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The aim of the current study was to explore elite athletes' experiences of the COVID-19 pandemic and its impact on both growth and well-being. Informed by two complementary theoretical models, this research focused on elite athletes' potential to experience growth. Five elite athletes completed the Stress-Related Growth Scale–Revised and underwent semistructured interviews to develop a narrative of their experiences. Through a thematic analysis, we articulated elite athletes' experiences of both illusory and real adversarial growth following the COVID-19 pandemic. Four themes illustrated their experiences: the COVID-19 experience, searching for positives, self-transformation, and the social impact. A fifth theme, well-being, was integral throughout, involving the continued protection and development of athlete well-being. Future research recommendations and implications include further exploration of adversarial growth experiences after the pandemic and long-term effects of the pandemic on elite athletes, the creation of an adversarial growth measure, and engagement with this research to inform support measures to decrease the impact of adversity on elite athletes' well-being. [ABSTRACT FROM AUTHOR]

The COVID-19 epidemic has increased its impact on a global scale and created the pandemic process, causing a change in the dynamics of urban life. On the basis of urban life dynamics, the effect of the city-space relationship of the COVID-19 pandemic has gained importance. In this context, the differences in green space usage experiences and habits before and after the Covid-19 pandemic process were examined with a questionnaire applied to 240 people, and the survey results were evaluated with the chi-square statistical method. As a result of the evaluation, it has been revealed that green areas have gained a new meaning and it is a necessity to include accessibility, functions, classification and user experiences in the urban space in planning studies.With the results of the study, the meaning of the effects of the COVID-19 pandemic in the planning studies at the point of creating resilient cities and how to evaluate this meaning within the framework of its application and the points that need attention are examined. Objectives are set in terms of using the results obtained with this study as a resource in planning studies, increasing the quality of urban life and achieving the goals of creating resilient cities. [ABSTRACT FROM AUTHOR]

This study follows up with librarians with chronic conditions who completed a survey about their work lives in early 2020, before the COVID-19 pandemic. Participants shared their experiences with health management, remote working, and the return to workplace during and after the pandemic. Results show that remote work generally made managing a chronic condition easier. 44% did not feel safe returning to the physical workplace, however, 57% felt at least somewhat supported by their employer. 71% believed that their employers had modified their views about remote work, an important accommodation request of many with chronic illnesses. [ABSTRACT FROM AUTHOR]

This paper explores the ontological politics and practices of handwashing using hot tap water during the COVID-19 pandemic in Sweden through attending to how handwashing was performed, what thoughts and emotions handwashing practices evoked, and reflections about why these thoughts and emotions emerged. In analyses based on written diaries, stories, digital photos, and videos from the private sphere of the home, we show how the concepts of humans, non-humans, childhood, economy, ethics, infrastructure, and nature – together with public health organizations' promotions of handwashing recommendations – are enacted and woven into the fabric of hot tap water use. Hot tap water emerged as an ambiguous commodity, differently shaped depending on past experiences and how messages from authorities were received. The politics of the seemingly mundane activity of washing hands (especially prior to the COVID-19 pandemic) consists of connectivities and relationships between various phenomena in fluid space, and blurs the boundaries between local and global, past and present. Thrifty handwashing practices previously established in the private sphere were challenged during the COVID-19 pandemic, as popular versions of surgical scrubbing were promoted. These versions were sometimes challenged when the inclusion of hot water was questioned at home and in public debate. [ABSTRACT FROM AUTHOR]

Background: Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV2, first detected in China in 2019. This disease causes respiratory infections and significantly impacts global health. Purpose: This study aims to analyze the risk factors for mortality in COVID-19 patients at Universitas Airlangga Hospital in 2021. Methods: This observational analytical study uses a case-control design, including 168 samples with 64 cases and 64 controls. Secondary data from patient medical records at Universitas Airlangga Hospital, including age, gender, education, comorbidities, oxygen saturation, and length of stay. Chi-square tests analyzed the data with a 95% confidence level (a=5%). Results: The analysis revealed significant associations between COVID-19 mortality and several factors. Age (p=0.01; OR=3.24; 95%CI=1.57-6.65), gender (p=0.01; OR=2.2; 95%CI=1.17-4.02), education (p=0.00; OR=2.40; 95%CI=1.11-5.40), comorbidities (p=0.08; OR=2.50; 95%CI=1.26-4.91), and oxygen saturation (p=0.00; OR=5.40; 95%CI=117.10-2490.06) were significantly associated with COVID-19 mortality. Oxygen saturation was the most influential factor (p=0.00; OR=901.73; 95%CI=120.75-6733.48) associated with mortality. Conclusion: Age, gender, education, comorbidities, and oxygen saturation significantly affect COVID-19 mortality rates. This study highlights the importance of monitoring and managing these risk factors in managing COVID-19 at Universitas Airlangga Hospital. [ABSTRACT FROM AUTHOR]

COVID-19 pneumonia has increased tracheal complications because it increases the need for mechanical ventilation and causes mucosal damage in the airway mucosa. One of these complications is subglottic stenosis. Four patients who developed subglottic stenosis following the COVID-19 infection were examined and referred to the ear, nose, and throat clinic between June 2020 and June 2022. All the patients included in our study were male and 57,75± 14.38 years old on average. The median intubation time was 15.75±7.8 days. All patients received laser surgery with balloon dilatation treatment. The median number of laser surgery with balloon dilatation treatments was 2.25±0.95. We used laser surgery and balloon dilatation as an effective and safe treatment method in our patients to treat subglottic stenosis resulting from the damage caused by COVID-19 pneumonia in the airway mucosa. [ABSTRACT FROM AUTHOR]

Long COVID comprises persistent symptoms that extend beyond four weeks post-SARS-CoV-2 infection. The potential association between long COVID and the endorsement of COVID-19 conspiracy theories has not been explored, particularly in Arab countries, where high endorsement of these theories has been reported. This study aimed to explore the association between endorsing COVID-19 conspiracy theories and the prevalence of self-reported long COVID symptoms among adults in Jordan and Kuwait in addition to other Arab countries. The study employed a cross-sectional design using Computer-Assisted Web Interviewing (CAWI), conducted in Arabic. Recruitment utilized convenience-based snowball sampling via social media and the survey was distributed in July 2024. Long COVID manifestations were assessed across ten recognized symptoms, and belief in conspiracy theories was measured using a five-point Likert scale across five items. The final study sample comprised 755 respondents, the majority of whom self-reported a history of confirmed COVID-19 diagnosis at least once (n = 493, 65.2%). The results indicated a neutral average attitude towards COVID-19 conspiracy theories (mean score = 15.18 ± 4.64 out of 30.00). Participants with high COVID-19 conspiracy theories scores were more likely to report high (aOR = 6.85, p < 0.001) or middle long COVID symptoms (aOR = 2.82, p = 0.008) compared to those with lower scores. Additional predictors of higher long COVID reporting included female sex, lower household income, frequent COVID-19 infections, and hospitalizations. The study results revealed a significant correlation between the endorsement of COVID-19 conspiracy theories and a higher frequency and magnitude of long COVID symptom reporting. The findings also highlighted the influence of sociodemographic factors and COVID-19 infection history on long COVID reporting, which suggests that public health strategies should address these factors to mitigate long COVID challenges effectively. [ABSTRACT FROM AUTHOR]

