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Abstract 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 Background Long-COVID symptoms remain incompletely defined due to a large heterogeneity in the populations studied, case definitions, and settings of care. The aim of this study was to assess, in patients accessing care for Long-COVID, the profile of symptoms reported, the possible clustering of symptoms and cases, the functional status compared to pre-infection, and the impact on working activity. Methods Multicentre cohort study with a collection of both retrospective and prospective data. Demographics, comorbidities, severity and timing of acute COVID, subjective functional status, working activity and presence of 30 different symptoms were collected using a shortened version of the WHO Post COVID-19 Case Report Form. The impact on working activity was assessed in multivariable logistic regression models. Clustering of symptoms was analysed by hierarchical clustering and the clustering of cases by two-step automatic clustering. Results The study evaluated 1297 individuals (51.5% women) from 30 clinical centres. Men and women had different profiles in terms of comorbidities, vaccination status, severity and timing of acute SARS-CoV-2 infection. Fatigue (55.9%) and dyspnea (47.2%) were the most frequent symptoms. Women reported more symptoms (3.6 vs. 3.1, p

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.

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 Background Ventilation management may differ between COVID–19 ARDS (COVID–ARDS) patients and patients with pre–COVID ARDS (CLASSIC–ARDS); it is uncertain whether associations of ventilation management with outcomes for CLASSIC–ARDS also exist in COVID–ARDS. Methods Individual patient data analysis of COVID–ARDS and CLASSIC–ARDS patients in six observational studies of ventilation, four in the COVID–19 pandemic and two pre–pandemic. Descriptive statistics were used to compare epidemiology and ventilation characteristics. The primary endpoint were key ventilation parameters; other outcomes included mortality and ventilator–free days and alive (VFD–60) at day 60. Results This analysis included 6702 COVID–ARDS patients and 1415 CLASSIC–ARDS patients. COVID–ARDS patients received lower median VT (6.6 [6.0 to 7.4] vs 7.3 [6.4 to 8.5] ml/kg PBW; p

Abstract Background Elevated rates of suicidal behavior were reported during the COVID-19 pandemic. However, information is scarce on patients’ profiles during this period. Studies evoke the potential adverse effects of the mandatory lockdown, but they remain relatively speculative. Methods We monitored fluctuations in suicide attempts (SA) in six European countries. We gathered data, retrospectively for under 18-year-old SA episodes (1 January 2018 to 31 December 2021), through records of psychiatric emergency services. We collected clinical profiles individually. We extracted environmental indicators by month, as provided by Oxford COVID-19 Government Response Tracker (OxCGRT). We used the Pruned Exact Linear Time (PELT) method to identify breakpoints in SA episodes reported for each country, and logistic regressions to estimate changes in patients’ characteristics after the breakpoints. Finally, we used a univariate and multivariate negative binomial model to assess the link between SA and OxCGRT indicators, accounting for the delay (lag) between the interventions and their impact on SA. Results The study comprised 2,833 children and adolescents (mean age = 15.1 years (SD 1.6); M: F sex-ratio = 1:5.4). A significant increase in SA was found either 6 or 10 months after the beginning of the pandemic, varying by country. Patients were more likely to be girls (aOR = 1.77 [1.34; 2.34]) and used SA methods “other than self-poisoning” (aOR = 1.34 [1.05; 1.7]). In the multivariate model, an association was found between SA and the contact tracing indicator with an 11 months delay, and the number of COVID-19 deaths with a 3-months delay. Conclusions Findings confirmed a delayed increase in SA during the COVID-19 pandemic in children and adolescents as well as changes in patients’ profiles. The duration and severity of the pandemic emerged as the strongest predictor in the rise of SA. If faced with a similar pandemic in the future, the gap between the onset of pandemic and the increase in suicide attempts presents an opportunity for prevention.

Purpose: This study aimed to explore how race and the socioeconomic index (SES) of residential zip codes influenced COVID-19 testing rates in St. Louis during the early and peak phases of the pandemic. Method: An ecological study was conducted using COVID-19 testing data from March to November 2020 in St. Louis City, including 16,915 tests from 30 residential zip codes. Geographical mapping identified areas lacking testing, descriptive statistics characterized testing rates by race and SES, and robust linear regression modeled the association between testing rates and race, controlling for SES. Results: The overall testing rate was 303.97 per 10,000 population. Testing rates among Blacks, Whites, American Indians/Alaskan Natives, and Asians were 374.26, 247.77, 360.63, and 242.41 per 10,000, respectively. Higher rates were observed in low- and middle-SES zip codes compared with high-SES areas. Adjusted for SES, testing rates per 10,000 were higher by 125 (1.25%), 448 (4.48%), and 32 (0.32%) among Blacks, American Indians/Alaskan Natives, and Asians compared with Whites. Testing rates decreased by 56 (0.56%) per unit SES improvement. There was statistically significant SES finding and that of the difference between American Indians/Alaskan Natives and Whites. Geographical mapping showed higher rates in the inner core and lower rates in the periphery of St. Louis. Conclusions: Race and SES influence testing rates. Targeted interventions are needed in areas with low testing rates in St. Louis.

Abstract Background Previous retrospective research has shown that maintaining prone positioning (PP) for an average of 40 h is associated with an increase of survival rates in intubated patients with COVID-19-related acute respiratory distress syndrome (ARDS). This study aims to determine whether a cumulative PP duration of more than 32 h during the first 2 days of intensive care unit (ICU) admission is associated with increased survival compared to a cumulative PP duration of 32 h or less. Methods This study is an ancillary analysis from a previous large international observational study involving intubated patients placed in PP in the first 48 h of ICU admission in 149 ICUs across France, Belgium and Switzerland. Given that PP is recommended for a 16-h daily duration, intensive PP was defined as a cumulated duration of more than 32 h during the first 48 h, whereas standard PP was defined as a duration equal to or less than 32 h. Patients were followed-up for 90 days. The primary outcome was mortality at day 60. An Inverse Probability Censoring Weighting (IPCW) Cox model including a target emulation trial method was used to analyze the data. Results Out of 2137 intubated patients, 753 were placed in PP during the first 48 h of ICU admission. The intensive PP group (n = 79) had a median PP duration of 36 h, while standard PP group (n = 674) had a median of 16 h during the first 48 h. Sixty-day mortality rate in the intensive PP group was 39.2% compared to 38.7% in the standard PP group (p = 0.93). Twenty-eight-day and 90-day mortality as well as the ventilator-free days until day 28 were similar in both groups. After IPCW, there was no significant difference in mortality at day 60 between the two-study groups (HR 0.95 [0.52–1.74], p = 0.87 and HR 1.1 [0.77–1.57], p = 0.61 in complete case analysis or in multiple imputation analysis, respectively). Conclusions This secondary analysis of a large multicenter European cohort of intubated patients with ARDS due to COVID-19 found that intensive PP during the first 48 h did not provide a survival benefit compared to standard PP.

