COVID

The COVID-19 pandemic caused immense physical disruptions, affecting young adults in the U.S. The Health Belief Model is a social psychological framework that predicts the likelihood of adopting health behavior. The purpose of this research is to investigate COVID-19-related health beliefs and dietary behaviors among undergraduate students during the pandemic. Using convenience sampling, a cross-sectional survey was completed by 304 individuals at a New Jersey state university. Survey data included the frequency of COVID-19 prevention behaviors (e.g., wearing an indoor mask, handwashing), and consumption of fruit and vegetables. The Health Belief Model constructs measured perceived susceptibility to COVID-19, severity, benefits, barriers, and self-efficacy. Frequency distributions, t-tests, and Kruskal–Wallis tests were investigated for racial subgroups (Whites, Blacks, Latinos, and Asians). The mean age of the sample was 21.7, with 27% males, and 46% self-identified as White. Whites adopted fewer COVID-19 prevention behaviors (p < 0.001) than non-Whites. Black students perceived less COVID-19 severity (p < 0.01) and stronger perceived benefits (p < 0.05) than the other subgroups. Latino students perceived greater susceptibility (p < 0.01) and greater barriers than non-Latinos. Asians practiced higher mask wearing frequency (p < 0.05) but less daily fruit intake than their counterparts (p < 0.01). This research highlights the importance of handwashing, wearing indoor masks, and consuming produce among university students. Addressing barriers to health action while promoting the benefits of enacting behaviors to mitigate the risk of COVID-19 is warranted. Full article

The COVID-19 pandemic sparked changes globally, as leaders scrambled to protect wellbeing and safety. With many U.S. students sent away from their campuses, undergraduate students still grappled with the time-old question: “what will I do after college,” except during an unprecedented time in history rife with heightened career uncertainty. This qualitative study presents the results of a survey administered as part of a mind–body health project conducted in the wake of the pandemic, speaking directly to undergraduate college students’ health-related career aspirations. Two open-ended survey questions—(1) what is your intended career, and (2) how (if at all) has the COVID-19 pandemic changed your perspective about your future career—were administered with thematic analysis conducted. Qualitative analysis using hybrid data and theory-driven approaches revealed several themes around an increased desire to work within health-related fields, decreased desire to work in healthcare, non-medical to medical career shift, and additional undecidedness. Connecting theory to practice, Super’s Life-Space, Life-Span Career Theory and Krumboltz’s Social Learning Theory of Career Decision-Making guide practical implications and grander discussion around career development during periods of crisis. Full article

COVID-19 causes instant and often prolonged effects with multisystemic and heterogeneous symptoms, significantly affecting the bio-psychosocial life of patients. In view of this, the present prospective cohort study aims to document the evolution of symptoms in hospitalized COVID-19 patients, monitoring variations in their mental and physical health for eighteen months after clinical recovery. A sample of 117 patients was examined at four distinct time points: at 2, 6, 12 and 18 months after discharge from the Pulmonology Clinic of the General University Hospital of Larissa (single-center approach). The data collection focused on psycho-physical symptoms, sleep disturbances and quality of life indicators. The study results revealed that over the 18-month period the participants gradually recovered both physically and psychologically, as well as regained pre-disease sleep patterns. However, substantial recovery was noted by month 6, followed by stabilization of their health status. However, a complete return to the pre-disease state of all assessed variables was not achieved, confirming and reinforcing the need for long-term follow-up and overall patient care. Full article