Background: Recovery from SARS CoV-2 infection is expected within 3 months. Long COVID occurs after SARS-CoV-2 when symptoms are present for more than 3 months that are continuous, relapsing and remitting, or progressive. Better understanding of Long COVID illness trajectories could strengthen patient care and support. Methods: We characterized functional impairments, quality of life (QoL), and cognition among patients who recovered from SARS-CoV-2 infection within 3 months (without Long COVID), after 3 months (Recovered Long COVID), or remained symptomatic (Long COVID). Among 7305 patients identified with previous SARS-CoV-2 infection between March 2020 and December 2021, confirmed in the medical record with laboratory test or physician diagnosis, 435 (6%) completed a single self-administered survey between March 2022 and September 2022. Multi-domain QoL and cognitive concerns were evaluated using PROMIS-29 and the Cognitive Change Index-12. Results: Nearly half the participants (47.7%) were surveyed more than 2 years from initial infection (median = 23.3 months; IQR = 18.6, 26.7) and 86.7% were surveyed more than 1 year from infection. A significantly greater proportion of the Long COVID (n = 215) group, (Current and Recovered combined), had moderate-to-severe impairment in all health domains assessed compared to those Without Long COVID (n = 220; all p < 0.05). The Recovered Long COVID group (n = 34) had significantly lower prevalence of fatigue, pain, depression, and physical and social function impairment compared to those with Current Long COVID (n = 181; all p < 0.05). However, compared to patients Without Long COVID, the Recovered Long COVID group had greater prevalences of fatigue, pain (p ≤ 0.06) and subjective cognitive decline (61.8% vs 29.1%; p < 0.01). Multivariate relative risk (RR) regression indicated Long COVID risk was greater for older age groups (RR range 1.46–1.52; all p ≤ 0.05), those without a bachelor's degree (RR = 1.33; 95% CI = 1.03–1.71; p = 0.03), and those with 3 or more comorbidities prior to SARS-CoV-2 infection (RR = 1.45; 95% CI = 1.11–1.90; p < 0.01). Conclusions: Long COVID is associated with long-term subjective cognitive decline and diminished quality of life. Clinically significant cognitive complaints, fatigue, and pain were present even in those who reported they had recovered from Long COVID. These findings have implications for the sustainability of participation in work, education, and social activities. [ABSTRACT FROM AUTHOR]

Background: Long COVID, also known as post-acute sequelae of COVID-19 (PASC), is a poorly understood condition with symptoms across a range of biological domains that often have debilitating consequences. Some have recently suggested that lingering SARS-CoV-2 virus particles in the gut may impede serotonin production and that low serotonin may drive many Long COVID symptoms across a range of biological systems. Therefore, selective serotonin reuptake inhibitors (SSRIs), which increase synaptic serotonin availability, may be used to prevent or treat Long COVID. SSRIs are commonly prescribed for depression, therefore restricting a study sample to only include patients with depression can reduce the concern of confounding by indication. Methods: In an observational sample of electronic health records from patients in the National COVID Cohort Collaborative (N3C) with a COVID-19 diagnosis between September 1, 2021, and December 1, 2022, and a comorbid depressive disorder, the leading indication for SSRI use, we evaluated the relationship between SSRI use during acute COVID-19 and subsequent 12-month risk of Long COVID (defined by ICD-10 code U09.9). We defined SSRI use as a prescription for SSRI medication beginning at least 30 days before acute COVID-19 and not ending before SARS-CoV-2 infection. To minimize bias, we estimated relationships using nonparametric targeted maximum likelihood estimation to aggressively adjust for high-dimensional covariates. Results: We analyzed a sample (n = 302,626) of patients with a diagnosis of a depressive condition before COVID-19 diagnosis, where 100,803 (33%) were using an SSRI. We found that SSRI users had a significantly lower risk of Long COVID compared to nonusers (adjusted causal relative risk 0.92, 95% CI (0.86, 0.99)) and we found a similar relationship comparing new SSRI users (first SSRI prescription 1 to 4 months before acute COVID-19 with no prior history of SSRI use) to nonusers (adjusted causal relative risk 0.89, 95% CI (0.80, 0.98)). Conclusions: These findings suggest that SSRI use during acute COVID-19 may be protective against Long COVID, supporting the hypothesis that serotonin may be a key mechanistic biomarker of Long COVID. [ABSTRACT FROM AUTHOR]

Mortality due to suicide is amongst the largest public health concerns across the world today in Bharat (India). There have been concerns that the COVID-19 pandemic has contributed to worsening mental health outcomes across the world, including in Bharat. Furthermore, long COVID has been proposed to be a major consequence of COVID-19, which can also worsen mental health outcomes. Therefore, our objective in this study was to analyse trends in suicide mortality across Bharat and to compare these trends to changes prior to the COVID-19 pandemic; in addition, we aimed to analyse if long COVID had any role in these changes. It was found that, at a national level, the average annual increase in the suicide rate between 2019 and 2022 was 0.7 per 100,000 people (a 6.41% increase). There was also an average annual rise in suicide rates across 27 states/union territories (out of the 33 that were analysed). States/UTs with the highest annual increases since the start of the COVID-19, despite a decrease from 2018 to 2019, were Tamil Nadu (increased by 2.7; a 15.17% increase) and Telangana (increased by 1.9; a 9.22% increase). Multi-linear regression showed that the annual suicide rate changes were not associated with COVID-19 deaths per 10,000 people (standardized beta coefficient = 0.077; p = 0.605) but were associated with COVID-19 cases per 100 people (standardized beta coefficient = 0.578; p < 0.001). It has been shown that suicide mortality has worsened, and long COVID may have a potential role in this in Bharat. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 )is still spreading widely around the world, and it is estimated that there are more than 760 million confirmed cases of SARS-CoV-2 infection (COVID-19) . Although most of the infected patients can be cured, there are still many patients who experience persistent clinical symptoms such as dizziness, fatigue, weakness, coughing and chest pain, etc. at two to three months or even longer after being infected with SARS-CoV-2. Internationally, this type of discomforts is referred to as long COVID. The emergence of long COVID has brought a new crisis to people’s health, which not only affects the quality of life and work of patients, but also brings great pressure on the health care of the society. Continuously exploring the impact of long COVID and its underlying mechanism, developing health management strategies for long COVID, and better prevention and treatment of long COVID are still the focus of research worldwide. The article introduces the definition of long COVID and reviews recent research progress in its underlying mechanism, common systemic clinical manifestations, risk factors, and health management of long COVID, aiming to provide more ideas for deepening clinicians’ understanding of long COVID. [ABSTRACT FROM AUTHOR]

Background Uncertainty exists regarding the effectiveness of COVID-19 vaccine to prevent postacute sequelae of COVID-19 (PASC) following a breakthrough infection. While most studies based on symptom surveys found an association between preinfection vaccination status and PASC symptoms, studies of medically attended PASC are less common and have reported conflicting findings. Methods In this retrospective cohort of patients with an initial SARS-CoV-2 infection who were continually empaneled for primary care in a large US health system, the electronic health record was queried for preinfection vaccination status, demographics, comorbidity index, and diagnosed conditions. Multivariable logistic regression was used to model the outcome of a medically attended PASC diagnosis within 6 months of SARS-CoV-2 infection. Likelihood ratio tests were used to assess the interaction between vaccination status and prevalent variant at the time of infection and between vaccination status and hospitalization for SARS-CoV-2 infection. Results During the observation period, 6.9% of patients experienced medically attended and diagnosed PASC. A diagnosis of PASC was associated with older age, female sex, hospitalization for the initial infection, and an increased severity-weighted comorbidity index and was inversely associated with infection during the Omicron period. No difference in the development of diagnosed PASC was observed between unvaccinated patients and those vaccinated with either 2 doses of an mRNA vaccine or >2 doses. Conclusions We found no association between vaccination status at the time of infection and development of medically diagnosed PASC. Vaccine remains an important measure to prevent SARS-CoV-2 infection and severity. Further research is needed to identify effective measures to prevent and treat PASC. [ABSTRACT FROM AUTHOR]

While the acute manifestations of infectious diseases are well known, in some individuals, symptoms can either persist or appear after the acute period. Postviral fatigue syndromes are recognized with other viral infections and are described after coronavirus disease 2019 (COVID-19). We have a growing number of individuals with symptoms that persist for weeks, months, and years. Here, we share the evidence regarding the abnormalities associated with postacute sequelae of COVID-19 (PASC) and therapeutics. We describe physiological and biochemical abnormalities seen in individuals reporting PASC. We describe the several evidence-based interventions to offer patients. It is expected that this growing understanding of the mechanisms driving PASC and the benefits seen with certain therapeutics may not only lead to better outcomes for those with PASC but may also have the potential for understanding and treating other postinfectious sequelae. [ABSTRACT FROM AUTHOR]

Host metabolic dysregulation, especially in tryptophan metabolism, is intricately linked to coronavirus disease 2019 (COVID-19) severity and its postacute sequelae (long COVID). People living with human immunodeficiency virus (HIV; PLWH) experience similar metabolic dysregulation and face an increased risk of developing long COVID. However, whether preexisting HIV-associated metabolic dysregulations contribute in predisposing PLWH to severe COVID-19 outcomes remains underexplored. Analyzing prepandemic samples from PLWH with documented postinfection outcomes, we found specific metabolic alterations, including increased tryptophan catabolism, predicting an elevated risk of severe COVID-19 and the incidence of long COVID. These alterations warrant further investigation for their potential prognostic and mechanistic significance in determining COVID-19 complications. [ABSTRACT FROM AUTHOR]

