COVID, Volume 5, Issue 2 (February 2025) – 15 articles

Background: The long-term effects of COVID-19 infection represent an emerging area of research that explores the relationships between a history of COVID-19 infection and its consequential sequelae. This study investigates the potential associations among the time since infection, the severity of the acute phase of the disease, and sex, while controlling for age, in relation to mental health. Methods: A total of 305 university students participated in this cross-sectional study, during which data were collected using the SCL-90-R questionnaire. The analysis of the collected data was conducted using the MANCOVA, ANCOVA, and partial Kendall’s Tau methods. Results: The findings indicated that factors such as sex—specifically being female—longer time elapsed since infection, and disease severity significantly influenced multiple scales of the SCL-90-R. Conclusions: Based on these findings, it is recommended that investigations into mental health issues consider biological sex, COVID-19 severity, and the time since infection as potential risk factors among young adults with a history of COVID-19 infection. Full article

This study investigates the psychological factors influencing remote work acceptance during the COVID-19 pandemic using a Bayesian network and probabilistic structural equation modeling (PSEM) approach. The research specifically explores the impact of stress factors induced by the pandemic, including compulsive checking, socio-economic consequences, danger, and contamination, on individuals’ willingness to adopt remote work arrangements. Data were collected from 586 participants with remote work experience, and the Bayesian analysis revealed that compulsive checking had the most significant positive influence on remote work acceptance, followed by socio-economic consequences, while danger and contamination showed no statistically significant effects. The findings suggest that psychological stress factors related to excessive information seeking and economic instability play a stronger role in influencing remote work decisions than direct health-related concerns. These results provide theoretical contributions by extending technology acceptance models to crisis situations and offer practical insights for organizations aiming to implement effective remote work policies. Specifically, strategies such as psychological support programs, financial stability measures, and clear communication regarding workplace safety can enhance employee well-being and productivity in remote settings. Future research should explore long-term effects of stress factors on remote work sustainability and cross-cultural comparisons in pandemic-related work adaptations. Full article

Modeling efforts are needed to predict trends in COVID-19 cases and related health outcomes, aiding in the development of management strategies and adaptation measures. This study was conducted to assess whether the SARS-CoV-2 viral load in wastewater could serve as a predictor for forecasting COVID-19 cases, hospitalizations, and deaths using copula-based time series modeling. SARS-CoV-2 RNA load in wastewater in Chesapeake, VA, was measured using the RT-qPCR method. A Gaussian copula time series (CTS) marginal regression model, incorporating an autoregressive moving average model and Gaussian copula function, was used as a forecasting model. Wastewater SARS-CoV-2 viral loads were correlated with COVID-19 cases. The forecasted model with both Poisson and negative binomial marginal distributions yielded trends in COVID-19 cases that closely paralleled the reported cases, with 90% of the forecasted COVID-19 cases falling within the 99% confidence interval of the reported data. However, the model did not effectively forecast the trends and the rising cases of hospital admissions and deaths. The forecasting model was validated for predicting clinical cases and trends with a non-normal distribution in a time series manner. Additionally, the model showed potential for using wastewater SARS-CoV-2 viral load as a predictor for forecasting COVID-19 cases. Full article

In this study, we analyzed daily time series data on newly confirmed COVID-19 cases in each prefecture of Japan to investigate the mechanisms driving the virus’s spread. The dataset spans from 20 January 2020 to 7 May 2023, covering 1204 days and providing insights into daily case variations across prefectures. First, the time series data for each prefecture were decomposed into trend, weekly variation, and short-term components. Using the trend components, we estimated the time lag of infection spread between prefectures, revealing that Okinawa and Tokyo consistently led the spread compared to other regions. Factors influencing these lag values were also analyzed. Through a cluster analysis, we categorized all of the prefectures into 13 groups and conducted a detailed investigation of the infection dynamics within each group. The results highlighted that regions centered around Tokyo in the Kanto area acted as a primary epicenter, driving the nationwide spread through regions centered around Osaka and Kyoto. Additionally, we examined the effects of holidays and seasonal variations within the short-term components using a regression analysis. The findings showed that holidays initially had a negative effect on case numbers, followed by a significant positive effect one week later. Regarding seasonal effects, November exhibited the highest positive impact, while March demonstrated a negative impact during the analyzed period. Full article

