COVID

Introduction: With changes in treatments, precautions, and the virus itself, the continued evaluation of post-COVID-19 patient rehabilitation needs is essential. Methods: Demographics, comorbidities, functional assessments, quality of life, and rehabilitation outcomes for 98 patients admitted to inpatient rehabilitation during New York’s most recent major COVID-19 hospitalization surge were analyzed. Patients were contacted at 6 months to evaluate functional improvement, post-COVID-19 symptoms, vaccination status, and quality of life. Results: Inpatient rehabilitation addressed significant limitations in lung capacity, mobility, and self-care. Median mobility scores improved significantly from admission (16) to discharge (34) and follow-up (42). Sixty-six percent of patients reported overall quality of life improvement during their rehabilitation stay; at follow-up, a more modest percentage (35%) reported additional gains. Continued improvement in supplemental oxygen use was observed in 49% of patients who completed the follow-up assessment. Consistent with previous studies on severe disease, post-COVID-19 condition features were exhibited by 86% of patients at follow-up; vaccinated individuals displayed fewer symptoms associated with post-COVID-19 condition than their unvaccinated counterparts. Conclusions: Individuals recovering from severe COVID-19, including previously ventilated patients, made significant functional and quality of life gains during inpatient rehabilitation. While functional independence continued to improve post-discharge, patients exhibited greater improvement from admission to discharge than from discharge to 6-month follow-up. Inpatient rehabilitation represents a crucial component for recovery from severe COVID-19. Full article

False positive reactive plasmin reagin (RPR) reactivity following a COVID-19 vaccine has been reported, and it is therefore conceivable that individuals who receive frequent coronavirus disease 2019 (COVID-19) vaccinations may exhibit durable RPR responses. Here, we sought to investigate the extent to which repeated mRNA COVID-19 vaccines can elicit chronic false RPR reactivity in a longitudinal cohort. Participants (n = 119) in an IRB-approved (#20201026), longitudinal SARS-CoV-2 cohort study were screened for RPR reactivity via manual RPR card assays. Samples with reactive results underwent additional testing, including follow-on RPR screening at additional timepoints, confirmatory fluorescent treponemal antibody (FTA-ABS) testing and anti-nuclear antibody (ANA) testing. Medical histories were collected. We observed (n = 2) screen-positive RPR results (1.7% [2/119]) following booster vaccination, for which two individuals exhibited chronic, vaccine-induced RPR reactivity for up to 9 months following booster vaccination. Both participants were ANA-negative. It is imperative for clinicians to be mindful of the potential immunologic interference of COVID-19 vaccines with standard infectious disease assays, including RPR testing. Detailed medical histories and clinical contexts, including recent vaccination, should be reviewed prior to proceeding with distressing and invasive workups. Full article

The emergence of novel pathogens is a well-known epidemiological risk; however, the unexpected emergence of a truly novel coronavirus-mediated pandemic due to SARS-CoV-2 underscored the significance of understanding this contagion. The pandemic, due to novel coronavirus, termed COVID-19, caused unprecedented social, economic, and educational disruptions on a scale never seen before. In addition to social protocols, safe, effective, and affordable vaccines were developed within months, the cornerstone of the mitigation of this pandemic. We present an overview of the evolution of the pandemic from a historical perspective and describe its biology and behavior, especially the immunological aspects of the disease. We further provide an overview of therapeutics, treatment, and vaccine development to mitigate SARS-CoV-2. It is critical to understand the transmission mechanism of the disease to control and mitigate its progression. We describe cohort studies to identify secondary and tertiary syndromes. The transmission characteristics help its diagnosis and detection. During the pandemic, a lot of emphasis was placed on personal protection equipment. It is now concluded that the virus particles are spread by aerosol dispersion. While the recommended distance may not have been sufficient, the use of personal protective equipment and social distancing was helpful in close-quarters environments. Such protocols, in conjunction with safe and effective vaccines and personal hygiene, are among the safe practices. While we learn from our experience, this review provides a holistic overview of the pandemic and encapsulates the event in a historical context. In doing so, we hope to understand the SARS-CoV-2 virus and take sufficient precautionary measures to mitigate consequences during any subsequent similar pandemics. In addition to a wide-spectrum automated analytics system introduced by the authors earlier, we propose the use of artificial intelligence in conjunction with data analytics to minimize the risk of speculatively diagnosing agents incorrectly by employing a novel concept of cloud-based presumptive diagnosis. Full article