Amid efforts to develop effective treatments for acute COVID-19, there is growing recognition of the need to address long COVID as a key outcome measure. We argue there are 7 compelling reasons to include long COVID measurements in clincal trials investigating acute COVID-19 treatments: (1) Long COVID is not rare. (2) Long COVID is debilitating to individuals and has a high societal cost. (3) Those at high risk of severe COVID-19 are also at higher risk of developing long COVID if they are infected with COVID-19. (4) Treatments for acute COVID-19 may reduce the risk of long COVID. (5) Measures exist to track long COVID. (6) Long COVID considerations are potentially important for acute COVID-19 treatment decision making. (7) Deaths and hospitalizations due to COVID-19 are increasingly rare. While not every trial needs to include assessments of long COVID, it is worth the research burden to include assessments where possible, as this could facilitate the uptake of acute COVID-19 treatments that lessen the societal burden of long COVID. [ABSTRACT FROM AUTHOR]

Summary People with COVID‐19 infection continue to have their symptoms or develop new ones after recovery. This is called long‐COVID syndrome. We aimed to examine the association of general and abdominal obesity with long COVID. This study was conducted using Isfahan COVID Cohort (ICC). Totally 4008 including 3213 hospitalized and 795 non‐hospitalized patients with positive RT‐PCR were included. Body mass index (BMI) and waist circumference (WC) were calculated. BMI >25 kg/m2 and WC >88 cm in women and 102 cm in men were considered generally and abdominally obese, respectively. By using an open‐ended questionnaire, subjects were asked whether they had any new or persistent symptom. Reported symptoms were categorized in three different fields including general, cardiac, and respiratory symptoms. Higher BMI and WC tended to increase general symptoms (odds ratio [OR] for BMI = 1.16, 95 % confidence interval (95% CI): 0.97, 1.38, and OR for WC = 1.14, 95% CI: 0.99, 1.32). Higher BMI significantly increased cardiovascular (OR = 1.38, 95% CI: 1.14, 1.67) and respiratory symptoms (OR = 1.43, 95% CI: 1.15, 1.78). Compared with patients with normal WC, the risk of cardiovascular (OR = 1.44, 95% CI: 1.24, 1.69) and respiratory symptoms was significantly higher in subjects with abdominal obesity (OR = 1.31, 95% CI: 1.10, 1.56). We found that general and abdominal obesity were associated with increased risk of cardiovascular and respiratory symptoms in patients with long‐COVID symptoms. However, only general obesity was associated with increased risk of general symptoms. [ABSTRACT FROM AUTHOR]

Background: In 2020, global spread of the coronavirus pandemic began. Subsequently, various companies compete to develop numerous vaccines which have shown varying side effects. Assessing menstrual abnormalities post covid -19 vaccination can helpunderstand whether the vaccine might influence menstrual health. We aim to assess the menstrual abnormalities after the COVID-19 vaccination among females working at Zagazig University. Methods: A cross-sectional study was conducted in the medical and administrative sectors at Zagazig University. The study included 346 females in the childbearing period from March to September 2023. A semistructured questionnaire was divided into three sections: demographics, COVID-19 vaccination data, and data about the menstrual cycle. Results: The mean age of participants was 36.76 years. Of them, 67.9% worked in the medical field, and 92.5% received the COVID-19 vaccination. About 43% of vaccinated women subjectively identified changes in their menstrual cycle. There is a statistically significant relationship between change in menstruation after COVID-19 vaccination and the presence of minor adverse effects and the number of doses. Receiving two doses of vaccines nonsignificantly increased the risk of menstrual changes by 1.478 folds, while receiving three doses and experiencing minor adverse effects postvaccination significantly independently increased the risk by 2.531 and 1.625 folds, respectively. Conclusions: About forty percent of vaccinated females reported menstrual changes post-vaccination. COVID-19 vaccination had effect on menstrual health which is linked to vaccination doses and immunologic response to vaccine. We recommend implementing screening programs in family health centers, and to limit number of doses to least effective ones. [ABSTRACT FROM AUTHOR]

Objective: COVID-19 vaccination has been related to menstrual irregularities; however, the effect on postmenopausal women is unknown. The aim of this study was to analyze the prevalence of postmenopausal bleeding (PMB) after COVID-19 vaccination. Methods: A retrospective study was conducted in the Department of Gynecology in Hospital del Mar. Consecutive postmenopausal women with data available and endometrial biopsy were included between February 2021 and January 2022. Patients were stratified between COVID-19 vaccinated and unvaccinated groups. PMB after 30 days from last vaccine dose was considered unrelated to vaccine. Endometrial pathology diagnoses were stratified into benign or malignant. Univariable and multivariable of regression analysis on variables potentially associated with PMB was performed. Results: A total of 381 patients were included, 91 in the vaccinated group and 290 in the unvaccinated group. Prevalence of PMB in the vaccinated group was 75.8% compared to 59.0% in the unvaccinated group (p < 0.005). No increase in endometrial malignant pathology was observed among the vaccinated group (p = 0.189). Multivariable analysis that correlates factors associated with PMB suggests COVID-19 vaccine and malignant endometrial biopsy as independent risk variables. Conclusions: A higher prevalence of PMB was associated with COVID-19 vaccine. Endometrial histological results showed no association with COVID-19 vaccination, but endometrial biopsy should be performed for PMB. [ABSTRACT FROM AUTHOR]

Objective: The new type of Coronavirus (SARS-CoV-2) damages cells by using the angiotensin converting enzyme-2 (ACE2) as a receptor to adhere and go through the cell membrane. It is known that some of the endocrine organs express ACE2 and these organs are potential targets for Coronavirus 2019 disease (Covid-19). This study aimed to investigate the effect of Covid-19 on Fluorine-18 fluorodeoxyglucose (18F-FDG) uptake of endocrine system organs. Methods: Sixteen patients who had Covid-19 underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) later, 77 patients who did not have Covid-19 underwent 18F-FDG PET/CT between March 2020-October 2021 were included. SUVmax and SUVmean of the pituitary, thyroid, adrenal gland, pancreas, and testis measured from the PET/CT of the patients who had Covid-19 were compared with SUVmax, and SUVmean measured from the same organs in PET/CT images of the patients who had not Covid-19. Results: Pancreatic mean SUVmax was significantly higher in patients who had Covid-19 than in patients who did not (p= 0.035). Pancreatic mean SUVmean was slightly higher in patients who had Covid-19 than in patients who did not, but this difference was not statistically significant (p= 0.072). No significant difference was found between the SUVmax and SUVmean values of the pituitary gland, thyroid gland, adrenal gland, and testis in patients who had Covid-19 and did not have. Conclusion: It was thought that the pancreas might have been affected in the course of Covid-19 due to the higher mean SUVmean values of the pancreas in patients who had Covid-19. [ABSTRACT FROM AUTHOR]

Introduction: During the Covid-19 pandemic, hospital frontliners faced serious risks of getting infected with the potentially fatal Covid-19 infection and their perception of Covid-19 exposure and depressive symptoms could affect their health and reduce their work quality and their productivity as hospital frontliners. The study aimed to determine the prevalence of depressive symptoms and their association with the perceived risk of exposure to Covid-19 infection. Materials and methods: A cross-sectional study was designed and carried out from May to June 2021. The universal sampling method was applied, and 454 people took part, giving a response rate of 98.7 per cent. Patient Health Questionnaire-9 items were used as a validated self-administered questionnaire, and the data were analysed using the Statistical Package for Social Sciences (SPSS) version 27. Results: Age, female gender, ethnicity, level of education, marital status, and chronic medical ailment had a statistically significant relationship with depressive symptoms. Perceived factors such as difficulty getting the mask (p=0.01), discomfort wearing the mask (p=0.01), and feeling vulnerable to infection after close contact with confirmed/suspected Covid-19 patients (p=0.04) were found to have a statistically significant association with depressive symptoms among the hospital frontliners. In this study, 40.2 percent of hospital frontliners were found with depression symptoms. Conclusion: The prevalence of depression symptoms among hospital frontliners indicates the need for it to be highlighted and measures to be taken accordingly. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to evaluate lung findings using lung ultrasonography (USG) in patients with PCRpositive COVID-19 pneumonia treated in the ward or intensive care unit and to explore the relationship with prolonged COVID-19 symptoms. Methods: This prospective cross-sectional study was conducted at the University Medical Faculty Hospital outpatient clinic from December 2022 to April 2023. It involved 54 adult patients with PCR-positive COVID-19 pneumonia, treated and discharged from the ward or intensive care unit (ICU). Clinical and demographic data, lung ultrasonography results, and prolonged COVID-19 symptoms were recorded. Results: Among the 54 patients, the ICU group had a mean age of 52.84±12.30 years, while the ward group had a mean age of 58.80±11.36 years (P=0.085). Shortness of breath was the most common prolonged symptom in both groups. The ICU group had significantly more right lung B lines than the ward group (P=0.002). Myalgia was more frequent in the ward group (P=0.024). No significant differences were observed in other variables (P>0.05). Prolonged COVID-19 symptoms were interrelated (P<0.05), and the total number of B lines was significantly associated with dyspnea (P=0.023). Conclusions: Our study demonstrated that lung USG is a valuable tool in the assessment of lung injury after COVID-19 and in the management of long-term COVID-19 symptoms. B lines detected by lung USG are significantly associated with the long-term COVID symptom of shortness of breath, and the number of B lines may be an important biomarker in the management of shortness of breath. [ABSTRACT FROM AUTHOR]

