COVID

The SI4CARE project is a transnational project which aims to develop both strategy and action plans to improve health and social care in the Adriatic–Ionian region. Starting from a survey of the status quo, each partner has developed some pilots to support the development and monitoring of the policy actions. In particular, partner number three, the Municipality of Miglierina, designed and developed a pilot related to the use of wearable devices for monitoring elderly patients in rural areas. With the collaboration of the complex unity of primary care (UCCP) of the Reventino area, the pilot is based on the use of smart wearable devices to monitor some parameters of older adults after their vaccinations for flu and covid. This paper focused on the design and implementation of the system. It describes its application in the Municipality of Miglierina. Presentation of the results and a discussion of the strengths and weaknesses will be presented, in detail, in future work. Finally, the possibility of extending the experiment to other Adriatic–Ionian regions is addressed. Full article

In the ongoing COVID-19 pandemic, digital technologies have played a vital role to minimize the spread of COVID-19, and to control its pitfalls for the general public. Without such technologies, bringing the pandemic under control would have been tricky and slow. Consequently, exploration of pandemic status, and devising appropriate mitigation strategies would also be difficult. In this paper, we present a comprehensive analysis of community-beneficial digital technologies that were employed to fight the COVID-19 pandemic. Specifically, we demonstrate the practical applications of ten major digital technologies that have effectively served mankind in different ways during the pandemic crisis. We have chosen these technologies based on their technical significance and large-scale adoption in the COVID-19 arena. The selected technologies are the Internet of Things (IoT), artificial intelligence(AI), natural language processing(NLP), computer vision (CV), blockchain (BC), federated learning (FL), robotics, tiny machine learning (TinyML), edge computing (EC), and synthetic data (SD). For each technology, we demonstrate the working mechanism, technical applications in the context of COVID-19, and major challenges from the perspective of COVID-19. Our analysis can pave the way to understanding the roles of these digital COVID-19-fighting technologies that can be used to fight future infectious diseases to prevent global crises. Moreover, we discuss heterogeneous data that have significantly contributed to addressing multiple aspects of the ongoing pandemic when fed to the aforementioned technologies. To the best of the authors’ knowledge, this is a pioneering work on community-beneficial and transformative technologies in the context of COVID-19 with broader coverage of studies and applications. Full article

Introduction: SARS-CoV-2 is the newest beta coronavirus family member to demonstrate neuroinvasive capability in severe cases of infection. Despite much research activity in the SARS-CoV-2/COVID-19 space, the gene-level biology of this phenomenon remains poorly understood. In the present analysis, we leveraged spatial transcriptomics methodologies to examine relevant gene heterogeneity in tissue retrieved from the human prefrontal cortex. Methods: Expression profiles of genes with established relations to the SARS-CoV-2 neuroinvasion process were spatially resolved in dorsolateral prefrontal cortex tissue (N = 4). Spotplots were generated with mapping to six (6) previously defined gray matter layers. Results: Docking gene BSG, processing gene CTSB, and viral defense gene LY6E demonstrated similar spatial enrichment. Docking gene ACE2 and transmembrane series proteases involved in spike protein processing were lowly expressed across DLPFC samples. Numerous other findings were obtained. Conclusion: Efforts to spatially represent expression levels of key SARS-CoV-2 brain infiltration genes remain paltry to date. Understanding the sobering history of beta coronavirus neuroinvasion represents a weak point in viral research. Here we provide the first efforts to characterize a motley of such genes in the dorsolateral prefrontal cortex. Full article

Background: COVID-19 increased health inequalities worldwide. Even among healthcare workers, social-economical features enhanced the risk of infection (having positive serology) during the first outbreak. The Omicron variant changed the pandemic course and differs from previous variants in many aspects (molecular, clinical, and epidemiological). Herein, we investigated if the profile of our hospital SARS-CoV-2-positive workers during the Omicron outbreak was the same as the first COVID-19 wave. Methods: Socio-demographics, previous infection, and vaccine status of 351 healthcare workers from our institution during the Omicron outbreak were compared between SARS-CoV-2-negative and -positive workers, using chi-square tests. These data were confronted with the profile observed at the beginning of the pandemic. Results: Compared to the original COVID-19 wave, higher odds of SARS-CoV-2 positivity in highly exposed workers in our hospital and a loss of impact of public transportation and other socio-demographic features in SARS-CoV-2 transmission were observed. Conclusions: Our data suggest the current phase of the pandemic is associated with a reduction of social inequalities among healthcare workers in Rio de Janeiro, possibly due to vaccine-associated protection. Therefore, a worldwide effort to advance vaccination coverage, especially for healthcare workers in developing countries, should be reinforced. Full article