This paper examines the subjective realities of female students in higher education as they navigated their well-being and active lives during the COVID-19 pandemic. Drawing upon Merleau-Ponty’s phenomenological framework, which confronts an often-neglected dimension of our experience—the lived body and the phenomenal world—we aim to inform the development of targeted support and interventions to address the specific needs of female students, in future pandemic times. By exploring how three female students studying sport and recreation in higher education perceived their experiences, this article seeks to shed light on the unique challenges faced by these women in maintaining physical activity, coping with isolation and a change in social networks, and managing their mental health in the context of the pandemic. Understanding these subjective realities (such as isolation, restricted physical activity, and loss of social connections) and interpreting the three students’ lived habitats, their bodily responsiveness, and their spontaneity ensures that their experience is heard, and appropriate future support can be given. Full article

This prospective study sought to characterise the educational experiences, mental health, and behavioural functioning of Australian children with a pre-existing learning difficulty or specific learning disorder (SLD) during the COVID-19 pandemic. The study also evaluated the potential role of parent psychological distress as a risk factor for poorer child functioning in this high-risk population. Using a prospective longitudinal design, the study involved 58 parents of children and adolescents with a pre-existing learning difficulty or specific learning disorder (M age = 11.9 years; range 7–17 years) who were initially referred to a state-wide diagnostic centre for specific learning disorders in Melbourne, Victoria, Australia. Child outcomes were assessed using the COVID-19 Wellbeing and Mental Health Survey (a modified version of the CoRonavIruS Health Impact Survey [CRISIS] tool), the Strengths and Difficulties Questionnaire (SDQ), and the Emotional Distress Scale from the Patient-Reported Outcomes Measurement Information System (PROMIS). Parents’ mental health was assessed using the CRISIS tool and the Kessler Psychological Distress Scale (K10). In keeping with initial predictions, a large proportion of parents expressed significant disruption to child educational experience and routines, including challenges related to child engagement in remote learning platforms during COVID-19. Compared to pre-pandemic mental health symptom ratings, children experienced significantly higher symptoms of worry, negative thoughts, loneliness, agitation, and aggression during the pandemic period (all p < 0.05). As expected, higher levels of parent distress predicted greater child worry symptoms (p = 0.003) and more frequent child behavioural difficulties (p = 0.004). These results help elucidate the specific psychological and educational challenges faced by children with pre-existing learning difficulty or SLD during the COVID-19 pandemic. Family-centred intervention and/or supports may help to address the unique educational and psychological needs of young people with pre-existing learning differences and their families during future global pandemics. Full article

Background: When schools reopened for face-to-face classroom instruction following the COVID-19 pandemic, teachers faced many professional challenges. Most studies examining teachers’ psychosocial condition after school reopening predominantly focused on negative aspects of their emotional well-being, leaving a gap in the understanding of the potential positive effects. This study is grounded in the theory of post-traumatic growth, which suggests that growth and development can occur alongside difficulties. Objectives: The purpose of this study was to shed light on the lesser explored associations between resilience, social support, and post-traumatic growth among teachers after the COVID-19 pandemic. It also examined the differences in post-traumatic growth between teachers in special education and those in general education. Methods: The participants in this cross-sectional study were recruited by convenience sampling. A self-report online survey was used to collect data from 208 Israeli teachers during November 2022. Results: Most of the participants (79.4%) reported experiences of post-traumatic growth during the pandemic. The findings revealed that post-traumatic growth exhibited a positive association with social support (r = 0.23, p < 0.001) and resilience (r = 0.18, p < 0.001). The multiple regression model was significant, explaining 14.5% of the variance in post-traumatic growth [F(4.202) = 8.58, p < 0.001]. Finally, special education teachers exhibited higher levels of post-traumatic growth than general education teachers (t = −2.36, p < 0.05). Conclusions: Social support for teachers must be provided during and after traumas caused by crises and pandemics similar to COVID-19. Intervention programs and ongoing training should offer effective tools to help teachers balance their professional and personal lives. Promoting positive changes in teacher well-being must be a priority in the education system. Full article

