COVID

The isolation period during the COVID-19 pandemic significantly altered physical activity and social interactions in children, with disproportionately severe effects in impoverished indigenous communities. To evaluate the impact of the COVID-19 pandemic on body composition and cognitive status in Maya children. A prospective study conducted from March 2020 (pre-COVID) to April 2022 (post-COVID) involving 80 school-aged children from Tahdziú, Yucatán, México. Somatometric, cognitive, and dietary parameters were assessed. Post-pandemic assessments revealed a statistically significant increase in the prevalence of excess body fat mass (2.5% vs. 16.3%)*, fat arm area (7.6% vs. 20%)*, and fat mass index (5.1% vs. 16.3%)*. There was also an upward trend in excess body weight (24.1% vs. 31.1%) and cardiometabolic risk index (24.1% vs. 32.5%). High rates of undernutrition persisted (78.8% and 76.3%), as did impaired cognitive function (13.8% and 21.3%). Additionally, 97.8% of children reported a low-dietary-quality (HEI score < 80). The pandemic negatively impacted body composition, increasing adiposity markers associated with future cardiometabolic risk. It also exacerbated pre-existing vulnerabilities, as evidenced by low diet quality and worsening cognitive performance, potentially contributing to long-term educational disparities in this population. Full article

With the growing prevalence of digital media use, increasing attention has been directed toward the impact of smartphone usage patterns on mental health. In particular, the COVID-19 pandemic fundamentally altered daily life, accelerating the integration of smartphones into social and economic activities. This study utilized four years of cross-sectional data (N = 75,450) to examine how different types of smartphone application usages—specifically gaming, social networking services (SNS), and online shopping—are associated with problematic smartphone use (PSU), comparing patterns during and after the pandemic. The findings indicate that excessive gaming had a consistently notable association with PSU across both periods. However, the relationship between SNS and shopping app usage on PSU was significantly stronger after the pandemic. This shift suggests that while such applications served essential roles during the pandemic, their continued and excessive use after the return to face-to-face interaction may potentially contribute to problematic use. These results highlight the evolving nature of smartphone application use and its psychological consequences, underscoring the importance of developing tailored intervention strategies that reflect post-pandemic digital behaviors. Full article

Despite a substantial volume of literature on the consequences of the recent pandemic, the relationship between psychological constructs that affect individual mindset and confidence, as well as travel intention, is missing. This study seeks to examine the travelers’ behavioral intentions and psychological constructs. The study was conducted among 398 Malaysian medical students. The study was conducted from the end of 2022 to the middle of 2023. The study followed PLS-SEM to estimate relationships between variables and predict dependent variables. The results revealed a negative correlation between travel risk, severity, travel barriers, and travel intention, while COVID-19 vaccination effectiveness and self-efficacy positively influenced travel intention. The present study reveals that individuals with higher levels of self-efficacy or confidence in overcoming obstacles and coping with the challenges of new circumstances exhibit a stronger intention to travel (ITT). This study contributes to understanding the cognitive process of individuals’ intentions to travel and the coping mechanisms during the post-pandemic. Utilizing the health belief model, this study validates how individual health behavior regarding perceived risk affects travel decisions or intentions. This study provides valuable insight into consumer behavior for decision-making in the aviation and tourism industries and for policymakers after the global health crisis. Full article

Background: This study aims to investigate and monitor cardiorespiratory fitness levels, measured by the 6-minute walk test (6MWT) and quality of life (QoL), assessed using the Short form-36 (SF-36), in patients with hypertension, both with and without coronavirus disease 2019 (COVID-19), at a 3-month follow-up. Methods: Sixty participants were recruited, comprising two groups: hypertensive patients with COVID-19 and hypertensive patients without COVID-19, with 30 individuals in each group. Cardiorespiratory response parameters were assessed before and after performing the 6MWT. QoL was evaluated using the SF-36 at baseline and again at 3 months. Results: Hypertensive patients who recovered from COVID-19 showed significant improvements, including reduced post-exercise HR, SBP, SpO₂, RPE, and leg fatigue, as well as increased 6MWT distance and enhanced QoL compared to baseline (p < 0.05). These parameters improved and returned to levels similar to those of hypertensive patients without COVID-19 by the 3-month follow-up. Conclusions: Hypertensive patients who have recovered from COVID-19 can achieve cardiorespiratory fitness and QoL levels comparable to those of hypertensive individuals who did not contract COVID-19 by the 3-month follow-up. Full article