Due to a large number of mutations in the spike protein and immune escape, the Omicron variant (B.1.1.529) has become a predominant variant of concern (VOC) strain. To prevent the disease, we developed a candidate inactivated vaccine (Omicron COVID-19 Vaccine (Vero Cell), Inactivated). To evaluate the safety of the vaccine, we tested the repeat-dose toxicity in Sprague-Dawley (SD) rats. The doses were administered randomly to three groups: physiological saline solution (control), aluminum adjuvant in PBS solution adjuvant (adjuvant group), and low-dose and high-dose omicron vaccines (vaccine group) for 6 weeks. The SD rats were allowed to recover for 4 weeks after withdrawal. We evaluated the physiological condition of the rats, including their ophthalmological condition, body weight, food intake, body temperature, blood biochemistry, urine, neutralizing antibody, inflammation at the injection site, and organs weight. In summary, no dose-dependent adverse toxicological changes were observed, and a recovery trend was obvious, which proved the preclinical safety of the candidate omicron vaccine and provided evidence for clinical trials in humans. Full article

Compared to previous SARS-CoV-2 variants, the Omicron variant exhibited different epidemiological features. The purpose of this study was to assess the wave dynamics of pre-Omicron and Omicron waves in terms of differences and similarities. We investigated the COVID-19 waves since the beginning of the pandemic up to 28 August 2022, 1000 waves in total, as to their effectiveness for flattening the curve, calculated from the first and second time derivative of the daily case data. The average number of Omicron waves per month (42.78) was greater than the one of pre-Omicron waves per month (25.62). Omicron waves steepen and flatten the curve significantly faster, more effectively and with sharper peaks. Omicron waves generated more daily case data than pre-Omicron waves; the pre-Omicron trend showed increasing numbers over time, whereas the Omicron trend showed decreasing numbers. In denser populated countries, pre-Omicron waves were managed more effectively, in contrast to Omicron waves which were managed less effectively (but more effectively in less densely populated countries). This study provides the evidence for a different behaviour of Omicron waves in terms of wave dynamics, and thereby confirms that the Omicron variant is not only genetically different but even more so in terms of epidemiological dynamics. Full article

Industries worldwide have faced continuous burdens since the beginning of the COVID-19 pandemic, while adjusting to rapidly changing rules and regulations. Industries need to be prepared to remain operational and productive in the face of current and emergent pathogens. While several businesses could remain functional through remote work, critical industries faced closings, worker shortages, and loss of productivity. Pharmaceutical industries were blessed with an increase in the stock market and creation of new jobs, but faced serious severe challenges due to shortage of medicines and drugs. Critical infrastructures such as healthcare, food and agriculture, manufacturing, construction, transportation, retail, waterworks, and waste management took a significant hit during the pandemic, and are still suffering from worker shortages to function optimally. Above all odds, companies were able to maintain the necessities by implementing strict safety protocols such as thorough and repeated cleaning, use of hand sanitizer/disinfectants, wearing face masks and personal protective equipment, and maintaining social distancing. This article addresses how COVID-19 disrupted normal operations on a large scale, and how essential businesses have learned to assess the impact, handle situations effectively, and become resilient for future crises. Best practices were tailored to each industry sector to prepare for and address the pandemic. Full article

At the end of 2019, COVID-19 outbreaks occurred one after another in countries worldwide. Managing the outbreak efficiently and stably is an essential public health issue facing countries worldwide. In this paper, based on the SEIR model, we propose a SCEIR model that incorporates close contacts (C) and self-protectors (P). Firstly, the epidemic data of China, the USA, and Italy are predicted and compared with the actual data. Secondly, sensitivity analysis of each parameter in the SCEIR model was conducted using Anylogic. The study shows that the SCEIR model established in this paper has a certain validity. The infection rate in contact with E (𝛽) etc., has positive effects on the basic regeneration number (R₀); the self-isolation rate (φ) etc., has a negative effect on the basic regeneration number (R₀). Emergency management measures are proposed according to the influencing factors corresponding to the model parameters. These can provide theoretical guidance for developing effective epidemic prevention and control measures in areas where the epidemic has not yet been controlled. It also provides some reference for formulating prevention and control policies for similar epidemics that may occur in the future. Full article