Almost a year after the declaration of the pandemic due to the SARS-CoV-2 virus which causes the COVID-19 disease and the need to contain the progression and treatment, the promising option was designing an effective and safe vaccine to reach a state of massive immunity. The first vaccine approved was the one produced by Pfizer–BioNTech, and its application started in December 2020. Within days of the first applications, 0.2% of adverse events were reported. Herein, a series of 26 cases with the manifestation of adverse events related to the application of the first dose of the BNT162b2 vaccine from Pfizer–BioNTech in healthcare workers from Mexico. Of these cases, only five patients were classified with a certainty of anaphylaxis; two of them presented seizures, and their management is described individually. After the examination of all the cases, the symptoms were resolved. In Mexico and around the globe, the vaccination process continues, and the report of possible AEFIs is still needed to contribute to the pharmacovigilance of this new vaccine and improve its safety profile. Full article

During COVID-19, self-directed learning, contrasted with standardized learning, became a necessary and promoted learning method in public schools—one potentially supportive of mental health regularly in public schools through the use of online learning. This is important because negative mental health has been classified as a global crisis, with the highest and lowest student achievers recognized as at greatest risk. Therefore, the conditions under which public school students’ mental health has been improved, leading to positive psychosocial outcomes, are relevant. Studies have identified that positive psychosocial outcomes in this regard require self-initiation of students’ self-directed learning. Also necessary is a reduction in the standardized expectations of parents to lead to positive psychosocial outcomes. Unknown is what research identifies the relevance of both self-initiated self-directed online learning and a reduction in parental expectations of standardization. To investigate this, self-directed learning, online learning, mental health, public schools, and COVID-19 were keywords searched following PRISMA guidelines for scoping reviews. The result: few returns considered either factor and those that did reinforce the need for both. The conclusion: self-initiated self-directed online learning supported by public schools and parents should be central in the aim of reducing the mental health crisis in students post COVID-19. Full article

The Coronavirus disease 2019 (COVID-19) has significantly affected kidney transplantation activities around the world, thus resulting in a substantial decrease in both deceased and living transplants. This study presents a COVID-19 overview from the perspective of the Brazilian kidney transplant program by comparing its differences or similarities with the situations observed in other countries. During the first year of the pandemic, there was a 40% reduction in the number of kidney transplants worldwide. A similar scenario was observed in Brazil, which has the world’s largest public transplantation program. Beyond its effect on transplant activity, COVID-19 has influenced the outcomes of prevalent kidney transplant recipients (KTRs) because the prolonged use of immunosuppressive drugs and comorbidities increase the susceptibility of such patients to severe disease and death. In the pre-vaccination era, almost two-thirds of KTRs required hospitalization, more than 20% required dialysis, and one-third was admitted to the intensive care unit. In the pre-vaccination period in Brazil, 15% and 21% of KTRs died within 28 and 90 days of COVID-19 diagnosis, respectively. Although high vaccination coverage rates have altered the COVID-19 landscape in many populations, persistently low immunogenicity rates following sequential vaccination shots and the absence of targeted treatments for severe cases continue to classify KTRs as highly vulnerable, thus warranting significant concern. Full article

Background: The coronavirus disease (COVID) 2019 pandemic has been reported to have resulted in psychological disturbances. The Japanese term “hikikomori” refers to a state of preferring to stay at home. The COVID pandemic provided an opportunity to extend our current understanding of hikikomori by examining the psychological states of individuals who were in this state under lockdown, during which, paradoxically, their condition may have been adaptive. Methods: We administered a questionnaire to examine psychological changes among 600 people with hikikomori traits in Japan. The Hospital Anxiety and Depression Scale (HADS), Subjective Stress Scale, and Stigma Questions for hikikomori were administered retrospectively at three time points. We also collected descriptive data regarding the participants’ coping strategies. Results: The participants’ sense of stigma regarding hikikomori was improved during the pandemic, whereas depression and anxiety worsened. The participants with ‘definite’ hikikomori (they met the diagnostic criteria) reported more severe depression and anxiety than those with ‘possible’ hikikomori. Their coping strategies were adaptive to the pandemic situation. Conclusion: Although the sense of stigma against hikikomori was improved and adaptive strategies were employed, the participants with hikikomori experienced a worsening of depression and anxiety during the COVID lockdowns. The improvement of stigma and the participants’ indoor adaptive coping strategies could not ameliorate the mental state of hikikomori. Therapeutic interventions should be considered in the future for definite hikikomori meeting the criteria. Full article