Background: Many patients hospitalized for COVID-19 experience long-term health problems, but comprehensive longitudinal data up to 2 years remain limited. We aimed to (1) assess 2-year trajectories of health outcomes, including comparison between intensive care unit (ICU) treated and non-ICU-treated patients, and (2) identify risk factors for prominent health problems post-hospitalization for COVID-19. Methods: The CO-FLOW multicenter prospective cohort study followed adults hospitalized for COVID-19 at 3, 6, 12, and 24 months post-discharge. Measurements included patient-reported outcomes (a.o., recovery, symptoms, fatigue, mental health, sleep quality, return to work, health-related quality of life [HRQoL]), and objective cognitive and physical tests. Additionally, routine follow-up data were collected. Results: 650 patients (median age 60.0 [IQR 53.0–67.0] years; 449/650 [69%] male) surviving hospitalization for COVID-19 were included, of whom 273/650 (42%) received ICU treatment. Overall, outcomes improved over time. Nonetheless, 73% (322/443) of patients had not completely recovered from COVID-19, with memory problems (274/443; 55%), concentration problems (259/443; 52%), and dyspnea (251/493; 51%) among most frequently reported symptoms at 2 years. Moreover, 61% (259/427) had poor sleep quality, 51% (222/433) fatigue, 23% (102/438) cognitive failures, and 30% (65/216) did not fully return to work. Objective outcome measures showed generally good physical recovery. Most outcomes were comparable between ICU- and non-ICU-treated patients at 2 years. However, ICU-treated patients tended to show slower recovery in neurocognitive symptoms, mental health outcomes, and resuming work than non-ICU-treated patients, while showing more improvements in physical outcomes. Particularly, female sex and/or pre-existing pulmonary disease were major risk factors for poorer outcomes. Conclusions: 73% (322/443) of patients had not completely recovered from COVID-19 by 2 years. Despite good physical recovery, long-term neurocognitive complaints, dyspnea, fatigue, and impaired sleep quality persisted. ICU-treated patients showed slower recovery in neurocognitive and mental health outcomes and resumption of work. Tailoring long-term COVID-19 aftercare to individual residual needs is essential. Follow-up is required to monitor further recovery. Trial registration: NL8710, registration date 12-06-2020. [ABSTRACT FROM AUTHOR]

Impaired pulmonary diffusing capacity for carbon monoxide (DLCO) following COVID-19 has been consistently reported among individuals recovering from severe-critical infection. However, most long COVID cases follow non-severe COVID-19. We assessed DLCO among individuals with long COVID recovering from mild to moderate acute illness. A cross-sectional study of adults with long COVID, assessed at a COVID recovery clinic > 3 months following the onset of acute infection, during 2020–2021. Participants subjectively ranked their dyspnea severity based on its impact on their daily living and underwent comprehensive pulmonary function testing (PFT). Clinical correlates for impaired DLCO (defined as < 80%) were assessed using multivariable logistic regression models. A total of 458 individuals, their mean age 45 (SD 16) and 246 (54%) of whom are women, were evaluated at an average of ~ 4 months following acute COVID-19. The most frequent PFT impairment was reduced DLCO, identified among 67 (17%) of the cohort. Clinical correlates of impaired DLCO included women (odds ration [OR] 3.64, 95% confidence interval [CI] 1.78–7.45, p < 0.001), cigarette smoking (OR 2.25, 95% CI 1.14–4.43, p = 0.019), and moderate-severe dyspnea (OR 2.77, 95% CI 1.39–5.50, p = 0.004). BMI inversely correlated with DLCO (OR 0.90, 95% CI 0.85–0.96 per 1 unit, p = 0.002). Impaired DLCO was not uncommon among individuals recovering from mild to moderate COVID-19. Women are at a greater risk, and subjective dyspnea correlated with impaired DLCO. Clinicians can rely on self-reported significant dyspnea to guide further assessment. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to the emergence of acute and chronic post-COVID syndromes, which present diverse clinical manifestations. The underlying pathophysiology of these conditions is not yet fully understood, but genetic instability has been proposed as a potential contributing factor. This study aimed to explore the differential impact of physical and psychological health factors on genetic instability in individuals with acute and chronic post-COVID syndromes. In this study, three groups of subjects were analyzed: a control group, an acute post-COVID group, and a chronic post-COVID group, with a total of 231 participants. The participants were assessed using a questionnaire for long-COVID-19COVID, and female participants reported more symptoms than male participants in areas related to fatigue, memory, mental health, and well-being during the chronic phase. Genetic instability was assessed using the comet assay, and participants' physical and psychological profiles were evaluated. The overall results showed no significant differences in DNA damage, as measured by the comet assay, among the three groups, suggesting that genetic instability, as assessed by this method, may not be a primary driver of the distinct clinical presentations observed in post-COVID syndromes. However, when gender was considered, male participants in the acute long COVID group exhibited higher levels of genetic instability compared to females. Multiple linear regression analysis revealed that gender, age, and waist circumference were significant predictors of DNA damage. Among females in the acute group, sexual health, and eye-related symptoms significantly influenced the increase in DNA damage. These findings indicate the need for further investigation on the gender-specific differences in genetic instability and their potential implications for the pathophysiology of post-COVID syndromes. Exploring alternative markers of genetic instability and the interplay between genetic, inflammatory, and cellular processes could provide valuable insights for the management of these debilitating post-viral sequelae. [ABSTRACT FROM AUTHOR]

With the global introduction and widespread administration of COVID-19 vaccines, there have been emerging reports of associated vasculitis, including leukocytoclastic cutaneous vasculitis (LCV). In this paper, we present a case of a 68-year-old female patient who developed painful purpuric skin lesions on her feet 12 days after administration of the inactivated COVID-19 vaccine BBIBP Cor-V with histopathological confirmation of LCV and no signs of systemic involvement. The case is followed by a comprehensive literature review of documented LCV cases associated with COVID-19 vaccination with overall 39 articles and 48 cases of LCV found in total. In the majority of cases (56.3%) the first symptom occurred after the first dose of the COVID-19 vaccine, with symptoms manifesting within an average of seven days (6.8 ± 4.8) post-vaccination. The adenoviral vaccine Oxford-AstraZeneca (41.7%) and the mRNA vaccine Pfizer-BioNTech (27.1%) were most frequently associated with LCV occurrences. On average, LCV resolved within 2.5 (± 1.5) weeks. The preferred treatment modality were glucocorticoids, used in 70.8% of cases, resulting in a positive outcome in most cases, including our patient. While the safety of a subsequent dose appears favorable based on our review, individual risk–benefit assessment is crucial. This review emphasis the importance of considering COVID-19 vaccination as a potential trigger for the development of cutaneous vasculitis. Despite rare adverse events, the benefits of the COVID-19 vaccination outweigh the risks, highlighting the importance of immunization programs. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionTo examine the association between somatic syndromes and long COVID through a pre-registered cross-sectional survey.United States adults (N = 2872) participated in an online survey detailing health history, including somatic syndrome and long COVID status. Multivariable logistic regression models were used to examine pre-COVID-19 somatic syndromes as a predictor of long COVID, as well as long COVID as a predictor of post-COVID-19 somatic syndromes.Of the 2872 participants, 562 (19.6%) developed long COVID, and 949 (33.0%) reported a prior somatic syndrome. Participants were on average 41.3 years (SD = 18.5), female (51.7%), White (87.7%), and non-Hispanic or Latino/a/x (84.1%). Having a pre-COVID-19 somatic syndrome increased the adjusted odds of long COVID by nearly three times (aOR = 2.80, 95% CI [2.25, 3.49], p < 0.001). Each additional somatic syndrome was significantly associated with increased adjusted odds of long COVID (aOR =   1.61, 95% CI [1.48, 1.76], p < 0.001). Long COVID was significantly associated with the adjusted odds of a post-infection somatic syndrome (aOR =   10.90, 95% CI [8.38, 14.17], p < 0.001).Somatic syndromes and long COVID were associated with each other. [ABSTRACT FROM AUTHOR]

