COVID, Volume 5, Issue 3 (March 2025) – 15 articles

Highly Urbanized Cities (HUCs) in the Philippines were at the forefront of public health surveillance and response during the COVID-19 pandemic. With the rapid spread of COVID-19 to Philippine cities, local government units continuously assessed, adapted, and implemented public health interventions (PHIs) and depended on available open-source government data (OSGD). This study consolidated PHIs in selected HUCs in the Philippines using high-quality OSGD to create a timeline of interventions and document good practices in local COVID-19 control. OSGD resources were collected from February 2020 to January 2023, and the data quality of OSGD was evaluated using the Journal of the American Medical Association (JAMA) benchmarks. A total of 180 metadata sources that met at least two core standards (Authorship and Currency) were included in the analysis. COVID-19 control strategies were analyzed vis-à-vis the rise of COVID-19 cases and types of PHIs, including the control of imported cases, case management, contact management, behavioral modification, and pharmaceutical intervention. Travel bans and hard lockdowns in Luzon early in the pandemic delayed the introduction of COVID-19 to other parts of the country. Good practices of LGUs for local COVID-19 control, such as quarantine passes, curfews and liquor bans, using QR-based contact tracing, massive community testing in high-risk communities, and free public swabbing centers, were implemented to slow down the local spread of COVID-19. With the evolving scenarios in city-level COVID-19 epidemics, local risk assessments based on available OSGD drove the adoption of relevant and innovative control strategies in HUCs in the Philippines. Lessons learned must be integrated into epidemic preparedness and response programs against future emerging or re-emerging infectious diseases. Full article

On 11 March 2020, the World Health Organization (WHO) declared a pandemic caused by SARS-CoV-2, raising global health concerns. Reports of persistent and new symptoms following the acute phase of infection highlighted the complexities of recovery and prompted the investigation of what is now termed long COVID. Officially recognized by the WHO in October 2021, long COVID presents various health implications, though the terminology—such as post-COVID syndrome and post-acute sequelae of COVID-19 (PASC)—remains inconsistent, complicating diagnostic standardization. Long COVID affects an estimated 10% to 30% of SARS-CoV-2-infected individuals, with common symptoms including fatigue, dyspnea, cognitive dysfunction, and joint pain, all of which significantly impair quality of life. Public perception is influenced by factors like education and health history, while misinformation and stigma hinder accurate diagnosis and treatment. The absence of biomarkers and overlap with other post-viral syndromes further complicate clinical recognition. Experts emphasize the need for refined diagnostic criteria and integrated strategies combining biomedical research, public policy, and educational initiatives to improve clinical management, address healthcare inequalities, and mitigate the impacts of long COVID. This review unveils the state of the art and knowledge gaps to encourage discussion, with the aim of achieving better clinical decision-making and public awareness related to long COVID. Full article

Background: South Korea was one of the first countries to experience the Coronavirus disease (COVID-19) epidemic, and the regional-level trends and patterns in the incidence and case-fatality rates have been observed to evolve with time. This study established yearly spatiotemporal evolution patterns of COVID-19 by region and identified possible regional risk factors accounting for the observed spatial variations. Methods: COVID-19 data between 20 January 2020 and 31 August 2023 were collected from the Korean Centers for Disease Prevention and Control (KCDA). We generated epidemic curves and calculated the yearly incidence and case-fatality rates for each region. In addition, choropleth maps for the location quotient of cases and deaths to visualize yearly regional intensities were generated and the Moran’s I calculated. Associations between the incidence and case-fatality rates with regional risk factors were estimated using regression models. All analyses were performed in R version 4.4.2. Results: We noted a significant difference in the incidence rate by year, with 2022 recording the highest for all regions. A consistent and significant spatial autocorrelation for cases and deaths across all years was observed with Moran I values above 0.4 (p < 0.05). There was a positive association of COVID-19 incidence rates with the population density (RR = 0.02, CI: 0.01–0.04, p = 0.03), percentage aged 60 years and above (RR = 0.03, CI: 0.01–0.05, p = 0.01), smoking prevalence (women) (RR = 0.79, CI: 0.54–1.04, p = 0.01), and diabetes prevalence (women) (RR = 0.51, CI: 0.32–0.71, p = 0.04). Conclusions: The spatiotemporal evolution patterns of COVID-19 in Korea consisted of oscillating hot and cold spots across the pandemic period in each region. These findings provide a useful reference to the government as it continues with the routine surveillance of COVID-19 across the country. Full article