The purpose of this study is to compare the accuracy and readability of Coronavirus Disease 2019 (COVID-19)-prevention and control knowledge texts generated by four current generative artificial intelligence (AI) models—two international models (ChatGPT and Gemini) and two domestic models (Kimi and Ernie Bot)—and to evaluate the other performance characteristics of texts generated by domestic and international models. This paper uses the questions and answers in the COVID-19 prevention guidelines issued by the U.S. Centers for Disease Control and Prevention (CDC) as the evaluation criteria. The accuracy, readability, and comprehensibility of the texts generated by each model are scored against the CDC standards. Then the neural network model in the intelligent algorithms is used to identify the factors that affect readability. Then the medical topics of the generated text are analyzed using text analysis technology. Finally, a questionnaire-based manual scoring approach was used to evaluate the AI-generated texts, which was then compared to automated machine scoring. Accuracy: domestic models have higher textual accuracy, while international models have higher reliability. Readability: domestic models produced more fluent and publicly accessible language; international models generated more standardized and formally structured texts with greater consistency. Comprehensibility: domestic models offered superior readability, while international models were more stable in output. Readability factors: the average words per sentence (AWPS) emerged as the most significant factor influencing readability across all models. Topic analysis: ChatGPT emphasized epidemiological knowledge; Gemini focused on general medical and health topics; Kimi provided more multidisciplinary content; and Ernie Bot concentrated on clinical medicine. From the empirical results, it can be found that the manual and machine scoring are highly consistent in the indicators SimHash and FKGL, which proves the effectiveness of the evaluation method proposed in this paper. Conclusion: Texts generated by domestic models are more accessible and better suited for public education, clinical communication, and health consultations. In contrast, the international model has a higher accuracy in generating expertise, especially in epidemiological studies and assessing knowledge literature on disease severity. The inclusion of manual evaluations confirms the reliability of the proposed assessment framework. It is therefore recommended that future AI-generated knowledge systems for infectious disease control balance professional rigor with public comprehensibility, in order to provide reliable and accessible reference materials during major infectious disease outbreaks. Full article

We present a case with unusual findings on nuclear imaging after mild SARS-CoV-2 infection. During evaluation for an incidentaloma, 18F-Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography imaging showed activity in the thyroid gland, in the lower thoracic spinal column, in portal lymph nodes, and in the terminal ileum and surrounding lymph nodes, all suspicious for metastatic cancer. The patient underwent extensive invasive and non-invasive diagnostic procedures, including biopsies of all the suspicious foci, only showing a small low-grade thyroid cancer that would often be followed and not immediately operated on. Three months later, the findings had either disappeared or were considered reactive. The patient later recalled having had mild COVID-19 seven days prior to the PET/CT. Full article

Background: The COVID-19 pandemic has affected countries globally, causing significant respiratory tract symptoms, including shortness of breath, coughing, chest tightness, and wheezing. Vitamin D has been proposed to play a key role, especially in upper respiratory tract infections. Recently, numerous studies and reports associating low serum 25-hydroxyvitamin D levels (s-25-(OH)D) and adverse outcomes in COVID-19 have emerged. We aimed to assess the association between vitamin D status and SARS-CoV-2 positivity among adults in Lebanon. Method: A cross-sectional study was conducted, recruiting 384 participants aged 18–75 years from a university hospital in South Lebanon. Background variables were collected through structured questionnaires. Serum 25(OH)D levels were measured using electrochemiluminescence immunoassay, and SARS-CoV-2 positivity was assessed through PCR testing. Results: The mean s-25(OH)D level was 46.8 nmol/L (SD 28.1), and 30% of the participants had vitamin D deficiency (s-25-(OH)D level <30 nmol/L). SARS-CoV-2 positivity was reported in 28% of participants. However, no significant association was found between s-25(OH)D levels and SARS-CoV-2 positivity. This study had several limitations, including potential selection bias due to recruiting participants from a hospital for PCR testing, the collection of data across different seasons, and the refusal of several eligible individuals to participate. Additionally, the lack of data on participants’ immunization status and assay variability may impact the generalizability and interpretation of the findings. Conclusion: There was a high prevalence of vitamin D insufficiency among adults participating in COVID-19 tests in Lebanon, but it was not associated with SARS-CoV-2 positivity. Full article