Background: The COVID-19 pandemic disrupted essential health services globally, including contraceptive provision. This study examined barriers to contraceptive access in Nigeria during the national lockdown and lessons for future health crisis preparedness. Methods: A cross-sectional online survey of 1273 respondents was conducted during the COVID-19 lockdown. Descriptive statistics and multivariate logistic regression were used to identify predictors of unmet contraceptive need. Online convenience sampling may limit representativeness. Results: Fear of contracting COVID-19 at health facilities (76.6%), closure of drug and chemist shops (53.7%), movement restrictions (48.4%), and inability to reach healthcare providers (43.5%) were the most reported barriers. Adults aged 26–33 years (AOR = 2.00, 95% CI: 1.05–3.73), those married or cohabiting (AOR = 3.87, 95% CI: 2.58–5.68), and Yoruba respondents (AOR = 1.70, 95% CI: 1.04–2.58) were significantly more likely to report unmet need. Tertiary education (AOR = 0.28, 95% CI: 0.13–0.55) and rural residence (AOR = 0.57, 95% CI: 0.37–0.86) were protective factors. Conclusion: COVID-19-related restrictions exposed systemic weaknesses in Nigeria’s contraceptive delivery. Addressing fragile supply chains, strengthening community-based alternatives, and embedding reproductive health into emergency preparedness plans will be critical to building resilient systems for future crises. Full article

Background: Vaccine hesitancy (VH) remains a pressing global health concern, particularly in low-resource settings, where vaccination remains the primary means of protection against infection. The urgency of this issue became evident during the COVID-19 pandemic. The present study aimed to elucidate the determinants of vaccine hesitancy among university students in medical and non-medical fields in Syria by utilizing the 5C framework (confidence, complacency, constraints, calculation, and collective responsibility). Methods: A structured interview-administered questionnaire collected responses from 4722 students at five universities in Syria. The questionnaire assessed sociodemographic factors, COVID-19 vaccination status, vaccination experience, sources of information, beliefs in vaccine-related conspiracies, attitudes toward vaccine policies and attributes, and the 5C psychological antecedents. Internal consistency and factor analysis of the Arabic 5C scale were performed to ensure construct validity. Statistical analyses included descriptive statistics, logistic regression, and multivariate multiple regression. Results: Our findings revealed that 64% of participants had not received the COVID-19 vaccine, with official sources (e.g., WHO, Ministry of Health) being the most trusted. The highest 5C score was for calculation (5.86, sd = 1.21), followed by confidence (5.29, sd = 1.26). Belief in vaccine conspiracies was common, particularly regarding profit motives and genetic modification. Only three of the 5C—complacency, calculation, and collective responsibility—significantly, predicted vaccination behavior, while all the 5C were influenced by contextual factors. Non-medical students showed significantly higher hesitancy (OR = 1.60, 95% CI [1.39–1.84, p < 0.001]) compared to their medical counterparts. Hesitant respondents displayed significantly, higher complacency, increased calculation, and reduced collective responsibility scores. Conspiracy beliefs eroded confidence and magnified perceived barriers, whereas trust in official sources and favorable views of the vaccine’s attributes strengthened collective responsibility and acceptance. The regression models explained 2.8% to 11.2% of variance across the 5C, with collective responsibility showing the highest explanatory power (adjusted R² = 0.112). Conclusions: Despite high self-reported knowledge, significant VH persisted—a paradox that highlights the limits of information alone. Given the cross-sectional design and the modest explanatory power of the models, these recommendations are tentative. These findings highlight the need for trust-based interventions targeting populations in conflict-affected areas. Full article

