1.5 times for singles, 2 times for those with chronic illnesses, and 2–3 times for people living in poverty. The main study findings show that German adult SWB is lower than pre-pandemic reference values. Special focus should be placed on vulnerable groups, such as females, younger persons, and people living in poverty who are most prone to a reduction in SWB and therefore suspected depression. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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24 pages, 3714 KiB

Open AccessArticle

Residential Mobility of a Cohort of Homeless People in Times of Crisis: COVID-19 Pandemic in a European Metropolis

by Agathe Allibert, Aurélie Tinland, Jordi Landier, Sandrine Loubière, Jean Gaudart, Marine Mosnier, Cyril Farnarier, Pascal Auquier and Emilie Mosnier

Int. J. Environ. Res. Public Health 2022, 19(5), 3129; https://doi.org/10.3390/ijerph19053129 - 07 Mar 2022

Cited by 3 | Viewed by 2152

Abstract

Most vulnerable individuals are particularly affected by the COVID-19 pandemic. This study takes place in a large city in France. The aim of this study is to describe the mobility of the homeless population at the beginning of the health crisis and to [...] Read more.

Most vulnerable individuals are particularly affected by the COVID-19 pandemic. This study takes place in a large city in France. The aim of this study is to describe the mobility of the homeless population at the beginning of the health crisis and to analyze its impact in terms of COVID-19 prevalence. From June to August 2020 and September to December 2020, 1272 homeless people were invited to be tested for SARS-CoV-2 antibodies and virus and complete questionnaires. Our data show that homeless populations are sociologically different depending on where they live. We show that people that were living on the street were most likely to be relocated to emergency shelters than other inhabitants. Some neighborhoods are points of attraction for homeless people in the city while others emptied during the health crisis, which had consequences for virus circulation. People with a greater number of different dwellings reported became more infected. This first study of the mobility and epidemiology of homeless people in the time of the pandemic provides unique information about mobility mapping, sociological factors of this mobility, mobility at different scales, and epidemiological consequences. We suggest that homeless policies need to be radically transformed since the actual model exposes people to infection in emergency. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 1092 KiB

Open AccessArticle

Epidemiological Algorithm for Early Detection of COVID-19 Cases in a Mexican Oncologic Center

by Moisés González-Escamilla, Diana Cristina Pérez-Ibave, Carlos Horacio Burciaga-Flores, Vanessa Natali Ortiz-Murillo, Genaro A. Ramírez-Correa, Patricia Rodríguez-Niño, Rafael Piñeiro-Retif, Hazyadee Frecia Rodríguez-Gutiérrez, Fernando Alcorta-Nuñez, Juan Francisco González-Guerrero, Oscar Vidal-Gutiérrez and María Lourdes Garza-Rodríguez

Healthcare 2022, 10(3), 462; https://doi.org/10.3390/healthcare10030462 - 01 Mar 2022

Cited by 1 | Viewed by 2127

Abstract

An early detection tool for latent COVID-19 infections in oncology staff and patients is essential to prevent outbreaks in a cancer center. (1) Background: In this study, we developed and implemented two early detection tools for the radiotherapy area to identify COVID-19 cases [...] Read more.

An early detection tool for latent COVID-19 infections in oncology staff and patients is essential to prevent outbreaks in a cancer center. (1) Background: In this study, we developed and implemented two early detection tools for the radiotherapy area to identify COVID-19 cases opportunely. (2) Methods: Staff and patients answered a questionnaire (electronic and paper surveys, respectively) with clinical and epidemiological information. The data were collected through two online survey tools: Real-Time Tracking (R-Track) and Summary of Factors (S-Facts). Cut-off values were established according to the algorithm models. SARS-CoV-2 qRT-PCR tests confirmed the positive algorithms individuals. (3) Results: Oncology staff members (n = 142) were tested, and 14% (n = 20) were positives for the R-Track algorithm; 75% (n = 15) were qRT-PCR positive. The S-Facts Algorithm identified 7.75% (n = 11) positive oncology staff members, and 81.82% (n = 9) were qRT-PCR positive. Oncology patients (n = 369) were evaluated, and 1.36% (n = 5) were positive for the Algorithm used. The five patients (100%) were confirmed by qRT-PCR. (4) Conclusions: The proposed early detection tools have proved to be a low-cost and efficient tool in a country where qRT-PCR tests and vaccines are insufficient for the population. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 1041 KiB

Open AccessArticle

Quality of National Disease Surveillance Reporting before and during COVID-19: A Mixed-Method Study in Indonesia

by Muhammad Hardhantyo, Hanevi Djasri, Aldilas Achmad Nursetyo, Andriani Yulianti, Bernadeta Rachela Adipradipta, William Hawley, Jennifer Mika, Catharina Yekti Praptiningsih, Amalya Mangiri, Endang Burni Prasetyowati and Laura Brye

Int. J. Environ. Res. Public Health 2022, 19(5), 2728; https://doi.org/10.3390/ijerph19052728 - 26 Feb 2022

Cited by 3 | Viewed by 4368

Abstract

Background: Global COVID-19 outbreaks in early 2020 have burdened health workers, among them surveillance workers who have the responsibility to undertake routine disease surveillance activities. The aim of this study was to describe the quality of the implementation of Indonesia’s Early Warning and [...] Read more.

Background: Global COVID-19 outbreaks in early 2020 have burdened health workers, among them surveillance workers who have the responsibility to undertake routine disease surveillance activities. The aim of this study was to describe the quality of the implementation of Indonesia’s Early Warning and Response Alert System (EWARS) for disease surveillance and to measure the burden of disease surveillance reporting quality before and during the COVID-19 epidemic in Indonesia. Methods: A mixed-method approach was used. A total of 38 informants from regional health offices participated in Focus Group Discussion (FGD) and In-Depth Interview (IDI) for informants from Ministry of Health. The FGD and IDI were conducted using online video communication. Yearly completeness and timeliness of reporting of 34 provinces were collected from the application. Qualitative data were analyzed thematically, and quantitative data were analyzed descriptively. Results: Major implementation gaps were found in poorly distributed human resources and regional infrastructure inequity. National reporting from 2017–2019 showed an increasing trend of completeness (55%, 64%, and 75%, respectively) and timeliness (55%, 64%, and 75%, respectively). However, the quality of the reporting dropped to 53% and 34% in 2020 concomitant with the SARS-CoV2 epidemic. Conclusions: Report completeness and timeliness are likely related to regional infrastructure inequity and the COVID-19 epidemic. It is recommended to increase report capacities with an automatic EWARS application linked systems in hospitals and laboratories. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 1041 KiB

Open AccessArticle

Impact on Sleep Quality, Mood, Anxiety, and Personal Satisfaction of Doctors Assigned to COVID-19 Units

by Pilar Andrés-Olivera, Judit García-Aparicio, María Teresa Lozano López, José Antonio Benito Sánchez, Carmen Martín, Ana Maciá-Casas, Armando González-Sánchez, Miguel Marcos and Carlos Roncero

Int. J. Environ. Res. Public Health 2022, 19(5), 2712; https://doi.org/10.3390/ijerph19052712 - 25 Feb 2022

Cited by 4 | Viewed by 2025

Abstract

The SARS-CoV-2 health emergency has led to a restructuring of health care systems and the reassignment of medical specialists from their usual duties to attend COVID-19 patients. The aim of this paper is to describe the levels of insomnia, anxiety, depression, and the [...] Read more.

The SARS-CoV-2 health emergency has led to a restructuring of health care systems and the reassignment of medical specialists from their usual duties to attend COVID-19 patients. The aim of this paper is to describe the levels of insomnia, anxiety, depression, and the impact on quality of life of doctors who were on the frontline of COVID-19 during the first two waves of the pandemic. Self-report surveys were conducted on said physicians during both waves, with 83 and 61 responses in the first and second waves, respectively. The reported presence of insomnia was frequent (71.8%), although it decreased in the second survey. Anxiety was moderate, decreasing from 57.1% to 43.1% between measurements. Overall, depression rates decreased between the two surveys. Substance use was found to have an indirect correlation with personal and professional satisfaction. In the light of the unforeseeable evolution of the pandemic and the medium- to long-term repercussions on professionals, we believe the adaptation of health resources is crucial to meet the new unpredictable mental health needs of this group. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 482 KiB

Open AccessArticle

Risk Perception among Psychiatric Patients during the COVID-19 Pandemic

by Antimo Natale, Carmen Concerto, Alessandro Rodolico, Andrea Birgillito, Marina Bonelli, Miriam Martinez, Maria Salvina Signorelli, Antonino Petralia, Carmenrita Infortuna, Fortunato Battaglia and Eugenio Aguglia

Int. J. Environ. Res. Public Health 2022, 19(5), 2620; https://doi.org/10.3390/ijerph19052620 - 24 Feb 2022

Cited by 4 | Viewed by 1624

Abstract

The fear of the new coronavirus infection has driven many non-COVID-19 patients away from essential healthcare. Our study aimed to investigate the perception of risk and feelings of danger for the contagion in a sample of Italian psychiatric patients. We conducted a cross-sectional [...] Read more.

The fear of the new coronavirus infection has driven many non-COVID-19 patients away from essential healthcare. Our study aimed to investigate the perception of risk and feelings of danger for the contagion in a sample of Italian psychiatric patients. We conducted a cross-sectional observational study during the second wave of the COVID-19 pandemic and the lockdown in Italy. The risk perception and risk-related variables were assessed in a sample of 150 consecutive patients with a previous diagnosis of major depression (50), bipolar I disorder (50), and schizophrenia seeking ambulatory care using a questionnaire previously administered to the general Italian population. Our results showed that patients were more concerned about economic, psychological, and interpersonal consequences of COVID-19 pandemic, rather than about their own health. At the multiple regression analysis, the likelihood of COVID-19 resolution was positively influenced by the diagnosis of schizophrenia, the increased perceived effectiveness, and the presence of positive emotions. Indeed, positive emotions and uncertainty positively influenced interpersonal risk. Our study highlights the need to provide more support to psychiatric patients during emergency events to prevent them from engaging in risky behaviors. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

20 pages, 1813 KiB

Open AccessArticle

Prevalence Estimates and Risk Factors of Anxiety among Healthcare Workers in Jordan over One Year of the COVID-19 Pandemic: A Cross-Sectional Study

by Ahmed Yassin, Abdel-Hameed Al-Mistarehi, Khalid El-Salem, Reema A. Karasneh, Sayer Al-Azzam, Aref A. Qarqash, Aws G. Khasawneh, Anas M. Zein Alaabdin and Ola Soudah

Int. J. Environ. Res. Public Health 2022, 19(5), 2615; https://doi.org/10.3390/ijerph19052615 - 24 Feb 2022

Cited by 12 | Viewed by 2055

Abstract

This study investigates the changes in prevalence estimates, severity, and risk factors of anxiety among healthcare workers (HCWs) over the first year of the COVID-19 pandemic. A survey was distributed among HCWs using snowball sampling, collecting their socio-demographics, occupation, and anxiety symptoms as [...] Read more.

This study investigates the changes in prevalence estimates, severity, and risk factors of anxiety among healthcare workers (HCWs) over the first year of the COVID-19 pandemic. A survey was distributed among HCWs using snowball sampling, collecting their socio-demographics, occupation, and anxiety symptoms as measured by the Generalized Anxiety Disorder-7 (GAD-7) scale. It was distributed one month after the pandemic’s onset in Jordan between 15 and 30 April 2020 (onset group) and after one year between 15 and 30 March 2021 (one-year group). A total of 422 HCWs were included (211 in each group). The one-year group reported a higher risk of GAD (30.8% vs. 16.6%; p = 0.001), a higher mean (SD) GAD-7 score (7.94 (5.29) vs. 6.15 (4.15); p < 0.001), and more severe symptoms (p = 0.003). Univariate analyses showed that participants who were younger, women, unmarried, had lower monthly incomes, underwent testing for COVID-19, had higher contact with COVID-19 patients, did not receive special education, and were unsatisfied with the institutional COVID-19 preparedness scored higher on the GAD-7 scale and had more severe symptoms than their counterparts in both groups. Unlike the onset group, occupation as a physician, COVID-19 infection history, and perception of remarkable changes in work were associated with higher anxiety scores and severity among the one-year group. The COVID-19 vaccine was a relative protective action. Logistic regression analyses showed that the female gender was a risk factor for developing GAD at the pandemic onset, while poor satisfaction with institutional preparedness was a significant GAD risk factor in the one-year group. Low monthly income and lack of special education were the shared risk factors for GAD in both groups. This study reveals a significant rise in anxiety among HCWs over a year of the COVID-19 pandemic and shows the vulnerable sub-groups who likely need psychological interventions. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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22 pages, 2100 KiB

Open AccessArticle

Development and Validation of the COVID-19 Knowledges and Behavior Questionnaire in a French Population (CoVQuest-CC)

by Elise Verot, Paul Bonjean, Robin Chaux, Julie Gagnaire, Amandine Gagneux-Brunon, Bruno Pozzetto, Philippe Berthelot, Elisabeth Botelho-Nevers and Franck Chauvin

Int. J. Environ. Res. Public Health 2022, 19(5), 2569; https://doi.org/10.3390/ijerph19052569 - 23 Feb 2022

Cited by 2 | Viewed by 1930

Abstract

Background: The SARS-CoV-2 pandemic has led most countries to take restrictive measures affecting social activities and individual freedoms to limit viral transmission. It was shown that practical, motivational and social barriers impact on adherence to the isolation and social distancing measures advocated by [...] Read more.

Background: The SARS-CoV-2 pandemic has led most countries to take restrictive measures affecting social activities and individual freedoms to limit viral transmission. It was shown that practical, motivational and social barriers impact on adherence to the isolation and social distancing measures advocated by the health authorities. The purpose of this study was to develop and validate a COVID-19 Knowledges and Behavior Questionnaire adapted to a teenager and adult French population. Methods: CoVQuest-CC was developed by a multidisciplinary team made of infectious diseases physicians, medical virologist, specialists of infectious control, experts of the questionnaires methodology, experts in public health and prevention, and statisticians. CoVQuest-CC was responded to by a big cohort from the general population during their participation in a massive SARS-CoV-2 screening campaign in 2021 in Saint-Etienne, France. Results: The confirmatory factorial analysis yielded good results (CFI = 0.94, TLI = 0.94, RMSEA = 0.04), and confirmed the five-dimensional structure of the questionnaire. Each dimension had a satisfying internal consistency, with Cronbach alphas of 0.83, 0.71, 0.65, 0.72 and 0.83 for transmission knowledge, barrier gesture respect, tests acceptability, home isolation possibility and test practicability, respectively. Conclusions: According to our knowledge, CoVQuest-CC is the first validated, consistent and reliable self-administrated French-specific questionnaire investigating the general population’s knowledge and attitudes towards COVID-19. It shows acceptable psychometric properties and can be use by Public Health teams or caregivers for public health and research purposes. Trial Registration: The study protocol was approved by the IRB ILE-DE-FRANCE 1 (No. IRB: I ORG0009918). All participants were given written and verbal information about the study and gave informed consent to participate. ClinicalTrials.gov identifier (NCT number): NCT04859023. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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5 pages, 216 KiB

Open AccessCommunication

BA.1 Omicron Variant of SARS-CoV-2: First Case Reported in Calabria Region, Italy

by Cinzia Peronace, Rossana Tallerico, Manuela Colosimo, Marco De Fazio, Federica Pasceri, Ilenia Talotta, Giuseppina Panduri, Letizia Pintomalli, Rosaria Oteri, Valeria Calantoni, Maria Teresa Fiorillo, Luca Gallelli, Erika Cione and Pasquale Minchella

COVID 2022, 2(3), 211-215; https://doi.org/10.3390/covid2030016 - 22 Feb 2022

Cited by 3 | Viewed by 2427

Abstract

In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of coronavirus disease 2019 (COVID-19), emerged in Wuhan, China. Several variants of concern (VOCs) have been identified so far. Recently, the B.1.1.529 (Omicron) variant of SARS-CoV-2 spread rapidly worldwide. We [...] Read more.

In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of coronavirus disease 2019 (COVID-19), emerged in Wuhan, China. Several variants of concern (VOCs) have been identified so far. Recently, the B.1.1.529 (Omicron) variant of SARS-CoV-2 spread rapidly worldwide. We describe the first case of the Omicron genetic lineage BA.1 in our region. The patient is a physician who traveled to Johannesburg (South Africa) and returned to Reggio Calabria (Italy). He underwent a SARS-CoV-2 screening before leaving—a required procedure where travelers present a negative PCR test one-day prior to departing. Three days after arriving in Italy, he started experiencing cold symptoms. Clinically, he was without fever or severe respiratory symptoms and reported suffering from a cold and sore throat. The nasopharyngeal swab specimen was tested by TaqPath COVID-19 RT-PCR and sequenced by Sanger sequencing, and next-generation sequencing (NGS) data were processed with their relative software. A peculiar drop-off of the S gene was obtained with TaqPath COVID-19 RT-PCR. S gene mutations indicative of the Omicron variant were obtained with both sequencing methods, pointing out 17 mutations in the 29 recognized by Sanger and the 28 recognized by NGS. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

19 pages, 2658 KiB

Open AccessArticle

The Longevity-Frailty Hypothesis: Evidence from COVID-19 Death Rates in Europe

by Sammy Zahran, Levi Altringer and Ashok Prasad

Int. J. Environ. Res. Public Health 2022, 19(4), 2434; https://doi.org/10.3390/ijerph19042434 - 20 Feb 2022

Cited by 5 | Viewed by 3092

Abstract

By the end of spring (31 May), the COVID-19 death rate was remarkably unevenly distributed across the countries in Europe. While the risk of COVID-19 mortality is known to increase with age, age-specific COVID-19 death rates across Europe were similarly unevenly distributed. To [...] Read more.

By the end of spring (31 May), the COVID-19 death rate was remarkably unevenly distributed across the countries in Europe. While the risk of COVID-19 mortality is known to increase with age, age-specific COVID-19 death rates across Europe were similarly unevenly distributed. To explain these mortality distributions, we present a simple model where more favorable survival environments promote longevity and the accumulation of health frailty among the elderly while less favorable survival environments induce a mortality selection process that results in lower health frailty. Because the age-related conditions of frailty render the elderly less resistant to SARS-CoV-2, pre-existing survival environments may be non-obviously positively related to the COVID-19 death rate. To quantify the survival environment parameter of our model, we leveraged historic cohort- and period-based age-specific probabilities of death and life expectancies at age 65 across Europe. All variables are significantly correlated with indicators of frailty like elderly dependence on others for personal and household care for a subset of European countries. With respect to COVID-19 death rates, we find significant positive relationships between our survival indicators and COVID-19 death rates across Europe, a result that is robust to statistical control for the capacity of a healthcare system to treat and survive infected persons, the timing and stringency of non-pharmaceutical interventions, population density, age structure, case rates and the volume of inbound international travelers, among other factors. To address possible concerns over reporting heterogeneity across countries, we show that results are robust to the substitution of our response variable for a measure of cumulative excess mortality. Also consistent with the intuition of our model, we also show a strong negative association between age-specific COVID-19 death rates and pre-existing all-cause age-specific mortality rates for a subset of European countries. Overall, results support the notion that variation in pre-existing frailty, resulting from heterogeneous survival environments, partially accounts for striking differences in COVID-19 death during the first wave of the pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 504 KiB

Open AccessArticle

Bacterial Coinfections Increase Mortality of Severely Ill COVID-19 Patients in Saudi Arabia

by Abdulaziz Alqahtani, Edrous Alamer, Mushtaq Mir, Ali Alasmari, Mohammed Merae Alshahrani, Mohammed Asiri, Irfan Ahmad, Abdulaziz Alhazmi and Abdullah Algaissi

Int. J. Environ. Res. Public Health 2022, 19(4), 2424; https://doi.org/10.3390/ijerph19042424 - 19 Feb 2022

Cited by 31 | Viewed by 3506

Abstract

Coronavirus disease 19 (COVID-19) is an ongoing global pandemic that is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The severity and mortality rates of COVID-19 are affected by several factors, such as respiratory diseases, diabetes, and hypertension. Bacterial coinfections are another [...] Read more.

Coronavirus disease 19 (COVID-19) is an ongoing global pandemic that is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The severity and mortality rates of COVID-19 are affected by several factors, such as respiratory diseases, diabetes, and hypertension. Bacterial coinfections are another factor that could contribute to the severity of COVID-19. Limited studies have investigated morbidity and mortality due to microbial coinfections in COVID-19 patients. Here, we retrospectively studied the effects of bacterial coinfections on intensive care unit (ICU)-admitted patients with COVID-19 in Asir province, Saudi Arabia. We analyzed electronic medical records of hospitalized patients with COVID-19 at Asir Central Hospital. A total of 34 patients were included, and the clinical data of 16 patients infected with SARS-CoV-2 only and 18 patients coinfected with SARS-CoV-2 and bacterial infections were analyzed in our study. Our data showed that the length of stay at the hospital for patients infected with both SARS-CoV-2 and bacterial infection was 35.2 days, compared to 16.2 days for patients infected with only SARS-CoV-2 (p = 0.0001). In addition, higher mortality rates were associated with patients in the coinfection group compared to the SARS-CoV-2-only infected group (50% vs. 18.7%, respectively). The study also showed that gram-negative bacteria are the most commonly isolated bacteria in COVID-19 patients. To conclude, this study found that individuals with COVID-19 who presented with bacterial infections are at higher risk for a longer stay at the hospital and potentially death. Further studies with a larger population are warranted to better understand the clinical outcomes of COVID-19 with bacterial infections. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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20 pages, 441 KiB

Open AccessArticle

‘Who Else If Not We’. Medical Students’ Perception and Experiences with Volunteering during the COVID-19 Crisis in Poznan, Poland

by Jan Domaradzki

Int. J. Environ. Res. Public Health 2022, 19(4), 2314; https://doi.org/10.3390/ijerph19042314 - 17 Feb 2022

Cited by 16 | Viewed by 2841

Abstract

Introduction: The first wave of the COVID-19 pandemic resulted in the closure of all Polish medical universities. Simultaneously, due to staff shortages and the Polish health-care system being seriously challenged, many students were eager to contribute to the fight against the outbreak. This [...] Read more.

Introduction: The first wave of the COVID-19 pandemic resulted in the closure of all Polish medical universities. Simultaneously, due to staff shortages and the Polish health-care system being seriously challenged, many students were eager to contribute to the fight against the outbreak. This study explores medial student volunteers’ (MSV) perspectives and their lived experiences during the COVID-19 pandemic in Poland. Material and Methods: Semi-structured interviews were conducted with twenty-one students. Results: A total of seven major themes emerged from the interviews: 1. students’ reactions to the COVID-19 pandemic, 2. students’ experiences of the outbreak, 3. motivations for volunteering, 4. students’ perceptions of the COVID-19 volunteering, 5. organization of students’ volunteering, 6. benefits and costs of volunteering during COVID-19, and 7. social perception of MSVs. Although students volunteering was an example of civic responsibility and created new learning opportunities, many students felt unprepared for the pandemic, lacked social skills and access to psychological support, and were the target of stigmatization and discrimination. Discussion: Because during the first wave of the COVID-19 pandemic medical universities were closed and classes were held online, students’ volunteering became an important part of service learning and created an opportunity for education. Consequently, while it benefited students, patients and the healthcare system, students’ involvement reinforced such important values of medical ethos as: altruism, public service, and (professional) solidarity. However, some systemic approach should be undertaken that would prepare students better for future crises. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 10136 KiB

Open AccessArticle

Seropositivity of SARS-CoV-2 in the Population of Kazakhstan: A Nationwide Laboratory-Based Surveillance

by Yuliya Semenova, Zhanna Kalmatayeva, Ainash Oshibayeva, Saltanat Mamyrbekova, Aynura Kudirbekova, Ardak Nurbakyt, Ardak Baizhaxynova, Paolo Colet, Natalya Glushkova, Alexandr Ivankov and Antonio Sarria-Santamera

Int. J. Environ. Res. Public Health 2022, 19(4), 2263; https://doi.org/10.3390/ijerph19042263 - 17 Feb 2022

Cited by 3 | Viewed by 1761

Abstract

The data on seroprevalence of anti-SARS-CoV-2 antibodies in Kazakhstani population are non-existent, but are needed for planning of public health interventions targeted to COVID-19 containment. The aim of the study was to estimate the seropositivity of SARS-CoV-2 infection in the Kazakhstani population from [...] Read more.

The data on seroprevalence of anti-SARS-CoV-2 antibodies in Kazakhstani population are non-existent, but are needed for planning of public health interventions targeted to COVID-19 containment. The aim of the study was to estimate the seropositivity of SARS-CoV-2 infection in the Kazakhstani population from 2020 to 2021. We relied on the data obtained from the results from “IN VITRO” laboratories of enzyme-linked immunosorbent assays for class G immunoglobulins (IgG) and class M (IgM) to SARS-CoV-2. The association of COVID-19 seropositivity was assessed in relation to age, gender, and region of residence. Additionally, we related the monitoring of longitudinal seropositivity with COVID-19 statistics obtained from Our World in Data. The total numbers of tests were 68,732 for SARS-CoV-2 IgM and 85,346 for IgG, of which 22% and 63% were positive, respectively. The highest rates of positive anti-SARS-CoV-2 IgM results were seen during July/August 2020. The rate of IgM seropositivity was the lowest on 25 October 2020 (2%). The lowest daily rate of anti-SARS-CoV-2 IgG was 17% (13 December 2020), while the peak of IgG seropositivity was seen on 6 June 2021 (84%). A longitudinal serological study should be envisaged to facilitate understanding of the dynamics of the epidemiological situation and to forecast future scenarios. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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18 pages, 1035 KiB

Open AccessArticle

Burnout Syndrome in a Military Tertiary Hospital Staff during the COVID-19 Contingency

by Adriana Martínez-Cuazitl, Iván Noé Martínez-Salazar, Guadalupe Maza-De La Torre, Jorge Arturo García-Dávila, Edgardo Alonso Montelongo-Mercado, Antonio García-Ruíz, Héctor Faustino Noyola-Villalobos, Mayra Gabriela García-Araiza, Sergio Hernández-Díaz, Dora Luz Villegas-Tapia, Eira Cerda-Reyes, Arleth Sarai Chávez-Velasco and Juan Salvador García-Hernández

Int. J. Environ. Res. Public Health 2022, 19(4), 2229; https://doi.org/10.3390/ijerph19042229 - 16 Feb 2022

Cited by 4 | Viewed by 2046

Abstract

(1) Background: Burnout syndrome (BOS) is defined as a psychological state of physical and mental fatigue associated with work. The COVID-19 pandemic greatly impacted the physical and mental wellbeing of health professionals. The objective of this work was to determine the impact on [...] Read more.

(1) Background: Burnout syndrome (BOS) is defined as a psychological state of physical and mental fatigue associated with work. The COVID-19 pandemic greatly impacted the physical and mental wellbeing of health professionals. The objective of this work was to determine the impact on personnel, monitoring the frequency of BOS throughout the pandemic. (2) Methods: The Maslach Burnout Inventory (MBI) was self-applied in four periods of the pandemic according to sociodemographic and employment characteristics. In this study, all hospital personnel were included; the association of BOS with sex, age, type of participant (civilian or military), military rank and profession was analyzed. (3) Results: The frequency of BOS was 2.4% (start of the pandemic), 7.9% (peak of the first wave), 3.7% (end of the first wave) and 3.6% (peak of the third wave). Emotional exhaustion (EE) was the most affected factor, and the groups most affected were men under 30 years of age, civilians, chiefs and doctors, especially undergraduate medical doctors and specialty resident doctors, and nursing personnel were less affected. (4) Conclusions: The low BOS levels show that the containment measures and military training implemented by the hospital authorities were effective, although the chief personnel were more affected in the first wave. It is probable that this combination allowed the containment of BOS, which was not observed in civilians. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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22 pages, 456 KiB

Open AccessReview

Lockdowns and Physical Activities: Sports in the Time of COVID

by Mónika Harangi-Rákos, Christa Pfau, Éva Bácsné Bába, Bence András Bács and Péter Miklós Kőmíves

Int. J. Environ. Res. Public Health 2022, 19(4), 2175; https://doi.org/10.3390/ijerph19042175 - 15 Feb 2022

Cited by 15 | Viewed by 4468

Abstract

As aging causes challenges in several countries globally, more and more people are suffering from bad health conditions. Nowadays, COVID-19 causes many problems—and one of the root causes of these problems is the isolation of people from each other. The aim of our [...] Read more.

As aging causes challenges in several countries globally, more and more people are suffering from bad health conditions. Nowadays, COVID-19 causes many problems—and one of the root causes of these problems is the isolation of people from each other. The aim of our article is to investigate the effects of COVID-19 on people’s physical activity. Physical activity is strongly correlated with health status and health preservation is very important to minimize the negative effects of the pandemic. In order to investigate this topic, we prepared an extended literature review, citing the most important sources of COVID-related health-preservation issues. Our results showed that the negative economic effects of the coronavirus pandemic have caused a decrease in physical activities in several cases. A reduction in possible physical activities has a potential negative effect on the life expectancies of elderly people. In order to underline the importance of physical activities, we prepared an extended literature review, aiming to summarize the available knowledge related to COVID-19. As a conclusion we recommend to strengthen, maintain, and develop available sporting possibilities for people. The most important of these recommendations is the development of physical activities that are available for free. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

10 pages, 340 KiB

Open AccessReview

Do COVID-19 and Food Insecurity Influence Existing Inequalities between Women and Men in Africa?

by Heather VanVolkenburg, Isabelle Vandeplas, Katim Touré, Safiétou Sanfo, Fatoumata Lamarana Baldé and Liette Vasseur

Int. J. Environ. Res. Public Health 2022, 19(4), 2065; https://doi.org/10.3390/ijerph19042065 - 12 Feb 2022

Cited by 6 | Viewed by 2777

Abstract

This review sought to understand what is currently known about how the ongoing COVID-19 pandemic and restrictive measures are affecting food security and equality between women and men in all of Africa. A review of both the academic and grey literature was performed [...] Read more.

This review sought to understand what is currently known about how the ongoing COVID-19 pandemic and restrictive measures are affecting food security and equality between women and men in all of Africa. A review of both the academic and grey literature was performed by following PRISMA guidelines. Results showed that a general disparity exists in gender-inclusive/-sensitive research. Most reported increases in inequalities between women and men were predictive only. Evidence-based articles found were mainly conducted online and target tertiary educated populations, among which neutral effects were found. A general lack of disaggregated data (e.g., women vs. men) was found to be a barrier in gaining a complete understanding of the situation on-the-ground. Furthermore, documents reporting on food security seldom included all four pillars (i.e., availability, access, utility, stability) in their analysis despite the reciprocal connection between them all. Within household disparities and the impacts on power relationships within households were also overlooked. Future studies must focus on rural settings and gender disaggregated interview processes as well as consider all pillars of food security. Doing so will help to better inform governments and humanitarian groups leading to better designed policies and social supports that target where they are most needed. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

12 pages, 516 KiB

Open AccessArticle

Risk Perception Influence on Vaccination Program on COVID-19 in Chile: A Mathematical Model

by Juan Pablo Gutiérrez-Jara and Chiara Saracini

Int. J. Environ. Res. Public Health 2022, 19(4), 2022; https://doi.org/10.3390/ijerph19042022 - 11 Feb 2022

Cited by 6 | Viewed by 2081

Abstract

The SARS-CoV-2 virus emergency prompted unprecedented safety measures, which were accepted by the population of each country to different degrees, for example, with more or less willingness to use personal protective elements (PPEs). We have developed a mathematical model of the contagion process, [...] Read more.

The SARS-CoV-2 virus emergency prompted unprecedented safety measures, which were accepted by the population of each country to different degrees, for example, with more or less willingness to use personal protective elements (PPEs). We have developed a mathematical model of the contagion process, based on chilean data, to assess the interaction between biological factors (such as the impact of vaccination) and behavioral factors (such as the population’s perception of risk). The model clearly shows that the virus spreads through three waves of contagion, the second being the most prominent, regardless of any alteration in the variables taken into account, which only affect the overall number of people infected. By considering alternative values of the risk perception variable and examining the different possible scenarios, we have also found that the less reaction to change the population has (and the lower the disposition to use PPEs), the higher the waves of contagion and the death toll are. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 1362 KiB

Open AccessArticle

A “Ballpark” Assessment of Social Distancing Efficiency in the Early Stages of the COVID-19 Pandemic

by Taejong Kim and Hyosun Kim

Int. J. Environ. Res. Public Health 2022, 19(3), 1852; https://doi.org/10.3390/ijerph19031852 - 07 Feb 2022

Cited by 2 | Viewed by 1467

Abstract

This paper presents an efficiency assessment of social distancing as an internationally adopted measure to tackle the COVID-19 pandemic in 2020. The simple framework adopted for the assessment accounts for two kinds of costs that a society may bear in a pandemic. The [...] Read more.

This paper presents an efficiency assessment of social distancing as an internationally adopted measure to tackle the COVID-19 pandemic in 2020. The simple framework adopted for the assessment accounts for two kinds of costs that a society may bear in a pandemic. The first is welfare loss due to infection and its consequences, and the second is welfare loss resulting from a slowdown in economic transactions. We call the first infection costs, and the second economic costs, for convenience in the paper. Efficient social distancing should minimize the sum of these costs. Infection costs are likely to decrease with social distancing at a decreasing rate as intensified social distancing eases pressure on scarce resources for intensive care. Economic costs on the other hand are likely to increase at an increasing rate as extreme slowdown in economic life may entail job losses and business failures. The resulting U-shaped total costs curve implies parity between infection costs and economic costs as a necessary condition for efficiency. In a simplified implementation of the framework, we approximate infection costs by the value of (statistical) lives lost, and economic costs by the gap between the actual gross domestic product (GDP) in 2020 and the potential GDP as predicted by the within-country growth trend during the preceding decade. The results for 158 countries suggest that the global community perhaps reacted with overly strict social distancing measures. The results for the subgroup of high-income countries, however, suggest that these countries were more successful in maintaining the parity between infection and economic costs. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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8 pages, 489 KiB

Open AccessArticle

Prevalence of Post COVID-19 Condition in Primary Care: A Cross Sectional Study

by Patricia Montenegro, Irene Moral, Alicia Puy, Esther Cordero, Noa Chantada, Lluis Cuixart and Carlos Brotons

Int. J. Environ. Res. Public Health 2022, 19(3), 1836; https://doi.org/10.3390/ijerph19031836 - 06 Feb 2022

Cited by 14 | Viewed by 3423

Abstract

Background: The COVID-19 pandemic is a major challenge for health systems, citizens and policymakers worldwide. It is not known how many people are affected with longer term sequelae after acute COVID-19 and a wide range of prevalence estimates have been reported with a [...] Read more.

Background: The COVID-19 pandemic is a major challenge for health systems, citizens and policymakers worldwide. It is not known how many people are affected with longer term sequelae after acute COVID-19 and a wide range of prevalence estimates have been reported with a high heterogeneity between studies. Methods: We designed a cross-sectional study to estimate the prevalence of post COVID-19 conditions in a community setting. We selected a random sample of 579 individuals from three different primary health care centers and collected information on symptoms through a standardized questionnaire. Results: Our main study finding was an overall population prevalence of 14.34% (95% CI 11.58–17.46%) of post COVID-19. Only 9% of patients were hospitalized in our study. Prevalence was higher in women than men (15.63% versus 13.06%) and the most frequent persistent symptoms were fatigue (44.6%), smell impairment (27.7%) and dyspnea (24.09%). Conclusions: The prevalence of post COVID-19 condition was lower than expected according to other studies published in the literature. The prevalence was higher in women than men, and the most frequent persistent symptoms were fatigue, smell impairment, and dyspnea. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 553 KiB

Open AccessArticle

Latent Class Analysis of Health Behavior Changes Due to COVID-19 among Middle-Aged Korean Workers

by Eun-Hi Choi, Won-Jong Kim and Eun-Mi Baek

Int. J. Environ. Res. Public Health 2022, 19(3), 1832; https://doi.org/10.3390/ijerph19031832 - 06 Feb 2022

Cited by 3 | Viewed by 2002

Abstract

The purpose of this study was to identify the latent class for changes in health behavior due to COVID-19, reveal the characteristics of participants by type, and identify predictive factors for these types. The participants of this study were office workers between the [...] Read more.

The purpose of this study was to identify the latent class for changes in health behavior due to COVID-19, reveal the characteristics of participants by type, and identify predictive factors for these types. The participants of this study were office workers between the ages of 40 and 60 and secondary data from the 2020 Community Health Survey of G city was utilized. Latent class analysis was performed on physical activities such as walking and exercise, eating fast food or carbonated drinks, eating delivered food, drinking alcohol, and smoking. Three types of health behavior changes due to COVID-19 were found: (1) decrease in all health behavior type, (2) increase in fast food and delivered food type, and (3) increase in smoking maintenance type. Second, the variables predicting the three types after controlling for general characteristics were health problems, social distancing among the COVID-19 quarantine rules, refraining from going out, and meeting with friends and neighbors and had an impact on COVID-19 life. It is necessary to strengthen non-face-to-face health promotion activities along with quarantine rules for COVID-19. In addition, there is a need for a health management plan for people with non-visible risk factors such as obesity and high blood pressure. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 342 KiB

Open AccessArticle

Is Lower Trust in COVID-19 Regulations Associated with Academic Frustration? A Comparison between Danish and German University Students

by Julia Ballmann, Stefanie M. Helmer, Gabriele Berg-Beckhoff, Julie Dalgaard Guldager, Signe Smith Jervelund, Heide Busse, Claudia R. Pischke, Sarah Negash, Claus Wendt and Christiane Stock

Int. J. Environ. Res. Public Health 2022, 19(3), 1748; https://doi.org/10.3390/ijerph19031748 - 03 Feb 2022

Cited by 5 | Viewed by 1740

Abstract

Despite the proximity of both countries, Danes and Germans differ in the level of trust in their government. This may play a role with respect to the disruptive impact of the COVID-19 pandemic on university students. This study investigated the association between trust [...] Read more.

Despite the proximity of both countries, Danes and Germans differ in the level of trust in their government. This may play a role with respect to the disruptive impact of the COVID-19 pandemic on university students. This study investigated the association between trust in governmental regulations, trust in university regulations, risk perceptions, and academic frustration among Danish and German students. As part of the COVID-19 International Student Well-being Study, an online survey was distributed among university students in participating European and non-European universities. In Denmark, 2945 students and Germany, 8725 students responded to the questionnaire between May and July 2020. Students from both countries reported approximately the same level of academic frustration concerning their progress and quality of education. However, German students perceived a higher risk of contracting SARS-CoV-2 compared to Danish respondents. Danish students showed higher trust in their government’s COVID-19 regulations than German students. Lower trust in government and university COVID-19 regulations and higher risk perception were associated with higher academic frustration. These results indicate that the level of trust in COVID-19 regulations might have an impact the overall frustration of students regarding their study conditions. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

9 pages, 1404 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on Atopic Dermatitis Patients

by Joanna Sieniawska, Aleksandra Lesiak, Karol Ciążyński, Joanna Narbutt and Magdalena Ciążyńska

Int. J. Environ. Res. Public Health 2022, 19(3), 1734; https://doi.org/10.3390/ijerph19031734 - 02 Feb 2022

Cited by 8 | Viewed by 2072

Abstract

Atopic dermatitis (AD) can have a significantly negative impact on quality of life (QoL). The impact of coronavirus disease 2019 (COVID-19) on the AD population is not yet well established. The study comprised 195 patients with diagnosed AD who were asked about their [...] Read more.

Atopic dermatitis (AD) can have a significantly negative impact on quality of life (QoL). The impact of coronavirus disease 2019 (COVID-19) on the AD population is not yet well established. The study comprised 195 patients with diagnosed AD who were asked about their cognitive and preventive behaviors regarding COVID-19 and the accessibility of medical support, including online consultations. Moreover, the patients responded to the self-reported Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HADS). Most of the patients were worried about being infected with COVID-19. Most of the patients believed that people suffering from skin disease were more prone to be infected with COVID-19 compared with the general population. Most the patients negatively assessed the availability of dermatological treatment during the pandemic. Furthermore, 66.1% of the patients declared using telemedicine. Nearly 50% of patients were discontented with telemedicine, and 1/3 of the patients did not mind the use of telemedicine. AD during the COVID-19 pandemic was associated with a lower overall health rating and life satisfaction and impaired QoL related to mental health in a Polish population. These results provide original information that can be applied in dermatologic patient screenings to evaluate the state of depression and anxiety during the epidemic period. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 3758 KiB

Open AccessArticle

Impacts of COVID-19 on Air Quality through Traffic Reduction

by Hyemin Hwang and Jae Young Lee

Int. J. Environ. Res. Public Health 2022, 19(3), 1718; https://doi.org/10.3390/ijerph19031718 - 02 Feb 2022

Cited by 10 | Viewed by 1914

Abstract

In 2020, the first case of COVID-19 was confirmed in Korea, and social distancing was implemented to prevent its spread. This reduced the movement of people, and changes in air quality were expected owing to reduced emissions. In the present paper, the impact [...] Read more.

In 2020, the first case of COVID-19 was confirmed in Korea, and social distancing was implemented to prevent its spread. This reduced the movement of people, and changes in air quality were expected owing to reduced emissions. In the present paper, the impact of traffic volume change caused by COVID-19 on air quality in Seoul, Korea, is examined. Two regression analyses were performed using the generalized additive model (GAM), assuming a Gaussian distribution; the relationships between (1) the number of confirmed COVID-19 cases in 2020–2021 and the rate of change in the traffic volume in Seoul, and (2) the traffic volume and the rate of change in the air quality in Seoul from 2016 to 2019 were analyzed. The regression results show that traffic decreased by 0.00431% per COVID-19 case; when traffic fell by 1%, the PM₁₀, PM_2.5, CO, NO₂, O₃, and SO₂ concentrations fell by 0.48%, 0.94%, 0.39%, 0.74%, 0.16%, and −0.01%, respectively. This mechanism accounts for air quality improvements in PM₁₀, PM_2.5, CO, NO₂, and O₃ in Seoul during 2020–2021. From these results, the majority of the reduction in pollutant concentrations in 2020–2021 appears to be the result of a long-term declining trend rather than COVID-19. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 2028 KiB

Open AccessArticle

A Prospective, Longitudinal Evaluation of SARS-CoV-2 COVID-19 Exposure, Use of Protective Equipment and Social Distancing in a Group of Community Physicians

by Eli D. Ehrenpreis, Sigrun Hallmeyer, David H. Kruchko, Alexea A. Resner, Nhan Dang, Natasha Shah, Nancy Mayer and Anne Rivelli

Healthcare 2022, 10(2), 285; https://doi.org/10.3390/healthcare10020285 - 01 Feb 2022

Cited by 1 | Viewed by 1783

Abstract

Introduction: Healthcare workers experience a significant risk of exposure to and infection from SARS-CoV-2, COVID-19. Nonetheless, little research has focused on physicians’ use of personal protective equipment (PPE), their concerns about becoming infected and their social distancing maneuvers. Methods: All staff physicians at [...] Read more.

Introduction: Healthcare workers experience a significant risk of exposure to and infection from SARS-CoV-2, COVID-19. Nonetheless, little research has focused on physicians’ use of personal protective equipment (PPE), their concerns about becoming infected and their social distancing maneuvers. Methods: All staff physicians at Advocate Lutheran General Hospital were invited to participate. Their COVID-19 IgG antibody level was measured and an online questionnaire was completed. The questionnaire assessed the risk of COVID-19 exposure, PPE usage, concern for contracting COVID-19, the performance of high-risk procedures, work in high-risk settings, and social distancing practices. Testing was performed in September (T0), and December 2020 (T1) at the height of the global pandemic. Results: A total of 481 (26.7%) of 1800 AGLH physicians were enrolled at T0 and 458 (95% of the original group) at T1. A total of 21 (4.3%) and 39 (8.5%) participants had antibodies at T0 and T1. A total of 63 (13.8%) worked in high-risk settings and 111 (24.2%) performed high-risk procedures. Participants working in high-risk settings had increased exposure to COVID-19 infected patients (OR = 4.464 CI = 2.522–8.459, p < 0.001). Participants were highly adherent to the use of PPE and social distancing practices including mask-wearing in public (86%, 82.1%), avoiding crowds (85.1%, 85.6%), six feet distancing (83.8%, 83.4%), and avoiding public transportation (78%, 83.8%). A total of 251 (55.4%) participants expressed moderate to extreme concern about becoming infected with COVID-19. Conclusions and Relevance: Among a group of community physicians, consistent PPE use and social distancing practices were common. These practices were associated with a low level of initial acquisition of COVID-19 infections and a relatively low longitudinal risk of infection. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 1821 KiB

Open AccessStudy Protocol

Neurological, Psychiatric, and Psychological Implications of the COVID-19 Pandemic: Protocol for a Large-Scale Umbrella Review of Observational Studies

by Ta-Chuan Yeh, Chih-Sung Liang, Chia-Kuang Tsai, Marco Solmi, Beny Lafer, Ping-Tao Tseng, Chih-Wei Hsu, Pao-Yen Lin, Joseph Firth, Brendon Stubbs, Lamiece Hassan, Michele Fornaro, Eduard Vieta, Trevor Thompson, Jaeil Shin and Andre F. Carvalho

Int. J. Environ. Res. Public Health 2022, 19(3), 1681; https://doi.org/10.3390/ijerph19031681 - 01 Feb 2022

Cited by 1 | Viewed by 2373

Abstract

The severe acute respiratory syndrome coronavirus 2 disease (SARS-CoV-2) is the most severe manifestation of the coronavirus disease 2019 (COVID-19) pandemic. Accruing evidence indicates that the COVID-19 pandemic may have profound deleterious neurological, psychiatric, and psychological outcomes. The number of systematic reviews (SRs) [...] Read more.

The severe acute respiratory syndrome coronavirus 2 disease (SARS-CoV-2) is the most severe manifestation of the coronavirus disease 2019 (COVID-19) pandemic. Accruing evidence indicates that the COVID-19 pandemic may have profound deleterious neurological, psychiatric, and psychological outcomes. The number of systematic reviews (SRs) and meta-analyses (MAs) on this topic has grown exponentially. This protocol aims to synthesize all evidence from SRs and MAs on the associations between the COVID-19 pandemic and neuropsychiatric outcomes. The following electronic databases will be systematically searched from inception up to 15 January 2022: PubMed, Embase, APA PsycINFO, and Cochrane Reviews. An umbrella review (UR) of SRs and MAs of observational studies will be conducted. SRs and/or MAs of observational studies examining any direct or indirect association of COVID-19 with the neuropsychiatric outcomes will be deemed eligible for potential inclusion in this UR. The direct associations include the impact on the (1) prognosis of COVID-19 and (2) neuropsychiatric sequelae after COVID-19 infection. The indirect associations include the influence of the COVID-19 pandemic on the (1) treatments and (2) outcomes of neurological and psychiatric conditions associated with the COVID-19 pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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22 pages, 4759 KiB

Open AccessArticle

Analyzing the Data of COVID-19 with Quasi-Distribution Fitting Based on Piecewise B-Spline Curves

by Qingliang Zhao, Zhenhuan Lu and Yiduo Wang

COVID 2022, 2(2), 175-196; https://doi.org/10.3390/covid2020013 - 31 Jan 2022

Viewed by 2822

Abstract

Facing the worldwide coronavirus disease 2019 (COVID-19) pandemic, a new fitting method (QDF, quasi-distribution fitting) which can be used to analyze the data of COVID-19 is developed based on piecewise quasi-uniform B-spline curves. For any given country or district, it simulates the distribution [...] Read more.

Facing the worldwide coronavirus disease 2019 (COVID-19) pandemic, a new fitting method (QDF, quasi-distribution fitting) which can be used to analyze the data of COVID-19 is developed based on piecewise quasi-uniform B-spline curves. For any given country or district, it simulates the distribution histogram data which is made from the daily confirmed cases (or the other data including daily recovery cases and daily fatality cases) of COVID-19 with piecewise quasi-uniform B-spline curves. After using the area normalization method, the fitting curves could be regarded as a kind of probability density function (PDF): its mathematical expectation and the variance could be used to analyze the situation of the coronavirus pandemic. Numerical experiments based on the data of certain countries have indicated that the QDF method demonstrates the intrinsic characteristics of COVID-19 data of a given country or district, and because the interval of data used in this paper is over one year (500 days), it reveals the fact that after the multi-wave transmission of the coronavirus, the case fatality rate has obviously declined. These results show that the QDF method is effective and feasible as an appraisal method. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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20 pages, 52676 KiB

Open AccessArticle

Spatiotemporal Analysis for COVID-19 Delta Variant Using GIS-Based Air Parameter and Spatial Modeling

by Mokhamad Nur Cahyadi, Hepi Hapsari Handayani, IDAA Warmadewanthi, Catur Aries Rokhmana, Soni Sunarso Sulistiawan, Christrijogo Sumartono Waloedjo, Agus Budi Raharjo, Endroyono, Mohamad Atok, Shilvy Choiriyatun Navisa, Mega Wulansari and Shuanggen Jin

Int. J. Environ. Res. Public Health 2022, 19(3), 1614; https://doi.org/10.3390/ijerph19031614 - 30 Jan 2022

Cited by 10 | Viewed by 3892

Abstract

The coronavirus disease of 2019 (COVID-19) pandemic is currently a global challenge, with 210 countries, including Indonesia, seeking to minimize its spread. Therefore, this study aims to determine the spatiotemporal spread pattern of this virus in Surabaya using various data on confirmed cases [...] Read more.

The coronavirus disease of 2019 (COVID-19) pandemic is currently a global challenge, with 210 countries, including Indonesia, seeking to minimize its spread. Therefore, this study aims to determine the spatiotemporal spread pattern of this virus in Surabaya using various data on confirmed cases from 28 April to 26 October 2021. It also aims to determine the relationship between pollutant parameters, such as carbon monoxide (CO), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and ozone (O₃), as well as the government’s high social restrictions policy in Java-Bali. Several methods, such as the weighted mean center, directional distribution, Getis–Ord Gi*, Moran’s I, and geographically weighted regression, were used to identify the spatial spread pattern of the virus. The weighted mean center indicated that the epicenter location of the outbreak moved randomly. The directional distribution demonstrated a decrease of 21 km² at the end of the study phase, which proved that its spread has significantly reduced in Surabaya. Meanwhile, the Getis–Ord Gi* results demonstrated that the eastern and southern parts of the study region were highly infected. Moran’s I demonstrate that COVID-19 cases clustered during the spike. The geographically weighted regression model indicated a number of influence zones in the northeast, northwest, and a few in the southwest parts at the peak of R² 0.55. The relationship between COVID-19 cases and air pollution parameters proved that people living at the outbreak’s center have low pollution levels due to lockdown. Furthermore, the lockdown policy reduced CO, NO₂, SO₂, and O₃. In addition, increase in air pollutants; namely, NO₂, CO, SO₂ and O₃, was recorded after 7 weeks of lockdown implementation (started from 18 August). Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 1854 KiB

Open AccessArticle

Trends and Risk Factors of In-Hospital Mortality of Patients with COVID-19 in Germany: Results of a Large Nationwide Inpatient Sample

by Lukas Hobohm, Ingo Sagoschen, Stefano Barco, Irene Schmidtmann, Christine Espinola-Klein, Stavros Konstantinides, Thomas Münzel and Karsten Keller

Viruses 2022, 14(2), 275; https://doi.org/10.3390/v14020275 - 28 Jan 2022

Cited by 29 | Viewed by 3219

Abstract

Unselected data of nationwide studies of hospitalized patients with COVID-19 are still sparse, but these data are of outstanding interest to avoid exceeding hospital capacities and overloading national healthcare systems. Thus, we sought to analyze seasonal/regional trends, predictors of in-hospital case-fatality, and mechanical [...] Read more.

Unselected data of nationwide studies of hospitalized patients with COVID-19 are still sparse, but these data are of outstanding interest to avoid exceeding hospital capacities and overloading national healthcare systems. Thus, we sought to analyze seasonal/regional trends, predictors of in-hospital case-fatality, and mechanical ventilation (MV) in patients with COVID-19 in Germany. We used the German nationwide inpatient samples to analyze all hospitalized patients with a confirmed COVID-19 diagnosis in Germany between 1 January and 31 December in 2020. We analyzed data of 176,137 hospitalizations of patients with confirmed COVID-19-infection. Among those, 31,607 (17.9%) died, whereby in-hospital case-fatality grew exponentially with age. Overall, age ≥ 70 years (OR 5.91, 95%CI 5.70–6.13, p < 0.001), pneumonia (OR 4.58, 95%CI 4.42–4.74, p < 0.001) and acute respiratory distress syndrome (OR 8.51, 95%CI 8.12–8.92, p < 0.001) were strong predictors of in-hospital death. Most COVID-19 patients were treated in hospitals in urban areas (n = 92,971) associated with the lowest case-fatality (17.5%), as compared to hospitals in suburban (18.3%) or rural areas (18.8%). MV demand was highest in November/December 2020 (32.3%, 20.3%) in patients between the 6th and 8th age decade. In the first age decade, 78 of 1861 children (4.2%) with COVID-19-infection were treated with MV, and five of them died (0.3%). The results of our study indicate seasonal and regional variations concerning the number of COVID-19 patients, necessity of MV, and case fatality in Germany. These findings may help to ensure the flexible allocation of intensive care (human) resources, which is essential for managing enormous societal challenges worldwide to avoid overloaded regional healthcare systems. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 687 KiB

Open AccessArticle

Burnout Syndrome among Staff at an Emergency Department during the COVID-19 Pandemic

by Mihaela Corlade-Andrei, Cornelia Măirean, Paul Nedelea, Gabriela Grigorași and Diana Cimpoeșu

Healthcare 2022, 10(2), 258; https://doi.org/10.3390/healthcare10020258 - 28 Jan 2022

Cited by 9 | Viewed by 2973

Abstract

Objective: The aim of this current study was to identify the prevalence of burnout manifestation in a sample recruited from the emergency department of a hospital. Moreover, we aimed to assess the role of professional experience, age, and the professional category in shaping [...] Read more.

Objective: The aim of this current study was to identify the prevalence of burnout manifestation in a sample recruited from the emergency department of a hospital. Moreover, we aimed to assess the role of professional experience, age, and the professional category in shaping burnout manifestations. Results: The results showed that higher proportions of burnout symptoms were reported by resident physicians, nurses, and physicians whereas lower proportions were encountered in the orderly group. Moreover, the results revealed a significant difference between men and women in the nurse group concerning depersonalization; men presented higher levels of depersonalization compared with women. Concerning emotional exhaustion and depersonalization, multiple comparisons showed differences among the professional categories. Conclusions: The implications of these results for preventing burnout syndrome are discussed. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 244 KiB

Open AccessArticle

The Experiences of African American Male Caregivers

by Barbara Pollard Deskins, Susan Letvak, Laurie Kennedy-Malone, Pamela Johnson Rowsey, Leandra Bedini and Denise Rhew

Healthcare 2022, 10(2), 252; https://doi.org/10.3390/healthcare10020252 - 28 Jan 2022

Cited by 5 | Viewed by 3254

Abstract

Aging of the population has led to an increasing number of caregivers. While research has been conducted on caregiver experiences, less is known about the experiences of African American males in the U.S. This qualitative descriptive study describes the experiences of 13 African [...] Read more.

Aging of the population has led to an increasing number of caregivers. While research has been conducted on caregiver experiences, less is known about the experiences of African American males in the U.S. This qualitative descriptive study describes the experiences of 13 African American men who acted as caregivers to adult chronically ill or debilitated loved ones, the majority of whom provided care during the COVID-19 pandemic. The revised Sociocultural Stress and Coping Model (R-SSCM) guided this study. Individual interviews were conducted via the Zoom application. Content analysis revealed four themes: (1) “My time to take the reins”, (2) “It’s a male thang”, (3) “Caring amid a pandemic”, and (4) “Effects of the caregiver’s journey”. This study’s findings in relation to the literature provide overdue attention to the African American male caregiving experience, especially in relation to the COVID-19 pandemic. The implications of our findings include the need for more culturally congruent support services for African American male caregivers, as well as increased efforts to encourage trust in the healthcare system—especially in relation to vaccination for the SARS-CoV-2 virus. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

13 pages, 552 KiB

Open AccessArticle

The Interpersonal Dimension of Pandemic Fear and the Dual-Factor Model of Mental Health: The Role of Coping Strategies

by Edita Fino, Denis Mema and Valbona Treska

Healthcare 2022, 10(2), 247; https://doi.org/10.3390/healthcare10020247 - 27 Jan 2022

Cited by 6 | Viewed by 2645

Abstract

(1) Background: Current COVID-19 research has mainly focused on negative outcomes associated with fear of the pandemic with the examination of potentially positive outcomes remaining underexplored. Based on the dual-factor model of mental health, which postulates positive and negative dimensions, we assessed the [...] Read more.