Abstract 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

Abstract Nirmatrelvir plus ritonavir received Emergency Use Authorization for treating mild to moderate COVID-19 in high-risk patients. Its efficacy against the Omicron variant of SARS-CoV-2 remains uncertain. This retrospective cohort study assessed the effect of nirmatrelvir–ritonavir in preventing severe disease progression and long COVID symptoms after acute COVID-19 in non-hospitalized adults. SALAMA medical records from Dubai’s COVID-19 healthcare centers between May 22, 2022, and April 30, 2023, were used to identify 7290 eligible patients, 9.6% of whom received nirmatrelvir–ritonavir. Treatment was associated with a notable reduction in COVID-19-related hospitalizations (adjusted hazard ratio [HR] of 0.39; 95% CI, 0.18–0.85) by day 28 of symptom onset. Moreover, nirmatrelvir–ritonavir was associated with fewer long COVID symptoms (adjusted HR of 0.42; 95% CI, 0.19–0.95). This suggests the significant effectiveness of nirmatrelvir–ritonavir against the Omicron variant, reducing both severe and long-term COVID-19 symptoms.

This article presents a literature review on visual impairments in COVID-19 and post-COVID syndrome and their possible pathogenesis. The data on possible cellular targets of SARS-CoV-2 in various damaged eye structures are discussed. The proposed approaches to the treatment of eye disorders in COVID-19 are reviewed. The main attention is given to the recently discovered family of cation channels — the channels with a transient receptor potential, or TRP channels, as possible targets of SARS-CoV-2 action on eye cells. The structure and properties of TRP channels, in particular their ability to act as receptors for temperature, pain and inflammation, and to participate in phototransduction, are examined. TRP channels are shown to be present in the anterior and posterior segments of the eye. The relationships are explored between TRP subfamilies, in particular TRPV1 channels, and various pathologies, such as dry eye syndrome, glaucoma, eye trauma, retinopathy, etc. Evidence is provided for a direct involvement of TRP channels in the pathogenesis of pulmonary pathology in COVID-19, and their role in the pathogenesis of many other diseases, including neuropathic and inflammatory pain, stroke, migraine, neurodegenerative disorders. The currently known pharmacological approaches targeting TRP channels are discussed. The paper highlights the importance of closely monitoring TRP channels activity, particularly TRPV1 ones, in assessing various COVID-19 manifestations, including eye infections.

Abstract Background and objectives Long COVID, characterized by persistent symptoms beyond the acute infection phase, remains poorly characterized in children. Our study aim is to determine if children who exhibit any symptoms/conditions associated with Long COVID after acute COVID-19 infection have higher Emergency Department (ED) utilization compared to those who do not exhibit these symptoms. Methods Data from the HealthJump ambulatory database from the COVID-19 Research Database Consortium was utilized to identify pediatric COVID-19 cases from March 2020 to May 2023. Long COVID cases were defined based on symptoms/conditions occurring 30–180 days after initial COVID diagnosis. Descriptive statistics and multivariable logistic regression models were used to model the relationship between Long COVID and child ED utilization. Results Out of 130,010 children diagnosed with COVID-19, 43,645 (33.6%) exhibited at least one Long COVID symptom/condition. Children with Long COVID symptoms/conditions had 152% higher odds (OR: 2.52, CI: 2.32–2.73) of ED visits, while those with specific symptoms including “chest pain” had 255% higher odds (AOR: 3.55, CI: 2.73–4.54) and “fluid and electrolyte disturbances” had 229% higher odds (AOR: 3.29, CI: 2.23–4.73) compared to those without those symptoms/conditions. Conclusion This study reveals that children with Long COVID symptoms had notably higher odds of ED visits, with chest pain, fluid imbalances, and generalized pain being most closely linked to such visits. This study highlights the burden of Long COVID on ED providers and underscores the importance of improved guidance for managing Long COVID symptoms in children.

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.

Objectives: This study aims to examine the serological and infectious characteristics of the Xokós indigenous community in Brazil, both prior to and following COVID-19 immunization; Methods: Immunofluorescence assays were employed to identify the SARS-CoV-2 viral antigen, while IgM and IgG antibody tests for COVID-19 were utilized to assess the participants’ infectious and serological profiles in July 2020, before the commencement of the COVID-19 vaccination campaign, and in March 2022, during the booster dose vaccination campaign; Results: The majority of participants (n = 22) were female, with an average age of 42.20 years. The most prevalent comorbidity was hypertension (60%; n = 9), followed by hypertension associated with diabetes (20%; n = 3). No statistically significant correlation was found between the timing of vaccination and the levels of antigens or IgM. However, the prevalence of reactive antigens and IgM was 13.3% (n = 4) in the pre-vaccination group and 3.3% (n = 1) in the post-vaccination group. A statistically significant difference in IgG production was observed before and after vaccination (χ2(1) = 39.095, p < 0.01), as well as differences in IgG antibody detection before and after vaccination and in the vaccines used. Participants showed a higher probability of reactive IgG antibodies following vaccination; Conclusions: Our data demonstrate the beneficial effects of vaccination on the indigenous community, highlighting that continued immunization is a crucial step in protecting indigenous health and preventing severe outbreaks and deaths associated with the disease.

Abstract Background Pregnant patients were a significant population to consider during the pandemic, given the impact of SARS-CoV-2 infection on obstetric outcomes. While COVID testing was a central pillar of infection control, it became apparent that a subset of the population declined to test. At the same time, data emerged about pregnant persons also declining testing. Yet, it was unknown why pregnant patients declined tests and if those reasons were similar or different from those of the general population. We conducted this study to explore pregnant patients’ attitudes, access, and utilization of COVID-19 testing to support healthcare for infection prevention management for this unique and medically complex population. Methods We conducted a qualitative study of patients who were currently or recently pregnant during the early stages of the pandemic and received outpatient prenatal care at one of the participating study sites. An interview guide was used to conduct in-depth telephone interviews. Coding was performed using NVivo, and analysis was conducted using Grounded Theory. Results The average age of the participants (N = 37) was 32 (SD 4.21) years. Most were

Introduction: The COVID-19 pandemic has deeply affected Latin American countries, with countless COVID-19 cases and deaths. In countries like Mexico, Brazil, Peru, Colombia and Ecuador, the public health system collapsed and the lack of testing capacity did not allow control of the spread of SARS-CoV-2 during the first year of the COVID-19 pandemic. Moreover, rural and Indigenous communities in these countries, particularly isolated ones like those in the Amazon Basin, were neglected in terms of access to COVID-19 testing and medical aid. Methods: In this study, we retrospectively analyzed the impact of COVID-19 outbreaks among several endangered Amazonian ethnic groups during the first wave of the COVID-19 pandemic in Ecuador. From June to August 2020, 21 Amazonian communities were included in a COVID-19 surveillance led by Indigenous community leaders and non-profit organizations. Results: A total of 853 individuals were tested for SARS-CoV-2 infection by RT-qPCR. A high SARS-CoV-2 infection rate of 54.05% (461 positive individuals) was found. Only one community was COVID-19 free, and the other 20 communities had severe COVID-19 outbreaks with infection rates up to 90%. For the different ethnic groups, the infection rates were 46.0% for Waoranis, 66.15% for Sionas, 49.8% for Kichwas, 54.9% for Kofans and 62.3% for Shuars. Additionally, 29 individuals had SARS-CoV-2 viral load values higher than 108 copies/mL. Conclusion: Our findings confirm that Indigenous communities of Ecuadorian Amazonia were exposed to SARS-CoV-2 community transmission since the early stages of the COVID-19 pandemic, with the potential occurrence of superspreading events. As the COVID-19 national surveillance program was focussed on symptomatic individuals attending hospital facilities, rural and remote Indigenous communities in the Ecuadorian Amazonia, including endangered ethnic minorities, were neglected during the first wave of the COVID-19 pandemic.

