COVID, Volume 5, Issue 5 (May 2025) – 13 articles

In the past 5 years, the COVID-19 pandemic has experienced frequently changing variants contextualizing immune evasion. The emergence of Omicron with >30–50 mutations on the spike gene has shown a sharp divergence from its relative VOCs, such as WT, Alpha, Beta, Gamma, and Delta. The requisition of prime boosting was essential within 3–6 months to improve the Nab response that had been not lasted for longer. Omicron subvariant BA.1.1 was less transmissible, but with an extra nine mutations in next variant BA.2 made it more transmissible. This remarkable heterogeneity was reported in ORF1ab or TRS sites, ORF7a, and 10 regions in the genomic sequences of Omicron BA.2 and its evolving subvariants BA.4.6, BF.7, BQ.2, BF. 7, BA.2.75.2, and BA.5 (BQ.1 and BQ.1.1). The mutational stability of subvariants XBB, XBB 1, XBB 1.5, and XBB 1.6 conferred a similar affinity towards ACE-2. This phenomenon has been reported in breakthrough infections and after booster vaccinations producing hybrid immunity. The reduced pathogenic nature of Omicron has implicated its adaptation either through immunocompromised individuals or other animal hosts. The binding capacity of RBD and ACE-2, including the proteolytic priming via TMPRSS2, reveals its (in-vitro) transmissibility behavior. RBD mutations signify transmissibility, S1/S2 enhances virulence, while S2 infers the effective immunogenic response. Initial mutations D614G, E484A, N501Y, Q493K, K417N, S477N, Y505H, and G496S were found to increase the Ab escape. Some mutations such as, R346K, L452R, and F486Vwere seen delivering immune pressure. HR2 region (S2) displayed mutations R436S, K444T, F486S, and D1199N with altered spike positions. Later on, the booster dose or breakthrough infections contributed to elevating the immune profile. Several other mutations in BA.1.1-N460K, R346T, K444T, and BA.2.75.2-F486S have also conferred the neutralization resistance. The least studied T-cell response in SARS-CoV-2 affects HLA- TCR interactions, thus, it plays a role in limiting the virus clearance. Antigenic cartographic analysis has also shown Omicron’s drift from its predecessor variants. The rapidly evolving SARS-CoV-2 variants and subvariants have driven the population-based immunity escape in fully immunized individuals within short period. This could be an indication that Omicron is heading towards endemicity and may evolve in future with subvariants could lead to outbreaks, which requires regular surveillance. Full article

This study investigates the cross-cultural experiences and evolving sense of belonging among international students during the COVID-19 pandemic at a large Midwestern U.S. university. Using a mixed-methods approach, we collected quantitative data through a Qualtrics survey and qualitative insights from in-depth interviews. Findings reveal that while students generally adapted to academic and social disruptions, they faced intensified challenges related to cultural isolation, mental health struggles, and immigration uncertainties. Resilience, individualized coping strategies, and shifts in their sense of belonging emerged as key themes. The study contributes practical and theoretical insights by identifying institutional strategies to strengthen cultural inclusion, mental health support, and student engagement during global crises. These findings inform future research, university policies, and support systems aimed at enhancing international students’ wellbeing and fostering more inclusive educational environments during times of uncertainty. Full article

This study explored the integration of technology into teaching practices by examining how faculty members at a newly established university in Saudi Arabia utilized the Blackboard learning system. Specifically, it investigated the use of multimedia e-learning tools by male and female faculty members during regular teaching periods following the COVID-19 pandemic. A survey questionnaire was developed using a 5-point Likert scale. The instrument covered demographic information, content creation, assessment methods, utility tools, and factors influencing Blackboard usage. Upon receiving approval, the survey was distributed via email to all faculty members across nine colleges. A total of 198 responses were collected and analyzed using both descriptive and inferential statistical methods. The findings indicated that gender had little to no statistically significant impact on the use of key Blackboard tools—such as content creation features (e.g., files, folders, items), assessment tools (e.g., tests, assignments), and utilities (e.g., virtual classes, email)—at the college level. However, when analyzed at the university level, some tools’ usage showed statistically significant gender differences at the α = 0.05 level. Furthermore, both male and female faculty members cited convenience, flexibility in uploading materials, access to virtual classes, and remote assessment of students as primary factors influencing their e-learning preferences. Full article

Introduction: A growing body of literature has identified a variety of factors affecting vaccine uptake, but the role of geographic accessibility remains unclear. This study fills this knowledge gap by empirically investigating the extent to which the time driving to vaccine sites as a measure of geographic friction affected COVID-19 vaccine uptake. Methods: A logistic model and a hazard-based duration model were applied to the official data of more than 142,000 adults who took at least one COVID-19 vaccine in Nueces County, Texas, between December 2020 and August 2022. Using the street network, travel time was calculated from individuals’ home addresses to the addresses of the sites where they received their vaccinations. Results: The logistic model indicated that individuals living farther from vaccine sites were less likely to receive full vaccination, controlling for their sociodemographic characteristics that affected vaccine hesitancy. The duration model further showed that fully vaccinated persons would delay a booster shot longer if they had to travel longer for a vaccine. Conclusions: To the extent that the health protection of a COVID-19 vaccine declines over time, the integration of spatial and temporal dimensions in the duration model allowed us to shed light on the relationship between travel time and delay in booster vaccination. A vaccination campaign should make vaccination services physically convenient for vaccine recipients from different communities. Full article

