COVID, Volume 5, Issue 10 (October 2025) – 14 articles

The emergence or mutation of aggressive viruses represents a latent threat to human health that could lead to new pandemics, so it is important to constantly monitor and analyze the behavior of the diseases they can cause. In this sense, the purpose of this work was to generate models to predict the behavior of recoveries and deaths from COVID-19 in Mexico in the post-pandemic era, applying machine learning techniques to data related to this disease, published by the Mexican government. Models based on artificial neural networks, logistic regression, and classification algorithms were generated and validated, yielding high rates of correct classification, accuracy, and recall, so that they could be used to make predictions about future cases of patients infected with the SARS-CoV-2 virus. Full article

Background: The COVID-19 pandemic significantly impacted adolescent development, increasing behavioral problems and emotional distress. This study aimed to examine the impact of sensation seeking, empathy, and COVID-19-related stressors on deviant behavior in adolescents. Methods: A cross-sectional study was conducted with 638 Italian adolescents and young adults (M = 18.8 years, SD = 3.51) recruited from schools, universities, and the general population in Tuscany and Emilia-Romagna. Participants completed validated measures assessing sensation seeking, empathy, COVID-19-related stress, and deviant behaviors. Multiple regression analyses examined predictors of deviant behavior, while mediation analyses tested whether empathy mediated the relationship between sensation seeking and deviant behavior. Results: Correlation analyses show a positive association between sensation seeking and deviant behavior and a weaker positive association with COVID-19 isolation. Conversely, affective empathy demonstrated negative correlations with both deviant behavior and sensation seeking. COVID-19 stress demonstrated differentiated effects: social isolation increased deviance, whereas fear of contagion was protective. Mediation analysis revealed that affective empathy partially mediated the relationship between sensation seeking and deviance. Conclusions: This study demonstrates that sensation seeking is a primary risk factor for deviant behavior in adolescents and young adults, while affective empathy acts as a protective mechanism that partially mediates this relationship. Furthermore, COVID-19-related stressors have shown complex effects, with social isolation amplifying the risk of deviance, while fear of contagion promotes more inhibited behavior. These findings underscore the importance of considering both stable personality traits and situational stressors when seeking to understand the pathways leading to adolescent behavioral problems during periods of social crisis. Full article

Severe acute respiratory syndrome (SARS), caused by the COVID-19 virus, continues to pose a significant public health challenge in Brazil, particularly in 2024, with high mortality rates among vulnerable groups. This study aimed to describe the sociodemographic, clinical and vaccination profiles of SARS cases due to COVID-19 in Brazil in 2024, as well as analysing factors associated with clinical outcomes such as death, admission to the intensive care unit (ICU) and the need for ventilatory support. A total of 30,529 reported cases were analysed. On average, the interval between the last vaccine dose and symptom onset was 30.31 months (SD = 6.77), while the interval between symptom onset and clinical outcome was 13.26 days (SD = 16.55), revealing significant variability. The results showed higher mortality rates among men (23.7%) than women (19.1%) (p < 0.0001). Mortality increased progressively with age, reaching 24.4% in individuals aged 60 years or older, whereas rates were below 2% in children under 10 years of age. The highest proportions of deaths were observed regionally in the Northeast (26.8%) and North (22.6%), in contrast to the Midwest (17.7%) (p < 0.0001). Men were also more likely to require ICU admission (38.1% vs. 33.6%) and ventilation (62.9% vs. 60.5%). A time interval of over 24 months since the last vaccine dose was associated with higher mortality (21.9% vs. 20.6%; p = 0.0005). These results highlight the importance of ongoing surveillance and updating the vaccination schedule, particularly for more vulnerable populations. Full article

The COVID-19 pandemic has placed a considerable psychological burden on healthcare workers, potentially leading to increased burnout and anxiety. This study aimed to evaluate burnout and anxiety levels among healthcare workers compared to non-healthcare professionals during the pandemic. We initially recruited 438 adults; 351 (217 HCWs and 134 non-HCWs) provided complete responses across all three survey waves and were analyzed. Burnout was assessed using the Maslach Burnout Inventory, and anxiety with the State–Trait Anxiety Inventory. Data were collected through an online self-administered survey at three different time points during the pandemic, and analyzed with non-parametric tests and effect sizes. Healthcare workers exhibited significantly higher levels of emotional exhaustion, depersonalization, overall burnout, and anxiety compared to non-healthcare workers across all three periods (p < 0.05). Of 438 consented individuals, 351 (80.1%) completed all waves, allowing within-population longitudinal comparisons. Within the healthcare worker group, women, individuals living alone, those working night shifts, and those considering a career change had notably higher burnout and anxiety scores. No significant differences were observed in personal accomplishment scores. Healthcare workers experienced greater psychological distress than non-healthcare workers during the COVID-19 pandemic. Identifying vulnerable subgroups and implementing supportive strategies are essential to protect the mental health and well-being of healthcare professionals during pandemics and similar crises. Full article