(1) Background: Current COVID-19 research has mainly focused on negative outcomes associated with fear of the pandemic with the examination of potentially positive outcomes remaining underexplored. Based on the dual-factor model of mental health, which postulates positive and negative dimensions, we assessed the influence of COVID-19 fear on both negative and positive mental health outcomes and examined the mediational role of coping strategies. (2) Methods: A convenience sample of 231 respondents participated in an online survey reporting on measures of pandemic fear (SFS), distress (HADS), post-traumatic growth (PTGI) and individual differences in terms of coping strategies (CSI-SF). (3) Results: Respondents’ main concerns related with the pandemic highlighted the interpersonal and social dimensions implicated in fear of COVID-19. As expected, fear of the pandemic was associated not just with negative but also positive outcomes, while different coping strategies played a role in determining such effects. More specifically, disengagement coping mediated the effects of fear on anxiety and depression, whereas engagement coping was the only mediator of the relationship between COVID-19 fear and post-traumatic growth. (4) Conclusions: Approaches to promote psychological wellbeing in the context of the COVID-19 pandemic should on the one hand be sensitive to the needs of the more vulnerable population groups, while on the other leverage existing resources to harness the potential for growth. Strengthening engagement coping in the context of fears triggered by the pandemic may constitute a valuable target to protect against negative and optimize positive mental health outcomes in the general population. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 331 KiB

Open AccessArticle

The Psychological Impacts of COVID-19 Pandemic among Emerging Adults: An Observational Cross-Sectional Study

by Fatemah Alghamdi, Amal Ashour, Lola Adeyemi, Paula Bamidele, Blessing Nwambo-Logan, Maha Alsharif, Amal M. Sindi and Nada Binmadi

Int. J. Environ. Res. Public Health 2022, 19(3), 1445; https://doi.org/10.3390/ijerph19031445 - 27 Jan 2022

Cited by 4 | Viewed by 3182

Abstract

(1) Background: COVID-19 has had psychological impacts, particularly anxiety, depression, anger, and suicidal ideation, on the world’s populace, including young persons who were prone to mental health disorders even before the pandemic. We described the psychological impacts of COVID-19 among emerging adults aged [...] Read more.

(1) Background: COVID-19 has had psychological impacts, particularly anxiety, depression, anger, and suicidal ideation, on the world’s populace, including young persons who were prone to mental health disorders even before the pandemic. We described the psychological impacts of COVID-19 among emerging adults aged 18–30 years in Saudi Arabia. (2) Methods: A cross-sectional survey was done among a randomly sampled population in Saudi Arabia between July 2020 and May 2021 using the DSM-5 Self-rated Level 1 Cross-Cutting Symptom Measure and Ask Suicide Questionnaire. Logistic regression was used to assess participant characteristics associated with reporting symptoms of mental disorders under each of the 13 domains that would warrant further investigation. (3) Results: Approximately, 91% of participants experienced different mental health symptoms; these participants are more likely to be young, female students, those who had a history of being diagnosed with a mental disorder, and those diagnosed or treated for COVID-19. (4) Conclusion: This study strongly showed an increased prevalence of mental health symptoms among young persons during the COVID-19 pandemic. Addressing the mental health burden among young persons in time using simple, self-administered screening tools linked to interventions will prevent dire consequences in the future. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

9 pages, 248 KiB

Open AccessArticle

Clinicians’ Social Support, Job Stress, and Intent to Leave Healthcare during COVID-19

by Ayhan Tabur, Avishek Choudhury, Abdurrahim Emhan, Cengiz Mengenci and Onur Asan

Healthcare 2022, 10(2), 229; https://doi.org/10.3390/healthcare10020229 - 26 Jan 2022

Cited by 19 | Viewed by 3747

Abstract

The onset of COVID-19 has escalated healthcare workers’ psychological distress. Multiple factors, including prolonged exposure to COVID-19 patients, irregular working hours, and workload, have substantially contributed to stress and burnout among healthcare workers. To explore the impact of COVID-19 on healthcare workers, our [...] Read more.

The onset of COVID-19 has escalated healthcare workers’ psychological distress. Multiple factors, including prolonged exposure to COVID-19 patients, irregular working hours, and workload, have substantially contributed to stress and burnout among healthcare workers. To explore the impact of COVID-19 on healthcare workers, our study compares the job stress, social support, and intention to leave the job among healthcare workers working in a pandemic (H_P) and a non-pandemic hospital (H_NP) in Turkey during the pandemic. The cross-sectional, paper-based survey involved 403 healthcare workers including physicians, registered nurses, health technicians, and auxiliary staff across two hospitals from 1 September 2020 to 31 November 2020. The findings indicate a significant impact of ‘Job stress’ on ‘Intent to leave’ job among participants in the H_P. We noted that ‘intent to leave’ and ‘job stress’ were significantly higher among the H_P healthcare workers than those working in the H_NP, respectively. However, workers’ ‘social support’ was significantly lower in the H_P. Healthcare workers, during COVID-19, face several hurdles such as job stress, reduced social support, and excessive workload, all of which are potential factors influencing a care provider’s intent to leave the job. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

18 pages, 1141 KiB

Open AccessArticle

Prevalence and Sociodemographic Predictors of Mental Health in a Representative Sample of Young Adults from Germany, Israel, Poland, and Slovenia: A Longitudinal Study during the COVID-19 Pandemic

by Joy Benatov, Dominika Ochnik, Aleksandra M. Rogowska, Ana Arzenšek and Urša Mars Bitenc

Int. J. Environ. Res. Public Health 2022, 19(3), 1334; https://doi.org/10.3390/ijerph19031334 - 25 Jan 2022

Cited by 40 | Viewed by 5369

Abstract

The aim of this cross-national longitudinal study was to evaluate the prevalence and sociodemographic predictors of mental health indicators (coronavirus-related post-traumatic stress disorder (PTSD), perceived stress, anxiety, depression, and suicidal/self-harm ideation) during the coronavirus disease-2019 (COVID-19) pandemic in a three-month period among representative [...] Read more.

The aim of this cross-national longitudinal study was to evaluate the prevalence and sociodemographic predictors of mental health indicators (coronavirus-related post-traumatic stress disorder (PTSD), perceived stress, anxiety, depression, and suicidal/self-harm ideation) during the coronavirus disease-2019 (COVID-19) pandemic in a three-month period among representative samples of young adults from Germany, Israel, Poland, and Slovenia. The participants were 1724 young adults between 20 and 40 years of age (M = 30.74, SD = 5.74). The first measurement (T1) was in February 2021 and the second (T2) was in May–June 2021. The samples were representative of young adults in each country: Germany (n = 418, 24%), Israel (n = 428, 25%), Poland (n = 446, 26%), and Slovenia (n = 431, 25%). Women constituted 54% (n = 935) of the total sample. The mental health indicators were coronavirus-related PTSD measured by PCL-S, perceived stress (PSS-10), anxiety (GAD-7), depression (PHQ-8), and suicidal ideation (PHQ-9). The participants completed an online questionnaire that also included a physical activity (PA) measurement and sociodemographic variables. The Pearson’s χ² independence test was used for prevalence comparisons and McNemar’s χ² was used for longitudinal changes, whereas generalized estimating equations (GEEs) were used for the predictors of change in mental health indices. Significant differences were found between countries in each mental health dimension in both T1 and T2, with moderate effect sizes for coronavirus-related PTSD and suicidal ideation. The highest rate of PTSD and depression risk was in Germany, the highest rates of stress and anxiety risk were in Poland, and there was insufficient PA in Slovenia. The anxiety, depression, and suicidal ideation rates were the lowest in Israel and Slovenia. Israeli participants reported the lowest rate of coronavirus-related PTSD among the other countries in T1 and T2. Significant decreases in coronavirus-related PTSD and stress were observed during T2 compared to T1 in the total sample. There was no change in the risk of anxiety, depression, or suicidal ideation. Being single was a predictor of changes in all mental health indices. Having children was a risk factor for coronavirus-related PTSD and high stress. Being a student was a predictor of depression and suicidal ideation. A younger age (20–29 years) predicted coronavirus-related PTSD risk, whereas female gender predicted high stress. The mental health indices improved over time or remained stable. The groups that are most prone to mental health problems were single individuals, students, and parents in young adulthood across all countries. Future intervention programs for young adults should consider these factors when prioritizing, planning, and implementing such programs. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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20 pages, 1652 KiB

Open AccessArticle

COVID-19 Vaccination Hesitancy or Acceptance and Its Associated Factors: Findings from Post-Vaccination Cross-Sectional Survey from Punjab Pakistan

by Rubeena Zakar, Ain ul Momina, Sara Shahzad, Mahwish Hayee, Ruhma Shahzad and Muhammad Zakria Zakar

Int. J. Environ. Res. Public Health 2022, 19(3), 1305; https://doi.org/10.3390/ijerph19031305 - 24 Jan 2022

Cited by 22 | Viewed by 5259

Abstract

COVID-19 has posed massive challenges related to health, economy, and the social fabric of the entire human population. To curb the spread of the virus, the Government of Pakistan initiated a vaccination campaign against COVID-19. The objective of this research was to assess [...] Read more.

COVID-19 has posed massive challenges related to health, economy, and the social fabric of the entire human population. To curb the spread of the virus, the Government of Pakistan initiated a vaccination campaign against COVID-19. The objective of this research was to assess the factors associated with COVID-19 vaccine acceptance or hesitancy. The data were collected telephonically using a cross-sectional survey design through a close-ended structured questionnaire from a sample of 1325 vaccinated and non-vaccinated individuals with a response rate of 38%. SPSS v. 26 was used to analyze the data. The study revealed that 73% of the respondents were male, half in the 40–49 age group, 78% living in urban areas, and 45% had a monthly income between 20,001–50,000 Pakistani rupees. People felt reluctant to get vaccinated because of myths and misinformation related to it. The socio-demographic factors including male, age 60–69, middle or higher level of education, marital status, currently employed, from middle socio-economic status, living in urban areas, high access to mass media, history of influenza vaccination, physical activity, and perceived good health status were significantly associated with COVID-19 vaccination uptake. Concerted efforts are needed to achieve vaccine targets for the broader population through understanding and identifying barriers to vaccination. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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16 pages, 1543 KiB

Open AccessArticle

Epidemiology of SARS-CoV-2 Infection in Italy Using Real-World Data: Methodology and Cohort Description of the Second Phase of Web-Based EPICOVID19 Study

by Fulvio Adorni, Nithiya Jesuthasan, Elena Perdixi, Aleksandra Sojic, Andrea Giacomelli, Marianna Noale, Caterina Trevisan, Michela Franchini, Stefania Pieroni, Liliana Cori, Claudio Maria Mastroianni, Fabrizio Bianchi, Raffaele Antonelli-Incalzi, Stefania Maggi, Massimo Galli, Federica Prinelli and on behalf of the EPICOVID19 Working Group

Int. J. Environ. Res. Public Health 2022, 19(3), 1274; https://doi.org/10.3390/ijerph19031274 - 24 Jan 2022

Cited by 5 | Viewed by 2744

Abstract

Digital technologies have been extensively employed in response to the SARS-CoV-2 pandemic worldwide. This study describes the methodology of the two-phase internet-based EPICOVID19 survey, and the characteristics of the adult volunteer respondents who lived in Italy during the first (April–May 2020) and the [...] Read more.

Digital technologies have been extensively employed in response to the SARS-CoV-2 pandemic worldwide. This study describes the methodology of the two-phase internet-based EPICOVID19 survey, and the characteristics of the adult volunteer respondents who lived in Italy during the first (April–May 2020) and the second wave (January–February 2021) of the epidemic. Validated scales and ad hoc questionnaires were used to collect socio-demographic, medical and behavioural characteristics, as well as information on COVID-19. Among those who provided email addresses during phase I (105,355), 41,473 participated in phase II (mean age 50.7 years ± 13.5 SD, 60.6% females). After a median follow-up of ten months, 52.8% had undergone nasopharyngeal swab (NPS) testing and 13.2% had a positive result. More than 40% had undergone serological test (ST) and 11.9% were positive. Out of the 2073 participants with at least one positive ST, 72.8% had only negative results from NPS or never performed it. These results indicate that a large fraction of individuals remained undiagnosed, possibly contributing to the spread of the virus in the community. Participatory online surveys offer a unique opportunity to collect relevant data at individual level from large samples during confinement. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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47 pages, 464 KiB

Open AccessArticle

Effects of the Early Phase of COVID-19 on the Autistic Community in Sweden: A Qualitative Multi-Informant Study Linking to ICF

by Anna Fridell, Hjalmar Nobel Norrman, Linda Girke and Sven Bölte

Int. J. Environ. Res. Public Health 2022, 19(3), 1268; https://doi.org/10.3390/ijerph19031268 - 24 Jan 2022

Cited by 23 | Viewed by 3808

Abstract

While the COVID-19 pandemic is ongoing, early outcome studies indicate severe and pervasive global effects of the pandemic and associated measures to prevent the spread of the virus. General population studies, as well as insight into the outcomes for particular groups, will be [...] Read more.

While the COVID-19 pandemic is ongoing, early outcome studies indicate severe and pervasive global effects of the pandemic and associated measures to prevent the spread of the virus. General population studies, as well as insight into the outcomes for particular groups, will be necessary in order to mitigate potentially long-term effects as well as to prepare for future epidemics or pandemics. The pandemic conditions have been marked by rapid and abrupt changes and unpredictability which are circumstances that leave the autistic population particularly vulnerable to adverse outcomes following the distinctive features of the diagnosis. Studies are only beginning to delineate the outcomes of the global autism community and the present study adds to these findings by providing a local, multi-perspective, qualitative analysis of the lived experiences of the Swedish autism community. In this study, autistic youth and adults, caregivers of autistic individuals, as well as representatives of Swedish interest organizations were interviewed. Thematic analysis was performed on the population as a whole and patterns of results were formalized according to the International Classification of Function, Disability and Health (ICF-CY). Participants report wide-ranging adverse outcomes of the pandemic relating to mental health and access to support, participation in daily activities and socialization, education, and work as well as parental resources. However, participants also report positive outcomes relating to a reduction in specific social and everyday demands, and normalization of lived experiences. Additionally, interviews outlined some strategies used to cope during pandemic conditions. Implications of these findings are discussed. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

19 pages, 782 KiB

Open AccessArticle

Teleworking, Work Engagement, and Intention to Quit during the COVID-19 Pandemic: Same Storm, Different Boats?

by Annick Parent-Lamarche

Int. J. Environ. Res. Public Health 2022, 19(3), 1267; https://doi.org/10.3390/ijerph19031267 - 24 Jan 2022

Cited by 19 | Viewed by 5797

Abstract

The ability to retain and engage employees is now, more than ever, a major strategic issue for organizations in the context of a pandemic paired with a persistent labor shortage. To this end, teleworking is among the work organization conditions that merit consideration. [...] Read more.

The ability to retain and engage employees is now, more than ever, a major strategic issue for organizations in the context of a pandemic paired with a persistent labor shortage. To this end, teleworking is among the work organization conditions that merit consideration. The purpose of this cross-sectional study is to examine the direct and indirect effects of teleworking on work engagement and intention to quit, as well as the potential moderating effect of organizational and individual characteristics on the relationship between teleworking, work engagement, and intention to quit during the COVID-19 pandemic, based on a sample of 254 Canadian employees from 18 small and medium organizations. To address these objectives, path analyses were conducted. Overall, we found that teleworking, use of emotion, skill utilization, and recognition appear to be key considerations for organizations that wish to increase work engagement and decrease intention to quit, in the context of a pandemic paired with a labor shortage. Our results extend the literature by revealing the pathways through which teleworking, use of emotion, skill utilization, and recognition are linked to work engagement and intention to quit, and by suggesting specific interventions and formation plans that are needed. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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20 pages, 2333 KiB

Open AccessReview

Cardiovascular System during SARS-CoV-2 Infection

by Maciej Koźlik, Adrianna Błahuszewska and Maciej Kaźmierski

Int. J. Environ. Res. Public Health 2022, 19(3), 1184; https://doi.org/10.3390/ijerph19031184 - 21 Jan 2022

Cited by 4 | Viewed by 2226

Abstract

SARS-CoV-2 virus can not only damage the respiratory system but may also pose a threat to other organs, such as the heart or vessels. This review focuses on cardiovascular complications of COVID-19, including acute cardiac injury, arrhythmias, biomarkers, accompanying comorbidities and outcomes in [...] Read more.

SARS-CoV-2 virus can not only damage the respiratory system but may also pose a threat to other organs, such as the heart or vessels. This review focuses on cardiovascular complications of COVID-19, including acute cardiac injury, arrhythmias, biomarkers, accompanying comorbidities and outcomes in patients diagnosed with SARS-CoV-2 infection. The research was conducted on the databases: PubMed, Springer, ScienceDirect, UpToDate, Oxford Academic, Wiley Online Library, ClinicalKey. Fifty-six publications from 1 November 2020 till 15 August 2021 were included in this study. The results show that cardiac injury is present in about 1 in 4 patients with COVID-19 disease, and it is an independent risk factor, which multiplies the death rate several times in comparison to infected patients without myocardial injury. New-onset cardiac injury occurs in nearly every 10th patient of the COVID-19-suffering population. Comorbidities (such as hypertension, cardiovascular disease and diabetes) severely deteriorate the outcome. Therefore, patients with SARS-CoV-2 infection should be carefully assessed in terms of cardiac medical history and possible cardiological complications. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 1154 KiB

Open AccessArticle

Changes in Mental Health among Psychiatric Patients during the COVID-19 Pandemic in Hong Kong—A Cross-Sectional Study

by Joyce Tik-Sze Li, Chui-Ping Lee and Wai-Kwong Tang

Int. J. Environ. Res. Public Health 2022, 19(3), 1181; https://doi.org/10.3390/ijerph19031181 - 21 Jan 2022

Cited by 8 | Viewed by 2795

Abstract

Background: The COVID-19 pandemic has had substantial impacts on citizens’ daily living. Concerns over mental health issues are rising. Recent studies assessing the psychosocial impact of COVID-19 on the general public revealed alarming results. Meanwhile, the impact of the COVID-19 pandemic on mental [...] Read more.

Background: The COVID-19 pandemic has had substantial impacts on citizens’ daily living. Concerns over mental health issues are rising. Recent studies assessing the psychosocial impact of COVID-19 on the general public revealed alarming results. Meanwhile, the impact of the COVID-19 pandemic on mental health among patients with pre-existing psychiatric disorders remained unclear. Methods: Patients diagnosed with anxiety disorders, depressive disorders, bipolar disorders, or schizophrenia were invited to complete a survey between July and October 2020. The survey collected information on subjects’ demographics, accommodation status, changes in mental health status during the COVID-19 outbreak, and the factors that affect subjects’ mental health during COVID-19. The primary outcome of this study was the change in mental health, defined by psychiatric symptom change and patient satisfaction on symptom control. The secondary outcomes were patients’ emotional status—measured by the Depression, Anxiety and Stress Scale (DASS-21)—during the COVID-19 pandemic and factors that impacted patients’ mental health during the COVID-19 pandemic. Results: Out of the 294 patients recruited, 65.0% were living in hostel while 35.0% were living in the community. The proportion of patients with ‘unsatisfied’ or ‘very unsatisfied’ mental disease control increased from 10.2% to 17.1% after the COVID-19 outbreak (p < 0.001). Under the DASS-21 questionnaire, 24.2% subjects, 32.6% subjects, and 18.9% subjects were classified as severe or extremely severe in terms of the level of depression, anxiety, and stress they experienced, respectively. Patients living in the community, patients with mood disorders, and female patients reported significantly worse control over anxiety and mood symptoms. The three major factors that affected patients’ mental health during COVID-19 were ‘reduced social activities’, ‘worries over people around getting infected’, and ‘reduced exercise’. Conclusion: Psychiatric patients in general have poorer disease control after the COVID-19 outbreak. Patients in the community appeared to be more affected than patients residing in hostels. More efforts should be directed to screening patients with pre-existing mental health disorders to enable timely interventions. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 593 KiB

Open AccessArticle

A SARS-CoV-2 Infection High-Uptake Program on Healthcare Workers and Cancer Patients of the National Cancer Institute of Naples, Italy

by Anna Crispo, Piergiacomo Di Gennaro, Sergio Coluccia, Sara Gandini, Concetta Montagnese, Giuseppe Porciello, Flavia Nocerino, Maria Grimaldi, Mariangela Tafuri, Assunta Luongo, Emanuela Rotondo, Alfonso Amore, Francesco Labonia, Serena Meola, Stefanie Marone, Giovanni Pierro, Simona Menegozzo, Leonardo Miscio, Francesco Perri, Maurizio Rainisio, Attilio A. M. Bianchi, Ernesta Cavalcanti, Marco Cascella and Egidio Celentano Show full author list Hide full author list

Healthcare 2022, 10(2), 205; https://doi.org/10.3390/healthcare10020205 - 20 Jan 2022

Cited by 1 | Viewed by 2228

Abstract

Background: From the beginning of 2020, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) quickly spread worldwide, becoming the main problem for the healthcare systems. Healthcare workers (HCWs) are at higher risk of infection and can be a dangerous vehicle for the spread of [...] Read more.

Background: From the beginning of 2020, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) quickly spread worldwide, becoming the main problem for the healthcare systems. Healthcare workers (HCWs) are at higher risk of infection and can be a dangerous vehicle for the spread of the virus. Furthermore, cancer patients (CPs) are a vulnerable population, with an increased risk of developing severe and lethal forms of Coronavirus Disease 19 (COVID-19). Therefore, at the National Cancer Institute of Naples, where only cancer patients are treated, a surveillance program aimed to prevent the hospital access of SARS-CoV-2 positive subjects (HCWs and CPs) was implemented. The study aims to describe the results of the monitoring activity for the SARS-CoV-2 spread among HCWs and CPs, from March 2020 to March 2021. Methods: This surveillance program included a periodic sampling through nasopharyngeal molecular swabs for SARS-CoV-2 (Real-Time Polymerase Chain Reaction, RT-PCR). CPs were submitted to the molecular test at least 48 h before hospital admission. Survival analysis and multiple logistic regression models were performed among HCWs and CPs to assess the main SARS-CoV-2 risk factors. Results: The percentages of HCWs tested with RT-PCR for the detection of SARS-CoV-2, according to the first and the second wave, were 79.7% and 91.7%, respectively, while the percentages for the CPs were 24.6% and 39.6%. SARS-CoV-2 was detected in 20 (1.7%) HCWs of the 1204 subjects tested during the first wave, and in 127 (9.2%) of 1385 subjects tested in the second wave (p < 0.001); among CPs, the prevalence of patients tested varied from 100 (4.6%) during the first wave to 168 (4.9%) during the second wave (p = 0.8). The multivariate logistic analysis provided a significant OR for nurses (OR = 2.24, 95% CI 1.23–4.08, p < 0.001) compared to research, administrative staff, and other job titles. Conclusions: Our findings show that the positivity rate between the two waves in the HCWs increased over time but not in the CPs; therefore, the importance of adopting stringent measures to contain the shock wave of SARS-CoV-2 infection in the hospital setting was essential. Among HCWs, nurses are more exposed to contagion and patients who needed continuity in oncological care for diseases other than COVID-19, such as suspected cancer. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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21 pages, 2670 KiB

Open AccessSystematic Review

Adverse Perinatal Outcomes in COVID-19 Infected Pregnant Women: A Systematic Review and Meta-Analysis

by Malshani L. Pathirathna, Buddhini P. P. Samarasekara, Thakshila S. Dasanayake, Padmapriya Saravanakumar and Ishanka Weerasekara

Healthcare 2022, 10(2), 203; https://doi.org/10.3390/healthcare10020203 - 20 Jan 2022

Cited by 24 | Viewed by 4867

Abstract

The impact of COVID-19 virus infection during pregnancy is still unclear. This systematic review and meta-analysis aimed to quantitatively pool the evidence on impact of COVID-19 infection on perinatal outcomes. Databases of Medline, Embase, and Cochrane library were searched using the keywords related [...] Read more.

The impact of COVID-19 virus infection during pregnancy is still unclear. This systematic review and meta-analysis aimed to quantitatively pool the evidence on impact of COVID-19 infection on perinatal outcomes. Databases of Medline, Embase, and Cochrane library were searched using the keywords related to COVID-19 and perinatal outcomes from December 2019 to 30 June 2021. Observational studies comparing the perinatal outcomes of COVID-19 infection in pregnancy with a non-infected comparator were included. The screening process and quality assessment of the included studies were performed independently by two reviewers. Meta-analyses were used to pool the comparative dichotomous data on perinatal outcomes. The database search yielded 4049 results, 1254 of which were duplicates. We included a total of 21 observational studies that assessed the adverse perinatal outcomes with COVID-19 infection. The odds of maternal death (pooled OR: 7.05 [2.41−20.65]), preeclampsia (pooled OR: 1.39 [1.29−1.50]), cesarean delivery (pooled OR: 1.67 [1.29−2.15]), fetal distress (pooled OR: 1.66 [1.35−2.05]), preterm birth (pooled OR: 1.86 [1.34−2.58]), low birth weight (pooled OR: 1.69 [1.35−2.11]), stillbirth (pooled OR: 1.46 [1.16−1.85]), 5th minute Apgar score of less than 7 (pooled OR: 1.44 [1.11−1.86]) and admissions to neonatal intensive care unit (pooled OR: 2.12 [1.36−3.32]) were higher among COVID-19 infected pregnant women compared to non-infected pregnant women. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 16395 KiB

Open AccessArticle

The Effects of Non-Pharmaceutical Interventions on COVID-19 Epidemic Growth Rate during Pre- and Post-Vaccination Period in Asian Countries

by Le Duc Huy, Nhi Thi Hong Nguyen, Phan Thanh Phuc and Chung-Chien Huang

Int. J. Environ. Res. Public Health 2022, 19(3), 1139; https://doi.org/10.3390/ijerph19031139 - 20 Jan 2022

Cited by 8 | Viewed by 3125

Abstract

There is little knowledge about how the influence of non-pharmaceutical interventions (NPIs) reduces the COVID-19 infection rate during the period of vaccine rollout. This study aimed to examine the effectiveness of NPIs on decreasing the epidemic growth of COVID-19 between before and after [...] Read more.

There is little knowledge about how the influence of non-pharmaceutical interventions (NPIs) reduces the COVID-19 infection rate during the period of vaccine rollout. This study aimed to examine the effectiveness of NPIs on decreasing the epidemic growth of COVID-19 between before and after the vaccine rollout period among Asian countries. Our ecological study included observations from 30 Asian countries over the 20 weeks of the pre- and post-vaccination period. Data were extracted from the Oxford COVID-19 Government Response Tracker and other open databases. Longitudinal analysis was utilized to evaluate the impacts of public health responses and vaccines. The facial covering policy was the most effective intervention in the pre-vaccination period, followed by border control and testing policies. In the post-vaccination period, restrictions on gatherings and public transport closure both play a key role in reducing the epidemic growth rate. Vaccine coverage of 1–5%, 5–10%, 10–30%, and over 30% of the population was linked with an average reduction of 0.12%, 0.32%, 0.31%, and 0.59%, respectively. Our findings support the evidence that besides the vaccine increasingly contributing to pandemic control, the implementation of NPIs also plays a key role. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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19 pages, 1677 KiB

Open AccessArticle

Social Group Differences in the Exposure Risk of COVID-19: A Case Study in Beijing, China

by Chen Lu, Xiaodi Yi and Xiaocui Ren

Int. J. Environ. Res. Public Health 2022, 19(3), 1121; https://doi.org/10.3390/ijerph19031121 - 20 Jan 2022

Cited by 1 | Viewed by 1445

Abstract

Taking Beijing as a case, this paper conducted a survey to collect the characteristics of residents’ daily activities, including the mode of frequency and duration of travel, the type and environment of activities, and the duration and frequency of activities. We calculated the [...] Read more.

Taking Beijing as a case, this paper conducted a survey to collect the characteristics of residents’ daily activities, including the mode of frequency and duration of travel, the type and environment of activities, and the duration and frequency of activities. We calculated the COVID-19 exposure risk of residents in different activities based on the exposure risk formula; the influencing factors of residents’ exposure risk were analyzed by regression analysis. The variance of residents’ COVID-19 exposure risk was calculated by coefficient of variation. The main conclusions are as follows: (1) There are differences in activity types of COVID-19 exposure risk, which are survival activity, daily activity and leisure activity from high to low. (2) There are differences in populations of COVID-19 exposure risk. Education level, occupation and income are the main factors affecting residents’ COVID-19 exposure risk. (3) There is internal inequity in the risk of COVID-19 exposure. The exposure risk was higher on work days than on rest days. Health inequities at work are highest on both work days and rest days. Among the different population characteristics, male, 31–40 years old, married, with a high school education, income level of 20,001–25,000 yuan, with a non-local rural hukou, rental housing, farmers, three generations or more living together have a greater degree of COVID-19 exposure risk. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 464 KiB

Open AccessArticle

Perspectives on Mass Media and Governmental Measures during the 2020 COVID-19 Pandemic in a Romanian Sample of Healthcare Practitioners

by Daniela Reisz and Iulia Crișan

Healthcare 2022, 10(2), 191; https://doi.org/10.3390/healthcare10020191 - 19 Jan 2022

Cited by 2 | Viewed by 1503

Abstract

Objective: Along with the rapid spread of the COVID-19 pandemic around the globe, a proliferation of mass media information exposed the population to an infodemic with various implications documented worldwide. The present study analyzed Romanian healthcare practitioners’ (HCPs) appraisal of COVID-19 mass media [...] Read more.

Objective: Along with the rapid spread of the COVID-19 pandemic around the globe, a proliferation of mass media information exposed the population to an infodemic with various implications documented worldwide. The present study analyzed Romanian healthcare practitioners’ (HCPs) appraisal of COVID-19 mass media information and governmental measures throughout 2020, ranking vaccination priorities and moral values. Methods: 97 HCP completed a cross-sectional survey with items referring to the COVID-19 pandemic in 2020. Results: Findings were consistent with other studies, indicating an overall negative appraisal of mass media information, which predicted anxiety and relaxation difficulties. Unlike other studies, our sample reported a moderate level of satisfaction with official measures in 2020, which was not related to their view on mass media information. The ranking of population categories in the vaccination order showed similarities with the governmental vaccination program in 2021. Despite placing freedom third after health and love in the hierarchy of values, HCPs showed a high tendency of limiting individual liberty for the common good. Conclusions: Results showed a dissociation between the overall negative appraisal of mass media information and the satisfaction with governmental measures in 2020. Romanian HCPs shared a secular perspective on moral values and assumed an authoritarian position. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 498 KiB

Open AccessArticle

Effects of a Reminiscence Program on Meaning of Life, Sense of Coherence and Coping in Older Women Living in Nursing Homes during COVID-19

by Alicia Sales, Sacramento Pinazo-Hernandis and Dolores Martinez

Healthcare 2022, 10(2), 188; https://doi.org/10.3390/healthcare10020188 - 19 Jan 2022

Cited by 8 | Viewed by 2833

Abstract

Aging is a dynamic process that can bring well-being but also physical and cognitive decline. Older adults can draw on their personal resources to help them cope and thrive through the aging process. Having personal resources to cope and ensure older adults’ well-being [...] Read more.

Aging is a dynamic process that can bring well-being but also physical and cognitive decline. Older adults can draw on their personal resources to help them cope and thrive through the aging process. Having personal resources to cope and ensure older adults’ well-being is important. Psychological strengths such as a sense of coherence, resilience, and coping are protective against the adversity associated with health problems such as those stemming from the COVID-19 pandemic. Our study’s purpose was to investigate the usefulness of reminiscence therapy for older women living in nursing homes during the COVID-19 pandemic. A sample composed of 29 older women was evaluated with the Purpose-in-Life Test (PIL), Sense of Coherence (SOC-13) and Brief Cope Inventory (COPE-28). Our reminiscence program consisted of 10 sessions lasting 60 min each. Reminiscence therapy is a psychological intervention for older adults to assist in remembering and interpreting the life events, feelings, and thoughts that define and give meaning to the person’s life. Reminiscence can lead to positive mental health and other elements of particular relevance to older adults. In each session, we worked on a different theme that promoted the memory of positive emotions: optimal experience, decisive moment, stresses, tensions, problems and solutions, memories of childhood, adolescence, maturity, significant people in life, sense of life, and future script. We compared an intervention group (n = 12) with a control group (n = 17) using a pre-post, single-blind design. Significant results were obtained and showed that reminiscence therapy was effective in increasing meaning of life, sense of coherence, and coping in older women. The reminiscence therapy applied yielded positive effects in older female participants living in a nursing home during COVID-19 pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 872 KiB

Open AccessArticle

Self-Assessment of Health Status and Willingness to Be Vaccinated in Adolescents from the Niigata Prefecture and the Khabarovsk Region during COVID-19

by Hiromi Inaba, Marina F. Rziankina, Fumi Hoshino, Kousuke Takano, Kseniia E. Potapova, Konstantin V. Zhmerenetsky and Kazuo Ishigami

Healthcare 2022, 10(2), 184; https://doi.org/10.3390/healthcare10020184 - 18 Jan 2022

Cited by 1 | Viewed by 1534

Abstract

This study examined the self-assessment of Niigata’s and Khabarovsk’s adolescents’ health status and their willingness to be vaccinated during the COVID-19 pandemic. A self-reported questionnaire was administered to 735 boys and girls (aged 15 years) from Niigata, Japan (n = 387), and [...] Read more.

This study examined the self-assessment of Niigata’s and Khabarovsk’s adolescents’ health status and their willingness to be vaccinated during the COVID-19 pandemic. A self-reported questionnaire was administered to 735 boys and girls (aged 15 years) from Niigata, Japan (n = 387), and Khabarovsk, Russia (n = 394), between May and July 2021. Specifically, this questionnaire focused on COVID-19, including a self-assessment of health status, adaptation to a new lifestyle, and impressions about the COVID-19 vaccination. The self-assessment was based on a 4-point scale: “Got very bad”; “Got a little bit bad”; “Did not change”; “Got better/I don’t know”. Additionally, binomial logistic regression was conducted to determine the association between the self-assessment of health status and the factors exacerbating their responses. Based on the findings, 25.7 and 29.9% of Niigata and Khabarovsk’s adolescents, respectively, selected “Got very bad” and “Got a little bit bad” for their self-assessments, while the binomial logistic regression showed that the difficulty of adapting to a new lifestyle was a factor worsening the boys’ subjective health. However, the items could not explain the deterioration of their subjective health in girls. Moreover, 76.9% of Niigata’s adolescents were positive about the COVID-19 vaccination, compared to 35.5% of the adolescents in Khabarovsk. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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16 pages, 1176 KiB

Open AccessArticle

The Relationship between Future Anxiety Due to COVID-19 and Vigilance: The Role of Message Fatigue and Autonomy Satisfaction

by Roselyn J. Lee-Won, Inyoung Jang, Hyun-Suk Kim and Sung-Gwan Park

Int. J. Environ. Res. Public Health 2022, 19(3), 1062; https://doi.org/10.3390/ijerph19031062 - 18 Jan 2022

Cited by 2 | Viewed by 2158

Abstract

How does future anxiety caused by the COVID-19 pandemic relate to people’s willingness to remain vigilant and adhere to preventive measures? We examined the mediating role of message fatigue and the moderating role of autonomy satisfaction in the relationship between future anxiety due [...] Read more.

How does future anxiety caused by the COVID-19 pandemic relate to people’s willingness to remain vigilant and adhere to preventive measures? We examined the mediating role of message fatigue and the moderating role of autonomy satisfaction in the relationship between future anxiety due to COVID-19 and willingness to remain vigilant. A cross-sectional online survey was conducted with adults residing in the United States in June 2021 when numerous U.S. states re-opened following the CDC’s relaxed guidelines for fully vaccinated individuals. Our data showed that message fatigue mediated the relationship between future anxiety due to the pandemic and willingness to remain vigilant. The data further revealed that autonomy satisfaction significantly moderated the mediation. Namely, the role of message fatigue in the indirect relationship between future anxiety and willingness to remain vigilant was significant only among people low to moderate in autonomy satisfaction; its role in the indirect path was not significant for those high in autonomy satisfaction. Notably, independent of the mechanism involving message fatigue, future anxiety was directly and positively associated with willingness to remain vigilant regardless of the levels of autonomy satisfaction. Implications of these findings are discussed in light of psychological and behavioral responses to the current pandemic and policy directions. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 326 KiB

Open AccessArticle

Health Behaviors in Austrian Apprentices and School Students during the COVID-19 Pandemic

by Teresa O’Rourke, Rachel Dale, Elke Humer, Thomas Probst, Paul Plener and Christoph Pieh

Int. J. Environ. Res. Public Health 2022, 19(3), 1049; https://doi.org/10.3390/ijerph19031049 - 18 Jan 2022

Cited by 6 | Viewed by 2389

Abstract

Background: The COVID-19 pandemic has disrupted our daily lives, which in turn has impacted health behaviors. Young people have been particularly affected. This study aimed to assess health behaviors in Austrian apprentices and high school students during the COVID-19 pandemic and whether vaccination [...] Read more.

Background: The COVID-19 pandemic has disrupted our daily lives, which in turn has impacted health behaviors. Young people have been particularly affected. This study aimed to assess health behaviors in Austrian apprentices and high school students during the COVID-19 pandemic and whether vaccination willingness is affected by health behaviors. Methods: Two online surveys were conducted via REDCap with 1442 apprentices (female: 53.5%, male: 45.4%) from 29 March to 18 May 2021 and 563 school students (female: 79.6%, male: 18.6%) from 19 June to 2 July 2021. The two samples were matched to account for sociodemographic differences and analyses were run on the matched sample. Besides the health behaviors, namely, smoking, alcohol consumption, cannabis consumption, and exercise, health status and vaccination willingness were also assessed. Results: Health behaviors were affected by both education group and gender. Apprentices reported significantly more smoking than high school students and this difference was more pronounced in women (all p < 0.01). Alcohol consumption was higher in apprentices than school students, but only in women (p < 0.01). There was a trend for the two education groups to differ in their cannabis use as well (p = 0.05). Apprentices took part in more weekly exercise (p < 0.0001), but high school students reported better average health status (p < 0.001). When included in the same model, health behaviors did not affect vaccine willingness, but education group did, with high school students showing a higher willingness to receive the COVD-19 vaccine than apprentices. Conclusions: These findings support the argument that education type is an important factor for health behaviors, but this is also mediated by gender. Appropriate interventions for adolescents are needed to prevent adverse health behavior changes following the COVID-19 pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

10 pages, 718 KiB

Open AccessArticle

Estimating US Earnings Loss Associated with COVID-19 Based on Human Capital Calculation

by Fuhmei Wang and Jung-Der Wang

Int. J. Environ. Res. Public Health 2022, 19(2), 1015; https://doi.org/10.3390/ijerph19021015 - 17 Jan 2022

Cited by 7 | Viewed by 2103

Abstract

Infection with COVID-19 could result in lockdown, quarantine of contacts, absenteeism from work, and temporary productivity loss. This research aims to calculate (1) how the pandemic affects on-the-job probability and earnings for the working population, and (2) how much productivity loss is associated [...] Read more.

Infection with COVID-19 could result in lockdown, quarantine of contacts, absenteeism from work, and temporary productivity loss. This research aims to calculate (1) how the pandemic affects on-the-job probability and earnings for the working population, and (2) how much productivity loss is associated with self or a family member sick with COVID-19. Based on data collected from the U.S Research and Development Survey (RANDS), this research projects the relationship between on-the-job possibility and age of the index group and calculates the employment possibilities of the index group relative to the healthy group, namely the employment ratio. The weekly loss of productivity, presented by earnings, associated with COVID-19 for groups aged 18–44 years and 45–64 years was calculated, since the 18- to 64-year-old population is an economy’s active workforce. Analytical results indicate that the older the age group, the lower the on-the-job possibility, and the higher the weekly productivity loss due to self or a family member being sick from COVID-19. For the group aged 45–64 years, the employment ratio of the index group relative to the healthy group dropped from 0.863 to 0.39, corresponding to a weekly productivity loss of 136–590 US dollars. The overall impact would be about a 9% loss in GDP. Infected or quarantined people would be confined to working in relatively isolated offices or places to allow for social distancing. Proactive health promotion in the workplace plus reactive work through telecommunication systems would reduce such losses. Such preparedness needs to be implemented early for more vulnerable workers who are of middle or old age and/or those comorbid with diabetes. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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8 pages, 308 KiB

Open AccessArticle

Psychological Impact and Compliance with Staying at Home of the Public to COVID-19 Outbreak during Chinese Spring Festival

by Huiwen Xu, Lin Liu, Luming Zhao, En Takashi, Akio Kitayama and Yan Zou

Int. J. Environ. Res. Public Health 2022, 19(2), 916; https://doi.org/10.3390/ijerph19020916 - 14 Jan 2022

Cited by 1 | Viewed by 1631

Abstract

In December 2019, COVID-19 was reported in Wuhan, China. Most of the studies related to the psychological impact and compliance with staying at home due to COVID-19 focused on ten days or one month after the initial “stay-at-home” phase of the COVID-19 pandemic. [...] Read more.

In December 2019, COVID-19 was reported in Wuhan, China. Most of the studies related to the psychological impact and compliance with staying at home due to COVID-19 focused on ten days or one month after the initial “stay-at-home” phase of the COVID-19 pandemic. The early psychological impact and behavior change to COVID-19 during the Chinese Spring Festival (the start time for recommendations to stay at home) is uncertain. In this study, people from 23 provinces in China were recruited to participate in an online survey, using Credamo. Psychological impact and compliance with staying at home were evaluated by a self-designed and validated questionnaire. The results indicated that anxiety was the most often reported feeling (mean: 3.69), followed by sadness (mean: 3.63). Participants employed in foreign-owned companies were most likely to express anxiety and sadness. Overall, 61.8% of participants reported hardly going out, whereas 2.4% said they frequently went out during the initial “stay-at-home” phase of the COVID-19 pandemic. Participants with higher levels of anxiety and sadness were most likely to stay at home against the spread of COVID-19, as were female gender. This survey is an important study of the first reaction to staying at home during the initial “stay-at-home” phase coinciding with Chinese Spring Festival. Our findings identified factors associated with higher level of psychological impact and better compliance with staying at home recommendations during Chinese Spring Festival. The findings can be used to formulate precaution interventions to improve the mental health of vulnerable groups and high uptake of policy during the COVID-19 epidemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

5 pages, 542 KiB

Open AccessCase Report

Symptomatic SARS-CoV-2 Infection with Ageusia after Two mRNA Vaccine Doses

by Vito Carlo Alberto Caponio, Maria Rosaria Lipsi, Francesca Fortunato, Fabio Arena and Lorenzo Lo Muzio

Int. J. Environ. Res. Public Health 2022, 19(2), 886; https://doi.org/10.3390/ijerph19020886 - 13 Jan 2022

Cited by 2 | Viewed by 1827

Abstract

To raise awareness about preventive measures in COVID-19 pandemic, even though fully vaccinated. Although recent trials showed high efficacy of vaccines in preventing symptomatic infections, there are some individuals experiencing symptomatic SARS-CoV-2 infection. In this case report, a fully vaccinated young dental practitioner [...] Read more.

To raise awareness about preventive measures in COVID-19 pandemic, even though fully vaccinated. Although recent trials showed high efficacy of vaccines in preventing symptomatic infections, there are some individuals experiencing symptomatic SARS-CoV-2 infection. In this case report, a fully vaccinated young dental practitioner experienced symptomatic SARS-CoV-2 infection 55 days postvaccination with BNT162b2 Pfizer vaccine with evident ageusia. Diagnostic swabs were performed and used for viral genome sequencing. The patient fully recovered 15 days after diagnosis. Loss of smell and taste, together with nasal congestion were the main reported symptoms. The use of personal protective equipment prevented spread of infection in patients and co-workers. With the increase of people being fully vaccinated, it is still necessary to follow infection preventive protocols by correctly applying personal protective equipment. Although high efficacy has been proved, some individuals may still be vulnerable to symptomatic infection and new guidelines and markers should be adopted and investigated to find out patients for whom vaccination may not determine full immunization. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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6 pages, 1900 KiB

Open AccessCase Report

A COVID-19 Patient with Simultaneous Renal Infarct, Splenic Infarct and Aortic Thrombosis during the Severe Disease

by Georgios Mavraganis, Sofia Ioannou, Anastasios Kallianos, Gianna Rentziou and Georgia Trakada

Healthcare 2022, 10(1), 150; https://doi.org/10.3390/healthcare10010150 - 13 Jan 2022

Cited by 9 | Viewed by 1813

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with a high incidence of arterial and venous thrombotic complications. However, thromboembolic events in unusual sites such as limb and visceral arterial ischemia are reported rarely in the literature. Herein, we describe [...] Read more.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with a high incidence of arterial and venous thrombotic complications. However, thromboembolic events in unusual sites such as limb and visceral arterial ischemia are reported rarely in the literature. Herein, we describe a rare case of a patient with severe coronavirus disease 2019 (COVID-19) infection who experienced severe abdominal pain during the hospitalization and presented simultaneously renal artery, splenic artery and vein as well as aortic thrombi despite prophylactic antithrombotic treatment. Information about his follow-up post discharge is also provided. This case report raises significant clinical implications regarding the correct dose of antithrombotic treatment during the acute phase of the severe COVID-19 infection and highlights the need for incessant vigilance in order to detect thrombosis at unusual sites as a possible diagnosis when severe abdominal pain is present in severe COVID-19 patients. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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28 pages, 8415 KiB

Open AccessArticle

An Explainable Machine Learning Approach for COVID-19’s Impact on Mood States of Children and Adolescents during the First Lockdown in Greece

by Charis Ntakolia, Dimitrios Priftis, Mariana Charakopoulou-Travlou, Ioanna Rannou, Konstantina Magklara, Ioanna Giannopoulou, Konstantinos Kotsis, Aspasia Serdari, Emmanouil Tsalamanios, Aliki Grigoriadou, Konstantina Ladopoulou, Iouliani Koullourou, Neda Sadeghi, Georgia O’Callaghan and Eleni Lazaratou

Healthcare 2022, 10(1), 149; https://doi.org/10.3390/healthcare10010149 - 13 Jan 2022

Cited by 10 | Viewed by 3156 | Correction

Abstract

The global spread of COVID-19 led the World Health Organization to declare a pandemic on 11 March 2020. To decelerate this spread, countries have taken strict measures that have affected the lifestyles and economies. Various studies have focused on the identification of COVID-19’s [...] Read more.

The global spread of COVID-19 led the World Health Organization to declare a pandemic on 11 March 2020. To decelerate this spread, countries have taken strict measures that have affected the lifestyles and economies. Various studies have focused on the identification of COVID-19’s impact on the mental health of children and adolescents via traditional statistical approaches. However, a machine learning methodology must be developed to explain the main factors that contribute to the changes in the mood state of children and adolescents during the first lockdown. Therefore, in this study an explainable machine learning pipeline is presented focusing on children and adolescents in Greece, where a strict lockdown was imposed. The target group consists of children and adolescents, recruited from children and adolescent mental health services, who present mental health problems diagnosed before the pandemic. The proposed methodology imposes: (i) data collection via questionnaires; (ii) a clustering process to identify the groups of subjects with amelioration, deterioration and stability to their mood state; (iii) a feature selection process to identify the most informative features that contribute to mood state prediction; (iv) a decision-making process based on an experimental evaluation among classifiers; (v) calibration of the best-performing model; and (vi) a post hoc interpretation of the features’ impact on the best-performing model. The results showed that a blend of heterogeneous features from almost all feature categories is necessary to increase our understanding regarding the effect of the COVID-19 pandemic on the mood state of children and adolescents. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 616 KiB

Open AccessArticle

Psychological Reactions of Hospital Workers to a Pandemic: A Comparison of SARS-CoV-2 in 2020 and SARS in 2003

by Yu Lee, Liang-Jen Wang, Wen-Jiun Chou, Ming-Chu Chiang, Shan Huang, Yi-Chun Lin, Jie-Yi Lin, Nien-Mu Chiu, Chih-Hung Chen, Ing-Kit Lee, Chia-Te Kung, Chih-Chi Wang and Mian-Yoon Chong

Int. J. Environ. Res. Public Health 2022, 19(2), 833; https://doi.org/10.3390/ijerph19020833 - 12 Jan 2022

Cited by 2 | Viewed by 1385

Abstract

Epidemic viral infections, including the outbreak of severe acute respiratory syndrome (SARS) in 2003 and SARS-CoV-2 in 2019, have brought tremendous loss to people across the nations. The aim of this study was to compare the psychological impact of the SARS-CoV-2 pandemic in [...] Read more.

Epidemic viral infections, including the outbreak of severe acute respiratory syndrome (SARS) in 2003 and SARS-CoV-2 in 2019, have brought tremendous loss to people across the nations. The aim of this study was to compare the psychological impact of the SARS-CoV-2 pandemic in 2020 and the SARS pandemic in 2003 on hospital workers. Hospital workers at a medical center in Southern Taiwan (n = 1816) were invited to complete questionnaires (SARS-CoV-2 Exposure Experience, the Impact of Event Scale, the Chinese Health Questionnaire, and the Distress Thermometer). The current data were compared to the data collected from hospital workers (n = 1257) at the same medical center during the SARS pandemic in 2003. We found the psychological impact on hospital workers during the SARS-CoV-2 pandemic was significantly lower than that during the previous SARS period. During the SARS-CoV-2 pandemic period, hospital workers with SARS experience were more accepting of the risk, felt a greater responsibility to take care of the SARS-CoV-2 patients, and were more likely to perceive the danger of becoming infected. The associated factors of psychiatric morbidity in hospital workers with SARS experience were being female, the degree of intrusion severity, and severity of psychological distress. Proper management strategies and lessons learned from the SARS experience might have led to low psychiatric morbidity during the SARS-CoV-2 pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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16 pages, 27810 KiB

Open AccessArticle

Spatiotemporal Associations between Local Safety Level Index and COVID-19 Infection Risks across Capital Regions in South Korea

by Youngbin Lym, Hyobin Lym, Keekwang Kim and Ki-Jung Kim

Int. J. Environ. Res. Public Health 2022, 19(2), 824; https://doi.org/10.3390/ijerph19020824 - 12 Jan 2022

Cited by 2 | Viewed by 2954

Abstract

This study aims to provide an improved understanding of the local-level spatiotemporal evolution of COVID-19 spread across capital regions of South Korea during the second and third waves of the pandemic (August 2020~June 2021). To explain transmission, we rely upon the local safety [...] Read more.

This study aims to provide an improved understanding of the local-level spatiotemporal evolution of COVID-19 spread across capital regions of South Korea during the second and third waves of the pandemic (August 2020~June 2021). To explain transmission, we rely upon the local safety level indices along with latent influences from the spatial alignment of municipalities and their serial (temporal) correlation. Utilizing a flexible hierarchical Bayesian model as an analytic operational framework, we exploit the modified BYM (BYM2) model with the Penalized Complexity (PC) priors to account for latent effects (unobserved heterogeneity). The outcome reveals that a municipality with higher population density is likely to have an elevated infection risk, whereas one with good preparedness for infectious disease tends to have a reduction in risk. Furthermore, we identify that including spatial and temporal correlations into the modeling framework significantly improves the performance and explanatory power, justifying our adoption of latent effects. Based on these findings, we present the dynamic evolution of COVID-19 across the Seoul Capital Area (SCA), which helps us verify unique patterns of disease spread as well as regions of elevated risk for further policy intervention and for supporting informed decision making for responding to infectious diseases. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 633 KiB

Open AccessArticle

A Cross-Sectional Study of the Satisfaction with, Adherence to, and Perspectives toward COVID-19 Preventive Measures among Public Health Students in Jazan, Saudi Arabia

by Mohammed J. Almalki

Int. J. Environ. Res. Public Health 2022, 19(2), 802; https://doi.org/10.3390/ijerph19020802 - 12 Jan 2022

Cited by 5 | Viewed by 3247

Abstract

The COVID-19 pandemic has had a significant influence on education systems, educational environments, teachers, and students. This study aims to assess the satisfaction with, adherence to, and perspectives toward COVID-19 preventive measures among public health students in Jazan, Saudi Arabia in order to [...] Read more.

The COVID-19 pandemic has had a significant influence on education systems, educational environments, teachers, and students. This study aims to assess the satisfaction with, adherence to, and perspectives toward COVID-19 preventive measures among public health students in Jazan, Saudi Arabia in order to enhance their campus experience. This study utilized a cross-sectional methodology. Data were collected using convenience sampling between 2–19 November 2020; this was accomplished using an online survey administered via Google Forms. The final sample consisted of 200 participants. More than half of the participants (55.0%) were dissatisfied with the preventive measures that had been applied on campus, while 19.0% had a neutral outlook. Interestingly, female participants showed a higher level of dissatisfaction toward the preventive measures (70.6%) than male participants (43.5%). The ordinal logistic regression analysis revealed a significant correlation between the degree of satisfaction with the COVID-19 preventive measures and the participant’s gender and education level. Male students were more likely to be satisfied with the preventive measures (p < 0.029, OR = 2.199) than female students. In addition, final year students were 4.1 times more likely to be satisfied with the COVID-19 preventive measures (p < 0.004, OR = 0.242) than Year 2 students, and 6.2 times more likely to be satisfied (p ≤ 0.001, OR = 0.162) than Year 3 students. Efforts are needed to improve the students’ satisfaction with COVID-19 preventive measures. Steps are also required to ensure that the procedures and actions introduced by the college extend to all students. In addition, further research is needed to recognize and understand the participants’ experiences after moving to the new buildings, receiving COVID-19 vaccines, and returning to on campus study. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 353 KiB

Open AccessArticle

Staying Physically Active Is Associated with Better Mental Health and Sleep Health Outcomes during the Initial Period of COVID-19 Induced Nation-Wide Lockdown in Jordan

by Yazan A. Al-Ajlouni, Su Hyun Park, Jude Alawa, Ban Dodin, Ghaith Shamaileh, Nour Makarem, Katherine M. Keyes and Dustin T. Duncan

Int. J. Environ. Res. Public Health 2022, 19(2), 776; https://doi.org/10.3390/ijerph19020776 - 11 Jan 2022

Cited by 4 | Viewed by 2061

Abstract

Jordan, a Middle Eastern country, initially responded to an outbreak of COVID-19 cases within its own borders by imposing a 7-week strict lockdown and closure of international and domestic travel. Such measures drastically influenced lifestyle behaviors of the population. This study aimed to [...] Read more.

Jordan, a Middle Eastern country, initially responded to an outbreak of COVID-19 cases within its own borders by imposing a 7-week strict lockdown and closure of international and domestic travel. Such measures drastically influenced lifestyle behaviors of the population. This study aimed to investigate the prevalence of physical activity, and its association with mental and sleep health outcomes among Jordanians during a period of COVID-19 induced lockdown. Validated questionnaires were administered using a web-based platform to evaluate moderate-to-vigorous physical activity (MVPA), anxiety and depressive symptoms, sleep health, and sociodemographic characteristics. A modified Poisson regression model with robust error variance was used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs). Compared to participants who met the guidelines, those who did not had significantly higher prevalence of moderate or severe anxiety symptoms than that of minimal or mild anxiety symptoms and increased depressive symptoms. Insufficient MVPA was associated with higher prevalence of poor sleep quality, short sleep duration (<7 h) and sleep problems. Overall, sufficient MVPA was associated with better mental and sleep health during the COVID-19 induced nation-wide lockdown in Jordan. While further research is necessary, promoting physical activity during the lockdown could potentially improve mental and sleep health outcomes among the population. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

11 pages, 6031 KiB

Open AccessArticle

Access to COVID-19 Vaccination during the Pandemic in the Informal Settlements of Rome

by Enrico Bentivegna, Silvia Di Meo, Anita Carriero, Nadia Capriotti, Alberto Barbieri and Paolo Martelletti

Int. J. Environ. Res. Public Health 2022, 19(2), 719; https://doi.org/10.3390/ijerph19020719 - 10 Jan 2022

Cited by 18 | Viewed by 1980

Abstract

With the advent of vaccines, the world has a chance to see a real end to the COVID-19 pandemic. To make this possible, however, it is necessary that all groups of people are considered. Contexts of informal settlements and populations such as the [...] Read more.