While COVID-19 imposed significant risks to the mental health of individuals of all ages, research suggests that university students were particularly vulnerable to such risks in this period. This study examined whether personality traits predicted the impact of COVID-19 on Chinese university students’ mental health during the COVID-19 pandemic; whether the coping strategies they used mediated such relationships; and whether the patterns of relationship differed across males and females. Participants (453 females, 374 males) completed online measures of personality, coping strategies, and of adverse shifts to mental health during the COVID-19 pandemic. Stepwise multiple regression analyses were conducted to assess the extent to which personality traits predicted mental health shifts, and path analyses were conducted to investigate whether these relationships were mediated by the coping strategies used. Neuroticism was found to be a significant predictor of more adverse mental health responses for both sexes during the pandemic, which was partially mediated by the coping strategies students used (in particular, avoidance coping strategies). Coping strategies played a weaker mediating role for females, suggesting that additional factors may influence their mental health responses. Tailored mental health support interventions should, therefore, consider both personality traits and the coping mechanisms used by individuals in response to stressful life events. Full article

This study examines the factors influencing the behavioral intention and compliance behavior of Transportation Network Vehicle Service (TNVS) drivers during the COVID-19 pandemic. Grounded in the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM), the study integrates psychological, environmental, and organizational factors to explain TNVS drivers’ adherence to safety protocols. Data were collected from 342 TNVS drivers in the National Capital Region (NCR) and CALABARZON through a structured survey. Structural Equation Modeling (SEM) was employed to analyze the relationships among variables and assess the determinants of compliance behavior. The results indicate that attitude toward compliance (β = 0.453, p < 0.001), risk perception (β = 0.289, p = 0.001), availability of personal protective equipment (PPE) (β = 0.341, p < 0.001), passenger compliance (β = 0.293, p = 0.002), company policies (β = 0.336, p = 0.001), and organizational support systems (β = 0.433, p < 0.001) significantly influence behavioral intention. In turn, behavioral intention strongly predicts compliance behavior (β = 0.643, p < 0.001), confirming its mediating role in linking influencing factors to actual adherence. However, stress and fatigue (β = 0.131, p = 0.211), ride conditions (β = 0.198, p = 0.241), and communication and training (β = 0.211, p = 0.058) showed non-significant relationships, suggesting that their direct effects on behavioral intention are limited. The model explains 69.1% of the variance in compliance behavior, demonstrating its robustness. These findings highlight the importance of fostering positive attitudes, ensuring adequate resource availability, and reinforcing organizational support to improve TNVS drivers’ compliance with safety measures. Practical recommendations include implementing educational campaigns, ensuring PPE access, strengthening company policies, and promoting passenger adherence to safety protocols. The study contributes to the broader understanding of health behavior in the ride-hailing sector, offering actionable insights for policymakers, ride-hailing platforms, and public health authorities. Future research should explore additional contextual factors, gender-based differences, and regional variations, as well as assess long-term compliance behaviors beyond the pandemic context. Full article