The present study aimed to evaluate the effect of maternal involvement in children’s home-based learning activities during the COVID-19 lockdown on mothers’ parenting stress, the quality of maternal care perceived by offspring, and the level of children’s internalizing/externalizing symptoms. This study recruited 415 subjects from the general population. To assess parenting stress, mothers were administered the Parenting Stress Index–Short Form; to assess children’s perceived quality of maternal care, this study used the Parental Bonding Inventory; and the Child Behavior Checklist/6–18 was used to assess internalizing/externalizing symptoms in children. Correlations showed that the amount of time spent by the mother supervising children’s self-study was highly and positively correlated with parental stress and offspring’s externalizing (but not internalizing) symptoms, and highly and positively correlated with the subscale of maternal overprotection in the children’s perceived quality of maternal care. Moreover, the multiple regression analyses conducted based on the above significant correlations showed that the amount of time spent by the mother overseeing children’s study was associated with parental stress, children’s externalizing symptoms, and maternal overprotection. Overall, the current study contributes to showing the burden families had to face as a result of school closures and accompanying distance learning during the COVID-19 epidemic. Full article

In order to understand how health beliefs map onto health behaviors, a national survey, administered in the wake of the COVID-19 campus closures, was conducted to explore college students’ mind-body health beliefs and their health behaviors (across dimensions of physical exercise, diet/nutrition, and socialization). To this end, the Mind-Body Health Screener (MBHS), a five-item, Likert scale, brief measure, was developed. The present study applied an online survey design administered nationally to U.S. undergraduate students during the initial lockdowns with the pandemic (n = 557). To examine the psychometric properties of the MBHS, exploratory and confirmatory factor analyses were run as well as measures of reliability. Furthermore, linear regressions and effect sizes were computed to understand the connection between mind-body health beliefs and behaviors. While initial data supported the psychometric properties of the Mind-Body Health Screener (MBHS) developed for this purpose, substantive results suggested that mind-body health beliefs did not relate to mind-body health behaviors (either before or after the campus closures), aligning with the Cognitive Dissonance Theory. Post hoc analysis did, however, suggest a significant change in health behaviors from pre-campus closures to during the closures, suggesting students engaged in more physical exercise, eating behaviors, and socializing before campus closed, observed with small to large effects. Taken together, the findings of the present study illustrate how the Cognitive Dissonance Theory is a relevant perspective to consider the relation between health beliefs and behaviors during a period of immense stress, such as the COVID-19 initial campus closures. Full article

Background: The aim of our study is to assess the risk factors for the development of coronary artery stent thrombosis and restenosis, as well as the main localization of these processes in patients who underwent repeated coronary revascularization during the COVID-19 pandemic. Materials and Methods: Data were retrospectively analyzed from 490 patients who underwent coronary angiography and required repeat revascularization from May 2020 to May 2023. The prevalence and anatomical distribution of coronary stenosis, restenosis, and stent thrombosis were assessed. Results: Coronary artery stenosis was detected in 46.9% of patients. The most affected arteries were the left anterior descending (13.7%), right coronary artery (15.1%), and circumflex branch (9.4%). In-stent restenosis was observed in 19.0% of cases. Coronary thrombosis occurred in 22.8% of patients, while stent thrombosis was found in 11.2%. Multivariate regression revealed that leukocyte count (OR = 1.18, p < 0.05), activated partial thromboplastin time (APTP) (OR = 1.021, p = 0.025), low-density lipoproteins (LDL) (OR = 1.421, p = 0.042), and prior COVID-19 infection (OR = 2.05, p = 0.038) were significant predictors of stent thrombosis. The left ventricular ejection fraction (LVEF) (OR = 0.959, p = 0.017) and hemoglobin levels (OR = 0.975, p = 0.014) have inverse association with risk of stent thrombosis. Conclusion: COVID-19 history is a strong independent risk factor for coronary stent thrombosis, alongside inflammatory and coagulation markers. Full article