Abstract Background There are limited data from sub-Saharan Africa describing the demographic characteristics, clinical features and outcome of patients admitted to public hospitals with severe acute respiratory infections during the COVID-19 pandemic. Methods We conducted a prospective longitudinal hospital-based sentinel surveillance between May 2020 and December 2022 at 16 public hospitals in Kenya. All patients aged above 18 years admitted to adult medical wards in the participating hospitals were included. We collected data on demographic and clinical characteristics, SARS-CoV-2 infection and COVID-19 vaccination status and, admission episode outcomes. We determined COVID-19 vaccine effectiveness (VE) against admission with SARS-CoV-2 positive severe acute respiratory illness (SARI) (i.e., COVID-19) and progression to inpatient mortality among patients admitted with SARI, using a test-negative case control design. Results Of the 52,636 patients included in the study, 17,950 (34.1%) were admitted with SARI. The median age was 50 years. Patients were equally distributed across sexes. Pneumonia was the most common diagnosis at discharge. Hypertension, Human Immunodeficiency Virus (HIV) infection and Diabetes Mellitus were the most common chronic comorbidities. SARS-CoV-2 test results were positive in 2,364 (27.9%) of the 8,471 patients that underwent testing. After adjusting for age, sex and presence of a chronic comorbidity, SARI patients were more likely to progress to inpatient mortality compared to non-SARI patients regardless of their SARS-CoV-2 infection status (adjusted odds ratio (aOR) for SARI and SARS-CoV-2 negative patients 1.22, 95% CI 1.10–1.37; and aOR for SARI and SARS-CoV-2 positive patients 1.32, 95% CI 1.24–1.40). After adjusting for age, sex and presence of a chronic comorbidity, COVID-19 VE against progression to inpatient mortality following admission with SARI for those with a confirmed vaccination status was 0.59 (95% CI 0.27–0.77). Conclusion We have provided a comprehensive description of the demographic and clinical pattern of admissions with SARI in Kenyan hospitals during the COVID-19 pandemic period as well as the COVID-19 VE for these patients. These data were useful in providing situational awareness during the first three years of the pandemic in Kenya and informing national response measures.

Abstract The first two years of the COVID-19 pandemic and subsequent health mandates resulted in significant disruptions to daily life, creating a period of heightened psychosocial stress in myriad aspects. Understanding the impact of this period on pregnant individuals’ bacteriomes is crucial as pregnancy is a period of heightened vulnerability to stress and its sequelae, anxiety and mood disorders, which have been demonstrated to alter gut microbiome composition. In a prospective cohort study (N = 12–26) conducted from February 2019 to August 2021, we examined psychometric responses and rectal microbiome swabs from pregnant individuals. Full-length 16 S rRNA sequencing followed by calculation of diversity metrics and relative abundance values were used to interrogate fecal microbiome community composition across pandemic groups. Distinct shifts in bacterial diversity and composition were observed during early to late pregnancy in the pandemic group, including lower relative abundance of pathogenic and lesser-known taxa. However, distribution of stress and depressive symptoms did not significantly differ from the pre-pandemic period while the correlation between stress and depressive symptoms dissipated during the pandemic. Our findings suggest that living through the COVID-19 pandemic altered the gut microbiome of pregnant individuals, independent of perceived stress.

Objectives The spread of misinformation through the internet can lead to dangerous behavioral changes and erode trust in reliable sources, especially during public health crises like coronavirus disease 2019 (COVID-19). To combat this issue, innovative strategies that leverage information technology are essential. This study focused on developing and evaluating a mobile application (app), COVID-Iran, aimed at countering COVID-19 misinformation by delivering accurate, reliable, and credible information. Methods The development of the app involved a multi-step, user-centered approach that integrated qualitative expert consultations with quantitative survey research to pinpoint and validate key features. The app was initially prototyped using Enterprise Architect software and subsequently developed using Android Studio and MySQL. We conducted a usability evaluation using the System Usability Scale (SUS), where participants engaged in various tasks related to information seeking, self-assessment, and health management. Data were analyzed using descriptive statistics in SPSS version 19. Results The findings revealed a high usability level (SUS score of 81.35), with participants reporting ease of use and learnability. The app effectively countered misinformation by providing access to trusted sources and evidence-based counterarguments. User feedback emphasized the app’s strengths in clarity, accuracy, trustworthiness, and its comprehensive approach. Plans for future improvements include the integration of artificial intelligence to deliver personalized content. Conclusions Despite limitations such as the small sample size and potential self-selection bias, this study highlights the significant potential of mHealth apps to provide reliable health information and combat misinformation.

Background The incidence of hypotension in parturients with coronavirus disease (COVID-19) undergoing regional anesthesia remains controversial. This study aimed to investigate the incidence of hypotension during spinal anesthesia in parturients infected with COVID-19, as well as to identify associated risk factors. Methods This retrospective study compared COVID-19-positive parturients who underwent cesarean section under spinal anesthesia (COVID-19 group) with a control group between January 2017 and June 2022. We reviewed the medical records and collected the following information: basic patient characteristics, spinal anesthesia, and newborn-related data. Results Compared with the control group, the COVID-19 group did not show any significant differences in terms of hypotension occurrence and vasopressor usage. A positive correlation was noted in the COVID-19 group between heart rate and duration of hospital stay (P < 0.001, Spearman’s rho = 0.422). In subgroup analysis of the COVID-19 group, group with a baseline heart rate ≥ 100 (group H) had lower Apgar scores at 1 min, longer hospital stays, and more severe COVID-19 symptoms than the with a baseline heart rate < 100 (group L). Moreover, in group H, there was a positive correlation between the heart rate and the lowest systolic blood pressure after spinal anesthesia (P = 0.012, Spearman’s rho = 0.528). Conclusions Parturients with COVID-19 do not appear to have a higher risk of hypotension during cesarean section under spinal anesthesia than those without COVID-19. Given the close association between preoperative heart rate and extent of hypotension in parturients with COVID-19 undergoing spinal anesthesia, vigilant monitoring of vital signs by anesthesiologists is crucial during the perioperative period.

Background: Positive mental health (PMH) response for families who have schizophrenic patients in the implementation of vaccination is a double burden that occurs in efforts to prevent the Covid-19 Virus in schizophrenic patients. Purpose: The study aims to explain Family Psychological Responses to the implementation of booster vaccination in Schizophrenia as a Prevention of Covid-19 based on PMH. Methods: This means Between October and December 2022, there will be 127 families with schizophrenia-afflicted members. This study used a sequential explanatory design with a mixed methodology. PMH scale instrument was employed as the research tool in a community-based adult with the PMH scale's sensitivity. Results: Results of the study findings revealed that the overall PMH questionnaire of PMH scale included 6 items 1) General coping Rural (2.99 ±1.2); Urban (2.27 ±1.1) 2) Emotional support Rural (2.99±1.2); Urban (2.27 ±1.1); 3) Spirituality, Rural (2.99±1.8); Urban (2.29 ± 1.3), 4) Interpersonal Skill highest score Rural (2.99 ± 1.2); Urban (2.27 ±1.1), 5) Personal Growth & Autonomous Rural (2.99 ±1.2); Urban (2.27 ±1.1), 6) Global Affect Rural (2.98 ±1.6); Urban (2.28 ±1.1). Conclusion: PMH psychological responses can occur in the implementation of booster vaccination in families of schizophrenia patients so Along with PMH, Negative Mental Health, and vaccination implementation in families of schizophrenia patients, it is important to pay attention to both (NMH).