The research note analyzes how states utilized human rights treaty derogations during the COVID-19 pandemic, finding that derogating states generally adhered to time limits on emergency measures and did not violate non-derogable rights. However, derogating states were more likely to implement discriminatory policies, while non-derogating states were less likely to have time limits on emergency measures. The study suggests that derogations were used as intended to combat the spread of disease through temporary suspension of human rights. It also explores the impact of the pandemic on human rights restrictions under the International Covenant on Civil and Political Rights, referencing academic works and UN notifications from countries like Argentina, Azerbaijan, Dominican Republic, and Guatemala, and provides insights for addressing challenges posed by the crisis. [Extracted from the article]

AbstractIndividuals recovering from COVID-19 may experience persistent impairment in verbal memory performance, potentially due to illness-related hippocampal injury. Although verbal memory dysfunction is central to schizophrenia, the interactions between this vulnerability and COVID-19 remain unclear, with no imaging studies addressing the issue to-date. To explore this gap and generate hypotheses for future research, we adopted a multiple case study approach. Two pairs of individuals with an ICD-10 diagnosis of schizophrenia were selected, each consisting of one case with a positive COVID-19 anamnesis and one without. We calculated the Reliable Change Index to estimate the clinical significance of verbal memory performance changes, with annualized change rates in hippocampal volumes assessed against normative data. Compared to their matches, COVID-19 positive cases did not show mutually consistent changes in verbal memory performance: one case experienced a significant decline in verbal memory and learning, while the other showed a general normalization of test scores. Left hippocampal volumes showed a comparatively slowed increase, while the right hippocampi decreased in volume, although these atrophy rates did not exceed those expected in general population samples. Based on these findings, we hypothesize that COVID-19 alone does not lead to verbal memory decline in schizophrenia. Instead, the relationship between the diseases may depend on additional factors. Our case pairs differed in body mass index, systolic blood pressure, sex, phase of illness, and whole grey matter volume trajectories, leading us to hypothesize that these variables represent additional predictors or moderators of this relationship. [ABSTRACT FROM AUTHOR]

As the COVID-19 pandemic began spreading worldwide in late 2019 and early 2020, many vaccine candidates were developed to combat the disease. However, new COVID-19 variants such as Omicron and Delta continue to emerge globally despite advancements in vaccine technology, leaving certain countries and variants more vulnerable than others to future outbreaks of these variants. This research aims to analyze the susceptibility of different countries to a COVID-19 outbreak, present the first visualization of the spread of COVID-19, and predict which countries are at greater risk for future outbreaks of new variants based on various factors. We created interactive maps to understand the pandemic's spread and identify high-risk countries based on their vaccination percentages. Then we employed binary classification, K-nearest neighbors (KNN), and neural network machine learning models to predict each country's risk factor. The risk factor determines whether a country is safe from a new COVID-19 variant based on vaccine percentage and government stringency. The neural network achieved the highest accuracy, classifying countries as high risk or low risk with 94% accuracy. Inspired by the Albert Barabasi model, we graphed connections between countries based on vaccination percentages. These graphs illustrate the correlation between the two countries and better demonstrate how their vaccination rates relate to the probability of a new COVID-19 outbreak. [ABSTRACT FROM AUTHOR]

Gastrointestinal (GI) complications are significant manifestations of COVID-19 and are increasingly being recognized. These complications range from severe acute pancreatitis to colitis, adding complexity to diagnosis and management. A comprehensive database search was conducted using several databases. Our inclusion criteria encompassed studies reporting severe and long-term GI complications of COVID-19. Digestive disorders were categorized into infections, inflammatory conditions, vascular disorders, structural abnormalities, other diagnoses, and undiagnosed conditions. Of the 73 studies that were selected for full-text review, only 24 met our inclusion criteria. The study highlights a broad range of gastrointestinal complications following COVID-19 infection (excluding liver complications, which are examined separately), including inflammatory conditions, such as ulcerative colitis (UC), acute pancreatitis, and multisystem inflammatory syndrome in children (MIS-C). Other GI complications were reported such as vascular disorders, including diverse thrombotic events and structural abnormalities, which ranged from bowel perforations to adhesions. Additionally, undiagnosed conditions like nausea and abdominal pain were prevalent across different studies involving 561 patients. The findings emphasize the substantial impact of COVID-19 on the GI tract. Ongoing research and monitoring are crucial to understanding the long-term effects and developing effective management strategies for these complications. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare workers (HCWs) are constantly on the frontlines, facing the brunt of the COVID 19 pandemic in their personal, professional, and social lives. They are not only the front liners battling this pandemic since the beginning, this pandemic has also taken a toll on the lives of healthcare workers over the past two years. Facing the stress and burnout since the pandemic has begun, currently, during the third wave of the pandemic, there might be an increase in mental health issues among HCWs in this state. The aim of the study is to assess the magnitude of anxiety and depression during the third wave of COVID-19 pandemic among the healthcare workers in a tertiary care hospital in West Bengal. Materials and methods: The observational study was conducted at IPGMER & SSKM Hospital, a tertiary care teaching hospital in Kolkata, West Bengal, over a period of one week from January 19 to January 26, 2022. A cross-sectional rapid survey was conducted using an online questionnaire containing the Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) among HCWs in the hospital using a Google Proforma through various social media groups. A total of 86 HCWs participated over a period of one week. The data was analysed using SPSS 16 software. Descriptive statistics and univariate logistic regression were used. Result: In the present study, it was found that among 86 people, 61 of them were aged between 26-40 years, half of them, i.e., 45 people, were male, and more than one-fifth (22.1%) (n = 86) had moderate to severe anxiety. Most of the participants, i.e., 39 of them (45.3%), had clinical depression ranging from borderline to extreme. No significant association of moderate to severe anxiety and depression and socio-demographic characteristics was noticed, except for the significantly higher preponderance of anxiety in female gender (p value= 0.0001) Anxiety showed a good positive correlation with depression (p value less than 0.001) and all who had severe anxiety was also suffering from either severe or extreme depression. Conclusion: An alarming proportion of anxiety and depression was noticed among HCWs. The prevalence of anxiety and depression (severe grade) among HCWs are 6% and 8% respectively. So awareness regarding their own mental health, preventive therapies, and proper diagnosis and treatment of cases are needed. [ABSTRACT FROM AUTHOR]

Background: Post COVID-19 syndrome or long COVID (LC) is a novel fluctuating condition with a protracted course in some patients. Specialist LC services have been operational in the UK since 2020 and deal with a high caseload of patients. Aims: To evaluate long-term outcomes in patients discharged from a community-based LC specialist service. Methods: A service evaluation study that included patients who were well engaged in the services [completed the standard Patient Reported Outcome Measures (PROMs) and received intervention from clinician(s)] and had been discharged for at least 3 months from the service. They consented to the study and completed standard PROMs: COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), EQ-5D-5L and National Institute for Health and Care Excellence (NICE) criteria for myalgia encephalomyelitis/chronic fatigue syndrome (ME/CFS). Results: Out of 460 patients contacted, 112 (average of 37.6 months since infection and 9.8 months post-discharge) completed the PROMs. Of these, 90.2% patients continued to experience LC symptoms and disability and had not returned to their pre-COVID-19 health status. The average EQ-5D-5L index score was 0.53 (SD 0.29), highlighting a significant disability and that LC had become a long-term condition (LTC) in the majority of patients who responded to the survey. Of these patients, 43% met the criteria for suspected ME/CFS. Conclusions: A proportion of LC patients develop persistent long COVID (PLC) consistent with a LTC and had a significant overlap with ME/CFS. [ABSTRACT FROM AUTHOR]