Background: Severe and critical forms of COVID-19 have been associated with high mortality, particularly in vulnerable or underrepresented populations. The neutrophil-to-lymphocyte ratio (NLR) is an emerging inflammatory biomarker that may aid in early risk stratification. Objective: To evaluate the prognostic value of the NLR in hospitalized patients with severe or critical COVID-19 and assess its association with in-hospital mortality in the Yucatecan Maya population of southeastern Mexico. Methods: This retrospective cohort study included 172 adult patients admitted with severe or critical COVID-19 to a tertiary care center in Yucatán, Mexico. Clinical, demographic, and laboratory variables were analyzed. Univariate and multivariate logistic regression were used to identify predictors of in-hospital mortality. ROC analysis determined the optimal NLR threshold. Results: Among the 172 patients, 79 (45.9%) died during hospitalization. Non-survivors exhibited significantly higher NLR values compared to survivors (median 18.4 vs. 6.3; p < 0.001). In multivariate analysis, the NLR remained an independent predictor of mortality (OR 1.66; 95% CI: 1.26–2.17; p < 0.001). The ROC curve showed an AUC of 0. 0.83 for Intensive Care Unit and 903 for in hospital death. Conclusions: In this regional cohort of the Yucatecan Maya population, the NLR was a strong independent predictor of mortality in patients with severe or critical COVID-19. The identified cutoff of the NLR ≥ 9.76 may serve as a valuable, low-cost tool for early risk assessment in similar settings with limited resources. Full article

The increased menstrual disturbances post-vaccination remain unclear. We examined factors, types, frequencies, and emotional challenges. We used a self-administered online questionnaire with the IBM-based SPSSv-24-Windows software for analysis. Of 1372 females, 61.1% (n = 838) were aged 19–29 years, 94.2% (n = 1292) were Saudis, 66.4% (n = 911) were graduates, 70% (n = 965) were single, and 15% (n = 205) had chronic diseases. Moreover, 96.5% (n = 1285/1332) had two vaccine doses, mostly Pfizer’s first- and second doses (82% and 78, respectively), while 3.5% (n = 47) only had one. Vaccine groups significantly differed (Pfizer, Moderna, Oxford, and do not know) after the first (0.047) and second (0.049) doses, while Pfizer vaccines were predictive [OR = 2.09 (0.96–4.10), p = 0.029] at two-doses [OR = 3.21 (1.23–5.21), p = 0.030]. No acute COVID appeared. The majority (77%; n = 1057) had no issues, except, in a subgroup of 23% (n = 315) of participants, 43% (n = 135) experienced worsening issues. However, 47.2% (n = 629) complained only post vaccination. Most issues were (75%; n = 471) cycle-timing disruptions; the rest were minor (decreased blood or bleeding, missed-periods, or pain). Other potential reasons were fear, stress, and mental health problems, which occurred in 51% (n = 674) of the group, while 53% (n = 701) were worried. Intriguingly, the menstrual issues in the remaining 47% (n=631) who were not worried could be due to a direct molecular vaccine interaction, irrespective of any mental issue ([OR = 1.78 (0.76–3.21), p = 0.033]. Age proportionalities were significant (p = 0.05) in the 30–39 year-old group (51%). Postgraduate education [OR = 2.11 (0.98–4.72), p = 0.015) and employment [OR = 2.18 (0.95–4.86), p = 0.049] were also predictors. These findings have significant implications in women’s health and vaccine improvement. Future studies on diverse factors are warranted. Full article

The COVID-19 pandemic significantly impacted daily life, disrupting routines and altering lifestyle behaviors. This study aimed to investigate changes in body weight, nutritional status, and weight loss practices among adults in Türkiye during the first year of the pandemic. A cross-sectional online survey was conducted between March and April 2021, including 806 participants. Height and weight were self-reported, and weight loss practices, along with their details, were evaluated. A qualitative component explored participants’ perceptions of weight change, with 274 valid responses. The mean weight gain during the pandemic was 0.88 kg (p < 0.001). Among participants, 44.9% reported weight gain, 22.6% reported weight loss, and 14.1% experienced weight fluctuation. Among those who experienced weight fluctuations, 47.4% resulted in weight loss, 14.9% showed no change, and 37.7% experienced weight gain. The prevalence of overweight increased from 19.2% to 22.8%, and obesity rose from 8.7% to 9.4% (p = 0.005). Regarding weight loss practices, 30.1% of participants engaged in physical exercise, while 25.7% reported following weight loss diets. Qualitative analysis revealed that changes in physical activity, eating habits, and psychological factors were key determinants of weight change. These findings emphasize the diverse effects of the pandemic on weight status and management. Full article