Background The abrupt outbreak of the pandemic COVID-19 started in late 2019 caused widespread problems and issues. The capability to inactivate SARS-CoV-2 under biologically important conditions has not been evaluated till now systematically. As a result, the contribution of the use of mouthrinse before any dental treatment in reducing salivary viral load in COVID-19 patients is still unclear. Aim The aim of the protocol is designed in PICO format as – patients taken are COVID-19 patients, intervention used is different mouthrinses, control taken as water, the studies included are clinical trials, and the outcome of the protocol is the efficacy of mouthrinses in reducing viral load. Review Methods The registration of the protocol of the study was done under the number CRD42022325615 at the International Prospective Register of Systematic Reviews. The databases including Medline (through PubMed), Scopus, The Cochrane Controlled Clinical Trials Register, and Google Scholar were thoroughly searched from December 2019 to April 2022. The articles were analyzed using the RevMan 5.3 software. The inclusion criteria for selecting studies were based on cyclic threshold values and log copies/mL of salivary viral load. The quality assessment was performed based on the Cochrane risk of the bias assessment tool. Results Eleven articles were included for systematic review, and out of these, eight articles were considered for meta-analysis. The result of the meta-analysis showed through forest plot which indicated that hydrogen peroxide 1% had potent antiviral efficacy at 30 min and 1 h of its use, whereas chlorhexidine and povidone-iodine effects were the same at 5 min and 1 h of their use. Conclusion The preprocedural mouthrinse with hydrogen peroxide 1% reduces the salivary viral load in COVID-19 patients and prevents its transmission. This mouthrinse can be used 30 min before initiation of any dental treatment and even in between the procedure.

Abstract Background Cancer patients are more susceptible to an aggressive course of COVID-19. Developing biomarkers identifying cancer patients at high risk of COVID-19-related death could help determine who needs early clinical intervention. The miRNAs hosted in the genomic regions associated with the risk of aggressive COVID-19 could represent potential biomarkers for clinical outcomes. Patients and methods Plasma samples were collected at The University of Texas MD Anderson Cancer Center from cancer patients (N = 128) affected by COVID-19. Serum samples were collected from vaccinated healthy individuals (n = 23) at the Municipal Clinical Emergency Teaching Hospital in Timisoara, Romania. An in silico positional cloning approach was used to identify the presence of miRNAs at COVID-19 risk-associated genomic regions: CORSAIRs (COvid-19 RiSk AssocIated genomic Regions). The miRNA levels were measured by RT-qPCR. Results We found that miRNAs were enriched in CORSAIR. Low plasma levels of hsa-miR-150-5p and hsa-miR-93-5p were associated with higher COVID-19-related death. The levels of hsa-miR-92b-3p were associated with SARS-CoV-2 test positivity. Peripheral blood mononuclear cells (PBMC) increased secretion of hsa-miR-150-5p, hsa-miR-93-5p, and hsa-miR-92b-3p after in vitro TLR7/8- and T cell receptor (TCR)-mediated activation. Increased levels of these three miRNAs were measured in the serum samples of healthy individuals between one and nine months after the second dose of the Pfizer-BioNTech COVID-19 vaccine. SARS-CoV-2 infection of human airway epithelial cells influenced the miRNA levels inside their secreted extracellular vesicles. Conclusions MiRNAs are enriched at CORSAIR. Plasma miRNA levels can represent a potential blood biomarker for predicting COVID-19-related death in cancer patients.

Negative effects of the COVID-19 pandemic on mental health have been widely reported. Chinese populations, especially those living overseas, are highly vulnerable to mental health problems considering the unique challenges they faced during the pandemic. Even though the pandemic lasted for three years, little is known about the mental health condition of this special population over this time course. The current study aimed to assess peritraumatic distress among Chinese migrants in Canada and identify its consistent risk predictors across the three years of the pandemic (2020, 2021, 2022). Three groups of Chinese adult migrants (i.e., aged 18 or above) living in Canada were randomly recruited through social media and the internet to complete an online survey in 2020, 2021, and 2022 respectively. Peritraumatic distress was assessed with the COVID-19 Peritraumatic Distress Index (CPDI). Univariate analysis of variance (ANOVA) models and a subsequent hierarchical multiple regression model were conducted to track peritraumatic distress differences across the three years and identify potential risk factors. The results showed that the CPDI score increased from 2020 to 2022 and peaked in 2021. Age, birthplace, health status, perceived discrimination, self-contraction and family contraction worry were identified as significant sociodemographic and COVID-19-related predictors for peritraumatic distress (absolute βs = 2.16–9.00; ps < 0.05). The results provide insight into the mental health condition of overseas Chinese migrants across the three years of the pandemic.

Abstract Rationale Tobacco use is a risk factor for COVID-19 adverse outcomes. Despite health implications, data conflict regarding COVID-19 and tobacco consumption. We present results from a survey of health behaviors during the pandemic to identify how COVID-19 influenced tobacco behaviors. Methods A nationally administered, internet-based survey was deployed between May–September 2020. Of respondents, we analyzed participants who reported current smoking and/or vaping. Our primary outcome of interest was change in tobacco or vape use using measures from the Behavioral Risk Factor Surveillance System, as well as whether participants reported that these changes were related to COVID-19. Our principal exposures were previously psychometrically evaluated measures of anxiety, depression, and novel perceived COVID-19 threat scale with additional adjustment for age. We employed multinomial logistic regression to determine associations between these factors and tobacco consumption. Results We identified 500 respondents who reported ever smoking in their lifetime, 150 of which reported currently smoking at the time of the survey. Of 220 participants who reported any use of vapes, 110 reported currently vaping. Increased perceived threat of COVID-19 was associated with both increased (aRRincrease 1.75, 95% CI [1.07–2.86], P = 0.03) and decreased (aRRdecrease 1.72 [1.04–2.85], P = 0.03) tobacco consumption relative to no change. There were no significant relationships found between perceived threat of COVID-19 and vaping behavior. Conclusions As perceived COVID-19 threat increased, people were more likely to increase or decrease their smoking as opposed to continue at the same amount of use, even after controlling for anxiety and depression, both of which are known to affect smoking in either direction. Further study into motivators of changing tobacco consumption behaviors, and how barriers to care from safer-at-home policies and changes in care delivery moderate change in tobacco use will aid planning tobacco reduction interventions during the ongoing and future respiratory viral pandemics. Trial registration This manuscript is derived from baseline survey data obtained in the “Understanding Community Considerations, Opinions, Values, Impacts, and Decisions in COVID-19” study. ClinicalTrials.gov registration NCT04373135, registered 04/30/2020.