COVID-19 represents the greatest health crisis in recent human history. To date, it is still difficult to estimate its impact on mortality. This paper investigates the excess crude mortality in 27 European countries. The differences between the values observed in 2020 and 2021 with those predicted by a joinpoint regression model were evaluated. A multi-regression analysis was implemented to assess the relationship between health variables and excess mortality. Europe experienced a marked and surprising (S-value > 52) increase in crude mortality during 2020 (Δ_% = +10.0%, 95% CI: [2.5; 18.7]) and 2021 (Δ_% = +12.1%, 95% CI: [4.3; 21.2]). The difference between average excesses of Eastern and Western countries was not surprising (S < 2) and had little relevance (Δ_E-W = −2.4, 95% CI: [−2; 7]) during 2020 but was more pronounced (S = 15, Δ_E-W = +17.2, 95% CI: [11.0; 23.5]) during 2021. Excess crude mortality increased in 2021 (Δ_% = +65%, 95% CI: [12.6; 118], S = 5.9). Evidence has been found for a surprising and marked negative linear relationship between COVID-19 vaccinations and excess mortality (“2021 excess mortality = A + BX₄”, with “A = 58 ± 7, S = 28” and “B = −0.65 ± 0.10, S = 22, R_adj² = 0.65, 95% CI: [0.38; 0.82]). In light of the current literature, these findings provide solid evidence of the substantial role of COVID-19 in the unexpected and marked excess mortality recorded in Europe. COVID-19 vaccinations have appeared to be one of the main determinants for reducing mortality. Future research should explore these aspects in more detail. Full article

São Paulo state has been the epicenter of the Coronavirus Disease 2019 (COVID-19) in Brazil, ranking first by state with over six million reported cases. In February 2021, the P.4 lineage was reported in 21 cities across the state by public health authorities due to the L452R mutation. Here, by analyzing 17,304 genome sequences of SARS-CoV-2 sampled between February and August of 2021 in 476 distinct cities in São Paulo, we assess the transmission dynamics of the P.4 lineage and other SARS-CoV-2 variants that were, at the time of the study, co-circulating in the state. Additionally, clinical parameters from the city of Araras, São Paulo (N = 251) were considered to estimate the potential risk and mortality rate associated with the P.4 lineage since its higher prevalence was observed in that city. Our data suggest a low frequency (0.55%) of the P.4 lineage across the state, with the gamma variant being the dominant form in all regions (90%) at that time. Furthermore, no evidence of increased transmissibility and disease severity related to the P.4 lineage was observed. The displacement through the time of different lineages in São Paulo highlights how challenging genomic surveillance appears to track the emergence of new SARS-CoV-2 lineages, which could better guide the implementation of control measures. Full article

Background: Remdesivir is a broad-spectrum antiviral that has been approved as promising medicine worldwide for the fatal pandemic COVID-19 disease. There is a debate over its efficacy, with different studies taking into account a variety of factors. Therefore, we conducted this study to evaluate the primary composite outcome of mortality rate, need for mechanical ventilation (MV), and escalation of care among Remdesivir (RDV) and non-Remdesivir (NoRDV) groups. Methods: Patients with moderate and severe PCR-confirmed COVID-19 infection were observed retrospectively, before and after including RDV in the treatment protocol during the period from August 2020 to February 2021. Result: From the 509 hospitalized patients, 35% received Remdesivir, with 64% being severe patients. The median age in both groups was 59 years old, and there was no significant difference between the two groups regarding gender, baseline characteristics, and comorbidities. In contrast, the median hospital length of stay in the RDV group was lower (8 days) than the NoRDV (9 days), p = 0.004. The composite outcome was 17.7% in the RDV group and 22.2% in the NoRDV group, but the difference was statistically insignificant (p-value 0.289). Adjusted logistic regression demonstrated a non-significant lower association of the composite outcome with RDV use (OR 0.623, 95CI% 0.37–1.02), and a significant reduction occurred in patients <60 years old (OR 0.39, 95%CI 0.17–0.83). However, survival analysis for mortality, MV, and transfer to a higher level revealed insignificant differences in the median time between groups. Subgroup analyses showed that RDV utilization had a non-significant effect on the risk of all three outcomes across different groups. Conclusion: Despite controlling all patient characteristics, treatment with RDV did not improve patient outcomes over other antivirals and standard care. There is an urgent need for further studies to investigate and evaluate new therapeutic approaches or combinations. Full article

