COVID, Volume 6, Issue 3 (March 2026) – 24 articles

Background: The COVID-19 pandemic significantly altered the daily routines of young adults. This study investigated alcohol consumption patterns and associated factors among young adults in Romania during this period. Method: A cross-sectional study was conducted using an online survey. Participants were asked to retrospectively report their alcohol consumption patterns before and during the COVID-19 pandemic, including the period of university campus closures. A cohort of 249 young adults (68.6% female) participated in an online survey focused on their alcohol consumption patterns, utilizing the standardized AUDIT-C questionnaire and some modified questions to better establish the habit of drinking. Results: In total, 41.7% of the included subjects were in medical school, 10% in IT, and 44% in various areas of work. Most respondents were female, between 20 and 25 years old (65%) and living in urban areas, with wine being the most favorable drink. Regarding AUDIT scores, approximately 90% fall into low-risk drinking or even abstinence, 10% belong to the high-risk group of alcohol consumption, and 3 people have a high score, which suggests drinking abuse and the likelihood of developing alcohol dependence. A comparison of pre- to post-closure drinking among medical students showed statistically significant changes in the typical number of drinks per week (from 11.5 to 9.9) and maximum drinks per day (from 4.9 to 3.3) and a slight increase in typical drinking days per week (from 3 to 3.2), p < 0.05, outlining a decrease in alcohol consumption. Conclusions: The study highlights specific drinking patterns during the pandemic. While some individuals decreased consumption, a significant portion remained at risk for alcohol-related complications, emphasizing the need for targeted screening and prevention programs. Full article

The COVID-19 pandemic has led to an unprecedented global health crisis, with millions recovering from acute infection but experiencing lingering symptoms, collectively referred to as post-acute sequelae of COVID-19 (PASC), or “long COVID.” While the precise mechanisms underlying long COVID remain elusive, one hypothesis gaining traction is the persistence of viral reservoirs in various tissues. Despite evidence of viral RNA and proteins detected in post-acute patients, the concept of viral reservoirs in the context of long COVID remains a subject of debate. This review explores the current scientific evidence for the existence of persistent SARS-CoV-2 in human tissues beyond the acute infection phase, focusing on the molecular mechanisms by which the virus may evade immune surveillance. We examine the role of immune dysregulation, chronic inflammation, and viral persistence in tissues such as the lungs, heart, brain, and gut. Additionally, we explore how these persistent viral elements may be associated with ongoing symptoms in long COVID and discuss the biological plausibility of these links. Finally, we discuss the clinical implications of viral persistence in post-COVID care, potential therapeutic strategies, and the need for further research to resolve the open questions surrounding this phenomenon. Full article

Long COVID is the disease entity triggered and potentially driven by SARS-CoV-2 infection. It is an heterogeneous condition characterized by dozens of different symptoms, signs and sequelae, which can affect all organs and body systems and evolve over the disease course. Clinical manifestations of Long COVID can vary from individual to individual and across the broader patient population. Pathology can range from asymptomatic and subclinical manifestations to fatal outcomes. Over 400 million people worldwide are estimated to suffer, or have suffered, from Long COVID, making the sequelae of SARS-CoV-2 infection one of the greatest public health challenges of the 21st century. This article provides an updated overview of epidemiology, definitions, main concepts and terminology for Long COVID. It also summarizes key evidence of pathology and disease mechanisms in major organs and body systems, such as the immune system, cardiovascular system, endothelium, heart, lungs, central nervous system, peripheral nervous system, gastrointestinal system, hapatobiliary system, pancreas and kidney. Heterogeneity in manifestations, potential risk of death and the degree of disability in several disease subsets call for timely diagnosis of each Long COVID types and a fuller understanding of their pathophysiological underpinnings. Further research is recommended to better understand pathobiology, develop effective clinical trials, and identify treatments and scalable biomarkers. Full article