Abstract Background Previous research has highlighted links between occupation and risk of COVID-19 transmission and suggests that occupational risk is influenced by covariates including socio-economic status, and deprivation. This study examined the perspectives of local authority teams of how changes in policy and advice, as set out in the UK government report ‘Living with COVID,’ affected COVID-19 transmission risk, response and resilience in workplace settings in Greater Manchester, an area that was disproportionately affected by the pandemic. Methods The project, which took place between August and November 2022, undertook a mixed methods approach to incorporate wide-ranging reflections of changes following the publication of ‘Living with COVID’. Quantitative data was collected from local employers (n = 149) and employees (n = 397) using online surveys, and qualitative interview data was collected from Greater Manchester local authority teams (n = 19). Results The research highlighted the inequitable impact of the pandemic on those already experiencing health inequalities, including people on more precarious employment contracts or those who were unable to work from home during the pandemic. The study found that the facilitators that helped local authorities to support employers to manage transmission included clear, detailed and timely national and local guidance, good communication, partnership working, funding, and timely access to data. Barriers to supporting employers included contradictory or confusing national guidance, structural inequalities, lack of funding, and delayed access to data. Interview participants reported that they were now utilising lessons learnt during the pandemic, along with the that partnerships developed, in order to tackle wider health issues and to prepare for future pandemics or health crises. Conclusion The findings of the study, which concur with previously published research conducted as part of the PROTECT project, highlight the importance of active reflection on the lessons learned during the course of the pandemic. The study draws on PH and EH teams’ perspectives of managing COVID-19 transmission, in an area that was disproportionately affected by the pandemic, in order to add to our understanding of the best ways to ensure preparedness for future pandemics or health crises at a national level.

Abstract “Long COVID”, which describes a diverse set of symptoms or conditions that persist or develop after four weeks from the onset of initial SARS-CoV-2 infection has been introduced. However, the true prevalence varies worldwide. This study aimed to determine the point prevalence and clinical characteristics of long COVID at three and six months after acute COVID-19 infection in Thailand. Methods All adult patients who were diagnosed with COVID-19 by positive nasopharyngeal RT-PCR for SARS-CoV-2 at Thammasat University Hospital between October and December 2021 were recruited and followed for long COVID symptoms by telephone interviews at 3 and 6 months after an acute infection. Among 1,400 eligible COVID-19 cases, interviews were complete for 1,129 and 932 individuals at 3 and 6 months, respectively. Of those, 431 and 314 reported at least one symptom consistent with long COVID. The point prevalence was 38.2% (95% confidence interval: 35.3–41.1%) and 33.7% (95% confidence interval: 30.7–36.7%) respectively. Female gender, disease severity, and symptomatic acute infection were identified as independent risk factors. Conclusion Based on the reported symptoms, long COVID is commonly observed either at 3 or 6 months in our study.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic led to overall interrupted medical care, resulting in disease progression and morbidity. The study aimed to evaluate clinicopathological presentations and severity of eyelid malignancy during the COVID era, comparing the results with patients presented during pre-COVID era and evaluating the reasons for delayed presentation in patients with advanced eyelid malignancy in the COVID-era. Methods: This was a comparative, ambispective observational study. Data regarding demographic, clinical, histopathology, and treatment modalities of confirmed cases of eyelid malignancy admitted during the period from March 2020 to September 2022 (defined as COVID era group) were collected and compared with retrospectively collected data from March 2017 to March 2020 (defined as pre-COVID era group). COVID era patients were further categorized as localized and advanced disease. Patients with advanced eyelid malignancy during COVID era were further subjected to a questionnaire to evaluate the reasons for delayed presentation. Results: In total, 115 patients of eyelid malignancy were studied [COVID era group 40 (35%) and pre-COVID era group 75 (65%)]. A statistically significant increase in the duration of disease (P = 0.0001) and advanced tumor T-stage (P = 0.03) was noticed in the COVID era group. Demographic, histopathology, and ocular morbidity details were similar in both groups. The common reasons that led to delay in presentation and treatment in advanced T-stage patients during the COVID era were fear of acquiring COVID, lockdown, and lack of medical facilities. Conclusion: During the COVID-19 pandemic, both hospital- and patient-related factors contributed to delay in presentation, leading to advanced-stage disease indicating need of triaging of eyelid malignancy in the event of such pandemics in future.

Abstract Background IL-6 polymorphisms were associated to viral infection outcomes through affection of IL-6 production and it is an early indicator of tissue injury and systemic inflammatory response. The study aimed to determine whether genetic IL-6 polymorphisms, serum interleukin-6 level and inflammatory markers (Presepsin, CXCL-10, C3, and C4) are associated with the prediction of disease severity in pediatric COVID-19 patients and its possible use as a prognostic tool in pediatric patients admitted to hospital. Methods This prospective cohort study was conducted on 150 children with COVID-19. Patients were divided according to the severity of infection into four groups: group I (mild) 67 cases; group II (moderate) 53 cases, group III (severe) 17 cases and group IV (critical) 14 cases. Serum Interleukin 6, CXCL-10, Presepsin, renal and liver functions, electrolytes, C3, C4, ferritin, and D dimer serum levels were assessed in all patients. The Kruskal Wallis test used to compare parametric quantitative data between studied groups and Mann Whitney test for each pair of groups. Non-parametric quantitative data was compared between studied groups using a one-way ANOVA test and post-hoc Bonferroni analysis for each pair of groups. Results Group I: 35 males and 32 females with a median age of 16 months. Group II: 17 males and 35 females with a median age of 13 months. Group III: 6 males and 11 females with a median age of 12 months and group IV: 3 males and 11 females with a median age of 12 months. There was no statistical difference between the studied groups regarding gender and age. Serum levels of IL- 6, serum ferritin; D-dimer, Presepsin and CXCL 10 were significantly higher in both severe and critical groups than the other 2 groups (mild and moderate). ROC curve analysis showed that interleukin-6 and Presepsin were good markers for prediction of severity of COVID-19 among the diseased children. For severe cases, the sensitivity of interleukin-6 was 76.47% and specificity was 92.31%. For critical cases, the sensitivity of interleukin-6 was 71.43% and specificity was 82.35%. The sensitivity of Presepsin was 76.47% and specificity was 88.46% in severe cases. For critical cases, the sensitivity of Presepsin was 78.57% and specificity of 91.2%. There was significant difference in IL-6 572 allelic among moderate cases with the most frequent 42.3% for genotype (GC) and allelic among severe cases with the most frequent 47.1% for genotype (GC). Significant difference in IL-6 174 allelic among critical cases with the most frequent 78.6% for genotype (CC). Conclusions Children whom expressed GC genotypes of IL6 (-572G > C) polymorphism are at a considerably higher risk of developing a severe disease. This risk is significantly larger in the severe group of children than in children in critical condition who have GC genotypes of IL6 (-174 G > C) polymorphism. While IL6 (-597G > A) polymorphism has no role in COVID 19 severity in children.

Background: The impact of the coronavirus disease 2019 (COVID-19) pandemic on the etiology of non-COVID-19 viral pneumonia remains to be identified. We investigated the evolution of non-COVID-19 viral pneumonia in hospitalized patients before and after the COVID-19 pandemic. Methods: This is a single-center retrospective study. Patients who came to West China Hospital of Sichuan University diagnosed with non-COVID-19 viral pneumonia from January 1, 2016 to December 31, 2021, were included and divided into pre- and post-COVID-19 groups according to the date of the COVID-19 outbreak in China. The results of 13 viral nucleic acid tests were compared between the two groups. Results: A total of 5937 patients (3954 in the pre-COVID-19 group and 1983 in the post-COVID-19 group) were analyzed. Compared with the pre-COVID-19 group, the proportion of patients tested for respiratory non-COVID-19 viral nucleic acid was significantly increased in the post-COVID-19 group (14.78% vs. 22.79%, P

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.