The ongoing COVID-19 pandemic has underscored the urgent need for rapid, sensitive, and versatile diagnostic tools. In this study, we developed a nanogold-based lateral flow immunoassay (LFIA) capable of detecting both SARS-CoV-2 nucleocapsid (N) protein antigens and anti-N IgG antibodies at the point of care. Following optimization of colloidal gold nanoparticle size, pH, and protein conjugation parameters, LFIA strips were assembled in two formats: a competitive assay for antigen detection and a sandwich assay for antibody detection. In the competitive format, gold nanoparticles (AuNPs)-conjugated N protein were used to detect varying concentrations of free N protein. The test line signal inversely correlated with antigen concentration, confirming the assay’s specificity and effectiveness. For antibody detection, the sandwich LFIA format employed immobilized anti-human IgG to capture anti-N antibodies in serum samples from COVID-19 patients. Strong test line signals were observed in samples collected ≥11 days post-symptom onset, indicating a time-dependent increase in IgG detectability. These results demonstrate that the AuNP-based LFIA platform provides a flexible, rapid, and low-cost diagnostic solution, suitable for both early antigen detection and serological monitoring during SARS-CoV-2 infection and recovery. Full article

Background: The COVID-19 pandemic placed unprecedented strain on long-term care facilities (LTCFs), disproportionately affecting care aides who provide essential frontline support. This study explored the impact of the pandemic on care aides’ job satisfaction in LTCFs across Northern British Columbia, a geographically and structurally underserved region. Methods: Eight care aides participated in semi-structured virtual interviews, and data were analyzed using Braun and Clarke’s thematic analysis. Results: Five key themes emerged: (1) work environment and staffing conditions, (2) emotional and psychological burden, (3) communication and team dynamics, (4) resident care and safety, and (5) effects of evolving COVID-19-related policies. Participants consistently described emotional exhaustion, policy fatigue, grief from resident deaths, communication breakdowns, and uncertainty stemming from frequent procedural changes. These stressors were compounded by staffing shortages and limited access to mental health support, especially in rural settings. Conclusion: The findings highlight the urgent need for structural and psychological supports, including responsive leadership, accessible mental health resources, and stable employment policies, to protect care aides’ well-being and ensure quality of care in future public health emergencies. Full article

Background: SARS-CoV-2, originally described as a respiratory pathogen, has been identified as a multisystem disease with complex and interconnected pathophysiological processes. Methods: The PRISMA framework was used to systematically review the evidence and identify and synthesize it in PubMed, Scopus, and Web of Science databases between January 2020 and May 2025. Of the 1410 screened records, 161 peer-reviewed studies involving more than 2 million patients were included in the analysis. The frequency of organ involvement, important biomarkers, and long-term outcomes were derived, and the quality of the studies was assessed using standardized tools. Results: The quantitative synthesis showed that 78%, 32%, 43%, and 28% of hospitalized patients had pulmonary, cardiovascular, 43% neurological, and 28% renal issues, respectively, with 10–35% showing persistent organ dysfunction at 6 months post-infection. The most common were cytokine storm (IL-6 (Interleukin-6) > 100 pg/mL in 72% of severe cases), endothelial dysfunction (biomarkers elevated in 87% of patients), and microvascular thrombosis (D-dimer > 2000 ng/mL in 46% of patients). Most domains were scored as having moderate-to-high confidence in the quality assessment. Conclusions: COVID-19 has long-term, multi-organ sequelae that require integrated multidisciplinary management. Healthcare systems should be ready to participate in long-term monitoring, rehabilitation, and special therapeutic development. The results offer a strong evidence base for clinical practice and post-pandemic health policy. Full article