In the early stages of the COVID-19 pandemic, uncertainty around the extent of SARS-CoV-2 spread hampered policymakers’ understanding of the epidemic’s extent. Mathematical models, which proved vital for aiding decision-making, relied primarily on reported cases that were unreliable due to significant underdetection and underreporting. While serological data was used to improve understanding of the epidemiology, it can be costly and difficult to implement without bias. To counter these issues, we integrated serological data from 7229 remnant serum samples collected in 15 Maryland emergency departments (EDs) in Maryland between August and December 2020 into a Bayesian modeling approach to derive an estimate of the incidence of infection and the case fatality rate during the pandemic’s initial wave. We estimated that 5.2% (95% CI, 3.7–7.2%) of the population of Maryland had been infected by late fall 2020. The inferred reporting rate that was estimated started low (<10% in March 2020) and increased to 32% (95% HDI = 26–41%) by the fall, while the estimated infection fatality rate was likely initially higher but fell to 0.51% (95% HDI = 0.43–0.68%) after 1 September 2020. These results demonstrate how existing ED infrastructure can be leveraged to generate less biased, more accurate estimates of the true prevalence of a disease, improving the ability to make decisions and allocate resources under uncertainty. Full article

The clinical severity of COVID-19 is influenced by cellular and humoral immune responses, as well as the dynamics of viral replication. In line with this, the current study examined systemic and mucosal immunity responses alongside viral load in unvaccinated SARS-CoV-2-infected individuals during the period of Omicron predominance. Between 2022 and 2023, when Omicron prevalence was at its peak, 48 SARS-CoV-2-positive cases with varied severity were recruited using positive PCR testing, and 48 negative controls were recruited using negative PCR testing at Moi Teaching and Referral Hospital, Kenya. Severe patients showed higher viral loads and systemic anti-spike IgG levels compared to moderate and asymptomatic individuals. Asymptomatic individuals had higher mucosal anti-spike IgG and receptor-binding domain (RBD) levels compared to severe patients. Systemic IFN-α mRNA transcripts were higher in asymptomatic individuals compared to patients with severe COVID-19 and healthy individuals. Severe patients had significantly lower expression of IFN-γ mRNA transcript levels in both blood and mucosa, as well as significantly lower systemic IFI-16 mRNA transcript levels. These findings reflect associations observed in a cross-sectional design and should not be interpreted as causal mechanisms. Suppressed interferon responses, both mucosal and systemic, were associated with severe disease. In conclusion, high systemic IgG and viral loads and low interferon responses were closely linked to severe COVID-19 outcomes. Full article

Vaccines worldwide reduce severe coronavirus disease 2019 (COVID-19) consequences; however, viral evolution escapes immunity, raising global concerns about vaccine protection and requiring monitoring. Bioinformatics is crucial for studying vaccine escape, speeding up variant detection, mapping antibody evasion epitopes and ensuring updated vaccines and public health responses. This study combines bibliometric analysis of the Scopus literature (n = 416) on SARS-CoV-2 immune evasion using bioinformatics tools with descriptive analysis of the top ten most highly cited original articles. Our results showed the United States (USA) as the dominant contributor, leading in publication output, citation impact and collaboration networks. The key themes identified were immune evasion, spike protein mutations, and viral evolution, highlighting the structural, functional and immune evasion mechanisms of spike mutations. Leading authors and journals reveal a globally connected research community that is making advances in our understanding of SARS-CoV-2 vaccine evasion, and supporting the development of future treatments and vaccines. The top ten articles showed molecular docking, dynamics simulations, and protein modeling as crucial to studying vaccine escape. In conclusion, global research led mainly by the USA and supported by active contributions has used bioinformatics to elucidate SARS-CoV-2 immune evasion, guiding variant future vaccine and treatment development, variant monitoring, and preparedness for emerging variants. Full article

Background: During the COVID-19 pandemic, Thailand prioritized hemodialysis patients for vaccination. Due to limited supply, heterologous regimens were used. This study evaluates the mortality rate and risk factors in hemodialysis patients who received heterologous versus homologous vaccine regimens. Methods: We retrospectively reviewed data of hemodialysis patients in Thailand from January 2021 to December 2022, using data from the Department of Medical Sciences, Ministry of Public Health, and Thailand Renal Replacement Therapy Registry. Mortality was defined as death within 30 days of a positive RT-PCR or rapid antigen test for SARS-CoV-2. Multivariate logistic regression was used to identify mortality risk factors. Results: The associated risks of mortality in hemodialysis patients with COVID-19 were female sex, age ≥ 50 years, diabetes, and BMI ≥ 25.0 kg/m². Regarding vaccination regimens, the inactivated–Viral vector–mRNA regimen was associated with lower mortality compared with the mRNA–mRNA regimen (OR 0.29, 95% CI 0.08–0.99). In contrast, no vaccination (OR 16.95, 95% CI 7.86–36.54) and single-dose vaccination with inactivated vaccine (OR 17.54, 95% CI 7.01–43.88) or Viral vector vaccine (OR 20.74, 95% CI 9.38–45.86) were associated with markedly higher mortality risk. Conclusion: The inactivated–Viral vector–mRNA vaccine regimen was associated with a decreased mortality risk among this population. Full article

