COVID, Volume 6, Issue 2 (February 2026) – 8 articles

Wastewater-Based Epidemiology (WBE) has emerged as a critical tool for monitoring SARS-CoV-2 circulation at the community level. This study assessed spatiotemporal viral dynamics in Las Heras, Mendoza, Argentina, by comparing wastewater samples from six sewer maintenance holes and three wastewater treatment plants (WWTPs) between January and June 2021, and by conducting long-term surveillance at Campo Espejo WWTP during epidemic (2020–2021) and endemic (2024–2025) phases of COVID-19. Viral particles from sewer manholes and WWTPs samples were concentrated by polyethylene glycol precipitation or aluminum polychloride adsorption–precipitation methods, and then SARS-CoV-2 RNA was quantified by reverse transcription quantitative polymerase chain reaction targeting N1 and N2 nucleocapsid viral markers. Results showed consistent detection of viral RNA across all sites, with peaks in wastewater preceding diagnosed COVID-19 cases increases, confirming WBE as an early-warning system. Localized sewer sampling identified urban hotspots, while WWTPs monitoring captured broader epidemiological trends. Recently, COVID-19 surveillance showed lower and intermittent viral loads, decoupled from diagnosed cases, compared to epidemic phase, indicating a transition to endemic circulation. Overall, combining upstream and downstream WBE enhanced spatial and temporal resolution, demonstrating its utility for public health monitoring during both epidemic and endemic phases. Full article

A rare but potentially fatal hyperinflammatory disease that develops following SARS-CoV-2 infection is called multisystem inflammatory syndrome in children (MIS-C). Mucocutaneous manifestations are common and frequently overlap with other pediatric inflammatory illnesses, including Kawasaki disease, and may serve as early diagnostic indicators. We describe a 6-year-old girl who was previously healthy but was hospitalized in the pediatric intensive care unit due to a high-grade fever, toxic appearance, and quickly progressing mucocutaneous symptoms, such as bilateral non-purulent conjunctivitis and broad maculopapular rash. Myocardial dysfunction, severe anemia and thrombocytopenia, respiratory failure necessitating mechanical ventilation, and hypotensive shock complicated the clinical course. Laboratory tests showed positive SARS-CoV-2 serology and significantly increased inflammatory markers. Several microbiological tests came up negative. Bacterial sepsis and Kawasaki diseases were not included. A diagnosis of MIS-C was made based on clinical, laboratory, and epidemiological data. In addition to supportive intensive care, the patient received systemic corticosteroids and intravenous immunoglobulin. After two weeks, she was released in a stable condition after gradually improving clinically and biochemically. This instance emphasizes how crucial it is to identify noticeable mucocutaneous manifestations as early warning signs of MIS-C. Immunomodulatory therapy must be started as soon as possible in order to minimize serious consequences and enhance the prognosis of afflicted infants. Full article

The COVID-19 pandemic disrupted the global construction industry, resulting in workforce shortages, project delays, and contractual disputes. This study used an online survey of private engineering and construction companies to assess their responses to the challenges posed by COVID-19. The survey focused on workforce management, technological advancements, safety protocols, and project execution. Workforce adaptations, particularly the shift to telework, saw 66% of respondents reporting partial telework and 22% indicating that telework became permanent after the pandemic. Technological advancements were crucial for maintaining operations during the pandemic, with 82% of respondents reporting the adaptation of new digital tools. These included widespread adoption of Microsoft Teams and Zoom by both office and field staff. Training was identified as essential for the effective implementation of these technologies, enabling employees to maximize their benefits. The pandemic affected project design and construction activities, with 69% of respondents reporting delays during the design phase and 70% during construction. Cost overruns of up to 25% were reported in the public sector and 67% of respondents in the private sector reported cost overruns, highlighting the financial impact of the pandemic. The findings provide insights into organizational resilience strategies adopted by private firms and offer lessons that can inform preparedness for future disruptions. Full article

University students are a major target population for infectious disease prevention programmes. Understanding the barriers to implementation of these programmes, and specifically vaccines, among student populations is critical for effective health prevention strategies. To assess changes in COVID-19 vaccine hesitancy and vaccine delivery programmes, we compared questionnaire-based survey data of two cohorts of first year students from two points, July and October 2021, during the COVID-19 vaccine rollout in the United Kingdom. We observed a highly significant increase in vaccine uptake without any alteration in vaccine hesitancy, as measured using a modified VAX score between the two survey dates. The October survey confirmed an association of vaccine hesitancy with the Non-White ethnic group and specifically identified concerns with the plurality of vaccine testing as a potential cause of this hesitancy. University pop-ups for COVID-19 vaccine delivery were not extensively utilised but were deemed as strongly or weakly favourable by 28.3% of students. Survey responses indicated that on-campus pop-ups for delivery of MMR and MenACWY were also supported by a significant minority of students. Full article