Cardiovascular diseases (CVDs) are among the most common comorbidities in COVID-19 patients. This multicenter cross-sectional study assessed knowledge, risk perception, precautionary measures, and psychological burden related to COVID-19 among Lebanese individuals with and without CVD during the pandemic’s first wave. A total of 485 CVD patients and 1033 control group (CG) participants completed standardized questionnaires, including the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), and Coronavirus Anxiety Scale. Compared to CG, CVD patients demonstrated significantly lower COVID-19-related knowledge (86.4% vs. 90.0%, p < 0.001) and adherence to preventive measures (81.5% vs. 85.7%, p < 0.001). After stratification, limited knowledge was more common among CVD patients (45.7% vs. 31.8%), as was limited precautionary behavior (70.3% vs. 54.2%). Risk perception was suboptimal in both groups, with no significant difference (41.3% vs. 38.6%, p = 0.072). Anxiety (GAD-7 ≥ 10) and depression (PHQ-9 ≥ 10) were more prevalent among CVD patients (13.4% and 11.3%) than CG participants (9.5% and 16.5%). Survey outcomes were influenced by educational, socioeconomic, and psychosocial factors. These findings highlight the need to target CVD patients in public health campaigns to enhance preparedness and mental health support during pandemics. Full article

The COVID-19 pandemic increased demand for intensive care unit (ICU) beds, requiring reliable disease severity scoring tools to optimise patient management and resource allocation. This retrospective study investigated the accuracy of the Sequential Organ Failure Assessment (SOFA) score in predicting mortality among critically ill COVID-19 patients. Data from 357 patients aged 18 years and above admitted to the ICU with COVID-19 category 5a and above, requiring ventilatory support throughout 2021, were analysed. The SOFA scores were calculated on days 1, 3 and 5 of ICU admission. The highest score and trends were noted; whether scores increased, were maintained or decreased was also determined. Patient outcomes were classified as survivors and non-survivors. There were significant differences in SOFA score trends between survivors and non-survivors. The high sensitivity (83.95%) and positive predictive value (PPV) (86.08%) in those with increased SOFA score trends showed that a SOFA score of ≥9 strongly predicted mortality, albeit with moderate specificity (65.63%). High sensitivity (81.85%) with low PPV (49.45%) was seen in those with decreased SOFA score trends. A high negative predictive value (87.50%) was observed for survivors. The SOFA score trend is effective in prognosticating survival in critically ill patients with COVID-19 infection, making it useful for critical care resource management. Full article

The COVID-19 pandemic has left millions worldwide with persistent cognitive difficulties, making long-term studies essential to understand their trajectory and inform rehabilitation strategies. This research is presented within the context of Long COVID, emphasizing that cognitive symptoms (including deficits in attention, memory, and executive functions) are reported even in non-hospitalized individuals, yet longitudinal evidence beyond two years remains scarce. An observational, cross-sectional, and retrospective design was applied to a sample of 297 adults with their cognition assessed, divided into mild, moderate, and severe COVID-19 groups, and evaluated using standardized cognitive tests. Findings showed that cognitive performance declined with increasing severity of COVID-19 symptoms, particularly in divided attention, working memory, executive control, verbal fluency, recognition memory, and general intelligence. Age consistently predicted lower scores across cognitive domains, especially in moderate and severe groups, whereas education level did not exert a significant protective effect. The study shows that cognitive deficits can persist at least three years after infection, affecting older adults and those with the more severe symptoms. These results highlight the need for long-term neuropsychological monitoring and individualized rehabilitation strategies to mitigate impacts on autonomy and quality of life. Full article

Background/Objectives: The impact of COVID-19 on male reproductive health remains unclear, with existing studies reporting conflicting results. This study aimed to evaluate longitudinal changes in sperm parameters, functional tests, and key markers related to the inflammasome complex in men diagnosed with COVID-19. Methods: In this experimental study, semen and blood samples were collected from 34 men at one- and three-months following COVID-19 diagnosis. Assessments included sperm parameters, chromatin damage, protamine deficiency, residual histones, and key inflammasome pathway markers (NLRP3, ASC, and caspase-1) in sperm samples. Additionally, blood levels of LH, testosterone, interleukin-6, and TNF-ɑ were measured. Results: While semen volume, sperm count, concentration, total motility, and DNA damage showed no significant changes, notable improvements were observed in sperm vitality, rapid motility, chromatin integrity, protamine content, and residual histones at three months compared to one-month post-diagnosis. Serum levels of LH, testosterone, and interleukin-6 remained stable, whereas TNF-ɑ levels significantly decreased after three months. Western blot analysis revealed a significant increase in NLRP3 protein expression after three months, while ASC and caspase-1 levels showed no significant changes. Conclusions: These results suggest a gradual recovery in sperm function over time after COVID-19 infection, highlighting possible implications for male reproductive health. Further studies with larger populations are necessary to better understand the underlying mechanisms and long-term effects of COVID-19 on male fertility. Full article