With the advent of vaccines, the world has a chance to see a real end to the COVID-19 pandemic. To make this possible, however, it is necessary that all groups of people are considered. Contexts of informal settlements and populations such as the homeless and migrants are often forgotten by vaccination campaigns. In this study, carried out as a result of a collaboration with MEDU, a non-profit association aimed at bringing healthcare to vulnerable populations, we provide important data related to the vaccination campaign carried out in the informal settlements of Rome. The objectives of this work are to (1) evaluate vaccination coverage in these contexts, (2) assess the gap with the vaccination coverage of the Italian population and try to hypothesize the causes, and (3) provide recommendations for how humanitarian associations can respond to reduce this gap. We observed important differences in vaccination coverage depending on the type of settlement. The percentage of vaccinated people in these contexts at the beginning of October range between 14.4% and 55.5%, underlining an important gap with the vaccination rate of Italy’s population, which is close to 80%. The data also show that particular attention must be paid to the transiting and irregular people as they are more at risk for a lack of access to vaccination. With this study, in which we provide recommendations that integrate MEDU’s fieldwork experience with the advice of the Framework report, we hope we can help those who work in similar contexts, to carry out a fair and effective vaccination campaign. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 681 KiB

Open AccessReview

The Great Lockdown in the Wake of COVID-19 and Its Implications: Lessons for Low and Middle-Income Countries

by Sigamani Panneer, Komali Kantamaneni, Vigneshwaran Subbiah Akkayasamy, A. Xavier Susairaj, Prasant Kumar Panda, Sanghmitra Sheel Acharya, Louis Rice, Champika Liyanage and Robert Ramesh Babu Pushparaj

Int. J. Environ. Res. Public Health 2022, 19(1), 610; https://doi.org/10.3390/ijerph19010610 - 05 Jan 2022

Cited by 28 | Viewed by 5098

Abstract

Concern for public health has been growing with the increasing volume of cases of COVID-19 in India. To combat this pandemic, India has implemented nationwide lockdowns, and unlocking phases continue with certain restrictions in different parts of the country. The lockdown has required [...] Read more.

Concern for public health has been growing with the increasing volume of cases of COVID-19 in India. To combat this pandemic, India has implemented nationwide lockdowns, and unlocking phases continue with certain restrictions in different parts of the country. The lockdown has required people to adopt social-distance measures to minimize contacts in order to reduce the risks of additional infection. Nevertheless, the lockdown has already impacted economic activities and other dimensions of the health of individuals and society. Although many countries have helped their people through advanced welfare protection networks and numerous support aids, several emerging economies face specific difficulties to adapt to the pandemic due to vulnerable communities and scarce resources. However, certain lower-income countries need more rigorous analysis to implement more effective strategies to combat COVID-19. Accordingly, the current systematic review addresses the impacts of the COVID-19 pandemic and lockdowns in India in relation to health and the economy. This work also provides further information on health inequalities, eco-nomic and social disparities in the country due to the COVID-19 pandemic and lockdowns and also contributes pragmatic suggestions for overcoming these challenges. These observations will be useful to the relevant local and national officials for improving and adopting novel strategies to face lockdown challenges Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 623 KiB

Open AccessArticle

Emotional Labor and Burnout of Public Health Nurses during the COVID-19 Pandemic: Mediating Effects of Perceived Health Status and Perceived Organizational Support

by Mi-Na Kim, Yang-Sook Yoo, Ok-Hee Cho and Kyung-Hye Hwang

Int. J. Environ. Res. Public Health 2022, 19(1), 549; https://doi.org/10.3390/ijerph19010549 - 04 Jan 2022

Cited by 23 | Viewed by 4647

Abstract

The purpose of this study was to identify the mediating effects of perceived health status (PHS) and perceived organizational support (POS) in the association between emotional labor and burnout in public health nurses (PHNs). The participants were 207 PHNs convenience sampled from 30 [...] Read more.

The purpose of this study was to identify the mediating effects of perceived health status (PHS) and perceived organizational support (POS) in the association between emotional labor and burnout in public health nurses (PHNs). The participants were 207 PHNs convenience sampled from 30 public health centers and offices in Jeju, Korea. Data regarding emotional labor, PHS, POS, and burnout were collected between February and March 2021 using a structured questionnaire. Collected data were analyzed by Pearson’s correlation coefficient and multiple regression analysis. Burnout of PHNs was positively correlated with emotional labor (r = 0.64, p < 0.001) and negatively correlated with PHS (r = −0.51, p < 0.001) and POS (r = −0.51, p < 0.001). In the association between emotional labor and burnout, PHS (B = −1.36, p < 0.001) and POS (B = −0.42, p = 0.001) had a partial mediating effect. Reduction of burnout among PHNs requires not only effective management of emotional labor but also personal and organizational efforts to improve PHS and POS. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 343 KiB

Open AccessArticle

The Social and Natural Environment’s Impact on SARS-CoV-2 Infections in the UK Biobank

by Ryan J. Scalsky, Yi-Ju Chen, Zhekang Ying, James A. Perry and Charles C. Hong

Int. J. Environ. Res. Public Health 2022, 19(1), 533; https://doi.org/10.3390/ijerph19010533 - 04 Jan 2022

Cited by 4 | Viewed by 2671

Abstract

COVID-19 has caused a global pandemic with considerable impact. Studies have examined the influence of socioeconomic status and air pollution on COVID-19 risk but in low detail. This study seeks to further elucidate the nuances of socioeconomic status, as defined by the Index [...] Read more.

COVID-19 has caused a global pandemic with considerable impact. Studies have examined the influence of socioeconomic status and air pollution on COVID-19 risk but in low detail. This study seeks to further elucidate the nuances of socioeconomic status, as defined by the Index of Multiple Deprivation (IMD), air pollution, and their relationship. We examined the effect of IMD and air pollution on the likelihood of testing positive for SARS-CoV-2 among 66,732 UKB participants tested for SARS-CoV-2 from 16 March 2020 through 16 March 2021. Logistic regression was performed controlling for age, sex, ancestry and IMD or air pollution in the respective models. IMD and its sub-scores were significantly associated with increased risk of testing positive for SARS-CoV-2. All particulate matter less than 2.5 μm (PM2.5), nitrogen oxide (NO_x), and nitrogen dioxide (NO₂) levels were associated with increased likelihood of testing positive for SARS-CoV-2. Measures of green space and natural environment around participants’ homes were associated with reduced likelihood of SARS-CoV-2. Socioeconomic status and air pollution have independent effects on the risk of testing positive for SARS-CoV-2. Green space and natural environment space in the proximity of people’s homes may mediate the effect of air pollution on the risk of testing positive for SARS-CoV-2. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

11 pages, 316 KiB

Open AccessArticle

Perception Regarding Knowledge of COVID-19 Prevention in a Sample of a Middle Eastern and North African (MENA) Community in Houston, Texas, USA

by Jenna Zamil, Fatin Atrooz, Zahra Majd, Sarah Zeidat, Ghalya Alrousan, Susan Abughosh and Samina Salim

Int. J. Environ. Res. Public Health 2022, 19(1), 524; https://doi.org/10.3390/ijerph19010524 - 04 Jan 2022

Cited by 3 | Viewed by 1570

Abstract

(1) Background: Knowledge of COVID-19 prevention among communities is the first step towards protective behaviors. The objective of this study was to assess COVID-19 prevention knowledge among a Middle Eastern and North African community in Houston, Texas. (2) Methods: A cross-sectional study was [...] Read more.

(1) Background: Knowledge of COVID-19 prevention among communities is the first step towards protective behaviors. The objective of this study was to assess COVID-19 prevention knowledge among a Middle Eastern and North African community in Houston, Texas. (2) Methods: A cross-sectional study was conducted using a validated quantitative survey; survey questions consisted of three parts: COVID-19 specific questions, general health questions, and sociodemographic questions. A multivariable logistic regression model was used to determine predictors of perception of knowledge on preventing COVID-19 spread. The outcome of interest comprised of “good/excellent” versus “average and below” knowledge. (3) Results: A total of 366 participants (66.39% males) completed the survey. A univariate analysis demonstrated significant differences in self-reported COVID-19 prevention knowledge among those with and without health insurance, different ages, level of knowledge, and perceived severity of COVID-19 infection. In the multivariate logistic regression, two predictors were identified: those in the 18–25-year-old group were more likely to have “excellent/good” knowledge on COVID-19 spread compared to the ≥40-year-old group (OR: 6.36; 95% CI: 1.38, 29.34). Those who somewhat agree with knowing how to protect themselves from COVID-19 were more likely to have “excellent/good” knowledge of preventing COVID-19 spread compared to those that neither agree nor disagree or disagree (OR: 7.74; 95% CI: 2.58, 23.26). (4) Conclusions: Younger adults reported higher knowledge of COVID-19 prevention. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

12 pages, 3886 KiB

Open AccessArticle

Burden of COVID-19 and Vaccination Coverage in the Italian Population as of October 2021

by Emma Altobelli, Francesca Marzi, Anna Maria Angelone, Riccardo Mazzocca, Marianna Mastrodomenico, Reimondo Petrocelli and Ciro Marziliano

Int. J. Environ. Res. Public Health 2022, 19(1), 496; https://doi.org/10.3390/ijerph19010496 - 03 Jan 2022

Cited by 6 | Viewed by 1838

Abstract

Following the pandemic scenario, researchers from all over the world, including Italians, have undertaken fervent research activity using the epidemiological data available on the sites of government and national and international research institutes. The objectives of our study were: (1) to analyze the [...] Read more.

Following the pandemic scenario, researchers from all over the world, including Italians, have undertaken fervent research activity using the epidemiological data available on the sites of government and national and international research institutes. The objectives of our study were: (1) to analyze the load and trend of the COVID-19 pandemic in Italy, from the beginning to October 2021; (2) to analyze vaccination coverage by age groups and types of vaccines administered and check how the vaccination campaign has influenced the course of the disease and deaths; (3) to evaluate the Italian situation in the European context, comparing the incidence and mortality of Italy with respect to European countries; (4) finally, to evaluate how much vaccination coverage may have had an effect on mortality in the various European countries. Databases were structured to archive Italian and European COVID-19 data provided by Our World in Data, and data came from the Ministry of Health, to evaluate percentage of vaccines administered. The monthly trend of the cumulative incidence per 100,000 inhabitants in the period January 2020–October 2021 was evaluated. It is important to underline 3 peaks of incidence and mortality rates that occurred during the three waves of COVID-19: March–April–May 2020, October–November–December 2020, and March–April–May 2021. There is a slight increase in incidence in August 2021 and in mortality in September 2021. The three mortality rate peaks, related to the three waves of COVID-19, are always higher in Italy than in Europe, particularly in April 2020, December 2020, and March 2021. From May 2021 to October 2021, the mortality trend reversed, and it turned out to be higher in Europe than in Italy. Regarding vaccination, Italy currently has an important coverage, not only in the most fragile population, where it exceeds 90%, but also in the 12–19 age group, with percentages above 65%. The Pfizer/BioNTech vaccine was used widely in all age groups (first and second dose), with highest administration in 12–19 age groups and 80+, while the lowest was recorded in the 70–79 age group. In conclusion, these data confirm the importance of vaccination in the management of the COVID-19 pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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16 pages, 278 KiB

Open AccessArticle

Experiences of Nurse Managers during the COVID-19 Outbreak in a Selected District Hospital in Limpopo Province, South Africa

by Idah Moyo, Siyabulela Eric Mgolozeli, Patrone Rebecca Risenga, Sheilla Hlamalani Mboweni, Livhuwani Tshivhase, Tshimangadzo Selina Mudau, Nthomeni Dorah Ndou and Azwihangwisi Helen Mavhandu-Mudzusi

Healthcare 2022, 10(1), 76; https://doi.org/10.3390/healthcare10010076 - 31 Dec 2021

Cited by 9 | Viewed by 4004

Abstract

The South African health care system was hard hit by the second wave of Coronavirus disease (COVID-19), which affected nurse managers as healthcare facilities became overwhelmed due to an increased workload emanating from the overflow of admissions. Therefore, this study sought to explore [...] Read more.

The South African health care system was hard hit by the second wave of Coronavirus disease (COVID-19), which affected nurse managers as healthcare facilities became overwhelmed due to an increased workload emanating from the overflow of admissions. Therefore, this study sought to explore and describe the nurse managers’ experiences during COVID-19 in order to identify gaps and lessons learnt. A descriptive phenomenological research approach was used to explore the experiences of ten nurse managers who were purposively selected from different units of a selected district hospital. Data was collected through telephonic unstructured individual interviews and analysed using Colaizzi’s seven steps method. The study revealed that nurse managers experienced human resource related challenges during COVID-19, worsened by the fact that vacant posts were frozen. It also emerged that there was a shortage of material resources that affected patient care. Nurse managers also indicated that COVID-19 brought a lot of administrative duties plus an additional duty of patient care. Also, nurse managers who had previously contracted COVID-19 experienced stigma and discrimination. The government needs to address resource related challenges in rural public hospitals and provide continuous support to nurse managers, particularly during a pandemic like COVID-19. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

29 pages, 33132 KiB

Open AccessArticle

COVID-19 Pandemic: How Effective Are Preventive Control Measures and Is a Complete Lockdown Justified? A Comparison of Countries and States

by Franz Konstantin Fuss, Yehuda Weizman and Adin Ming Tan

COVID 2022, 2(1), 18-46; https://doi.org/10.3390/covid2010003 - 30 Dec 2021

Cited by 8 | Viewed by 8421

Abstract

For fighting the COVID-19 pandemic, countries used control measures of different severity, from “relaxed” to lockdown. Drastic lockdown measures are considered more effective but also have a negative impact on the economy. When comparing the financial value of lost lives to the losses [...] Read more.

For fighting the COVID-19 pandemic, countries used control measures of different severity, from “relaxed” to lockdown. Drastic lockdown measures are considered more effective but also have a negative impact on the economy. When comparing the financial value of lost lives to the losses of an economic disaster, the better option seems to be lockdown measures. We developed a new parameter, the effectiveness of control measures, calculated from the 2nd time derivative of daily case data, for 92 countries, states and provinces. We compared this parameter, and also the mortality during and after the effective phase, for countries with and without lockdowns measures by means of the Mann–Whitney test. We did not find any statistically significant difference in the effectiveness between countries with and without lockdowns (p > 0.76). There was also no significant difference in mortality during the effective phase (p > 0.1); however, a significant difference after the effective phase, with higher mortality for lockdown countries, was identified. The effectiveness correlated well with a parameter derived from the reproductive number (R² = 0.9480). The average duration of the effective phase was 17.3 ± 10.5 days. The results indicated that lockdown measures are not necessarily superior to relaxed measures, which in turn are not necessarily a recipe for failure. Relaxed measures are, however, more economy-friendly. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 890 KiB

Open AccessArticle

The Experiences of People with Diabetes during COVID-19 Pandemic Lockdown

by Modi Al-Moteri, Virginia Plummer, Hanan A. M. Youssef, Ruba W. H. Yaseen, Mohammed Al Malki, Ahmed AbdElbagy Ibrahim Elryah and Ahmed Al Karani

Int. J. Environ. Res. Public Health 2022, 19(1), 340; https://doi.org/10.3390/ijerph19010340 - 29 Dec 2021

Cited by 3 | Viewed by 2915

Abstract

Little is known about the theoretical foundation underling the response of people with diabetes managing their everyday routines during COVID-19 pandemic lockdown. Aim: To explore the experience of people with diabetes during COVID-19 pandemic lockdown in light of the risk perception, response and [...] Read more.

Little is known about the theoretical foundation underling the response of people with diabetes managing their everyday routines during COVID-19 pandemic lockdown. Aim: To explore the experience of people with diabetes during COVID-19 pandemic lockdown in light of the risk perception, response and behavioral change theories. Method: A qualitative descriptive design was employed, and Braun and Clark’s six step analysis were used for thematic analysis. Semi-structured interviews were conducted online using Zoom Videos Communication. Result: Five themes were defined as follows: (1) perceived the threat and faced their fears, (2) appraised the damage, (3) identified the challenges, (4) modified their routine, and (5) identified the strengths that facilitate the efficacy of their response. There were eight sub-themes within the themes. Conclusion: The results of this study may provide an opportunity for nurses to reflect on issues highlighted by the patients regarding more effective communication, knowledge and skill development for people to support self-care during national emergencies. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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8 pages, 568 KiB

Open AccessArticle

Association between SARS-CoV-2 Seroprevalence in Nursing Home Staff and Resident COVID-19 Cases and Mortality: A Cross-Sectional Study

by Ania Wisniak, Lakshmi Krishna Menon, Roxane Dumont, Nick Pullen, Simon Regard, Richard Dubos, María-Eugenia Zaballa, Hélène Baysson, Delphine Courvoisier, Laurent Kaiser, Didier Pittet, Andrew S. Azman, Silvia Stringhini, Idris Guessous, Jean-François Balavoine, Omar Kherad and The SEROCoV-WORK + Study Group

Viruses 2022, 14(1), 43; https://doi.org/10.3390/v14010043 - 28 Dec 2021

Cited by 5 | Viewed by 2461

Abstract

The burden of COVID-19 has disproportionately impacted the elderly, who are at increased risk of severe disease, hospitalization, and death. This cross-sectional study aimed to assess the association between SARS-CoV-2 seroprevalence among nursing home staff, and cumulative incidence rates of COVID-19 cases, hospitalizations, [...] Read more.

The burden of COVID-19 has disproportionately impacted the elderly, who are at increased risk of severe disease, hospitalization, and death. This cross-sectional study aimed to assess the association between SARS-CoV-2 seroprevalence among nursing home staff, and cumulative incidence rates of COVID-19 cases, hospitalizations, and deaths among residents. Staff seroprevalence was estimated within the SEROCoV-WORK+ study between May and September 2020 across 29 nursing homes in Geneva, Switzerland. Data on nursing home residents were obtained from the canton of Geneva for the period between March and August 2020. Associations were assessed using Spearman’s correlation coefficient and quasi-Poisson regression models. Overall, seroprevalence among staff ranged between 0 and 31.4%, with a median of 8.3%. A positive association was found between staff seroprevalence and resident cumulative incidence of COVID-19 cases (correlation coefficient R = 0.72, 95%CI 0.45–0.87; incidence rate ratio [IRR] = 1.10, 95%CI 1.07–1.17), hospitalizations (R = 0.59, 95%CI 0.25–0.80; IRR = 1.09, 95%CI 1.05–1.13), and deaths (R = 0.71, 95%CI 0.44–0.86; IRR = 1.12, 95%CI 1.07–1.18). Our results suggest that SARS-CoV-2 transmission between staff and residents may contribute to the spread of the virus within nursing homes. Awareness among nursing home professionals of their likely role in the spread of SARS-CoV-2 has the potential to increase vaccination coverage and prevent unnecessary deaths due to COVID-19. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 759 KiB

Open AccessArticle

The Impact of COVID-19 Pandemic on the Learning Outcomes of Medical Students in Taiwan: A Two-Year Prospective Cohort Study of OSCE Performance

by Tzyy-Yurn Tzeng, Chia-An Hsu, Ying-Ying Yang, Eunice J. Yuan, Ya-Ting Chang, Tzu-Hao Li, Chung-Pin Li, Jen-Feng Liang, Jiing-Feng Lirng, Tzeng-Ji Chen, Chia-Chang Huang, Ming-Chih Hou, Chen-Huan Chen and Wayne Huey-Herng Sheu

Int. J. Environ. Res. Public Health 2022, 19(1), 208; https://doi.org/10.3390/ijerph19010208 - 25 Dec 2021

Cited by 8 | Viewed by 3386

Abstract

Background/Aims: To avoid the negative impacts of the COVID-19 pandemic on clinical clerkship, supplemental teachings such as digital materials in the scenario-based distal simulations were implemented. This study utilized the OSCE (objective-structured clinical examination) to evaluate the impact of COVID-19 pandemic on the [...] Read more.

Background/Aims: To avoid the negative impacts of the COVID-19 pandemic on clinical clerkship, supplemental teachings such as digital materials in the scenario-based distal simulations were implemented. This study utilized the OSCE (objective-structured clinical examination) to evaluate the impact of COVID-19 pandemic on the learning outcome of medical students from the regular group (class of 2020) and pandemic-impacted group (class of 2021). Methods: All medical students serially took, firstly, the mock-OSCE, secondly, the mock-OSCE, and the national OSCE. Then, the serial OSCE scores were compared between groups. Results: Although with similar scores in the first mock OSCE, the regular group (n = 78) had a higher average score in the national OSCE than the pandemic-impacted group (n = 80) (872.18 vs. 834.96, p = 0.003). In terms of improvement, the performances of the regular group were also better than the pandemic-impacted group between the second mock OSCE and the national OSCE (79.10 vs. 38.14, p = 0.014), and between the second mock OSCE and the national OSCE (125.11 vs. 77.52, p = 0.003). While separating distinct genres, the regular group had more of a score increment in standardized patient-based stations between the second mock OSCE and the national OSCE (regular vs. pandemic-impacted: 57.03 vs. 18.95, p = 0.003), as well as between the first mock OSCE and the national OSCE (75.97 vs. 26.36, p < 0.001), but there was no significant difference among the skill-based stations. In particular, the scores of the emergency medicine associated station in the national OSCE of the pandemic-impacted group was lower. Conclusions: Our study implies that the pandemic significantly hampered the learning outcomes of final year medical students in their clinical participation. Especially facing the COVID-19 pandemic, more supplemental teachings are needed to compensate the decreasing emergency medicine exposure. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 627 KiB

Open AccessArticle

Vaccination Hesitancy among Health-Care-Workers in Academic Hospitals Is Associated with a 12-Fold Increase in the Risk of COVID-19 Infection: A Nine-Month Greek Cohort Study

by Fotinie Ntziora, Evangelia Georgia Kostaki, Ioannis Grigoropoulos, Amalia Karapanou, Ismini Kliani, Maria Mylona, Alexa Thomollari, Sotirios Tsiodras, Theoklis Zaoutis, Dimitrios Paraskevis, Nikolaos V. Sipsas, Anastasia Antoniadou and Petros P. Sfikakis

Viruses 2022, 14(1), 26; https://doi.org/10.3390/v14010026 - 24 Dec 2021

Cited by 4 | Viewed by 3055

Abstract

Health-Care-Workers (HCWs) are considered at high risk for SARS-CoV-2 infection. We sought to compare rates and severity of Coronavirus disease 2019 (COVID-19) among vaccinated and unvaccinated HCWs conducting a retrospective cohort study in two tertiary Academic Hospitals, namely Laiko and Attikon, in Athens, [...] Read more.

Health-Care-Workers (HCWs) are considered at high risk for SARS-CoV-2 infection. We sought to compare rates and severity of Coronavirus disease 2019 (COVID-19) among vaccinated and unvaccinated HCWs conducting a retrospective cohort study in two tertiary Academic Hospitals, namely Laiko and Attikon, in Athens, Greece. Vaccinated by BNT162b2 Pfizer-BioNTech COVID-19 mRNA vaccine and unvaccinated HCWs were included and data were collected between 1 January 2021 and 15 September 2021. Overall, 2921 of 3219 HCWs without a history of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection were fully vaccinated during the study period (90.7% at each Hospital). Demographic characteristics were comparable between 102/2921 (3.5%) vaccinated and 88/298 (29.5%) unvaccinated HCWs with COVID-19, although age and occupation differed significantly. None were in need of hospital admission in the vaccinated Group, whereas in the unvaccinated Group 4/88 (4.5%) were hospitalized and one (1.1%) died. Multivariable logistic regression analysis revealed that lack of vaccination was an independent risk factor for COVID-19 with an odds ratio 11.54 (95% CI: 10.75–12.40). Vaccination hesitancy among HCWs resulted to highly increased COVID-19 rates; almost one in three unvaccinated HCWs was SARS-CoV-2 infected during the 9-month period. The absolute need of vaccination of HCWs, including boosting dose, is highlighted. Evidence should be used appropriately to overcome any hesitancy. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 1620 KiB

Open AccessArticle

Perioperative Outcomes in COVID-19 Obstetric Patients Undergoing Spinal Anesthesia for Cesarean Section: A Prospective Observational Study

by Omar Ababneh, Mustafa Alrabayah, Ahmad I. El-Share’, Isam Bsisu, Yara Bahar, Banan Dabousi, Alia Sandoqa, Dania AlWreikat and Ayman Qatawneh

Healthcare 2022, 10(1), 23; https://doi.org/10.3390/healthcare10010023 - 24 Dec 2021

Cited by 2 | Viewed by 2486

Abstract

Coronavirus disease 2019 (COVID-19) adds more challenges to the perioperative management of parturients. The aim of this study is to examine perioperative adverse events and hemodynamic stability among COVID-19 positive parturients undergoing spinal anesthesia. This prospective observational investigation was conducted at a tertiary [...] Read more.

Coronavirus disease 2019 (COVID-19) adds more challenges to the perioperative management of parturients. The aim of this study is to examine perioperative adverse events and hemodynamic stability among COVID-19 positive parturients undergoing spinal anesthesia. This prospective observational investigation was conducted at a tertiary teaching hospital in Jordan between January and June 2021, during which 31 COVID-19 positive parturients were identified. Each COVID-19 positive parturient was matched with a COVID-19 negative parturient who received anesthesia under similar operating conditions as a control group. Of the 31 COVID-19 patients, 22 (71%) were otherwise medically free, 8 (25.8%) were emergency cesarean sections. The sensory level of spinal block after 10 min was T8 (T6–T10) among COVID-19 positive group, compared to T4 (T4–T6) among control group (p = 0.001). There were no significant differences in heart rate, SBP, DBP, and MAP intraoperatively (p > 0.05). Twelve (36.4%) neonates born to COVID-19 positive patients were admitted to NICU, compared to four (11.8%) among control group (p = 0.018). There was no statistically significant difference in postoperative complications. In conclusion, spinal anesthesia is considered a safe anesthetic technique in COVID-19 parturients, and therefore it is the anesthetic method of choice for cesarean deliveries among COVID-19 patients. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 325 KiB

Open AccessArticle

Stress and Coping Strategies of Nurses Working with Patients Infected with and Not Infected with SARS-CoV-2 Virus

by Grażyna Puto, Maria Jurzec, Anna Leja-Szpak, Joanna Bonior, Marta Muszalik and Agnieszka Gniadek

Int. J. Environ. Res. Public Health 2022, 19(1), 195; https://doi.org/10.3390/ijerph19010195 - 24 Dec 2021

Cited by 10 | Viewed by 3784

Abstract

Introduction: Working during the COVID-19 pandemic is a particular challenge for nurses because, while performing their daily routines, they are exposed to physical and social consequences of the SARS-CoV-2 virus, which is accompanied by intensified stress. The aim of this study was to [...] Read more.

Introduction: Working during the COVID-19 pandemic is a particular challenge for nurses because, while performing their daily routines, they are exposed to physical and social consequences of the SARS-CoV-2 virus, which is accompanied by intensified stress. The aim of this study was to assess the intensity of stress and coping strategies applied by nurses working with both infected and non-infected patients with SARS-CoV-2 virus during the COVID-19 pandemic. Materials and Methods: The study was conducted between January and March 2021. Due to the epidemiological situation, the questionnaire was posted on Facebook in nurses’ groups and sent out via the “Messenger” and “WhatsApp” applications. Stress intensity was assessed by means of the Perceived Stress Scale (PSS-10), whereas coping strategies were assessed using the Mini-COPE stress coping inventory. Results: Among 151 surveyed nurses, more than half (52.3%) worked with infected patients and the remaining ones (47.7%) worked with non-infected patients. The level of stress perceived by nurses working with infected patients was higher than among nurses working with patients without SARS-CoV-2 infection (22.22 ± 5.94 vs. 20.21 ± 5.68, p = 0.03). The nurses working with infected patients were most likely to choose coping strategies focused on the problem (2.00 ± 0.62) and emotions (2.01 ± 0.69), whereas those working with non-infected patients usually chose strategies focused only on the problem (2.11 ± 0.58). Conclusions: During the COVID-19 pandemic, nurses working with SARS-CoV-2 patients experienced more intense stress than those working with non-infected patients. Nurses working with SARS-CoV-2 patients tended to cope with stress using strategies focused on the problem and on emotions, while those working with non-infected patients were more likely to choose strategies focused only on the problem. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

11 pages, 375 KiB

Open AccessArticle

Caregivers of Individuals with Cancer in the COVID-19 Pandemic: A Phenomenological Study

by Leila Abou Salha, Julio Cesar Souza Silva, Cleusa Alves Martins, Cristiane Soares da Costa Araújo, Edinamar Aparecida Santos da Silva, Angela Gilda Alves, Cácia Régia de Paula, Flavio Henrique Alves de Lima, Veidma Siqueira de Moura, José Elmo de Menezes, Virginia Visconde Brasil and Maria Alves Barbosa

Int. J. Environ. Res. Public Health 2022, 19(1), 185; https://doi.org/10.3390/ijerph19010185 - 24 Dec 2021

Cited by 6 | Viewed by 2651

Abstract

Caregivers of individuals with cancer in the COVID-19 pandemic are faced with the demands of cancer and the health needs produced by it, along with their own health and self-care needs, and the uncertainties of expectations and risks. A qualitative analytical phenomenological study [...] Read more.

Caregivers of individuals with cancer in the COVID-19 pandemic are faced with the demands of cancer and the health needs produced by it, along with their own health and self-care needs, and the uncertainties of expectations and risks. A qualitative analytical phenomenological study with caregivers of individuals with cancer registered at the state referral hospital supplying medications, who answered the sociodemographic assessment questionnaires and semi-structured questions about their feelings and perceptions in the COVID-19 pandemic. Bardin’s content analysis was used, with methodological quality assessed using SRQR Standards for Reporting Qualitative Research and the MAXQDA software. Most of the caregivers are women, married, Catholic, of low income and education, aged between 30 and 60 years, optimistic, comply with health guidelines regarding social distancing, use of masks, and routine hand hygiene, do not practice regular physical activities, mention concern for their own physical and financial survival, and that of their family. The main need identified in the affective sphere was to reframe contact with family members, seeking to strengthen the bonds of affection. The feeling of emotional vulnerability shows the importance of building effective public policies for social support consistent with the improvement of health care for this population. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

13 pages, 365 KiB

Open AccessArticle

Depression, Anxiety and Stress on Caregivers of Persons with Dementia (CGPWD) in Hong Kong amid COVID-19 Pandemic

by Tommy Kwan-Hin Fong, Teris Cheung, Wai-Chi Chan and Calvin Pak-Wing Cheng

Int. J. Environ. Res. Public Health 2022, 19(1), 184; https://doi.org/10.3390/ijerph19010184 - 24 Dec 2021

Cited by 21 | Viewed by 5481

Abstract

Background: Coronavirus disease 2019 (COVID-19) contributed to increasing prevalence of depressive symptoms and other psychological repercussions, particularly in the disease population in Hong Kong. Nonetheless, the caregiver burden of caregivers of persons with dementia (CGPWD), has been under-investigated. Aims: This study examined the [...] Read more.

Background: Coronavirus disease 2019 (COVID-19) contributed to increasing prevalence of depressive symptoms and other psychological repercussions, particularly in the disease population in Hong Kong. Nonetheless, the caregiver burden of caregivers of persons with dementia (CGPWD), has been under-investigated. Aims: This study examined the psychological impact and its correlates on the CGPWD in Hong Kong amid the COVID-19 outbreak. Methods: CGPWD referred from rehabilitation clinics and online seminar were used to recruit participants to complete an online questionnaire by the end of the second-wave of the COVID-19 outbreak (June 2021). To be eligible, either full-time or part-time CGPWD, aged 18 or above, can understand Cantonese, currently reside in Hong Kong and offering care to PWD for at least one year, were recruited. Those CGPWD diagnosed with any type of psychiatric disorder were excluded from this study. The Chinese Center for Epidemiologic Studies Depression Scale (CES-D), Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder (GAD-7), Zarit Burden Interview (ZBI-22), and Nonattachment Scale (NAS-7) were used to measure participants’ depression, perceived stress, anxiety symptoms, caregiver burden and wisdom in subjective feelings of internal stress. The modified Medical Outcomes Study Social Support Survey (mMOS-SS) and the SARS Appraisal Inventory (SAI) were also administered to measure participants’ perceived support and coping efficacy. Follow-up responses were gathered by the end of third-wave outbreak (October 2021). Results: A total of 51 CGPWD participated, of which, 33 (64.7%) suffered from probable depression (CES-D score ≥ 16). Participants also showed a significant increase in depression symptom scores at the three-month follow-up period (t = 2.25, p = 0.03). CGPWD with probable depression had less non-attachment awareness and higher scores in anxiety, stress, caregiving burden, and coronavirus impact (all p < 0.05) than those without. Conclusions: High prevalence of depressive symptoms was noted among our CGPWD sample and these symptoms seemed to worsen substantially. Contingent online mental health support should be prioritized to those CGPWD to reduce psychiatric morbidity and the global disease burden. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

9 pages, 309 KiB

Open AccessReview

Women’s Healthcare Services since the COVID-19 Pandemic Outbreak in Poland

by Katarzyna Wszołek, Dominik Pruski, Katarzyna Tomczyk, Małgorzata Kampioni, Karolina Chmaj-Wierzchowska, Marcin Przybylski and Maciej Wilczak

Int. J. Environ. Res. Public Health 2022, 19(1), 180; https://doi.org/10.3390/ijerph19010180 - 24 Dec 2021

Cited by 7 | Viewed by 3105

Abstract

The COVID-19 pandemic had a direct impact on the extent of guaranteed healthcare services. Many gynecologists’, obstetricians’, and midwives’ offices were closed, laboratories suspended their activities, the collection of necessary tests was delayed, and women had to wait much longer for test results [...] Read more.

The COVID-19 pandemic had a direct impact on the extent of guaranteed healthcare services. Many gynecologists’, obstetricians’, and midwives’ offices were closed, laboratories suspended their activities, the collection of necessary tests was delayed, and women had to wait much longer for test results than they had to previously. General women’s healthcare prophylactic programs were suspended or delayed. In 2020, screening financed by public funds covered less than one-seventh of the female population in Poland. As medical teams, professionals, clinicians, and scientists, we have been facing a challenge to help, protect, and care for one of the most vulnerable population groups, pregnant women. A significant part of that challenge has been in preventing the spread of severe COVID-19, along with other preventable diseases, among women who are pregnant, who are in labor, or who have recently given birth. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

9 pages, 2061 KiB

Open AccessBrief Report

Remote Health Monitoring in the Workplace for Early Detection of COVID-19 Cases during the COVID-19 Pandemic Using a Mobile Health Application: COVIDApp.

by Patricia Echeverría, Jordi Puig, José María Ruiz, Jordi Herms, Maria Sarquella, Bonaventura Clotet and Eugenia Negredo

Int. J. Environ. Res. Public Health 2022, 19(1), 167; https://doi.org/10.3390/ijerph19010167 - 24 Dec 2021

Cited by 7 | Viewed by 2775

Abstract

Background: COVIDApp is a platform created for management of COVID-19 in the workplace. Methods: COVIDApp was designed and implemented for the follow-up of 253 workers from seven companies in Catalonia. The assessment was based on two actions: first, the early detection and management [...] Read more.

Background: COVIDApp is a platform created for management of COVID-19 in the workplace. Methods: COVIDApp was designed and implemented for the follow-up of 253 workers from seven companies in Catalonia. The assessment was based on two actions: first, the early detection and management of close contacts and potential cases of COVID-19, and second, the rapid remote activation of protocols. The main objectives of this strategy were to minimize the risk of transmission of COVID-19 infection in the work area through a new real-time communication channel and to avoid unnecessary sick leave. The parameters reported daily by workers were close contact with COVID cases and signs and/or symptoms of COVID-19. Results: Data were recorded between 1 May and 30 November 2020. A total of 765 alerts were activated by 76 workers: 127 green alarms (16.6%), 301 orange alarms (39.3%), and 337 red alarms (44.1%). Of all the red alarms activated, 274 (81.3%) were activated for symptoms potentially associated with COVID-19, and 63 (18.7%) for reporting close contact with COVID-19 cases. Only eight workers (3.1%) presented symptoms associated with COVID-19 infection. All of these workers underwent RT-PCR tests, which yielded negative results for SARS-CoV2. Three workers were considered to have had a risk contact with COVID-19 cases; only 1 (0.4%) asymptomatic worker had a positive RT-PCR test result, requiring the activation of protocols, isolation, and contact tracing. Conclusions: COVIDApp contributes to the early detection and rapid activation of protocols in the workplace, thus limiting the risk of spreading the virus and reducing the economic impact caused by COVID-19 in the productive sector. The platform shows the progression of infection in real time and can help design new strategies. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 2088 KiB

Open AccessArticle

Emerging SARS-CoV-2 Genotypes Show Different Replication Patterns in Human Pulmonary and Intestinal Epithelial Cells

by Gabriel Augusto Pires de Souza, Marion Le Bideau, Celine Boschi, Lorène Ferreira, Nathalie Wurtz, Christian Devaux, Philippe Colson and Bernard La Scola

Viruses 2022, 14(1), 23; https://doi.org/10.3390/v14010023 - 23 Dec 2021

Cited by 14 | Viewed by 3683

Abstract

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) quickly spread worldwide following its emergence in Wuhan, China, and hit pandemic levels. Its tremendous incidence favoured the emergence of viral variants. The current genome diversity of SARS-CoV-2 has a clear impact on epidemiology and clinical [...] Read more.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) quickly spread worldwide following its emergence in Wuhan, China, and hit pandemic levels. Its tremendous incidence favoured the emergence of viral variants. The current genome diversity of SARS-CoV-2 has a clear impact on epidemiology and clinical practice, especially regarding transmission rates and the effectiveness of vaccines. In this study, we evaluated the replication of different SARS-CoV-2 isolates representing different virus genotypes which have been isolated throughout the pandemic. We used three distinct cell lines, including Vero E6 cells originating from monkeys; Caco-2 cells, an intestinal epithelium cell line originating from humans; and Calu-3 cells, a pulmonary epithelium cell line also originating from humans. We used RT-qPCR to replicate different SARS-CoV-2 genotypes by quantifying the virus released in the culture supernatant of infected cells. We found that the different viral isolates replicate similarly in Caco-2 cells, but show very different replicative capacities in Calu-3 cells. This was especially highlighted for the lineages B.1.1.7, B.1.351 and P.1, which are considered to be variants of concern. These results underscore the importance of the evaluation and characterisation of each SARS-CoV-2 isolate in order to establish the replication patterns before performing tests, and of the consideration of the ideal SARS-CoV-2 genotype–cell type pair for each assay. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 477 KiB

Open AccessBrief Report

Comparison of Antigen Tests and qPCR in Rapid Diagnostics of Infections Caused by SARS-CoV-2 Virus

by Adrianna Klajmon, Aldona Olechowska-Jarząb, Dominika Salamon, Agnieszka Sroka-Oleksiak, Monika Brzychczy-Włoch and Tomasz Gosiewski

Viruses 2022, 14(1), 17; https://doi.org/10.3390/v14010017 - 23 Dec 2021

Cited by 4 | Viewed by 3093

Abstract

Diagnostics of the coronavirus disease 2019 (COVID-19) using molecular techniques from the collected respiratory swab specimens requires well-equipped laboratory and qualified personnel, also it needs several hours of waiting for results and is expensive. Antigen tests appear to be faster and cheaper but [...] Read more.

Diagnostics of the coronavirus disease 2019 (COVID-19) using molecular techniques from the collected respiratory swab specimens requires well-equipped laboratory and qualified personnel, also it needs several hours of waiting for results and is expensive. Antigen tests appear to be faster and cheaper but their sensitivity and specificity are debatable. The aim of this study was to compare a selected antigen test with quantitative polymerase chain reaction (qPCR) tests results. Nasopharyngeal swabs were collected from 192 patients with COVID-19 symptoms. All samples were tested using Vitassay qPCR SARS-CoV-2 kit and the Humasis COVID-19 Ag Test (MedSun) antigen immunochromatographic test simultaneously. Ultimately, 189 samples were tested; 3 samples were excluded due to errors in taking swabs. The qPCR and antigen test results were as follows: 47 positive and 142 negative, and 45 positive and 144 negative, respectively. Calculated sensitivity of 91.5% and specificity of 98.6% for the antigen test shows differences which are not statistically significant in comparison to qPCR. Our study showed that effectiveness of the antigen tests in rapid laboratory diagnostics is high enough to be an alternative and support for nucleic acid amplification tests (NAAT) in the virus replication phase in the course of COVID-19. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 477 KiB

Open AccessArticle

Acceptance of COVID-19 Vaccines among Patients with Inflammatory Bowel Disease in Japan

by Yu Nishida, Shuhei Hosomi, Yumie Kobayashi, Rieko Nakata, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Fumio Tanaka, Yasuaki Nagami, Koichi Taira, Noriko Kamata and Yasuhiro Fujiwara

Healthcare 2022, 10(1), 6; https://doi.org/10.3390/healthcare10010006 - 22 Dec 2021

Cited by 7 | Viewed by 2639

Abstract

Coronavirus disease 2019 (COVID-19) vaccination is recommended for patients with inflammatory bowel disease (IBD). However, the acceptance of COVID-19 vaccines has not been sufficiently evaluated in patients with IBD. We aimed to assess the acceptance and hesitancy of COVID-19 vaccination and related factors [...] Read more.

Coronavirus disease 2019 (COVID-19) vaccination is recommended for patients with inflammatory bowel disease (IBD). However, the acceptance of COVID-19 vaccines has not been sufficiently evaluated in patients with IBD. We aimed to assess the acceptance and hesitancy of COVID-19 vaccination and related factors among these patients. A retrospective cohort study using a self-reported questionnaire was performed among patients with IBD between 22 June 2021 and 30 August 2021. Of the 187 participants, 10.2% (n = 19) were hesitant to be vaccinated. Patients in the vaccine-hesitant group were younger (p = 0.009) and had a shorter disease duration (p = 0.020). Vedolizumab was prescribed more frequently (p = 0.024) and immunomodulators were less frequently used (p = 0.027) in this group. Multivariable logistic regression analysis identified age (odds ratio [OR]: 0.96, 95% confidence interval [CI]: 0.92–1.00, p = 0.042) and the use of immunomodulators (OR: 0.08, 95% CI: 0.01–0.66, p = 0.019) as independent significant factors for vaccine hesitancy. The COVID-19 vaccine hesitancy rate in patients with IBD in Japan was 10% in this study. The Japanese COVID-19 vaccination campaign appears to be successful. The risk of COVID-19 among patients with IBD requires adequate measures to ensure that vaccines are accepted by vaccine-hesitant patients. These findings may be helpful in achieving adequate vaccination rates. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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17 pages, 380 KiB

Open AccessArticle

Experiencing the Unprecedented COVID-19 Lockdown: Abu Dhabi Older Adults’ Challenges and Concerns

by Masood A. Badri, Mugheer A. Alkhaili, Hamad Aldhaheri, Guang Yang, Muna Albahar, Asma Alrashdi, Bushra Almulla and Layla Alhyas

Int. J. Environ. Res. Public Health 2021, 18(24), 13427; https://doi.org/10.3390/ijerph182413427 - 20 Dec 2021

Cited by 1 | Viewed by 2672

Abstract

This study focused on older adults (60+ years old) of both genders in Abu Dhabi during the COVID-19 pandemic before vaccines were made available (age ranged from 60 years to 75 years). They faced more strict rules of movement restriction and isolation that [...] Read more.

This study focused on older adults (60+ years old) of both genders in Abu Dhabi during the COVID-19 pandemic before vaccines were made available (age ranged from 60 years to 75 years). They faced more strict rules of movement restriction and isolation that might have resulted in certain psychological feelings and social reactions. The main objective was to understand Abu Dhabi older adults’ psychological feelings during the pandemic and to identify their main concerns and challenges considering the various COVID-19-related policies and restrictions. The psychological feelings focused on fear, loneliness, sadness, irritability, emotional exhaustion, depressive symptoms, sleeping disorders, overeating, and excessive screen use. The objectives also included the changes in the psychological feelings concerning time. Other objectives covered better understanding the differences in (some activities) compared to the other age categories. Data were gathered through an online survey of community members from February to July 2020 as part of government initiatives (Department of Community Development). Responses were collected from 574 older adults in Abu Dhabi (60.1% male and 39.9% female). The analysis mainly used descriptive analysis, t-tests, analysis of variance (ANOVA), and simple trend analysis. For all tests, a p-value less than 0.05 was used for significance. The results pointed to the significant rise in feelings related to excessive screen use, fear, loneliness, and stress. The most significant concerns were related to more restrictions being imposed and not being able to see the grandchildren.The impact of new technologies on their quality of life was significantly reflected by respondents. The influence of the pandemic on older adults’ health and weight was also investigated. Analysis of variance, t-tests, and regression analysis with relevant tests were employed. The relevant results showed that some negative psychological feelings were common among older adults during the pandemic. However, the psychological feelings did not portray significant changes with time, except for sleeping disorders and overeating. Overall, older adults scored significantly different from other age groups on many challenges, concerns, and views regarding new technologies during the pandemic. No significant differences were observed regarding gender and marital status for the challenges and concerns. The research summarizes some policy guidance while noting some limitations of this study and future research directions. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

13 pages, 2125 KiB

Open AccessArticle

Response of Saudi Population to Strict Preventive Measures against COVID-19

by Amro K. Bin Abdulrahman, Khalid A. Bin Abdulrahman and Randa M. Nouh

Int. J. Environ. Res. Public Health 2021, 18(24), 13424; https://doi.org/10.3390/ijerph182413424 - 20 Dec 2021

Cited by 4 | Viewed by 2702

Abstract

The Saudi ministry of health (MOH) started the preventive measures very early on before having a single case of COVID-19. There were very few studies regarding the awareness and adherence to the preventive measures against COVID-19 among the Saudi population in the literature. [...] Read more.

The Saudi ministry of health (MOH) started the preventive measures very early on before having a single case of COVID-19. There were very few studies regarding the awareness and adherence to the preventive measures against COVID-19 among the Saudi population in the literature. Objectives: The study aims to examine the awareness and commitment to the strict Saudi government preventive measures against COVID-19. Methods: A cross-sectional online survey targeted Saudi and non-Saudi populations aged 18+ in March–April 2020. The online questionnaire was designed to explore the participant’s sociodemographic data, washing hygiene habits, the general level of awareness regarding COVID-19, and the extent to which they adhere to the government’s strict instructions. Results: Out of the 2958 participants in the survey, 23% washed their hands for between 20 and 30 s, 59.6% washed their hands after shaking hands with other people, 67.9% washed their hands after use of other’s utilities, 65.9% had appropriately followed the MOH recommended guidelines for home quarantine and social distancing. People in different age groups differed significantly on their practiced hygienic practices score p < 0.001. Respondents’ educational level had converged considerably and positively on their clean proper prevention practices score, f(2838.3) = 15.70. Conclusion: The majority of the participants adhere to the strict government instructions regarding COVID-19 as they have to obey the law. Health sector employees measured significantly greater hygienic preventive measures and precautions in comparison to other sectors. More public health efforts should increase hygienic best practice scores to achieve the best outcome. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 256 KiB

Open AccessArticle

A Qualitative Study on the Care Experience of Emergency Department Nurses during the COVID-19 Pandemic

by Hsing-Chi Hsu, Hsin-Ju Chou and Kai-Yu Tseng

Healthcare 2021, 9(12), 1759; https://doi.org/10.3390/healthcare9121759 - 19 Dec 2021

Cited by 6 | Viewed by 3681

Abstract

Background: The rapid spread of the disease has severely impacted healthcare systems around the world. There is a lack of evidence related to the care experience of emergency department nurses. Objective: To understand the care experience and thoughts of emergency department nurses during [...] Read more.

Background: The rapid spread of the disease has severely impacted healthcare systems around the world. There is a lack of evidence related to the care experience of emergency department nurses. Objective: To understand the care experience and thoughts of emergency department nurses during the COVID-19 epidemic. Methods: Purposive sampling was used to recruit 16 emergency department nurses from a medical center, and a semi-structured interview was used for data collection. The enrollment period was from 28 July 2021 to 30 October 2021. Thematic content analysis was used for data analysis. Results: The care experiences of emergency department nurses during the COVID-19 epidemic can be classified into three themes and six sub-themes. Theme 1: I am the gatekeeper; theme 2: Care and environment challenges: difficulties with equipment and environment, managing patient’s and family members’ emotions, insufficient manpower of care; theme 3: Conflicting emotions: worrying about being infected or transmitting the disease, needs of effective support and empathy, and lack of understanding and discrimination towards the occupation. Conclusion: Emergency department nurses adhered to professional awareness and responsibility during the epidemic and play a critical role in epidemic prevention. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

21 pages, 1598 KiB

Open AccessArticle

The Sustained Psychological Impact of the COVID-19 Pandemic on Health Care Workers One Year after the Outbreak—A Repeated Cross-Sectional Survey in a Tertiary Hospital of North-East Italy

by Antonio Lasalvia, Luca Bodini, Francesco Amaddeo, Stefano Porru, Angela Carta, Ranieri Poli and Chiara Bonetto

Int. J. Environ. Res. Public Health 2021, 18(24), 13374; https://doi.org/10.3390/ijerph182413374 - 19 Dec 2021

Cited by 26 | Viewed by 3880

Abstract

This study aimed to evaluate the mental health outcomes of health care workers (HCWs) of the Verona academic hospital trust (Italy) one year after the outbreak of COVID-19 and to identify predicted risk factors. A web-based survey was conducted from mid-April to mid-May [...] Read more.

This study aimed to evaluate the mental health outcomes of health care workers (HCWs) of the Verona academic hospital trust (Italy) one year after the outbreak of COVID-19 and to identify predicted risk factors. A web-based survey was conducted from mid-April to mid-May 2021 on hospital workers one year after the first evaluation performed during the lock-down phase of the COVID-19 pandemic. Post-traumatic stress, general anxiety, depression, and burnout were assessed by using, respectively, the impact of event scale (IES-R), the self-rating anxiety scale (SAS), the patient health questionnaire (PHQ-9) and the Maslach burnout inventory-general survey (MBI-GS). Multivariate logistic regression analysis was performed to identify factors associated with each of the four mental health outcomes one year after the COVID-19 outbreak. A total of 1033 HCWs participated. The percentage of HCWs scoring above the cut-off increased from 2020 to 2021 in all of the outcome domains (anxiety, 50.1% vs. 55.7, p < 0.05; depression, 26.6% vs. 40.6%, p < 0.001; burnout, 28.6% vs. 40.6%, p < 0.001; chi-square test), with the exception of post-traumatic distress. There was also an increase when stratifying by occupation and workplace, with a greater increase for depression and burnout. Multivariate analysis revealed that, one year after the COVID-19 outbreak, nurses were at the greatest risk of anxiety and depression, whereas residents were at the greatest risk of burnout (in terms of low professional efficacy). Working in intensive care units was associated with an increased risk of developing severe emotional exhaustion and a cynical attitude towards work. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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24 pages, 1791 KiB

Open AccessArticle

COVID-19 Vaccine Acceptance of Pregnant and Lactating Women (PLW) in Czechia: An Analytical Cross-Sectional Study

by Abanoub Riad, Anna Jouzová, Batuhan Üstün, Eliška Lagová, Lukáš Hruban, Petr Janků, Andrea Pokorná, Jitka Klugarová, Michal Koščík and Miloslav Klugar

Int. J. Environ. Res. Public Health 2021, 18(24), 13373; https://doi.org/10.3390/ijerph182413373 - 19 Dec 2021

Cited by 61 | Viewed by 5501

Abstract

Pregnant and lactating women (PLW) represent a particular population subset with increased susceptibility for COVID-19 morbidity and mortality, even though the evidence about the safety and efficacy of COVID-19 vaccines was delayed due to their initial exclusion from development trials. This unclear situation [...] Read more.

Pregnant and lactating women (PLW) represent a particular population subset with increased susceptibility for COVID-19 morbidity and mortality, even though the evidence about the safety and efficacy of COVID-19 vaccines was delayed due to their initial exclusion from development trials. This unclear situation could have led to increased COVID-19 vaccine hesitancy levels among PLW; therefore, this study aimed to evaluate the attitudes of Czech PLW towards COVID-19 vaccines and the determinants of their attitudes. An analytical cross-sectional survey-based study was carried out in the University Hospital Brno (South Moravia, Czechia) between August and October 2021. The study utilised a self-administered questionnaire (SAQ) adapted from previous instruments used for the same purpose. The SAQ included closed-ended items covering demographic characteristics, clinical and obstetric characteristics, attitudes towards COVID-19 vaccination, and potential psychosocial predictors of vaccine acceptance. Out of the 362 included participants, 278 were pregnant (PW) and 84 were lactating women (LW). The overall COVID-19 vaccine acceptance (immediate and delayed) level was substantially high (70.2%), with a significant difference between PW (76.6%) and LW (48.8%). Out of the 70.2% who agreed to receive the vaccine, 3.6% indicated immediate acceptance, and 66.6% indicated delayed acceptance. Only 13.3% of the participants indicated their acceptance of their physician’s vaccination recommendation during pregnancy or while lactating, and 62.2% were against it. Our results agreed with the recent studies that revealed that PW tended to have a high level of COVID-19 vaccine acceptance, and they were also inclined to resist professional recommendations because they predominantly preferred to delay their vaccination. The pregnancy trimester, education level, employment status, and previous live births were significant determinants for COVID-19 vaccine acceptance. The most commonly preferred vaccine type was mRNA-based vaccines, followed by viral vector-based and inactivated virus vaccines. The first top priority of PLW was vaccine safety for their children, followed by vaccine safety for the PLW and vaccine effectiveness. Regarding psychosocial predictors, media/social media, trust in the government, the pharmaceutical industry, and healthcare professionals, partners, and a positive risk-benefit ratio were significant promoters for COVID-19 vaccine acceptance. Findings from this study suggest that promotional interventions targeting PLW should use web platforms and focus on vaccine safety evidence, the expected benefits of vaccines and potential harms of the infection. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 369 KiB

Open AccessArticle

Alcohol Use and Its Related Psychosocial Effects during the Prolonged COVID-19 Pandemic in Japan: A Cross-Sectional Survey

by Nagisa Sugaya, Tetsuya Yamamoto, Naho Suzuki and Chigusa Uchiumi

Int. J. Environ. Res. Public Health 2021, 18(24), 13318; https://doi.org/10.3390/ijerph182413318 - 17 Dec 2021

Cited by 10 | Viewed by 2666

Abstract

We conducted a large-scale survey in the Japanese population, about one year after the initial declaration of the state of emergency, to investigate alcohol use under the prolonged coronavirus disease 2019 (COVID-19) pandemic and its related psychosocial and demographic characteristics. The survey was [...] Read more.