Background: Discussing healthcare professional safety—not just patient safety—is crucial for delivering safe and high-quality healthcare, an essential component for achieving the third Sustainable Development Goal. The evaluation of the safety of healthcare professionals requires instruments that address multiple dimensions of their safety: organizational, emotional, professional and structural. The aim of this study was to validate the Questionnaire on Health Professional Safety in the COVID-19 Pandemic (QSP COVID-19). Methods: This is a methodological study to develop and validate the QSP COVID-19. Data were collected in a Brazilian municipality in 2022 and 2023. Exploratory factor analysis was carried out using the FACTOR software version 12.04.04. Results: A total of 259 professionals answered the QSP COVID-19. The factor analysis extracted four factors (organizational, emotional, professional and structural dimensions) which explained 55.4% of the total variance. The QSP COVID-19 has 30 items, all of which had factor loadings above 0.300. The latent and observed H-index of the four domains suggests that the factors may be replicable in future studies. Conclusions: the QSP COVID-19 has evidence of validity for assessing the safety of healthcare professionals in the context of COVID-19. Full article

Despite the end of the COVID-19 pandemic, there still remain risks of new aggressive strains of coronavirus. As the human population increases progressively, it is mandatory to ensure both preventive measures and an immediate response to emerging infectious threats. Another essential component for rapidly restraining a new possible pandemic is the development of new anticoronaviral therapeutics. In the present study, the anticoronaviral capabilities of Gc protein-derived macrophage-activating factor (GcMAF) are characterized. It is demonstrated that the administration of GcMAF to Syrian hamsters infected with SARS-CoV-2 within the first phase of infection (six days postinfection) is accompanied by (i) a statistically significant reduction in the viral load of the lung tissue and (ii) the switching of the inflammatory status of the lung tissue to a neutral one in terms of mRNA expression levels of the groups of pro/anti-inflammatory cytokines and chemokines. The potential mechanism for this antiviral action and the containment of the inflammatory response by the drug associated with the engagement of terminal N-acetylgalactosamine GcMAF and C-type lectin domain containing 10A expressed at the surface of lung-infiltrating macrophages and pneumocytes, which simultaneously express angiotensin-converting enzyme 2, is discussed. Full article

Given the critical role of media in times of crisis, particularly for relaying scientific knowledge and political decisions, we evaluated to what extent the first COVID-19 pandemic wave affected the treatment by traditional media of important societal topics. We searched a database of 650 French-speaking Swiss media outlets using specific keywords and reported the number of publications per month containing these items, associated or not with SARS-CoV-2. The number of publications related to viruses increased 12-fold during the first semester 2020, while the media coverage of topics about bacteria, parasites, and fungi remained stable. During the first pandemic wave, media generated a larger number of publications treating of political and medical subjects than before the pandemic, whereas the coverage of other topics was unchanged. All topics were viewed through the prism of the pandemic, up to 82% of the publications being associated with COVID-19. The media largely covered all medical aspects related to SARS-CoV-2 infection and offered scientists multiple opportunities to communicate with the public. However, their influence was strongly challenged by the capacity of social networks to disseminate rumors and misinformation. We also assessed the articles published in traditional media during the five subsequent epidemic waves, showing that the largest media peaks occurred during the first infection wave studied extensively in the present work, and during the huge fifth infection wave due to Omicron variant BA1. Undoubtedly, the COVID-19 pandemic highlighted how important it is for science communication to harness the tremendous power of social media. Full article

During the COVID-19 pandemic, concerns grew about excessive opioid dosing in Intensive Care Unit (ICU) patients. This study aimed to evaluate opioid dosing in the ICU by comparing objective (Nociception Level Monitor (NOL)) and subjective (Behavioral Pain Score (BPS)) pain measurement tools in COVID-19 and non-COVID-19 ICU patients. This observational study included 40 sedated, mechanically ventilated ICU patients, with half confirmed as COVID-19. Measurements included NOL, BPS, Richmond Agitation Sedation Scale (RASS), Bispectral Index (BIS) and nurse questionnaires. NOL was categorized as <10 (possible excessive analgesia), 10–25 (adequate analgesia), and >25 (possible need for more analgesia). The Time Weighted Average (TWA) assessed the duration of NOL >25 (TWA_NOL>25). Primary outcomes were NOL and BIS over time. COVID-19 patients received higher sufentanil (18 ± 9 µg/h versus 9 ± 6 µg/h) and propofol (307 ± 127 mg/h versus 277 ± 137 mg/h) doses (p < 0.001). No significant differences were found in TWA_NOL>25 (p = 0.78) or BPS (p = 0.1). NOL values were <10 for 63% and 57% of the time in COVID-19 and non-COVID-19 patients. BIS (p < 0.001) and RASS (p = 0.02) were lower in COVID-19 patients. While COVID-19 patients received higher opioid doses, low NOL and BPS were seen in all patients, suggesting high analgesia in all patients. Based on our data, we cannot determine whether higher opioid doses in COVID-19 were warranted. Full article