Long COVID is a chronic and often disabling illness with long-term consequences. Although progress has been made in the clinical characterization of long COVID, no approved treatments exist and disconnects between patients and researchers threaten to hinder future progress. Incorporating patients as active collaborators in long COVID research can bridge the gap and accelerate progress toward treatments and cures. [ABSTRACT FROM AUTHOR]

Long COVID-19 syndrome occurs in 10–20 % of people after a confirmed/probable SARS-COV-2 infection; new symptoms begin within three months of COVID-19 diagnosis and last > 8 weeks. Little is known about risk factors for long COVID, particularly in older people who are at greater risk of COVID complications. Data are from Women's Health Initiative (WHI) postmenopausal women who completed COVID surveys that included questions on whether they had ever been diagnosed with COVID and length and nature of symptoms. Long COVID was classified using standard consensus criteria. Using WHI demographic and health data collected at study enrollment (1993–98) through the present day, machine learning identified the top 20 risk factors for long COVID. These variables were tested in logistic regression models. Of n = 37,280 survey respondents, 1237 (mean age = 83 years) reported a positive COVID-19 test and 425 (30 %) reported long COVID. Symptoms included an array of neurological, cardio-pulmonary, musculoskeletal, and general fatigue, and malaise symptoms. Long COVID risk factors included weight loss, physical and mobility limitations, and specific heath conditions (e.g., history of heart valve procedure, rheumatoid arthritis). Knowledge of risk factors for long COVID may be the first step in understanding the etiology of this complex disease. [ABSTRACT FROM AUTHOR]

During COVID-19 pandemic in Japan, nightclubs were identified as high-risk locations for COVID-19 outbreaks, but an outbreak investigation in this setting is challenging because of the anonymous and opportunistic nature of interactions. The joint rapid response team collected epidemiological data, conducted descriptive epidemiology to determine the characteristics of cases associated with the nightclub, and implemented countermeasures. Polymerase chain reaction (PCR) tests were performed by the Local Institute of Public Health, Kagoshima University, and several commercial laboratories. Between June 15 and July 20, 2020, 121 individuals tested positive for SARS-CoV-2 (59 confirmed and 62 asymptomatic) of whom 8 were nightclub staff who had no travel history of outside Kagoshima, 66 were guests, and 47 were subsequent contacts. The median age was 32 years (interquartile range: 24–43 years). One individual showed severe symptoms but there were no fatal. The epidemic curve showed one peak on June 30 and July 1 with a limited number of cases subsequently. Of the 121 cases, 116 and 5 were in individuals living in and outside Kagoshima Prefecture, respectively. Haplotype network analysis showed 5 genome-wide single-nucleotide variants between the isolates before and during this outbreak. There is a possibility that unidentified guests from outside Kagoshima Prefecture could infect staff who could subsequently spread the virus to guests and other staff, who were mainly a younger population. The rapid outbreak response enabled onward transmission in the community to be minimized. This outbreak investigation could provide insights for effective responses to challenging situations in future pandemic. [ABSTRACT FROM AUTHOR]

Background: Identifying symptom clusters in Long COVID is necessary for developing effective therapies for this diverse condition and improving the quality of life of those affected by this heterogeneous condition. In this study, we aimed to identify and compare symptom clusters at 9 and 12 months after a SARS-CoV-2 positive test and describe each cluster regarding factors at infection. Methods: This is a cross-sectional study with individuals randomly selected from the Portuguese National System of Epidemiological Surveillance (SINAVE) database. Individuals who had a positive RT-PCR SARS-CoV-2 test in August 2022 were contacted to participate in a telephonic interview approximately 9 and 12 months after the test. A hierarchical clustering analysis was performed, using Euclidean distance and Ward's linkage. Clustering was performed in the 35 symptoms reported 9 and 12 months after the SARS-CoV-2 positive test and characterised considering age, sex, pre-existing health conditions and symptoms at time of SARS-CoV-2 infection. Results: 552 individuals were included at 9 months and 458 at 12 months. The median age was 52 years (IQR: 40–64 years) and 59% were female. Hypertension and high cholesterol were the most frequently reported pre-existing health conditions. Memory loss, fatigue or weakness and joint pain were the most frequent symptoms reported 9 and 12 months after the positive test. Four clusters were identified at both times: no or minor symptoms; multi-symptoms; joint pain; and neurocognitive-related symptoms. Clusters remained similar in both times, but, within the neurocognitive cluster, memory loss and concentration issues increased in frequency at 12 months. Multi-symptoms cluster had older people, more females and more pre-existing health conditions at 9 months. However, at 12 months, older people and those with more pre-existing health conditions were in joint pain cluster. Conclusions: Our results suggest that Long COVID is not the same for everyone. In our study, clusters remained similar at 9 and 12 months, except for a slight variation in the frequency of symptoms that composed each cluster. Understanding Long COVID clusters might help identify treatments for this condition. However, further validation of the observed clusters and analysis of its risk factors is needed. [ABSTRACT FROM AUTHOR]

Introduction: In December 2019, COVID-19 emerged in Wuhan, Hubei Province, China, and rapidly spread worldwide. On December 2022, the Chinese government ended the zero-COVID policy, leading to a surge in cases and significantly impacting daily life. IBD patients face heightened infection risks and substantial effects on their quality of life during the pandemic. Methods: This cross-sectional study collected demographic, COVID-19-related, and HRQoL data from 224 IBD patients who had previously received treatment at Nanjing BenQ Medical Center. Participants completed an online survey between January 9, 2023, and January 23, 2023. The SIBDQ was used to assess HRQoL. Statistical analysis was performed using SPSS version 26. Results: The study found that UC patients reported higher HRQoL compared to CD patients (p = 0.037). Patients who perceived themselves as less susceptible to COVID-19 had higher scores (p = 0.006 and p = 0.009). Those whose work or study was unaffected also had higher scores (p < 0.001 and p = 0.002). Additionally, irregular medication adherence was associated with lower HRQoL scores (p = 0.014 and p = 0.007). Multivariate linear regression results showed that IBD patients whose work or study was affected during the COVID-19 pandemic scored lower than those who were not affected (p = 0.038; 95% CI, -7.96 to -0.25). Patients who discontinued IBD medication scored higher than those with irregular medication use (p = 0.020; 95% CI, 1.00 to 10.90). Conclusions: This study highlights the significant impact of the COVID-19 pandemic on the HRQoL of IBD patients. The findings emphasize the need for integrated care addressing both the physical and psychological aspects of IBD. [ABSTRACT FROM AUTHOR]

As is now well-known, COVID-19 is a highly contagious disease, which for some can cause symptoms that last long after initial infection. In 2021, a clinical set of symptoms referred to as long-COVID was identified. For many patients, long-COVID is a confusing and frightening multisystem disease, with the potential for myriad negative psychosocial effects, including significant impacts on employment and mental health, and requiring ongoing care. Research and treatment of long-COVID will be facilitated by a sound measure that addresses aspects of well-being, symptom experiences, and psychosocial impacts among long-COVID patients. The present work addresses this need by presenting the results of the development and preliminary psychometrics for the Long-COVID Well-Being Scale (LCOVID-WBS). In an exploratory factor analysis with a panel of 236 participants, researchers identified four factors: Emotional Strain, Physical Ability Strain, Control of Life, and Overall Evaluation of Health. The nascent measure represents the first step to measuring the impacts of long-COVID. • Long-COVID is a multisystem disease, with negative psychosocial effects • A sound measure of long-COVID is needed • This paper presents the Long-COVID Well-Being Scale (LCOVID-WBS) • Researchers identified four factors: Emotional Strain, Physical Ability Strain, Control of Life, and Overall Evaluation of Health [ABSTRACT FROM AUTHOR]