Introduction: Healthcare institutions and care providers, including medical professionals, were at the forefront of the rapid response to the challenges of the pandemic. As medical professionals across the country actively fought the COVID-19 pandemic, many ethical, social, and legal challenges arose that had not been previously encountered. This study was conducted to determine the ethical challenges and dilemmas faced by medical professionals during the COVID-19 pandemic. Materials and Methods: A descriptive cross-sectional questionnaire-based survey was conducted among the registered medical practitioners in the year 2022. The study setting included health care institutions in India where COVID patients were treated. Results: 558 participants took part in this study. The availability of personal protective equipment was sufficient in 519 (93%) of cases, while 39 (7%) of respondents reported insufficient quantities of personal protective equipment. Overall, 318 (56.99%) respondents were comfortable with their duty patterns, and 435 (77.96%) medical professionals received clear-cut and updated guidelines for practicing safely; 534 (95.70%) completed both doses of vaccines available at that time in India. Conclusions: Indian medical professionals experienced substantial ethical, occupational, and psychological challenges during the COVID-19 pandemic, despite the high availability of protective equipment and vaccination coverage. Resource allocation dilemmas, demanding duty patterns, and psychological distress during quarantine underscore the need for stronger institutional support, clear guidelines, and mental health interventions during future public health crises. Full article

Coronavirus disease 2019 (COVID-19) is associated with systemic inflammation and immune dysregulation, potentially affecting hypothalamic–pituitary–adrenal (HPA) axis function and glucocorticoid signaling. However, the dynamics and clinical relevance of these alterations across different disease phases remain insufficiently defined. In this cross-sectional observational study, 101 participants were divided into three groups: patients with active COVID-19 (n = 33), individuals ≥ 6 months post-COVID-19 (n = 35), and a reference group of healthy individuals (n = 33). Serum cortisol, circulating glucocorticoid receptor alpha (GRα), and selected cytokines were measured. Statistical analysis included parametric and non-parametric tests, multivariable generalized linear models adjusted for age and sex, correlation analysis, and receiver operating characteristic (ROC) analysis. Lower serum cortisol levels were observed in approximately two-thirds of patients during the acute phase. Circulating GRα concentrations demonstrated a significant gradient across groups, with the lowest levels in active infection and partial restoration post-COVID. Active COVID-19 status remained independently associated with reduced GRα levels after adjustment for age and sex. The cytokine profile, including interleukin-17A (IL-17A), tumor necrosis factor-alpha (TNF-α), and interleukin-10 (IL-10), provided a mechanistic context for inflammation-associated modulation of glucocorticoid signaling, most evident during acute infection. Significant correlations between cortisol, GRα, and inflammatory mediators were observed only in this phase. ROC analysis demonstrated a high degree of statistical separation between active COVID-19 and healthy individuals (AUC 0.942; 95% CI: 0.878–1.000). Given the predefined group structure and modest sample size, these findings should be considered exploratory. Overall, the results support the presence of dynamic and potentially reversible immune–endocrine dysregulation during and after SARS-CoV-2 infection. Further validation in larger prospective cohorts is required. Full article

Infection with SARS-CoV-2, the virus responsible for COVID-19, is associated with cytokine storm, an excessive immune response. Interleukin-6, a multifunctional cytokine, is involved in the COVID-19 immune response. Functional polymorphisms in the interleukin-6 gene promoter, namely rs1800796, rs1800797, and rs2069845, may contribute to individual susceptibility to or severity of COVID-19. In this study, 106 healthy SARS-CoV-2-negative individuals (controls) and 106 patients with severe COVID-19 (COVID-19 group), confirmed by qPCR or rapid antigen tests, were genotyped using fluorescent probes for polymorphisms. All participants were from southern Brazil. Groups were matched for sex and body mass index, with a median age of 56–57 years. The COVID-19 group exhibited blood biomarker concentrations consistent with severe disease. No significant differences were detected in genotypic or allelic frequencies between groups, and all polymorphisms conformed to the Hardy–Weinberg equilibrium. The control group minor allelic frequencies for rs1800796 (allele C, 11.3%; 95% CI, 7–16), rs1800797 (allele A, 28.3%; 95% CI, 22–34), and rs2069845 (allele G, 36.8%; 95% CI, 30–50) were similar to those of African, American, and European populations. The polymorphisms investigated were not associated with severe COVID-19 in this cohort. Full article