This qualitative study explored the motivations for, and resilience of, family caregivers visiting family members with dementia in residential care homes (RCHs) in Hong Kong during the COVID-19 pandemic. Data for this qualitative descriptive study was obtained through audio-recorded, semi-structured, in-depth interviews with 25 family caregivers of individuals with dementia in RCHs. Following transcription, a thematic analysis was performed on the verbatim data. Three main themes emerged: (a) virtue of respect and filial piety; (b) family expectations and hopes; and (c) from red flags to resilience and rebuilding stronger relational bonds. The findings elucidate family caregiver motivations and resilience during RCH visits, offering crucial insights for healthcare policymakers. This can inform the design of care services and support to bolster the resilience of both caregivers and their relatives with dementia amidst ongoing global health-system pressures. Full article

This qualitative study explored the development of an innovative simulation training program designed to bolster the preparedness and resilience of healthcare teams during the unprecedented challenges of the COVID-19 pandemic. Focus groups with interprofessional clinicians illuminated key educational priorities, revealing a need for enhanced safety protocols, clear in communication, and targeted training to address knowledge gaps specific to the novel coronavirus. Recognizing the profound emotional toll of the pandemic, the program also emphasized cultivating compassion and fostering emotional resilience alongside the essential clinical skills. By immersing participants in realistic, evolving scenarios that were reflective of the dynamic COVID-19 landscape, the simulations offered a safe space to rehearse critical skills, practice crisis resource management, and build confidence in navigating the complexities of pandemic care. This tailored approach aimed to empower healthcare teams not only with enhanced knowledge and expertise but also with the emotional fortitude and resilience necessary to provide optimal patient care while safeguarding their own well-being throughout the ongoing COVID-19 pandemic. The findings highlight the profound potential of simulation-based training to strengthen both individual and systemic resilience within healthcare systems facing the enduring strain of this global health crisis. Full article

Post-COVID-19 syndrome (PCS) is a common outcome of severe COVID-19 infection; however, less is known about PCS following mild COVID-19. Healthcare workers (HCWs) are more susceptible to acquiring COVID-19 and potentially suffering physical and psychological morbidity secondary to their role. We surveyed HCWs at four hospitals in northeast England at two timepoints during the pandemic, assessing physical and psychophysiological symptoms of PCS, alongside associated factors, whilst also testing for COVID-19 status by SARS-CoV-2 serology and reviewing evidence of infection from previous PCR nasopharyngeal swabs. Of the 379 participants at baseline and 250 HCWs recruited 18 months later, 46% and 64% (respectively) had evidence of previous COVID-19, with no significant associations between COVID-19 status or demographics and symptom scores or self-described PCS. Depression and fatigue were more common later in the pandemic. Furthermore, 20% self-described having PCS, 34% of whom had no evidence of previous COVID-19. Scores for fatigue, pain, mobility, anxiety, and depression were significantly worse in the PCS group compared to those without ongoing symptoms. Significant proportions of HCWs continued to suffer debilitating symptoms during the later pandemic period, although a significant minority had no evidence of previous COVID-19 infection, suggesting that other factors may be involved in their symptomatology. Full article

Background/Objectives: The COVID-19 pandemic has highlighted the importance of identifying factors influencing disease susceptibility and severity. This study investigates the association of ABO blood groups, the D antigen, and comorbidities such as hypertension and diabetes with COVID-19 severity among hospitalized patients in one Croatian center. Methods: A retrospective observational study was performed on 1687 moderately and severely ill COVID-19 patients and 7086 voluntary blood donors. We used medical records from PCR-confirmed COVID-19 patients hospitalized at University Hospital Center Osijek in Osijek, Croatia, and compared their ABO, RhD, and comorbidity profiles with those of voluntary blood donors. Key clinical data and outcomes, such as mortality and comorbidities, were assessed. Results: Our findings reveal a statistically significant association between blood group A and severe COVID-19 outcome and mortality. Conversely, D antigen status showed no significant impact. The combined presence of hypertension and diabetes emerged as a significant predictor of mortality. Conclusions: These results suggest that blood group A and specific comorbidities may be associated with worse outcomes, but age remained the strongest independent predictor of mortality. Blood group typing could still support risk stratification when interpreted alongside other clinical factors. Full article