COVID-19 pandemic brought chemosensory impairment to the forefront of medicine, revealing gaps in the knowledge of pathophysiological mechanisms, true prevalence and preventive/therapeutic alternatives. This is a sub-study of the ORCHESTRA cohort focusing on post-COVID-19 chemosensory symptoms. Risk factors for neurosensorial cluster of post-COVID-19 syndrome (NSc-PCS) were assessed through multivariable analysis. Psychophysical validated tests were applied on a sub-population of 50 patients. Qualitative chemosensory symptoms as well as nasal and oral chemesthesis were evaluated through anamnestic interview and the quality of life through the SF-36 questionnaire. Chemosensory symptoms evolution and olfactory training's outcome were assessed through phone-call interviews. Out of 1187 patients (female, N = 630), 550 (47%) presented NSc-PCS, with a lower risk for older age and monoclonal antibodies treatment, and a higher risk in females (p < 0.001). Out of the 50 patients evaluated with psychophysical tests, 66% showed smell reduction with a qualitative alteration in 50% of hyposmic and 35% of normosmic patients. Hypogeusia was present in 14 (28%) of the patients assessed, with 56% showing a qualitative alteration; 53% of normogeusic patients presented qualitative disorders. NSc-PCS has a complex, fluctuating, multifaceted presentation. Quantifying and characterizing COVID-19-related chemosensory impairment is key to understand underlying mechanisms and to develop preventive and therapeutic treatment. [ABSTRACT FROM AUTHOR]

Summary To investigate the association between symptoms of long‐term effects of coronavirus disease 2019 (long COVID) and sleep problems in a sample population from southern Brazil. This cross‐sectional study used data from the SULcovid‐19 survey, developed in the municipality of Rio Grande, RS, Brazil. The outcome, long COVID, was investigated through the presence of 18 symptoms, and the exposure variable was sleep problems. Poisson regression with robust adjustment for variance was used to estimate crude and adjusted prevalence ratios for the outcome–exposure relationship. Odds ratio was calculated through multinomial regression of the relationship between the number of symptoms of long COVID and sleep problems. Analyses were adjusted for sex, age, marital status, income, body mass index, smoking status, comorbidities, and hospital admission. A total of 2919 adults and older adults were interviewed. The prevalence of long COVID was 48.3% (95% confidence interval [CI] 46.5–50.1%) and sleep problems were reported by 41.2% of the sample (95% CI 39.4–43.0%). Individuals with sleep problems were more likely to exhibit altered sensitivity (prevalence ratio [PR] 3.27; 95% CI 1.96–5.45), nasal congestion (PR 2.75; 95% CI 1.53–4.94), musculoskeletal symptoms (PR 1.75; 95% CI 1.48–2.06), respiratory issues (PR 1.58; 95% CI 1.24–2.01), and one or more symptom of long COVID (PR 1.27; 95% CI 1.15–1.39). Approximately one‐half of the population analysed had long COVID, and four of 10 reported experiencing sleep problems. In addition, the sample tended to have experienced a greater number of symptoms compared with those who reported to sleep well. [ABSTRACT FROM AUTHOR]

BACKGROUND For many patients with post–COVID-19 condition (long COVID), primary care is the first point of interaction with the health care system. In principle, primary care is well situated to manage long COVID. Beyond expressions of disempowerment, however, the patient’s perspective regarding the quality of long COVID care is lacking. Therefore, this study aimed to analyze the expectations and experiences of primary care patients seeking treatment for long COVID. METHODS A phenomenological approach guided this analysis. Using purposive sampling, we conducted semistructured interviews with English-speaking, adult primary care patients describing symptoms of long COVID. We deidentified and transcribed the recorded interviews. Transcripts were analyzed using inductive qualitative content analysis. RESULTS This article reports results from 19 interviews (53% female, mean age = 54 years). Patients expected their primary care practitioners (PCPs) to be knowledgeable about long COVID, attentive to their individual condition, and to engage in collaborative processes for treatment. Patients described 2 areas of experiences. First, interactions with clinicians were perceived as positive when clinicians were honest and validating, and negative when patients felt dismissed or discouraged. Second, patients described challenges navigating the fragmented US health care system when coordinating care, treatment and testing, and payment. CONCLUSION Primary care patients’ experiences seeking care for long COVID are incongruent with their expectations. Patients must overcome barriers at each level of the health care system and are frustrated by the constant challenges. PCPs and other health care professionals might increase congruence with expectations and experiences through listening, validating, and advocating for patients with long COVID. [ABSTRACT FROM AUTHOR]

Vaccination implementation became mandatory after the issuance of Presidential Regulation no. 14 of 2021 concerning amendments to Presidential Regulation no. 99 of 2020 concerning Procurement of Vaccines and Implementation of Vaccinations in the Context of Combating the 2019 Coroiva Virus Dtsease (Covid-19) Pandemic. 14 of 2021 concerning amendments to Presidential Regulation no. 99 of 2020 concerning Procurement of Vaccines and Implementation of Vaccinations in the Context of Overcoming the Covid-19 Pandemic. this is contrary to Law No. 33 of 2014 concerning Halal Produce in Article 4. The results of the research show that the Implementation of Vaccinations is mandatory. Conflict of regulations regarding Vaccine obligations based on Presidential Regulation. In this case the Regulations President No. 14 of 2021 concerning amendments to Presidential Regulation no. 99 of 2020 concerning Procurement of Vaccines and Implementation of Vaccinations in the Context of Handling the 2019 Coroiva Virus Disease (Covid-19) Pandemic, it is the opposite, however, due to the massive spread of the Covid 19 virus plus the declaration of a health emergency, it is based on the principle of Salus populi suprema est where the safety of the people is more important. What is meant in this case is that under the threat of situations and emergencies, the safety of the people must be the most important goal, including if the rule of law must be set aside. [ABSTRACT FROM AUTHOR]

Since the WHO declared COVID-19 a pandemic, prominent social actors and institutions have warned about the threat of misinformation, calling for policy action to address it. However, neither the premises underlying expert claims nor the standards to separate truth from falsehood have been appraised. We conducted a scoping review of the medical and social scientific literature, informed by a critical policy analysis approach, examining what this literature means by misinformation. We searched academic databases and refereed publications, selecting a total of 68 articles for review. Two researchers independently charted the data. Our most salient finding was that verifiability relied largely on the claims of epistemic authorities, albeit only those vetted by the establishment, to the exclusion of independent evidentiary standards or heterodox perspectives. Further, "epistemic authority" did not depend necessarily on subject matter expertise, but largely on a new type of "expertise": in misinformation itself. Finally, policy solutions to the alleged threat that misinformation poses to democracy and human rights called for suppressing unverified information and debate unmanaged by establishment approved experts, in the name of protecting democracy and rights, contrary to democratic practice and respect for human rights. Notably, we identified no pockets of resistance to these dominant meanings and uses. We assessed the implications of our findings for democratic public policy, and for fundamental rights and freedoms. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic underscores the need for accurate prognostic tools to predict patient outcomes. This study evaluates the effectiveness of four prominent COVID-19 prediction scores—PAINT, ISARIC4C, CHIS, and COVID-GRAM—at two critical time points: at admission and seven days post-symptom onset, to assess their utility in predicting mortality among hospitalized patients. Conducted at the Clinical Emergency Hospital Pius Brînzeu in Timișoara, this retrospective analysis included adult patients hospitalized with confirmed SARS-CoV-2 infection. Eligible patients had complete data for the scores at both time points. Statistical analysis involved ROC curves and logistic regression to assess the scores' predictive accuracy for mortality. The study included 215 patients, split into 139 survivors and 76 non-survivors. At admission, the PAINT, ISARIC4C, CHIS, and COVID-GRAM scores significantly differentiated between the survival outcomes (p < 0.0001). The best cutoff values at admission were 6.26 for PAINT, 7.95 for ISARIC4C, 5.58 for CHIS, and 0.63 for COVID-GRAM, corresponding to sensitivities of 85.47%, 80.56%, 88.89%, and 83.33% and specificities of 77.34%, 82.12%, 75.01%, and 78.45%, respectively. By day seven, the cutoff values increased, indicating deteriorating conditions in patients who eventually succumbed to the virus. The hazard ratios at admission for exceeding these cutoffs were significant: PAINT (HR = 3.45), ISARIC4C (HR = 2.89), CHIS (HR = 4.02), and COVID-GRAM (HR = 3.15), highlighting the scores' abilities to predict severe outcomes. One week post symptom onset, these scores' predictive values and corresponding hazard ratios increased, further validating their prognostic significance over time. The evaluated COVID-19 prediction scores robustly predict mortality at admission and become more predictive by the seventh day of symptom onset. These findings support the use of these scores in clinical settings to facilitate early identification and intervention for high-risk patients, potentially improving patient outcomes during the ongoing global health crisis. [ABSTRACT FROM AUTHOR]