Background: Autophagy is a conserved intracellular degradation pathway essential for maintaining cellular homeostasis by recycling damaged organelles and proteins. Dysregulation of autophagy has been implicated in pregnancy-related complications such as preeclampsia and fetal growth restriction, underscoring its importance in maternal and fetal health. However, the autophagy status in the placental tissue of COVID-19-infected pregnant women remains unknown. Objective: To investigate autophagy activity in term placentas from pregnant women infected with COVID-19 compared to those from uninfected control pregnant women. Methods: In this prospective cross-sectional single-center study, 15 COVID-19-positive and 15 COVID-19-negative term pregnant women who delivered at Sultan Qaboos University Hospital between January 2020 and December 2022 were included. Immediately after delivery, the placental tissue samples were collected and assessed for autophagy activity using immunohistochemistry for LC3B and p62 markers, histopathological examination, and transmission electron microscopy. The proportion and intensity of LC3B and p62 staining were quantified. Statistical analysis was performed using the Mann–Whitney U test. Results: There was a significant reduction in p62 and LC3B expression in both the proportion and intensity in COVID-19 placentas compared to the control group. The proportion of p62 (p = 0.001) and LC3B (U = 46.000, p = 0.003) was significantly reduced in infected placentas. Similarly, intensity levels of both markers showed significant differences (p < 0.05), supporting the evidence of reduced LC3B/p62, suggesting autophagy modulation in COVID-19 patients’ placentas. Additionally, abnormal ultrastructural changes were observed in COVID-19–positive placentas, including mitochondrial injury, endoplasmic reticulum stress, microvillus loss, and basement membrane thickening. Conclusion: The study results from a limited sample size demonstrate a significantly altered autophagy flux in the placental tissues of term pregnant women with COVID-19 infection. These findings highlight the potential impact of COVID-19 infection on placental function and fetal development and underscore the need for further investigation into autophagy-modulating strategies to improve maternal–fetal health. Full article

An 87-year-old woman was referred to our ophthalmology ward due to decreased visual acuity and intense right orbital pain, which had been present for four weeks. The anamnesis was not contributory, except that she had been vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) four weeks prior to symptom onset. Her best-corrected visual acuity was hand movements in the right eye and 20/20 in the left eye. Intra-ocular pressure was 34 mmHg and 16 mmHg, respectively. Right eye slit lamp examination revealed palpebral oedema, chemosis, and temporal scleral thickening with conjunctival injection. The cornea was edematous with endothelial precipitates. The anterior chamber was shallow with a closed angle, associated with grade 1+ cells and 1+ flare, according to the SUN grading system. Mild vitreous inflammation was present (grade 0.5+ vitreous cells), and a total choroidal detachment was visible. In the absence of any other plausible cause, unilateral choroidal effusion with secondary angle-closure due to severe panuveitis was considered a possible adverse event following vaccination against SARS-CoV2. Full article

This paper studies the mental health impacts of the COVID-19 pandemic on older adults with a particular focus on the role of technology use. We use nationally representative individual-level survey data from a random sample of 3257 community-dwelling older Americans (65+) from the National Health and Aging Trends Study (NHATS) COVID-19 supplement (2020). We empirically estimate the impact of COVID-19 (under three alternative specifications) on the five mental health outcomes while controlling other confounding factors. The mental health indicators include feelings of loneliness, anxiety, feeling sad or depressed, poor sleep quality, and not feeling hopeful about the future. The confounding control factors in our empirical model are age, gender, race, financial difficulty, physical health, area of residence, and living arrangement. We further examine whether the mental health effects differ between the technology users and the non-users of technology. Our findings indicate a lower likelihood of adverse health outcomes among technology users (compared to the non-users of technology) during the pandemic. These results validate the potential use of technology for healthcare delivery, mental health therapy, and other lifestyle interventions to improve the quality of life in the older population. Full article