Background: The presence and level of anti-SARS-CoV-2 antibodies in PLWH from the Lower Silesia region in Poland. Material and Methods: A total of 216 serum samples of both sexes, aged 21–77, and treated with TDF or TAF together with FTC and INSTI at two points of time. Anyone who did not experience COVID-19 symptoms. Samples were checked for the presence and levels of anti-SARS-CoV-2 antibodies regarding CD4 + T and CD8 + T cells counts, the ratio of these cells, age, sex, VL, and type of tenofovir used. Results: The average level and prevalence of anti-SARS-CoV-2 antibodies during the first wave were 65.81 IU/mL and 4.17%, while during the second wave, they were 125.98 IU/mL and 14.29%, respectively. There was a significant correlation between the number and type of lymphocytes and the presence of anti-SARS-CoV-2 antibodies. We did not find the same correlation regarding anti-SARS-CoV-2 levels. The average level of antibodies was higher during the second wave. There was no difference between the type of tenofovir used and the humoral response, as well as no correlation of anti-SARS-CoV-2 levels with age, gender, or VL. Conclusion: PLWH can have asymptomatic SARS-CoV-2 infection, which can influence the presence, but not levels, of anti-SARS-CoV-2 Ab. No correlation with type of tenofovir was observed. Full article

Multiple vaccines were developed and administered to immunize people worldwide against SARS-CoV-2 infection. However, changes in platelet count following the course of vaccination have been reported by many studies, suggesting vaccine-induced thrombocytopenia. In this context, designing an effective targeted subunit vaccine with high specificity and efficiency for people with low platelet counts has become a challenge for researchers. Using the in silico-based approaches and methods, the present study explored the antigenic epitopes of the spike protein of SARS-CoV-2 involved in initial binding of the virus with the angiotensin converting enzyme-2 receptor (ACE-2) on the respiratory epithelial cells. The top ten major histocompatibility complex-I (MHC-I) and MHC-II restricted epitopes were found to have 95.26% and 99.99% HLA-class-I population coverage, respectively. Among the top ten promiscuous MHC-I restricted epitopes, ’FTISVTTEI’ had the highest global HLA population coverage of 53.24%, with an antigenic score of 0.85 and a docking score of −162.4 Kcal/mol. The epitope ‘KLNDLCFTNV’ had the best antigenic score of 2.69 and an HLA population coverage of 43.4% globally. The study predicted and documented the most suitable epitopes with the widest global HLA coverage for synthesis of an efficient peptide-based vaccine against the deadly COVID-19. Full article

Six months following the national launch of COVID-19 vaccinations in Cameroon, only 1.1% of the target population was fully vaccinated, with women representing less than one-third of the vaccinated population regardless of age, profession, or comorbidities. Hence, the aim of this study was to understand the low COVID-19 vaccination rate of women in order to enhance vaccine uptake. A cross-sectional study was conducted between July and October 2021 through an online survey. Additionally, a retrospective analysis of the Cameroon Ministry of Public Health (MINSANTE) database of the pandemic (COVID-19) for the period of March 2020 to October 2021 was simultaneously carried out. Our sample consisted of 249 responders aged between 18 and 50 years enrolled in the 10 regions of Cameroon, with 142 (57%) who were female. We assessed factors related to having been vaccinated against COVID-19 and predictors of COVID-19 vaccination among non-vaccinated people. Concerning COVID-19 vaccination, 39.2% were not vaccinated. Non-vaccination was statistically associated with being female, being a healthcare worker, fear of adverse effects, and not believing in the vaccine. In the qualitative analysis, women identified themselves as being anti-COVID-19-vaccine for several reasons, including doubts about the quality or safety of the vaccine; the perception that COVID-19 vaccines are presented as being an obligation; and regarding the multitude of vaccines on the market, the belief that there are “more local” effective alternatives to the vaccine. The implementation of the gender approach to COVID-19 vaccination is one factor influencing its effectiveness and sustainability. Full article

Pneumomediastinum, pneumothorax, and subcutaneous emphysema may occur as rare complications of COVID-19. They are associated with worsened prognosis and survival from SARS-CoV-2 pneumonia. The treatment of pneumomediastinum involves supportive care and management of underlying diseases. Our case presents a female patient suffering from COVID-19 pneumonia with life-threatening mediastinal emphysema. According to guidelines, literature, and other clinical sources, no further therapy options were recommended, and survival was improbable. During an interdisciplinary case discussion, we decided to establish a mediastinal drain and tracheal cannula. This achieved a significant reduction of emphysema as well as an improvement in the patient’s clinical condition and long-term survival. This case demonstrates a rarely used invasive therapy for pneumomediastinum. Furthermore, it demonstrates the importance of cooperation with other centers, interdisciplinary teamwork, and of presenting case reviews—especially when guidelines are unavailable. Full article