Coronavirus disease 2019 (COVID-19) has caused substantial global health and economic disruption, and identifying factors associated with adverse outcomes remains essential. This study is a first-wave observational study and examined risk factors and outcomes among patients admitted with COVID-19 to a non-acute hospital during the first wave of the pandemic, with particular focus on social deprivation and frailty. We conducted a retrospective review of clinical notes for 205 patients admitted between December 2019 and June 2020. Frailty was assessed using the Clinical Frailty Score and the Charlson Comorbidity Index, and social deprivation was evaluated using the Welsh Index of Multiple Deprivation. Although more women than men were admitted, mortality rates were similar across sexes. Older age was associated with increased mortality, and ischaemic heart disease was the most common comorbidity, occurring more frequently among patients who died. Those who died also demonstrated greater frailty, reflected in higher frailty and comorbidity scores. Most patients, irrespective of survival, were from less deprived areas, and greater social deprivation was not associated with increased admission or mortality. These findings indicate that older age, frailty, and ischaemic heart disease are important predictors of mortality in non-acute hospital settings, while social deprivation did not appear to influence admission risk or outcomes in this cohort. As this cohort predates widespread vaccination and antiviral therapy, these findings provide insight into baseline risk factors for COVID-19 mortality in frail populations during the first pandemic wave. Full article

The COVID-19 pandemic (2020–2023) profoundly disrupted healthcare systems and imposed sustained psychological burdens on healthcare professionals and trainees. Reliable instruments are essential for assessing these impacts. This study evaluated the construct validity and reliability of the Fear of COVID-19 Scale (FCV-19S) in a convenience sample of 1761 healthcare professionals, trainees, and academic staff at a single U.S. academic health sciences center (the University of Oklahoma Health Campus). Participants completed the FCV-19S; confirmatory factor analysis (CFA) examined its dimensional structure; and internal consistency was assessed using Cronbach’s α and McDonald’s ω. The one-factor model demonstrated good internal consistency (α = 0.89; ω = 0.89) but exhibited sub-optimal model fit (CFI = 0.89; TLI = 0.83; SRMR = 0.06; RMSEA = 0.18). The two-factor model, distinguishing emotional and somatic fear, showed substantially improved fit (CFI = 0.97; TLI = 0.96; SRMR = 0.03; RMSEA = 0.09) and acceptable internal consistency for both factors (α = 0.85 and 0.86; ω = 0.85 and 0.87), although RMSEA remained above conventional thresholds for close fit. Overall, findings support a two-factor structure as a comparatively superior and more nuanced representation of fear responses among an academic health workforce. The validated FCV-19S offers a reliable tool for assessing COVID-19-related distress in clinical and educational health settings, informing targeted interventions to strengthen workforce resilience. Full article

Background: Endocrine disturbances are increasingly recognized as components of long COVID, yet long-term data remain limited. This study evaluated the prevalence of dysglycemia and thyroid autoimmunity four years after SARS-CoV-2 infection in adults without previously known endocrine disease. Methods: We conducted a retrospective longitudinal 4-year evaluation of adults hospitalized for COVID-19 between 2020 and 2021. Of 1009 eligible patients without prior diabetes or thyroid disease, 96 completed a standardized 4-year post-infection evaluation. Acute-phase data included COVID-19 severity, admission glucose, inflammatory markers, imaging findings, and treatments. The 4-year evaluation comprised fasting plasma glucose, thyroid function tests, anti-thyroid antibodies (anti-TPO, anti-Tg), and thyroid ultrasonography. Baseline HbA1c, thyroid autoantibodies, and thyroid imaging were not available. Results: At four years post-infection, 27.1% of patients exhibited dysglycemia compatible with type 2 diabetes mellitus, 41.6% showed thyroid autoimmunity, and 15.6% presented with both conditions. Overall, 47.9% developed at least one endocrine alteration. Admission hyperglycemia strongly predicted long-term dysglycemia (OR 6.67; 95% CI: 1.45–30.58), and diabetes prevalence increased with acute disease severity. Thyroid autoimmunity was frequent but not associated with initial COVID-19 severity. Conclusions: Four years after SARS-CoV-2 infection, a substantial proportion of patients exhibited persistent metabolic and autoimmune alterations, supporting a long COVID immunometabolic phenotype. In the absence of baseline endocrine data, the reported findings reflect long-term endocrine alterations identified at the 4-year evaluation, with a potential role of SARS-CoV-2 infection. These findings highlight the importance of baseline metabolic and thyroid assessment—including HbA1c and thyroid autoantibodies—in hospitalized COVID-19 patients and underscore the need for structured long-term endocrine monitoring. Full article

Although self-administered antigen tests are widely available, anatomical knowledge of nasal anatomy in the general population is limited. Cerebrospinal fluid leakage has been reported in multiple cases following damage to the roof of the nasal cavity due to accidental penetration of the cribriform plate of the ethmoid bone. Methods: Images of anatomical prosections used for teaching in the Dissection Room of the Faculty of Medicine of the University of Barcelona were obtained to illustrate the viable pathway to the nasopharynx through the inferior meatus, below the inferior turbinate. Screenshots from publicly available videos produced by the author demonstrating perpendicular swab insertion were analyzed, and multiethnic illustrative images were taken from staff volunteers. Publicly available instructions for patients included in the first eight nasal antigen tests for self-diagnosis authorized in Spain in 2021 were reviewed. Results: Most of the initially authorized antigen tests (all but one) still recommended in 2025 a vertical swab insertion. However, successful insertion into the inferior meatus towards the nasopharynx can be achieved with a perpendicular approach. A schematic illustration for free use is provided. Conclusion: Swab instructions should indicate an insertion perpendicular to the face to access the inferior meatus safely and reduce the risk of injury to the ethmoidal cells. Full article