Background: Patients diagnosed with Acute Respiratory Distress Syndrome (ARDS) who require Intensive Care Unit (ICU) admission often require invasive vascular access including central venous catheters and arterial lines. Early reports of excessive thrombosis combined with the severity of illness in COVID-19 could lead to more line-related thrombosis and infections, requiring more line replacements. This retrospective cohort study explores differences in vascular access usage and line-related complications between patients with COVID-19 ARDS and non-COVID-19 ARDS. Methods: A cohort of patients with COVID-19 ARDS (n = 81) was compared to a cohort of patients with non-COVID-19 ARDS (n = 46). We compared baseline characteristics, total number and placement rate of lines (arterial lines, central venous catheters, and dialysis catheters), and incidence of line-related complications (bleeding, thrombosis, or infection). Statistical analysis was performed utilizing Excel software, with associations assessed using Chi-squared, Fisher’s exact, and t-tests. A p-value < 0.05 was considered statistically significant. Results: The COVID-19 cohort had significantly greater total number of lines per patient (4.00 vs. 2.76, p < 0.001). This was due to more arterial (2.17 vs. 1.41, p = 0.003) and dialysis lines (0.43 vs. 0.13, p = 0.002) per patient. There was no significant difference in the number of central venous catheters. When adjusted for length of stay in the ICU, the rate of line placement was not significantly different between groups. The COVID-19 cohort had a significantly greater number of line-related complications defined as thrombosis, bleeding, and infections (18 vs. 2, p = 0.008). Conclusions: The significantly greater total number of lines in the COVID-19 group was likely attributable to COVID-19 patients’ longer lengths of stay in the ICU. Patients with COVID-19 appear to have significantly more line-related complications, which may be due to the greater total number of lines, the longer lengths of stay, and inherent demographic and comorbid differences. Future studies are needed to assess methods for prevention of line-related complications in patients with COVID-19 ARDS. Full article

The aim of this study was to examine the factors associated with COVID-19-related fear in older adults from Kazakhstan, and to explore its associations with sociodemographic characteristics, health status and multiple domains of quality of life in a regional context. A total of 445 individuals aged 60 and above from both urban and rural locations in Kazakhstan participated in this cross-sectional study. To assess the quality of life among older people we used the OPQoL (Older People’s Quality of Life) Scale. Further variables were evaluated: sociodemographic (age, gender, education level, marital status, and place of residence); health-related (self-reported overall health, hypertension, diabetes, cerebrovascular disease, cardiovascular disease, and chronic obstructive pulmonary disease (COPD); and COVID-19-related fear variable. Female gender (OR = 2.344; p = 0.001), present hypertension (OR = 2.106; p = 0.008), the specialized secondary educational level (OR = 2.321; p = 0.012) and at the border of significance university educational level (OR = 1.832; p = 0.051) were variables significantly associated with the COVID-19-related fear in older adults. For individuals with reported COVID-19-related fear, advanced age was significantly negatively associated with leisure and activities domain (B = −0.747; p = 0.020) of OPQoL; better self-reported overall health was significantly positively associated with life overall domain (B = 0.691; p < 0.001), health domain (B = 1.320; p < 0.001), psychological and emotional well-being domain (B = 0.395; p = 0.001), home and neighborhood domain (B = 0.249; p = 0.036), independence, control over life and freedom domain (B = 1.082; p < 0.001), financial circumstances domain (B = 1.132; p < 0.001), and leisure and activities domain (B = 0.556; p = 0.026) of OPQoL; present hypertension was significantly negatively associated with health domain (B = −0.888; p = 0.004) of OPQoL; present cardiovascular disease was significantly negatively associated with life overall domain (B = −0.588; p = 0.027), health domain (B = −0.967; p = 0.009), and independence, control over life and freedom domain (B = −0.542; p = 0.039) of OPQoL; being single was significantly negatively associated with life overall domain (B = −0.481; p = 0.033), social relations domain (B = −0.671; p = 0.014) and financial circumstances domain (B = −0.694; p = 0.036) of OPQoL; and urban place of residency was significantly positively associated with health domain (B = 0.735; p = 0.011) and psychological and emotional well-being domain (B = 0.483; p = 0.010) of OPQoL. Our findings pointed that numerous variables were associated with the COVID-19-related fear and quality of life domains regarding COVID-19-related fear in older adults from Kazakhstan during pandemics. Full article