The implementation of a range of social distancing and lockdown measures during the COVID-19 pandemic were seen to impact on the well-established epidemiology of facial trauma. This narrative review aimed to synthesize the international findings of this effect by evaluating the previously published literature. Relevant studies published between 1 January 2020, and 31 December 2024, were identified using four databases: PubMed, Embase, Cochrane, and SAGE Journals. A total of 63 studies across 19 countries were included. Descriptive analysis found that these were predominantly undertaken within oral and maxillofacial surgery departments (n = 48), as a single-center cohort study (n = 56), including greater than 500 patients (n = 22), with a duration of study between 1 and 52 weeks (n = 52). The principal finding was that 83% (n = 52) of studies reported a significant decrease in the number of facial trauma presentations. Falls (n = 35) in a domestic setting (n = 13) were identified, respectively, as the predominant etiology and place of injury. This is an out-of-the-ordinary observation when compared to routinely encountered causes. This study demonstrated that social distancing measures significantly influenced the epidemiology of facial trauma presentations that occurred during the pandemic. Full article

During the COVID-19 pandemic, longitudinal serological surveillance was critical to accurately assess the cumulative incidence of COVID-19 and monitor population-level immunity among children. We characterized the epidemiology of COVID-19 among North and South Carolina children using remote electronic symptom surveillance and serial at-home antibody testing in 2–17-year-old children from April to December 2021. We estimated accumulation of infection-induced antibodies, defined as seropositivity before vaccination. Reported novel symptoms were characterized for seropositive and seronegative participants. A total of 1058 children (median age 10 years (IQR 7–13)) participated in symptom surveillance. Estimated cumulative prevalence of infection-induced antibody increased from 0% (0–60%) to 85.7% (31.6–97%), 3.1% (0–9.0%) to 61.7% (46.1–72.7%) and 5.6% (0–15.6%) to 75% (59.9–84.4%), respectively, among those aged 2–4, 5–11 and 12–17 years. Determinants of seropositivity included Black race (OR 2.06 (1.19 to 3.47)) and having >5 household members (OR 3.05 (1.21 to 7.45)). Participants seroconverting reported mostly respiratory or systemic symptoms, but 52% (28/52) were asymptomatic. We demonstrate the role of at-home testing in trending SARS-CoV-2 seroprevalence in a community cohort of children. Such regional serological surveillance complements national data for a more complete assessment of SARS-CoV-2 burden and transmission. Future applications of the remote surveillance platform may be leveraged for characterizing the epidemiology of novel pathogens. Full article

This study investigates the impact of the COVID-19 pandemic on teachers’ labor market outcomes and estimates the returns on unionization. Using a difference-in-differences approach, I identify the effects of the pandemic on employment, earnings, and other labor market outcomes for unionized teachers relative to their non-unionized counterparts. The findings suggest that unionized teachers experienced greater job security and maintained their pre-pandemic wage premium. The role of unions varies significantly across teacher characteristics. Additionally, unionized teachers were more likely to work remotely and remain employed during the pandemic. Full article

Background: This study aimed to investigate the provision of dental care to patients admitted to a public tertiary hospital due to SARS-CoV-2 infection. Methods: A chart review was conducted using medical records of patients admitted with a confirmed diagnosis of SARS-CoV-2 infection at a public tertiary hospital. Patients hospitalized for at least 10 days were included, and data were collected on demographic variables, comorbidities, oral health status, and hospitalization outcomes. Results: A total of 295 patients were included (mean age 60.8 ± 17.4 years). Comorbidities were common, with 29.8% of patients diagnosed with diabetes and 53.3% with hypertension. Only 47.5% of patients received an oral health assessment upon admission, and 58% received oral hygiene care during hospitalization. Oral health evaluations revealed that older adults exhibited significantly higher rates of total edentulism, received more oral hygiene care during hospitalization, and were more likely to undergo oral evaluation at admission. Regarding clinical outcomes, patients with altered mouth opening had significantly lower Glasgow Coma Scale scores (p < 0.001), and those with altered oral mucosa showed reduced oxygen saturation levels (p = 0.006). Conclusions: These study findings highlight the importance of dental care in critically ill COVID-19 patients, particularly in ICU settings. It emphasizes the need for improved dental documentation and integration of dental professionals into hospital-care teams to reduce complications and enhance both oral and systemic health outcomes. Full article