The COVID-19 pandemic caused unprecedented global disruptions, profoundly impacting mental health and social well-being. While significant research has addressed the negative health consequences of social isolation, little is known about the post-pandemic experience, particularly in Greece. This qualitative study investigates the lasting effects of social isolation during the COVID-19 lockdowns on individuals in Greece, exploring both the negative and positive consequences in the post-pandemic context. One-on-one interviews were conducted with fifteen participants, and the data were analyzed using a thematic analysis. The findings revealed that the lockdown had a profound and enduring impact. Many participants reported heightened social anxiety, a sense of disconnection, and lingering fear about re-engaging in normal social interactions. Nostalgia for pre-pandemic life, characterized by greater social connection and freedom, was a recurring theme. Despite these challenges, the study also highlighted positive outcomes. Some participants viewed enforced solitude as an opportunity for self-reflection and growth, discovering new interests or deepening their understanding of personal values and goals. These findings underscore the complex and enduring effects of social isolation. The study calls for targeted interventions to foster social connectedness and mental health resources, ensuring support as society transitions to a post-pandemic reality. Continued attention from policymakers and public health professionals is crucial. Full article

Online learning during the COVID-19 pandemic has positioned students as objects. They are not given a position as subjects in the teaching–learning process. The policies of the online education system have forced students to lose their rights to negotiate and interact with teachers and friends. They are required to comply with all applicable regulations in their schooling during the COVID-19 pandemic. This paper maps the objectification aspects experienced by students during online education, including the types of burdens experienced during the learning process, as well as learning evaluations that are not optimal. The qualitative method used in this paper relies on data from interviews with 30 elementary school students. The results of this paper show that the online education system during the pandemic has positioned children as passive objects who only accept the decisions of adults, depriving them of opportunities to ask questions or engage in discussions with their teachers and peers. Children were expected to adhere to all predetermined policies without being given a platform to express their perspectives. This paper concludes that learning in the time of COVID-19 has taken away the ideal meaning of education for students, which should have been realized and safeguarded according to the expected goals. Full article

This study aimed to develop a scoring system to predict mortality risk in hospitalised COVID-19 patients using clinical, laboratory, and imaging data. A retrospective analysis was conducted at a single centre, including 325 patients admitted between March 2020 and December 2021. The data collected included patient demographics, laboratory results, medications, and thoracic CT images. Pulmonary involvement was assessed using the CO-RADS classification, while coronary artery calcification (CAC), aortic calcification, and epicardial adipose tissue were evaluated with specific scoring methods. Mortality predictors were identified through univariate and multivariate Cox proportional hazards models. The key mortality predictors identified in this study were an age above 67 years, elevated high-sensitivity troponin levels, a heart rate greater than 100 bpm, an oxygen saturation below 90%, the presence of CAC and aortic calcification, low haemoglobin levels, and the absence of acetylsalicylic acid (ASA) use at admission. The developed HEARRT-C scoring system demonstrated a strong predictive ability, with an area under the curve (AUC) of 0.91, showing 81% sensitivity and 86% specificity for predicting mortality. This study concluded that the HEARRT-C score is an effective tool for early risk stratification in COVID-19 patients, which may guide management decisions and emphasise the importance of cardiovascular factors and the potential protective role of ASA. Full article

The COVID-19 pandemic disrupted healthcare delivery across the United States (U.S.), including childhood vaccine administration. This study analyzed data from the National Health Interview Survey (NHIS), a nationally representative survey of the U.S. population, assessing trends and predictors of influenza vaccination uptake among children ≤ 5 years before and amid the COVID-19 pandemic. Influenza vaccination coverage declined significantly, from 56% in 2019 to 46% in 2022 (p < 0.001). Age-specific declines were notable, with rates dropping among one-year-olds from 68% to 53%, two-year-olds from 63% to 49%, and infants from 31% to 24% (p < 0.001). Logistic regression revealed African American children had lower odds of vaccination compared to non-Hispanic White children (OR = 0.70, p < 0.001), while Asian children had higher odds (OR = 1.32, p = 0.018). Uninsured children were less likely to be vaccinated than insured children (OR = 0.71, p = 0.022). Regional analysis showed the Northeast had the highest vaccination rates (60% in 2019, 56% in 2022), while the South had the lowest (52% in 2019, 41% in 2022). These findings underscore the need for targeted strategies to address socioeconomic disparities and improve influenza vaccine uptake in young children in the U.S. Full article