We conducted a large-scale survey in the Japanese population, about one year after the initial declaration of the state of emergency, to investigate alcohol use under the prolonged coronavirus disease 2019 (COVID-19) pandemic and its related psychosocial and demographic characteristics. The survey was conducted online between 15 and 20 June 2021. A total of 11,427 participants were included in the analysis (48.5% female, 48.82 ± 13.30 years, range = 20–90 years). Compared with females, males were more prevalent in the hazardous user and the potential alcoholism group and were less prevalent in the no alcohol-related problem group. However, the prevalence of potential alcoholism among the participants in our study was higher than that previously reported. This trend was particularly pronounced in women. The presence of potential alcoholism was related to a deteriorated psychological status, particularly depression and anxiety, and various difficulties in their daily lives due to the COVID-19 pandemic. In the future, intervention methods and systems should be developed to provide optimal assistance to people with psychological problems who are vulnerable to alcohol-related problems during the COVID-19 pandemic, while conducting further long-term follow-up studies. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

6 pages, 1907 KiB

Open AccessBrief Report

Causes of Death during the First COVID-19 Pandemic Wave in Italy: A Comparison with Some European Countries

by Enrico Grande, Giulia Marcone, Alessia Scuro, Tania Bracci, Simona Cinque, Roberta Crialesi, Luisa Frova, Stefano Marchetti, Simone Navarra, Chiara Orsi, Marilena Pappagallo, Silvia Simeoni and Francesco Grippo

COVID 2021, 1(4), 751-756; https://doi.org/10.3390/covid1040060 - 16 Dec 2021

Cited by 1 | Viewed by 2666

Abstract

Studies comparing cause-of-death patterns across countries during the COVID-19 outbreak are still lacking although such studies would contribute to the understanding of the direct and indirect effect of the virus on mortality. In this report, we compare the mortality pattern observed in Italy [...] Read more.

Studies comparing cause-of-death patterns across countries during the COVID-19 outbreak are still lacking although such studies would contribute to the understanding of the direct and indirect effect of the virus on mortality. In this report, we compare the mortality pattern observed in Italy during the first pandemic wave (March–April 2020) with that of some European countries. We calculated cause-specific, age-standardized mortality ratios (SMR) for Spain, England, and Sweden for the two mentioned months from 2016 to 2020, using already published data. Although Italy presented the highest crude overall mortality rate (267 per 100,000 population), age-adjusted ratios showed that all-cause and COVID-19 mortality in Italy were higher than in Sweden but lower than in the other two countries. Some causes had a similar increase in 2020 compared to previous years in all countries, i.e., endocrine diseases (especially diabetes), dementia and Alzheimer’s (in general mental disorders), and hypertensive heart diseases. Conversely, respiratory diseases, in particular pneumonia and influenza, increased to a greater extent in Italy. This latter result could be, in part, related to the underreporting of COVID-19 on death certificates during the first period of the pandemic, when Italy was the first European country severely hit by the virus. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 816 KiB

Open AccessArticle

General and COVID-19-Related Mortality by Pre-Existing Chronic Conditions and Care Setting during 2020 in Emilia-Romagna Region, Italy

by Nicola Caranci, Chiara Di Girolamo, Letizia Bartolini, Daniela Fortuna, Elena Berti, Stefano Sforza, Paolo Giorgi Rossi and Maria Luisa Moro

Int. J. Environ. Res. Public Health 2021, 18(24), 13224; https://doi.org/10.3390/ijerph182413224 - 15 Dec 2021

Cited by 9 | Viewed by 1594

Abstract

In 2020, the number of deaths increased in Italy, mainly because of the COVID-19 pandemic; mortality was among the highest in Europe, with a clear heterogeneity among regions and socio-demographic strata. The present work aims to describe trends in mortality and to quantify [...] Read more.

In 2020, the number of deaths increased in Italy, mainly because of the COVID-19 pandemic; mortality was among the highest in Europe, with a clear heterogeneity among regions and socio-demographic strata. The present work aims to describe trends in mortality and to quantify excess mortality variability over time and in relation to demographics, pre-existent chronic conditions and care setting of the Emilia-Romagna region (Northern Italy). This is a registry-based cross-sectional study comparing the 2020 observed mortality with figures of the previous five years by age, sex, month, place of death, and chronicity. It includes 300,094 deaths in those 18 years of age and above resident in the Emilia-Romagna region. Excess deaths were higher during the first pandemic wave, particularly among men and in March. Age-adjusted risk was similar among both men and women (Mortality Rate Ratio 1.15; IC95% 1.14–1.16). It was higher among females aged 75+ years and varied between sub-periods. Excluding COVID-19 related deaths, differences in the risk of dying estimates tended to disappear. Metabolic and neuropsychiatric diseases were more prevalent among those that deceased in 2020 compared to the deaths that occurred in 2015–2019 and therefore can be confirmed as elements of increased frailty, such as being in long-term care facilities or private homes as the place of death. Understanding the impact of the pandemic on mortality considering frailties is relevant in a changing scenario. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 983 KiB

Open AccessArticle

Differences in the Association between Physical Activity and People’s Resilience and Emotions during Two Consecutive Covid-19 Lockdowns in Israel

by Sima Zach, Sigal Eilat-Adar, Miki Ophir and Avital Dotan

Int. J. Environ. Res. Public Health 2021, 18(24), 13217; https://doi.org/10.3390/ijerph182413217 - 15 Dec 2021

Cited by 4 | Viewed by 1480

Abstract

Governments worldwide have imposed harsh restrictions for decreasing the Covid-19 pandemic and maintaining public health. Yet such limitations have impacted people’s physical activity. This study examined relationships between changes in physical activity and resilience, emotions, and depression during two lockdowns in Israel. An [...] Read more.

Governments worldwide have imposed harsh restrictions for decreasing the Covid-19 pandemic and maintaining public health. Yet such limitations have impacted people’s physical activity. This study examined relationships between changes in physical activity and resilience, emotions, and depression during two lockdowns in Israel. An online survey was completed twice by 135 participants during two consecutive lockdowns. The results indicate that resilience and positive emotions were higher, and negative emotions and depression were lower during the second lockdown compared to the first one—even though people spent less time performing physical activity in the later lockdown. Moreover, negative emotions significantly decreased among people who reported increased physical activity during the second lockdown [M = 2.2 (SD = 0.9) compared to M = 1.9 (SD = 0.8) on a scale of 1–5] and increased among those who reported a reduction in activity [M = 1.8 (SD = 0.7) compared to M = 2.2 (SD = 0.7)]. It could therefore be concluded that while the Israeli population’s resilience is higher compared to other populations (who do not regularly deal with crisis situations), their increased physical activity was associated with better resilience and emotions and lower depression scores. Since lockdowns are an extreme yet often repeated phenomenon, it is important to understand the psychological implications of engaging in physical activity. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 257 KiB

Open AccessReview

Development of Serological Assays and Seroprevalence Studies of the New Coronavirus 2019 (COVID-19): Reports from Saudi Arabia

by Thamir A. Alandijany and Arwa A. Faizo

Healthcare 2021, 9(12), 1730; https://doi.org/10.3390/healthcare9121730 - 14 Dec 2021

Cited by 3 | Viewed by 2390

Abstract

Serological assays are valuable tools for tracking COVID-19 spread, estimation of herd immunity, and evaluation of vaccine effectiveness. Several reports from Saudi Arabia describe optimized in-house protocols that enable detection of SARS-CoV-2 specific antibodies and measurement of their neutralizing activity. Notably, there were [...] Read more.

Serological assays are valuable tools for tracking COVID-19 spread, estimation of herd immunity, and evaluation of vaccine effectiveness. Several reports from Saudi Arabia describe optimized in-house protocols that enable detection of SARS-CoV-2 specific antibodies and measurement of their neutralizing activity. Notably, there were variations in the approaches utilized to develop and validate these immunoassays in term of sample size, validation methodologies, and statistical analyses. The developed enzyme-linked immunoassays (ELISAs) were based on the viral full-length spike (S), S1 subunit, and nucleocapsid (NP), and enabled detection of IgM and/or IgG. ELISAs were evaluated and validated against a microneutralization assay utilizing a local SARS-CoV-2 clinical isolate, FDA-approved commercially available immunoassays, and/or real-time polymerase chain reaction (RT-PCR). Overall, the performance of the described assays was high, reaching up to 100% sensitivity and 98.9% specificity with no cross-reactivity with other coronaviruses. In-house immunoassays, along with commercially available kits, were subsequently applied in a number of sero-epidemiological studies aiming to estimate sero-positivity status among local populations including healthcare workers, COVID-19 patients, non-COVID-19 patients, and healthy blood donors. The reported seroprevalence rates differed widely among these studies, ranging from 0.00% to 32.2%. These variations are probably due to study period, targeted population, sample size, and performance of the immunoassays utilized. Indeed, lack of sero-positive cases were reported among healthy blood donors during the lockdown, while the highest rates were reported when the number of COVID-19 cases peaked in the country, particularly among healthcare workers working in referral hospitals and quarantine sites. In this review, we aim to (1) provide a critical discussion about the developed in-house immunoassays, and (2) summarize key findings of the sero-epidemiological studies and highlight strengths and weaknesses of each study. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

16 pages, 1321 KiB

Open AccessReview

Testing Antigens, Antibodies, and Immune Cells in COVID-19 as a Public Health Topic—Experience and Outlines

by Monica Neagu, Carolina Constantin and Mihaela Surcel

Int. J. Environ. Res. Public Health 2021, 18(24), 13173; https://doi.org/10.3390/ijerph182413173 - 14 Dec 2021

Cited by 7 | Viewed by 2920

Abstract

The current COVID-19 pandemic has triggered an accelerated pace in all research domains, including reliable diagnostics methodology. Molecular diagnostics of the virus and its presence in biological samples relies on the RT-PCR method, the most used and validated worldwide. Nonconventional tests with improved [...] Read more.

The current COVID-19 pandemic has triggered an accelerated pace in all research domains, including reliable diagnostics methodology. Molecular diagnostics of the virus and its presence in biological samples relies on the RT-PCR method, the most used and validated worldwide. Nonconventional tests with improved parameters that are in the development stages will be presented, such as droplet digital PCR or CRISPR-based assays. These molecular tests were followed by rapid antigen testing along with the development of antibody tests, whether based on ELISA platform or on a chemiluminescent microparticle immunoassay. Less-conventional methods of testing antibodies (e.g., lateral flow immunoassay) are presented as well. Left somewhere in the backstage of COVID-19 research, immune cells and, furthermore, immune memory cells, are gaining the spotlight, more so in the vaccination context. Recently, methodologies using flow-cytometry evaluate circulating immune cells in infected/recovered patients. The appearance of new virus variants has triggered a surge for tests improvement. As the pandemic has entered an ongoing or postvaccination era, all methodologies that are used to monitor public health focus on diagnostic strategies and this review points out where gaps should be filled in both clinical and research settings. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 464 KiB

Open AccessReview

SARS-CoV-2 and Variant Diagnostic Testing Approaches in the United States

by Emmanuel Thomas, Stephanie Delabat, Yamina L. Carattini and David M. Andrews

Viruses 2021, 13(12), 2492; https://doi.org/10.3390/v13122492 - 13 Dec 2021

Cited by 31 | Viewed by 5308

Abstract

Purpose of Review Given the rapid development of diagnostic approaches to test for and diagnose infection with SARS-CoV-2 and its associated variants including Omicron (B.1.1.529), many options are available to diagnose infection. Multiple established diagnostic companies are now providing testing platforms whereas initially, [...] Read more.

Purpose of Review Given the rapid development of diagnostic approaches to test for and diagnose infection with SARS-CoV-2 and its associated variants including Omicron (B.1.1.529), many options are available to diagnose infection. Multiple established diagnostic companies are now providing testing platforms whereas initially, testing was being performed with simple PCR-based tests using standard laboratory reagents. Recent Findings Additional testing platforms continue to be developed, including those to detect specific variants, but challenges with testing, including obtaining testing reagents and other related supplies, are frequently encountered. With time, the testing supply chain has improved, and more established companies are providing materials to support these testing efforts. In the United States (U.S.), the need for rapid assay development and subsequent approval through the attainment of emergency use authorization (EUA) has superseded the traditional arduous diagnostic testing approval workflow mandated by the FDA. Through these efforts, the U.S. has been able to continue to significantly increase its testing capabilities to address this pandemic; however, challenges still remain due to the diversity of the performance characteristics of tests being utilized and newly discovered viral variants. Summary This review provides an overview of the current diagnostic testing landscape, with pertinent information related to SARS-CoV-2 virology, variants and antibody responses that are available to diagnose infection in the U.S. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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27 pages, 1391 KiB

Open AccessArticle

Challenges and Innovations Brought about by the COVID-19 Pandemic Regarding Medical and Pharmacy Education Especially in Africa and Implications for the Future

by Ayukafangha Etando, Adefolarin A. Amu, Mainul Haque, Natalie Schellack, Amanj Kurdi, Alian A. Alrasheedy, Angela Timoney, Julius C. Mwita, Godfrey Mutashambara Rwegerera, Okwen Patrick, Loveline Lum Niba, Baffour Boaten Boahen-Boaten, Felicity Besong Tabi, Olufunke Y. Amu, Joseph Acolatse, Robert Incoom, Israel Abebrese Sefah, Anastasia Nkatha Guantai, Sylvia Opanga, Ibrahim Chikowe, Felix Khuluza, Dan Kibuule, Francis Kalemeera, Ester Hango, Jennie Lates, Joseph Fadare, Olayinka O. Ogunleye, Zikria Saleem, Frasia Oosthuizen, Werner Cordier, Moliehi Matlala, Johanna C. Meyer, Gustav Schellack, Amos Massele, Oliver Ombeva Malande, Aubrey Chichonyi Kalungia, James Sichone, Sekelani S. Banda, Trust Zaranyika, Stephen Campbell and Brian Godman Show full author list Hide full author list

Healthcare 2021, 9(12), 1722; https://doi.org/10.3390/healthcare9121722 - 13 Dec 2021

Cited by 34 | Viewed by 5059

Abstract

Background: Multiple measures introduced early to restrict COVID-19 have dramatically impacted the teaching of medical and pharmacy students, exacerbated by the lack of infrastructure and experience with e-learning at the start of the pandemic. In addition, the costs and reliability of the Internet [...] Read more.

Background: Multiple measures introduced early to restrict COVID-19 have dramatically impacted the teaching of medical and pharmacy students, exacerbated by the lack of infrastructure and experience with e-learning at the start of the pandemic. In addition, the costs and reliability of the Internet across Africa pose challenges alongside undertaking clinical teaching and practical programmes. Consequently, there is a need to understand the many challenges and how these were addressed, given increasingly complex patients, to provide future direction. Method: An exploratory study was conducted among senior-level medical and pharmacy educators across Africa, addressing four key questions, including the challenges resulting from the pandemic and how these were dealt with. Results: Staff and student members faced multiple challenges initially, including adapting to online learning. In addition, concerns with the lack of equipment (especially among disadvantaged students), the costs of Internet bundles, and how to conduct practicals and clinical teaching. Multiple activities were undertaken to address these challenges. These included training sessions, developing innovative approaches to teaching, and seeking ways to reduce Internet costs. Robust approaches to practicals, clinical teaching, and assessments have been developed. Conclusions: Appreciable difficulties to teaching arising from the pandemic are being addressed across Africa. Research is ongoing to improve education and assessments. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 3727 KiB

Open AccessArticle

Sentiment Analysis of Comments of American Birders during Two Waves of the COVID-19 Pandemic Reveal More Negative Sentiments in the Context of Birding

by Christoph Randler, Nadine Kalb and Piotr Tryjanowski

Int. J. Environ. Res. Public Health 2021, 18(24), 13142; https://doi.org/10.3390/ijerph182413142 - 13 Dec 2021

Cited by 2 | Viewed by 2210

Abstract

Human–nature relationships are an important aspect of leisure research. Previous studies also reported that nature-related activities have a health benefit. In this study, we surveyed US-American birdwatchers at two time points during the COVID pandemic (independent samples). During the beginning of the COVID [...] Read more.

Human–nature relationships are an important aspect of leisure research. Previous studies also reported that nature-related activities have a health benefit. In this study, we surveyed US-American birdwatchers at two time points during the COVID pandemic (independent samples). During the beginning of the COVID pandemic in spring 2020, we analyzed their comments with an AI sentiment analysis. Approximately one year later (winter 2020/21), during the second wave, the study was repeated, and a second data set was analyzed. Here we show that during the ongoing pandemic, the sentiments became more negative. This is an important result because it shows that despite the positive impact of nature on mental health, the sentiments become more negative in the enduring pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 970 KiB

Open AccessArticle

Physical Activity and Screen Time among Hungarian High School Students during the COVID-19 Pandemic Caused Distance Education Period

by Zsolt Bálint Katona, Johanna Takács, László Kerner, Zoltán Alföldi, Imre Soós, Tamás Gyömörei, Robert Podstawski and Ferenc Ihász

Int. J. Environ. Res. Public Health 2021, 18(24), 13024; https://doi.org/10.3390/ijerph182413024 - 10 Dec 2021

Cited by 6 | Viewed by 3290

Abstract

Background: High school education took place in the form of distance learning during SARS-CoV-2 pandemic worldwide, including Hungary. Decreased physical activity and an increase in inactive behaviours may lead to an increased risk of obesity, diabetes, and cardiovascular disease. Aim: Our study targeted [...] Read more.

Background: High school education took place in the form of distance learning during SARS-CoV-2 pandemic worldwide, including Hungary. Decreased physical activity and an increase in inactive behaviours may lead to an increased risk of obesity, diabetes, and cardiovascular disease. Aim: Our study targeted changes in physical activity (aerobic exercise, muscle strengthening) and screen time in adolescents and young adults during the pandemic. Methods: High school students were interviewed in 66 public schools in 37 Hungarian cities (N = 2508). Survey items on physical activity and screen time were derived from the WHO Health Behaviour of School-aged Children Survey and the Centers for Disease Control Youth Risk Behavior Survey. A 2 × 2 factorial ANCOVA was used to test the effects of gender (male vs. female) and/or age (adolescents vs. young adults) on the reported changes in physical activity and screen time before and during lockdown (covariate: BMI Z-score). Results: The majority of the cohort indicated less physical activity. Aerobic and muscle-strengthening type of exercises significantly decreased, and screen time increased during distance education. Male individuals showed a higher decrease in the level of aerobic exercise, and young adults reported a higher increase in the time spent in front of the screen. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 499 KiB

Open AccessArticle

Sources of Resilience in Frontline Health Professionals during COVID-19

by Lydia Brown, Simon Haines, Hermioni L. Amonoo, Cathy Jones, Jeffrey Woods, Jeff C. Huffman and Meg E. Morris

Healthcare 2021, 9(12), 1699; https://doi.org/10.3390/healthcare9121699 - 08 Dec 2021

Cited by 15 | Viewed by 3961

Abstract

Background: While the challenges for psychological well-being for Australian healthcare workers have been documented, there has been a dearth of qualitative research on the sources of resilience that sustained workers during the COVID-19 pandemic. This study identified sources of resilience that clinicians used [...] Read more.

Background: While the challenges for psychological well-being for Australian healthcare workers have been documented, there has been a dearth of qualitative research on the sources of resilience that sustained workers during the COVID-19 pandemic. This study identified sources of resilience that clinicians used to cope with frontline challenges during the COVID-19 pandemic. Methods: Semi-structured interviews were conducted with 20 frontline health professionals, across five Australian hospitals, between October 2020 and April 2021. The interviews were recorded and transcribed, and the results were analysed using thematic analysis based on a phenomenological approach. Results: Three sources of resilience were identified by respondents: personal, relational, and organisational. A positive mindset, sense of purpose, and self-care behaviours emerged as key sources of personal resilience. Teamwork, altruism, and social support from family and friends contributed to relational resilience. Leadership, effective communication, and effective implementation of COVID-19 policies were associated with resilience at the organisational level. Frontline healthcare workers also voiced the need for the implementation of further strategies to support personal resilience whilst nurturing resilience within clinical teams and across entire healthcare organisations. Conclusions: Trust in healthcare systems, organisation leaders, colleagues, and personal support teams was an overarching theme supporting resilience. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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20 pages, 1638 KiB

Open AccessArticle

Vaccine Hesitancy and Political Populism. An Invariant Cross-European Perspective

by Almudena Recio-Román, Manuel Recio-Menéndez and María Victoría Román-González

Int. J. Environ. Res. Public Health 2021, 18(24), 12953; https://doi.org/10.3390/ijerph182412953 - 08 Dec 2021

Cited by 16 | Viewed by 3739

Abstract

Vaccine-hesitancy and political populism are positively associated across Europe: those countries in which their citizens present higher populist attitudes are those that also have higher vaccine-hesitancy rates. The same key driver fuels them: distrust in institutions, elites, and experts. The reluctance of citizens [...] Read more.

Vaccine-hesitancy and political populism are positively associated across Europe: those countries in which their citizens present higher populist attitudes are those that also have higher vaccine-hesitancy rates. The same key driver fuels them: distrust in institutions, elites, and experts. The reluctance of citizens to be vaccinated fits perfectly in populist political agendas because is a source of instability that has a distinctive characteristic known as the “small pockets” issue. It means that the level at which immunization coverage needs to be maintained to be effective is so high that a small number of vaccine-hesitants have enormous adverse effects on herd immunity and epidemic spread. In pandemic and post-pandemic scenarios, vaccine-hesitancy could be used by populists as one of the most effective tools for generating distrust. This research presents an invariant measurement model applied to 27 EU + UK countries (27,524 participants) that segments the different behaviours found, and gives social-marketing recommendations for coping with the vaccine-hesitancy problem when used for generating distrust. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 3302 KiB

Open AccessArticle

Factors Associated with Psychological Distress in French Medical Students during the COVID-19 Health Crisis: A Cross-Sectional Study

by Carole Pelissier, Manon Viale, Philippe Berthelot, Brigitte Poizat, Catherine Massoubre, Theophile Tiffet and Luc Fontana

Int. J. Environ. Res. Public Health 2021, 18(24), 12951; https://doi.org/10.3390/ijerph182412951 - 08 Dec 2021

Cited by 13 | Viewed by 2666

Abstract

Background: The purpose of this study was to assess the prevalence of psychological distress in medical students during the COVID-19 health crisis and to identify factors associated with psychological distress. Methods: A cross-sectional observational study was presented to 1814 medical students (from first [...] Read more.

Background: The purpose of this study was to assess the prevalence of psychological distress in medical students during the COVID-19 health crisis and to identify factors associated with psychological distress. Methods: A cross-sectional observational study was presented to 1814 medical students (from first to sixth year) in a French university hospital center. Sociodemographic, occupational and medical information (psychological distress measured on the French GHQ12 scale) were collected via an online anonymous self-administered questionnaire. Variables associated with psychological distress were investigated using univariate analysis and multivariate analysis (modified Poisson regression). Results: In total, 832 medical students responded (46%) and 699 completed the questionnaire in full (39%); 625 (75%) showed signs of psychological distress and 109 (15%) reported suicidal ideation. Female gender, psychological trauma during the COVID-19 health crisis, change in alcohol consumption, and difficulties with online learning emerged as risk factors for psychological distress, whereas a paid activity, a feeling of mutual aid and cooperation within the studies framework, and recognition of work appeared to be protective factors. Conclusions: Mental health care or suicide prevention should be provided to students at risk in the aftermath of the pandemic. Knowing the educational and medical factors associated with psychological distress enables areas for prevention to be identified. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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17 pages, 949 KiB

Open AccessSystematic Review

Risk Factors for Venous Thromboembolism in Severe COVID-19: A Study-Level Meta-Analysis of 21 Studies

by Hervé Lobbes, Sabine Mainbourg, Vicky Mai, Marion Douplat, Steeve Provencher and Jean-Christophe Lega

Int. J. Environ. Res. Public Health 2021, 18(24), 12944; https://doi.org/10.3390/ijerph182412944 - 08 Dec 2021

Cited by 17 | Viewed by 2315

Abstract

Venous thromboembolism (VTE) in patients with COVID-19 in intensive care units (ICU) is frequent, but risk factors (RF) remain unidentified. In this meta-analysis (CRD42020188764) we searched for observational studies from ICUs reporting the association between VTE and RF in Medline/Embase up to 15 [...] Read more.

Venous thromboembolism (VTE) in patients with COVID-19 in intensive care units (ICU) is frequent, but risk factors (RF) remain unidentified. In this meta-analysis (CRD42020188764) we searched for observational studies from ICUs reporting the association between VTE and RF in Medline/Embase up to 15 April 2021. Reviewers independently extracted data in duplicate and assessed the certainty of the evidence using the GRADE approach. Analyses were conducted using the random-effects model and produced a non-adjusted odds ratio (OR). We analysed 83 RF from 21 studies (5296 patients). We found moderate-certainty evidence for an association between VTE and the D-dimer peak (OR 5.83, 95%CI 3.18–10.70), and length of hospitalization (OR 7.09, 95%CI 3.41–14.73) and intubation (OR 2.61, 95%CI 1.94–3.51). We identified low-certainty evidence for an association between VTE and CRP (OR 1.83, 95% CI 1.32–2.53), D-dimer (OR 4.58, 95% CI 2.52–8.50), troponin T (OR 8.64, 95% CI 3.25–22.97), and the requirement for inotropic drugs (OR 1.67, 95% CI 1.15–2.43). Traditional VTE RF (i.e., history of cancer, previous VTE events, obesity) were not found to be associated to VTE in COVID-19. Anticoagulation was not associated with a decreased VTE risk. VTE RF in severe COVID-19 correspond to individual illness severity, and inflammatory and coagulation parameters. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 237 KiB

Open AccessArticle

Effectiveness of BNT162b2 and ChAdOx1 Vaccines against Symptomatic COVID-19 among Healthcare Workers in Kuwait: A Retrospective Cohort Study

by Walid Q. Alali, Lamiaa A. Ali, Mohammad AlSeaidan and Mohammad Al-Rashidi

Healthcare 2021, 9(12), 1692; https://doi.org/10.3390/healthcare9121692 - 07 Dec 2021

Cited by 6 | Viewed by 2700

Abstract

Background: Estimating vaccine effectiveness (VE) against severe, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCWs) is necessary to demonstrate protection from the disease. Between 24 December 2020 and 15 June 2021, we determined the factors associated with vaccine coverage and estimated [...] Read more.

Background: Estimating vaccine effectiveness (VE) against severe, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCWs) is necessary to demonstrate protection from the disease. Between 24 December 2020 and 15 June 2021, we determined the factors associated with vaccine coverage and estimated VE against SARS-CoV-2 infection in HCWs at a secondary hospital in Kuwait. Methods: We extracted sociodemographic, occupational, SARS-CoV-2 infection, and vaccination data for eligible HCWs from the hospital records. Vaccine coverage percentages were cross-tabulated with the HCW factors. Cox regression was used to estimate hazard ratios in vaccinated versus unvaccinated. Results: 3246 HCWs were included in the analysis, of which 82.1% received at least one vaccine dose (50.4% only one dose of ChAdOx1, 3.3% only one dose of BNT162b2, and 28.3% two doses of BNT162b2). However, 17.9% of HCWs were unvaccinated. A significantly lower vaccination coverage was reported amongst female HCWs, younger age group (20–30 years), and administrative/executive staff. The adjusted VE of fully vaccinated HCWs was 94.5% (95% CI = 89.4–97.2%), while it was 75.4% (95% CI = 67.2–81.6%) and 91.4% (95% CI = 65.1–97.9%) in partially vaccinated for ChAdOx1 and BNT162b2, respectively. Conclusions: BNT162b2 and ChAdOx1 vaccines prevented most symptomatic infections in HCWs across age groups, nationalities, and occupations. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

14 pages, 1014 KiB

Open AccessArticle

Developing a Hybrid Platform for Emergency Remote Education of Nursing Students in the Context of COVID-19

by Hiromi Kawasaki, Satoko Yamasaki and Md Moshiur Rahman

Int. J. Environ. Res. Public Health 2021, 18(24), 12908; https://doi.org/10.3390/ijerph182412908 - 07 Dec 2021

Cited by 5 | Viewed by 2371

Abstract

Due to the COVID-19 pandemic, many nursing students are being taught remotely. Remote learning has drawbacks, such as decreased motivation for learning and difficulties conveying the instructor’s intentions. Strategies that compensate for the shortcomings of remote learning should be identified. This study aimed [...] Read more.

Due to the COVID-19 pandemic, many nursing students are being taught remotely. Remote learning has drawbacks, such as decreased motivation for learning and difficulties conveying the instructor’s intentions. Strategies that compensate for the shortcomings of remote learning should be identified. This study aimed to evaluate the understanding of the knowledge use and awareness of negotiation methods through cases and teaching tools in nursing student classes on environmental assessment and daily life support, and to examine whether supplementary assistance can compensate for the drawbacks of remote learning. This study used a mixed-method design, and included 59 second-year nursing students attending an environmental assessment course in 2021. Students’ knowledge use and awareness of negotiation methods were evaluated using self-assessment worksheets before and after the class. The pre- and post-class scores were compared using the Wilcoxon signed-rank test. The mean knowledge score increased significantly during the study period (p < 0.001). Students acquired awareness of how to use the knowledge gained during class and negotiation awareness by observing role play, factors that strengthen motivation when learning alone. This study provides insight into the potential of class supplements to compensate for the deficits of remote learning. Supplementing the shortcomings of remote learning should be a priority and may be a focal point of hybrid learning. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 336 KiB

Open AccessArticle

Factors Associated with COVID-19 Vaccine Hesitancy in Mongolia: A Web-Based Cross-Sectional Survey

by Davaalkham Dambadarjaa, Gan-Erdene Altankhuyag, Unurtesteg Chandaga, Ser-Od Khuyag, Bilegt Batkhorol, Nansalmaa Khaidav, Oyunbileg Dulamsuren, Nadmidtseren Gombodorj, Avirmed Dorjsuren, Pramil Singh, Gunchmaa Nyam, Dashpagma Otganbayar and Nyamsuren Tserennadmid

Int. J. Environ. Res. Public Health 2021, 18(24), 12903; https://doi.org/10.3390/ijerph182412903 - 07 Dec 2021

Cited by 22 | Viewed by 4138

Abstract

Vaccine acceptance in the general public is essential in controlling the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to assess the COVID-19 vaccine hesitancy in the adult population of Mongolia, and determine the associated factors. A total of 2875 individuals from urban [...] Read more.

Vaccine acceptance in the general public is essential in controlling the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to assess the COVID-19 vaccine hesitancy in the adult population of Mongolia, and determine the associated factors. A total of 2875 individuals from urban and rural areas were recruited, and completed an online survey. Older age, urban residence, previous vaccination, high education, good knowledge of side effects, and a personal view of the importance of vaccines were associated with vaccine acceptability, whereas gender and religion were not. Receiving COVID-19 vaccine information from official government pages was related to a higher acceptance rate. Reliance on social media as a source of COVID-19 vaccine information was associated with high level of vaccine hesitancy. The side effects and the type of the COVID-19 vaccine were a major reason for hesitation. Countering false information regarding COVID-19 vaccines on social media, and promoting vaccine importance on general news websites is necessary. Moreover, providing clear and direct educational materials through official communication channels on the safety and efficacy of COVID-19 vaccines alongside information on COVID-19 symptoms, vaccine side effects, and location of vaccine administration centers among the younger populations, rural residents, and those with lower education is needed. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

14 pages, 342 KiB

Open AccessArticle

Achievements and Challenges for Higher Education during the COVID-19 Pandemic: A Rapid Review of Media in Africa

by Inge K. Sonn, Marieta Du Plessis, Carel D. Jansen Van Vuuren, Janene Marais, Emma Wagener and Nicolette V. Roman

Int. J. Environ. Res. Public Health 2021, 18(24), 12888; https://doi.org/10.3390/ijerph182412888 - 07 Dec 2021

Cited by 12 | Viewed by 3649

Abstract

The coronavirus (COVID-19) pandemic struck globally and has affected higher education institutions (HEIs) and their operations, indirectly impacting the progress of the Sustainable Development Goal 4 achieved thus far. This article addresses HEIs achievements and challenges experienced in the wake of the pandemic. [...] Read more.

The coronavirus (COVID-19) pandemic struck globally and has affected higher education institutions (HEIs) and their operations, indirectly impacting the progress of the Sustainable Development Goal 4 achieved thus far. This article addresses HEIs achievements and challenges experienced in the wake of the pandemic. Online news media reports played a facilitative role in providing information to the HEI communities. A rapid review exploring online news media messages relating to higher education at the onset of the COVID-19 pandemic in Africa was utilised. Narrative synthesis was used to analyse the data. The results highlight HEIs achievements, which aim to ensure that all students receive the same level of education and provision in terms of devices and mental health support. However, challenges were also experienced at HEIs and include students feeling uncertainty and fear regarding completing their education. Furthermore, the results also show that not all students received the same level of education due to contextual factors, thus deepening the existing social disparities in Africa. The pandemic provides an opportunity for HEIs to embed the components of global citizenship education into the curriculum and to work in an innovative way to promote Sustainable Development Goal 4. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

9 pages, 391 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on Patients with Gastrointestinal Cancer Undergoing Active Cancer Treatment in an Ambulatory Therapy Center: The Patients’ Perspective

by Koichi Taira, Hisashi Nagahara, Hiroaki Tanaka, Akie Kimura, Akinobu Nakata, Yasuhito Iseki, Tatsunari Fukuoka, Masatsune Shibutani, Takahiro Toyokawa, Shigeru Lee, Kazuya Muguruma, Masaichi Ohira, Tomoya Kawaguchi and Yasuhiro Fujiwara

Healthcare 2021, 9(12), 1688; https://doi.org/10.3390/healthcare9121688 - 06 Dec 2021

Cited by 1 | Viewed by 2112

Abstract

Background: The mortality risk increases greatly in patients with cancer if they are infected with severe acute respiratory syndrome coronavirus 2. The new American Society of Clinical Oncology (ASCO) and the European Society of Medical Oncology (ESMO) guidelines for the COVID-19 pandemic suggested [...] Read more.

Background: The mortality risk increases greatly in patients with cancer if they are infected with severe acute respiratory syndrome coronavirus 2. The new American Society of Clinical Oncology (ASCO) and the European Society of Medical Oncology (ESMO) guidelines for the COVID-19 pandemic suggested modifications to the standards of care to reduce harm from treatment. However, it is unclear whether these changes suit the wishes of patients. Methods: We conducted a survey of patients with gastrointestinal cancer who were undergoing active chemotherapy in our ambulatory therapy center between 17 August and 11 September 2020. The survey comprised 18 questions on five topics: patient characteristics, lifestyle changes, disturbance in their psychological health, thoughts on the cancer treatment, and infection control in the hospital. Results: Among the 63 patients who received the questionnaire, 61 participated in the study. The COVID-19 pandemic has led to changes in their lifestyles and substantially impacted their psychological wellbeing. The incidence of anxiety and insomnia has considerably increased during the pandemic. However, female patients and patients aged 70 years or older reported no notable differences. There was no significant difference in the responses to the questions regarding thoughts on the cancer treatment. Conclusion: Our study revealed that the COVID-19 pandemic has substantially impacted patients’ lifestyles and psychological wellbeing. However, most patients preferred to continue their usual treatment without any change to their treatment plan. It is important to involve the patient in the decision-making process when formulating treatment goals. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 667 KiB

Open AccessArticle

The Experiences of People with Dementia and Informal Carers Related to the Closure of Social and Medical Services in Poland during the COVID-19 Pandemic—A Qualitative Study

by Maria Maćkowiak, Adrianna Senczyszyn, Katarzyna Lion, Elżbieta Trypka, Monika Małecka, Marta Ciułkowicz, Justyna Mazurek, Roksana Świderska, Clarissa Giebel, Mark Gabbay, Joanna Rymaszewska and Dorota Szcześniak

Healthcare 2021, 9(12), 1677; https://doi.org/10.3390/healthcare9121677 - 03 Dec 2021

Cited by 8 | Viewed by 3035

Abstract

Older people with dementia are particularly at risk of COVID-19; however, relatively little is known about the indirect impact of the pandemic on the lives of those living with, and/or caring for someone with, dementia. The aim of this study was to investigate [...] Read more.

Older people with dementia are particularly at risk of COVID-19; however, relatively little is known about the indirect impact of the pandemic on the lives of those living with, and/or caring for someone with, dementia. The aim of this study was to investigate the experiences of people with dementia and informal carers during the closure of available social and medical services in Poland during the COVID-19 pandemic. A qualitative thematic analysis of semi-structured interviews with people with dementia (n = 5) and informal carers (n = 21) was performed between June and August 2020 after the first wave of COVID-19 in Poland. Three overarching themes were identified: (1) care re-organization; (2) psychological responses; (3) emerging needs. The factor underlying all these elements was reliance on other people. Social support and engagement are vital to the ongoing health and well-being of people living with dementia and their informal carers. Services need to be strengthened to provide ongoing provision to those living with dementia to reach pre-pandemic levels, if not better. Within the post-pandemic environment, people with dementia and their informal carers need reassurance that they can rely on external institutional and social support able to meet their needs. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 363 KiB

Open AccessArticle

Stress and Bio-Ethical Issues Perceived by Romanian Healthcare Practitioners in the COVID-19 Era

by Daniela Reisz, Iulia Crișan, Andrea Reisz, Raluca Tudor and Doina Georgescu

Int. J. Environ. Res. Public Health 2021, 18(23), 12749; https://doi.org/10.3390/ijerph182312749 - 03 Dec 2021

Cited by 2 | Viewed by 2043

Abstract

Objective: The COVID-19 pandemic had a major impact on different areas of life, especially in the medical system. Because of the pandemic outbreak, the medical system was remodeled to treat COVID-19 patients in secure conditions. Those changes and restrictive measures have put pressure [...] Read more.

Objective: The COVID-19 pandemic had a major impact on different areas of life, especially in the medical system. Because of the pandemic outbreak, the medical system was remodeled to treat COVID-19 patients in secure conditions. Those changes and restrictive measures have put pressure on individual adaptability. The present study investigated the stress of Romanian healthcare practitioners (HCP) and the capacity to deal with new bio-ethical issues that emerged during the COVID-19 pandemic in 2020. Methods: We analyzed results from a survey on 97 Romanian HCP in several areas: personal experience with COVID-19, perceived emotional distress, and appraisal of bio-ethical principles respected or infringed during the pandemic in 2020. Results: Unlike previous studies, our respondents reported low to moderate stress levels. In addition, few bio-ethical principles were infringed on a personal level. Tendencies to sacrifice individual autonomy and make decisions affecting patients and co-workers were more prevalent among HCP with over 30 years of experience. Conclusions: Retrospectively, Romanian HCP in our sample appeared to share an embellished view of the COVID-19 pandemic in 2020. Potentially related factors and coping mechanisms with stress are discussed. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

14 pages, 389 KiB

Open AccessArticle

Mental Health among Higher Education Students during the COVID-19 Pandemic: A Cross-Sectional Survey from Lithuania

by Emilijus Žilinskas, Giedrė Žulpaitė, Kristijonas Puteikis and Rima Viliūnienė

Int. J. Environ. Res. Public Health 2021, 18(23), 12737; https://doi.org/10.3390/ijerph182312737 - 02 Dec 2021

Cited by 13 | Viewed by 3383

Abstract

Mental health issues—anxiety, depression, suicidal ideation and behavior—are prevalent among students of higher education. The COVID-19 pandemic further affected students’ daily life through academic and socioeconomic disturbances. We set out to investigate students’ mental health amidst the COVID-19 pandemic and conducted a cross-sectional [...] Read more.

Mental health issues—anxiety, depression, suicidal ideation and behavior—are prevalent among students of higher education. The COVID-19 pandemic further affected students’ daily life through academic and socioeconomic disturbances. We set out to investigate students’ mental health amidst the COVID-19 pandemic and conducted a cross-sectional online survey at higher education institutions in Lithuania in 2021. The questionnaire consisted of the Hospital Anxiety and Depression scale (HADS) and the Sense of Coherence scale (SOC-3) questionnaires, evaluation of suicidal risk, experiences during the COVID-19 pandemic and self-rated health status (SRHS). Among 1001 students who completed the survey, the prevalence of clinically relevant anxiety was high (46.6%) and contrasted with the lower prevalence of depression (11.1%). 37.5% of all students admitted that they had thought about suicide at least once during their lifetime and a similar number of students thought about suicide during the previous year. High levels of anxiety and depression were statistically significant predictors of suicidal ideation and planning during the past year in binary regression models. High SRHS (higher score refers to more positive health status) was the only significant independent variable associated with less frequent suicidal attempts in the past year (p < 0.01, OR = 0.29, 95% CI = 0.12 to 0.66). Our study highlights anxiety and suicidality to be burdensome mental health issues among higher education students in Lithuania during the COVID-19 pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

13 pages, 2163 KiB

Open AccessArticle

The Disproportionate Impact of COVID-19 among Undocumented Immigrants and Racial Minorities in the US

by Mohammad Tawhidul Hasan Bhuiyan, Irtesam Mahmud Khan, Sheikh Saifur Rahman Jony, Renee Robinson, Uyen-Sa D. T. Nguyen, David Keellings, M. Sohel Rahman and Ubydul Haque

Int. J. Environ. Res. Public Health 2021, 18(23), 12708; https://doi.org/10.3390/ijerph182312708 - 02 Dec 2021

Cited by 18 | Viewed by 4456

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), has had an unprecedented effect, especially among under-resourced minority communities. Surveillance of those at high risk is critical for preventing and controlling the pandemic. We must better understand [...] Read more.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), has had an unprecedented effect, especially among under-resourced minority communities. Surveillance of those at high risk is critical for preventing and controlling the pandemic. We must better understand the relationships between COVID-19-related cases or deaths and characteristics in our most vulnerable population that put them at risk to target COVID-19 prevention and management efforts. Population characteristics strongly related to United States (US) county-level data on COVID-19 cases and deaths during all stages of the pandemic were identified from the onset of the epidemic and included county-level socio-demographic and comorbidities data, as well as daily meteorological modeled observation data from the North American Regional Reanalysis (NARR), and the NARR high spatial resolution model to assess the environment. Advanced machine learning (ML) approaches were used to identify outbreaks (geographic clusters of COVID-19) and included spatiotemporal risk factors and COVID-19 vaccination efforts, especially among vulnerable and underserved communities. COVID-19 outcomes were found to be negatively associated with the number of people vaccinated and positively associated with age, the prevalence of cardiovascular disease, diabetes, and the minority population. There was also a strong positive correlation between unauthorized immigrants and the prevalence of COVID-19 cases and deaths. Meteorological variables were also investigated, but correlations with COVID-19 were relatively weak. Our findings suggest that COVID-19 has had a disproportionate impact across the US population among vulnerable and minority communities. Findings also emphasize the importance of vaccinations and tailored public health initiatives (e.g., mask mandates, vaccination) to reduce the spread of COVID-19 and the number of COVID-19 related deaths across all populations. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 345 KiB

Open AccessArticle

SARS-CoV-2 Infection among School Population of One Developing Country. Do School Closures Protect Students and Teachers against SARS-CoV-2 Infection?

by Carol Bibiana Colonia, Rosanna Camerano-Ruiz, Andrés Felipe Mora-Salamanca, Ana Beatriz Vásquez-Rodríguez, Camilo Alberto Pino-Gutiérrez, Luz Amparo Pérez-Fonseca, Deidamia García-Quintero, Jennifer Ruiz-González, Iván Osejo-Villamil, Edwin Alberto Ussa-Cristiano and Fernando de la Hoz-Restrepo

Int. J. Environ. Res. Public Health 2021, 18(23), 12680; https://doi.org/10.3390/ijerph182312680 - 01 Dec 2021

Cited by 1 | Viewed by 2223

Abstract

Evidence about the effectiveness of school closures as a measure to control the spread of COVID-19 is controversial. We posit that schools are not an important source of transmission; thus, we analyzed two surveillance methods: a web-based questionnaire and a telephone survey that [...] Read more.

Evidence about the effectiveness of school closures as a measure to control the spread of COVID-19 is controversial. We posit that schools are not an important source of transmission; thus, we analyzed two surveillance methods: a web-based questionnaire and a telephone survey that monitored the impact of the pandemic due to COVID-19 cases in Bogotá, Colombia. We estimated the cumulative incidences for Acute Respiratory Infection (ARI) and COVID-19 for each population group. Then, we assessed the differences using the cumulative incidence ratio (CIR) and 95% confidence intervals (CI95%). The ARI incidence among students was 20.1 times higher when estimated from the telephone survey than from the online questionnaire (CIR: 20.1; CI95% 17.11–23.53). Likewise, the ARI incidence among schoolteachers was 10 times higher in the telephone survey (CIR: 9.8; CI95% 8.3–11.5). the incidence of COVID-19 among schoolteachers was 4.3 times higher than among students in the online questionnarie (CIR: 4.3, CI95%: 3.8–5.0) and 2.1 times higher in the telephone survey (CIR = 2.1, CI95%: 1.8–2.6), and this behavior was also observed in the general population data. Both methods showed a capacity to detect COVID-19 transmission among students and schoolteachers, but the telephone survey estimates were probably closer to the real incidence rate. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

19 pages, 622 KiB

Open AccessReview

COVID-19: Marking the Gaps in Migrant and Refugee Health in Some Massive Migration Areas

by Stephen A. Matlin, Ozge Karadag, Claudio R. Brando, Pedro Góis, Selma Karabey, Md. Mobarak Hossain Khan, Shadi Saleh, Amirhossein Takian and Luciano Saso

Int. J. Environ. Res. Public Health 2021, 18(23), 12639; https://doi.org/10.3390/ijerph182312639 - 30 Nov 2021

Cited by 11 | Viewed by 4229

Abstract

The health of migrants and refugees, which has long been a cause for concern, has come under greatly increased pressure in the last decade. Against a background where the world has witnessed the largest numbers of migrants in history, the advent of the [...] Read more.

The health of migrants and refugees, which has long been a cause for concern, has come under greatly increased pressure in the last decade. Against a background where the world has witnessed the largest numbers of migrants in history, the advent of the COVID-19 pandemic has stretched the capacities of countries and of aid, health and relief organizations, from global to local levels, to meet the human rights and pressing needs of migrants and refugees for access to health care and to public health measures needed to protect them from the pandemic. The overview in this article of the situation in examples of middle-income countries that have hosted mass migration in recent years has drawn on information from summaries presented in an M8 Alliance Expert Meeting, from peer-reviewed literature and from reports from international agencies concerned with the status and health of migrants and refugees. The multi-factor approach developed here draws on perspectives from structural factors (including rights, governance, policies and practices), health determinants (including economic, environmental, social and political, as well as migration itself as a determinant) and the human security framework (defined as “freedom from want and fear and freedom to live in dignity” and incorporating the interactive dimensions of health, food, environmental, economic, personal, community and political security). These integrate as a multi-component ‘ecological perspective’ to examine the legal status, health rights and access to health care and other services of migrants and refugees, to mark gap areas and to consider the implications for improving health security both for them and for the communities in countries in which they reside or through which they transit. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 660 KiB

Open AccessArticle

Analysis of Characteristics and Clinical Outcomes for Crisis Management during the Four Waves of the COVID-19 Pandemic

by Watchara Amasiri, Kritsasith Warin, Karicha Mairiang, Chatchai Mingmalairak, Wararit Panichkitkosolkul, Krittin Silanun, Rachasak Somyanonthanakul, Thanaruk Theeramunkong, Surapon Nitikraipot and Siriwan Suebnukarn

Int. J. Environ. Res. Public Health 2021, 18(23), 12633; https://doi.org/10.3390/ijerph182312633 - 30 Nov 2021

Cited by 3 | Viewed by 2327

Abstract

This study aims to analyze the patient characteristics and factors related to clinical outcomes in the crisis management of the COVID-19 pandemic in a field hospital. We conducted retrospective analysis of patient clinical data from March 2020 to August 2021 at the first [...] Read more.

This study aims to analyze the patient characteristics and factors related to clinical outcomes in the crisis management of the COVID-19 pandemic in a field hospital. We conducted retrospective analysis of patient clinical data from March 2020 to August 2021 at the first university-based field hospital in Thailand. Multivariable logistic regression models were used to evaluate the factors associated with the field hospital discharge destination. Of a total of 3685 COVID-19 patients, 53.6% were women, with the median age of 30 years. General workers accounted for 97.5% of patients, while 2.5% were healthcare workers. Most of the patients were exposed to coronavirus from the community (84.6%). At the study end point, no patients had died, 97.7% had been discharged home, and 2.3% had been transferred to designated high-level hospitals due to their condition worsening. In multivariable logistic regression analysis, older patients with one or more underlying diseases who showed symptoms of COVID-19 and whose chest X-rays showed signs of pneumonia were in a worse condition than other patients. In conclusion, the university-based field hospital has the potential to fill acute gaps and prevent public agencies from being overwhelmed during crisis events. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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18 pages, 2555 KiB

Open AccessArticle

A Routine Sanger Sequencing Target Specific Mutation Assay for SARS-CoV-2 Variants of Concern and Interest

by Sin Hang Lee

Viruses 2021, 13(12), 2386; https://doi.org/10.3390/v13122386 - 29 Nov 2021

Cited by 8 | Viewed by 4385

Abstract

As SARS-CoV-2 continues to spread among human populations, genetic changes occur and accumulate in the circulating virus. Some of these genetic changes have caused amino acid mutations, including deletions, which may have a potential impact on critical SARS-CoV-2 countermeasures, including vaccines, therapeutics, and [...] Read more.

As SARS-CoV-2 continues to spread among human populations, genetic changes occur and accumulate in the circulating virus. Some of these genetic changes have caused amino acid mutations, including deletions, which may have a potential impact on critical SARS-CoV-2 countermeasures, including vaccines, therapeutics, and diagnostics. Considerable efforts have been made to categorize the amino acid mutations of the angiotensin-converting enzyme 2 (ACE2) receptor binding domain (RBD) of the spike (S) protein, along with certain mutations in other regions within the S protein as specific variants, in an attempt to study the relationship between these mutations and the biological behavior of the virus. However, the currently used whole genome sequencing surveillance technologies can test only a small fraction of the positive specimens with high viral loads and often generate uncertainties in nucleic acid sequencing that needs additional verification for precision determination of mutations. This article introduces a generic protocol to routinely sequence a 437-bp nested RT-PCR cDNA amplicon of the ACE2 RBD and a 490-bp nested RT-PCR cDNA amplicon of the N-terminal domain (NTD) of the S gene for detection of the amino acid mutations needed for accurate determination of all variants of concern and variants of interest according to the definitions published by the U.S. Centers for Disease Control and Prevention. This protocol was able to amplify both nucleic acid targets into cDNA amplicons to be used as templates for Sanger sequencing on all 16 clinical specimens that were positive for SARS-CoV-2. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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17 pages, 7090 KiB

Open AccessArticle

Local Characteristics Related to SARS-CoV-2 Transmissions in the Seoul Metropolitan Area, South Korea

by Changmin Im and Youngho Kim

Int. J. Environ. Res. Public Health 2021, 18(23), 12595; https://doi.org/10.3390/ijerph182312595 - 29 Nov 2021

Cited by 3 | Viewed by 2470

Abstract

The Seoul metropolitan area is one of the most populated metropolitan areas in the world; hence, Seoul’s COVID-19 cases are highly concentrated. This study identified local demographic and socio-economic characteristics that affected SARS-CoV-2 transmission to provide locally targeted intervention policies. For the effective [...] Read more.

The Seoul metropolitan area is one of the most populated metropolitan areas in the world; hence, Seoul’s COVID-19 cases are highly concentrated. This study identified local demographic and socio-economic characteristics that affected SARS-CoV-2 transmission to provide locally targeted intervention policies. For the effective control of outbreaks, locally targeted intervention policies are required since the SARS-CoV-2 transmission process is heterogeneous over space. To identify the local COVID-19 characteristics, this study applied the geographically weighted lasso (GWL). GWL provides local regression coefficients, which were used to account for the spatial heterogeneity of SARS-CoV-2 outbreaks. In particular, the GWL pinpoints statistically significant regions with specific local characteristics. The applied explanatory variables involving demographic and socio-economic characteristics that were associated with higher SARS-CoV-2 transmission in the Seoul metropolitan area were as follows: young adults (19~34 years), older population, Christian population, foreign-born population, low-income households, and subway commuters. The COVID-19 case data were classified into three periods: the first period (from January 2020 to July 2021), the second period (from August to November 2020), and the third period (from December 2020 to February 2021), and the GWL was fitted for the entire period (from January 2020 to February 2021). The result showed that young adults, the Christian population, and subway commuters were the most significant local characteristics that influenced SARS-CoV-2 transmissions in the Seoul metropolitan area. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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24 pages, 418 KiB

Open AccessArticle

The Influence of Socio-Demographic Factors on the Forms of Leisure for the Students at the Faculty of Physical Education and Sports

by George Danut Mocanu, Gabriel Murariu and Dan Munteanu

Int. J. Environ. Res. Public Health 2021, 18(23), 12577; https://doi.org/10.3390/ijerph182312577 - 29 Nov 2021

Cited by 6 | Viewed by 1840

Abstract

The study investigates the influences of gender, area of origin and age stage variables and also of the interaction between them, on the free time behavior of the students at the Faculty of Physical Education and Sports from Galati. The questionnaire applied in [...] Read more.

The study investigates the influences of gender, area of origin and age stage variables and also of the interaction between them, on the free time behavior of the students at the Faculty of Physical Education and Sports from Galati. The questionnaire applied in the academic year 2019–2020 had 85 items and was structured on 4 factors: leisure budget, leisure limiting factors, preferred leisure activities, and leisure sports activities. The multivariate/MANOVA analysis showed statistically significant data for some of the analyzed items, with values of F associated with thresholds p < 0.05. The results support longer screen time for urban areas and for those <25 years and time limitation for the favorite activities of students >25 years, while reading had higher stress scores for men and students <25 years. Men tended to limit their free time working overtime and women limited their free time due to housework. Students from rural areas and men >25 years were more stressed by socializing on the internet and shopping. Financial limitations for preferred activities were higher for women and students <25 years—women read more and visited their friends more often while men had higher scores in relation to involvement in physical activities throughout the week, an aspect also reported for those <25 years. Students >25 years spent more time with their family, while those <25 years socialized more on the internet and had better scores when going out with friends. Those in urban areas did more jogging, men had better scores in relation to playing sports games, higher indicators for the satisfaction generated by sports activity, and women preferred jogging and cycling/rollerblading. Sports games and different types of fitness were the most common variants practiced at the level of the studied group. Conclusion: There was no dominant orientation of the investigated group towards forms of passive leisure and there were no cases of sedentariness, even if the use of technologies (video games, socializing on the Internet and TV) were forms of leisure often used by students. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

11 pages, 663 KiB

Open AccessArticle

Seroprevalence of Anti-SARS-CoV-2 Antibodies among Municipal Staff in the Municipality of Prishtina

by Bujar Gashi, Vesa Osmani, Rrezart Halili, Teuta Hoxha, Agron Kamberi, Nexhmedin Hoti, Riaz Agahi, Vlora Basha, Visar Berisha and Ilir Hoxha

Int. J. Environ. Res. Public Health 2021, 18(23), 12545; https://doi.org/10.3390/ijerph182312545 - 28 Nov 2021

Cited by 3 | Viewed by 2984

Abstract

Background: Some studies have assessed the seroprevalence of anti-SARS-CoV-2 antibodies in different populations. Very few studies have explored seroprevalence in municipal workers, an important and potentially high-risk population. This study aims to determine the prevalence of anti-SARS-CoV-2 antibodies in municipal workers, with the [...] Read more.