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of Coronavirus disease 2019 (COVID-19), exploits angiotensin-converting enzyme 2 (ACE2) for cell entry, implicating the renin–angiotensin system (RAS) in disease pathogenesis. Hypertension (HT), a major comorbidity, is strongly influenced by genetic factors within RAS, including angiotensin ii receptor type 1 (AGTR1) and ACE2) polymorphisms. However, data on these variants in African populations remain scarce. This study investigated associations between AGTR1 and ACE2 single-nucleotide polymorphisms (SNPs), HT, and COVID-19 severity in patients at a Tshwane Academic Hospital. Methods: We genotyped AGTR1 and ACE2 SNPs in 94 PCR-confirmed COVID-19 patients using Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight (MALDI-TOF) mass spectrometry. Clinical data were extracted from hospital records. Ordinal logistic regression models assessed relationships between SNPs, HT, and COVID-19 severity. Results: The cohort (mean age: 53.9 years; HT prevalence: 54.9%) exhibited mild (54.9%), moderate (18.6%), and severe (26.5%) COVID-19. Although the rs2106809 A genotype appeared to be associated with lower odds of severe disease (OR = 0.39, 95% CI: 0.14–1.08, p = 0.04), this observation should be interpreted with caution given the limited sample size of this study. Other SNPs and clinical variables showed no significant associations. Conclusions: This exploratory study represents the first description of AGTR1 and ACE2 SNP patterns in COVID-19 patients from Tshwane. While the rs2106809 variant may indicate a possible protective trend, the evidence remains preliminary. Age correlated with severity. Larger, multi-ethnic studies are needed to confirm these findings. Full article

Long COVID is a complex condition characterized by persistent symptoms following SARS-CoV-2 infection. Understanding its biochemical mechanisms is essential for effective management and treatment strategies. Objective: This study investigated biochemical alterations associated with long COVID in unvaccinated individuals presenting symptoms persisting for more than six months, highlighting the prolonged nature of the condition and its systemic and neurological manifestations. A cross-sectional study was conducted with 60 unvaccinated patients at least six months post-COVID-19 infection. Serum biomarkers, including C-reactive protein (CRP), interleukin-6 (IL-6), N-terminal pro-brain natriuretic peptide (NT-proBNP), and irisin, were analyzed. Correlations between these biomarkers and persistent symptoms were assessed using statistical regression models. Elevated CRP levels were significantly associated with persistent respiratory and musculoskeletal symptoms, suggesting ongoing inflammation. Increased IL-6 levels correlated with fatigue and musculoskeletal complaints. NT-proBNP elevations were linked to cardiovascular manifestations, including dyspnea and chest pain. A positive correlation between irisin and persistent sensory impairments, such as anosmia and dysgeusia, indicates potential neuroinflammatory mechanisms. This study highlights that persistent inflammation plays a critical role in long-term (>6 months) post-COVID manifestations. Monitoring biomarkers such as CRP, IL-6, NT-proBNP, and irisin may enhance understanding and management of prolonged post-COVID conditions. Full article

Respiratory viral infections such as influenza and SARS-CoV-2 induce complex immune responses characterized by dysregulated cytokine production, which may influence disease severity and lead to post-infection immunometabolic alterations. However, comparative data on local epithelial and systemic immune responses during acute infection and recovery remain limited. Objective: To evaluate the expression of IFN-γ, TNF-α, and interleukins IL-2, IL-4, IL-6, and IL-10 in nasopharyngeal epithelial cells from patients with influenza and SARS-CoV-2 infection, as well as in peripheral blood mononuclear cells (PBMCs) from individuals who recovered from COVID-19. Methods: A total of 120 participants were distributed into four groups (control, influenza, asymptomatic SARS-CoV-2 infection, and symptomatic COVID-19; n = 30 per group), in addition to 90 individuals who had recovered from COVID-19. COVID-19 and influenza diagnoses were established by the treating physician based on clinical presentation and confirmed by RT–qPCR. Cytokine gene expression was quantified by real-time PCR, and hematological and biochemical parameters were measured using automated analyzers. Results: The asymptomatic SARS-CoV-2 group showed significantly increased expression of IFN-γ (p = 0.0001), TNF-α (p = 0.0007), and IL-4 (p = 0.01). Individuals who recovered from COVID-19 exhibited elevated erythrocyte and leukocyte counts, along with increased glucose, glycated hemoglobin, triglycerides, and very-low-density lipoprotein levels, while no significant alterations in liver function markers were observed. Conclusions:Influenza and SARS-CoV-2 infections are associated with distinct epithelial cytokine expression profiles during acute infection, and COVID-19 recovery is characterized by persistent immunometabolic alterations, suggesting prolonged systemic effects beyond viral clearance. Full article