Despite advances in vaccination and treatment, the emergence of Long COVID cases has highlighted the continued public health concern posed by the disease. Studies on the early prediction of COVID-19 severity and the identification of associated biomarkers are decisive for preventing Long COVID. The objective is to utilise laboratory test data from patients diagnosed with COVID-19 and apply machine learning techniques to predict disease severity and identify associated biomarkers. From a university hospital in southern Brazil, we processed biochemical and haematological data from patients with COVID-19 (non-severe = non-ICU admission; severe = ICU admission). The data were used to train 15 machine learning algorithms to predict patient prognosis. The Light Gradient Boosting Machine (LGBM) model demonstrated the most effective performance in predicting the prognosis of patients with COVID-19, with accuracy, sensitivity, specificity, and precision values between 80 and 88%. Biomarkers associated with disease severity included Platelets, Creatinine, Erythrocytes, C-reactive protein, Lymphocytes, Albumin, Glucose, Urea, and Sodium. The results of this study demonstrate that machine learning, particularly LGBM, is an effective method for predicting the severity of COVID-19. Identifying specific biomarkers associated with disease severity is crucial for the early intervention and prevention of Long COVID, thereby improving clinical outcomes and patient management. LGBM maintained its performance across different age groups. Full article

COVID-19 infection is often accompanied by psychological symptoms, which may persist long after the end of the infection (long COVID). The symptoms include fatigue, cognitive impairment, and anxiety. The reason for these long-term effects is currently unclear. Therapeutic approaches have included cognitive rehabilitation therapy, physical activity, and serotonin reuptake inhibitors (SSRIs) if depression co-exists. The neuropsychological evaluation of subjects with suspected cognitive issues is essential for the correct diagnosis. Most of the COVID-19 studies used the Montreal Cognitive Assessment (MoCA) or the Mini Mental State Examination (MMSE). However, MoCA scores can be confusing if not interpreted correctly. For this reason, we have developed an original technique to map cognitive domains and motor performance on various brain areas in COVID-19 patients aiming at improving the follow-up of long-COVID-19 symptoms. To this end, we retrospectively reanalyzed data from a cohort of 40 patients hospitalized for COVID-19 without requiring intubation or hemodialysis. Cognitive function was tested during hospitalization and six months after. Global cognitive function and cognitive domains were retrieved using MoCA tests. Laboratory data were retrieved regarding kidney function, electrolytes, acid–base, blood pressure, TC score, and P/F ratio. The dimensionality of cognitive functions was represented over cortical brain structures using a transformation matrix derived from fMRI data from the literature and the Cerebroviz mapping tool. Memory function was linearly dependent on the P/F ratio. We also used the UMAP method to reduce the dimensionality of the data and represent them in low-dimensional space. Six months after hospitalization, no cases of severe cognitive deficit persisted, and the number of moderate cognitive deficits reduced from 14% to 4%. Most cognitive domains (visuospatial abilities, executive functions, attention, working memory, spatial–temporal orientation) improved over time, except for long-term memory and language skills, which remained reduced or slightly decreased. The Cerebroviz algorithm helps to visualize which brain regions might be involved in the process. Many patients with COVID-19 continue to suffer from a subclinical cognitive deficit, particularly in the memory and language domains. Cerebroviz’s representation of the results provides a new tool for visually representing the data. Full article

The rollout of COVID-19 vaccines marked a turning point in pandemic control, yet vaccine hesitancy emerged as a significant obstacle in sub-Saharan Africa (SSA). The study aims to investigate socio-behavioural drivers of vaccine hesitancy in three high-resistance countries: the Republic of Congo, the Democratic Republic of the Congo, and the Republic of Guinea-Bissau. By employing a qualitative ethnographic design, in the period from April to October 2022, the study enrolled 752 participants in semi-structured in-depth interviews and focus group discussions, involving community leaders, women’s leaders, healthcare providers, traditional practitioners, traditional leaders, drivers, and youth leaders, ensuring diverse perspectives. Findings indicate that vaccine hesitancy is fluid and contextual with three principal drivers: (1) denial of COVID-19’s existence, often reinforced by scepticism among healthcare providers and the belief that the disease is foreign or a governmental scheme for financial gain; (2) misinformation, including rumours about vaccine incompatibility with certain foods, and fears of sterility and witchcraft; (3) a firm reliance on traditional medicine, seen as effective alternative to biomedical interventions. Vaccine hesitancy can only be addressed through culturally responsive, multisectoral approaches centred on community dialogue, improved communication, and the integration of trusted networks. Without inclusive strategies, resistance will undermine pandemic response and future health interventions in SSA. Full article