Background: Some studies have assessed the seroprevalence of anti-SARS-CoV-2 antibodies in different populations. Very few studies have explored seroprevalence in municipal workers, an important and potentially high-risk population. This study aims to determine the prevalence of anti-SARS-CoV-2 antibodies in municipal workers, with the additional examination of the association of prevalence with various demographic, health-related, and epidemiological factors. Methods: We surveyed and tested for seroprevalence 418 public servants from the municipality of Prishtina, the capital of Kosovo. The primary prespecified outcome was the seroprevalence of anti-SARS-CoV-2 antibodies, IgG, and IgM. Additional outcomes were crude and adjusted odds ratios of seroprevalence by different factors. Results: 21.1% of municipal workers tested positive for either IgM or IgG. Of these, 9.6% were positive for IgM and 19.4% for IgG. Data showed high levels of adherence to protective measures, e.g., social distancing in the office, but calculation of ORs did not show a significant difference between those reporting adherence to such measures and those reporting nonadherence. Of other examined factors, significantly lower odds were observed for smokers (0.52, 95% CI 0.28, 0.97), while municipal workers with infected family members had elevated odds of seropositivity according to both crude (2.19, 95% CI 1.34, 3.59) and adjusted (2.00, 95% CI 1.17, 3.41) ORs. Conclusions: Most answers from public servants demonstrated compliance to social-distancing policies in the workplace, but analysis of crude and adjusted odds ratios did not suggest a significant effect between municipal workers who followed these guidelines and those who did not. Results from this study help Kosovo policy makers in understanding the level of prevalence of COVID-19 in municipal workers and the effect of different factors on such prevalence. Results from the study could inform future decisions on the design and application of protective measures for municipal workers. Our findings should encourage further research to assess the extent of the spread of COVID-19 to other essential workers in Kosovo, including retail workers. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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8 pages, 1170 KiB

Open AccessArticle

Psychological and Physical Distress in Italian People during COVID-19 Pandemic: One Year Later

by Alessandra Impellizzeri, Maddalena Dilucca, Francesca Squillace, Rosanna Guarnieri, Antonella Polimeni and Gabriella Galluccio

Int. J. Environ. Res. Public Health 2021, 18(23), 12525; https://doi.org/10.3390/ijerph182312525 - 28 Nov 2021

Cited by 3 | Viewed by 1563

Abstract

The aim of this study was to evaluate the major life changes that Italian people experienced after one year of the COVID-19 pandemic. We assessed the psychological and physical impact of COVID-19 within one year of the pandemic situation, and its possible correlation [...] Read more.

The aim of this study was to evaluate the major life changes that Italian people experienced after one year of the COVID-19 pandemic. We assessed the psychological and physical impact of COVID-19 within one year of the pandemic situation, and its possible correlation with the positive COVID-19 trend in the Italian region. We invited Italian people to complete a cross-sectional, online survey within a three-week period from 14 March to 4 April 2021. The survey collected data on the participants’ stress and physical levels, attitude, perceived control, norms, personal and professional backgrounds, and place of stay in the last year. We used Student’s t-test and the software package GRETL for Windows to assess the association between the study outcome variables and the explanatory variables (stress, attitude, perceived control, and norms). All participants who declared a level of physical stress in their answer suffered from psychological stress, but not vice versa. The result to be highlighted is that this level of stress was found more in women and in the age range of 21–45 years. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 625 KiB

Open AccessArticle

Clinical Application of Ultraviolet C Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 in Contaminated Hospital Environments

by Wen-Lin Su, Chih-Pei Lin, Hui-Ching Huang, Yao-Kuang Wu, Mei-Chen Yang, Sheg-Kang Chiu, Ming-Yieh Peng, Ming-Chin Chan and You-Chen Chao

Viruses 2021, 13(12), 2367; https://doi.org/10.3390/v13122367 - 26 Nov 2021

Cited by 1 | Viewed by 1991

Abstract

To overcome the ongoing coronavirus disease 2019 (COVID-19) pandemic, transmission routes, such as healthcare worker infection, must be effectively prevented. Ultraviolet C (UVC) (254 nm) has recently been demonstrated to prevent environmental contamination by infected patients; however, studies on its application in contaminated [...] Read more.

To overcome the ongoing coronavirus disease 2019 (COVID-19) pandemic, transmission routes, such as healthcare worker infection, must be effectively prevented. Ultraviolet C (UVC) (254 nm) has recently been demonstrated to prevent environmental contamination by infected patients; however, studies on its application in contaminated hospital settings are limited. Herein, we explored the clinical application of UVC and determined its optimal dose. Environmental samples (n = 267) collected in 2021 were analyzed by a reverse transcription-polymerase chain reaction and subjected to UVC irradiation for different durations (minutes). We found that washbasins had a high contamination rate (45.5%). SARS-CoV-2 was inactivated after 15 min (estimated dose: 126 mJ/cm²) of UVC irradiation, and the contamination decreased from 41.7% before irradiation to 16.7%, 8.3%, and 0% after 5, 10, and 15 min of irradiation, respectively (p = 0.005). However, SARS-CoV-2 was still detected in washbasins after irradiation for 20 min but not after 30 min (252 mJ/cm²). Thus, 15 min of 254-nm UVC irradiation was effective in cleaning plastic, steel, and wood surfaces in the isolation ward. For silicon items, such as washbasins, 30 min was suggested; however, further studies using hospital environmental samples are needed to confirm the effective UVC inactivation of SARS-CoV-2. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 618 KiB

Open AccessArticle

Community-Based Seroprevalence of SARS-CoV-2 Antibodies following the First Wave of the COVID-19 Pandemic in Jazan Province, Saudi Arabia

by Abdulaziz Alhazmi, Edrous Alamer, Siddig Abdelwahab, Nizar Khamjan, Abdullah Hamami, Moayad Haddad, Majid Darraj, Anwar M. Hashem and Abdullah Algaissi

Int. J. Environ. Res. Public Health 2021, 18(23), 12451; https://doi.org/10.3390/ijerph182312451 - 26 Nov 2021

Cited by 8 | Viewed by 2039

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread globally, causing unprecedented effects on global health and economies. Community-based serological data are essential for understanding the true prevalence of infections, specifically the subclinical infections, as COVID-19 asymptomatic infections are common. Such data [...] Read more.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread globally, causing unprecedented effects on global health and economies. Community-based serological data are essential for understanding the true prevalence of infections, specifically the subclinical infections, as COVID-19 asymptomatic infections are common. Such data would also be important for decision making around choosing appropriate epidemiological control measures, as well as for the true estimation of mortality rates in the population. Further, determining the seroprevalence of anti-SARS-CoV-2 antibodies in the population would provide important information on herd immunity. In this study, we conducted a population-based age-stratified serological study to understand the prevalence of SARS-CoV-2 in Jazan Province, Saudi Arabia. Out of 594 participants who were recruited from 29 August to 30 December 2020, just before the vaccination rollout program in Saudi Arabia, about 157 were seropositive for SARS-CoV-2, indicating an estimated seropositivity rate of 26%. Although no significant difference in seropositivity was seen between male and female participants, we found that lower seroprevalence was associated with the younger (below 18 years old) and older populations (older than 56 years) compared with other age groups (19–55 years). These data indicate a high prevalence of SARS-CoV-2 antibodies following the peak of COVID-19 spread in Jazan province; however, most of the population (three-quarters) remains susceptible to SARS-CoV-2 infection. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 2162 KiB

Open AccessArticle

Did COVID-19 Pandemic Change People’s Physical Activity Distribution, Eating, and Alcohol Consumption Habits as well as Body Mass Index?

by Albertas Skurvydas, Ausra Lisinskiene, Marc Lochbaum, Daiva Majauskiene, Dovile Valanciene, Ruta Dadeliene, Natalja Fatkulina and Asta Sarkauskiene

Int. J. Environ. Res. Public Health 2021, 18(23), 12405; https://doi.org/10.3390/ijerph182312405 - 25 Nov 2021

Cited by 9 | Viewed by 6296

Abstract

This cross-sectional study aimed to evaluate whether COVID-19 had an impact on people’s (aged 18–74) physical activity distribution, eating, and alcohol consumption habits as well as body mass index. We interviewed 6369 people (4545 women and 1824 men) in Lithuania before the COVID-19 [...] Read more.

This cross-sectional study aimed to evaluate whether COVID-19 had an impact on people’s (aged 18–74) physical activity distribution, eating, and alcohol consumption habits as well as body mass index. We interviewed 6369 people (4545 women and 1824 men) in Lithuania before the COVID-19 pandemic started and 2392 during COVID-19 (1856 women and 536 men). They were aged 18–74 years. We found that both genders had not stopped their physical activity (PA) completely because of lockdown imitations (for example, prohibition from attending sport clubs), but they started doing different physical exercises at sport clubs. We determined the PA distribution according to the Danish Physical Activity Questionnaire (DPAQ). Despite increases in independent PA and the quantity of light PA, the amount of total energy used in metabolic equivalent of task (MET) units per day decreased significantly for both genders irrespective of age. Although the amounts of sedentary behavior, moderate PA (MPA), vigorous PA (VPA) or a combination of MPA and VPA (MVPA) did not change significantly. Surprisingly, lockdown reduced the duration of sleep for older women but increased their amount of intense VPA (>6 METs). However, the amount of intense VPA decreased for men. Both genders reported overeating less during the pandemic than before it, but did not start consuming more alcohol, and their body mass index did not change. Thus, the COVID-19 in Lithuania represented ‘good stress’ that mobilized these individuals to exercise more independently and overeat less. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 289 KiB

Open AccessArticle

The Way of Distance Teaching Is Related to Adolescent Students’ Health and Loneliness during the School Closure in Finland

by Arja Rimpelä, Pirjo Lindfors, Jaana M. Kinnunen, Anna Myöhänen, Risto Hotulainen, Satu Koivuhovi and Mari-Pauliina Vainikainen

Int. J. Environ. Res. Public Health 2021, 18(23), 12377; https://doi.org/10.3390/ijerph182312377 - 25 Nov 2021

Cited by 3 | Viewed by 2070

Abstract

The COVID-19 pandemic enforced countries to close schools and rapidly transfer to distance teaching without preparation. Little is known about how different distance teaching practices influenced students’ wellbeing. We studied this during the period of school closures in Finland. Wellbeing was measured by [...] Read more.

The COVID-19 pandemic enforced countries to close schools and rapidly transfer to distance teaching without preparation. Little is known about how different distance teaching practices influenced students’ wellbeing. We studied this during the period of school closures in Finland. Wellbeing was measured by health complaints and perceived loneliness, and distance learning was measured in terms of structure and dialogue of teaching, functioning of internet and digital equipment, difficulty of given tasks, and support for studies. All lower secondary schools were invited, and 29,898 students from 340 schools (grades 7–9) participated. A digital survey was distributed through schools just when these were reopened in May 2020. The main results were that the distance learning practices were related to adolescent health complaints and loneliness, so that less structure and dialogue in teaching, more problems with digital devices and internet, more difficult tasks and less support for studies were associated with higher health complaints and loneliness. From the point of view of students’ wellbeing, it matters how the distance learning is organised, how digital communication works, and if enough support for studies is available. These results of our research on distance learning practices during the present pandemic may guide schools in future crises and pandemic situations when distance learning is needed. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

20 pages, 3003 KiB

Open AccessReview

Artificial Intelligence for Forecasting the Prevalence of COVID-19 Pandemic: An Overview

by Ammar H. Elsheikh, Amal I. Saba, Hitesh Panchal, Sengottaiyan Shanmugan, Naser A. Alsaleh and Mahmoud Ahmadein

Healthcare 2021, 9(12), 1614; https://doi.org/10.3390/healthcare9121614 - 23 Nov 2021

Cited by 35 | Viewed by 2856

Abstract

Since the discovery of COVID-19 at the end of 2019, a significant surge in forecasting publications has been recorded. Both statistical and artificial intelligence (AI) approaches have been reported; however, the AI approaches showed a better accuracy compared with the statistical approaches. This [...] Read more.

Since the discovery of COVID-19 at the end of 2019, a significant surge in forecasting publications has been recorded. Both statistical and artificial intelligence (AI) approaches have been reported; however, the AI approaches showed a better accuracy compared with the statistical approaches. This study presents a review on the applications of different AI approaches used in forecasting the spread of this pandemic. The fundamentals of the commonly used AI approaches in this context are briefly explained. Evaluation of the forecasting accuracy using different statistical measures is introduced. This review may assist researchers, experts and policy makers involved in managing the COVID-19 pandemic to develop more accurate forecasting models and enhanced strategies to control the spread of this pandemic. Additionally, this review study is highly significant as it provides more important information of AI applications in forecasting the prevalence of this pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 918 KiB

Open AccessArticle

Factors That Influence Mortality in Critically Ill Patients with SARS-CoV-2 Infection: A Multicenter Study in the Kingdom of Saudi Arabia

by Khalid A Alhasan, Mohamed A Shalaby, Mohamad-Hani Temsah, Fadi Aljamaan, Reem Shagal, Talal AlFaadhel, Mohammed Alomi, Khalid AlMatham, Adi J. AlHerbish, Rupesh Raina, Sidharth K. Sethi, Sarah Alsubaie, Marwah H Hakami, Najla M Alharbi, Razan A Shebeli, Hanan Mohamed Nur, Ohoud F Kashari, Faiza A Qari, Amr S Albanna and Jameela A Kari

Healthcare 2021, 9(12), 1608; https://doi.org/10.3390/healthcare9121608 - 23 Nov 2021

Cited by 8 | Viewed by 2272

Abstract

Background: SARS-CoV-2 infection has a high mortality rate and continues to be a global threat, which warrants the identification of all mortality risk factors in critically ill patients. Methods: This is a retrospective multicenter cohort study conducted in five hospitals in the Kingdom [...] Read more.

Background: SARS-CoV-2 infection has a high mortality rate and continues to be a global threat, which warrants the identification of all mortality risk factors in critically ill patients. Methods: This is a retrospective multicenter cohort study conducted in five hospitals in the Kingdom of Saudi Arabia (KSA). We enrolled patients with confirmed SARS-COV-2 infection admitted to any of the intensive care units from the five hospitals between March 2020 and July 2020, corresponding to the peak of recorded COVID-19 cases in the KSA. Results: In total, 229 critically ill patients with confirmed SARS-CoV-2 infection were included in the study. The presenting symptoms and signs of patients who died during hospitalization were not significantly different from those observed among patients who survived. The baseline comorbidities that were significantly associated with in-hospital mortality were diabetes (62% vs. 48% among patients who died and survived (p = 0.046)), underlying cardiac disease (38% vs. 19% (p = 0.001)), and underlying kidney disease (32% vs. 12% (p < 0.001)). Conclusion: In our cohort, the baseline comorbidities that were significantly associated with in-hospital mortality were diabetes, underlying cardiac disease, and underlying kidney disease. Additionally, the factors that independently influenced mortality among critically ill COVID-19 patients were high Activated Partial Thromboplastin Time (aPTT )and international normalization ratio (INR), acidosis, and high ferritin. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 1237 KiB

Open AccessArticle

SARS-CoV-2 Infection and C-Section: A Prospective Observational Study

by Eva Morán Antolín, José Román Broullón Molanes, María Luisa de la Cruz Conty, María Begoña Encinas Pardilla, María del Pilar Guadix Martín, José Antonio Sainz Bueno, Laura Forcén Acebal, Pilar Pintado Recarte, Ana Álvarez Bartolomé, Juan Pedro Martínez Cendán, Óscar Martínez-Pérez and on behalf of the Spanish Obstetric Emergency Group

Viruses 2021, 13(11), 2330; https://doi.org/10.3390/v13112330 - 22 Nov 2021

Cited by 8 | Viewed by 2942

Abstract

Pregnant women are particularly vulnerable to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. In addition to unfavorable perinatal outcomes, there has been an increase in obstetric interventions. With this study, we aimed to clarify the reasons, using Robson’s classification model, and [...] Read more.

Pregnant women are particularly vulnerable to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. In addition to unfavorable perinatal outcomes, there has been an increase in obstetric interventions. With this study, we aimed to clarify the reasons, using Robson’s classification model, and risk factors for cesarean section (C-section) in SARS-CoV-2-infected mothers and their perinatal results. This was a prospective observational study that was carried out in 79 hospitals (Spanish Obstetric Emergency Group) with a cohort of 1704 SARS-CoV-2 PCR-positive pregnant women that were registered consecutively between 26 February and 5 November 2020. The data from 1248 pregnant women who delivered vaginally (vaginal + operative vaginal) was compared with those from 456 (26.8%) who underwent a C-section. C-section patients were older with higher rates of comorbidities, in vitro fertilization and multiple pregnancies (p < 0.05) compared with women who delivered vaginally. Moreover, C-section risk was associated with the presence of pneumonia (p < 0.001) and 41.1% of C-sections in patients with pneumonia were preterm (Robson’s 10th category). However, delivery care was similar between asymptomatic and mild–moderate symptomatic patients (p = 0.228) and their predisposing factors to C-section were the presence of uterine scarring (due to a previous C-section) and the induction of labor or programmed C-section for unspecified obstetric reasons. On the other hand, higher rates of hemorrhagic events, hypertensive disorders and thrombotic events were observed in the C-section group (p < 0.001 for all three outcomes), as well as for ICU admission. These findings suggest that this type of delivery was associated with the mother’s clinical conditions that required a rapid and early termination of pregnancy. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 382 KiB

Open AccessArticle

Mental Well-Being during COVID-19: A Cross-Sectional Study of Fly-In Fly-Out Workers in the Mining Industry in Australia

by Bernard Yeboah-Asiamah Asare, Elizabeth Thomas, Jacquita S. Affandi, Myles Schammer, Paul Brown, Matthew Pilbeam, Chris Harris, Chris Ellison, Dominika Kwasnicka, Daniel Powell, Christopher M. Reid and Suzanne Robinson

Int. J. Environ. Res. Public Health 2021, 18(22), 12264; https://doi.org/10.3390/ijerph182212264 - 22 Nov 2021

Cited by 6 | Viewed by 2937

Abstract

Coronavirus disease 2019 (COVID-19) has devastated the world, and its mental health impact has been recognized in the general population. However, little is known about the mental health impact of COVID-19 on fly-in fly-out (FIFO) workers, who are flown to temporarily stay and [...] Read more.

Coronavirus disease 2019 (COVID-19) has devastated the world, and its mental health impact has been recognized in the general population. However, little is known about the mental health impact of COVID-19 on fly-in fly-out (FIFO) workers, who are flown to temporarily stay and work in remote areas, during this pandemic. This study examined the mental well-being of FIFO workers in the mining industry during COVID-19 restrictions in Western Australia. An online survey was conducted between May to November 2020 among (N = 842) FIFO workers who underwent COVID-19 screening at a large mining company in Western Australia. The mental well-being score among workers was higher than population norms. One-way ANOVA with Bonferroni post-hoc tests showed significant differences in mental well-being by age, being placed under travel quarantine, undertaking self-isolation, impact of social distance guidelines, and experience of COVID-19 related symptoms. Multiple linear regression analysis showed workers who were younger, placed under travel quarantine and experienced two or more COVID-19 related symptoms were more likely to have worse mental well-being. Acknowledging the negative emotions and distress experiences among the vulnerable groups could help in providing suitable support to help lessen these negative experiences in FIFO workers. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

12 pages, 1060 KiB

Open AccessArticle

Molecular and Serological Characterization of the SARS-CoV-2 Delta Variant in Bangladesh in 2021

by Asish Kumar Ghosh, Marco Kaiser, Md. Maruf Ahmed Molla, Tasnim Nafisa, Mahmuda Yeasmin, Rifat Hossain Ratul, Md. Mohiuddin Sharif, Arifa Akram, Nur Hosen, Rashid Mamunur, Md. Robed Amin, Alimul Islam, Md. Ehsanul Hoque, Olfert Landt and Simon D. Lytton

Viruses 2021, 13(11), 2310; https://doi.org/10.3390/v13112310 - 19 Nov 2021

Cited by 9 | Viewed by 2345

Abstract

Novel SARS-CoV-2 variants are emerging at an alarming rate. The delta variant and other variants of concern (VoC) carry spike (S)-protein mutations, which have the potential to evade protective immunity, to trigger break-through infections after COVID-19 vaccination, and to propagate future waves of [...] Read more.

Novel SARS-CoV-2 variants are emerging at an alarming rate. The delta variant and other variants of concern (VoC) carry spike (S)-protein mutations, which have the potential to evade protective immunity, to trigger break-through infections after COVID-19 vaccination, and to propagate future waves of COVID-19 pandemic. To identify SARS CoV-2 variants in Bangladesh, patients who are RT-PCR-positive for COVID-19 infections in Dhaka were screened by a RT-PCR melting curve analysis for spike protein mutations. To assess the anti-SARS CoV-2 antibody responses, the levels of the anti-S -proteins IgA and IgG and the anti-N-protein IgG were measured by ELISA. Of a total of 36 RT-PCR positive samples (75%), 27 were identified as delta variants, with one carrying an additional Q677H mutation and two with single nucleotide substitutions at position 23029 (compared to Wuhan-Hu-1 reference NC 045512) in the genome sequence. Three (8.3%) were identified as beta variants, two (5.5%) were identified as alpha variants, three (8.3%) were identified as having a B.1.1.318 lineage, and one sample was identified as an eta variant (B.1.525) carrying an additional V687L mutation. The trend of higher viral load (lower Cp values) among delta variants than in the alpha and beta variants was of borderline statistical significance (p = 0.045). Prospective studies with larger Bangladeshi cohorts are warranted to confirm the emergence of S-protein mutations and their association with antibody response in natural infection and potential breakthrough in vaccinated subjects. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 252 KiB

Open AccessArticle

Differences in Perceived Occupational Stress by Demographic Characteristics, of European Emergency Medical Services Personnel during the COVID-19 Virus Pandemic—An International Study

by Tomasz Ilczak, Małgorzata Rak, Kacper Sumera, Carl Robert Christiansen, Esther Navarro-Illana, Pasi Alanen, Juha Jormakka, Elena Gurková, Darja Jarošová, Danka Boguská, Michał Ćwiertnia, Monika Mikulska, Wioletta Pollok-Wakmańska, Rafał Bobiński and Marek Kawecki

Healthcare 2021, 9(11), 1582; https://doi.org/10.3390/healthcare9111582 - 19 Nov 2021

Cited by 5 | Viewed by 2773

Abstract

Objectives: The outbreak of the COVID-19 pandemic has brought commercial, social, and economic consequences in every country that has experienced substantial SARS-CoV-2 infection rates. The complete change in the environment that took place due to the outbreak of the pandemic can lead to [...] Read more.

Objectives: The outbreak of the COVID-19 pandemic has brought commercial, social, and economic consequences in every country that has experienced substantial SARS-CoV-2 infection rates. The complete change in the environment that took place due to the outbreak of the pandemic can lead to stressful situations, especially among healthcare personnel. Material and methods: The research were conducted during the COVID-19 pandemic between the 27 March 2020 and the 20 April 2020. The research included 1984 employees of emergency medical systems in seven European countries. An internet-based questionnaire format was adopted for the study (ΩMc-Donald > 0.7). Results: The highest level of stress was experienced by personnel in the United Kingdom M = 4.03, and the lowest by Norwegian employees M = 2.89. High levels of stress were also experienced by nurses from Spain and Poland. Women actively working in the healthcare system during the pandemic experienced higher stress levels than men. Conclusions: Women working in European emergency medical systems are more vulnerable to work-related stress, while carrying out emergency medical procedures during the pandemic. Differences in the level of stress experienced while carrying out duties in pre-hospital conditions were only found among Spanish emergency medical system personnel. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

9 pages, 648 KiB

Open AccessArticle

Fear of COVID-19 and Trust in the Healthcare System Mediates the Association between Individual’s Risk Perception and Preventive COVID-19 Behaviours among Iranians

by Mehran Alijanzadeh, Daniel Kwasi Ahorsu, Zainab Alimoradi, Narges Mahmoudi, Mark D. Griffiths, Chung-Ying Lin, Hsien-Kuan Liu and Amir H. Pakpour

Int. J. Environ. Res. Public Health 2021, 18(22), 12146; https://doi.org/10.3390/ijerph182212146 - 19 Nov 2021

Cited by 32 | Viewed by 2850

Abstract

Problems caused by the novel coronavirus disease-2019 (COVID-19) and its mutations have brought challenges in pandemic control for all countries worldwide. The present study examines the mediating roles of fear of COVID-19 and trust in the healthcare system in the association between individual’s [...] Read more.

Problems caused by the novel coronavirus disease-2019 (COVID-19) and its mutations have brought challenges in pandemic control for all countries worldwide. The present study examines the mediating roles of fear of COVID-19 and trust in the healthcare system in the association between individual’s risk perception and performing preventive COVID-19 behaviours among Iranians. A cross-sectional study design was used to collect data from 3652 residents of Qazvin province in Iran from 3 February to 15 April 2021 using a multistage stratified cluster sampling method. Participants responded to an online questionnaire concerning their fear of COVID-19, risk perception, trust in the healthcare system, and preventive COVID-19 behaviours. Small to medium positive interrelationships were observed between the variables of the study. Fear of COVID-19, trust in the healthcare system or both (fear of COVID-19 and trust in the healthcare system) mediated the association between an individual’s risk perception and performing preventive COVID-19 behaviours. The study demonstrated there are at least four ways through which an individual’s risk perception can influence preventive COVID-19 behaviours. Therefore, clinicians, health communicators, and researchers may capitalize on these findings to enhance preventive COVID-19 behaviours to help mitigate the spread of COVID-19 infection. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 573 KiB

Open AccessArticle

Associations of COVID-19 Knowledge and Risk Perception with the Full Adoption of Preventive Behaviors in Seoul

by Jina Choo, Sooyeon Park and Songwhi Noh

Int. J. Environ. Res. Public Health 2021, 18(22), 12102; https://doi.org/10.3390/ijerph182212102 - 18 Nov 2021

Cited by 4 | Viewed by 1860

Abstract

This study explores the levels of COVID-19 knowledge, risk perception, and preventive behavior practice in Seoul, to determine whether knowledge and risk perception are significantly associated with the full adoption of preventive behaviors, for the delivery of a customized public campaign to Seoul’s [...] Read more.

This study explores the levels of COVID-19 knowledge, risk perception, and preventive behavior practice in Seoul, to determine whether knowledge and risk perception are significantly associated with the full adoption of preventive behaviors, for the delivery of a customized public campaign to Seoul’s citizens. A total of 3000 Seoul residents participated in this study through an online questionnaire survey. They had a mean score of 84.6 for COVID-19 knowledge (range: 0–100 points) and 4.2 (range: 1–7 points) for risk perception. Of the participants, 33.4% practiced full adoption of all three preventive behaviors: hand hygiene, wearing a face mask, and social distancing; wearing a face mask was practiced the most (81.0%). Women significantly adopted these three preventive behaviors more often compared with men. Both COVID-19 knowledge and risk perception were found to be significantly associated with the full adoption of preventive behaviors; however, this association differed by the type of preventive behavior. This indicates that city-level information on the levels of COVID-19 knowledge, risk perception, and preventive behaviors should be clearly and periodically communicated among public officers and healthcare professionals to continually raise the public’s awareness of the full adoption of non-pharmaceutical preventive behaviors. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 954 KiB

Open AccessArticle

The Mediating Effect of Coping Style on Physical Activity and Negative Affect Caused by Public Health Emergencies: Evidence from Chinese College Students

by Yuetao Liu, Zhiyuan Wang and Songhui You

Int. J. Environ. Res. Public Health 2021, 18(22), 12086; https://doi.org/10.3390/ijerph182212086 - 17 Nov 2021

Cited by 3 | Viewed by 2185

Abstract

In this study, we explored the relationship between physical activity (PA), coping style (CS) and negative affect caused by public health emergencies (PHENA), to examine if CS can play a mediating role between PA and PHENA, and analyzed the different effects of positive [...] Read more.

In this study, we explored the relationship between physical activity (PA), coping style (CS) and negative affect caused by public health emergencies (PHENA), to examine if CS can play a mediating role between PA and PHENA, and analyzed the different effects of positive coping (PC) and negative coping (NC). Using the method of random sampling, 700 students from four universities in Beijing and Shanghai were recruited to complete questionnaires about PA, CS and PHENA. Data collection was conducted through online and offline questionnaires. Firstly, there is a significant correlation between PA, CS and PHENA. Secondly, PA can negatively predict PHENA, and PA has positive impact on PC and negative impact on NC. Thirdly, the mediating role of NC related to PHENA is significant, the mediating role of PC related to PHENA is not significant. College students’ participation in physical activity can reduce the probability of adopting negative coping mechanisms, thereby alleviating the PHENA. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 335 KiB

Open AccessArticle

Acceptance of the COVID-19 Vaccine by Foreigners in South Korea

by Chiara Achangwa, Tae-Jun Lee and Moo-Sik Lee

Int. J. Environ. Res. Public Health 2021, 18(22), 12035; https://doi.org/10.3390/ijerph182212035 - 16 Nov 2021

Cited by 6 | Viewed by 2098

Abstract

Vaccination against COVID-19 is an important strategy for its control. Assessing the willingness to accept the COVID-19 vaccine in different subgroups is important for an inclusive vaccination program design. Our aim was to determine the COVID-19 vaccine acceptance rate and associated factors among [...] Read more.

Vaccination against COVID-19 is an important strategy for its control. Assessing the willingness to accept the COVID-19 vaccine in different subgroups is important for an inclusive vaccination program design. Our aim was to determine the COVID-19 vaccine acceptance rate and associated factors among foreigners in South Korea. An online cross-sectional study was carried out from May to June 2021. In this study, 710 individuals participated and most were aged between 26 and 29 (36.1%) years. Overall, 70.8% were willing to receive the vaccine. Males were less likely to accept the vaccine than females (OR: 0.5; 95% CI: 0.4–0.7, p < 0.001). Single people were more likely to receive the vaccine than those who were married (OR: 1.4; 95% CI: 0.9–2.0, p = 0.04). Other factors associated with willingness to accept COVID-19 vaccine were; vaccine convenience (OR: 1.7; 95% CI: 1.2–2.3, p = 0.002), doctors’ recommendation (OR: 2.8; 95% CI: 2.0–3.9, p < 0.001), vaccine price (OR: 1.7; 95% CI: 1.2–2.3, p = 0.003), vaccine effectiveness (OR: 8.3; 95% CI: 5.8–12.1, p < 0.001), vaccine importance (OR: 7.9; 95% CI: 4.6–14.1, p < 0.001), and vaccine safety (OR: 6.9; 95% CI: 4.5–10.8, p < 0.001). Providing more information on vaccine safety and effectiveness is required to increase vaccine acceptance. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

12 pages, 1364 KiB

Open AccessArticle

Neurosurgical Care during the COVID-19 Pandemic in Central Germany: A Retrospective Single Center Study of the Second Wave

by Caroline Sander, Nikolaus von Dercks, Michael Karl Fehrenbach, Tim Wende, Sebastian Stehr, Dirk Winkler, Jürgen Meixensberger and Felix Arlt

Int. J. Environ. Res. Public Health 2021, 18(22), 12034; https://doi.org/10.3390/ijerph182212034 - 16 Nov 2021

Cited by 7 | Viewed by 1547

Abstract

The healthcare system has been placed under an enormous burden by the SARS-CoV-2 (COVID-19) pandemic. In addition to the challenge of providing sufficient care for COVID-19 patients, there is also a need to ensure adequate care for non-COVID-19 patients. We investigated neurosurgical care [...] Read more.

The healthcare system has been placed under an enormous burden by the SARS-CoV-2 (COVID-19) pandemic. In addition to the challenge of providing sufficient care for COVID-19 patients, there is also a need to ensure adequate care for non-COVID-19 patients. We investigated neurosurgical care in a university hospital during the pandemic. We examined the second wave of the pandemic from 1 October 2020 to 15 March 2021 in this retrospective single-center study and compared it to a pre-pandemic period from 1 October 2019 to 15 March 2020. Any neurosurgical intervention, along with patient- and treatment-dependent factors, were recorded. We also examined perioperative complications and unplanned readmissions. A statistical comparison of the study groups was performed. We treated 535 patients with a total of 602 neurosurgical surgeries during the pandemic. This compares to 602 patients with 717 surgeries during the pre-pandemic period. There were 67 fewer patients (reduction to 88.87%) admitted and 115 fewer surgeries (reduction to 83.96%) performed, which were essentially highly elective procedures, such as cervical spinal stenosis, intracranial neurinomas, and peripheral nerve lesions. Regarding complication rates and unplanned readmissions, there was no significant difference between the COVID-19 pandemic and the non-pandemic patient group. Operative capacities were slightly reduced to 88% due to the pandemic. Nevertheless, comprehensive emergency and elective care was guaranteed in our university hospital. This speaks for the sufficient resources and high-quality processes that existed even before the pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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19 pages, 2830 KiB

Open AccessArticle

Regional Differentiation and Influencing Factor Analysis of Residents’ Psychological Status during the Early Stage of the COVID-19 Pandemic in South China

by Yeqing Cheng, Yan Chen, Bing Xue and Jinping Zhang

Int. J. Environ. Res. Public Health 2021, 18(22), 11995; https://doi.org/10.3390/ijerph182211995 - 15 Nov 2021

Cited by 3 | Viewed by 2019

Abstract

A scientific understanding of the impact of COVID-19 on the psychological status of residents is important for improving medical services and responding to public health emergencies. With the help of some of the most popular network communication tools (including Wechat and Weiboand QQ), [...] Read more.

A scientific understanding of the impact of COVID-19 on the psychological status of residents is important for improving medical services and responding to public health emergencies. With the help of some of the most popular network communication tools (including Wechat and Weiboand QQ), online questionnaires were completed by South China citizens during the early stage of the COVID-19 pandemic based on psychological stress theory and using a comprehensive sampling method. Through cooperation with experts from other institutions, the content of the questionnaire was designed to include interviewees’ spatial locations and individual information, identify whether negative emotions were generated, and determine the level of psychological stress and the degree of perception change, etc. According to the data type, mathematical statistics and multiple logistic regression methods were used to examine regional differentiation and influencing factors regarding the psychological stress of residents using 1668 valid questionnaires from 53 municipal administrative units in South China. The results firstly showed that over the whole area there was typical regional differentiation in South China, especially in relation to negative expression and psychological stress, with this feature reflecting the dual urban–rural structure. Secondly, regional differences were obvious. Residents of Hainan showed stronger change of psychological stress than those of the other two provinces. In contrast, Guangdong residents were the least psychological stress, and the concept of a harmonious relationship between human beings and nature was not accepted as well as in the other two provinces. Thirdly, in each province the capital city acted as the regional pole, with greater psychological status. This polarization effect decreased with greater distance, reflecting the theory of growth poles in human geography. Fourthly, gender, education level, occupation, informational correction, and the possibility of infection were notable factors that affected the psychological status of interviewees facing COVID-19. However, the functions were different and were decided by the dependent variable. Lastly, based on conclusions summarized from three perspectives, it was found that regional differentiation, public information, and social structure need to focused upon in order to handle sudden major health issues. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 1240 KiB

Open AccessArticle

The Development of Telemedicine and eHealth in Surgery during the SARS-CoV-2 Pandemic

by Anas Taha, Bara Saad, Bassey Enodien, Marta Bachmann, Daniel M. Frey and Stephanie Taha-Mehlitz

Int. J. Environ. Res. Public Health 2021, 18(22), 11969; https://doi.org/10.3390/ijerph182211969 - 15 Nov 2021

Cited by 6 | Viewed by 2620

Abstract

SARS-CoV-2 has hampered healthcare systems worldwide, but some countries have found new opportunities and methods to combat it. In this study, we focused on the rapid growth of telemedicine during the pandemic around the world. We conducted a systematic literature review of all [...] Read more.

SARS-CoV-2 has hampered healthcare systems worldwide, but some countries have found new opportunities and methods to combat it. In this study, we focused on the rapid growth of telemedicine during the pandemic around the world. We conducted a systematic literature review of all the articles published up to the present year, 2021, by following the requirements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. The data extracted comprised eHealth and telemedicine in surgery globally, and independently in Europe, the United States, and Switzerland. This review explicitly included fifty-nine studies. Out of all the articles included, none of them found that telemedicine causes poor outcomes in patients. Telemedicine has created a new path in the world of healthcare, revolutionizing how healthcare is delivered to patients and developing alternative methods for clinicians. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 1441 KiB

Open AccessArticle

Effectiveness of Telephone Monitoring in Primary Care to Detect Pneumonia and Associated Risk Factors in Patients with SARS-CoV-2

by Jose Miguel Baena-Díez, Isabel Gonzalez-Casafont, Sara Cordeiro-Coelho, Soledad Fernández-González, Migdalia Rodríguez-Jorge, Clara Uxía Fernández Pérez-Torres, Andrea Larrañaga-Cabrera, Manel García-Lareo, Ana de la Arada-Acebes, Esther Martín-Jiménez, Almudena Pérez-Orcero, Rosario Hernández-Ibáñez, Ana Gonzalo-Voltas, Noemí Bermúdez-Chillida, Consuelo Simón-Muela, Guillermo del Carlo, Carolina Bayona-Faro, Cristina Rey-Reñones, Isabel Aguilar-Palacio and María Grau

Healthcare 2021, 9(11), 1548; https://doi.org/10.3390/healthcare9111548 - 13 Nov 2021

Cited by 6 | Viewed by 1854

Abstract

Improved technology facilitates the acceptance of telemedicine. The aim was to analyze the effectiveness of telephone follow-up to detect severe SARS-CoV-2 cases that progressed to pneumonia. A prospective cohort study with 2-week telephone follow-up was carried out March 1 to May 4, 2020, [...] Read more.

Improved technology facilitates the acceptance of telemedicine. The aim was to analyze the effectiveness of telephone follow-up to detect severe SARS-CoV-2 cases that progressed to pneumonia. A prospective cohort study with 2-week telephone follow-up was carried out March 1 to May 4, 2020, in a primary healthcare center in Barcelona. Individuals aged ≥15 years with symptoms of SARS-CoV-2 were included. Outpatients with non-severe disease were called on days 2, 4, 7, 10 and 14 after diagnosis; patients with risk factors for pneumonia received daily calls through day 5 and then the regularly scheduled calls. Patients hospitalized due to pneumonia received calls on days 1, 3, 7 and 14 post-discharge. Of the 453 included patients, 435 (96%) were first attended to at a primary healthcare center. The 14-day follow-up was completed in 430 patients (99%), with 1798 calls performed. Of the 99 cases of pneumonia detected (incidence rate 20.8%), one-third appeared 7 to 10 days after onset of SARS-CoV-2 symptoms. Ten deaths due to pneumonia were recorded. Telephone follow-up by a primary healthcare center was effective to detect SARS-CoV-2 pneumonias and to monitor related complications. Thus, telephone appointments between a patient and their health care practitioner benefit both health outcomes and convenience. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 1469 KiB

Open AccessArticle

Impact of COVID-19 Stay-at-Home Restrictions on Employment Status, Physical Activity, and Sedentary Behavior

by Cheryl A. Howe, Riley J. Corrigan, Fernanda Rocha de Faria, Zoe Johanni, Paul Chase and Angela R. Hillman

Int. J. Environ. Res. Public Health 2021, 18(22), 11935; https://doi.org/10.3390/ijerph182211935 - 13 Nov 2021

Cited by 6 | Viewed by 2289

Abstract

Background. North Americans report insufficient moderate-to-vigorous physical activity (MVPA) and ample sedentary behaviors (SBs), suggesting possible barriers to an active lifestyle. This study compared self-reported MVPA and SB before and during COVID-19 “Stay-at-Home” restrictions as a potential barrier across North America. Methods: Questionnaires [...] Read more.

Background. North Americans report insufficient moderate-to-vigorous physical activity (MVPA) and ample sedentary behaviors (SBs), suggesting possible barriers to an active lifestyle. This study compared self-reported MVPA and SB before and during COVID-19 “Stay-at-Home” restrictions as a potential barrier across North America. Methods: Questionnaires were distributed from 21 April to 9 May 2020. ANOVAs compared data overall and by group (age, sex, race, income, education, employment status). Results: During restrictions, 51.4% (n = 687) of the 1336 responses (991 female, 1187 Caucasian, 634 18–29 years) shifted to work from home and 12.1% (n = 162) lost their job. Overall, during restrictions, 8.3% (n = 110) fewer reported work-related MVPA (−178.6 ± 20.9 min/week). Similarly, 28.0% (n = 374) fewer reported travel-related MVPA, especially females and younger age groups. While the 7.3% (n = 98) fewer reporting recreational MVPA was not statistically significant (−30.4 ± 11.5 min/week), there was an increase in SB (+94.9 ± 4.1 min/week) in all groups, except the oldest age group (70+ years). Locomotive activities and fitness class remained the predominant MVPA mode. Of those reportedly using facilities (68%; n = 709) before COVID, 31.3% (n = 418) would not return due to it “being unsafe”. Conclusion: While barriers related to pandemic restrictions had a negative short-term impact on MVPA and SB in North America, the long-term impact is unknown. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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8 pages, 736 KiB

Open AccessArticle

COVID-19 Symptoms and Diagnoses among a Sociodemographically Diverse Cohort of Children from New York City: Lessons from the First Wave, Spring 2020

by Linda G. Kahn, Akhgar Ghassabian, Melanie H. Jacobson, Keunhyung Yu and Leonardo Trasande

Int. J. Environ. Res. Public Health 2021, 18(22), 11886; https://doi.org/10.3390/ijerph182211886 - 12 Nov 2021

Cited by 1 | Viewed by 2087

Abstract

Early in the pandemic, in the North American epicenter, we investigated associations between sociodemographic factors and rates of pediatric COVID-19 diagnoses in a non-clinical setting and whether symptoms varied by child age. From 20 April–31 August 2020, COVID-19-related data were collected on 2694 [...] Read more.

Early in the pandemic, in the North American epicenter, we investigated associations between sociodemographic factors and rates of pediatric COVID-19 diagnoses in a non-clinical setting and whether symptoms varied by child age. From 20 April–31 August 2020, COVID-19-related data were collected on 2694 children aged ≤ 18 years living in households participating in the New York University Children’s Health and Environment Study. We examined differences in rates of subjective and objective diagnoses according to sociodemographic characteristics and differences in reported symptoms by child age. Children of women who were non-Hispanic White, had private health insurance, higher income, or more education were more likely to be diagnosed via WHO criteria or healthcare provider. Children of women who were Hispanic or Asian, reported low income, had less education, or were/lived with an essential worker were more likely to test positive. Older children were less likely to experience cough or runny nose and more likely to experience muscle/body aches, sore throat, headache, and loss of smell or taste than younger children. In conclusion, relying on subjective disease ascertainment methods, especially in the early stage of an outbreak when testing is not universally available, may misrepresent the true prevalence of disease among sociodemographic subgroups. Variations in symptoms by child age should be considered when determining diagnostic criteria. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 260 KiB

Open AccessArticle

Psychological Well-Being of Malaysian University Students during COVID-19 Pandemic: Do Religiosity and Religious Coping Matter?

by Aisyah Che Rahimi, Raishan Shafini Bakar and Mohd Azhar Mohd Yasin

Healthcare 2021, 9(11), 1535; https://doi.org/10.3390/healthcare9111535 - 10 Nov 2021

Cited by 11 | Viewed by 3072

Abstract

The COVID-19 pandemic and the restrictions imposed that changed the teaching and learning activities may add a psychological impact to the existing academic stress faced by university students. Past studies have associated low levels of psychological disorder with high religiosity and positive religious [...] Read more.

The COVID-19 pandemic and the restrictions imposed that changed the teaching and learning activities may add a psychological impact to the existing academic stress faced by university students. Past studies have associated low levels of psychological disorder with high religiosity and positive religious coping (RC). This study aimed to determine the level of psychological disorder among university students in Malaysia during the COVID-19 pandemic and measure their association with religiosity and religious coping (RC). An online cross-sectional survey was conducted between March and June 2020 involving 450 students. The survey instruments consisted of sociodemographic proforma, Duke University Religious Index (DUREL) for religiosity, Brief RCOPE Scale for RC and General Health Questionnaire-12 (GHQ-12) for psychological disorder; 36% of the participants experienced psychological disorder. Younger age, being a Muslim, living in the Green/Yellow zone and higher negative RC were significantly associated with psychological disorder. Higher positive RC was found to be protective against psychological disorder. However, the level of religiosity had no significant association with psychological disorder. In conclusion, the level of psychological disorder among university students has been high during the pandemic. Measures and interventions focusing on positive RC and reducing negative RC are recommended to improve the psychological well-being. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

10 pages, 639 KiB

Open AccessArticle

COVID-19 Anti-Vaccine Sentiments: Analyses of Comments from Social Media

by Li Ping Wong, Yulan Lin, Haridah Alias, Sazaly Abu Bakar, Qinjian Zhao and Zhijian Hu

Healthcare 2021, 9(11), 1530; https://doi.org/10.3390/healthcare9111530 - 09 Nov 2021

Cited by 17 | Viewed by 4356

Abstract

Purpose: This study analyzed the insights and sentiments of COVID-19 anti-vaccine comments from Instagram feeds and Facebook postings. The sentiments related to the acceptance and effectiveness of the vaccines that were on the verge of being made available to the public. Patients and [...] Read more.

Purpose: This study analyzed the insights and sentiments of COVID-19 anti-vaccine comments from Instagram feeds and Facebook postings. The sentiments related to the acceptance and effectiveness of the vaccines that were on the verge of being made available to the public. Patients and methods: The qualitative software QSR-NVivo 10 was used to manage, code, and analyse the data. Results: The analyses uncovered several major issues concerning COVID-19 vaccine hesitancy. The production of the COVID-19 vaccine at an unprecedented speed evoked the fear of skipping steps that would compromise vaccine safety. The unknown long-term effects and duration of protection erode confidence in taking the vaccines. There were also persistent concerns with regard to vaccine compositions that could be harmful or contain aborted foetal cells. The rate of COVID-19 death was viewed as low. Many interpreted the 95% effectiveness of the COVID-19 vaccine as insufficient. Preference for immunity gains from having an infection was viewed as more effective. Peer-reviewed publication-based data were favoured as a source of trust in vaccination decision-making. Conclusions: The anti-COVID-19 vaccine sentiments found in this study provide important insights for the formulation of public health messages to instill confidence in the vaccines. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 1290 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on Cancer Patient’s Management—Lithuanian Cancer Center Experience

by Daiva Dabkeviciene, Ieva Vincerzevskiene, Vincas Urbonas, Jonas Venius, Audrius Dulskas, Birute Brasiuniene, Ernestas Janulionis, Arvydas Burneckis, Asta Zileviciene, Sigitas Tiskevicius, Rasa Vanseviciute-Petkeviciene, Jurgita Usinskiene, Ruta Briediene, Giedre Bulotiene, Eugenijus Stratilatovas, Valerijus Ostapenko, Jolita Gibaviciene, Ignas Karnas, Saule Kekstaite, Jurgita Navickiene, Albertas Ulys, Algirdas Zalimas, Algimantas Sruogis, Zygimantas Kardelis, Sigitas Zaremba, Renatas Askinis, Saulius Cicenas, Renatas Tikuisis, Ruta Ciurliene and Sonata Jarmalaite Show full author list Hide full author list

Healthcare 2021, 9(11), 1522; https://doi.org/10.3390/healthcare9111522 - 09 Nov 2021

Cited by 10 | Viewed by 2323

Abstract

The pandemic spread of the COVID-19 virus significantly affected daily life, but the highest pressure was piled on the health care system. Our aim was to evaluate an impact of COVID-19 pandemic management measures on cancer services at the National Cancer Institute (NCI) [...] Read more.

The pandemic spread of the COVID-19 virus significantly affected daily life, but the highest pressure was piled on the health care system. Our aim was to evaluate an impact of COVID-19 pandemic management measures on cancer services at the National Cancer Institute (NCI) of Lithuania. We assessed the time period from 1 February 2020 to 31 December 2020 and compared it to the same period of 2019. Data for our analysis were extracted from the NCI Hospital Information System (HIS) and the National Health Insurance Fund (NHIF). Contingency table analysis and ANOVA were performed. The COVID-19 pandemic negatively affected the cancer services provided by NCI. Reductions in diagnostic radiology (−16%) and endoscopy (−29%) procedures were accompanied by a decreased number of patients with ongoing medical (−30%), radiation (−6%) or surgical (−10%) treatment. The changes in the number of newly diagnosed cancer patients were dependent on tumor type and disease stage, showing a rise in advanced disease at diagnosis already during the early period of the first lockdown. The extent of out-patient consultations (−14%) and disease follow-up visits (−16%) was also affected by the pandemic, and only referrals to psychological/psychiatric counselling were increased. Additionally, the COVID-19 pandemic had an impact on the structure of cancer services by fostering the application of modified systemic anticancer therapy or hypofractionated radiotherapy. The most dramatic drop occurred in the number of patients participating in cancer prevention programs; the loss was 25% for colon cancer and 62% for breast cancer screening. Marked restriction in access to preventive cancer screening and overall reduction of the whole spectrum of cancer services may negatively affect cancer survival measures in the nearest future. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 548 KiB

Open AccessBrief Report

Early Postpartum Stress, Anxiety, Depression, and Resilience Development among Danish First-Time Mothers before and during First-Wave COVID-19 Pandemic

by Monica Ladekarl, Nanna Julie Olsen, Karoline Winckler, Anne Brødsgaard, Ellen Aagaard Nøhr, Berit Lilienthal Heitmann and Ina Olmer Specht

Int. J. Environ. Res. Public Health 2021, 18(22), 11734; https://doi.org/10.3390/ijerph182211734 - 09 Nov 2021

Cited by 5 | Viewed by 2516

Abstract

On 11 March 2020, a lockdown to limit the spread of COVID-19 was implemented in Denmark. The pandemic and the lockdown might have caused stress, depression, and anxiety in new mothers. Individuals with high resilience to stress may have been less affected. This [...] Read more.

On 11 March 2020, a lockdown to limit the spread of COVID-19 was implemented in Denmark. The pandemic and the lockdown might have caused stress, depression, and anxiety in new mothers. Individuals with high resilience to stress may have been less affected. This study aimed to investigate if changes in perceived stress, anxiety, depression, and resilience from the second trimester until two months postpartum were different before and during the COVID-19 pandemic in Denmark in spring 2020. Pregnant women enrolled in an ongoing feasibility study completed an online questionnaire measuring perceived stress, depression, anxiety, and resilience in the second trimester and two months postpartum. Changes in scores between women completing the two-month postpartum questionnaire before (n = 26) or during (n = 47) the COVID-19 pandemic were calculated. No statistically significant differences in changes from baseline to follow-up between pre- and during-pandemic groups in Cohen’s Perceived Stress Scale (PSS), the Depression, Anxiety, Stress Scale (DASS), or the Connor–Davidson Resilience Scale (CD-RISC) were found. Adjusted differences in group means were as follows: PSS: 0.70 (CI—2.45; 3.85); DASS Stress: 0.76 (CI—3.59; 2.08); DASS Anxiety: 0.47 (CI—0.84; 1.77); DASS Depression: 0.88 (CI—0.95; 2.71); and CD-RISC: 1.19 (CI—3.16; 5.54). In conclusion, we did not find significant differences in the development of stress, depression, anxiety, or resilience before or during the Danish COVID-19 pandemic in spring 2020. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 347 KiB

Open AccessArticle

Effects of COVID-19 Social Distancing Measures in Individuals with Chronic Pain Living in Spain in the Late Stages of the Lockdown

by Jordi Miró, Elisabet Sánchez-Rodríguez, Alexandra Ferreira-Valente, José Pais-Ribeiro and Antonella Ciaramella

Int. J. Environ. Res. Public Health 2021, 18(22), 11732; https://doi.org/10.3390/ijerph182211732 - 09 Nov 2021

Cited by 8 | Viewed by 2266

Abstract

Social distancing measures during the lockdown have had a negative impact on chronic pain patients’ function. Research, however, has only focused on the early stages of the first lockdowns. The aim of this study was to improve the understanding of the effects of [...] Read more.

Social distancing measures during the lockdown have had a negative impact on chronic pain patients’ function. Research, however, has only focused on the early stages of the first lockdowns. The aim of this study was to improve the understanding of the effects of COVID-19 social distancing measures on individuals with chronic pain living in Spain during the late stages of the lockdown. A group of 361 adults with pain participated in this study. They responded to an online survey and provided information on sociodemographic issues, pain, fatigue, perceived health, and quality of life. The data showed that most participants suffered moderate to severe pain and interferences with pain treatment and an increase in pain intensity during the lockdown. Most participants also informed us that fatigue had worsened during the lockdown (62%). Importantly, females with lower monthly family income and lower education have been found to be associated with greater levels of pain and fatigue. Despite this, participants perceived themselves as having good health and good quality of life. The findings from this study can be used to inform policy and specific responses for future COVID-19 waves and future pandemics where social distancing measures must be implemented. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

11 pages, 339 KiB

Open AccessArticle

Public Stigma of COVID-19 and Its Correlates in the General Population of China

by Tian-Ming Zhang, Qi Fang, Hao Yao and Mao-Sheng Ran

Int. J. Environ. Res. Public Health 2021, 18(21), 11718; https://doi.org/10.3390/ijerph182111718 - 08 Nov 2021

Cited by 20 | Viewed by 2954

Abstract

This study aimed to examine the profile of COVID-19-related public stigma and its correlates in the general population of China. A cross-sectional online survey was conducted in China from 7 May to 25 May in 2020. A total of 1212 participants from the [...] Read more.

This study aimed to examine the profile of COVID-19-related public stigma and its correlates in the general population of China. A cross-sectional online survey was conducted in China from 7 May to 25 May in 2020. A total of 1212 participants from the general population completed the survey measuring their stigmatizing attitudes towards COVID-19, as well as knowledge and causal attributions of COVID-19. Univariate and multivariate analyses were performed to examine the correlates of COVID-19-related public stigma. A total of 31.8% of participants endorsed stigmatization towards people with COVID-19. Those who were of older age (t = −3.97, p < 0.001), married (F = 3.04, p < 0.05), had a lower level of education (F = 8.11, p < 0.001), and a serious psychological response (F = 3.76, p < 0.05) reported significantly higher scores of public stigma. Dangerousness (B = 0.047, p < 0.001), fear (B = 0.059, p < 0.001), anger (B = 0.038, p < 0.01), and responsibility (B = 0.041, p < 0.001) were positively associated with public stigma. This study shows that public stigma related to COVID-19 is prevalent in the general population of China. Actions against public stigma need to contain the spread of misinformation about COVID-19, alter inappropriate attributions, alleviate unfavorable reactions, and provide psychosocial support for the public. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

17 pages, 4972 KiB

Open AccessArticle

A Descriptive Analysis on the Impact of COVID-19 Lockdowns on Road Traffic Incidents in Sydney, Australia

by Sai Chand, Ernest Yee, Abdulmajeed Alsultan and Vinayak V. Dixit

Int. J. Environ. Res. Public Health 2021, 18(21), 11701; https://doi.org/10.3390/ijerph182111701 - 07 Nov 2021

Cited by 18 | Viewed by 3180

Abstract

COVID-19 has had tremendous effects worldwide, resulting in large-scale death and upheaval. An abundance of studies have shown that traffic patterns have changed worldwide as working from home has become dominant, with many facilities, restaurants and retail services being closed due to the [...] Read more.

COVID-19 has had tremendous effects worldwide, resulting in large-scale death and upheaval. An abundance of studies have shown that traffic patterns have changed worldwide as working from home has become dominant, with many facilities, restaurants and retail services being closed due to the lockdown orders. With regards to road safety, there have been several studies on the reduction in fatalities and crash frequencies and increase in crash severity during the lockdown period. However, no scientific evidence has been reported on the impact of COVID-19 lockdowns on traffic incident duration, a key metric for crash management. It is also unclear from the existing literature whether the impacts on traffic incidents are consistent across multiple lockdowns. This paper analyses the impact of two different COVID-19 lockdowns in Sydney, Australia, on traffic incident duration and frequency. During the first (31 March–28 April 2020) and second (26 June–31 August 2021) lockdowns, the number of incidents fell by 50% and 60%, respectively, in comparison to the same periods in 2018 and 2019. The proportion of incidents involving towing increased significantly during both lockdowns. The mean duration of crashes increased by 16% during the first lockdown, but the change was less significant during the subsequent lockdown. Crashes involving diversions, emergency services and towing saw an increase in the mean duration by 67%, 16%, and 47%, respectively, during the first lockdown. However, this was not reflected in the 2021 data, with only major crashes seeing a significant increase, i.e., by 58%. There was also a noticeable shift in the location of incidents, with more incidents recorded in suburban areas, away from the central business area. Our findings suggest drastic changes in incident characteristics, and these changes should be considered by policymakers in promoting a safer and more sustainable transportation network in the future. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 797 KiB

Open AccessReview

Safe Return to Work for Domestic Workers in the Time of COVID-19

by Rupkatha Bardhan, Traci Byrd and Julie Boyd

COVID 2021, 1(3), 575-589; https://doi.org/10.3390/covid1030048 - 05 Nov 2021

Viewed by 3609

Abstract

Domestic workers including housecleaners, nannies, and caregivers are facing a challenging time in the era of COVID-19 exposure. Many domestic workers have lost their jobs worldwide. As businesses and organizations have started to reopen in full capacity, domestic workers are unsure of their [...] Read more.