Objective: To summarize the prevalence of Long COVID symptoms among the general population reported in published articles from the pre-omicron SARS-CoV2 era. This narrative review examined 21 symptoms. Methods: A PubMed/manual search returned 114 articles on general Long COVID symptoms. Manuscripts were excluded if they were not research studies, did not report symptom prevalence, or used a pediatric population. Ninety-eight studies were selected for review and fifty-nine met the criteria for inclusion. The risk of bias was assessed with the Hoy critical appraisal tool. Results: After excluding studies with a high risk of bias, meta-analysis of prevalence for 21 symptom categories ranged from 2.6–28.7% in studies based on surveys to 0.3–7.1% in studies based on electronic health record data. Conclusions: Long COVID symptom studies are limited by the variability in study design and representation of the general population. Further research is needed to effectively cluster symptoms in meaningful ways that enable focused treatment.

The COVID-19 pandemic has had profound impact, necessitating a deeper understanding of factors influencing virus transmission. The negative impacts have weakened the economy and changed billions of lives around the world. COVID-19 is a new virus, and a lot of studies have tried to investigate its effect on, for example, the economy or environment. This research reveals new approaches to recognizing and stopping the spread of this virus with its connection to weather conditions and relevant parameters. By analyzing how temperature and humidity affect COVID-19 spread, alongside evaluating the effectiveness of initial public policies, this study addresses the critical gap in research by investigating the interplay between climate conditions and government regulations during the early stages of the pandemic in South Korea. This dual approach provides a comprehensive framework for understanding how environmental and policy factors jointly influence pandemic dynamics, offering valuable lessons for future global health crises. Although it focuses only on the first phase of South Korea COVID-19 regulations, outcomes show that these regulations were notably effective against the COVID-19 pandemic. The outcomes prove that higher temperature and higher relative humidity lead to lower transmission. Hence, based on the results during winter, the number of infections would be expected to speed up again.

Background. People living with HIV (PWH) frequently have co-morbid substance use disorders that may have been impacted by the COVID-19 pandemic. This study examined associations between COVID-related stress and increased substance use among PWH in Washington State. Methods. Between August 2020 and March 2021, we conducted an online survey of 397 PWH in western Washington. Logistic regression was used to analyze associations between a COVID-19 stress score and four self-reported outcomes: increased alcohol use, increased cigarette smoking, increased marijuana use, and increased use of illicit substances. Results. Thirty-five (38.0%) of 92 participants who smoked, 61 (23.4%) of 261 participants who used alcohol, 15 (14.6%) of 103 participants who used marijuana, and 35 (33.0%) of 102 participants who used illicit substances reported increased use of these substances. Higher COVID-19 stress scores were associated with higher odds of increased cigarette smoking (adjusted odds ratio [aOR] = 1.15, 95% confidence interval [CI]: 1.04–1.27), even after adjustment for anxiety and depressive symptoms (aOR 1.14, 95%CI: 1.03–1.27). COVID-19 stress was not associated with an increased use of alcohol, marijuana, or illicit substances. Conclusions. COVID-19-related stress was associated with self-reported increased cigarette smoking among PWH in western Washington during the pandemic.

Objective: To determine whether COVID-19 causes an increase in spleen dimensions in individuals with a recent history of COVID-19 infection. Methods: This case-control study was conducted at the Radiology Department of the University of Lahore Teaching Hospital and Sehat Medical Complex, both in Lahore. The study sample comprised 384 individuals, selected using a convenience sampling technique. Participants included individuals of all age groups and both genders; however, those under 18 were excluded due to the potential for incomplete spleen maturation. Other exclusion criteria included a history of splenectomy, the presence of traumatic or non-traumatic splenic lesions, or any other splenic abnormalities. Data collection commenced after obtaining approval from the Research Ethics Committee at the University of Lahore. The Siemens Sonovista c3000 Grey Scale Ultrasound Machine was used, and the data were analyzed using SPSS version 24. Results: In a study involving 384 participants, the mean age was 35.7 ± 6.14, ranging from 22 to 50 years. Of these, 296 (71.1%) were female, and 88 (22.9%) were male. Echogenicity varied, with 29 participants (7.6%) exhibiting heterogeneous echogenicity and 355 (92.4%) showing homogeneous echogenicity. Spleen margins were irregular in 67 participants (17.4%) and smooth in 317 participants (82.6%). Regarding the history of Covid-19, 188 participants (49%) tested negative, while 196 participants (51%) tested positive. Conclusion: Patients with a history of COVID-19 exhibited a significant increase in spleen length, volume, and thickness.

Relevance. To control COVID-19, a net of special infection hospitals and departments was created, a system of medicaments and protective means’ supply was set up, necessary normative and regulatory documentation was developed and overall vaccination of population was performed in Moscow. Within frames of work for prophylaxis of COVID-19 spread in patients with tuberculosis at in-patient units of the State Budgetary Healthcare Institution of Moscow city «The Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health” (hereinafter referred as the Center), observational departments for treatment of patients with tuberculosis from COVID-19 contact and convalescents after COVID-19. Aims. To evaluate specialized observational departments’ work as part of general anti-epidemic control measure system for COVID- 19 at tuberculosis hospitals. Materials and methods. The observational departments’ work within the period of 2020–2022 with 1075 patients treated including 400 patients from COVID-19 contact areas (37.2%) and 675 convalescent patients after COVID-19 (62.8%), was analyzed. The results obtained during the study were statistically treated by means of application program package Microsoft Office 2007. The quantitative parameters with presumably normal distribution were described with mean arithmetic values (M) and standard deviations (SD), and 95% confidence interval (CI 95%). The estimation of significance of differences between outcomes was evaluated with the Pearson χ2 test. The differences were considered to be statistically significant with p < 0,05. Results and discussion. The evaluation data on functioning efficacy of observational departments for patients with tuberculosis from COVID-19 contact and convalescent patients with tuberculosis after COVID-19 within the large medical institution hospital of physiatry profile. Among all patients, 153 of patients who fell ill with COVID-19 (14.2%; 95% CI [12.21–16.38%]) were determined, which lowered the number of COVID-19 areas at in-patient departments of the Center by 11.8%. The mean timeframes of COVID- 19 determination in general were 8.0 days: 5.4 days among contacts from new coronavirus infection areas and 12.4 days among convalescents at the department for the treatment of patients with tuberculosis and new coronavirus infection. The comparative analysis showed that COVID-19 was more frequently determined in tuberculosis patients from the contact with those who fell ill with COVID-19 (p < 0.001) than in convalescents. Conclusions. During medical care for patients of physiatry profile in Moscow city, a wide range of management decisions consisting in the change of routing system in specialized medical care, was taken. Among them, creation and functioning of observational departments for contact persons from COVID-19 areas and convalescents after COVID-19 play a particular role.Creation of such departments within a large medical institution enabled the contemporary isolation of contact persons from COVID- 19 areas and convalescents after COVID-19 and allowed the additional control of nosocomial infection spread

Abstract 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 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 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.