Cervical cancer is a leading cause of morbidity and mortality among women, particularly in low- and middle-income countries. Early detection through routine Pap smear screening is essential to prevent disease progression. The COVID-19 pandemic severely disrupted healthcare services worldwide, including cancer screening programs. This study aimed to evaluate the impact of the COVID-19 pandemic on cervical cancer screening in Brazil. A nationwide retrospective population-based study was conducted using data from the Cancer Information System (SISCAN) of Brazil’s public health system (SUS). Data from 2018–2019 (pre-pandemic) were compared to 2020–2021 (pandemic period) regarding the number of Pap smear tests performed, regional distribution, and diagnostic outcomes. Furthermore, data from 2022–2023 were incorporated to evaluate the volume of cytopathological exams performed in the post-pandemic context. Statistical analyses included paired t-tests, Wilcoxon signed-rank tests, and repeated measures ANOVA with Bonferroni correction. A significant reduction in Pap smear testing was observed nationwide during the pandemic (p < 0.01), with variations across regions. Despite fewer screenings, there was an increase in unsatisfactory exams and a rise in adenocarcinoma and atypical findings in some regions. In contrast, the post-pandemic period showed a significant recovery in the number of exams, reaching volumes comparable to those observed before the pandemic (p < 0.05). The COVID-19 pandemic substantially reduced cervical cancer screening coverage in Brazil, highlighting structural vulnerabilities in the healthcare system. Strengthening organized screening programs is essential to mitigate the long-term impact of these disruptions. Full article

The COVID-19 pandemic created unprecedented conditions for examining how vaccination willingness evolves during prolonged health crises. This longitudinal mixed-methods study examines temporal dynamics in COVID-19 vaccination willingness across three phases of Germany’s vaccination campaign (N = 1063 survey respondents; n = 40 interview participants). Using mixed-effects models and thematic analysis, we tested whether institutional trust and personal risk perception predict vaccination willingness and how their relative importance changes over time. Results reveal that trust in scientific institutions emerges as the strongest predictor, outperforming political trust and becoming more influential over time, while risk perceptions become less predictive with time. Qualitative analysis identified a multitude of different argumentative themes for and against COVID-19 vaccination (as well as conditional acceptance), with 30% of participants expressing both. The themes complement the quantitative analysis by demonstrating a shift from analytical, risk-focused decision-making to heuristic, trust-based processing as vaccination campaigns progress, with important implications for adaptive public health communication strategies. Full article

The COVID-19 pandemic caused by SARS-CoV-2 has significantly impacted public health worldwide. This study aimed to assess the clinical and diagnostic features of COVID-19 cases in the Tlemcen region, Algeria, and analyze epidemiological trends from January to December 2021. This retrospective study included 68,745 confirmed snapshot active COVID-19 cases from the Public Local Health Care Establishment (EPSP)—University Hospital of Tlemcen. Patients underwent PCR testing and chest CT imaging for clinical evaluation. Data on symptoms, PCR cycle threshold (Ct) values, and CT imaging findings were collected, and statistical analysis was performed to examine the patient’s viral load and lung involvement data. Among 488 confirmed cases, common symptoms included fever, cough, and shortness of breath. PCR Ct values ranged from 15 to 35, and CT imaging revealed widespread lung involvement, with ground-glass opacities being the predominant feature. Epidemiological trends showed a consistent increase in cumulative cases, highlighting sustained transmission throughout the study period. Over the study period, epidemiological surveillance recorded a progressive rise in daily cases, peaking in July with 72 cases, followed by a gradual decline toward the end of the year. The findings underscore the utility of PCR Ct values and CT imaging in evaluating disease severity and monitoring regional case progression. The upward trend in cumulative cases emphasizes the need for ongoing public health measures and diagnostic strategies to manage future outbreaks effectively. Full article