Domestic workers including housecleaners, nannies, and caregivers are facing a challenging time in the era of COVID-19 exposure. Many domestic workers have lost their jobs worldwide. As businesses and organizations have started to reopen in full capacity, domestic workers are unsure of their future and whether they will be rehired by their employers. They have less protections from labor laws unlike other occupations and usually their employers/agencies do not provide training on safe practices for working in a home setting. There are gaps in understanding safety and health issues associated with precarious work for domestic workers. This review article has searched the literature on safe strategies for domestic workers to eliminate exposure and provides helpful suggestions for domestic workers to safely return to work. Employers or house owners can have a proper reopening plan when considering hiring or rehiring domestic workers. Domestics working in a home environment should use best practices to protect themselves and others from infectious diseases. Having open communication between employers and their domestic workers can go a long way. Implementing and following an effective working plan for both employers and their domestic workers will provide a path towards minimization of hazard and control of infectious diseases like COVID-19. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 548 KiB

Open AccessArticle

Does In-Person Visiting Affect the Number of COVID-19 Cases in Prisons?

by Lysandro Pinto Borges, Aline Fagundes Martins, Daniela Raguer Valadão de Souza, José Melquiades de Rezende Neto, Aryanne Araujo Santos, Brenda Morais Oliveira, Igor Leonardo Santos Matos, Grazielly Bispo da Invenção, Kezia Alves dos Santos, Nicolas Alessandro Alves Souza, Pamela Chaves de Jesus, Cliomar Alves dos Santos, Marco Aurélio de Oliveira Goes, Mércia Simone Feitosa de Souza, Ikaro Daniel de Carvalho Barreto, Adriana Gibara Guimarães and Lucindo José Quintans-Júnior

Life 2021, 11(11), 1184; https://doi.org/10.3390/life11111184 - 05 Nov 2021

Cited by 3 | Viewed by 2460

Abstract

Even with the current advances that have been made in regard to COVID-19, such as a better understanding of the disease and the steady growth in the number of vaccinated individuals, it remains a challenge for humanity. Dealing with the disease in prison [...] Read more.

Even with the current advances that have been made in regard to COVID-19, such as a better understanding of the disease and the steady growth in the number of vaccinated individuals, it remains a challenge for humanity. Dealing with the disease in prison settings has been particularly difficult. This study sought to discover whether in-person visiting affected the number of cases of SARS-CoV-2 infection in the penitentiaries in the state of Sergipe (Brazil). We conducted a two-phase study (when visiting was suspended and after it recommenced) in seven penitentiaries in Sergipe using immunochromatography and nasopharyngeal swab testing to evaluate whether visiting affects the number of COVID-19 cases. In the first phase (n = 778), 57.6% of inmates reported risk factors and 32.5% were positive for COVID-19 (18.9% IgM, 24.2% IgG, 1% antigen). In the second phase, 19.6% tested positive (13.9% IgM, 7.9% IgG, 0.2% antigen). The occurrence of positive cases of COVID-19 and positive results (IgM and IgG) were significantly higher in the first phase. In the second phase, 56.7% of inmates had received visits and 18.7% were positive for COVID-19 (14% IgM, 7% IgG). Among those who had not received visits, 20.9% tested positive (13.8% IgM, 9.2% IgG, 0.5% antigen). There was no significant difference in positive cases/results between inmates that had and had not received visits. These findings suggest that, under the conditions assessed, visiting does not seem to affect the number of COVID-19 cases in prisons and reinforces the importance of sanitary measures to control dissemination. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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18 pages, 1055 KiB

Open AccessArticle

Neurological Manifestations and Outcomes in a Retrospective Cohort of Mexican Inpatients with SARS-CoV-2 Pneumonia: Design of a Risk Profile

by Silvia García, Francisco Manuel Cuatepotzo-Burgos, Christian Gabriel Toledo-Lozano, Adriana Balderrama-Soto, Sofía Lizeth Alcaraz-Estrada, Luis Montiel-López, Alberto Hilarión De la Vega-Bravo, Paul Mondragón-Terán, Maribel Santosbeña-Lagunes, Maricela Escarela-Serrano, Celia Mireya Rodríguez-Martínez, María del Carmen Méndez-Vidrio, Sandra Muñoz-López, José Alfredo Merino-Rajme, Rodrigo Alberto Rodríguez-Briseño, Fidel Cerda-Téllez, Ramón Mauricio Coral-Vázquez, Sergio Sauri-Suárez, Sandra Quiñonez-Aguilar, Juan Antonio Pineda-Juárez and Juan Antonio Suárez-Cuenca Show full author list Hide full author list

Healthcare 2021, 9(11), 1501; https://doi.org/10.3390/healthcare9111501 - 04 Nov 2021

Cited by 10 | Viewed by 2597

Abstract

We analyzed the neurological manifestations in Mexican patients hospitalized with pneumonia due to COVID-19 and investigated the association between demographic, clinical, and biochemical variables and outcomes, including death. A retrospective, analytical study was conducted using the electronic records of patients hospitalized between 1 [...] Read more.

We analyzed the neurological manifestations in Mexican patients hospitalized with pneumonia due to COVID-19 and investigated the association between demographic, clinical, and biochemical variables and outcomes, including death. A retrospective, analytical study was conducted using the electronic records of patients hospitalized between 1 April 2020 and 30 September 2020. Records of 1040 patients were analyzed: 31.25% died and 79.42% had neurological symptoms, including headache (80.62%), anosmia (32.20%), ageusia (31.96%), myopathy (28.08%), disorientation (14.89%), encephalopathy (12.22%), neuropathy (5.4%), stroke (1.3%), seizures (1.3%), cerebral hemorrhage (1.08%), encephalitis (0.84%), central venous thrombosis (0.36%), and subarachnoid hemorrhage (0.24%). Patients also had comorbidities, such as hypertension (42.30%), diabetes mellitus (38.74%), obesity (61.34%), chronic obstructive pulmonary disease (3.17%), and asthma (2.01%). Factors associated with neurological symptoms were dyspnea, chronic obstructive pulmonary disease, advanced respiratory support, prolonged hospitalization, and worsening fibrinogen levels. Factors associated with death were older age, advanced respiratory support, amine management, chronic obstructive pulmonary disease, intensive care unit management, dyspnea, disorientation, encephalopathy, hypertension, neuropathy, diabetes, male sex, three or more neurological symptoms, and obesity grade 3. In this study we designed a profile to help predict patients at higher risk of developing neurological complications and death following COVID-19 infection. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 337 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on Chinese Postgraduate Students’ Mental Health

by Zhengyan Liang, Derong Kang, Minqiang Zhang, Yuanlin Xia and Qing Zeng

Int. J. Environ. Res. Public Health 2021, 18(21), 11542; https://doi.org/10.3390/ijerph182111542 - 03 Nov 2021

Cited by 14 | Viewed by 4435

Abstract

To understand the mental health status of Chinese postgraduate students during the COVID-19 pandemic, we used three online questionnaires: self-rating anxiety (SAS) scale, self-rating depression (SDS) scale, and social avoidance and distress (SAD) scale. A total of 3137 postgraduate students from different regions [...] Read more.

To understand the mental health status of Chinese postgraduate students during the COVID-19 pandemic, we used three online questionnaires: self-rating anxiety (SAS) scale, self-rating depression (SDS) scale, and social avoidance and distress (SAD) scale. A total of 3137 postgraduate students from different regions of China participated in our study. We explored the relationship between participant characteristics and mental health using an analysis of variance (ANOVA). We found that the proportions of respondents with severe, mild, and moderate depression were 1.4%, 10.48%, and 21.99%, respectively, and the corresponding proportions of respondents with anxiety were 1.56%, 4.65%, and 14.69%, respectively. A one-way ANOVA revealed that the mental health statuses of the participants were different between the subgroups based on majors, classes, degree types, and the method of communication with advisors and students. A two-way ANOVA revealed significant effects on interaction and the method of communication with advisors and peers. These findings suggest that the mental health of postgraduate students should be monitored during the pandemic, especially when they are unable to communicate directly with their advisors or peers, and targeted psychological counselling must be focused on anxiety and depression. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

15 pages, 2085 KiB

Open AccessArticle

Assessment of Retrospective COVID-19 Spatial Clusters with Respect to Demographic Factors: Case Study of Kansas City, Missouri, United States

by Hadeel AlQadi, Majid Bani-Yaghoub, Sindhu Balakumar, Siqi Wu and Alex Francisco

Int. J. Environ. Res. Public Health 2021, 18(21), 11496; https://doi.org/10.3390/ijerph182111496 - 01 Nov 2021

Cited by 6 | Viewed by 2492

Abstract

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The United States (U.S.) has the highest number of reported COVID-19 infections and related deaths in the world, accounting for 17.8% of total global confirmed cases as of August [...] Read more.

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The United States (U.S.) has the highest number of reported COVID-19 infections and related deaths in the world, accounting for 17.8% of total global confirmed cases as of August 2021. As COVID-19 spread throughout communities across the U.S., it became clear that inequities would arise among differing demographics. Several researchers have suggested that certain racial and ethnic minority groups may have been disproportionately impacted by the spread of COVID-19. In the present study, we used the daily data of COVID-19 cases in Kansas City, Missouri, to observe differences in COVID-19 clusters with respect to gender, race, and ethnicity. Specifically, we utilized a retrospective Poisson spatial scan statistic with respect to demographic factors to detect daily clusters of COVID-19 in Kansas City at the zip code level from March to November 2020. Our statistical results indicated that clusters of the male population were more widely scattered than clusters of the female population. Clusters of the Hispanic population had the highest prevalence and were also more widely scattered. This demographic cluster analysis can provide guidance for reducing the social inequalities associated with the COVID-19 pandemic. Moreover, applying stronger preventive and control measures to emerging clusters can reduce the likelihood of another epidemic wave of infection. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 1210 KiB

Open AccessArticle

Mental Health and Substance Use Associated with Hospitalization among People with COVID-19: A Population-Based Cohort Study

by Héctor Alexander Velásquez García, James Wilton, Kate Smolina, Mei Chong, Drona Rasali, Michael Otterstatter, Caren Rose, Natalie Prystajecky, Samara David, Eleni Galanis, Geoffrey McKee, Mel Krajden and Naveed Zafar Janjua

Viruses 2021, 13(11), 2196; https://doi.org/10.3390/v13112196 - 31 Oct 2021

Cited by 19 | Viewed by 3228

Abstract

This study identified factors associated with hospital admission among people with laboratory-diagnosed COVID-19 cases in British Columbia. The study used data from the BC COVID-19 Cohort, which integrates data on all COVID-19 cases with data on hospitalizations, medical visits, emergency room visits, prescription [...] Read more.

This study identified factors associated with hospital admission among people with laboratory-diagnosed COVID-19 cases in British Columbia. The study used data from the BC COVID-19 Cohort, which integrates data on all COVID-19 cases with data on hospitalizations, medical visits, emergency room visits, prescription drugs, chronic conditions and deaths. The analysis included all laboratory-diagnosed COVID-19 cases in British Columbia to 15 January 2021. We evaluated factors associated with hospital admission using multivariable Poisson regression analysis with robust error variance. Of the 56,874 COVID-19 cases included in the analysis, 2298 were hospitalized. Factors associated with increased hospitalization risk were as follows: male sex (adjusted risk ratio (aRR) = 1.27; 95% CI = 1.17–1.37), older age (p-trend < 0.0001 across age groups increasing hospitalization risk with increasing age [aRR 30–39 years = 3.06; 95% CI = 2.32–4.03, to aRR 80+ years = 43.68; 95% CI = 33.41–57.10 compared to 20–29 years-old]), asthma (aRR = 1.15; 95% CI = 1.04–1.26), cancer (aRR = 1.19; 95% CI = 1.09–1.29), chronic kidney disease (aRR = 1.32; 95% CI = 1.19–1.47), diabetes (treated without insulin aRR = 1.13; 95% CI = 1.03–1.25, requiring insulin aRR = 5.05; 95% CI = 4.43–5.76), hypertension (aRR = 1.19; 95% CI = 1.08–1.31), injection drug use (aRR = 2.51; 95% CI = 2.14–2.95), intellectual and developmental disabilities (aRR = 1.67; 95% CI = 1.05–2.66), problematic alcohol use (aRR = 1.63; 95% CI = 1.43–1.85), immunosuppression (aRR = 1.29; 95% CI = 1.09–1.53), and schizophrenia and psychotic disorders (aRR = 1.49; 95% CI = 1.23–1.82). In an analysis restricted to women of reproductive age, pregnancy (aRR = 2.69; 95% CI = 1.42–5.07) was associated with increased risk of hospital admission. Older age, male sex, substance use, intellectual and developmental disability, chronic comorbidities, and pregnancy increase the risk of COVID-19-related hospitalization. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 1046 KiB

Open AccessArticle

Diagnostic Accuracy of SARS-CoV-2 Antigen Tests for Community Transmission Screening: A Systematic Review and Meta-Analysis

by Cheng-Chieh Chen, Shou-Cheng Lu, Chyi-Huey Bai, Pei-Yu Wang, Kang-Yun Lee and Yuan-Hung Wang

Int. J. Environ. Res. Public Health 2021, 18(21), 11451; https://doi.org/10.3390/ijerph182111451 - 30 Oct 2021

Cited by 16 | Viewed by 3155

Abstract

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) caused the global pandemic of coronavirus disease 2019 (COVID-19). Rapid identification and isolation of infectious patients are critical methods to block COVID-19 transmission. Antigen tests can contribute to prompt identification of infectious individuals. This meta-analysis aims to [...] Read more.

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) caused the global pandemic of coronavirus disease 2019 (COVID-19). Rapid identification and isolation of infectious patients are critical methods to block COVID-19 transmission. Antigen tests can contribute to prompt identification of infectious individuals. This meta-analysis aims to evaluate the diagnostic accuracy of antigen tests for SARS-CoV-2. We conducted a literature search in PubMed, Embase, the Cochrane Library, and Biomed Central databases. Studies evaluating the diagnostic accuracy of antigen tests for SARS-CoV-2 in community participants were included. Only English-language articles were reviewed. We included eligible studies that provided available data to construct a 2 × 2 table on a per-patient basis. Overall sensitivity and specificity for antigen tests were generated using a bivariate random-effects model. Eighteen studies with 34,865 participants were retrieved. The meta-analysis for SARS-CoV-2 antigen tests generated a pooled sensitivity of 0.82 and a pooled specificity of 1.00. A subgroup analysis of ten studies that reported outcomes for 5629 symptomatic participants generated a pooled sensitivity of 0.87 and a pooled specificity of 1.00. Antigen tests might have higher sensitivity in detecting SARS-CoV-2 in symptomatic patients in the community and may be an effective tool to identify patients to be quarantined to prevent further SARS-CoV-2 transmission. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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16 pages, 752 KiB

Open AccessArticle

Quality of Life, Needs and Fears of Mothers of Children with Disabilities in Saudi Arabia during the COVID-19 Lockdown

by Nisreen Al Awaji, Monira Aldhahi, Shahnaz Akil, Salwa Awad and Eman Mortada

Int. J. Environ. Res. Public Health 2021, 18(21), 11442; https://doi.org/10.3390/ijerph182111442 - 30 Oct 2021

Cited by 11 | Viewed by 2574

Abstract

Substantial changes in life dynamics resulting from the outbreak of the coronavirus disease 2019 (COVID-19) could have an impact on the quality of life (QoL) of mothers of children with and without disabilities. This study compared the quality of life (QoL) of mothers [...] Read more.

Substantial changes in life dynamics resulting from the outbreak of the coronavirus disease 2019 (COVID-19) could have an impact on the quality of life (QoL) of mothers of children with and without disabilities. This study compared the quality of life (QoL) of mothers of children with disabilities (MCD) to the QoL of mothers of children without disabilities (CON) in Saudi Arabia during COVID-19 lockdown. It explored mothers’ concerns and the type of support they need during the quarantine. A comparative cross-sectional study was conducted during the lockdown. An online questionnaire was distributed to mothers raising children with and without disabilities in Saudi Arabia. A total of 340 mothers participated in the study by completing the survey: 93 MCD and 247 CON. The QoL of MCD and CON was assessed using the WHOQOL-BREF questionnaire. Furthermore, detailed information was provided by the mothers regarding their needs and concerns during the lockdown. The results of the study revealed that the overall QoL was significantly higher in the CON group, compared to the MCD group, during the COVID-19 lockdown. The social well-being and environmental well-being reported by MCD were significantly lower on the total scale of the WHOQOL-BREF than those reported by the CON group. The comparison between the two groups revealed significant differences in the support required by mothers during the COVID-19 pandemic: a higher percentage of MCD needed emotional and psychological support, especially from family members. The major concerns reported by MCD were the deterioration of their children’s medical conditions and the lack of medical supplies during the lockdown. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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19 pages, 1979 KiB

Open AccessArticle

Impact of the State of Emergency during the COVID-19 Pandemic in 2020 on Asthma Exacerbations among Children in Kobe City, Japan

by Hiroshi Yamaguchi, Kandai Nozu, Shinya Ishiko, Atsushi Kondo, Takeshi Ninchoji, China Nagano, Hiroki Takeda, Ai Unzaki, Kazuto Ishibashi, Ichiro Morioka, Hiroaki Nagase, Kazumoto Iijima and Akihito Ishida

Int. J. Environ. Res. Public Health 2021, 18(21), 11407; https://doi.org/10.3390/ijerph182111407 - 29 Oct 2021

Cited by 12 | Viewed by 2318

Abstract

The coronavirus disease (COVID-19) pandemic altered environmental factors. We studied the impact of these changes on asthma exacerbation (AE) by comparing the AE-related environmental factors between COVID-19 (2020) and pre-COVID-19 (2011–2019) eras. Between 2011 and 2020, 278,465 children (<16 years old) visited our [...] Read more.

The coronavirus disease (COVID-19) pandemic altered environmental factors. We studied the impact of these changes on asthma exacerbation (AE) by comparing the AE-related environmental factors between COVID-19 (2020) and pre-COVID-19 (2011–2019) eras. Between 2011 and 2020, 278,465 children (<16 years old) visited our emergency department, and 7476 were diagnosed with AE. The number of patients showed spring and fall peaks in 2011–2019. Multivariate analyses showed significant positive relationships of the number of AE patients with the average temperature among all patients and 0–5-year-olds and with sulfur dioxide (SO₂) levels in 2011–2019 among 0–5-year-olds. Although the spring peak in the number of patients was not observed in 2020 after declaration of a state of emergency, the fall peak was again observed after the state of emergency was lifted. No changes in average temperature were detected, but SO₂ was significantly reduced following declaration of the state of emergency in 2020. Therefore, SO₂ reduction might have contributed to the disappearance of the peak of AE. However, a fall peak was observed again in 2020, although SO₂ levels continued to be low. These data suggest that person to person interaction seems to be associated with AE, presumably due to unknown viral infections. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 1253 KiB

Open AccessArticle

Caring for Caregivers: Italian Health Care Workers’ Needs during the COVID-19 Pandemic

by Diego De Leo, Maria Maddalena Martucci, Antonello Grossi, Francesca Siviero, Silvia Vicentini, Carolina Romascu, Arianna Mercurio, Martina Battaglia and Noemi Tribbia

Int. J. Environ. Res. Public Health 2021, 18(21), 11386; https://doi.org/10.3390/ijerph182111386 - 29 Oct 2021

Cited by 2 | Viewed by 2242

Abstract

Aim: An online survey was proposed to the health workers of a public hospital of an Italian northern city. This was done with the aim of assessing the unmet needs of a special population under strain (the health carers) due to the fight [...] Read more.

Aim: An online survey was proposed to the health workers of a public hospital of an Italian northern city. This was done with the aim of assessing the unmet needs of a special population under strain (the health carers) due to the fight against the coronavirus disease 19 (COVID-19). Results: By answering the survey, five hundred and nine people provided their observations, complaints and suggestions. This qualitative material was organised into three main areas: (1) relationship with the health organization management; (2) needs of the health workers; and (3) perceived consequences of the pandemic. Discussion: Overall, respondents expressed dissatisfaction for the unpreparedness of their health units and the confusion created by frequent changes in operational guidelines. Many participants felt abandoned, unheard and unprotected by the health organization, whilst the psychological support service formally set up by the hospital for its health workers was grossly under-utilised. Instead, support from colleagues and family constituted the main protective factor to counteract negative emotions. Restrictions in social contacts and recreational opportunities were frequently mentioned. Several respondents reported a sense of pride for their work and commitment; many others saw in the pandemic an opportunity for personal growth and better focus on important life values, like family and solidarity. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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19 pages, 4069 KiB

Open AccessArticle

High Individual Heterogeneity of Neutralizing Activities against the Original Strain and Nine Different Variants of SARS-CoV-2

by Rita Jaafar, Celine Boschi, Sarah Aherfi, Audrey Bancod, Marion Le Bideau, Sophie Edouard, Philippe Colson, Henri Chahinian, Didier Raoult, Nouara Yahi, Jacques Fantini and Bernard La Scola

Viruses 2021, 13(11), 2177; https://doi.org/10.3390/v13112177 - 28 Oct 2021

Cited by 18 | Viewed by 4190

Abstract

Background: Since the beginning of the COVID-19 pandemic, several SARS-CoV-2 variants have sequentially emerged. In France, most cases were due to spike D641G-harbouring viruses that descended initially from the Wuhan strain, then by the variant of B.1.160 lineage we called Marseille-4 since the [...] Read more.

Background: Since the beginning of the COVID-19 pandemic, several SARS-CoV-2 variants have sequentially emerged. In France, most cases were due to spike D641G-harbouring viruses that descended initially from the Wuhan strain, then by the variant of B.1.160 lineage we called Marseille-4 since the summer of 2020, which was followed by the Alpha and Beta variants in early 2021, then the Delta variant currently. Methods: We determined the neutralising antibody (nAb) titres in sera from convalescent individuals previously infected by these four major local variants and from vaccine recipients to the original Wuhan strain and nine variants, including two recent circulating Delta isolates. Results: The results show high inter-individual heterogeneity in nAbs, especially according to the variant tested. The major variations among nAbs are based on the genotype responsible for the infection. Patients previously infected with the beta and B.1.160 variants had the lowest nAb titres. We show that this heterogeneity is well explained by spike protein mutants modelling using in silico approaches. The highest titres were observed in individuals vaccinated with the Pfizer/BioNTech COVID-19 vaccine, even against the delta variant. Conclusions: Immunity acquired naturally after infection is highly dependent on the infecting variant, and, unexpectedly, mRNA-based vaccine efficacy was shown to be often better than natural immunity in eliciting neutralising antibodies. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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21 pages, 4489 KiB

Open AccessArticle

A One-Year Longitudinal Study: Changes in Depression and Anxiety in Frontline Emergency Department Healthcare Workers in the COVID-19 Pandemic

by Francesca Th’ng, Kailing Adriel Rao, Lixia Ge, Desmond Mao, Hwee Nah Neo, Joseph Antonio De Molina and Eillyne Seow

Int. J. Environ. Res. Public Health 2021, 18(21), 11228; https://doi.org/10.3390/ijerph182111228 - 26 Oct 2021

Cited by 25 | Viewed by 2927

Abstract

Frontline healthcare workers (HCWs) fighting COVID-19 have been associated with depression and anxiety, but there is limited data to illustrate these changes over time. We aim to quantify the changes in depression and anxiety amongst Emergency Department (ED) HCWs over one year and [...] Read more.

Frontline healthcare workers (HCWs) fighting COVID-19 have been associated with depression and anxiety, but there is limited data to illustrate these changes over time. We aim to quantify the changes in depression and anxiety amongst Emergency Department (ED) HCWs over one year and examine the factors associated with these changes. In this longitudinal single-centre study in Singapore, all ED HCWs were prospectively recruited face-to-face. Paper-based surveys were administered in June 2020 and June 2021. Depression and anxiety were measured using DASS-21. The results of 241 HCWs who had completed both surveys were matched. There was significant improvement in anxiety amongst all HCWs (Mean: 2020: 2.85 (±3.19) vs. 2021: 2.54 (±3.11); Median: 2020: 2 (0–4) vs. 2021: 2 (0–4), p = 0.045). HCWs living with elderly and with concerns about infection risk had higher odds of anxiety; those living with young children had lower odds of anxiety. There was significant worsening depression amongst doctors (Mean: 2020: 2.71 (±4.18) vs. 2021: 3.60 (±4.50); Median: 2020: 1 (0–3) vs. 2021: 3 (0–5), p = 0.018). HCWs ≥ 41 years, living with elderly and with greater concerns about workload had higher odds of depression. HCWs who perceived better workplace support and better social connectedness had lower odds of depression. In summary, our study showed significant improvement in anxiety amongst ED HCWs and significant worsening depression amongst ED doctors over one year. Age, living with elderly, and concerns about workload and infection risk were associated with higher odds of depression and anxiety. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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16 pages, 539 KiB

Open AccessArticle

COVEVOL: Natural Evolution at 6 Months of COVID-19

by Louise Messin, Marc Puyraveau, Yousri Benabdallah, Quentin Lepiller, Vincent Gendrin, Souheil Zayet, Timothée Klopfenstein, Lynda Toko, Alix Pierron and Pierre-Yves Royer

Viruses 2021, 13(11), 2151; https://doi.org/10.3390/v13112151 - 25 Oct 2021

Cited by 9 | Viewed by 2067

Abstract

Many studies have investigated post-COVID symptoms, but the predictors of symptom persistence remain unknown. The objective was to describe the natural course of the disease at 6 months and to identify possible factors favoring the resurgence or persistence of these symptoms. COVEVOL is [...] Read more.

Many studies have investigated post-COVID symptoms, but the predictors of symptom persistence remain unknown. The objective was to describe the natural course of the disease at 6 months and to identify possible factors favoring the resurgence or persistence of these symptoms. COVEVOL is a retrospective observational descriptive study of 74 patients. All patients with positive SARS-CoV-2 PCR from March 2020 were included. We compared a group with symptom persistence (PS group) with another group without symptom persistence (no-PS group). Fifty-three out of seventy-four patients (71.62%) described at least one persistent symptom at 6 months of SARS-CoV-2 infection. In the PS group, 56.6% were women and the average age was 54.7 years old [21–89.2] ± 16.9. The main symptoms were asthenia (56.6%, n = 30), dyspnea (34%, n = 18), anxiety (32.1% n = 17), anosmia (24.5%, n = 13) and agueusia (15.1% n = 8). Ten patients (13.51%) presented a resurgence in symptoms. Patients in the PS group were older (p = 0.0048), had a higher BMI (p = 0.0071), and were more frequently hospitalized (p = 0.0359) compared to the no-PS group. Odynophagia and nasal obstruction were less present in the inaugural symptoms of COVID-19 in the PS group (p = 0.0202 and p = 0.0332). Persistent post-COVID syndromes are common and identification of contributing factors is necessary for understanding this phenomenon and appropriate management. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 615 KiB

Open AccessArticle

Body Image, Anxiety, and Bulimic Behavior during Confinement Due to COVID-19 in Mexico

by Gisela Pineda-García, Aracely Serrano-Medina, Estefanía Ochoa-Ruíz and Ana Laura Martínez

Healthcare 2021, 9(11), 1435; https://doi.org/10.3390/healthcare9111435 - 25 Oct 2021

Cited by 3 | Viewed by 1951

Abstract

Background: The potential impact of the COVID-19 pandemic on weight, shape-related appearance behaviors (body image dissatisfaction), and bulimic symptoms in nonclinical participants is poorly evaluated. This study aimed to identify the relationship between labor status, confinement degree due to COVID-19, dissatisfaction with body [...] Read more.

Background: The potential impact of the COVID-19 pandemic on weight, shape-related appearance behaviors (body image dissatisfaction), and bulimic symptoms in nonclinical participants is poorly evaluated. This study aimed to identify the relationship between labor status, confinement degree due to COVID-19, dissatisfaction with body image, and anxiety and to discover its effect on bulimic behavior in Mexican adults. Methods: A cross-sectional study was conducted with a non-probabilistic sample of 276 participants via an online survey. Questions addressed their anxiety, body image dissatisfaction, and bulimic behavior. Results: The path analysis showed direct effects on the confinement degree (β = −0.157); of the labor situation (β = −0.147) and gender (β = 0.129) on anxiety; of dissatisfaction on bulimic behavior (β = 0.443) and anxiety about bulimic behavior (β = 0.184); and dissatisfaction (β = 0.085). Conclusions: The confinement, gender, and labor status are predictors of anxiety, while anxiety and body dissatisfaction directly influence bulimic behavior. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 489 KiB

Open AccessArticle

Determinants of Vaccine Acceptance against COVID-19 in China: Perspectives on Knowledge and DrVac-COVID19S Scale

by Chen Dong, Qian Liang, Tanao Ji, Jun Gu, Jian Feng, Min Shuai, Xiaoming Zhang, Rui Zhao and Zhifeng Gu

Int. J. Environ. Res. Public Health 2021, 18(21), 11192; https://doi.org/10.3390/ijerph182111192 - 25 Oct 2021

Cited by 8 | Viewed by 2595

Abstract

Background: This study determined the knowledge and attitudes regarding COVID-19 and assessed the acceptance of the COVID-19 vaccine among the Chinese population. Methods: An online and offline cross-sectional study was conducted from 1 to 18 June 2021 among the Chinese population. Demographic characteristics, [...] Read more.

Background: This study determined the knowledge and attitudes regarding COVID-19 and assessed the acceptance of the COVID-19 vaccine among the Chinese population. Methods: An online and offline cross-sectional study was conducted from 1 to 18 June 2021 among the Chinese population. Demographic characteristics, attitudes, knowledge, values, impact, and autonomy regarding the COVID-19 vaccine were collected using questionnaire. The variables in our study were analyzed by Mann-Whitney test and chi-square test. Results: A total of 93.8% participants were willing to be vaccinated, 2.7% refused, and 3.5% hesitated. In regards to knowledge about the COVID-19 vaccine, 94.3% citizens surveyed knew about the spread of droplets and 65% had knowledge about surfaces touched by an infected person. In addition, 93.8% of participants had knowledge of the common symptoms related to COVID-19, such as fever and cough (93.8%), shortness of breath/anorexia/fatigue/nausea/vomiting/diarrhea (80.2%), and panic and chest tightness (69.4%). Most participants had a strong self-prevention awareness, such as washing hands regularly (92.1%) and wearing a facemask (94.1%). Besides, over ninety percent of respondents would report exposure to SARS-CoV-2 (96.6%) and exposure to symptoms possibility related to COVID-19 (92.9%). If necessary, most respondents would agree to isolate at home (93.5%) or an isolation in hospital (96.3%). Knowledge of COVID-19, including transmission, symptoms, protective measures, and vaccines itself, is associated with vaccination attitude. Values, perceived impacts, knowledge, and autonomy, assessed by the scale of DrVac-COVID19S, have also been revealed as important determinants to vaccine acceptance. Conclusions: Almost 93% of Chinese people surveyed in this study showed a willing attitude toward COVID-19 vaccination. Based on the above results, government and social workers can take measures from these perspectives to improve the vaccination attitude, so as to increase vaccine immunization rates. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 569 KiB

Open AccessArticle

Family Function and Child Adjustment Difficulties in the COVID-19 Pandemic: An International Study

by Sarah Foley, Farzaneh Badinlou, Karin C. Brocki, Matilda A. Frick, Luca Ronchi and Claire Hughes

Int. J. Environ. Res. Public Health 2021, 18(21), 11136; https://doi.org/10.3390/ijerph182111136 - 23 Oct 2021

Cited by 15 | Viewed by 3604

Abstract

To estimate specific proximal and distal effects of COVID-19-related restrictions on families on children’s adjustment problems, we conducted a six-site international study. In total, 2516 parents from Australia, China, Italy, Sweden, the United Kingdom, and the United States of America living with a [...] Read more.

To estimate specific proximal and distal effects of COVID-19-related restrictions on families on children’s adjustment problems, we conducted a six-site international study. In total, 2516 parents from Australia, China, Italy, Sweden, the United Kingdom, and the United States of America living with a young child (M_age = 5.77, SD = 1.10, range = 3 to 8 years, 47.9% female) completed an online survey between April and July 2020. The survey included the Strengths and Difficulties Questionnaire and family risk factors (parent distress, parent–child conflict, couple conflict, and household chaos) as well as a scale to index COVID-19-related family disruption. Our analyses also included public data on the stringency of national restrictions. Across the six sites, parental responses indicated elevated levels of hyperactivity, conduct, and emotion problems in children from families characterized by heightened levels of parent distress, parent–child conflict, and household chaos. In contrast, increased peer problems were more strongly related to COVID-19-related social disruption and stringency measures. Mediation models demonstrated that associations between COVID-19 social disruption and child difficulties could be explained by parental distress. Taken together, these results suggest that although the experience of the pandemic differed across countries, associations between COVID-19-related family experiences and child adjustment difficulties were similar in their nature and magnitude across six different contexts. Programs to support family resilience could help buffer the impact of the pandemic for two generations. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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26 pages, 8102 KiB

Open AccessArticle

Malaysia’s Health Systems Response to COVID-19

by Zen Yang Ang, Kit Yee Cheah, Md. Sharif Shakirah, Weng Hong Fun, Jailani Anis-Syakira, Yuke-Lin Kong and Sondi Sararaks

Int. J. Environ. Res. Public Health 2021, 18(21), 11109; https://doi.org/10.3390/ijerph182111109 - 22 Oct 2021

Cited by 12 | Viewed by 8458

Abstract

This study aimed to highlight the COVID-19 response by the Ministry of Health (MOH) and the Government of Malaysia in order to share Malaysia’s lessons and to improve future pandemic preparedness. The team conducted a rapid review using publicly available information from MOH, [...] Read more.

This study aimed to highlight the COVID-19 response by the Ministry of Health (MOH) and the Government of Malaysia in order to share Malaysia’s lessons and to improve future pandemic preparedness. The team conducted a rapid review using publicly available information from MOH, PubMed, and World Health Organisation (WHO) Global Research on Coronavirus Disease Database to compile Malaysia’s responses during the COVID-19 pandemic. Measures taken between 31 December 2019 and 3 June 2020 were classified into domains as well as the pillars described in the WHO COVID-19 Strategic Preparedness and Response Plan (WHO SPRP). Malaysia’s response incorporated all pillars in the WHO SPRP and consisted of five domains, (i) whole-of-government, (ii) cordon sanitaire/lockdown, (iii) equity of access to services and supports, (iv) quarantine and isolation systems, and (v) legislation and enforcement. Some crucial measures taken were activation of a centralised multi-ministerial coordination council where MOH acted as an advisor, with collaboration from non-government organisations and private sectors which enabled an effective targeted screening approach, provision of subsidised COVID-19 treatment and screening, isolation or quarantine of all confirmed cases, close contacts and persons under investigation, with all strategies applied irrespective of citizenship. This was provided for by way of the Prevention and Control of Infectious Diseases Act 1988. A combination of these measures enabled the nation to contain the COVID-19 outbreak by the end of June 2020. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 1939 KiB

Open AccessArticle

Distress Levels of Parents of Children with Neurodevelopmental Disorders during the COVID-19 Pandemic: A Comparison between Italy and Australia

by Dayle Burnett, Anne Masi, Antonio Mendoza Diaz, Renata Rizzo, Ping-I Lin and Valsamma Eapen

Int. J. Environ. Res. Public Health 2021, 18(21), 11066; https://doi.org/10.3390/ijerph182111066 - 21 Oct 2021

Cited by 7 | Viewed by 2544

Abstract

Parents of children with a neurodevelopmental disorder (NDD) report higher levels of distress compared to those of typically developing children. Distress levels may be heightened by the restrictions associated with the COVID-19 pandemic. However, it is unclear whether distress levels of parents varied [...] Read more.

Parents of children with a neurodevelopmental disorder (NDD) report higher levels of distress compared to those of typically developing children. Distress levels may be heightened by the restrictions associated with the COVID-19 pandemic. However, it is unclear whether distress levels of parents varied by the diagnosis of neurodevelopmental disorder in children during the COVID-19 pandemic. This study aims to investigate whether parental distress was influenced by the type of NDD. Participants were from Australia (N = 196) and Italy (N = 200); the parents of children aged 3–18 were invited to complete an online self-reported survey which included the 6-item Kessler Psychological Distress Scale (K6) to determine parental distress. The results show that intellectual or learning disorder (ILD) is a major contributor to parental distress compared to other NDDs in both Australia and Italy. Moreover, the worsening of symptomatic changes in children with NDDs was significantly associated with parental distress. The differences between the two countries in terms of the pandemic impact, however, were not statistically significant. The results suggest that intervention strategies need to be tailored for individual clinical information and factor in the society’s stringency level of anti-contagion policies to improve parental wellbeing. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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8 pages, 2036 KiB

Open AccessArticle

Identification of COVID-19 Waves: Considerations for Research and Policy

by Andrés Ayala, Pablo Villalobos Dintrans, Felipe Elorrieta, Claudio Castillo, Claudio Vargas and Matilde Maddaleno

Int. J. Environ. Res. Public Health 2021, 18(21), 11058; https://doi.org/10.3390/ijerph182111058 - 21 Oct 2021

Cited by 24 | Viewed by 4060

Abstract

The identification of COVID-19 waves is a matter of the utmost importance, both for research and decision making. This study uses COVID-19 information from the 52 municipalities of the Metropolitan Region, Chile, and presents a quantitative method—based on weekly accumulated incidence rates—to define [...] Read more.

The identification of COVID-19 waves is a matter of the utmost importance, both for research and decision making. This study uses COVID-19 information from the 52 municipalities of the Metropolitan Region, Chile, and presents a quantitative method—based on weekly accumulated incidence rates—to define COVID-19 waves. We explore three different criteria to define the duration of a wave, and performed a sensitivity analysis using multivariate linear models to show their commonalities and differences. The results show that, compared to a benchmark definition (a 100-day wave), the estimations using longer periods of study are worse in terms of the model’s overall fit (adjusted R²). The article shows that defining a COVID-19 wave is not necessarily simple, and has consequences when performing data analysis. The results highlight the need to adopt well-defined and well-justified definitions for COVID-19 waves, since these methodological choices can have an impact in research and policy making. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 1831 KiB

Open AccessArticle

Telehealth and COVID-19: Empowering Standards of Management for Patients Affected by Phenylketonuria and Hyperphenylalaninemia

by Valentina Rovelli, Juri Zuvadelli, Sabrina Paci, Vittoria Ercoli, Alice Re Dionigi, Raed Selmi, Elisabetta Salvatici, Graziella Cefalo and Giuseppe Banderali

Healthcare 2021, 9(11), 1407; https://doi.org/10.3390/healthcare9111407 - 20 Oct 2021

Cited by 2 | Viewed by 1696

Abstract

Phenylketonuria (PKU) and Hyperphenylalaninemia (HPA) are inborn errors of metabolism (IEM) due to mutations in the PAH gene resulting in increased blood phenylalanine (Phe) concentrations. Depending on the Phe levels, a lifelong dietary intervention may be needed. During the COVID-19 pandemic, finding new [...] Read more.

Phenylketonuria (PKU) and Hyperphenylalaninemia (HPA) are inborn errors of metabolism (IEM) due to mutations in the PAH gene resulting in increased blood phenylalanine (Phe) concentrations. Depending on the Phe levels, a lifelong dietary intervention may be needed. During the COVID-19 pandemic, finding new strategies to ensure follow-up and metabolic control for such patients became mandatory and telehealth was identified as the most eligible tool to provide care and assistance beyond barriers. The aim of this study was to evaluate how telehealth use may have impacted disease follow-ups. Seven hundred and fifty-five patients affected by PKU/HPA in follow-ups at the Clinical Department of Pediatrics (San Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Italy) were included in this study. The data regarding the used telehealth model, type of performed consultations and patients’ perspectives were retrospectively collected and analyzed after a one-year experience of implemented follow-ups. The results demonstrated that telehealth seemed to be a useful tool to improve the adherence to treatment and that it could guarantee continuous assistance and care beyond the surrounding epidemiological status. Patients expressed great satisfaction with the offered services and requested that they were implemented in standards of care on a long-term basis. Our results suggested the implementation of telehealth in the management guidelines for PKU/HPA patients. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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21 pages, 10789 KiB

Open AccessArticle

Applying a Pedestrian Level of Service in the Context of Social Distancing: The Case of the City of Madrid

by Ruben Talavera-Garcia and Rocío Pérez-Campaña

Int. J. Environ. Res. Public Health 2021, 18(21), 11037; https://doi.org/10.3390/ijerph182111037 - 20 Oct 2021

Cited by 10 | Viewed by 2177

Abstract

During the COVID-19 pandemic, there has been a lot of discussion about keeping interpersonal distance to prevent the virus from spreading. To keep this interpersonal distance, authorities at different levels have taken measures to reduce people’s interactions, such as reducing capacities, curfews, pop-up [...] Read more.

During the COVID-19 pandemic, there has been a lot of discussion about keeping interpersonal distance to prevent the virus from spreading. To keep this interpersonal distance, authorities at different levels have taken measures to reduce people’s interactions, such as reducing capacities, curfews, pop-up cycle lanes, temporary pedestrianisation, and lockdowns. Many of these temporary measures have been perceived from a static view. Nevertheless, in a scenario of “new normality” or in the face of a possible new pandemic, the amount of data (big data) generated by different sources, such as sensors, in large cities has extraordinary potential to be used together with tactical urbanism for quick adaptation. The aim of this study was to gain insight into the aforementioned issues by analysing spatio-temporal patterns of pedestrian mobility and developing a variation of the pedestrian level of service measure; the pandemic pedestrian level of service (P-PLOS). This measure provides a dynamic view of pavement capacities according to the interpersonal distance recommendations during the pandemic. P-PLOS was tested in the city of Madrid based on the pedestrian counter data that was provided by the local government through its open data website. We found that the application of P-PLOS, together with street design, allows for knowing where and when it is necessary to take tactical urbanism measures in order to maintain or improve the level of service, as well as where it is necessary to take measures to reduce pedestrian flow. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 2980 KiB

Open AccessArticle

Heterogeneity of COVID-19 Risk Perception: A Socio-Mathematical Model

by Alfonso Gastelum-Strozzi, Claudia Infante-Castañeda, Juan Guillermo Figueroa-Perea and Ingris Peláez-Ballestas

Int. J. Environ. Res. Public Health 2021, 18(21), 11007; https://doi.org/10.3390/ijerph182111007 - 20 Oct 2021

Cited by 4 | Viewed by 1933

Abstract

The perception of risk has been a key element in the experiences, containment and differential impact of the COVID-19 pandemic worldwide. The complexity of this phenomenon requires the interdisciplinary integration of theoretical and methodological aspects, as this integration informs the objective of developing [...] Read more.

The perception of risk has been a key element in the experiences, containment and differential impact of the COVID-19 pandemic worldwide. The complexity of this phenomenon requires the interdisciplinary integration of theoretical and methodological aspects, as this integration informs the objective of developing a mathematical proposal based on a conceptual model located within the social theory of risk at the micro-social level. The mathematical risk model used here was developed from a secondary analysis of a study of 12,649 individuals on the experiences of the COVID-19 pandemic in a population in which the quantity and quality of the information made it possible to define a risk factor and its relationship to emotions and the sources of information used. Four sequential strategies were used to construct the model: choosing the variables for the questionnaire that theoretically corresponded to the conceptual model, constructing the risk vector and initial grouping of individuals by perception of risk, modeling by using principal component analysis and applying network methods. The theoretical model of risk, proposed and constructed through the analysis of groupings by quartiles and by networks in the studied population from a social and mathematical perspective, demonstrates the heterogeneity of risk perception as manifested by differences in perception by age, gender, expression of feelings and media consulted in a university community. The knowledge and methodology generated in these analyses contribute to the body of knowledge informing the response to future epidemiological contingencies. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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8 pages, 296 KiB

Open AccessCommunication

COVID-19 among Healthcare Workers: A Prospective Serological-Epidemiological Cohort Study in a Standard Care Hospital in Rural Germany

by Stephanie Hoffmann, Juliane Schiebel, Frank Hufert, Heinz-Detlef Gremmels and Jacob Spallek

Int. J. Environ. Res. Public Health 2021, 18(20), 10999; https://doi.org/10.3390/ijerph182010999 - 19 Oct 2021

Cited by 6 | Viewed by 1984

Abstract

Healthcare workers (HCW) play a vital role in the SARS-CoV-2 pandemic control. The aim of this study was to assess the prevalence of SARS-CoV-2 antibodies and the risk of COVID-19 infections in a cohort of HCW from four different risk groups (from intensive [...] Read more.

Healthcare workers (HCW) play a vital role in the SARS-CoV-2 pandemic control. The aim of this study was to assess the prevalence of SARS-CoV-2 antibodies and the risk of COVID-19 infections in a cohort of HCW from four different risk groups (from intensive care unit to administration) of a hospital of a primary care level in rural Germany. The outcomes were monthly measures of antibody seroprevalence over a period of 6 months. Overall, a seroprevalence of 13.41% was determined, with significantly higher prevalence rates among HCW working in areas with more frequent contact to confirmed or suspected cases (30.30%, p = 0.003). The group specific differences in the risk of infection from COVID-19 were detected, as HCW groups with frequent exposure seemed to have an increased risk (RR = 3.18, p = 0.02; CI95 1.09–9.24). The findings contribute to the epidemiological understanding of the virus spread in an unvaccinated population group, which is highly relevant for the pandemic management. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

15 pages, 1184 KiB

Open AccessArticle

Indoor Dining and In-Person Learning: A Comparison of 30 US Cities

by Gabriella O’Leary, Alina S. Schnake-Mahl, Vaishnavi Vaidya, Usama Bilal and Jennifer Kolker

Int. J. Environ. Res. Public Health 2021, 18(20), 10967; https://doi.org/10.3390/ijerph182010967 - 19 Oct 2021

Cited by 1 | Viewed by 2637

Abstract

With limited US federal leadership on closing and re-opening strategies to mitigate the COVID-19 pandemic, cities and states were left to enact their own policies. This article examines two key sets of policies—in-person learning in public elementary schools and indoor dining—across 30 of [...] Read more.

With limited US federal leadership on closing and re-opening strategies to mitigate the COVID-19 pandemic, cities and states were left to enact their own policies. This article examines two key sets of policies—in-person learning in public elementary schools and indoor dining—across 30 of the largest US cities in the summer, fall, and winter of 2020. We review indoor dining and in-person elementary education policy decisions between 1 May 2020 and 14 December 2020 across 30 US cities. We review the public health evidence, political power, and jurisdictional challenges that cities faced, and the policy implications of these factors. Overwhelmingly, indoor dining re-opened in cities while in-person elementary schools were kept closed; indoor dining re-opened in all cities in fall 2020, while only 40% of public elementary schools re-opened for in-person instruction. Looking ahead to fully bringing students back for in-person learning, and considering future potential community outbreaks, this retrospective analysis can help inform city and state governments on policy decisions around indoor dining and reopening/closing schools for in-person learning. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 2022 KiB

Open AccessArticle

Analysis of SARS-CoV-2 Genomes from West Java, Indonesia

by Azzania Fibriani, Rebecca Stephanie, Afifah Alifia Alfiantie, Agust Leo Fany Siregar, Gusti Ayu Prani Pradani, Nicholas Yamahoki, William Steflandel Purba, Cut Nur Cinthia Alamanda, Ema Rahmawati, Rifky Waluyajati Rachman, Rini Robiani and Ryan Bayusantika Ristandi

Viruses 2021, 13(10), 2097; https://doi.org/10.3390/v13102097 - 18 Oct 2021

Cited by 13 | Viewed by 4242

Abstract

West Java Health Laboratory (WJHL) is one of the many institutions in Indonesia that have sequenced SARS-CoV-2 genome. Although having submitted a large number of sequences since September 2020, however, these submitted data lack advanced analyses. Therefore, in this study, we analyze the [...] Read more.

West Java Health Laboratory (WJHL) is one of the many institutions in Indonesia that have sequenced SARS-CoV-2 genome. Although having submitted a large number of sequences since September 2020, however, these submitted data lack advanced analyses. Therefore, in this study, we analyze the variant distribution, hotspot mutation, and its impact on protein structure and function of SARS-CoV-2 from the collected samples from WJHL. As many as one hundred sixty-three SARS-CoV-2 genome sequences submitted by West Java Health Laboratory (WJHL), with collection dates between September 2020 and June 2021, were retrieved from GISAID. Subsequently, the frequency and distribution of non-synonymous mutations across different cities and regencies from these samples were analyzed. The effect of the most prevalent mutations from dominant variants on the stability of their corresponding proteins was examined. The samples mostly consisted of people of working-age, and were distributed between female and male equally. All of the sample sequences showed varying levels of diversity, especially samples from West Bandung which carried the highest diversity. Dominant variants are the VOC B.1.617.2 (Delta) variant, B.1.466.2 variant, and B.1.470 variant. The genomic regions with the highest number of mutations are the spike, NSP3, nucleocapsid, NSP12, and ORF3a protein. Mutation analysis showed that mutations in structural protein might increase the stability of the protein. Oppositely, mutations in non-structural protein might lead to a decrease in protein stability. However, further research to study the impact of mutations on the function of SARS-CoV-2 proteins are required. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 563 KiB

Open AccessArticle

The Impact of Different Coping Styles on Psychological Distress during the COVID-19: The Mediating Role of Perceived Stress

by Yi Ding, Xinchen Fu, Rude Liu, Jacqueline Hwang, Wei Hong and Jia Wang

Int. J. Environ. Res. Public Health 2021, 18(20), 10947; https://doi.org/10.3390/ijerph182010947 - 18 Oct 2021

Cited by 19 | Viewed by 3906

Abstract

The present study aimed to understand the impact of different coping methods endorsed by Chinese college students during COVID-19 through the examination of the mediating role of perceived stress. We recruited a total of 492 undergraduate students to complete an online survey from [...] Read more.

The present study aimed to understand the impact of different coping methods endorsed by Chinese college students during COVID-19 through the examination of the mediating role of perceived stress. We recruited a total of 492 undergraduate students to complete an online survey from May to June 2020. The results of structural equation modeling indicated that perceived stress was a significant mediator in the association between different coping styles and psychological distress. Three coping styles, including problem-focused, adaptive emotion-focused, and maladaptive emotion-focused coping styles were all significantly correlated with psychological distress. Perceived stress significantly mediated the association between the three coping styles and psychological distress. The results indicated a full mediation model in which problem-focused coping and adaptive emotion-focused coping affected psychological distress entirely through the mediation of perceived stress. Maladaptive emotion-focused coping positively predicted perceived stress, which in turn positively predicted psychological distress through a partial mediation model. We discuss the implications of these findings and offer suggestions for future research. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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18 pages, 416 KiB

Open AccessArticle

Pregnancy and Birth Outcomes during the Early Months of the COVID-19 Pandemic: The MOACC-19 Cohort

by Marta Rodríguez-Díaz, Jéssica Alonso-Molero, María J. Cabero-Perez, Javier Llorca, Trinidad Dierssen-Sotos, Inés Gómez-Acebo and The MOACC-19 Group

Int. J. Environ. Res. Public Health 2021, 18(20), 10931; https://doi.org/10.3390/ijerph182010931 - 18 Oct 2021

Cited by 4 | Viewed by 2135

Abstract

The new coronavirus, SARS-CoV-2, is devastating for specific groups of patients, but currently there is not enough information concerning its effects on pregnant women. The purpose of this study is to identify the impact of SARS-CoV-2 infection on pregnancy and the consequences that [...] Read more.

The new coronavirus, SARS-CoV-2, is devastating for specific groups of patients, but currently there is not enough information concerning its effects on pregnant women. The purpose of this study is to identify the impact of SARS-CoV-2 infection on pregnancy and the consequences that it could cause. We studied a cohort of pregnant ladies who were tested for SARS-CoV-2 infection by RT-PCR and classified as infected or not infected. The recruitment was carried out in the HUMV hospital, a third-level hospital located in Santander, northern Spain. It started on 23 March 2020 and ended on 14 October 2020. Data from our cohort were compared to another cohort recruited in 2018 at the same hospital. We found that gestational hypertension, placental abruptio, and home exposure to an infected person, among other variables, could be associated with SARS-CoV-2 infection. In conclusion, we consider pregnant women a high-risk group of patients towards a possible SARS-CoV-2 infection, especially those who present with conditions such as gestational hypertension or obesity; moreover, we think that SARS-CoV-2 infection could increase the possibilities of having an abruptio placentae, although this result was found in only a few women, so it requires further confirmation. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

10 pages, 761 KiB

Open AccessArticle

COVID-19 Infection in Academic Dental Hospital Personnel; A Cross-Sectional Survey in Saudi Arabia

by Osama Abu-Hammad, Ahmad Alnazzawi, Hamzah Babkair, Safa Jambi, Maher Mirah, Ismail Abdouh, Rahaf Saeed Aljohani, Rahaf Ayeq, Layan Ghazi, Heba Al-subhi and Najla Dar-Odeh

Int. J. Environ. Res. Public Health 2021, 18(20), 10911; https://doi.org/10.3390/ijerph182010911 - 17 Oct 2021

Cited by 5 | Viewed by 2300

Abstract

Background: Close patient contact is an essential component of clinical dental education, which can expose students and faculty to risk of COVID-19 and its sequelae. Methods: The study was a cross-sectional survey conducted among faculty and clinical students at an academic dental hospital [...] Read more.

Background: Close patient contact is an essential component of clinical dental education, which can expose students and faculty to risk of COVID-19 and its sequelae. Methods: The study was a cross-sectional survey conducted among faculty and clinical students at an academic dental hospital in Al Madinah western Saudi Arabia. An online questionnaire was distributed to collect data on prevalence, risk factors, clinical manifestations, and long-term health and socioeconomic complications of COVID-19 infection. Results: Prevalence of COVID-19 was 19.6% among a total of 316 students and faculty. Participants cited family and friends as the primary source of infection (40.3%). Among cross-infection control practices, they cited failure to practice distancing as the primary reason for infection transmission (61.3%). The disease was symptomatic in 85.5% of infected personnel. Most frequently reported clinical manifestations were: fever, cough, malaise, and diarrhoea (74.1%, 56.5%, 40.3%, 32.3%, respectively). A proportion of 37.1% of infected personnel stated that they had long COVID-19, and 58.3% of infected students reported deteriorated academic achievement. Conclusions: One in five of clinical dental students and their faculty had COVID-19. Most cases were symptomatic, and a large proportion developed long COVID or adverse socioeconomic consequences. Regardless of the severity of symptoms encountered during the acute stage of COVID-19 infection, all infected dental healthcare personnel should be followed, especially those who report long COVID. Continuous follow-up and assistance for infected students may be warranted to mitigate the potential academic and mental drawbacks caused by the pandemic. Dental schools should adopt clear policies regarding COVID-19 transmission and prevention and should implement them in their infection-control education and training. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 2962 KiB

Open AccessArticle

The Use of Digital Portfolio in Higher Education before and during the COVID-19 Pandemic

by Soledad Domene-Martos, Margarita Rodríguez-Gallego, David Caldevilla-Domínguez and Almudena Barrientos-Báez

Int. J. Environ. Res. Public Health 2021, 18(20), 10904; https://doi.org/10.3390/ijerph182010904 - 17 Oct 2021

Cited by 4 | Viewed by 3582

Abstract

This study is focused on the advantages and disadvantages of using a digital portfolio to improve the learning and evaluation processes in the initial teacher training of 4th-year students in the University of Seville (Spain). One of the interests of this research was [...] Read more.