The isolation period during the COVID-19 pandemic significantly altered physical activity and social interactions in children, with disproportionately severe effects in impoverished indigenous communities. To evaluate the impact of the COVID-19 pandemic on body composition and cognitive status in Maya children. A prospective study conducted from March 2020 (pre-COVID) to April 2022 (post-COVID) involving 80 school-aged children from Tahdziú, Yucatán, México. Somatometric, cognitive, and dietary parameters were assessed. Post-pandemic assessments revealed a statistically significant increase in the prevalence of excess body fat mass (2.5% vs. 16.3%)*, fat arm area (7.6% vs. 20%)*, and fat mass index (5.1% vs. 16.3%)*. There was also an upward trend in excess body weight (24.1% vs. 31.1%) and cardiometabolic risk index (24.1% vs. 32.5%). High rates of undernutrition persisted (78.8% and 76.3%), as did impaired cognitive function (13.8% and 21.3%). Additionally, 97.8% of children reported a low-dietary-quality (HEI score < 80). The pandemic negatively impacted body composition, increasing adiposity markers associated with future cardiometabolic risk. It also exacerbated pre-existing vulnerabilities, as evidenced by low diet quality and worsening cognitive performance, potentially contributing to long-term educational disparities in this population. Full article

With the growing prevalence of digital media use, increasing attention has been directed toward the impact of smartphone usage patterns on mental health. In particular, the COVID-19 pandemic fundamentally altered daily life, accelerating the integration of smartphones into social and economic activities. This study utilized four years of cross-sectional data (N = 75,450) to examine how different types of smartphone application usages—specifically gaming, social networking services (SNS), and online shopping—are associated with problematic smartphone use (PSU), comparing patterns during and after the pandemic. The findings indicate that excessive gaming had a consistently notable association with PSU across both periods. However, the relationship between SNS and shopping app usage on PSU was significantly stronger after the pandemic. This shift suggests that while such applications served essential roles during the pandemic, their continued and excessive use after the return to face-to-face interaction may potentially contribute to problematic use. These results highlight the evolving nature of smartphone application use and its psychological consequences, underscoring the importance of developing tailored intervention strategies that reflect post-pandemic digital behaviors. Full article

Despite a substantial volume of literature on the consequences of the recent pandemic, the relationship between psychological constructs that affect individual mindset and confidence, as well as travel intention, is missing. This study seeks to examine the travelers’ behavioral intentions and psychological constructs. The study was conducted among 398 Malaysian medical students. The study was conducted from the end of 2022 to the middle of 2023. The study followed PLS-SEM to estimate relationships between variables and predict dependent variables. The results revealed a negative correlation between travel risk, severity, travel barriers, and travel intention, while COVID-19 vaccination effectiveness and self-efficacy positively influenced travel intention. The present study reveals that individuals with higher levels of self-efficacy or confidence in overcoming obstacles and coping with the challenges of new circumstances exhibit a stronger intention to travel (ITT). This study contributes to understanding the cognitive process of individuals’ intentions to travel and the coping mechanisms during the post-pandemic. Utilizing the health belief model, this study validates how individual health behavior regarding perceived risk affects travel decisions or intentions. This study provides valuable insight into consumer behavior for decision-making in the aviation and tourism industries and for policymakers after the global health crisis. Full article

Background: This study aims to investigate and monitor cardiorespiratory fitness levels, measured by the 6-minute walk test (6MWT) and quality of life (QoL), assessed using the Short form-36 (SF-36), in patients with hypertension, both with and without coronavirus disease 2019 (COVID-19), at a 3-month follow-up. Methods: Sixty participants were recruited, comprising two groups: hypertensive patients with COVID-19 and hypertensive patients without COVID-19, with 30 individuals in each group. Cardiorespiratory response parameters were assessed before and after performing the 6MWT. QoL was evaluated using the SF-36 at baseline and again at 3 months. Results: Hypertensive patients who recovered from COVID-19 showed significant improvements, including reduced post-exercise HR, SBP, SpO₂, RPE, and leg fatigue, as well as increased 6MWT distance and enhanced QoL compared to baseline (p < 0.05). These parameters improved and returned to levels similar to those of hypertensive patients without COVID-19 by the 3-month follow-up. Conclusions: Hypertensive patients who have recovered from COVID-19 can achieve cardiorespiratory fitness and QoL levels comparable to those of hypertensive individuals who did not contract COVID-19 by the 3-month follow-up. Full article