Background: Elective surgery soon after SARS-CoV-2 infection is linked to high morbidity, but the risk > 7 weeks post-infection is uncertain. Methods: A PROSPERO-registered systematic review (CRD42023416842) following PRISMA 2020 searched PubMed, Web of Science, WHO COVID Database, Wiley, Google Scholar, and Scopus (Jane 2020–July 2025) for studies reporting postoperative outcomes in patients with confirmed COVID-19 ≥ 7 weeks before elective surgery. Primary endpoints were cardiopulmonary, neurological, renal and thrombotic complications, ICU/hospital stay and 30-day mortality. Results: Thirteen observational studies (38,055 patients) met inclusion criteria. In patients operated ≥7 weeks after mild or asymptomatic infection, overall mortality rate was 2.27% (607/26,688), with no significant excess versus uninfected controls. Pneumonia (1.66%), pulmonary embolism (1.47%), arrhythmias (2.57%) and myocardial injury (1.06%)—did not exceed baseline surgical rates. Thrombosis occurred in 2.8% but lacked a clear association with prior infection. Conversely, individuals with previous moderate-to-severe disease or recent COVID-19-related hospitalization showed higher complication rates, especially in complex procedures such as coronary bypass. Conclusions: Evidence to date indicates that COVID-19 history beyond seven weeks does not independently raise perioperative morbidity or mortality for most elective procedures. Full article

Wastewater-based epidemiology (WBE) is increasingly recognized as a valuable tool for monitoring disease cycles, including pandemics like COVID-19. Unlike pandemics, epidemics exhibit distinct dynamics, spread patterns, multiple origin points, and varying levels of population immunity. This study evaluates the applicability of WBE for epidemic monitoring and emergency preparedness by analyzing SARS-CoV-2 presence in Jaipur’s wastewater over one year post-second pandemic wave, covering a minor surge (third) and a mild resurgence (fourth) of COVID-19. A total of 1050 samples from different city localities were analyzed using a combination of two concentration methods (the direct method and the Polyethylene Glycol (PEG) method) and two detection kits (qualitative and quantitative). WBE effectively detected both minor and major epidemic outbreak cycles of SARS-CoV-2. A total of 62.91% samples out of all untreated samples tested, were found to be positive with viral genome; however, the positivity rate of any particular day did not exceed 25% even during the peaks. Notably, short-distance transportation under ambient conditions had no significant impact (p > 0.05) on detection, and the combination of the direct method with quantitative kits provided the highest sensitivity. Based on these findings, a cost-effective bi-phase surveillance model is proposed for year-round epidemic monitoring. This model suggests routine use of the faster, cheaper direct method, switching to the PEG concentration method during rising viral loads for enhanced resolution. Such an approach ensures sustainable, resource-efficient surveillance, particularly benefiting low- and middle-income countries facing financial constraints. Full article

This study examines the use of alternative financial services in the context of COVID-19-induced economic displacement. We utilize data from the 2020 Collaborative Multiracial Post-Election Survey and the ABC-X model of family stress and coping to examine how economic displacement, prior AFS use, and sociodemographic factors collectively promote AFS utilization. This study examines four types of financial coping strategies: credit cards, payday loans, public benefits, and borrowing from family and friends. Of these, payday loan use represents the primary indicator of AFS reliance. Our findings indicate that borrowing from friends and family is a significant predictor of payday loan usage. Furthermore, prior use of AFS, such as payday loans, check-cashing services, and pawnshops, strongly predict future AFS use. This study also finds a negative relationship between ethno-racial identity and AFS use which contradicts much of the existing literature. We find that lower levels of education and living in large urban areas are predictors of AFS use. This study highlights how the pandemic exacerbated financial vulnerabilities and validates the need for education and advocacy to prepare the most vulnerable to break cycles of AFS use. Full article