This study is focused on the advantages and disadvantages of using a digital portfolio to improve the learning and evaluation processes in the initial teacher training of 4th-year students in the University of Seville (Spain). One of the interests of this research was to compare the learning capacities perceived by the students to improve their learning process before and during the COVID-19 pandemic. A qualitative, descriptive methodology was applied, identifying the most relevant dimensions, categories and codes for the analysis, management and interpretation of the opinions of the students, with a research triangulation (Cohen’s kappa coefficient) and a coding performed using the ATLAS.ti 8.4 software. The results show that the advantages with greater percentage correspond to the following categories: learning, usefulness of OneDrive, autonomy and evaluation. The greatest disadvantages detected were: time, uncertainty, usefulness of OneDrive and autonomy. There are differences in the perceptions of the students, between before and during the COVID-19 pandemic, about the learning capacities developed with the use of digital portfolio, since they consider that they have acquired more significant learning, greater self-regulation of their learning and greater reflection capacity. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 3103 KiB

Open AccessArticle

A Data Driven Analysis and Forecast of COVID-19 Dynamics during the Third Wave Using SIRD Model in Bangladesh

by Omar Faruk and Suman Kar

COVID 2021, 1(2), 503-517; https://doi.org/10.3390/covid1020043 - 16 Oct 2021

Cited by 8 | Viewed by 4518

Abstract

In this study, we developed a compartmental SIRD model to analyze and forecast the transmission dynamics of the COVID-19 pandemic in Bangladesh during the third wave caused by the Indian delta variant. With the help of the nonlinear system of differential equations, this [...] Read more.

In this study, we developed a compartmental SIRD model to analyze and forecast the transmission dynamics of the COVID-19 pandemic in Bangladesh during the third wave caused by the Indian delta variant. With the help of the nonlinear system of differential equations, this model can analyze the trends and provide reliable predictions regarding how the epidemic would evolve. The basic reproduction number regarding the pandemic has been determined analytically. The parameters used in this model have been estimated by fitting our model to the reported data for the months of May, June, and July 2021 and the goodness of fit of the parameter’s value has been found by the respective regression coefficients. Further, we conducted a sensitivity analysis of the basic reproduction number and observed that decreasing the transmission rate is the most significant factor in disease prevention. Our proposed model’s appropriateness for the available COVID-19 data in Bangladesh has been demonstrated through numerical simulations. According to the numerical simulation, it is evident that a rise in the transmission rate leads to a significant increase in the infected number of the population. Numerical simulations have also been performed by using our proposed model to forecast the future transmission dynamics for COVID-19 over a longer period of time. Knowledge of these forecasts may help the government in adopting appropriate measures to prepare for unforeseen situations that may arise in Bangladesh as well as to minimize detrimental impacts during the outbreak. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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20 pages, 307 KiB

Open AccessArticle

The Prevalence and Determinant of PTSD Symptoms among Home-Quarantined Chinese University Students during the COVID-19 Pandemic

by Yueyang Zhang, Jingjing Zhao, Juzhe Xi, Bingbing Fan, Qiong Wang, Zhiying Yao, Tianhui Huang and Han Bai

Healthcare 2021, 9(10), 1383; https://doi.org/10.3390/healthcare9101383 - 16 Oct 2021

Cited by 8 | Viewed by 2482

Abstract

Background: When COVID-19 emerged in China in late 2019, most Chinese university students were home-quarantined to prevent the spread of the virus, considering the great impact of the lockdown on young people habits and their psychological well-being. This study explored the prevalence of [...] Read more.

Background: When COVID-19 emerged in China in late 2019, most Chinese university students were home-quarantined to prevent the spread of the virus, considering the great impact of the lockdown on young people habits and their psychological well-being. This study explored the prevalence of post-traumatic stress disorder (PTSD) and its associated factors among Chinese university students who are isolated at home during the COVID-19 pandemic. Method: 4520 participants from five universities in China were surveyed by online questionnaire and the PTSD Checklist—Civilian Version (PCL-C) was adopted as a screening instrument. Results: Exposure to virus was significantly related to PTSD outcomes. The most important predictors for PTSD outcomes were parents’ relationship and the way parents educated, and university-provided psychological counseling was a protective factor against developing PTSD. Conclusions: The COVID-19 pandemic had adverse psychological consequences on Chinese university students who were isolated at home due to the relatively high prevalence rate of PTSD which was reported. Adverse parental relationships and the extreme way parents educate their children could be the major risk factors for PTSD outcomes. Psychological interventions need to be made available to home-quarantined university students, and those in the worst-hit and exposed areas to virus should be given priority focus. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

8 pages, 527 KiB

Open AccessArticle

Prevalence of Asymptomatic SARS-CoV-2 Infection in the General Population of the Veneto Region: Results of a Screening Campaign with Third-Generation Rapid Antigen Tests in the Pre-Vaccine Era

by Silvia Cocchio, Michele Nicoletti, Francesco Paolo De Siena, Gaia Lattavo, Patrizia Furlan, Marco Fonzo, Michele Tonon, Federico Zabeo, Francesca Russo and Vincenzo Baldo

Int. J. Environ. Res. Public Health 2021, 18(20), 10838; https://doi.org/10.3390/ijerph182010838 - 15 Oct 2021

Cited by 2 | Viewed by 1575

Abstract

The aim of our study was to ascertain the prevalence of SARS-CoV-2 infection in the general population during a period of moderate risk, just before Italy started to implement its vaccination campaign. A third-generation antigenic nasal swab sample was collected by a healthcare [...] Read more.

The aim of our study was to ascertain the prevalence of SARS-CoV-2 infection in the general population during a period of moderate risk, just before Italy started to implement its vaccination campaign. A third-generation antigenic nasal swab sample was collected by a healthcare provider, and all individuals testing positive subsequently had a nasopharyngeal swab for molecular testing; the result was used to calculate the positive predictive value. The population consisted of 4467 asymptomatic adults with a mean age of 46.8 ± 16.00 years. The 62.2% tested for the first time, while 37.8% had previously undergone a mean 2.2 tests for SARS-CoV-2. With 77 of our overall sample reporting they had previously tested positive for COVID-19 and 14 found positive on our screening test, the overall estimated prevalence of the infection was 0.31%. Nine of the 14 cases were confirmed on molecular testing with a PPV of 64.3%. The mean age of the individuals testing positive was 38.1 ± 17.4. Based on the timing of symptom onset, six of the above cases were classified as false negatives, and the adjusted estimated prevalence was 0.34%. Describing levels of infection in a general population seems to be very difficult to achieve, and the universal screening proved hugely expensive particularly in a low-prevalence situation. Anyway, it is only thanks to mass screening efforts that epidemiological data have been collected. This would support the idea that routine screening may have an impact on mitigating the spread of the virus in higher-risk environments, where people come into contact more frequently, as in the workplace. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 1013 KiB

Open AccessArticle

Not Just a ‘Breath of Death’: Indirect Consequences of Working in a COVID-19 Unit

by Anasuya Guha, Petr Schalek, Martin Chovanec, Pavel Kraml, Jakub Bala and Jan Plzak

Int. J. Environ. Res. Public Health 2021, 18(20), 10802; https://doi.org/10.3390/ijerph182010802 - 14 Oct 2021

Cited by 1 | Viewed by 1435

Abstract

We carried out a survey in the Czech Republic between January and February 2021 to evaluate the impact of COVID-19 on doctors working in the COVID-19 unit. A rise in 250,000 cases were seen in the Czech Republic during the time of the [...] Read more.

We carried out a survey in the Czech Republic between January and February 2021 to evaluate the impact of COVID-19 on doctors working in the COVID-19 unit. A rise in 250,000 cases were seen in the Czech Republic during the time of the survey. The indirect impact of the disease on doctors working in COVID-19 units and strategies to control the situation in the Czech Republic were evaluated here. About 35% doctors were concerned with health issues, 40% had tested positive for SARS-CoV-2 antigen, 51% reported lack of support for those who had contracted COVID-19 and 163 agreed that medical, psychological counselling and financial services should be provided. Most doctors experienced moderate and severe degrees of psychological impact. Doctors with the least working experience and those with at least 21 to 35 years were most affected. Mental fatigue was the most common reported psychosomatic effect. The effects were higher in doctors who were more concerned about working in COVID-19 units. Around 87% agreed that the best strategy in controlling the situation in the Czech Republic would be ‘preventive measures in combination with vaccination’. History shows us that pandemics can occur in multiple waves. Subsequent waves, inadequate support as well as unparalleled workload can lead to a serious rise in psychological disorders amongst HCWs worldwide. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 909 KiB

Open AccessArticle

The COVID-19 Run on Medical Resources in Wuhan China: Causes, Consequences and Lessons

by Gaofeng Yin, Hanning Song, Jian Wang, Stephen Nicholas and Elizabeth Maitland

Healthcare 2021, 9(10), 1362; https://doi.org/10.3390/healthcare9101362 - 13 Oct 2021

Cited by 8 | Viewed by 2555

Abstract

The COVID-19 run on medical resources crashed Wuhan’s medical care system, a medical disaster duplicated in many countries facing the COVID-19 pandemic. In a novel approach to understanding the run on Wuhan’s medical resources, we draw from bank run theory to analyze the [...] Read more.

The COVID-19 run on medical resources crashed Wuhan’s medical care system, a medical disaster duplicated in many countries facing the COVID-19 pandemic. In a novel approach to understanding the run on Wuhan’s medical resources, we draw from bank run theory to analyze the causes and consequences of the COVID-19 run on Wuhan’s medical resources and recommend policy changes and government actions to attenuate runs on medical resources in the future. Like bank runs, the cause of the COVID-19 medical resource run was rooted in China’s local medical resource context and a sudden realignment of expectations, reflecting shortages and misallocations of hospital resources (inadequate liquidity and portfolio composition); high level hospitals siphoning-off patients from lower level health providers (bank moral hazard and adverse selection problem); patients selecting high-level hospitals over lower-level health care (depositor moral hazard problem); inadequate government oversight and uncontrolled risky hospital behavior (inadequate bank regulatory control); biased medical insurance schemes (inadequate depositor insurance); and failure to provide medical resource reserves (failure as lender of last resort). From Wuhan’s COVID-19 run on medical resources, we recommend that control and reform by government enlarge medical resource supply, improve the capacity of primary medical care, ensure timely virus information, formulate principles for the allocation of medical resources that suit a country’s national conditions, optimize the medical insurance schemes and public health fund allocations and enhance the emergency support of medical resources. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 1710 KiB

Open AccessArticle

A Comprehensive Descriptive Epidemiological and Clinical Analysis of SARS-CoV-2 in West-Mexico during COVID-19 Pandemic 2020

by Oliver Viera-Segura, Natali Vega-Magaña, Mariel García-Chagollán, Marcela Peña-Rodríguez, Germán Muñoz-Sánchez, Ahtziri Socorro Carranza-Aranda, Iris Monserrat Llamas-Covarrubias, Moisés Ramos-Solano, Jesús Mora-Mora, Carlos Daniel Díaz-Palomera, Gabriela Espinoza-De León, José Sergio Zepeda-Nuño, Enrique Santillán-López, Samuel García-Arellano, Christian David Hernández-Silva, Darbi Alfredo Zerpa-Hernandez, Guillermina Muñoz-Rios, J. Samael Rodríguez-Sanabria and José Francisco Muñoz-Valle

Int. J. Environ. Res. Public Health 2021, 18(20), 10644; https://doi.org/10.3390/ijerph182010644 - 11 Oct 2021

Cited by 4 | Viewed by 2303

Abstract

This study aimed to summarize the epidemiological and clinical characteristics of COVID-19 from Western Mexico people during 2020. A retrospective analysis from an electronic database of people visiting a sentinel center for molecular SARS-CoV-2 confirmatory diagnosis by RT-PCR from April to December 2020 [...] Read more.

This study aimed to summarize the epidemiological and clinical characteristics of COVID-19 from Western Mexico people during 2020. A retrospective analysis from an electronic database of people visiting a sentinel center for molecular SARS-CoV-2 confirmatory diagnosis by RT-PCR from April to December 2020 was carried out for epidemiological and clinical description of COVID-19. Out of 23,211 patients evaluated, 6918 (29.8%) were confirmed for SARS-CoV-2 infection (mean age 38.5 ± 13.99), mostly females (53.8%). Comorbidities, such as diabetes (34.7%), obesity (31.15%), and hypertension (31.8%), presented an increased odds OR = 1.27, CI = 1.14–1.41; OR = 1.08, CI = 1.01–1.16; and OR = 1.09, CI = 0.99–1.19, respectively, for viral-infection. Moreover, fever, headache, and dry cough were the most frequent symptoms. No infection difference among sex was found. Those patients >60 years old were prone to COVID-19 severity (OR = 3.59, CI = 2.10–6.14), evaluated by the number of manifested symptoms, increasing with age. In conclusion, a high SARS-CoV-2 prevalence was found in Western Mexico. Comorbidities were frequent in infected people; nevertheless, no association with disease outcomes was observed, in contrast with the highest disease severity risk found in older patients; however, continuous monitoring should be carried since comorbidities have been reported as aggravating factors. This study can help the health officials for the elaboration of planning efforts of the disease management and others in the future. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 2664 KiB

Open AccessArticle

Prediction and Analysis of Tourist Management Strategy Based on the SEIR Model during the COVID-19 Period

by Yongdong Shi, Rongsheng Huang and Hanwen Cui

Int. J. Environ. Res. Public Health 2021, 18(19), 10548; https://doi.org/10.3390/ijerph181910548 - 08 Oct 2021

Cited by 4 | Viewed by 2028

Abstract

Tourism destinations are now facing a dilemma choice of controlling the epidemic or developing the economy. This paper takes Macao, a typical international tourist city, as an example to study the strategy of tourist source control during the COVID-19 period. According to the [...] Read more.

Tourism destinations are now facing a dilemma choice of controlling the epidemic or developing the economy. This paper takes Macao, a typical international tourist city, as an example to study the strategy of tourist source control during the COVID-19 period. According to the published epidemic data of Macao, this study has established an improved SEIR (Susceptible-Exposed-Infected-Recovered) model, formulated six control strategies against the current epidemic, and used the model above to simulate the time required for all confirmed cases to recover and discharge under different strategies. By taking into consideration the gross revenue of Macao’s gambling industry from 2017 to 2019, the impact of different strategies on the economy is predicted and three control strategies are found to be feasible. This study shows that an effective way to break through the above dilemma is to design the tourist management strategy by screening the source of passengers and controlling the upper limit of capacity of destination. These findings provide a scientific basis for tourism destinations in formulating public policies. The improved SEIR model is more consistent with the actual conversion rule of patients in the current COVID-19 epidemic, and it can be applied to further public health related research. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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7 pages, 773 KiB

Open AccessBrief Report

Evolution of SARS-CoV-2 Key Mutations in Vienna Detected by Large Scale Screening Program

by Jakob Thannesberger, Anna Edermayr, Alireza Karimi, Mathias Mueller, Ursula Karnthaler, Richard Gauss, Daniela Penz, Arnulf Ferlitsch and Christoph Steininger

Viruses 2021, 13(10), 2014; https://doi.org/10.3390/v13102014 - 07 Oct 2021

Cited by 5 | Viewed by 1794

Abstract

Currently countries across the globe are preparing for the fourth wave of SARS-CoV-2 infections, which is mainly driven by the rapid spread of novel SARS-CoV-2 variants. Austria and, in particular, the capital city of Vienna, witnessed a disproportionally steep rise in SARS-CoV-2 infection [...] Read more.

Currently countries across the globe are preparing for the fourth wave of SARS-CoV-2 infections, which is mainly driven by the rapid spread of novel SARS-CoV-2 variants. Austria and, in particular, the capital city of Vienna, witnessed a disproportionally steep rise in SARS-CoV-2 infection rates during the last wave of infections. By the end of January 2021, the government of Vienna launched an innovative, state-wide SARS-CoV-2 screening program based on PCR analysis of self-collected mouthwash samples. More than 400,000 mouthwash samples were collected in Vienna during the third wave of infection from January to March 2021. All preanalytical and analytical steps were carried out in a highly standardized manner at a single certified testing center. SARS-CoV-2 specific PCR analysis revealed in these samples a positivity rate of 0.43%. The relative proportion of N501Y positive virus samples increased continually to 68% of weekly samples. Mutation K417N was detected only in three samples. With this study, we were able to map the temporal occurrence of SARS-CoV-2 variants in a highly unbiased manner. Positivity rates and variant prevalence rates in this study were lower than in other nationwide programs. The results presented in this study indicate that actual virus prevalence tends to be overestimated by surveillance programs such as results of cluster analysis or contact tracing programs. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 761 KiB

Open AccessArticle

Passport to a Mighty Nation: Exploring Sociocultural Foundation of Chinese Public’s Attitude to COVID-19 Vaccine Certificates

by Mingyu Hu, Hepeng Jia and Yu Xie

Int. J. Environ. Res. Public Health 2021, 18(19), 10439; https://doi.org/10.3390/ijerph181910439 - 04 Oct 2021

Cited by 16 | Viewed by 2788

Abstract

Vaccination against COVID-19 is essential against the pandemic. There are broad discussions on adopting certificates for vaccination and the immunity obtained after infection. Based on a national sample of over 2000 participants administered in April 2021, the current study examines the Chinese public’s [...] Read more.

Vaccination against COVID-19 is essential against the pandemic. There are broad discussions on adopting certificates for vaccination and the immunity obtained after infection. Based on a national sample of over 2000 participants administered in April 2021, the current study examines the Chinese public’s attitudes to the so-called COVID-19 vaccination passport and factors contributing to their viewpoints. Generally, the Chinese people had favorable opinions on the passport. Among possible contributing factors, income, personal benefit perception, the subjective norm of COVID-19 vaccination, and nationalism were significantly associated with the public’s positive attitude. At the same time, general vaccine knowledge and scientific literacy had an inconstant effect. Echoing recent studies, these findings reveal a collectivism-oriented attitude of the Chinese public towards the proposal to certify vaccination publicly. Theoretical and practical implications of the results were discussed. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 361 KiB

Open AccessArticle

Telework and Psychological Health in Hospital Staff during the First Wave of the COVID-19 Epidemic in France

by Carole Pelissier, Joelane Paredes, Martine Moulin, Thierry Bitot, Eric Fakra and Luc Fontana

Int. J. Environ. Res. Public Health 2021, 18(19), 10433; https://doi.org/10.3390/ijerph181910433 - 03 Oct 2021

Cited by 12 | Viewed by 2668

Abstract

Background: The COVID-19 pandemic led to a change in work organization with the development of telework. The purpose of this study was to assess the prevalence of anxiety and depressive symptoms in teleworking staff in a university hospital center in France during the [...] Read more.

Background: The COVID-19 pandemic led to a change in work organization with the development of telework. The purpose of this study was to assess the prevalence of anxiety and depressive symptoms in teleworking staff in a university hospital center in France during the first lockdown, and to identify personal, medical and occupational factors associated with anxiety disorder. Methods: A cross-sectional observational study was conducted in 474 hospital staff working from home during the first lockdown. The sociodemographic, occupational and medical information (anxiety and depressive disorders measured on the Hospital Anxiety and Depression (HAD) scale) was collected by an anonymous online self-administered questionnaire. The variables associated with anxiety disorder were investigated by a univariate analysis (chi² and Fisher tests) and a multivariate analysis (logistic regression model). Results: Three hundred and forty hospital staff participated in the study (72% response rate). Of the participants, 106 subjects (32.1%) showed signs of an anxiety disorder and 26 (7.65%) of a depressive disorder. An anxiety disorder was significantly associated with mental workload, changes in working hours, difficulties in teleworking due to issues of internet connection or due to noise, difficulties in combining family and occupational life, sleep disturbance, worry about media information and worry about the health of a loved one. An anxiety disorder remained associated with occupational stress and personal stress during lockdown after a multivariate logistic regression. Conclusions: This study highlighted the association between an anxiety disorder and perceived occupational and personal stress levels in hospital staff teleworking during the first lockdown. Stress management workshops could be proposed to hospital staff. Prevention of anxiety requires reinforced medical monitoring and reduced stress. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

14 pages, 625 KiB

Open AccessArticle

The Impact of COVID-19 Vaccination on Anxiety Levels of Turkish Dental Professionals and Their Attitude in Clinical Care: A Cross-Sectional Study

by Fatih Karayürek, Ahmet Taylan Çebi, Aydın Gülses and Mustafa Ayna

Int. J. Environ. Res. Public Health 2021, 18(19), 10373; https://doi.org/10.3390/ijerph181910373 - 01 Oct 2021

Cited by 21 | Viewed by 2423

Abstract

Background: The current study aimed to assess the anxiety and fear levels and the attitude towards clinical care, such as the use of personal protective equipment and number of patients examined, before and after COVID-19 vaccination among Turkish dental professionals. Methods: A questionnaire [...] Read more.

Background: The current study aimed to assess the anxiety and fear levels and the attitude towards clinical care, such as the use of personal protective equipment and number of patients examined, before and after COVID-19 vaccination among Turkish dental professionals. Methods: A questionnaire including socio-demographical characteristics and clinical data regarding the number of patients, the use of personal protective equipment, vaccine confidence interval, positive or negative COVID-19 diagnosis, and fear and anxiety levels were examined. Results: A total of 475 dentists (196 men and 279 women) participated. Overall, the vaccination had a positive effect on the decrease of fear and anxiety levels of dental professionals. It was observed that the number of interventional procedures significantly increased after vaccination. Besides that, the amount of personal protective equipment used in patients, especially after the vaccination, has decreased. Conclusion: Despite the positive effects of vaccination on the anxiety levels of dental professionals, protective measurements should further be the main concern, regardless of the vaccination status of both the dental professional and the patient. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 340 KiB

Open AccessArticle

Burden, Depression, and Awareness of Information on Safety Behavior in Korean Hemodialysis Patients during the COVID-19 Pandemic

by Ok-Hee Cho, Yun-Hee Cho and Mi-Young Chung

Int. J. Environ. Res. Public Health 2021, 18(19), 10348; https://doi.org/10.3390/ijerph181910348 - 30 Sep 2021

Cited by 4 | Viewed by 1757

Abstract

The purpose of this study was to investigate the relationships among burden, depression, awareness of information (AIC), and safety behavior among hemodialysis patients in Korea during the COVID-19 pandemic. The study participants included 149 patients who received hemodialysis at seven general hospitals in [...] Read more.

The purpose of this study was to investigate the relationships among burden, depression, awareness of information (AIC), and safety behavior among hemodialysis patients in Korea during the COVID-19 pandemic. The study participants included 149 patients who received hemodialysis at seven general hospitals in Korea between January and February 2021. A structured questionnaire was used to survey their levels of burden, depression, AIC, adherent safety behavior (ASB), and dysfunctional safety behavior (DSB). The study results showed that the influencing factors of ASB for COVID-19 were AIC (β = 0.265, p < 0.001), the burden of “not receiving hemodialysis on time” (β = 0.233, p = 0.008), and the burden of “social exclusion of hemodialysis patients” (β = 0.186, p = 0.032). The influencing factors of DSB were the burden of “social exclusion of hemodialysis patients” (β = 0.258, p = 0.003) and AIC (β = 0.217, p = 0.004). As the COVID-19 pandemic continues, the latest evidence-based information must be provided to hemodialysis patients to promote self-care and prevention behavior that encourages ASB and discourages DSB. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

22 pages, 1844 KiB

Open AccessArticle

Teaching Disruption by COVID-19: Burnout, Isolation, and Sense of Belonging in Accounting Tutors in E-Learning and B-Learning

by Laura Parte and Teresa Herrador-Alcaide

Int. J. Environ. Res. Public Health 2021, 18(19), 10339; https://doi.org/10.3390/ijerph181910339 - 30 Sep 2021

Cited by 19 | Viewed by 3685

Abstract

This study examines burnout syndrome, feelings of isolation, and sense of belonging in a sample of accounting tutors enrolled in e-learning and b-learning modalities before and after COVID-19 disruption. The study also includes several sociodemographic and labour variables to better understand the three [...] Read more.

This study examines burnout syndrome, feelings of isolation, and sense of belonging in a sample of accounting tutors enrolled in e-learning and b-learning modalities before and after COVID-19 disruption. The study also includes several sociodemographic and labour variables to better understand the three dimensions. The participants were tutors enrolled in two accounting courses at higher education during the academic years 2019–2020 and 2020–2021. Our results do not show high levels of tutor burnout syndrome, neither before COVID-19 disruption nor after COVID-19 disruption. Findings also reveal that the isolation perception of accounting tutors is not high in both periods, while the sense of belonging of the teaching community is high in both periods. The evidence also suggests some variations in dimension scores according to sociodemographic and labour variables, but the evidence should be interpreted with caution due to the sample size. Despite this limitation, to the best of our knowledge, this is the first study that evaluates burnout, feelings of isolation, and sense of belonging in a tutor collective in e-learning and b-learning before and after COVID-19 disruption. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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19 pages, 34555 KiB

Open AccessArticle

Measuring of the COVID-19 Based on Time-Geography

by Zhangcai Yin, Wei Huang, Shen Ying, Panli Tang, Ziqiang Kang and Kuan Huang

Int. J. Environ. Res. Public Health 2021, 18(19), 10313; https://doi.org/10.3390/ijerph181910313 - 30 Sep 2021

Cited by 6 | Viewed by 2551

Abstract

At the end of 2019, the COVID-19 pandemic began to emerge on a global scale, including China, and left deep traces on all societies. The spread of this virus shows remarkable temporal and spatial characteristics. Therefore, analyzing and visualizing the characteristics of the [...] Read more.

At the end of 2019, the COVID-19 pandemic began to emerge on a global scale, including China, and left deep traces on all societies. The spread of this virus shows remarkable temporal and spatial characteristics. Therefore, analyzing and visualizing the characteristics of the COVID-19 pandemic are relevant to the current pressing need and have realistic significance. In this article, we constructed a new model based on time-geography to analyze the movement pattern of COVID-19 in Hebei Province. The results show that as time changed COVID-19 presented an obvious dynamic distribution in space. It gradually migrated from the southwest region of Hebei Province to the northeast region. The factors affecting the moving patterns may be the migration and flow of population between and within the province, the economic development level and the development of road traffic of each city. It can be divided into three stages in terms of time. The first stage is the gradual spread of the epidemic, the second is the full spread of the epidemic, and the third is the time and again of the epidemic. Finally, we can verify the accuracy of the model through the standard deviation ellipse and location entropy. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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14 pages, 981 KiB

Open AccessArticle

Psychological Aspects of Media Communication during the COVID-19 Pandemic: Insights from Healthcare and Pharmacy Specialists in Lithuania

by Nida Žemaitienė, Milda Kukulskienė, Vilma Miglinė, Loreta Kubilienė, Gabrielė Urbonaitė, Laura Digrytė-Šertvytienė, Aušra Norė and Kastytis Šmigelskas

Healthcare 2021, 9(10), 1297; https://doi.org/10.3390/healthcare9101297 - 29 Sep 2021

Viewed by 2004

Abstract

In the setting of disasters, people seek information as they hope that knowledge will provide security. This makes the media a critical source of crisis exposure. The aim of the study described in this article was to analyze COVID-19 pandemic-related psychological aspects of [...] Read more.

In the setting of disasters, people seek information as they hope that knowledge will provide security. This makes the media a critical source of crisis exposure. The aim of the study described in this article was to analyze COVID-19 pandemic-related psychological aspects of media use by healthcare and pharmacy workers in Lithuania and to reveal the subjective effects of media consumption on their psychological well-being. 967 healthcare workers and pharmacists in Lithuania completed an electronic survey, which consisted of questions about the changes in well-being experienced since the beginning of the lockdown and media use in the search for information on COVID-19. It was found that communication might have ambiguous effects on psychological well-being. Excessive, unreliable, misleading, contradictory information and “catastrophizing” were subjectively related to impaired psychological well-being. Objective and reliable, relevant, clear, timely, hopeful and supportive information had a subjective positive effect. Seeking COVID-19-related information many times a day was associated with increased fear of becoming infected with COVID-19, feeling unable to control the risk of contracting COVID-19, fear of infecting relatives with COVID-19 and feeling that other people would avoid interaction with healthcare workers and pharmacists because of their job. General browsing was not consistently associated with COVID-19-related fears. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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7 pages, 219 KiB

Open AccessArticle

The Impact of COVID-19 on the Service of Emergency Department

by Shaia Alharthi, Modi Al-Moteri, Virginia Plummer and Abdulellah Al Thobiaty

Healthcare 2021, 9(10), 1295; https://doi.org/10.3390/healthcare9101295 - 29 Sep 2021

Cited by 13 | Viewed by 2700

Abstract

(1) Introduction: the COVID-19 pandemic significantly impacted the number and acuity of emergency departments (ED) patients, specifically those with non-COVID-19-related health problems. However, the exact impact of the COVID-19 pandemic on ED services is the subject of comprehensive debate. (2) Aim: to gain [...] Read more.

(1) Introduction: the COVID-19 pandemic significantly impacted the number and acuity of emergency departments (ED) patients, specifically those with non-COVID-19-related health problems. However, the exact impact of the COVID-19 pandemic on ED services is the subject of comprehensive debate. (2) Aim: to gain insight into the consequences of the first wave of the COVID-19 pandemic based on non-COVID-19 presentations and patient acuity using the Canadian Triage and Acuity Scale (CTAS). (3) Method: in Phase 1, the ED records of one of the main regional non-COVID-19 hospitals in Saudi Arabia were retrospectively audited from August 2020 to February 2021—after the first wave of COVID-19—then compared to information collected for the same period in previous year. Phase 2 included calculating the waiting time to identify delays and issues that may impact the triage effectiveness. (4) Results: a change across all CTAS levels was observed post the 1st wave of COVID-19 pandemic. Specifically, there was an increase in the number of patients presenting as higher acuity (CTAS 1 and 2) and a decrease in patients presenting as lower acuity (CTAS 4 and 5). Longer waiting times for patients presenting to ED were also reported. Specifically, 83% of patients presenting as higher acuity experienced a delay. (5) Conclusion: further studies are required to investigate association between the 1st wave of COVID-19 and patient presentations and/or acuity or patient demand and ED capacity. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

7 pages, 2230 KiB

Open AccessCommentary

Polypharmacy Exposure, Aging Populations, and COVID-19: Considerations for Healthcare Providers and Public Health Practitioners in Africa

by Jamaji C. Nwanaji-Enwerem, Edward W. Boyer and Ayobami Olufadeji

Int. J. Environ. Res. Public Health 2021, 18(19), 10263; https://doi.org/10.3390/ijerph181910263 - 29 Sep 2021

Cited by 2 | Viewed by 2481

Abstract

Given the continent’s growing aging population and expanding prevalence of multimorbidity, polypharmacy is an increasingly dire threat to the health of persons living in Africa. The COVID-19 pandemic has only exacerbated these issues. Widespread misinformation, lack of vaccine access, and attempts to avoid [...] Read more.

Given the continent’s growing aging population and expanding prevalence of multimorbidity, polypharmacy is an increasingly dire threat to the health of persons living in Africa. The COVID-19 pandemic has only exacerbated these issues. Widespread misinformation, lack of vaccine access, and attempts to avoid being infected have resulted in increases in Africans’ willingness to take multiple prescription and nonprescription medications and supplements. Issues with counterfeit pharmaceuticals and the relatively new recognition of emergency medicine as a specialty across the continent also create unique challenges for addressing this urgent public health need. Experts have called for more robust pharmaceutical regulation and healthcare/public health infrastructure investments across the continent. However, these changes take time, and more near-term strategies are needed to mitigate current health needs. In this commentary, we present a nonexhaustive set of immediately implementable recommendations that can serve as local strategies to address current polypharmacy-related health needs of Africans. Importantly, our recommendations take into consideration that not all healthcare providers are emergency medicine trained and that local trends related to polypharmacy will change over time and require ever-evolving public health initiatives. Still, by bolstering training to safeguard against provider availability biases, practicing evidence-based prescribing and shared decision making, and tracking and sharing local trends related to polypharmacy, African healthcare providers and public health practitioners can better position themselves to meet population needs. Furthermore, although these recommendations are tailored to Africans, they may also prove useful to providers and practitioners in other regions facing similar challenges. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 2162 KiB

Open AccessArticle

Feelings, Behavioral Actions and Depressive Symptoms Related to COVID-19 among Undergraduates in Hail, Saudi Arabia

by Badr K. Aldhmadi, Ramaiah Itumalla, Rakesh Kumar and Bilesha Perera

Healthcare 2021, 9(10), 1280; https://doi.org/10.3390/healthcare9101280 - 28 Sep 2021

Cited by 2 | Viewed by 1658

Abstract

The severe acute respiratory syndrome coronavirus 2 (COVID-19) outbreak has had a profound psychological impact on university undergraduates. Feelings, behavioral actions, and depressive symptoms related to COVID-19 in undergraduates in Hail, Saudi Arabia, were assessed using an online survey. Eighteen feelings and six [...] Read more.

The severe acute respiratory syndrome coronavirus 2 (COVID-19) outbreak has had a profound psychological impact on university undergraduates. Feelings, behavioral actions, and depressive symptoms related to COVID-19 in undergraduates in Hail, Saudi Arabia, were assessed using an online survey. Eighteen feelings and six behavioral acts were assessed. The Center for Epidemiological Studies Depression Scale was used to measure depressive symptomatology. Descriptive statistics and logistic regression techniques were used. The mean age of the participants (n = 418) was 20.2 years (standard deviation (SD) = 1.8 years), and 52.9% (n = 221) were males. Elevated levels of depressive symptoms were reported by 47.1% of male and 51.3% of female participants. Social isolation, loss of interest, obsessive monitoring of symptoms, concentration difficulties, recurrent negative thoughts, and worries about health services emerged as vital negative feelings related to COVID-19 that were expressed by the participants. Younger age (odds ratio (OR) = 0.636, 95% confidence interval (95% CI) = 0.428–0.946) and coming from the middle-income category (OR = 0.388, 95% CI = 0.151–0.994) were found to be protective factors against developing depressive symptoms. Frequent cleaning of hands, wearing masks when going out, and adherence to social distancing rules were practiced by 71.5% (95% CI = 67.2–75.8%), 78.7% (95% CI = (74.4–82.5%) and 66.0% (95% CI = (61.3–70.5%) of the participants, respectively. These behavioral acts were not associated with the development of depressive symptoms. Although the practice of COVID-19 precautionary measures by the participants was satisfactory, nearly half of the participants reported depressive symptoms. Innovative educational strategies are needed to curb concentration difficulties and social isolation experienced by undergraduates during outbreaks such as COVID-19. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 378 KiB

Open AccessArticle

Risk Factors for COVID-19 Morbidity and Mortality in Institutionalised Elderly People

by Ander Burgaña Agoües, Marta Serra Gallego, Raquel Hernández Resa, Beatriz Joven Llorente, Maria Lloret Arabi, Jessica Ortiz Rodriguez, Helena Puig Acebal, Mireia Campos Hernández, Itziar Caballero Ayala, Pedro Pavón Calero, Montserrat Losilla Calle, Rosario Bueno Nieto, Laura Oliver Messeguer, Rosa Madridejos Mora, Rosa Abellana Sangrà and Tomás M. Perez-Porcuna

Int. J. Environ. Res. Public Health 2021, 18(19), 10221; https://doi.org/10.3390/ijerph181910221 - 28 Sep 2021

Cited by 12 | Viewed by 2601

Abstract

Background: SARS-CoV-2 has caused a high mortality in institutionalised individuals. There are very few studies on the involvement and the real impact of COVID-19 in nursing homes. This study analysed factors related to morbidity and mortality of COVID-19 in institutionalised elderly people. Methods: [...] Read more.

Background: SARS-CoV-2 has caused a high mortality in institutionalised individuals. There are very few studies on the involvement and the real impact of COVID-19 in nursing homes. This study analysed factors related to morbidity and mortality of COVID-19 in institutionalised elderly people. Methods: This cohort study included 842 individuals from 12 nursing homes in Sant Cugat del Vallès (Spain) from 15 March to 15 May 2020. We evaluated individual factors (demographic, dependence, clinical, and therapeutic) and those related to the nursing homes (size and staff) associated with infection and mortality by SARS-CoV-2. Infection was diagnosed by molecular biology test. Results: Of the 842 residents included in the analysis, 784 underwent a Polymerase Chain Reaction (PCR) test; 74.2% were women, the mean age was 87.1 years, and 11.1% died. The PCR test was positive in 44%. A total of 33.4% of the residents presented symptoms compatible with COVID-19 and of these, 80.9% were PCR-positive for SARS-CoV-2. Infection by SARS-CoV-2 among residents was associated with the rate of staff infected in the homes. Mortality by SARS-CoV-2 was related to male sex and a greater grade of dependence measured with the Barthel index. Conclusions: SARS-Cov-2 infection in institutionalised people is associated with the infection rate in nursing home workers and mortality by SARS-Cov-2 with sex and greater dependency according to the Barthel index. Adequate management of nursing home staff and special attention to measures of infection control, especially of individuals with greater dependence, are keys for successful management of future pandemic situations. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

20 pages, 2427 KiB

Open AccessBrief Report

The Impact of COVID-19 on Individuals with Hearing and Visual Disabilities during the First Pandemic Wave in Italy

by Luciano Bubbico, Saverio Bellizzi, Salvatore Ferlito, Antonino Maniaci, Raffaella Leone Guglielmotti, Giulio Antonelli, Giuseppe Mastrangelo and Luca Cegolon

Int. J. Environ. Res. Public Health 2021, 18(19), 10208; https://doi.org/10.3390/ijerph181910208 - 28 Sep 2021

Cited by 5 | Viewed by 3770

Abstract

Background. The COVID-19 pandemic has imposed radical behavioral and social changes in the general population, significantly impacting the lives of individuals affected by disabilities. The aim of this study was to investigate the impact of COVID-19 on non-institutionalized subjects with sensorineural disabilities during [...] Read more.

Background. The COVID-19 pandemic has imposed radical behavioral and social changes in the general population, significantly impacting the lives of individuals affected by disabilities. The aim of this study was to investigate the impact of COVID-19 on non-institutionalized subjects with sensorineural disabilities during the first COVID-19 wave in Italy. Methods. A 39-item online national survey was disseminated from 1 April 2020 to 31 June 2020 via social media throughout Italy to communities of individuals with proven severe sensorineural disabilities, affiliated to five national patient associations. The survey collected extensive information on the socio-demographic profile, health, everyday activities, and lifestyle of individuals with hearing and visual disabilities. Results. One hundred and sixty-three respondents with hearing (66.9%) and visual (33.1%) disabilities returned a usable questionnaire. The mean age of interviewees was 38.4 ± 20.2 years and 56.3% of them were females. Despite the vast majority of respondents (77.9%) perceiving their health status as unchanged (68.8% of interviewees with hearing deficits vs. 96.3% of those with visual impairments), about half the interviewees reported sleep disorders during lock-down, more likely those with visual deficits. Remote services were seemingly more effective for business than school activities. Furthermore, although just 18.8% of respondents rated remote rehabilitation care unsatisfactory, only 12.8% of interviewees felt supported by health and social services during the COVID-19 emergency. The vast majority of respondents were concerned about the future and the risk of SARS-CoV-2 contagion, particularly individuals with hearing impairments. Among the various risk mitigation measures, facemasks caused the greatest discomfort due to communication barriers, particularly among interviewees affected by hearing disabilities (92.2% vs. 45.7%). The most common request (46.5%) of respondents to reduce the inconveniences of the COVID-19 emergency was improving the access to and delivery of health and social services for individuals with sensorineural disabilities (19.3%), followed by the use of transparent masks (17.5%). Conclusions. Although health protection measures such as face masks and social distancing play a key role in preventing and controlling the spread of SARS-CoV-2, the unmet needs of disabled individuals should be carefully considered, especially those affected by sensory disabilities. Tailored access to health and social services for individuals affected by sensorineural disabilities should be implemented. Additional actions should include the use of face shields as a valid alternative to face masks to reduce communication barriers linked to hearing-impairment, as well as the improvement of remote services, especially distance learning at school. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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16 pages, 859 KiB

Open AccessArticle

Simple Disposable Odor Identification Tests for Predicting SARS-CoV-2 Positivity

by Laura Ziuzia-Januszewska, Paweł Dobrzyński, Krzysztof Ślączka, Jaromir Ciszek, Łukasz Krawiec, Waldemar Wierzba and Artur Zaczyński

Int. J. Environ. Res. Public Health 2021, 18(19), 10185; https://doi.org/10.3390/ijerph181910185 - 28 Sep 2021

Cited by 2 | Viewed by 1419

Abstract

Olfactory dysfunction (OD) is a common manifestation of COVID-19 and may be useful for screening. Survey-based olfactory evaluation tends to underestimate the prevalence of OD, while psychophysical olfactory testing during a pandemic has the disadvantage of being time consuming, expensive, and requiring standardized [...] Read more.

Olfactory dysfunction (OD) is a common manifestation of COVID-19 and may be useful for screening. Survey-based olfactory evaluation tends to underestimate the prevalence of OD, while psychophysical olfactory testing during a pandemic has the disadvantage of being time consuming, expensive, and requiring standardized laboratory settings. We aimed to develop a quick, simple, affordable, and reliable test to objectively assess the prevalence and diagnostic accuracy of OD in COVID-19. The olfactory function of 64 COVID-19 inpatients and 34 controls was evaluated using a questionnaire and a simple disposable odor identification test (SDOIT) developed for this study. Four SDOIT models were assessed: 10-SDOIT, 9-SDOIT, 8-SDOIT, and 4-SDOIT, with 10, 9, 8 and 4 samples, respectively. We found a high frequency of self-reported OD in COVID-19 patients, with 32.8% and 42.2% reporting current and recent OD, respectively. Different SDOIT models revealed smell impairment in 54.7–64.1% of COVID-19 patients. The combination of either 10-SDOIT results and self-reported OD, or 8-SDOIT results and self-reported OD, were the best predictors of COVID-19, both with an AUC value of 0.87 (0.85 and 0.86 for the age-matched subjects). OD is a common symptom of COVID-19. A combination of self-reported smell deterioration and OD psychophysically evaluated using SDOIT appears to be a good predictor of COVID-19. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 2706 KiB

Open AccessArticle

Temporal Analysis of SARS-CoV-2 Variants during the COVID-19 Pandemic in Nepal

by Samrat Paudel, Amol Dahal and Hitesh Kumar Bhattarai

COVID 2021, 1(2), 423-434; https://doi.org/10.3390/covid1020036 - 26 Sep 2021

Cited by 9 | Viewed by 5625

Abstract

Nepal has suffered two waves of SARS-CoV-2 infections, one in the year 2020 and another in the year 2021. Although the government of Nepal keeps a detailed record of daily coronavirus infections and deaths throughout the country, and publishes the result every day, [...] Read more.

Nepal has suffered two waves of SARS-CoV-2 infections, one in the year 2020 and another in the year 2021. Although the government of Nepal keeps a detailed record of daily coronavirus infections and deaths throughout the country, and publishes the result every day, genomic surveillance of mutants in the country has lagged behind. Sequencing of COVID-19 samples has been conducted sporadically during the pandemic. From the GISAID database, 127 high-quality sequences deposited by different health authorities in Nepal were collected and analyzed. From the analysis, it can be concluded that at least two variants of concern, alpha and delta, and one variant of interest, kappa, were detected in Nepal in 2021. As in other countries, the delta variant outcompeted the kappa and alpha variants and by July 2021 had established itself as the dominant variant. It can be hypothesized that the second wave in Nepal was primarily caused by the delta variant. Further, phylogenetic tree analysis suggests cases of local transmission and global transmission of coronavirus. This analysis reveals the global nature of the disease, where variants arising in one part of the world can quickly spread to other parts of the world and can also spread through individual communities. This paper highlights a need to structure public policy of Nepal to target the delta variant since it has become the predominant variant in Nepal. A further policy suggestion is to appropriately sample and sequence genomes of SARS-CoV-2 at regular intervals to understand the dynamics of variants in the population. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 241 KiB

Open AccessArticle

The COVID-19 Global Pandemic and Its Impact on the Mental Health of Nurses in Malaysia

by Ping Lei Chui, Mei Chan Chong, Khatijah Lim Abdullah, Vimala Ramoo, Li Yoong Tang, Wan Ling Lee, Chong Chin Che, Nor Aziyan Yahaya, Kavitha Rasaiah, Noor Hanita Zaini, Nor Zehan Ahmad and Chin Hai Teo

Healthcare 2021, 9(10), 1259; https://doi.org/10.3390/healthcare9101259 - 24 Sep 2021

Cited by 9 | Viewed by 5504

Abstract

The Coronavirus disease 2019 (COVID-19) global pandemic since its onset has had a dramatic and often devastating impact, both physical and psychological, on all healthcare workers. This study aimed to assess the impact of psychological distress that COVID-19 has on nurses, as well [...] Read more.

The Coronavirus disease 2019 (COVID-19) global pandemic since its onset has had a dramatic and often devastating impact, both physical and psychological, on all healthcare workers. This study aimed to assess the impact of psychological distress that COVID-19 has on nurses, as well as the coping strategies that they employed. This is a cross-sectional national online survey. A total of 859 nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia participated in the study. More than three-quarters of the nurses experienced stress (77.2%). A total of 88.7% and 7.2% of nurses revealed a moderate and high stress level, respectively. Approximately one in eight (12.1%) nurses reported feeling depressed. Nurses working in the outpatient departments reported significantly higher stress levels than nurses working in inpatient care departments. Nurses having chronic health problems reported significantly higher depression levels than nurses with no chronic health problem. Highly stressed or depressed nurses tend to adopt avoidance coping strategies while religion and emotional support were used regardless of the stress or depression levels experienced. The findings of the study provide insight into the mental health and coping strategies of nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia. This would be of tremendous help to nursing administrators in implementing mental health services for nurses during and following the COVID-19 global pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

15 pages, 727 KiB

Open AccessArticle

The Intentions to Wear Face Masks and the Differences in Preventive Behaviors between Urban and Rural Areas during COVID-19: An Analysis Based on the Technology Acceptance Model

by Bo Zhang, Zhongjie Li and Lei Jiang

Int. J. Environ. Res. Public Health 2021, 18(19), 9988; https://doi.org/10.3390/ijerph18199988 - 23 Sep 2021

Cited by 9 | Viewed by 3953

Abstract

The SARS-CoV-2 virus first emerged in late 2019 and has since spread quickly throughout China and become a global pandemic. As the situation with COVID-19 has evolved, wearing a face mask in public has grown commonplace. Using the technology acceptance model (TAM) as [...] Read more.

The SARS-CoV-2 virus first emerged in late 2019 and has since spread quickly throughout China and become a global pandemic. As the situation with COVID-19 has evolved, wearing a face mask in public has grown commonplace. Using the technology acceptance model (TAM) as a foundation, this study introduces three new variables, namely, perceived risk, social pressure, and social image, to establish an extended model for investigating the factors that influence if residents wear masks. A total of 1200 questionnaires were distributed in China, from 1 February to 30 May 2020, through China’s largest online platform. The results indicate the following: 1. Residents’ positive attitude towards mask wearing promotes their behavioral intention to wear masks. 2. Perceived risk, social pressure, and social image have a positive impact on attitude towards mask wearing. 3. The intention to wear masks and attitude were both positively influenced by perceived usefulness. 4. The perceived usefulness is more influential in rural than urban groups, in terms of behavioral intention. This article proposes that public education on the facts related to the coronavirus, the threats posed by the COVID-19 pandemic to health, and the usefulness of face masks in preventing the transmission of COVID-19 could increase residents’ intention to wear a mask. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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19 pages, 3010 KiB

Open AccessArticle

Using Systems Dynamics for Capturing the Multicausality of Factors Affecting Health System Capacity in Latin America while Responding to the COVID-19 Pandemic

by Kathya Lorena Cordova-Pozo, Hubert P. L. M. Korzilius, Etiënne A. J. A. Rouwette, Gabriela Píriz, Rolando Herrera-Gutierrez, Graciela Cordova-Pozo and Miguel Orozco

Int. J. Environ. Res. Public Health 2021, 18(19), 10002; https://doi.org/10.3390/ijerph181910002 - 23 Sep 2021

Cited by 2 | Viewed by 2853

Abstract

Similar interventions to stop the spread of COVID-19 led to different outcomes in Latin American countries. This study aimed to capture the multicausality of factors affecting HS-capacity that could help plan a more effective response, considering health as well as social aspects. A [...] Read more.

Similar interventions to stop the spread of COVID-19 led to different outcomes in Latin American countries. This study aimed to capture the multicausality of factors affecting HS-capacity that could help plan a more effective response, considering health as well as social aspects. A facilitated GMB was constructed by experts and validated with a survey from a wider population. Statistical analyses estimated the impact of the main factors to the HS-capacity and revealed the differences in its mechanisms. The results show a similar four-factor structure in all countries that includes public administration, preparedness, information, and collective self-efficacy. The factors are correlated and have mediating effects with HS-capacity; this is the base for differences among countries. HS-capacity has a strong relation with public administration in Bolivia, while in Nicaragua and Uruguay it is related through preparedness. Nicaragua lacks information as a mediation effect with HS-capacity whereas Bolivia and Uruguay have, respectively, small and large mediation effects with it. These outcomes increase the understanding of the pandemic based on country-specific context and can aid policymaking in low-and middle-income countries by including these factors in future pandemic response models. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 503 KiB

Open AccessArticle

Assessment of SARS-CoV-2 Anti-Spike IgG Antibody in Women and Children in Madinah, Saudi Arabia: A Single-Center Study

by Waleed H. Mahallawi, Nadir A. Ibrahim, Ammar S. Aljohani, Ehab A. Shaikh, Rayan H. Nafe, Anas M. Khan and Walaa A. Mumena

Int. J. Environ. Res. Public Health 2021, 18(19), 9971; https://doi.org/10.3390/ijerph18199971 - 22 Sep 2021

Cited by 10 | Viewed by 2668

Abstract

Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Information on the prevalence of SARS-CoV-2 antibodies in women and children in Madinah has been limited. The current study aimed to evaluate SARS-CoV-2 IgG seropositivity among women and children [...] Read more.

Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Information on the prevalence of SARS-CoV-2 antibodies in women and children in Madinah has been limited. The current study aimed to evaluate SARS-CoV-2 IgG seropositivity among women and children at Madinah Maternity and Children’s Hospital. Methods: In this cross-sectional study, 579 participants were recruited between January and April 2021 from Madinah Maternity and Children’s Hospital, Saudi Arabia. Data concerning age, sex (for children), blood group, and height and weight (for women) were collected from the hospital database. SARS-CoV-2 anti-spike (anti-S) IgG antibodies were detected by enzyme-linked immunosorbent assay (ELISA). Results: Over 58% of children (n = 195), including 60% of children ≤ 1 year (n = 75), and 50.2% (n = 124) of women were SARS-CoV-2 anti-S IgG seropositive. Significantly higher anti-S IgG levels were observed in children than in women (0.78 ± 1.05 vs. 0.65 ± 0.98, p = 0.008). Compared with women, children had higher odds of high SARS-CoV-2 anti-S IgG levels (odds ratio: 1.41; 95% confidence interval: 1.01–1.97; p = 0.041). No significant associations were observed for anti-S IgG levels with age in women or children or with body mass index among women. Conclusion: Non-reported COVID-19 infections were more prevalent among children than women, and non-reported COVID-19 infections children represent a viral transmission risk; therefore, increased screening, especially among school-aged children, may represent an important COVID-19 preventive control measure. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 358 KiB

Open AccessArticle

Anxiety, Depression and Risk of Post-Traumatic Stress Disorder in Health Workers: The Relationship with Burnout during COVID-19 Pandemic in Italy

by Lucio Ghio, Sara Patti, Giulia Piccinini, Cinzia Modafferi, Eleonora Lusetti, Massimo Mazzella and Massimo Del Sette

Int. J. Environ. Res. Public Health 2021, 18(18), 9929; https://doi.org/10.3390/ijerph18189929 - 21 Sep 2021

Cited by 19 | Viewed by 3946

Abstract

During the COVID-19 pandemic, healthcare workers (HW) have faced an extremely difficult work environment, with an increased workload and traumatic events. Our study aimed to investigate the impact of COVID-19 pandemic on HW’s mental wellbeing. We analyzed the correlations between levels of burnout [...] Read more.

During the COVID-19 pandemic, healthcare workers (HW) have faced an extremely difficult work environment, with an increased workload and traumatic events. Our study aimed to investigate the impact of COVID-19 pandemic on HW’s mental wellbeing. We analyzed the correlations between levels of burnout and other mental health disorders and we searched for the presence of specific risk factors of post-traumatic symptomatology related to the pandemic. A structured an on-line questionnaire and validated instruments were completed by a sample of HW from some hospitals in Genoa, Italy. Anxious, depressive, post-traumatic and other psychological symptoms were assessed and risk factors, related to the pandemic, were considered. Then, we investigated the correlation between levels of burnout and the risk of developing psychopathology. A total of 731 HW were screened, and we found increased levels of anxiety (61%), depression (62%), PTSD (34%) and high levels of burnout; especially emotional exhaustion (37%). A statistically significant association between burnout and insomnia, depression, anxiety, and post-traumatic symptoms was demonstrated. This study indicates that during the COVID-19 pandemic, HW showed high levels of psychological distress and that burnout is an important predictor of sufferance. These findings support the idea to provide psychological and psychiatric support for HW. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

13 pages, 22788 KiB

Open AccessArticle

Application of Pandemic Intelligence in Dynamic Data in Taiwan

by Tzu-Yin Chang, Wen-Ray Su, Hongey Chen, Ming-Wey Huang and Lu-Yen A. Chen

Int. J. Environ. Res. Public Health 2021, 18(18), 9925; https://doi.org/10.3390/ijerph18189925 - 21 Sep 2021

Viewed by 1711

Abstract

Taiwan was successful in containing the spread of the novel coronavirus (COVID-19) in 2020. One major factor in this success was the compilation and provision of comprehensive information about the pandemic. The present study proposes a pandemic intelligence system that provides data on [...] Read more.

Taiwan was successful in containing the spread of the novel coronavirus (COVID-19) in 2020. One major factor in this success was the compilation and provision of comprehensive information about the pandemic. The present study proposes a pandemic intelligence system that provides data on the number of epidemic prevention professionals in each county and city, as well as daily confirmed cases, the demographics of the confirmed cases, and available resources (negative-pressure room beds and artificial ventilation apparatuses) in hospitals. Furthermore, the system provides the location of pharmacies selling masks and their current inventories, as well as the distribution of crowds at popular tourist destinations and social-distance monitoring. The most frequently used map layer in the thematic map of the pandemic is that of crowd distribution during the study period from March 2020 until the end of the same year. The case study used in this investigation for applying the system is represented by the 4-day weekend for Tomb-Sweeping Day of 2020. Through the real-time analysis of dynamic data and the integration of intelligence, the system offers a clear insight into changes in relevant information and, thus, enables the preemptive deployment of control measures by the county/city governments regarding pandemic management. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 886 KiB

Open AccessArticle

Cytokine Response to SARS-CoV-2 Infection in Children

by Antonietta Curatola, Antonio Chiaretti, Serena Ferretti, Giulia Bersani, Donatella Lucchetti, Lavinia Capossela, Alessandro Sgambato and Antonio Gatto

Viruses 2021, 13(9), 1868; https://doi.org/10.3390/v13091868 - 18 Sep 2021

Cited by 11 | Viewed by 2061

Abstract

The causal connection between serum biomarkers and COVID-19 severity or pathogenicity in children is unclear. The aim of this study was to describe clinical and immunological features of children affected by COVID-19. The secondary aim was to evaluate whether these cytokines could predict [...] Read more.