Background: The COVID-19 pandemic disrupted global healthcare systems, requiring rapid adaptations. This study evaluates the impact on health systems and services in India during the peak of the first wave and its aftermath. It analyses disruptions, adaptive measures, and challenges faced by healthcare providers and seekers to enhance future preparedness. Methods: Primary studies conducted in India exploring the impact of COVID-19 on health services provision, utilisation, availability, and the well-being of providers and seekers were included. Electronic searches were conducted in six databases: PubMed, MEDLINE, Embase, Global Health, CINAHL, and the WHO database on COVID-19. The results were analysed using narrative synthesis. Results and Conclusion: The review examined 38 articles with 22,502 subjects. Health service provision, utilisation, and availability were significantly impacted, particularly in outpatient departments (n = 19) and elective services (n = 16), while emergency services remained sub-optimal (n = 20). Adaptations were made in precautionary measures, protocols, staff allocation, training, personal protective equipment (PPE), infrastructure, and resources. Providers faced mental health challenges including depression, stress (n = 14), fear of infection (n = 9), stigmatisation (n = 5), and financial repercussions (n = 5). Seekers also encountered notable challenges (n = 13). Future preparedness necessitates improved healthcare infrastructure, resource optimisation, and comprehensive protocols. Lessons should inform strategies to mitigate disruptions and prioritise the well-being of providers and seekers in future outbreaks. Full article

The coronavirus disease-2019 (COVID-19) pandemic has had a profound impact on the world, causing loss of life, economic damage, and social disruption. Individuals with chronic kidney disease (CKD) are prone to complications and increased mortality related to COVID-19. Efforts have been made to increase understanding of the effects of COVID-19 in individuals with CKD. This paper aims to gather and discuss the state-of-the-art in the COVID-19 and CKD literature, involving the early history of COVID-19, the immunological aspects of CKD (such as abnormalities in neutrophilicand dendritic cells functions), the mechanisms of kidney injury by SARS-CoV-2 (for example, viral tropism to kidney tissue and direct cytotoxicity), the clinical course of the disease and consequences for CKD individuals (including kidney transplant recipients), and the emerging treatments (such as the use of Remdesivir, nirmatrelvir, and monoclonal neutralizing antibodies) and immunization for the CKD population. Full article

The World Health Organization (WHO)-confirmed pandemic (March 2020) of the new Coronavirus 2 severe acute respiratory syndrome infection (SARS-CoV-2) reported in Wuhan, China, in December 2019 (first reported cases), then spread to Italy and successively around the world. The objective of this study is to evaluate the effectiveness of the restrictions implemented by different governments from a statistical point of view. We quantitatively evaluated how restrictions influenced the temporal evolution of the distribution of the weekly number of hospitalized patients in the intensive care unit (ICU) for different countries that applied different levels of restrictions, which can be summarized with the average stringency index, a synthetic index that represents a metric for quantifying the severity of the restrictions applied. We found that the stringency index is strongly correlated with the distribution skewness, while standard deviation and kurtosis are poorly and moderately influenced. Furthermore, we compared the values of the skewness of the distribution of hospitalized patients during several pre-pandemic influenza outbreaks in Italy (data not available for other countries). Analysis shows that for normal flu, there is a substantial difference in skewness (as much as 70%) in the distribution with respect to the first COVID-19 pandemic outbreak, where social restrictions were applied. This large difference highlights that the restrictions implemented modify the symmetry of the peak of the distribution of the hospitalized patient in the ICU. Therefore, skewness can be used as a valid indicator to assess whether restriction has any effect on pandemic transmission and can be used as a support for decision makers. Full article

In evaluating the effectiveness of COVID-19 control measures, we propose a standardized approach to assess the impact of COVID-19 management on flattening the curve by analyzing the case data of Victoria, Australia. Its capital, Melbourne, is considered the most lock-downed city in the world. We used the daily case data from Victoria and their first time derivative and compared the dates when the six lockdowns were imposed with the start and end of the effective period, i.e., the period between the maximum and minimum acceleration. Lockdowns 1, 2 (Level 4 restrictions), 3, and 4 were found to be implemented too late, as they were expected to come into effect at the end or after the effective phase, and they were therefore ineffective. It was determined that Lockdown 2 (Level 3 restrictions) did not initiate the effective phase, and it was therefore ineffective, too. Lockdown 5 was expected to take effect in the second half of the effective phase, but showed no changes in the acceleration curve, and it was therefore also ineffective. Lockdown 6, implemented well before the effective period, did not flatten the curve, and was thus also found to be ineffective. The mask mandate between Lockdown 2 (Level 3 and 4 restrictions) initiated the effective phase (likely along with Lockdown 2, Level 3 restrictions), and was therefore found to effectively flatten the curve. The temporal relationship between the assumed cause (control measure) and the observed effect (flattening of the curve) is thus a crucial parameter for assessing the effect of control measures. Full article

