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9 pages, 207 KiB

Open AccessArticle

Vitamin D Status and SARS-CoV-2 Positivity in Lebanon Among Adults: A Cross-Sectional Study in South Lebanon

by Ahmed A. Madar, Firass Al Lababidi, Filali Samia and Haakon E. Meyer

COVID 2025, 5(7), 97; https://doi.org/10.3390/covid5070097 - 27 Jun 2025

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Abstract

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 [...] Read more.

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

(This article belongs to the Special Issue COVID and Public Health)

16 pages, 413 KiB

Open AccessArticle

Frequent Menstrual Disturbance Post-COVID-19 Vaccination in Saudi Arabia

by Khalid F. Alshammari, Kamaleldin B. Said, Ahmed Aljadani, Arwa A. Alotaibi, Fahad M. Alshammary, Ruba M. Elsaid Ahmed, Abdulrahman T. Alshammari, Turki A. Al-shammari, Hend Alkwai, Mona M. Shahin, Gamal Eldin M. O. Elhussein, Somaia Ibrahim, Fayez R. Alfouzan, Tarig Mahmoud, Rania A. H. Abdalla, Abdelrahim A. A. Mohamed, Zaid A. Albayih and Abuzar A. A. Osman

COVID 2025, 5(7), 95; https://doi.org/10.3390/covid5070095 - 20 Jun 2025

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Abstract

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 [...] Read more.

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

(This article belongs to the Special Issue COVID and Public Health)

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15 pages, 605 KiB

Open AccessArticle

Self-Reported Body Weight Change and Weight Loss Practices During the COVID-19 Pandemic: A Mixed-Methods Study from Türkiye

by Nagihan Kircali-Haznedar, Mehmet Haydaroğlu and Pelin Bilgiç

COVID 2025, 5(6), 94; https://doi.org/10.3390/covid5060094 - 19 Jun 2025

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Abstract

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 [...] Read more.

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 article belongs to the Special Issue COVID and Public Health)

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14 pages, 516 KiB

Open AccessArticle

Rethinking the Impact of Social Media Exposure and Source Credibility on the Social Amplification of Risk and Public Engagement During the COVID-19 Pandemic

by Longfei Li and Ran Feng

COVID 2025, 5(6), 84; https://doi.org/10.3390/covid5060084 - 30 May 2025

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Abstract

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 [...] Read more.

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

(This article belongs to the Special Issue COVID and Public Health)

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17 pages, 1101 KiB

Open AccessArticle

Delay in COVID-19 Vaccinations: The Role of Travel Time to Vaccine Sites

by Yuxia Huang and Jim Lee

COVID 2025, 5(5), 70; https://doi.org/10.3390/covid5050070 - 12 May 2025

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Abstract

Introduction: A growing body of literature has identified a variety of factors affecting vaccine uptake, but the role of geographic accessibility remains unclear. This study fills this knowledge gap by empirically investigating the extent to which the time driving to vaccine sites as [...] Read more.

Introduction: A growing body of literature has identified a variety of factors affecting vaccine uptake, but the role of geographic accessibility remains unclear. This study fills this knowledge gap by empirically investigating the extent to which the time driving to vaccine sites as a measure of geographic friction affected COVID-19 vaccine uptake. Methods: A logistic model and a hazard-based duration model were applied to the official data of more than 142,000 adults who took at least one COVID-19 vaccine in Nueces County, Texas, between December 2020 and August 2022. Using the street network, travel time was calculated from individuals’ home addresses to the addresses of the sites where they received their vaccinations. Results: The logistic model indicated that individuals living farther from vaccine sites were less likely to receive full vaccination, controlling for their sociodemographic characteristics that affected vaccine hesitancy. The duration model further showed that fully vaccinated persons would delay a booster shot longer if they had to travel longer for a vaccine. Conclusions: To the extent that the health protection of a COVID-19 vaccine declines over time, the integration of spatial and temporal dimensions in the duration model allowed us to shed light on the relationship between travel time and delay in booster vaccination. A vaccination campaign should make vaccination services physically convenient for vaccine recipients from different communities. Full article

(This article belongs to the Special Issue COVID and Public Health)

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11 pages, 528 KiB

Open AccessArticle

High- and Low-Cost Healthcare Utilization for Cancer and COVID-19 Patients

by Li Huang and Sue Min Lai

COVID 2025, 5(4), 56; https://doi.org/10.3390/covid5040056 - 16 Apr 2025

Viewed by 458

Abstract

Background: Healthcare total spending accelerated during the COVID-19 pandemic. Understanding broad high- and low-cost healthcare utilization while the healthcare system is under stress can help identify strategies and gaps to improve the future quality of care while reducing high-cost care and maximizing low-cost [...] Read more.