Endotheliopathy plays an essential role in the pathophysiology of COVID-19. The endothelial activation and stress index (EASIX) indicates endothelial dysfunction. We aimed to investigate the relationship between a high EASIX score and mortality in patients with COVID-19. We retrospectively reviewed COVID-19 patients admitted to the ICU (intensive care unit) of the Ankara Bilkent City Hospital. We recorded hematological and biochemical parameters at the ICU admission and further calculated EASIX with the following equation: EASIX = Lactate dehydrogenase (U/L) × creatinine (mg/dL)/platelet count (10⁹/L). Statistical comparisons were made between the surviving and non-surviving groups in terms of EASIX. The median EASIX score was 1.2 (0.7–2.0) in the survivor group and a median of 2.5 (1.6–4.2) in the non-survivor group (p < 0.001). The mean log2-EASIX was 0.2 ± 0.9 in the survivor group and 1.3 ± 1.2 in the non-survivor group (p < 0.001). Lactate dehydrogenase, creatinine, Troponin I, D-dimer, procalcitonin, ferritin, and IL-6 were statistically significantly higher in the non-survivor group compared to the survivor group. The receiver operating characteristic (ROC) curve analysis showed that the cut-off value of the EASIX score was 2.05 (The area under the curve [AUC] = 0.764, p = 0.001, 95% CI: 0.662–0.847). Our study showed an association between high EASIX scores and poor prognosis in COVID-19 patients. Lactate dehydrogenase, creatinine, Troponin I, D-dimer, procalcitonin, ferritin, IL-6, EASIX, and log2-EASIX were statistically significantly higher in the non-survivor group compared to the survivor group. Being old and having chronic kidney disease increases the risk of death. Eventually, EASIX can be used to predict mortality in COVID-19 patients. Full article

Emerging but limited evidence suggests that HIV infection does not affect in-hospital COVID-19 mortality, regardless of the prevalence of HIV infection in most parts of sub-Saharan Africa, especially the southern Africa region, and Zambia, Lusaka District in particular, is not an exception. Therefore, this study aimed to determine the effect of HIV infection, demographics, and clinical factors on mortality among hospitalized COVID-19 patients at Levy Mwanawasa University Teaching Hospital (LMUTH). A cross-sectional study was conducted with a sample size of 698 adults admitted for COVID-19 at LMUTH from 18 March 2020 to 31 December 2021. For all statistical analysis of data, STATA statistical software, version 15 MP (College Station, TX 77845, USA) was used—ensuring that appropriate statistical techniques were applied to the data. Unadjusted and adjusted logistic regressions were conducted to model COVID-19 mortality among COVID-19 patients based on their HIV status while controlling for five predictor variables. Based on the results, the best predictors of in-hospital COVID-19 mortality were HIV status, number of comorbidities, age in years, smoking, and alcohol intake. The results suggest that COVID-19 mortality among those with HIV and those without HIV infection was different. People living with HIV infection had increased odds of COVID-19 mortality compared to those without HIV. The results further suggested that a unit increase in age was associated with increased odds of COVID-19 mortality. Furthermore, drinking alcohol and having two or more comorbidities increased the odds of COVID-19 mortality compared to not drinking alcohol, having no comorbidity, or having a comorbidity. This study, therefore, concludes that HIV infection has a significant effect on COVID-19 mortality among patients hospitalized at LMUTH and that the proportion of COVID-19 mortality in the HIV-infected group is relatively higher than in the uninfected group. Therefore, there is a need for close monitoring of COVID-19 patients with HIV infection. Full article

Since the establishment of the State of Alarm resulting from the current COVID-19 pandemic, lockdown, and quarantine have been imposed in most countries, with serious health, social, economic, and educational consequences. The health emergency caused by COVID-19 led to the closure of schools, forcing students from all over the world to stop attending schools and compromising the quality of care offered to students with autism spectrum disorder (ASD). In order to examine how teachers supervised students with ASD virtually during the lockdown period, and to determine whether families considered the support provided by teachers to be adequate, a cross-cultural study design was adopted. An ad hoc questionnaire was administered to 415 families in Spain and Mexico in April 2020. We calculated frequencies and carried out descriptive analyses, parametric inferential analyses, and correlations. Families reported that educational monitoring and contact with the family member with ASD during home lockdown was scarce, despite the provision of activities appropriate to their needs. Significant differences were found as a function of country, age of participant, age of family member with ASD, type of ASD, type of schooling, and length of lockdown. This study highlights the need to train teachers in inclusive digital education and to establish effective protocols for communication and follow-up with the families of students with ASD. Full article