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) caused a global public health emergency in humans from 2020 to 2023 and was associated with over 7 million human deaths. Besides humans, SARS-CoV-2 has been detected in a wide range of animals, including companion, farm, zoo, and wild animals. At least 61 animal species from 29 animal families of 12 animal orders have tested SARS-CoV-2 positive. Documented evidence reported that not only human-to-animal transmission but also animal-to-human transmission events occurred. During the course of the pandemic progression in humans, SARS-CoV-2 strains in animals evolved in parallel with those in humans. Continued monitoring of SARS-CoV-2 in animals is needed to safeguard both human and animal health. In this study, we report investigation of two outbreaks of SARS-CoV-2 Omicron variant infection in tigers and gorillas in two zoological institutions. In the first zoo, six tigers tested positive by SARS-CoV-2 real-time RT-PCR and shed viral nucleic acid in feces for up to two weeks. Three of the tigers showed intermittent shedding patterns, while the other tigers shed only for 7–10 days. No other species, including cheetah, otter, lion, anteater, gibbon, and tamarin, tested positive. During the outbreak at the second zoo, a total of six gorillas were tested positive for SARS-CoV-2, while other primates housed in the same building (colobus and orangutan) tested negative. Follow-up testing revealed that two gorillas tested positive for SARS-CoV-2 over a one-month period (30 and 33 days, respectively), while the other four gorillas had positive SARS-CoV-2 PCR results for 14 to 25 days. Four gorillas had intermittent shedding patterns. Notably, compared to tigers, gorillas had a prolonged duration of fecal viral shedding. Sequencing was performed on the positive samples, and analysis indicated that strains detected in tigers and gorillas belonged to SARS-CoV-2 Omicron BQ.1.10 and XBB.1.16, respectively. Overall, this study offers valuable insights into the duration of viral RNA shedding for SARS-CoV-2 Omicron in zoo animals, facilitating accurate diagnostic evaluation and management of infected tigers and gorillas. Full article

Rapid antigenic drift in the coronavirus spike protein motivates alternative antiviral strategies. We target the conserved nucleocapsid (N) protein—central to RNA binding, genome packaging, and replication—and perform a comparative, cross-species 3D structure-based in silico evaluation. A library of 494 compounds (natural, phytochemical, synthetic) was docked with AutoDock Vina against the MERS-CoV N–terminal RNA–binding domain (NTD; PDB 7DYD) and the C–terminal dimerization domains (CTD) of SARS-CoV (2CJR) and SARS-CoV-2 (8R6E), reflecting the availability of high-resolution, functionally relevant domain structures for each virus. Top-ranked poses underwent ADME profiling and 100 ns GROMACS molecular-dynamics (MD) simulations. Myricetin 3-O-β-D-Galactopyranoside (myricetin) showed the most favorable predicted docking scores across targets (−8.9 kcal/mol, MERS–NTD; −10.1, SARS–CTD; −9.8, SARS-CoV-2 CTD). Curcumin showed moderate predicted affinity (−7.1 to −8.1), while MCC950 achieved consistently favorable docking score (−7.9 to −9.0). ADME results highlighted a trade-off: glycosylated flavonoids offered rich interaction networks but violated oral drug-likeness criteria (e.g., high TPSA), whereas MCC950 met Lipinski/Veber guidelines, supporting translational potential. MD analyses revealed ligand- and target-specific stability: myricetin maintained persistent binding over 100 ns in the SARS-CoV-2 CTD with lower RMSD than comparators; curcumin exhibited transient stability (~30 ns) in MERS- and SARS-bound complexes; MCC950 showed intermittent interactions. Collectively, these findings suggest that the conserved N protein RNA-binding groove represents a resistance-resilient target for broad-spectrum antiviral discovery. Natural flavonoids provide promising scaffolds for optimization, and MCC950 warrants further exploration given its drug-like profile. As this study is purely computational, the results are hypothesis-generating and should be validated via RNA-binding disruption assays, antiviral cell studies, and in vivo models. Full article