Approximately 31% of patients previously infected with SARS-CoV-2 are living with symptoms of long COVID in the United States. Long COVID significantly reduces quality of life and increases morbidity and disability; however, treatment options are limited. Enhanced External Counterpulsation (EECP) is an FDA-approved, non-invasive treatment for the management of cardiovascular symptoms with a mechanism of action which stimulates pathways that induce endothelial homeostasis, improving microvascular function, inflammation, and immune regulation, thereby potentially targeting the underlying etiology of long COVID. We recently reported that EECP improved symptoms in 231 patients with long COVID. Previous studies assessing the effects of EECP for long COVID have lacked a control group. As such, this analysis is the first comparing outcomes in patients with long COVID undergoing EECP (n = 33) to a non-treated group (control, n = 33). The patients were matched for baseline characteristics, and all patients completed patient-reported outcome assessments, including PROMIS Fatigue, the Duke Activity Status Index (DASI), and the Rose Dyspnea Scale (RDS), two times within a specified time interval. When comparing the average change from baseline in both groups, the EECP-treated patients’ improvement was significantly greater than the improvement in the control group across all measured endpoints, including PROMIS Fatigue (−15.0 ± 8.9 vs. −2.8 ± 5.9, p < 0.001) and DASI (+17.8 (11.8, 26.8) vs. +1.8 (−3.5, 5.5), p < 0.001), and there was an improvement of ≥1 in the RDS class (75.8% vs. 33.3%, p < 0.001). This study’s limitations include the small sample size and lack of information regarding concurrent treatments or interventions in the non-treated group; however, these preliminary data support EECP as a potential low-risk treatment option for patients with long COVID.

Subjective well-being (SW) is understood as the personal judgment that an individual has about their value, perception, and level of satisfaction with respect to his or her life and existence. The present study had the purpose of understanding how pandemics have affected subjective well-being; therefore, the objective was to determine the subjective well-being of the staff at a teaching dental center in a COVID-19 epidemiological surveillance system between the years 2020 and 2022. A cross-sectional design was applied and was based on data from two records of the Centro Dental Docente of the Universidad Peruana Cayetano Heredia, Lima, Peru, between the years 2021 and 2022. The results show that the mean SW did not significantly vary (p = 0.114) between 2021 (69.32; SD = 19.92) and 2022 (63.16; SD = 29.87). At a bivariate level, significant associations were also observed between SW and multiple variables such as the diagnosis and type of COVID-19, vaccination, contact with COVID-19 patients, systemic conditions, body mass index, educational level, gender, and age. Meanwhile, according to the regression analysis, not having COVID-19 was positively associated with higher levels of subjective well-being. This study highlights the impact of the COVID-19 pandemic on the mental and emotional states of dental healthcare personnel, emphasizing the need for strategies to mitigate stress and anxiety in such critical work environments.

COVID-19, a novel infectious disease caused by the emergence of the SARS-CoV-2 virus in 2020, has had a profound impact on healthcare, both at the individual and population level. The impact at the population level was felt most acutely during the emergency phase of the pandemic, with hospital capacity issues leading to widespread disruptions and delays in the delivery of healthcare services such as screening programs and elective surgeries. While hospitals are no longer being acutely overwhelmed by COVID-19 patients, the impact of the virus on vulnerable patient populations such as cancer patients continues to be of ongoing consequence. Cancer patients remain at high risk of hospitalization, ICU admission, and death due to COVID-19, even in the era of vaccination. Infection prevention and risk mitigation strategies such air quality control, masking, testing, vaccination, and treatment should therefore be integrated into the usual care and counseling of cancer patients moving forward to avoid preventable morbidity and mortality from this infection and ensure the safety of this vulnerable cohort as they navigate their cancer diagnosis and treatment in the era of COVID-19.

Introduction: The relationship between viral infections and acute or chronic urticaria is rarely reported in some articles. But its exact mechanisms are not known. There is evidence of urticaria in the patients with covid-19 infection. Therefore, there was no structured research to clarify the role of the corona virus in the pathogenesis of urticaria. Methods: The articles that were published from January 2020 to October 2022 were reviewed by "PubMed" and "Google scholar" databases using the keywords acute urticarial urticaria, chronic urticaria along with COVID-19. Inclusion criteria were articles reporting acute or chronic urticaria in the patients with confirmed COVID-19 infection in English. Review articles and studies that reported suspected corona infection and in which urticaria were related to drug hypersensitivity and other allergic diseases were considered as exclusion criteria. Results: In this search, 43 articles were reviewed that were related to our goals. Among these articles, 27 studies that met the inclusion criteria were selected. 16 articles were case reports, case series, letters to the editor and 7 original articles. In this review, it was reported 17 patients in 16 case reports and case series with urticaria associated with COVID-19. Conclusion: The severity of chronic urticaria may increase with corona infection. Acute urticaria may be a precursor symptom of COVID-19 infection. Finally, due to the small number of articles and some contradictory results, more studies are suggested in this field.

Severe Acute Respiratory Syndrome (SARS-CoV-2) causes the coronavirus disease (COVID-19), which is characterised by severe respiratory syndrome and other complications. It is a serious threat to global public health if proper vaccination is not followed. The efficient COVID-19 management requires vaccination along with other precautionary measures. Public transmission of COVID-19 seems to have decreased and immune response to viral infections has improved by vaccination. The present review discusses in detail about the current situation of the COVID-19, based on the latest reports about approved vaccine types and their efficacy, vaccination status, and various SARS-CoV-2 variants. This review also includes insights into the post-COVID complications in recovered patients. Besides, some of the ill-effects of drugs in inducing other diseases in COVID-19 recovered patients, are also discussed in this review article. This study will help the researchers to prepare strategies for further research on vaccine production and prevent the occurrence of the disease in future.

Abstract Background It has been proposed that prolonged use of anti-inflammatory and anti-fibrotic drugs diminish the probability of development of lung fibrosis. Prolonged low-dose corticosteroid may prevent remodeling of the lung in survivors. Pirfenidone and colchicine may exhibit anti-fibrotic and anti-inflammatory properties as well. Methods This retrospective observational study was conducted at post COVID-19 clinic, Mansoura University Hospitals, during the period between October 2020 and March 2022. This study included 104 patients who had COVID-19 pneumonia confirmed either by RT-PCR or radiologically by CT scan and divided into 3 groups; group A (corticosteroids only) included 33 (31.7%) patients, group B (corticosteroids and colchicine) included 56 (53.8%) patients, and group C (corticosteroids, colchicine, and pirfenidone) included 15 (14.4%) patients. All patients were assessed during follow-up visits in post COVID-19 clinic 1 and 3 months after discharge by evaluation of resting SpO2, spirometry, and radiological assessment. Patients’ data during hospitalization was collected from hospital electronic systems. Results There was non-statistically significant improvement in FEV1 in group A while there was statistically significant improvement in FEV1 in groups B and C (P value = 0.002 and 0.041, respectively) 1 month and 3 months after discharge. Group B exhibited more statistically significant improvement in FVC as well compared to group C (P value = 0.003 and 0.025, respectively) while group A showed non-statistically significant improvement in FVC. There was a statistically significant decrease in CT severity score in all the groups during follow-up with P value