The causal connection between serum biomarkers and COVID-19 severity or pathogenicity in children is unclear. The aim of this study was to describe clinical and immunological features of children affected by COVID-19. The secondary aim was to evaluate whether these cytokines could predict severity of COVID-19. All children (aged 0−18) admitted to the Pediatric Emergency Department and tested with nasopharyngeal swab for SARS-CoV-2 were recruited and assigned to three groups: COVID-19, other infections, control group. Clinical and laboratory data of these patients, including circulating cytokine levels, were analyzed in three groups. Fever was the most frequent symptom in COVID-19 (67.3%). Neutropenia was found in the COVID-19 group (p < 0.05); no difference was observed for lymphocyte counts in the three groups. Higher levels of IL-6 and TNF-alpha were found in the COVID-19 group compared to other infections and control groups (p = 0.014 and p = 0.001, respectively). Whereas, in the COVID-19 group, no difference was observed as for the same cytokines among sub-groups of different disease severity (p = 0.7 and p = 0.8). Serum levels of IL-6 and TNF-alpha were higher in COVID-19 children than in children with other infectious diseases, but those levels did not correlate with disease severity. Clinical studies in a large pediatric population are necessary to better define the role of the immune-mediated response in SARS-CoV-2 infections in children. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 2377 KiB

Open AccessArticle

The Impact of COVID-19 on the Preparation for the Tokyo Olympics: A Comprehensive Performance Assessment of Top Swimmers

by Emese Csulak, Árpád Petrov, Tímea Kováts, Márton Tokodi, Bálint Lakatos, Attila Kovács, Levente Staub, Ferenc Imre Suhai, Erzsébet Liliána Szabó, Zsófia Dohy, Hajnalka Vágó, Dávid Becker, Veronika Müller, Nóra Sydó and Béla Merkely

Int. J. Environ. Res. Public Health 2021, 18(18), 9770; https://doi.org/10.3390/ijerph18189770 - 16 Sep 2021

Cited by 24 | Viewed by 3839

Abstract

Background: The Olympic preparation of athletes has been highly influenced by COVID and post-COVID syndrome. As the complex screening of athletes is essential for safe and successful sports, we aimed to repeat the 2019-year sports cardiology screening of the Olympic Swim Team before [...] Read more.

Background: The Olympic preparation of athletes has been highly influenced by COVID and post-COVID syndrome. As the complex screening of athletes is essential for safe and successful sports, we aimed to repeat the 2019-year sports cardiology screening of the Olympic Swim Team before the Olympics and to compare the results of COVID and non-COVID athletes. Methods: Patient history, electrocardiogram, laboratory tests, body composition analysis, echocardiography, cardiopulmonary exercise test (CPET) were performed. We used time-ranking points to compare swimming performance. Results: From April 2019, we examined 46 elite swimmers (24 ± 4 years). Fourteen swimmers had COVID infection; all cases were mild. During CPET there was no difference in the performance of COVID (male: VO₂ max 55 ± 4 vs. 56.5 ± 5 mL/kg/min, p = 0.53; female: VO₂ max 54.6 ± 4 vs. 56 ± 5.5 mL/kg/min, p = 0.86) vs. non-COVID athletes (male VO₂ max 56.7 ± 5 vs. 55.5 ± 4.5 mL/kg/min, p = 0.50; female 49.6 ± 3 vs. 50.7 ± 2.6 mL/kg/min, p = 0.47) between 2019 and 2021. When comparing the time results of the National Championships, 54.8% of the athletes showed an improvement (p = 0.75). Conclusions: COVID infection with short-term detraining did not affect the performance of well-trained swimmers. According to our results, the COVID pandemic did not impair the effectiveness of the preparation for the Tokyo Olympics. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 365 KiB

Open AccessArticle

The Mediating Role of Resilience in the Relationship between Perceived Stress and Mental Health

by Mariela Loreto Lara-Cabrera, Moisés Betancort, C. Amparo Muñoz-Rubilar, Natalia Rodríguez Novo and Carlos De las Cuevas

Int. J. Environ. Res. Public Health 2021, 18(18), 9762; https://doi.org/10.3390/ijerph18189762 - 16 Sep 2021

Cited by 35 | Viewed by 5795

Abstract

The COVID-19 pandemic has created great uncertainty around the world, and due to the pandemic, nurses have been exposed to an increase in highly stressful clinical situations. This study examines the relationships between perceived stress and emotional disorders among nurses who have provided [...] Read more.

The COVID-19 pandemic has created great uncertainty around the world, and due to the pandemic, nurses have been exposed to an increase in highly stressful clinical situations. This study examines the relationships between perceived stress and emotional disorders among nurses who have provided direct patient care during the COVID-19 pandemic and explores the mediating role of resilience in these relationships. In an online cross-sectional design, we asked Spanish nurses (N = 214) to complete self-reported scales, and we performed correlation and mediation analyses between perceived stress (Perceived Stress Scale, PSS-4), resilience (Wagnild Resilience Scale, RS-14), wellbeing (World Health Organization Wellbeing Index, five items, WHO-5), anxiety (PHQ-2) and depression (GAD-2). The nurses self-reported moderate levels of perceived stress, considerable psychological distress and high resilience. We found resilience to be significantly negatively correlated with the reported levels of perceived stress, anxiety and depression (p < 0.001). The mediating analysis revealed that resilience played a protective role in the direct relationships of stress with depression, anxiety, and psychological distress. To conclude, our findings supported the hypothesis that resilience mediated the relationship between stress and mental health. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

16 pages, 8682 KiB

Open AccessArticle

Impact Measurement of COVID-19 Lockdown on China’s Electricity-Carbon Nexus

by Mingyue Zhao, Yuqing Niu, Lei Tian, Yizhi Liu and Qiang Zhai

Int. J. Environ. Res. Public Health 2021, 18(18), 9736; https://doi.org/10.3390/ijerph18189736 - 15 Sep 2021

Cited by 1 | Viewed by 2144

Abstract

Lockdown measures to prevent the spread of coronavirus disease 2019 (COVID-19) resulted in the plummeting of China’s overall electric-power demand and production. To date, power generation remains one of the largest carbon dioxide (CO₂) emitting sectors of China on account of [...] Read more.

Lockdown measures to prevent the spread of coronavirus disease 2019 (COVID-19) resulted in the plummeting of China’s overall electric-power demand and production. To date, power generation remains one of the largest carbon dioxide (CO₂) emitting sectors of China on account of its high carbon intensity. Within this context, our study seeks to measure the impacts of COVID-19 lockdown on the electricity-power related carbon footprints on both generation and consumption sides. Built on statistical data of electricity generation and consumption released by the National Bureau of Statistics of China (NBSC), we calculate he nationwide electricity related CO₂ emission changes in regional, economic-sectoral and technological dimensions during January–April 2020, when the strictest lock-down measures were taken in China and compare the results with the same months of the year prior. Our results show that both east and central China power grids witnessed drastic reduction (15.0% and 13.8%) in electricity-generation caused CO₂ emissions; and the biggest falls of provincial-scale electricity-generation CO₂ emission took place in Hubei (27.3%). Among China’s electricity production mix, coal remains the biggest CO₂ emitter and contributed 95.7% of the overall nationwide reduction. The most significant decline of the nationwide consumptive-electricity carbon footprint was by 10.1% in February, with the secondary economic sector the biggest contributor. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 356 KiB

Open AccessArticle

Changes in Substance Use and Mental Health Burden among Women during the Second Wave of COVID-19 in Germany

by Henrike Schecke, Madeleine Fink, Alexander Bäuerle, Eva-Maria Skoda, Adam Schweda, Venja Musche, Hannah Dinse, Benjamin Maurice Weismüller, Sheila Moradian, Norbert Scherbaum and Martin Teufel

Int. J. Environ. Res. Public Health 2021, 18(18), 9728; https://doi.org/10.3390/ijerph18189728 - 15 Sep 2021

Cited by 11 | Viewed by 2738

Abstract

Unlike men, who are disproportionately affected by severe disease progression and mortality from COVID-19, women may be more affected by the economic, social and psychological consequences of the pandemic. Psychological distress and mental health problems are general risk factors for increases in the [...] Read more.

Unlike men, who are disproportionately affected by severe disease progression and mortality from COVID-19, women may be more affected by the economic, social and psychological consequences of the pandemic. Psychological distress and mental health problems are general risk factors for increases in the use of alcohol and other substances as a dysfunctional coping mechanism. Methods: An analysis was carried out of the female subset (n = 2153) of a population-based, cross-sectional online survey (October–December 2020), covering the “second wave” of the COVID-19 pandemic in Germany. Results: Among women, 23% increased their alcohol use, 28.4% increased their nicotine use and 44% increased their illicit substance use during the COVID-19 pandemic. Twenty percent reported major depressive symptoms and 23.4% symptoms of generalized anxiety. Generalized anxiety proved to be a significant predictor of increases in alcohol and nicotine use in logistic regression. Discussion: The mental health burden remained high during the second wave of COVID-19 and alcohol, nicotine and other substance use increased. However, the association between mental health and substance use was weak. Psychological distress does not seem to be the main motivator of substance use. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

14 pages, 4695 KiB

Open AccessArticle

Practical Impact of the COVID-19 Pandemic on Indoor Air Quality and Thermal Comfort in Kindergartens. A Case Study of Slovenia

by Vesna Lovec, Miroslav Premrov and Vesna Žegarac Leskovar

Int. J. Environ. Res. Public Health 2021, 18(18), 9712; https://doi.org/10.3390/ijerph18189712 - 15 Sep 2021

Cited by 12 | Viewed by 2702

Abstract

The experimental monitoring of carbon dioxide concentration was carried out in kindergartens in Slovenia, together with indoor air temperature and relative humidity, before and during the COVID-19 pandemic. The aim of the research was to estimate the practical impact of the pandemic on [...] Read more.

The experimental monitoring of carbon dioxide concentration was carried out in kindergartens in Slovenia, together with indoor air temperature and relative humidity, before and during the COVID-19 pandemic. The aim of the research was to estimate the practical impact of the pandemic on indoor air quality and thermal comfort. The case study sample included buildings with different architectural typology, which are predominantly present in the building stock of Slovenia. The monitoring process lasted for 125 days before and during the COVID-19 pandemic. The results have shown a better indoor air quality in kindergartens during the pandemic, mostly due to ventilation protocols and almost imperceptibly changed indoor air temperature. The COVID-19 pandemic affected air quality in kindergarten classrooms in Slovenia by reducing the average carbon dioxide concentration when children were present in classrooms by 30%. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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18 pages, 9748 KiB

Open AccessArticle

Temporal Geospatial Analysis of COVID-19 Pre-Infection Determinants of Risk in South Carolina

by Tianchu Lyu, Nicole Hair, Nicholas Yell, Zhenlong Li, Shan Qiao, Chen Liang and Xiaoming Li

Int. J. Environ. Res. Public Health 2021, 18(18), 9673; https://doi.org/10.3390/ijerph18189673 - 14 Sep 2021

Cited by 6 | Viewed by 2499

Abstract

Disparities and their geospatial patterns exist in morbidity and mortality of COVID-19 patients. When it comes to the infection rate, there is a dearth of research with respect to the disparity structure, its geospatial characteristics, and the pre-infection determinants of risk (PIDRs). This [...] Read more.

Disparities and their geospatial patterns exist in morbidity and mortality of COVID-19 patients. When it comes to the infection rate, there is a dearth of research with respect to the disparity structure, its geospatial characteristics, and the pre-infection determinants of risk (PIDRs). This work aimed to assess the temporal–geospatial associations between PIDRs and COVID-19 infection at the county level in South Carolina. We used the spatial error model (SEM), spatial lag model (SLM), and conditional autoregressive model (CAR) as global models and the geographically weighted regression model (GWR) as a local model. The data were retrieved from multiple sources including USAFacts, U.S. Census Bureau, and the Population Estimates Program. The percentage of males and the unemployed population were positively associated with geodistributions of COVID-19 infection (p values < 0.05) in global models throughout the time. The percentage of the white population and the obesity rate showed divergent spatial correlations at different times of the pandemic. GWR models fit better than global models, suggesting nonstationary correlations between a region and its neighbors. Characterized by temporal–geospatial patterns, disparities in COVID-19 infection rate and their PIDRs are different from the mortality and morbidity of COVID-19 patients. Our findings suggest the importance of prioritizing different populations and developing tailored interventions at different times of the pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 480 KiB

Open AccessArticle

Compassionate Use of GC5131 (Hyperimmunoglobulin) Therapy in Critically Ill Patients Diagnosed with COVID-19: A Case Series and Review of Literature

by Sunha Choi, Soyoon Hwang and Kitae Kwon

Viruses 2021, 13(9), 1826; https://doi.org/10.3390/v13091826 - 14 Sep 2021

Viewed by 1821

Abstract

Presently, the use of convalescent plasma and hyperimmunoglobulin obtained from individuals who have recovered from coronavirus disease 2019 (COVID-19) has proved to potentially provide passive antibody-based immunity, thereby leading to several clinical trials to develop an immune-based COVID-19 treatment. However, the therapeutic efficacy [...] Read more.

Presently, the use of convalescent plasma and hyperimmunoglobulin obtained from individuals who have recovered from coronavirus disease 2019 (COVID-19) has proved to potentially provide passive antibody-based immunity, thereby leading to several clinical trials to develop an immune-based COVID-19 treatment. However, the therapeutic efficacy of hyperimmunoglobulin in critically ill patients with COVID-19 remains unknown. On 23 October 2020, we first administered GC5131 in a compassionate-use program to critically ill patients at the Kyungpook National University, Chilgok Hospital, Korea. Since then, five more critically ill patients were treated with GC5131 in this compassionate-use program in our hospital up until 17 December 2020. We retrospectively reviewed the clinical responses of six critically ill patients diagnosed with COVID-19 who received the hyperimmunoglobulin concentrate, GC5131, which was produced by the Green Cross Corporation. After the administration of GC5131, five patients died due to an exacerbation of COVID-19 pneumonia. GC5131 was ineffective when administered to critically ill patients with COVID-19. Nevertheless, we propose that to expect a therapeutic effect from GC5131, it should be administered as early as possible to avoid the excessive inflammatory response phase in patients with severe and advanced COVID-19 infection. This step was difficult to achieve in the real world due to the time required for decision making and the process of the compassionate-use program. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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18 pages, 1971 KiB

Open AccessArticle

Pandemic Growth and Benfordness: Empirical Evidence from 176 Countries Worldwide

by Noah Farhadi and Hooshang Lahooti

COVID 2021, 1(1), 366-383; https://doi.org/10.3390/covid1010031 - 13 Sep 2021

Cited by 1 | Viewed by 1973

Abstract

In the battle against the Coronavirus, over 190 territories and countries independently work on one end goal: to stop the pandemic growth. In this context, a tidal wave of data has emerged since the beginning of the COVID-19 crisis. Extant research shows that [...] Read more.

In the battle against the Coronavirus, over 190 territories and countries independently work on one end goal: to stop the pandemic growth. In this context, a tidal wave of data has emerged since the beginning of the COVID-19 crisis. Extant research shows that the pandemic data are partially reliable. Only a small group of nations publishes reliable records on COVID-19 incidents. We collected global data from 176 countries and explored the causal relationship between average growth ratios and progress in the reliability of pandemic data. Furthermore, we replicated and operationalized the results of prior studies regarding the conformity of COVID-19 data to Benford’s law. Our outcomes confirm that the average growth rates of new cases in the first nine months of the Coronavirus pandemic explain improvement or deterioration in Benfordness and thus reliability of COVID-19 data. We found significant evidence for the notion that nonconformity to BL rises by the growth of new cases in the initial phases of outbreaks. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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15 pages, 1012 KiB

Open AccessArticle

Public Protests and the Risk of Novel Coronavirus Disease Hospitalizations: A County-Level Analysis from California

by Linh N. Bui, Rachel L. Berkowitz, Wendy Jilek, Andrew J. Bordner, Kristen M. J. Azar, Alice Pressman and Robert J. Romanelli

Int. J. Environ. Res. Public Health 2021, 18(18), 9481; https://doi.org/10.3390/ijerph18189481 - 08 Sep 2021

Cited by 4 | Viewed by 2648

Abstract

The objective of this study was to assess the relationship between public protests and county-level, novel coronavirus disease (COVID-19) hospitalization rates across California. Publicly available data were included in the analysis from 55 of 58 California state counties (29 March–14 October 2020). Mixed-effects [...] Read more.

The objective of this study was to assess the relationship between public protests and county-level, novel coronavirus disease (COVID-19) hospitalization rates across California. Publicly available data were included in the analysis from 55 of 58 California state counties (29 March–14 October 2020). Mixed-effects negative binomial regression models were used to examine the relationship between daily county-level COVID-19 hospitalizations and two main exposure variables: any vs. no protests and 1 or >1 protest vs. no protests on a given county-day. COVID-19 hospitalizations were used as a proxy for viral transmission since such rates are less sensitive to temporal changes in testing access/availability. Models included covariates for daily county mobility, county-level characteristics, and time trends. Models also included a county-population offset and a two-week lag for the association between exposure and outcome. No significant associations were observed between protest exposures and COVID-19 hospitalization rates among the 55 counties. We did not find evidence to suggest that public protests were associated with COVID-19 hospitalization within California counties. These findings support the notion that protesting during a pandemic may be safe, ostensibly, so long as evidence-based precautionary measures are taken. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 302 KiB

Open AccessArticle

New Nurses’ Experience of Caring for COVID-19 Patients in South Korea

by Eun-Joo Ji and Young-Hee Lee

Int. J. Environ. Res. Public Health 2021, 18(18), 9471; https://doi.org/10.3390/ijerph18189471 - 08 Sep 2021

Cited by 15 | Viewed by 2738

Abstract

The purpose of this study was to explore the experiences of new nurses who took care of COVID-19 patients. For this study, study subjects were conducted with a total of nine new nurses, and data were collected through individual in-depth interviews from September [...] Read more.

The purpose of this study was to explore the experiences of new nurses who took care of COVID-19 patients. For this study, study subjects were conducted with a total of nine new nurses, and data were collected through individual in-depth interviews from September to November 2020. The data were analyzed using the phenomenological analysis method suggested by Colaizzi. New nurses’ experience of caring for COVID-19 patients consisted of three categories. The three categories are “The fear as a new nurse about infectious diseases that they have not experienced”, “Physical and psychological burden in an isolated environment”’, and “Building professional values”. Findings from this study presented vivid experiences of new nurses who took care of COVID-19 patients. This study is meaningful in that it grasped the physical and psychological difficulties of nurses nursing COVID-19 patients, especially the difficulties as a new nurse, and the implications for developing and growing within them. It is expected that it will serve as basic data for the establishment of strategies for infectious education programs for new nurses. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

11 pages, 1359 KiB

Open AccessArticle

Experience of a Neuro-Emergency Expert in the Emergency Department during One Year of the COVID-19 Pandemic

by Yong-Won Jung, Sang-Ook Ha, Jin-Hyouk Kim, Won-Seok Yang and Young-Sun Park

Int. J. Environ. Res. Public Health 2021, 18(18), 9461; https://doi.org/10.3390/ijerph18189461 - 08 Sep 2021

Cited by 2 | Viewed by 2257

Abstract

We aimed to evaluate the overall clinical characteristics of patients treated by a neuro-emergency expert dedicated to the emergency department (ED) as an attending neurologist during the COVID-19 pandemic. We included adult patients who visited the ED between 1 January and 31 December [...] Read more.

We aimed to evaluate the overall clinical characteristics of patients treated by a neuro-emergency expert dedicated to the emergency department (ED) as an attending neurologist during the COVID-19 pandemic. We included adult patients who visited the ED between 1 January and 31 December 2020 and were treated by a neuro-emergency expert. We retrospectively obtained and analyzed the data on patients’ clinical characteristics and outcome. The neuro-emergency expert treated 1155 patients (mean age, 62.9 years). The proportion of aged 18–40 years was the lowest, and the most common modes of arrival were public ambulance (50.6%) and walk-in (42.3%). CT and MRI examinations were performed in 94.4 and 33.1% of cases, respectively. The most frequent complaints were dizziness (31.8%), motor weakness (24.2%), and altered mental status (15.8%). The ED diagnoses were acute ischemic stroke (19.8%), benign paroxysmal positional vertigo (14.2%), vestibular neuritis (9.9%), and seizure (8.8%). The mean length of stay in the ED was 207 min. Of the patients, 55.0% were admitted to the hospital, and 41.8% were discharged for outpatient follow-up. Despite the longer stay and the complexity and difficulty of neurological diseases during the COVID-19 pandemic, the accurate diagnosis and treatment provided by a neuro-emergency expert can be presented as a good model in the ED. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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10 pages, 5390 KiB

Open AccessBrief Report

The Impact of COVID-19 Era on Pulmonary Embolism Patients: Increased Incidence of Hospitalizations and Higher Mortality—What Can Be Done?

by Aura Vîjîiac, Diana Irena Stănciulescu, Alexandru Emil Băetu, Iulia-Adelina Grigore, Denisa Vintilă, Cosmin Cojocaru, Elisabeta Bădilă, Horatiu Moldovan and Alexandru Scafa-Udriște

COVID 2021, 1(1), 357-365; https://doi.org/10.3390/covid1010030 - 07 Sep 2021

Cited by 1 | Viewed by 2077

Abstract

The coronavirus disease outbreak in 2019 (COVID-19) reached devastating pandemic proportions, still representing a challenge for all healthcare workers. Furthermore, the social environment underwent significant changes and healthcare facilities were overwhelmed by COVID-19 patients. The purpose of our study was to compare the [...] Read more.

The coronavirus disease outbreak in 2019 (COVID-19) reached devastating pandemic proportions, still representing a challenge for all healthcare workers. Furthermore, the social environment underwent significant changes and healthcare facilities were overwhelmed by COVID-19 patients. The purpose of our study was to compare the prevalence, characteristics and outcomes of 234 patients presenting with pulmonary embolism diagnosed by computed tomography pulmonary angiography (CTPA) during the COVID-19 pandemic, to patients presenting with PE one year before, aiming to assess differences and similarities between these patients. Or main findings were: patients with PE had worse survival during the pandemic, there was an increased incidence of PE among hospitalizations in our cardiology unit during the COVID-19 pandemic, and patients hospitalized with PE during the pandemic were more likely to be obese, allowing us to infer that weight control can have a positive impact on preventing PE. Future research should establish optimal therapeutic, epidemiological and economical strategies for non-COVID patients, as the pandemic continues to put significant burden on the healthcare systems worldwide. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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18 pages, 2847 KiB

Open AccessArticle

Effective Preventive Strategies to Prevent Secondary Transmission of COVID-19 in Hemodialysis Unit: The First Month of Community Outbreak in Taiwan

by Chun-Yu Chen, Jung-Jr Ye, Ting-Shuo Huang, Chin-Chan Lee, Yih-Ting Chen, Cheng-Kai Hsu, Heng-Jung Hsu, Chiao-Yin Sun, Heng-Chih Pan, Kuo-Su Chen, Hao-Hsi Kao, Chia-Chun Ko, Yun-Hsuan She, Chun-Ying Wu, Chi-Chun Lai, Shang-Jyh Hwang and I-Wen Wu

Healthcare 2021, 9(9), 1173; https://doi.org/10.3390/healthcare9091173 - 07 Sep 2021

Cited by 5 | Viewed by 2356

Abstract

Background: Dialyzed patients are vulnerable to coronavirus infection disease 2019 (COVID-19). The incidence and outcome of COVID-19 in hemodialysis (HD) patients in Taiwan remain unclear. A series of preventive measures were executed to combat COVID-19 transmission among HD patients. Methods: We carried out [...] Read more.

Background: Dialyzed patients are vulnerable to coronavirus infection disease 2019 (COVID-19). The incidence and outcome of COVID-19 in hemodialysis (HD) patients in Taiwan remain unclear. A series of preventive measures were executed to combat COVID-19 transmission among HD patients. Methods: We carried out a series of forward-looking and practical preventive strategies of COVID-19 control in our HD center. Incidences of COVID-19 of our HD unit were compared with those of national and local estimates from a community outbreak from 15 May to 30 June 2021. Prognostic factors associated with mortality were analyzed. Results: The national incidence of COVID-19 was 0.062%; being highest in Taipei City (0.173%), followed by New Taipei City (0.161%) and Keelung (0.083%). The overall incidence in Keelung HD patients was 0.666%. One patient of our HD center contracted COVID-19 from the household; however, we have contained secondary transmission in our HD center by implementing strict preventive measures. The mortality rate of HD patients in Keelung was 66.6%. The median Ct value of HD patients was 17.53 (11.75–27.90) upon diagnosis. The deceased patients had a higher cardiac/thoracic ratio than alive (0.61 vs. 0.55, p = 0.036). Conclusions: Taking aggressive and proactive infection preventive measures impedes the secondary transmission of COVID-19 in HD facilities. COVID-19-associated mortality was high in HD patients, being the high cardiac-thoracic ratio, an important prognostic factor for clinical outcome of infected HD patients. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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21 pages, 4786 KiB

Open AccessArticle

Influencing Factors of Environmental Risk Perception during the COVID-19 Epidemic in China

by Jingfei Zhang, Zhicheng Zheng, Lijun Zhang, Yaochen Qin, Jieran Duan and Anyi Zhang

Int. J. Environ. Res. Public Health 2021, 18(17), 9375; https://doi.org/10.3390/ijerph18179375 - 05 Sep 2021

Cited by 13 | Viewed by 3286

Abstract

The spread of COVID-19 is having a serious impact on socioeconomic development, and increased environmental risk perception (ERP). ERP provide new ideas for the orderly recovery of society. However, there have been studies that often pay attention to individual factors, and less concerned [...] Read more.

The spread of COVID-19 is having a serious impact on socioeconomic development, and increased environmental risk perception (ERP). ERP provide new ideas for the orderly recovery of society. However, there have been studies that often pay attention to individual factors, and less concerned about the external environment. In fact, ERP will be affected by the external environment and individual factors. We used a Python script to collect 65,277 valid Weibo comments during the COVID-19 epidemic in China to assess urban residents’ environmental risk perception (ERP). SnowNLP emotion analysis was used to measure the ERP of 366 urban in China, and the structural proportion characteristics and spatial-temporal differentiation of ERP were analyzed. Then, an order logistic regression model was used to investigate the relationship between economic level, social security, medical facilities and ERP. The study investigated the Chinese cities have a higher ERP during the COVID-19 period, and it shows marked fluctuations. As COVID-19 spreads, the ERP shows a distribution pattern of “high in the southeast and low in the northwest” with Hu line as the boundary and “from high to low” with Wuhan as the high value center. COVID-19 serves as catalysts for ERP, the impact of COVID-19 is enhanced after socioeconomic factors are considered. The economic level effectively regulates ERP, except the stage of accelerating diffusion. ERP is effectively stabilized by social security and medical facilities. After considering all the variables simultaneously, we found that the mitigation effect of social security and medical facilities on ERP has improved. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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8 pages, 1373 KiB

Open AccessCommunication

A Simple and Fast Method to Sequence the Full-Length Spike Gene for SARS-CoV-2 Variant Identification from Patient Samples

by Patricia Recordon-Pinson, Marie-Lise Blondot, Pantxika Bellecave, Marie-Edith Lafon, Camille Tumiotto, Mathieu Métifiot and Marie-Line Andreola

COVID 2021, 1(1), 337-344; https://doi.org/10.3390/covid1010028 - 03 Sep 2021

Cited by 5 | Viewed by 3898

Abstract

Since the beginning of the pandemic, a race has been underway to detect SARS-CoV-2 virus infection (PCR screening, serological diagnostic kits), treat patients (drug repurposing, standard care) and develop a vaccine. After almost a year of active circulation worldwide, SARS-CoV-2 variants have appeared [...] Read more.

Since the beginning of the pandemic, a race has been underway to detect SARS-CoV-2 virus infection (PCR screening, serological diagnostic kits), treat patients (drug repurposing, standard care) and develop a vaccine. After almost a year of active circulation worldwide, SARS-CoV-2 variants have appeared in different countries. Those variants include mutations in multiple regions of the genome, particularly in the spike gene. Because this surface protein is a key player in both the spread of the virus and the efficacy of vaccine strategies, the challenge is to efficiently monitor the appearance of spike mutations in the population. The present work describes a procedure based on the widely available Sanger technology to produce a full-length sequence of the spike gene from patient-derived samples. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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17 pages, 2311 KiB

Open AccessReview

Evaluation of the Effectiveness of Employers and H&S Services in Relation to the COVID-19 System in Polish Manufacturing Companies

by Joanna Bartnicka, Patrycja Kabiesz, Dorota Palka, Paulina Gajewska, Ejaz Ul Islam and Damian Szymanek

Int. J. Environ. Res. Public Health 2021, 18(17), 9302; https://doi.org/10.3390/ijerph18179302 - 03 Sep 2021

Cited by 6 | Viewed by 2347

Abstract

With the advent of the COVID-19 pandemic, companies had to adapt quickly to survive in the market. During this time, employers played a key role, along with employees involved in Occupational Health and Safety (OHS) activities, as they were responsible for implementing the [...] Read more.

With the advent of the COVID-19 pandemic, companies had to adapt quickly to survive in the market. During this time, employers played a key role, along with employees involved in Occupational Health and Safety (OHS) activities, as they were responsible for implementing the recommendations of the European Commission. There is no unambiguous definition of OHS in Polish legislation. It is assumed that it is a set of rules defining the manner of performing work, and above all, a method of providing employees with working conditions so that their performance is safe and hygienic. Responsibility for the health and safety in the workplace is imposed on the employer by the legislature. Thus, effective health and safety training is an essential element of the success of any properly operating company. In the literature, no studies have been identified that evaluate the effectiveness of actions during the COVID-19 outbreak. The aim of the article is to present the actions of Polish employers along with their effectiveness assessment related to the protection of employees during the COVID-19 outbreak. The article presents a proposal for conducting remote OHS (Occupational Health and Safety) training using the platform Moodle. The created course was implemented during OHS training conducted in a selected manufacturing company. At its end, an evaluation of the course was carried out, and the collected opinions of training participants allowed the formulation of interesting conclusions, which became the contribution of this paper. The authors pay special attention to three main points of the work. The first is the form of training, which gives the possibility to conduct training at a distance while maintaining its effectiveness. The second important point is the mandatory feedback of the trainees, ensuring the possibility of continuous improvement and quality enhancement of both the program and the form of training. The evaluation was developed on the basis of the extended Kirkpatrick model, which is a completely new approach to OHS training evaluation. The third point emphasized by the authors is the possibility of precise adaptation of the training to other plants and even industries. Therefore, it can be concluded that the course developed by the authors is a very interesting and practical didactic tool with great implementation potential. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 694 KiB

Open AccessArticle

Sort and Sieve: Pre-Triage Screening of Patients with Suspected COVID-19 in the Emergency Department

by Kirsten R.C. Hensgens, Inge H.T. van Rensen, Anita W. Lekx, Frits H.M. van Osch, Lieve H.H. Knarren, Caroline E. Wyers, Joop P. van den Bergh and Dennis G. Barten

Int. J. Environ. Res. Public Health 2021, 18(17), 9271; https://doi.org/10.3390/ijerph18179271 - 02 Sep 2021

Cited by 4 | Viewed by 6095

Abstract

Introduction. To reduce the risk of nosocomial transmission, suspected COVID-19 patients entering the Emergency Department (ED) were assigned to a high-risk (ED) or low-risk (acute medical unit, AMU) area based on symptoms, travel and contact history. The objective of this study was to [...] Read more.

Introduction. To reduce the risk of nosocomial transmission, suspected COVID-19 patients entering the Emergency Department (ED) were assigned to a high-risk (ED) or low-risk (acute medical unit, AMU) area based on symptoms, travel and contact history. The objective of this study was to evaluate the performance of our pre-triage screening method and to analyse the characteristics of initially undetected COVID-19 patients. Methods. This was a retrospective, observational, single centre study. Patients ≥ 18 years visiting the AMU-ED between 17 March and 17 April 2020 were included. Primary outcome was the (correct) number of COVID-19 patients assigned to the AMU or ED. Results. In total, 1287 patients visited the AMU-ED: 525 (40.8%) AMU, 762 (59.2%) ED. Within the ED group, 304 (64.3%) of 473 tested patients were COVID-19 positive, compared to 13 (46.4%) of 28 tested patients in the AMU group. Our pre-triage screening accuracy was 63.7%. Of the 13 COVID-19 patients who were initially assigned to the AMU, all patients were ≥65 years of age and the majority presented with gastro-intestinal or non-specific symptoms. Conclusion. Older COVID-19 patients presenting with non-specific symptoms were more likely to remain undetected. ED screening protocols should therefore also include non-specific symptoms, particularly in older patients. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 1293 KiB

Open AccessArticle

Challenges in Preventive Practices and Risk Communication towards COVID-19: A Cross-Sectional Study in Bangladesh

by Farah Naz Rahman, Md Al Amin Bhuiyan, Kabir Hossen, Hafiz T. A. Khan, AKM Fazlur Rahman and Koustuv Dalal

Int. J. Environ. Res. Public Health 2021, 18(17), 9259; https://doi.org/10.3390/ijerph18179259 - 02 Sep 2021

Cited by 9 | Viewed by 3232

Abstract

Bangladesh recently experienced a COVID-19 second wave, resulting in the highest number of new cases and deaths in a single day. This study aims to identify the challenges for COVID-19 preventive practices and risk communications and associated factors among Bangladeshi adults. A cross-sectional [...] Read more.

Bangladesh recently experienced a COVID-19 second wave, resulting in the highest number of new cases and deaths in a single day. This study aims to identify the challenges for COVID-19 preventive practices and risk communications and associated factors among Bangladeshi adults. A cross-sectional survey was conducted between December 2020 and January 2021 involving 1382 Bangladeshi adults (aged ≥ 18-years) in randomly selected urban and rural areas from all eight divisions in Bangladesh. Descriptive data analysis was conducted to highlight the challenges for preventive practices and risk communications for COVID-19. Multiple logistic regression analysis was used to determine the sociodemographic groups vulnerable to these challenges. Lack of availability of protective equipment (44.4%), crowded living situations/workspaces (36.8%), inadequate information on the proper use of protective measures (21.9%), inadequate handwashing and sanitation facilities (17.6%), and negative influences on family/friends (17.4%) were identified as barriers to COVID-19 preventive practices. It was also found that males (OR = 1.3, 95% CI = 1.01, 1.7), rural residents (OR = 1.5, 95% CI = 1.2, 2), respondents with a low level of education: no schooling vs. ≥higher secondary (OR = 3.5, 95% CI = 2.3, 5.2), primary vs. ≥higher secondary (OR = 2.5, 95% CI = 1.7, 3.8), respondents engaged in agricultural (OR = 1.7, 95% CI = 1.2, 2.4), laboring (OR = 3.2, 95% CI = 2, 5), and domestic works (OR = 1.6, 95% CI = 1.07, 2.5), and people with disabilities (OR = 1.7, 95% CI = 1.1, 2.6) were all likely to have difficulty in practicing effective COVID-19 protective behaviors. Respondents’ education and occupation were significant predictors of inadequate understanding of COVID-19 risk communications and was identified as a problem among 17.4% of the respondents. A substantial percentage of Bangladeshi adults have difficulty practising COVID-19 protective behaviours and have poor comprehension of risk communications, particularly in rural areas and among those with low education. This research can aid policymakers in developing tailored COVID-19 risk communications and mitigation strategies to help prevent future waves of the pandemic. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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9 pages, 882 KiB

Open AccessArticle

Potential Protection of Pre-Existent Antibodies to Human Coronavirus 229E on COVID-19 Severity

by Oscar Guzmán-Martínez, Kathia Guardado, Miguel Varela-Cardoso, Alejandro Trujillo-Rivera, Iván Gómez-Ñañez, María Cristina Ortiz-León, Rafaela Espinosa, Celso Ramos, Julio Isael Pérez-Carreón, Delia Vanesa López-Guerrero, Clara Luz Sampieri, Adrián Baruch Alanís-García, Fausto Rojas-Durán, Roberto Zenteno-Cuevas, Michelle Gutiérrez and Hilda Montero

Int. J. Environ. Res. Public Health 2021, 18(17), 9058; https://doi.org/10.3390/ijerph18179058 - 27 Aug 2021

Cited by 1 | Viewed by 2476

Abstract

The causes of the broad spectrum of severity in COVID-19 are unknown. A protective effect through humoral immunity from previous infections by viruses of the SARS-CoV-2 family could explain a mild form of this disease. This study aimed to address whether the presence [...] Read more.

The causes of the broad spectrum of severity in COVID-19 are unknown. A protective effect through humoral immunity from previous infections by viruses of the SARS-CoV-2 family could explain a mild form of this disease. This study aimed to address whether the presence of antibodies against human seasonal coronaviruses (HCoVs) could prevent severe manifestations of COVID-19. A cross-sectional study was carried out in 165 participants. The presence of pre-existent antibodies against the seasonal HCoV-OC43, HCoV-HKU1, HCoV-229E, and HCoV-NL63 were detected. From all of the seasonal HCoVs studied, it was only found that being seropositive to HCoV-229E presented an association (p = 0.012) with developing mild clinical symptoms of COVID-19 or being asymptomatic. Multinomial regression analysis showed that being seropositive to HCoV-229E is associated with mild or moderate clinical symptoms for COVID-19. Statistical analysis also showed that being female is associated with being asymptomatic for SARS-CoV-2 infection or developing mild COVID-19. A subgroup analysis taking only seropositive to HCoV-229E revealed that females are more likely to develop asymptomatic SARS-CoV-2 infection (OR = 27.242, 95% CI 2.092–354.706, p = 0.012). Our results suggest that previous infections by HCoV-229E could prevent more serious clinical manifestations of COVID-19, but these are not the only variables that influence this event. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 604 KiB

Open AccessArticle

COVID-19 Screening by Anti-SARS-CoV-2 Antibody Seropositivity: Clinical and Epidemiological Characteristics, Comorbidities, and Food Intake Quality

by Gabriela Macedo-Ojeda, José Francisco Muñoz-Valle, Patricia Yokogawa-Teraoka, Andrea Carolina Machado-Sulbarán, María Guadalupe Loza-Rojas, Atziri Citlally García-Arredondo, Rafael Tejeda-Constantini, Alejandra Natali Vega-Magaña, Guillermo González-Estevez, Mariel García-Chagollán, José Sergio Zepeda-Nuño and Jorge Hernández-Bello

Int. J. Environ. Res. Public Health 2021, 18(17), 8995; https://doi.org/10.3390/ijerph18178995 - 26 Aug 2021

Cited by 6 | Viewed by 2358

Abstract

Developing countries have reported lower molecular diagnostic testing levels due to a lack of resources. Therefore, antibody tests represent an alternative to detect exposure to SARS-CoV-2 and analyze possible risk factors. We aimed to describe and compare the clinical-epidemiological characteristics and the quality [...] Read more.

Developing countries have reported lower molecular diagnostic testing levels due to a lack of resources. Therefore, antibody tests represent an alternative to detect exposure to SARS-CoV-2 and analyze possible risk factors. We aimed to describe and compare the clinical-epidemiological characteristics and the quality of food intake in Mexican individuals with a positive or negative test to antibodies against SARS-CoV-2. We carried out antibody tests and applied a survey to 1799 individuals; 42% were positive, and diabetes was more prevalent in these cases (p < 0.01). No differences were identified in the blood type nor influenza vaccination between groups. Coughing, respiratory distress, muscle pain, joint pain, and anosmia were the most prevalent symptoms among seropositive cases (p < 0.0001). Food intake quality was similar in both groups, except for the most consumed type of fat (p = 0.006). In conclusion, this study supports the association of diabetes as a principal risk factor for SARS-CoV-2 infection in the Mexican population. The results do not support previous associations between blood group or influenza vaccination as protective factors against SARS-CoV-2 infection. However, frequent consumption of polyunsaturated fats is highlighted as a new possible associated factor with COVID-19, which more studies should corroborate as with all novel findings. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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21 pages, 1858 KiB

Open AccessArticle

Knowledge, Attitudes, and Practices Related to Dietary Supplementation, before and during the COVID-19 Pandemic: Findings from a Cross-Sectional Survey in the Lebanese Population

by Hala Mohsen, Nour Yazbeck, Ayoub Al-Jawaldeh, Nazih Bou Chahine, Houssein Hamieh, Youmna Mourad, Farouk Skaiki, Hassan Salame, Pascale Salameh and Maha Hoteit

Int. J. Environ. Res. Public Health 2021, 18(16), 8856; https://doi.org/10.3390/ijerph18168856 - 23 Aug 2021

Cited by 36 | Viewed by 5492

Abstract

At the start of 2020, a new coronavirus (COVID-19) invaded the world leading to the death of 3.92 million people. Sadly, to date, no remedy has been discovered for this virus. Preventive vaccines have been under investigation, but were unavailable until December 2020. [...] Read more.

At the start of 2020, a new coronavirus (COVID-19) invaded the world leading to the death of 3.92 million people. Sadly, to date, no remedy has been discovered for this virus. Preventive vaccines have been under investigation, but were unavailable until December 2020. Clinical deficiencies of nutrients may increase susceptibility to infections. This knowledge may have provided an incentive for some dietary supplement (DS) manufacturers to advertise their products as COVID-19 preventatives or cures without any substantiation, targeting mainly social media fans. The objective of this research was to assess the usage, knowledge and attitudes towards dietary supplementation before and during the COVID-19 pandemic among Lebanese people. A cross-sectional study was conducted based on a convenience sample (N = 2966) and information from participants aged 18 years and above was collected about periods before and during the pandemic. Our findings showed that attitudes towards DSs changed when the pandemic emerged and people believed that DSs can improve their health and strengthen their immunity. Despite the rise in DS prescription by healthcare professionals, the prevalence of DS use decreased from 73.3% before the pandemic to 69.9% during the pandemic (p < 0.001). Study results declared that the weekly or the daily estimated intake had increased during the pandemic as compared to before the pandemic, from 14% to 15.6% for antioxidants (p = 0.014), from 35.3% to 42.1% for vitamin C (p < 0.001), from 35.5% to 41% for vitamin D (p < 0.001), from 15.2% to 17.5% for vitamin E (p = 0.002), and from 18.8% to 29.3% for zinc (p < 0.001) and other vitamins and minerals (from 9% to 10.9%, p < 0.001). Binary logistic regression indicated that the use of DSs during the pandemic was 4 times higher among those infected with COVID-19, 30 times higher among those who used to take DSs before pandemic, and 1.5 times higher among those who worked in the medical sector. To conclude, there is a crucial need to increase awareness among Lebanese people regarding the use of DSs. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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13 pages, 2765 KiB

Open AccessSystematic Review

Repurposing Colchicine in Treating Patients with COVID-19: A Systematic Review and Meta-Analysis

by Chi-Hone Lien, Ming-Dar Lee, Shun-Long Weng, Chao-Hsu Lin, Lawrence Yu-Min Liu, Yu-Lin Tai, Wei-Te Lei, Jui-Ming Liu, Ya-Ning Huang, Hsin Chi, Nan-Chang Chiu and Chien-Yu Lin

Life 2021, 11(8), 864; https://doi.org/10.3390/life11080864 - 23 Aug 2021

Cited by 21 | Viewed by 3966

Abstract

Coronavirus disease 2019 (COVID-19) had caused huge health losses worldwide. Several drugs had been applied to treat patients with COVID-19, and repurposing colchicine had been proposed for its anti-inflammatory properties via several pathways. In this systematic review, we evaluated the effects of colchicine [...] Read more.

Coronavirus disease 2019 (COVID-19) had caused huge health losses worldwide. Several drugs had been applied to treat patients with COVID-19, and repurposing colchicine had been proposed for its anti-inflammatory properties via several pathways. In this systematic review, we evaluated the effects of colchicine treatment. From inception to May 31, 2021, databases, including PubMed, EMbase, medRxiv, and Research Square were searched, and 11 studies were enrolled. A total of 17,205 COVID-19 patients with male predominance (62.9%) were analyzed. Patients with colchicine treatment had a significantly lower risk of mortality (odds ratio (OR): 0.57, 95% confidence interval (CI): 0.38–0.87, I²: 72%; p < 0.01) and a non-significantly lower rate of mechanical ventilation (OR: 0.67, 95%CI: 0.39–1.15). The side effects were mild and not significantly different (OR: 2.03, 95%CI: 0.51–8.09). Subgroup analysis with randomized controlled trials showed no statistically significant difference in the mortality (OR: 0.80, 95%CI: 0.44–1.46, I²: 33%; p = 0.22). In conclusion, our meta-analysis found that colchicine treatment was associated with a significantly lower risk of mortality in patients with COVID-19. However, this benefit was not observed in the subgroup analysis of randomized controlled trials. Further randomized controlled studies are required to confirm the potential benefits of colchicine treatment. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 349 KiB

Open AccessArticle

Burnout of Physicians, Pharmacists and Nurses in the Course of the COVID-19 Pandemic: A Serbian Cross-Sectional Questionnaire Study

by Biljana Jakovljevic, Katarina Stojanovic, Tamara Nikolic Turnic and Vladimir Lj. Jakovljevic

Int. J. Environ. Res. Public Health 2021, 18(16), 8728; https://doi.org/10.3390/ijerph18168728 - 18 Aug 2021

Cited by 10 | Viewed by 3103

Abstract

This research was a prospective, cross-sectional observational study of 128 health workers in the central part of the Republic of Serbia. The study surveyed health workers (physicians, pharmacists and nurses) who worked during peaks of the COVID-19 pandemic in the Republic of Serbia [...] Read more.

This research was a prospective, cross-sectional observational study of 128 health workers in the central part of the Republic of Serbia. The study surveyed health workers (physicians, pharmacists and nurses) who worked during peaks of the COVID-19 pandemic in the Republic of Serbia in June and November 2020. The Maslach Burnout Survey for Medical Personnel addresses three scales: (a) emotional exhaustion (EE) measures feelings of being emotionally overextended and exhausted by one’s work; (b) depersonalization (DP) measures an unfeeling and impersonal response toward recipients of one’s service, care treatment, or instruction; and (c) personal accomplishment (PA) measures feelings of competence and successful achievement in one’s work. Linear regression and the chi-square test were used to test a relationship between the input variables (x) and the single output variable (y). We can conclude that most health workers had a high degree of emotional exhaustion, but also a low degree of depersonalization and a high degree of sense of personal achievement. Nurses and physicians had similar answers on the pandemic during their work, but pharmacists had different answers. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

10 pages, 331 KiB

Open AccessArticle

Estimates of COVID-19 Risk Factors among Social Strata and Predictors for a Vulnerability to the Infection

by Dimitra S. Mouliou, Ourania S. Kotsiou and Konstantinos I. Gourgoulianis

Int. J. Environ. Res. Public Health 2021, 18(16), 8701; https://doi.org/10.3390/ijerph18168701 - 18 Aug 2021

Cited by 22 | Viewed by 2633

Abstract

Coronavirus disease 2019 (COVID-19) has emerged as a potentially severe disease, especially for individuals presenting with certain underlying medical conditions. We analyzed the rates of comorbidities and symptoms to reveal the potential severity of the pandemic in Volos, one of the most air-polluted [...] Read more.

Coronavirus disease 2019 (COVID-19) has emerged as a potentially severe disease, especially for individuals presenting with certain underlying medical conditions. We analyzed the rates of comorbidities and symptoms to reveal the potential severity of the pandemic in Volos, one of the most air-polluted cities in Greece. Environmental and health-related predictors for SARS-CoV-2 infection were investigated. A web-based questionnaire was disseminated through social media in the first half of March 2021 during a five-month strict lockdown. Sociodemographic data, preexisting medical conditions, frequency of clinical symptoms, and COVID-19 information were recorded. The study population consisted of 2000 responders. Four-fifths of the participants reported comorbidities that could increase vulnerability to severe COVID-19. Respiratory symptoms were reported from the unemployed and from retirees, and cold-related symptoms were reported in the education sector and in undergraduates. Women and younger generations shaped social vulnerability to respiratory infections similar to the elderly. SARS-CoV-2 infection was reported in 3.7% of the study population. Common headache (OR 2; CI 1189–3013; p = 0.007) and prior pneumonia (OR 1.9; CI 1024–2898; p = 0.04) were significant predictors for susceptibility to SARS-CoV-2 infection. The importance of monitoring society through community-based questionnaires is highlighted, for predicting and preventing future widespread transmission of infectious diseases. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

8 pages, 445 KiB

Open AccessArticle

The Alpha Variant (B.1.1.7) of SARS-CoV-2 in Children: First Experience from 3544 Nucleic Acid Amplification Tests in a Cohort of Children in Germany

by Meike Meyer, Anna Holfter, Esra Ruebsteck, Henning Gruell, Felix Dewald, Robert Walter Koerner, Florian Klein, Clara Lehmann, Christoph Huenseler and Lutz Thorsten Weber

Viruses 2021, 13(8), 1600; https://doi.org/10.3390/v13081600 - 12 Aug 2021

Cited by 20 | Viewed by 2626

Abstract

In May 2021, the Alpha variant (B.1.1.7) of SARS-CoV-2 was found in 91% of the SARS-CoV-2 cases in Germany. Not much is known about the symptoms, courses of disease, and infectiousness in pediatric patients with the Alpha variant. Objective: The aim of this [...] Read more.

In May 2021, the Alpha variant (B.1.1.7) of SARS-CoV-2 was found in 91% of the SARS-CoV-2 cases in Germany. Not much is known about the symptoms, courses of disease, and infectiousness in pediatric patients with the Alpha variant. Objective: The aim of this retrospective analysis was to gain information on the infection with the Alpha variant in children and adolescents. Methods: Between 12 January 2021 and 3 June 2021, all nucleic acid amplification tests (NAATs) of children who received a swab for SARS-CoV-2 were included. Data were collected on standardized questionnaires. The analysis of data was anonymized and retrospective. Results: We investigated 3544 NAATs; 95 children were tested positive (2.7%) for SARS-CoV-2. For the sub-analysis, 65 children were analyzed. In 59 children, the Alpha variant was found (90.8%), and 54.2% (n = 32/59) were symptomatic. The most common symptoms were fever, cough, and rhinitis. The median Ct value was 24.0 (min 17.0; max 32.7). Conclusions: We can underline early findings that children are still less effected by SARS-CoV-2 infection with the spread of the Alpha variant. We found no evidence that children infected with the Alpha variant showed more severe symptoms or suffered from a more severe clinical course than those infected with the wild type. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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12 pages, 967 KiB

Open AccessCommunication

The Positive Rhinovirus/Enterovirus Detection and SARS-CoV-2 Persistence beyond the Acute Infection Phase: An Intra-Household Surveillance Study

by Pedro Brotons, Iolanda Jordan, Quique Bassat, Desiree Henares, Mariona Fernandez de Sevilla, Sara Ajanovic, Alba Redin, Vicky Fumado, Barbara Baro, Joana Claverol, Rosauro Varo, Daniel Cuadras, Jochen Hecht, Irene Barrabeig, Juan Jose Garcia-Garcia, Cristian Launes and Carmen Muñoz-Almagro

Viruses 2021, 13(8), 1598; https://doi.org/10.3390/v13081598 - 12 Aug 2021

Cited by 13 | Viewed by 4284

Abstract

We aimed to assess the duration of nasopharyngeal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA persistence in adults self-confined at home after acute infection; and to identify the associations of SARS-CoV-2 persistence with respiratory virus co-detection and infection transmission. A cross-sectional intra-household [...] Read more.

We aimed to assess the duration of nasopharyngeal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA persistence in adults self-confined at home after acute infection; and to identify the associations of SARS-CoV-2 persistence with respiratory virus co-detection and infection transmission. A cross-sectional intra-household study was conducted in metropolitan Barcelona (Spain) during the time period of April to June 2020. Every adult who was the first family member reported as SARS-CoV-2-positive by reverse transcription polymerase chain reaction (RT-PCR) as well as their household child contacts had nasopharyngeal swabs tested by a targeted SARS-CoV-2 RT-PCR and a multiplex viral respiratory panel after a 15 day minimum time lag. Four-hundred and four households (404 adults and 708 children) were enrolled. SARS-CoV-2 RNA was detected in 137 (33.9%) adults and 84 (11.9%) children. Rhinovirus/Enterovirus (RV/EV) was commonly found (83.3%) in co-infection with SARS-CoV-2 in adults. The mean duration of SARS-CoV-2 RNA presence in adults’ nasopharynx was 52 days (range 26–83 days). The persistence of SARS-CoV-2 was significantly associated with RV/EV co-infection (adjusted odds ratio (aOR) 9.31; 95% CI 2.57–33.80) and SARS-CoV-2 detection in child contacts (aOR 2.08; 95% CI 1.24–3.51). Prolonged nasopharyngeal SARS-CoV-2 RNA persistence beyond the acute infection phase was frequent in adults quarantined at home during the first epidemic wave; which was associated with RV/EV co-infection and could enhance intra-household infection transmission. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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16 pages, 1130 KiB

Open AccessReview

Efficacy of Different Types of Therapy for COVID-19: A Comprehensive Review

by Anna Starshinova, Anna Malkova, Ulia Zinchenko, Dmitry Kudlay, Anzhela Glushkova, Irina Dovgalyk, Piotr Yablonskiy and Yehuda Shoenfeld

Life 2021, 11(8), 753; https://doi.org/10.3390/life11080753 - 27 Jul 2021

Cited by 15 | Viewed by 2428

Abstract

A new coronavirus disease (COVID-19) has already affected millions of people in 213 countries. The possibilities of treatment have been reviewed in recent publications but there are many controversial results and conclusions. An analysis of the studies did not reveal a difference in [...] Read more.

A new coronavirus disease (COVID-19) has already affected millions of people in 213 countries. The possibilities of treatment have been reviewed in recent publications but there are many controversial results and conclusions. An analysis of the studies did not reveal a difference in mortality level between people treated with standard therapy, such as antiviral drugs and dexamethasone, and new antiviral drugs/additional immune therapy. However, most studies describe clinical improvement and a decrease in mortality among patients with severe and critical conditions, with the early initiation of additional immune therapy. Possible new targets based on viral life cycles were considered. Unfortunately, the data analysis on the efficacy of different medicine and therapy regimens among patients with COVID-19, showed little success in decreasing the mortality rate in all treatment methods. Some efficacy has been shown with an immunosuppressive therapy in small patient samples, but when a larger number of patients were analyzed the data did not differ significantly from the control groups. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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6 pages, 551 KiB

Open AccessEditorial

SARS-CoV-2, CT-Values, and Infectivity—Conclusions to Be Drawn from Side Observations

by Martin Platten, Dennis Hoffmann, Roger Grosser, Fabian Wisplinghoff, Hilmar Wisplinghoff, Gerhard Wiesmüller, Oliver Schildgen and Verena Schildgen

Viruses 2021, 13(8), 1459; https://doi.org/10.3390/v13081459 - 27 Jul 2021

Cited by 63 | Viewed by 9142

Abstract

In their recent article published in Viruses, Michel Drancourt and colleagues [...] Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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11 pages, 950 KiB

Open AccessArticle

Seroprevalence of SARS-CoV-2 Binding and Neutralizing Antibodies in Healthcare Workers during the Epidemic Peak in Referral Hospitals and Quarantine Sites: Saudi Arabia

by Rowa Y. Alhabbab, Ahdab Alsaieedi, Abdullah Algaissi, Sara Almahboub, Rajaa M. Al-Raddadi, Omaima I. Shabouni, Rahaf Alhabbab, Abdulelah A. Alfaraj, Sawsan S. Alamri, Najwa D. Aljehani, Rwaa H. Abdulal, Mohamed A. Alfaleh, Turki S. Abujamel, Almohanad A. Alkayyal, Ahmad Bakur Mahmoud, Adel M. Abuzenadah and Anwar M. Hashem

Viruses 2021, 13(7), 1413; https://doi.org/10.3390/v13071413 - 20 Jul 2021

Cited by 15 | Viewed by 2480

Abstract

Healthcare workers (HCWs) are at high risk for SARS-CoV-2 infection compared to the general population. Here, we aimed to evaluate and characterize the SARS-CoV-2 seropositivity rate in randomly collected samples among HCWs from the largest referral hospitals and quarantine sites during the peak [...] Read more.

Healthcare workers (HCWs) are at high risk for SARS-CoV-2 infection compared to the general population. Here, we aimed to evaluate and characterize the SARS-CoV-2 seropositivity rate in randomly collected samples among HCWs from the largest referral hospitals and quarantine sites during the peak of the COVID-19 epidemic in the city of Jeddah, the second largest city in Saudi Arabia, using a cross-sectional analytic study design. Out of 693 participants recruited from 29 June to 10 August 2020, 223 (32.2%, 95% CI: 28.8–35.8) were found to be confirmed seropositive for SARS-CoV-2 antibodies, and among those 197 (88.3%) had never been diagnosed with COVID-19. Seropositivity was not significantly associated with participants reporting COVID-19 compatible symptoms as most seropositive HCW participants 140 (62.8%) were asymptomatic. The large proportion of asymptomatic SARS-CoV-2 cases detected in our study demands periodic testing as a general hospital policy. Full article

(This article belongs to the Topic Burden of COVID-19 in Different Countries)

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