Background: The epidemiology, characteristics and outcomes of coinfections in COVID-19 are still poorly understood. Methods: We investigated the prevalence of coinfections in COVID-19 patients hospitalized in Switzerland over the first three epidemic waves between 1 March 2020 and 1 June 2021, as well as risk factors and outcomes. Patients were identified from six hospitals of the Swiss prospective surveillance system database (CH-SUR). Details of the type and treatment of coinfections were retrieved retrospectively from medical charts. We assessed the proportion of patients with suspected coinfections and analyzed risk factors and 90-day in-hospital survival using logistic and Cox regression. Results: Of 13,265 identified patients, 36.6% (4859/13,625) had suspected coinfections, and 44.8% (5941/13,625) received antibiotics. Respiratory coinfections (25.6%) were the most common, followed by bloodstream (19.8%) and urinary tract infections (14.6%). Escherichia coli (14.8%), Staphylococcus aureus (10.7%) and Klebsiella pneumoniae (6.1%) were the most frequently isolated pathogens. The risk factors for coinfections included increasing age, male gender, certain underlying medical conditions and immunosuppression. Suspected coinfections were associated with a longer hospital stay (13 vs. 7 days, p < 0.001), more frequent ICU admission (26% vs. 6.7%, p < 0.001) and higher rates of in-hospital death (24% vs. 9.5%, p < 0.001). Hospitalization in the ICU at the time of COVID-19 diagnosis had the strongest association with coinfections. Conclusions: A high proportion of COVID-19 patients had coinfections, particularly respiratory infections, and received antibiotics. Coinfections were associated with severe illness and worse outcomes. Full article

The replication machinery of SARS-CoV-2 is a primary target for therapeutic intervention, and has led to significant progress in antiviral medication discovery. This review consolidates contemporary molecular insights into viral replication and rigorously assesses treatment methods at different phases of viruses’ clinical development. Direct-acting antivirals, such as nucleoside analogs (e.g., remdesivir, molnupiravir) and protease inhibitors (e.g., nirmatrelvir), have shown clinical effectiveness in diminishing morbidity and hospitalization rates. Simultaneously, host-targeted medicines like baricitinib, camostat, and brequinar leverage critical host–virus interactions, providing additional pathways to reduce viral replication while possibly minimizing the development of resistance. Notwithstanding these advancements, constraints in distribution methods, antiviral longevity, and the risk of mutational evasion demand novel strategies. Promising investigational approaches encompass CRISPR-mediated RNA degradation systems, inhalable siRNA-nanoparticle conjugates, and molecular glue degraders that target host and viral proteins. Furthermore, next-generation treatments aimed at underutilized enzyme domains (e.g., NiRAN, ExoN) and host chaperone systems (e.g., TRiC complex) signify a transformative approach in antiviral targeting. The integration of high-throughput phenotypic screening, AI-driven medication repurposing, and systems virology is transforming the antiviral discovery field. An ongoing interdisciplinary endeavor is necessary to convert these findings into versatile, resistance-resistant antiviral strategies that are applicable beyond the present pandemic and in future coronavirus epidemics. Full article

Promoting public engagement through social media has always been a core issue in risk communication studies. Based on the Social Amplification of Risk Framework (SARF), this study conducts an online survey in China (N = 908) and constructs a moderated mediation model. Using bootstrapped moderated mediation analysis, this study examines the relationships among social media exposure to pandemic information, risk perception, source credibility, and public engagement on social media at the early stages of the pandemic. The results demonstrate a positive relationship between social media exposure and public engagement, which can be mediated by risk perception. The relationship between social media exposure and public engagement via risk perception is moderated by source credibility. The higher perceived credibility of official and interpersonal sources undermines risk perception, but also hinders public engagement in the crisis. The moderating effect of professional source credibility is not significant. This study has expanded the SARF and has contributed to promoting risk communication strategies from the perspective of risk information processing. Full article