This study aimed to evaluate the type, frequency, onset, and recovery duration of neurological symptoms caused by COVID-19, including newly emerging post-COVID-19 neurological findings, to contribute to improved prognosis and follow-up strategies. A total of 110 COVID-19 patients hospitalized with positive SARS-CoV-2 PCR tests (24 December 2021–10 March 2022) were prospectively assessed. Neurological symptoms during hospitalization and at 1, 3, and 6 months post-discharge were documented, with all findings confirmed by a neurologist. The time of symptom onset was recorded for each patient. Fatigue (75.5%) was the most common symptom, lasting 10.43 weeks on average, followed by myalgia (57.3%, 4.29 weeks) and headache (56.4%, 3.35 weeks). Forgetfulness persisted the longest (22.03 weeks). Headache and myalgia were more frequent in women, while symptoms like dizziness, insomnia, and nausea/vomiting were more common in patients aged ≤50. No significant differences in symptom duration were observed based on age or gender. Neurological symptoms, such as fatigue, headache, myalgia, and forgetfulness, were prevalent in both the acute and post-COVID-19 phases. The study underscores the importance of systematic neurological monitoring and the development of individualized follow-up strategies to manage long-term neurological effects and improve patient outcomes. Full article

This research study explores the readiness, strengths, and challenges of the district health system and local bodies during Nepal’s COVID-19 vaccination program. The primary aim of this study is to identify gaps in the current health system and provide actionable insights for the effective implementation and management of large-scale health programs in the future. A qualitative approach was employed, gathering perspectives of key stakeholders through twelve key informant interviews of stakeholders involved in the planning, management, and execution of the vaccination program in Makwanpur district, the district with the administrative headquarters of Bagmati Province. The study was conducted in the context of Nepal’s transitioning health system following federalization. The qualitative data were analyzed using thematic analysis, guided by the VIRAT2.0 framework for vaccine readiness provided by the WHO. Seven domains from the framework were used to assess readiness and challenges faced by the newly formed health system. The challenges identified by key informants included insufficient logistics and supply chain management, poor coordination between local and higher levels of government, limited awareness about vaccination among the public, vaccine hesitancy, and lack of a robust system for data management and reporting. These findings highlight critical areas for improvement and can be useful evidence to inform the design and implementation of future health programs and policies. Full article

The COVID-19 pandemic lockdown restrictions had significant impacts on the well-being and academic functioning of students worldwide. When universities closed campuses and moved teaching and learning online, students faced numerous challenges. The researchers conducted a study to establish which factors most affected South African students’ academic competence during the initial months of lockdown and the shift to online learning. Using an online survey that focused on students’ wellness, perceived academic competence and coping behaviour, data were collected from 3239 university students. Multiple linear regression showed that students’ subjective sense of intellectual wellness, coping behaviour, satisfaction with support from the university, and mental health were strong predictors of academic competence. Other factors that influenced students’ academic competence were emotional and spiritual wellness, perceptions of safety and security, and hopefulness. Females, undergraduates, and Faculty of Law students reported higher perceptions of academic competence. These findings have practical implications for universities as they identify factors that contribute to students’ academic competence, especially during times of crisis and online learning. Academic and support services staff at universities may find the findings valuable when developing policies to provide appropriate resources and services to promote and sustain students’ academic functioning. Full article

This bibliometric review analyzes global research on COVID-19 vaccine side effects, focusing on publication trends, collaborations, and key topic areas. Using VOSviewer and Bibliometrix for data analysis and visualization, this study examines 1353 unique papers indexed in Scopus and Web of Science (2020–2024). The results indicate a significant increase in publications in 2021 and 2022, with the United States, China, and Europe contributing the most. While many studies focused on common side effects, such as headache, fatigue, and injection-site pain, rare but serious adverse events, such as myocarditis, thrombocytopenia, Guillain–Barré syndrome, pericarditis, and thrombosis, were also reported. However, regions with limited research infrastructure, particularly in developing countries, remain underrepresented despite the critical need for vaccine safety studies in these areas. Additionally, journals such as Vaccines, Vaccine, and Human Vaccines and Immunotherapeutics, all ranked Q1, dominate the publication volume, ensuring wide dissemination through open-access availability. This analysis also highlights global collaboration networks, identifying key authors and regions with high levels of co-authorship. Thematic mapping distinguishes niche topics focused on rare and severe side effects from driving topics addressing more common reactions. This review, therefore, underscores the importance of scaling up research efforts in underrepresented regions and strengthening global collaborations to ensure effective pharmacovigilance. Finally, future research should prioritize the long-term, ongoing monitoring of side effects and address disparities in scientific output, particularly in developing countries where vaccine safety data are urgently needed. Full article