Located in the center of the largest river basin in the world, the State of Amazonas in Brazil has an extensive network of more than 20 thousand kilometers of navigable waterways, which is the main mode of transportation between localities, both for cargo and passengers. The region is practically disconnected from the rest of the country due to the lack of roads. Thus, the Amazon River network acted as an efficient means of transmission of the new coronavirus (COVID-19), rapidly transforming the region into an epicenter of the pandemic with one of the highest infection rates in Brazil. Despite the adoption of national and state measures to combat new infections, the situation continued to deteriorate for reasons still under investigation. Given this scenario, this work aims to identify possible infection risks in typical passenger vessels used in the Brazilian Amazon. Three case studies of different passenger vessels were considered, discussing possible scenarios that could allow the spread of COVID and proposing some recommendations for infection prevention. It is hoped that this communication will contribute to the dissemination of information related to the typical means of long-distance passenger transport in the Amazon, to the planning of infectious disease prevention strategies on board regional ships and to ensure a sustainable future for the Amazonian population. Furthermore, this research aims to contribute to the sustainable development goals of the United Nations 2030 Agenda on health and well-being. Full article

Background: As vaccination acceptance is dynamic, the current COVID-19 pandemic may have changed maternal perceptions towards childhood vaccination and influenced their decision to vaccinate their children. This study aimed to examine the associations between socio-demographic characteristics and maternal attitudes towards childhood vaccination at the beginning of the COVID-19 pandemic in Cyprus. Methods: A web-based cross-sectional study was conducted between April and June 2020 using a self-administered survey. Adult mothers with at least one child under the age of 18 were included in this study. Results: Overall, 703 mothers were included, with the majority of them strongly agreeing or agreeing that all vaccinations included in the National Vaccination Program should be available to children (89.3%), recognizing the usefulness of vaccines (91.4%) and their ability to provide protection (90%), acknowledging that the benefits of vaccination outweigh potential risks (86.6%), and being aware that some vaccines may cause adverse reactions (84.1%). Socio-demographic factors, particularly marital status, single-parent status, and employment status, have a significant impact on maternal attitudes and perceptions regarding childhood vaccination. Conclusions: Public health policies should be designed to overcome structural and healthcare system barriers specifically related to socio-demographic factors, ensuring effective and comprehensive strategies to improve childhood vaccination uptake. Full article

The COVID-19 pandemic necessitated sensitive, fast, and inexpensive testing for the virus in 2020 prior to the widespread availability of vaccines. Early testing efforts were limited by bottlenecks on reagents, low-throughput testing options, and the slow return of test results. In this paper, we detail the testing pipeline we established at the University of Wisconsin-Madison for rapid, inexpensive, and sensitive surveillance testing for SARS-CoV-2, and we highlight the strengths of the platform that would allow it to be applied to other disease surveillance projects, SARS-CoV-2 variant testing, or future pandemics. This pipeline can be quickly established for further accreditation and clinical application. Full article

Billions of people have been impacted by the SARS-CoV-2 pandemic with over 600 million infections worldwide. Researchers have turned their attention to describing the post-viral phenomenon known commonly as “Long COVID”. While post-viral syndromes have been documented after other viral pandemics, the scale of the SARS-CoV-2 pandemic provides a unique opportunity to study and understand both the epidemiology and pathophysiology of the long COVID syndrome. While the pandemic impacted populations from all continents, there is a significant gap in what is known about long COVID on the sub-Saharan African continent. We review what is known about long COVID and highlight the need for further research within the African population. Full article

The aim of this study was to determine which characteristics of recreational, collegiate, and professional endurance athletes were associated with training changes due to COVID-19 safety restrictions. A Qualtrics survey was distributed to endurance athletes around the world from June 2020 to February 2021. Significant differences between athlete characteristics and changes in training status were determined using a Chi-squared test (significance p < 0.05). Approximately 66% of the 331 endurance athletes changed their training due to restrictions. Significant group differences were found for age, sex, prior coaching status, prior use of a training program, and athlete primary sport compared to the whole sample. Understanding these factors may allow athletes/coaches to approach training in a different way to help minimize or prevent the effects of detraining for a greater portion of athletes should a COVID-19 variant or any other pandemic emerge in the future. Full article