Public health officials reported increases in stigma, discrimination, and verbal and physical abuse during the coronavirus (COVID-19) pandemic. This study, conducted in Vietnam, examined how stigma, fear of the virus, self-protective behaviors, and threats to and loss of resources during the pandemic were associated with post-traumatic stress and belief in vaccine effectiveness. Participants were 380 persons (237 women, 129 men, 14 unreported) who completed measures assessing demographics, stigma experienced during the pandemic, resource loss, fear about becoming infected with the virus, self-protective actions to avoid illness, post-traumatic stress, and belief in COVID-19 vaccination effectiveness. Hierarchical multiple regression showed post-traumatic stress was positively associated with COVID-19 stigma personal experience, minimizing the COVID-19 threat, personal characteristic and support resource loss, perceived susceptibility to illness, and fear of COVID-19. Vaccine support was positively associated with age, COVID-19 stigma personal experience, and self-protective behaviors to avoid illness, and negatively associated with number of people known who died due to the virus. The findings support the hypotheses and extend conservation of resources stress theory. The findings underscore the importance of promptly addressing stigma, enhancing public education, and addressing barriers to receiving the vaccine. Full article

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a positive-sense RNA virus with an unusually large genome of approximately 30 kb. It is highly transmissible and exhibits broad tissue tropism. The third most pathogenic of all known coronaviruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for the clinical manifestation known as coronavirus disease 2019 (COVID-19), which has resulted in the loss of millions of lives on a global scale. This pandemic has prompted significant efforts to develop therapeutic strategies that target the virus and/or human proteins to control viral infection. These efforts include the testing of hundreds of potential drugs and thousands of patients in clinical trials. Although the global pandemic caused by the SARS-CoV-2 virus is approaching its end, the emergence of new variants and drug-resistant mutants highlights the need for additional oral antivirals. The appearance of variants and the declining effectiveness of booster shots are resulting in breakthrough infections, which continue to impose a significant burden on healthcare systems. Computer-aided drug design (CADD) has been widely utilized for predicting drug–target interactions and evaluating drug safety; it is regarded as an effective tool for identifying promising drug candidates to combat SARS-CoV-2. The CADD approach aids in the discovery of new drugs or the repurposing of United States Food and Drug Administration (FDA)-approved drugs, whose safety and side effects are already well established, thus making the process more viable. This review summarizes potential therapeutic agents that target SARS-CoV-2 or host proteins critical for viral pathogenesis, as identified using CADD approaches. Additionally, this study provides insights into the common in silico methods used in CADD and their current applications in the SARS-CoV-2 drug discovery process. Full article

During COVID-19 “lockdown” most high school and college students experienced a sudden ending of face-to-face classes and were forced into multiple, rapidly prepared online courses. These experiences produced students more knowledgeable about online education than ever before. With this came a degree of certainty regarding their future educational delivery preferences. This survey (2021–2024) examined the attitudes and barriers associated with online course selection at a university within the State University of New York (SUNY) system. Using an introductory nutrition course, 658 surveys were exclusively collected from the face-to-face sections of a Natural Science course. Only 30.2% of these students reported a preference for online courses. Respondents reported similar percentages on Course Difficulty (48.5% online vs. 51.5% face-to-face) and which course required more Work/Time (43.2% online vs. 56.8% face-to-face). Previous negative online experiences were affirmed by 27.4% of the students. Importantly, only 14.5% self-reported a better academic performance in online courses. Major online avoidance variables were boredom (53.1%), inferior learning (52.9%), and communication limitations (43.0%). Surprisingly, 67.7% stated they would consider taking future online courses. Understanding post-COVID-19 student attitudes and barriers provides useful information and should be part of any comprehensive approach to future online education design and implementation. Full article