Background: Understanding the extent of the disease penetration and assessing its impact is critical during a pandemic. However, laboratory-based COVID-19 estimation can be resource-intensive and may not be feasible during an emergency, particularly in low-resource settings. Aim: To investigate whether self-reported symptoms can be used for COVID-19 screening to estimate the burden among individuals aged 18 years and above in a rural setting. Methods: A community-based cross-section study was conducted in a rural district of Haryana, a state in north India, using a self-reported semi-structured questionnaire developed on a digital platform. Information on COVID-19 manifestations as essential and non-essential, confirmed laboratory tests, and disability data using Washington Groups of Short Set were obtained. The sensitivity of the COVID-19 symptoms was estimated against laboratory-confirmed true positives. A chi-square or Fisher exact test for association and a multivariable regression to determine the predictors of the prevalence was carried out. Results: In total, 2954 respondents (79.8%), out of 3700 enumerated, were interviewed. The mean age of respondents was 42 years (SD 17.2), with 54.8% female respondents. The prevalence of COVID-19 based on self-reported symptoms was 6.2% (95%CI: 5.3–7.1). The age-adjusted prevalence was 6.04% (95%CI: 5.9–6.1). Of the total COVID-19 cases, 170 (5.7%, 95%CI: 4.9–6.5) revealed a laboratory-confirmed test. Given three essential symptoms to declare provisionally COVID-19 cases, the sensitivity was 82.9% (141/170), but considering two or more essential symptoms along with two or more non-essential, the sensitivity reached up to 91.8% (156/170). The multivariable analysis showed that increased age, higher education attainment, students, entrepreneurs, persons working in private sectors, and participants with poor hygiene were predictors. Conclusions: A symptoms-based identification of COVID-19 cases can give a reliable estimate and valuable insight into the extent of the penetration, especially in low-middle-income countries, and can be a supplement, not a replacement, to a laboratory test. Full article

This study scrutinizes the influence of “blame attribution” and the Theory of Planned Behaviour (TPB) on compliance with COVID-19 public health measures in Australia. This study elucidates that blaming individuals rather than governments surprisingly augments support for governmental regulations, highlighting the complexities of blame attribution in shaping public adherence to health policies. It underscores the nuanced roles of TPB elements like subjective norms and behavioural control, revealing that feelings of empowerment, social responsibility, and recognizing personal roles in pandemic control enhance the inclination to support governmental directives. The outcomes emphasize the criticality of understanding blame attribution and TPB dynamics for devising efficacious communication and management strategies, promoting societal adherence to essential regulations and actions during health crises, and fostering a more resilient societal infrastructure for dealing with pandemics. Full article

The association between family violence and the COVID-19 pandemic remains complex. This meta-analysis aimed to determine trends in the observed changes in family violence comparing the pre-pandemic period to the pandemic period. A systematic search was performed in electronic databases to identify all relevant research reporting on COVID-19 and family violence. There was a statistically significant increase in family violence after the first lockdown. The odds ratio for the prevalence of physical and sexual violence together was 7.24 (95% CI = 4.74, 11.03 p < 0.001). A small marginal increase in the prevalence of various types of family violence leading to hospitalization was found, however, the result was not statistically significant (OR = 1.91, 95% CI = 0.91, 3.96, p = 0.09). A small significant increase in the prevalence of victims with a perception of increased violence during the pandemic lockdown was observed (proportion = 33%, 95% CI = 15.72%, 50.34%, p = 0.002). This meta-analysis found that during the COVID-19 lockdown, there was an increase in the prevalence of overall family violence, a small, non-significant, increase in the prevalence of hospitalizations due to family violence, as well as an increase in the perception of family violence by victims. These results are clinically relevant for implementing effective measures of violence prevention to safeguard vulnerable populations. Full article