Background: The purpose of this study was to investigate the incidence and impact of neuropsychological symptoms related to long COVID syndrome to better understand, characterize, and treat symptoms. Methods: A retrospective chart review was performed utilizing de-identified patient data obtained from UConn Health’s Long COVID Clinic and Recovery Center within the Department of Pulmonary, Critical Care, and Sleep Medicine in Farmington, CT between March 2020 and August 2022. A total of 155 patients were included, and data was collected via standardized patient questionnaires. These included a review of systems, followed by physical examination and further diagnostic testing and treatment as indicated. Results: Of the 155 patients, many were female (females n = 102 versus males n = 53) and more than 60% of patients were between 41 and 60 years of age. This was despite higher hospitalization rates in males (n = 24, 45.3%) and those over the age of 71 (n = 7, 70.0%). Most patients did report experiencing neuropsychological symptoms attributed to long COVID syndrome, which unfortunately did not correlate with diagnostic modalities such as brain imaging in most cases. Conclusions: In the aftermath of the COVID-19 pandemic, patients have been left with lingering symptoms now defined as long COVID syndrome. Our study highlights the extent of neuropsychiatric symptom burden in the setting of long COVID syndrome. Pathophysiological mechanisms in the development of long COVID syndrome in certain patient cohorts are not well understood, and are believed to be secondary to immune system dysregulation leading to chronic inflammation. Full article

COVID-19 introduced widespread challenges in healthcare access and was demonstrated to be a significant stressor for patients with pelvic floor dysfunction (PFD). Pelvic Floor Physical Therapy (PFPT) is a first line behavioral modification to address PFD. The impact of COVID-19 on PFPT adherence rates in a urogynecologic population is unknown; therefore, a retrospective chart review was conducted looking at “pre-pandemic” (referring to before 1 March 2020) and “pandemic” (referring to after 1 March 2020) cohorts. A total of 173 women met the inclusion criteria (93 pre-pandemic vs. 80 pandemic). The PFPT adherence rates were similar between the pre-pandemic and pandemic groups (20.0% vs. 18.8%, p = 0.85). Patient-reported barriers to initiation included insurance coverage, transportation, and time commitment. When looking for clinical correlates associated with non-adherence, patients who utilized an internal referral to a hospital-associated PFPT facility were 4.9-fold more likely to adhere to PFPT for PFD (95% confidence interval: 1.31–18.23, p = 0.018). While COVID-19 was not identified as a barrier to PFPT adherence, identifying barriers preventing patients from attending PFPT remains an area for improvement. Increasing the utilization of an internal referral system to a hospital-associated PFPT facility may be an effective solution for increasing patient adherence. Full article

The COVID-19 pandemic has necessitated urgent measures to curb its spread, with vaccination emerging as a pivotal strategy. This prospective observational study evaluated breakthrough COVID-19 infections among healthcare workers (HCWs) vaccinated with Comirnaty (Pfizer-BioNTech) at a tertiary care hospital in Greece. Over an 8-month period, from February to September 2021, 1958 fully vaccinated HCWs were monitored. Rapid antigen tests and RT-PCR tests were conducted weekly for asymptomatic HCWs. Contact tracing and whole-genome sequencing were performed. Results showed that 2.75% (54 cases) of HCWs experienced breakthrough infections. Among these, 25 (45%) were asymptomatic, mild symptoms occurred in 21 (37%), while 7 (13%) had a fever (≥38 °C) alone and 3 (5%) developed high fever (≥39 °C) with respiratory symptoms. Physicians and nursing staff were the most affected groups. Dominant SARS-CoV-2 variants detected included Delta, British, and Wild type variants. Comparison with existing literature underscored the effectiveness of Comirnaty in reducing breakthrough infections. The findings emphasize the importance of continued booster vaccinations and ongoing surveillance to mitigate breakthrough infections among HCWs. Full article

Through engagement with multi-stakeholders—including African, Caribbean, and Black (ACB) community members and leaders, as well as service providers in Ottawa, Ontario, Canada—this study explores in-depth narratives and first-hand accounts of their lived experiences in the context of COVID-19 vaccine promotion. A thematic analysis of the focus group discussions, conducted in NVivo, revealed that vaccine acceptance among ACB communities is shaped by factors such as racial discrimination, COVID-19 knowledge, misconceptions, communication strategies and barriers, preference for alternative medicines, and community resilience. These findings highlight several implications for policymakers and provide directions for future research. Full article

Introduction: A limited March 2024 Google Scholar search regarding COVID-19 redeployment to emergency care in fourteen medical specialties found no oncologist returns. Identifying oncologist redeployment through a scoping review of peer-reviewed research from several databases investigates this anomaly. Method: Searched are Web of Science, Scopus, PubMed, OVID, Google Scholar, and the Cochrane COVID-19 Study Register with the keywords “burnout AND COVID-19 AND emergencies AND oncologists” concerning the emergency experienced, their burnout response, and patient outcome. Results: Following the PRISMA scoping review process, the assessment is of eight reports from 17,848 results. The finding is that there was a redeployment of oncologists to emergency care. It was defined in various ways and caused oncologist burnout for several internally and externally directed reasons. These reasons negatively affected patient outcomes, contributing to the adoption of different coping techniques by oncologists. Oncologists, uniquely among medical specialists, experienced burnout regarding empathy for the increased mortality risk of their patients and the diminished doctor/patient bond. They also lacked symptom-directed coping. Conclusion: The results of this study may reinforce to oncologists the importance of their doctor/patient dyad and of initiating coping strategies that include symptom-directed health improvement techniques when the redeployment of oncologists is again to emergency care. Full article