The novel coronavirus (COVID-19) pandemic has become one of the most devastating epidemics recorded in world history. The adverse impact of the pandemic is significant within the architecture, engineering, and construction (AEC) industry and other sectors of the economy. A considerable number of COVID-19 research studies have been undertaken in response to this global challenge across disciplines, with minimal output in the built environment. Thus, this study aims to identify, analyse, and visualise COVID-19 research trends in the AEC industry to unfold the sector’s response and readiness for possible future global pandemics. The study employed the scientometric approach to explore COVID-19 research outputs in the AEC industry, an aspect of health and safety in construction that has not been considered in past studies owing to the novel nature of the coronavirus pandemic. The findings revealed that the USA, China, and the United Kingdom were the top published countries and most affected as well. Co-occurring keywords analysis further showed that the predominant focus of scholarly outputs on the subject is around four clusters focusing on sustainable resilience, pandemic pathways and insights, land use and energy strategies, and indoor air excellence. Notwithstanding its limitations, the findings establish the need for the AEC industry to adopt innovative and holistically sustainable construction practices in the event of future disasters and pandemics. The findings of the study provide a robust theoretical foundation for researchers and stakeholders in the built environment, improving the sector’s mitigative and adaptive capacity in the potential occurrence of future pandemics. Full article

The early introduction of strict measures during the first wave of COVID-19 in Slovakia resulted in a low number of fatal cases. Most of them (27/28) were autopsied with microscopic evaluation focusing on changes in the lungs. The average age of the patients was 79. The most common microscopic finding was diffuse alveolar damage in various stages. There were statistically significant relationships between microthrombi and neutrophil count, level of C-reactive protein, and immobility. Oxygen therapy, as a factor that might cause changes typical for diffuse alveolar damage, showed statistically significant relationships with perivascular lymphocytic infiltrate, alveolar capillaritis, alveolar bleeding, and pneumocyte hyperplasia. Hyaline membranes showed a statistically significant relationship with monocyte count, and borderline statistically significant relationships with platelet count and antimalarial therapy. The level of C-reactive protein and neutrophil count seemed to be useful for predicting microthrombi formation. Interestingly, there were no statistically significant relationships between microthrombosis and anticoagulant therapy, platelet count, or level of D-dimer. Full article

While the COVID-19 pandemic’s impact on mortality and morbidity is becoming more understood, the severity of the long-term effects remains unknown: this includes medical sequelae of long COVID but also the impact of the social and economic upheaval on population health. Working parents faced many challenges during the pandemic, and the impact of these on the mental health and well-being of parents has been demonstrated. However, the extent of trauma-related symptoms among working parents who have faced unique challenges related to the virus itself and the social and structural consequences of containment efforts remains underexamined. Using data from a national panel survey of fworking parents (n = 1941), we explored the relationship between workplace policies and practices and COVID-19-related PTSD and psychological distress. Results demonstrate that nearly 50% of working parents experienced COVID-19-related PTSD as measured by the Impact of Events Scale-6, and over 60% had moderate to high levels of psychological distress. We examined mechanisms to understand the impact of job support on employees’ levels of PTSD and distress and found that both socio-demographic factors and workplace support related to levels of PTSD and distress among working parents. Our study highlights the distress and PTSD levels experienced by working parents in the early stages of the pandemic, underscoring the impact of workplace support on mental health outcomes. Full article