Objectives: The objectives were to investigate the clinical characteristics and course of long COVID, defined as the persistence of symptoms at least one month after the onset of COVID-19, in outpatients and to clarify differences in symptoms between SARS CoV-2 mutant strains. Methods: Our observational study in a primary care institution in Japan included 1053 patients with long COVID who visited our outpatient clinic between April 2021 and March 2023. Symptom distribution, performance status, and patient background at the time of the first outpatient visit were compared between infectious strains (Delta and before group and Omicron group). Background factors and symptoms related to time to remission were also analyzed. Results: The severity of COVID-19 in the acute phase was mild, moderate, and severe in 82.2%, 14.9%, and 2.9% in the Delta and before group; and in 97.6%, 1.7%, and 0.4% in the Omicron group, respectively. Vaccination coverage was significantly different between the Delta and before (37.1%) and Omicron groups (73.1%) (p < 0.001), probably due to the period of vaccine unavailability in the former group. Symptoms of fatigue and headache occurred most frequently, irrespective of infectious strain. The mean number of symptoms per patient was significantly higher in the Delta and before group than the Omicron group (3.4 vs. 2.7, p < 0.0001). The median time overall to remission of long COVID was 169 days. Cox hazard model analysis identified female sex, high body mass index, and dyspnea (but not infectious strain) as significant factors prolonging the time to remission (p < 0.05). Conclusions: Differences in the number of symptoms between infectious strains may be related to differences in viral virulence and/or vaccination coverage. However, the clinical course was found to be minimally influenced by the infectious strain. The present results should improve the understanding of prognosis in patients with long COVID from both the clinical and social perspectives. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has significantly spurred the development of deep learning (DL) models for the pathology automatic diagnosis based on CT scan images. However, the assumption about the generalization of the proposed models remains to be assessed and shown for concrete clinical use. In this work, we have investigated the real value of widely used public datasets for the elaboration of DL models that are dedicated to automatic diagnosis of Covid-19 using CT scans. We have collected various international public datasets from 13 countries. Different Convolutional Neural Networks (CNNs) have been trained and their performances carefully assessed. Two evaluations have been conducted: (1) an internal evaluation following a cross-validation procedure, and (2) an external evaluation on real patients coming from new and different sources. The objective is to assess the generalization capabilities considering real-world conditions: different acquisition conditions, devices and configurations. Three families from the most effective CNN models have been selected (ResNet, DenseNet and EfficientNet). These have been fine-tuned, evaluated and used within a training methodology based on transfer learning. The most effective models have been further customized in order to create new models that are dedicated to the task at hand. These models have significantly improved the diagnosis performance. [ABSTRACT FROM AUTHOR]

Introduction: Vaccination is considered as one of the most promising strategies to overcome the COVID-19 pandemic. However, it could be associated with rare but serious complications. In the present study, we aimed to review the clinical course and etiology of post COVID-19 vaccination meningitis. Methods: After a systematic search in PubMed, Scopus, and Web of Sciences online databases as well as Google Scholar, documents were screened and qualified. Then data extraction was performed and the most frequent underlying agent of meningitis was found based on the reported cases. Results: Overall, 35 cases of post COVID-19 vaccination meningitis from 33 articles were included in the review. Among them, 12 cases had proven viral diagnosis and 23 of them were reported to be vaccine-induced. The most frequent viral pathogen among the cases was VZV. The most prevalent symptom was headache, and the most common time of appearance symptoms was one week after vaccination. Conclusion: Overall, our study suggested meningitis as a critical but not devastating complication of COVID-19 vaccination. Almost all patients responded well to common agents used to manage viral or vaccine-induced meningitis. It is recommended to monitor patients with a history of chickenpox after COVID-19 vaccination regarding the development of meningitis. [ABSTRACT FROM AUTHOR]

The long-term effects of SARS-CoV-2 infection, and their determinants, are still unknown. This study aimed to assess symptoms one year after admission for COVID-19, according to the organ/system involved, and to identify factors. Cross-sectional study with retrospective data collection from March 2020 to February 2021. Inclusion criteria: aged ≥ 18 years and admitted for COVID-19. Exclusion criteria: death, not localized, refusal to participate, cognitive impairment or language barrier. A telephone survey was conducted on long COVID-related symptoms one year after hospital discharge. n = 486. The most frequent symptom groups were neurological (n = 225; 46.3%) and respiratory (n = 201; 41.4%). Multivariable analysis showed that a history of anxiety was significantly associated with psychiatric symptoms (ORa = 2.04, 95%CI = 1.02–4.06), fibromyalgia/chronic fatigue with general symptoms (ORa = 11.59, 95%CI = 1.47–9.34) and obesity with respiratory (ORa 1.90, 95%CI = 1.27–2.83) and musculoskeletal symptoms (ORa 1.96, 95%CI = 1.30–2.96). Male sex was associated with a significantly lower risk of neurological (ORa 0.64, 95%CI = 0.44–0.93), respiratory (ORa 0.45, 95%CI = 0.31–0.67), general (ORa 0.43, 95%CI = 0.29–0.63), psychiatric (ORa 0.34, 95%CI = 0.22–0.51), musculoskeletal (ORa 0.47, 95%CI = 0.32–0.70), dermatological (ORa 0.24, 95%CI = 0.14–0.42) and digestive (ORa 0.38, 95%CI = 0.20–0.73) symptoms. Advanced age (≥ 71 years) also had a protective effect against general (ORa 0.60, 95%CI = 0.39–0.95), psychiatric (ORa 0.39, 95%CI = 0.23–0.64), and dermatological (ORa 0.47, 95%CI = 0.24–0.92) symptoms. Patients admitted for SARS-CoV-2 infection frequently experience symptoms at one year, especially neurological and respiratory symptoms. Female sex, obesity, a history of anxiety and fibromyalgia/chronic fatigue were independent risk factors for presenting symptoms. Advanced age acted as a protective factor. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has brought significant attention to the respiratory system, with much focus on lung-related disorders. However, the diaphragm, a crucial component of respiratory physiology, has not been adequately studied, especially in the context of long COVID. This review explores the multipotential role of the diaphragm in both respiratory health and disease, emphasizing its involvement in long-term complications following SARS-CoV-2 infection. The diaphragm's fundamental role in respiratory physiology and its impact on balance and posture control, breathing patterns, and autonomic nervous system regulation are discussed. This review examines complications arising from COVID-19, highlighting the diaphragm's involvement in neurological, musculoskeletal, and inflammatory responses. Particular attention is given to the neuroinvasive impact of SARS-CoV-2, the inflammatory response, and the direct viral effects on the diaphragm. The diaphragm's role in long COVID is explored, with a focus on specific symptoms such as voice disorders, pelvic floor dysfunction, and sleep disturbances. Diagnostic challenges, current methods for assessing diaphragmatic dysfunction, and the complexities of differentiating it from other conditions are also explored. This article is the first to comprehensively address diaphragmatic dysfunction resulting from COVID-19 and long COVID across various physiological and pathological aspects, offering a new perspective on its diagnosis and treatment within a multisystem context. [ABSTRACT FROM AUTHOR]

SARS CoV-2 virus (COVID-19) emerged as a highly infectious human pathogen in late 2019. Started in China but rapidly started spreading all over the world and soon became a pandemic. More than seven million deaths have been reported so far that devasted millions of families worldwide. Several drugs, such as hydroxychloroquine, chloroquine, remdesivir, favipiravir and arbidol have undergone some clinical studies since early 2020, but their safety concerns remained a serious issue. However, within an year from late 2019, several successful vaccines were invented to prevent people from the infection. Almost at the same time, two drugs were discovered. These are PAXLOVID™ (nirmatrelvir, ritonavir) from Pfizer and molnupiravir from Merck which were soon approved by the US-FDA, for emergency use in the treatment of COVID-19. But several challenges were soon reported in treatments with these drugs, particularly for those who are immunocompromised or have vaccine immunity and suffering for a long time from the infection (known as long-COVID). Complex issues for treatments of long-COVID patients continue to remain unresolved. Thus, discovery of new drugs to assist treatment for emerging COVID-19 problems is urgently needed. But it is important to note that discovery of new COVID-19 therapeutics, particularly small molecules is not a simple task. However, there are several excellent reviews on attempts for COVID-19 drug discovery including a handful of articles on theoretical approaches towards the goal. This review summarizes the theoretical attempts for discovery of COVID-19 drugs, their challenges and future opportunities along with efforts from the author's lab. [ABSTRACT FROM AUTHOR]