The strategy of relying solely on current SARS-CoV-2 vaccines to halt SARS-CoV-2 transmission has proven infeasible. In response, many public-health authorities have advocated for using vaccines to limit mortality while permitting unchecked SARS-CoV-2 spread (“learning to live with the disease”). The feasibility of this strategy critically depends on the infection fatality rate (IFR) of SARS-CoV-2. An expectation exists that the IFR will decrease due to selection against virulence. In this work, we perform a viral fitness estimation to examine the basis for this expectation. Our findings suggest large increases in virulence for SARS-CoV-2 would result in minimal loss of transmissibility, implying that the IFR may vary freely under neutral evolutionary drift. We use an SEIRS model framework to examine the effect of hypothetical changes in the IFR on steady-state death tolls under COVID-19 endemicity. Our modeling suggests that endemic SARS-CoV-2 implies vast transmission resulting in yearly US COVID-19 death tolls numbering in the hundreds of thousands under many plausible scenarios, with even modest increases in the IFR leading to unsustainable mortality burdens. Our findings highlight the importance of enacting a concerted strategy and continued development of biomedical interventions to suppress SARS-CoV-2 transmission and slow its evolution. Full article

The declaration of the coronavirus disease 2019 (COVID-19) pandemic led to the enforcement of national lockdowns in several countries. While lockdowns are generally effective in containing the spread of infectious diseases, they are associated with negative impacts on livelihoods. Although evidence suggests that urban informal sector populations in low-resource settings bore the brunt of the adverse economic effects of COVID-19 lockdowns, there is little on how they survived. The article provides insights into the survival mechanisms of urban informal sector populations during a COVID-19 lockdown. Data are from narrative interviews with 30 residents of Kampala City and surrounding areas. We found that the COVID-19 lockdown chiefly jeopardized the livelihoods of urban residents through job loss and reduced incomes. Affected individuals and households primarily survived by making improvisations such as adjusting expenditures and reconfiguring their livelihoods. The cardinal elements of the informal sector, such as limited regulation, served as both a facilitator and constraint to survival. Therefore, the informal sector is an important buffer against livelihood shocks in situations of crisis. However, its inherent limitations imply that promoting livelihood resilience among urban residents during lockdowns and similar shocks may necessitate harnessing both formal and informal safety nets. Full article

During the coronavirus pandemic, buying and consumption patterns of US consumers shifted towards contactless buying. While the topic of online buying is well explored within the existing literature on this topic, purchasing fruit from a vending machine is still yet to be investigated. This exploratory study used quantitative data to examine the factors driving US consumers’ willingness to try, buy and pay a premium for fruit from vending machines. An online survey of 391 US consumers was conducted to fill this research gap between 7 July and 10 July 2022. This survey was distributed via Amazon Mechanical Turk, a crowdsourcing platform which is widely used for consumer research. Smart PLS 4 facilitated the Partial Least Squares Structural Equation Modeling (PLS-SEM) analysis, as this method well suited for testing exploratory models with complex relations between the latent variables. Results indicated that COVID-19 pandemic-related benefits, quality benefits, value-related benefits and experiential benefits were the most important predictors that determined willingness to try, buy and pay a price premium when purchasing fruit from a vending machine. Full article

Cities around the world have been hit by the COVID-19 crisis. The worst consequences of the pandemic are closely related to urban areas. Many studies investigated the impact of COVID-19 on people but there are few studies that have investigated the satisfaction level of university students during the COVID-19 lockdown at the neighborhood level. Therefore, the aim of this study is to investigate the satisfaction of university students at the neighborhood level during the COVID-19 lockdown and investigate the experience of online education during that period—if they received any. An online survey was conducted involving university students of different countries, and a total of 427 responses (n = 427) were received and analyzed using the CHAID model. Results show that comfort at residences during the COVID-19 lockdown was affected by the neighborhood environment (viz., greenery, pleasant views, independent housing with gardening facilities), transportation (i.e., saving 1–2 commuting hours on a daily basis and safety from traffic hazards), and the provision of online education (i.e., effectiveness, such as traditional methods of education and the opportunity to connect with field experts). Thus, it can be concluded that providing green neighborhoods, detached or terraced houses (townhouses) with visual connection, and gardening facilities for the residents should be encouraged in the future because these types of neighborhoods are not only comfortable in ordinary situations but also provide comfort during critical periods such as COVID-19 lockdowns. It can also be concluded that a hybrid style of education should be encouraged for universities, as it can save travel time, provide safety from traffic, and provide more opportunities to become connected with international experts through online guest lectures, seminars, and workshops. Full article