Wastewater-based epidemiology (WBE) allows for early surveillance of viral pathogens, including SARS-CoV-2. Simplified low-cost approaches are needed to deploy WBE surveillance in resource-limited small-island settings, where high sensitivity must be maintained. In this study, we optimized key upstream steps in an electronegative membrane virus adsorption–elution (VIRADEL) workflow, including sample acidification, composite sampling duration, and RT-qPCR inhibition mitigation. Wastewater influent was sampled at a pump station in Grenada using 12 h and 24 h time-weighted composite samples, concentrated using electronegative membrane VIRADEL with and without sample acidification (pH 3.5), and used Phi 6 (enveloped virus) and MS2 (non-enveloped virus) bacteriophages as process controls and PMMoV as a fecal-derived normalization target. Targets for SARS-CoV-2 N1 and a non-enveloped virus surrogate were measured by RT-qPCR. Quantitative wastewater data were compared to reported clinical cases in the community. Sample acidification significantly increased recovery of the enveloped process control, Phi 6 (p < 0.01) indicating improved efficiency in capturing enveloped viral targets during filtration. Twelve-hour composite samples had a false-negative percentage of 88%, while 24 h samples had only 6% false negatives and were able to mirror clinical case trends. Wastewater viral signals were detected 3–5 days prior to an increase in clinical cases. Hydraulic travel time within the contributing sewer network was not directly measured; therefore, the reported 3–5 day lead time reflects the combined effect of shedding dynamics, sampling integration, and sewer transport. This optimized workflow was deployed for nine months showing sustained analytical performance and operational feasibility. Full article

The COVID-19 pandemic disrupted traditional financing channels, accelerating the adoption of crowdfunding as an alternative capital-raising mechanism across Africa. Limited access to finance for women entrepreneurs remains a pivotal issue globally, particularly in Africa, where most women are significantly underrepresented. This study investigates the role of gender differences in campaign design, communication, and signalling in crowdfunding success during the COVID-19 pandemic, rather than focusing on gender as a direct factor. Guided by signalling, Congruity, Feminist Economics, and Social Network theories, the research investigates whether gender-related differences in campaign presentation and communication strategies contributed to variations in funding outcomes. A quantitative research approach was adopted to analyse reward-based crowdfunding campaigns launched between March 2020 and December 2020. The study measures success through funding attainment ratios and goal achievement rates. The findings reveal nuanced gender effects, with male-led campaigns exhibiting strengths in social engagement and narrative appeal, while female-led campaigns demonstrated advantages in higher average contribution sizes. This awareness contributes to the literature on gender and entrepreneurial finance in crisis contexts, offering practical implications for platform design, policy interventions, and inclusive funding strategies in Africa’s evolving crowdfunding ecosystem. In line with the empirical results, the impact of gender is mostly indirect and mediated by campaign variables such as updates, videos, and engagement intensity. Full article

Treatment seeking among individuals who misuse substances can be a complex process, with many factors contributing to treatment seeking. Guided by Gelberg–Andersen’s Behavioral Model for Vulnerable Populations, this research seeks to establish predisposing, enabling, and need factors contributing to treatment seeking during COVID-19. A total of 201 individuals participated in the study. Contrary to existing literature, no predisposing factors were associated with treatment seeking during COVID-19. However, variations were seen in enabling and need factors. Perceiving a need for treatment and having reliable transportation to treatment were associated with treatment seeking during COVID-19, underlying the importance of addressing both physical barriers to treatment and readiness for treatment. Additional enabling factors contributing to treatment seeking were a history of past treatment and differing types of recovery supports, underscoring the importance of addressing structural access barriers and individual-level determinants of treatment seeking. More research is needed on individual differences in perception of need that lead to treatment seeking. Full article

The COVID-19 pandemic revealed substantial variation in vaccine attitudes and susceptibility to misinformation, raising concerns from an occupational health perspective about potential differences across employment sectors. This study examined associations between employment category and pandemic-related changes in mental health, and vaccine-related misinformation among adults in Poland. Data were collected between 13 January and 14 February 2022 using a cross-sectional online survey. Complete questionnaires from 7018 respondents were analyzed. Employment category (services, industry, agriculture, unemployed) was examined in relation to self-reported changes in sleep, mental health, physical activity, and diet. A misinformation index was constructed based on agreement with eight vaccine-related misinformation statements. Overall, 81.8% of participants reported being vaccinated. Employment category was significantly associated with perceived changes in sleep, mental health, and diet. The misinformation index was consistently higher among unvaccinated individuals across all employment groups, with the largest differences observed among the unemployed and agricultural workers. These findings show a strong link between vaccine misinformation and remaining unvaccinated, highlighting the need for targeted occupational health education and reliable health information. Increasing vaccination coverage therefore requires not only vaccine availability but also systematic efforts to counteract misinformation and strengthen digital health literacy across occupational groups. Full article