Aim: To assess lung function in patients with persistent dyspnea 1 year after mild coronavirus disease 2019 (COVID-19) and compare with those hospitalized with moderate or critical COVID-19. Methods: Adults with confirmed severe acute respiratory syndrome coronavirus-2 infection with mild COVID-19 and persistent dyspnea (n = 18) or with moderate (n = 34) or critical COVID-19 (n = 19) were followed up 11–13 months after initial infection. Inclusion criteria were age < 65 years, no smoking history, and no preexisting respiratory diseases. Sociodemographic and clinical data were collected, and patients underwent spirometry and measurement of diffusing capacity for carbon monoxide (DLCO). Results: The non-hospitalized patients were significantly younger and more often female compared with those in the moderate and critical groups (P = 0.002 and P < 0.001, respectively). No significant differences in comorbidities or body mass index (BMI) were noted between severity groups. An obstructive spirometry pattern (ratio of forced expiratory volume during the first exhalation second to forced vital capacity under the lower limit of normal (LLN)) was found in 5.6, 5.9, and 5.3% of patients in the mild, moderate, and critical groups, respectively (P = 0.995). Abnormal DLCO (< LLN) rates were seen in 5.6, 16.7, and 47.4% in the mild, moderate, and critical groups, respectively (P = 0.018). DLCO, expressed as a z-score, was significantly lower in the critical group compared with the mild group after adjustment for age, sex, and BMI. Conclusion: Only a few subjects with mild COVID-19 and persistent dyspnea had abnormal lung function 1 year after initial infection, assessed based on spirometry and DLCO measurements. An obstructive spirometry pattern at 1-year follow-up was uncommon even in patients with moderate or critical COVID-19. Impaired DLCO was more common in patients with critical COVID-19.

Abstract Introduction Migrant populations (asylum seekers, permit holders, refugees, and undocumented migrants) living in South Africa face various individual, social, and physical circumstances that underpin their decisions, motivation, and ability to receive the COVID-19 vaccine. We conducted a qualitative study to explore the experiences and perceptions of migrant populations in South Africa on COVID-19 vaccines to inform recommendations for improved COVID-19 immunization. Methods We conducted an Interpretative Phenomenological Analysis (IPA) with 20 asylum seekers, permit holders, refugees, and undocumented migrants living in South Africa. We applied a maximum variation purposive sampling approach to capture all three categories of migrants in South Africa. Semi-structured interviews were conducted and recorded electronically with consent and permission from the study participants. The recordings were transcribed and analyzed thematically following the IPA using Atlas.ti version 9. Results Four major reflective themes emanated from the data analysis. (1) While some migrants perceived being excluded from the South African national immunization program at the level of advertisement and felt discriminated against at the immunization centers, others felt included in the program at all levels. (2) Skepticism, myths, and conspiracy theories around the origin of SARS-CoV-2 and the COVID-19 vaccine are pervasive among migrant populations in South Africa. (3) There is a continuum of COVID-19 vaccine acceptance/hesitancy ranging from being vaccinated through waiting for the chance to be vaccinated to refusal. (4) Accepting the vaccine or being hesitant follows the beliefs of the participant, knowledge of the vaccine’s benefits, and lessons learned from others already vaccinated. Conclusion COVID-19 vaccine inclusiveness, awareness, and uptake should be enhanced through migrant-aware policies and actions such as community mobilization, healthcare professional training, and mass media campaigns.

Yao-Hsiang Chen,1,2 Yu-Shan Hsieh2 1Department of Nursing, Tri-Service General Hospital Songshan Branch, Taipei City, Taiwan; 2School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, TaiwanCorrespondence: Yu-Shan Hsieh, National Taipei University of Nursing and Health Sciences, No. 365, Ming-te Road, Peitou Dist, Taipei City, 112303, Taiwan, Tel +886-2-28227101, Email 228455300teresa@gmail.comAbstract: Long COVID refers to symptoms that appear 3 months after initial infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus of Coronavirus disease 2019 (COVID-19), and last for at least 2 months, not attributable to other diagnoses. This health issue significantly burdens patients’ quality of life, the economy, and society. Improving the af-termath of COVID-19 is a crucial global health issue in the post-pandemic era. According to current results, it is evident that developing a simple, low-cost respiratory training method that can be easily used at home by themselves with long Coronavirus disease 2019 symptoms (long COVID) is an important and urgent issue. The incentive spirometer is widely used in physical, speech, and respiratory therapy, as well as in preventing postoperative pulmonary infections and improving sputum clearance. However, to date, the role of incentive spirometer respiratory training in long COVID symptoms is still limited. In this literature review is presented to explore the effectiveness of incentive spirometer respiratory training in alleviating symptoms among individuals recovering from long COVID. We also compile non-invasive assessment methods, with the aim to enable individuals to undergo training and assessments conveniently at home or in the community. In this review, a literature review approach was utilized to explore the effectiveness of incentive spirometer intervention in alleviating long-term COVID symptoms. This study is to synthesize the findings of articles published during January 2019 and December 2023 retrieved from PubMed/CINAHL/MEDLINE/ Google Scholar without re-strictions on study type. We ultimately identified seven articles and have summarized similar past studies. This review could contribute to improving symptoms related to long COVID by incentive spirometer respiratory training and serve as practical reference material for clinical medical staff and provide insights for healthcare policymakers in de-veloping guidelines for future research directions, clinical guidance, and educational strategies in the context of nursing care.Keywords: COVID-19, long COVID, incentive spirometer respiratory training, respiratory training, incentive Spirometer

Abstract Background Current observational data indicates that ischemic stroke (IS) affects a significant proportion of people with COVID-19. The current study sought to evaluate the causal relationship between COVID-19 and IS. Methods A two-sample Mendelian randomization (2 S-MR) approach was used to probe the relationship between genetic determinants of three COVID-19 parameters (SARS-CoV‐2 infection, COVID-19 hospitalization, and severe COVID-19) and the incidence of IS based on genome-wide association studies (GWAS) data. Using this 2 S-MR technique, expression quantitative trait loci (eQTL) and GWAS studies were further assessed for overlap to identify common causative genes associated with severe COVID-19 and IS. Results IVW approaches indicated the genetic variants linked to COVID-19 hospitalization (OR 1.04, 95% CI 1.01–1.08, p = 0.023) and severe COVID-19 (OR 1.03, 95% CI 1.01–1.05, p = 0.007) were both significantly linked to greater odds of IS. In contrast, there was no causal association between genetic SARS-CoV-2 infection susceptibility and the occurrence of IS (OR 0.99, 95% CI 0.92–1.06, p = 0.694). Ten shared causal genes (TNFSF8, CFL2, TPM1, C15orf39, LHFPL6, FAM20C, SPAG9, KCNJ2, PELI1, and HLA-L) were established as possible mediators of the interplay between severe COVID-19 and the development of IS, with these genes primarily being enriched in immune-related and renin-angiotensin-aldosterone system pathways. Conclusion These findings indicate a possible causative relationship between IS risk and COVID-19 severity, offering crucial new information for managing COVID-19 patients. Promising options for therapeutic therapies for severe COVID-19 complicated by IS include the common genes found in the present study.

Abstract 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 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