Background: Healthcare total spending accelerated during the COVID-19 pandemic. Understanding broad high- and low-cost healthcare utilization while the healthcare system is under stress can help identify strategies and gaps to improve the future quality of care while reducing high-cost care and maximizing low-cost care. Methods: This was a population-based cross-sectional study with 56,141 individuals in the U.S. using 2020–2021 Medical Expenditure Panel Survey (MEPS) data sources. We applied a Poisson regression approach to test differences among patients with/without cancer/COVID-19 in healthcare utilization outcomes, including emergency department (ED) visits, inpatient discharge, inpatient nights of stay, outpatient visits, and home provider days. Results: Outpatient visits were affected by both cancer and COVID-19 diagnoses (86% to 109% higher for individuals with cancer and/or COVID-19, p < 0.001). COVID-19 patients with/without cancer had statistically significant increases in high-cost care, including (1) ED visits (151% to 245% higher, p < 0.001), (2) number of inpatient visits (94% to 170%, p < 0.001, p < 0.001), and (3) inpatient nights of stay (259% to 268% higher, p < 0.001). There were no statistically significant differences in home-based utilization when compared to individuals without cancer and without COVID-19. Conclusions: Improving and adopting innovative low-cost home-based care utilization are critical to reduce future healthcare spending and strengthen pandemic preparedness. Full article

(This article belongs to the Special Issue COVID and Public Health)

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17 pages, 1415 KiB

Open AccessArticle

COVID-19 Control in Highly Urbanized Philippine Cities: Leveraging Public Health Open-Source Government Data for Epidemic Preparedness and Response

by Maria Catherine B. Otero, Lorraine Joy L. Bernolo, Refeim M. Miguel, Zypher Jude G. Regencia, Lyre Anni E. Murao and Emmanuel S. Baja

COVID 2025, 5(3), 42; https://doi.org/10.3390/covid5030042 - 19 Mar 2025

Viewed by 2064

Abstract

Highly Urbanized Cities (HUCs) in the Philippines were at the forefront of public health surveillance and response during the COVID-19 pandemic. With the rapid spread of COVID-19 to Philippine cities, local government units continuously assessed, adapted, and implemented public health interventions (PHIs) and [...] Read more.

Highly Urbanized Cities (HUCs) in the Philippines were at the forefront of public health surveillance and response during the COVID-19 pandemic. With the rapid spread of COVID-19 to Philippine cities, local government units continuously assessed, adapted, and implemented public health interventions (PHIs) and depended on available open-source government data (OSGD). This study consolidated PHIs in selected HUCs in the Philippines using high-quality OSGD to create a timeline of interventions and document good practices in local COVID-19 control. OSGD resources were collected from February 2020 to January 2023, and the data quality of OSGD was evaluated using the Journal of the American Medical Association (JAMA) benchmarks. A total of 180 metadata sources that met at least two core standards (Authorship and Currency) were included in the analysis. COVID-19 control strategies were analyzed vis-à-vis the rise of COVID-19 cases and types of PHIs, including the control of imported cases, case management, contact management, behavioral modification, and pharmaceutical intervention. Travel bans and hard lockdowns in Luzon early in the pandemic delayed the introduction of COVID-19 to other parts of the country. Good practices of LGUs for local COVID-19 control, such as quarantine passes, curfews and liquor bans, using QR-based contact tracing, massive community testing in high-risk communities, and free public swabbing centers, were implemented to slow down the local spread of COVID-19. With the evolving scenarios in city-level COVID-19 epidemics, local risk assessments based on available OSGD drove the adoption of relevant and innovative control strategies in HUCs in the Philippines. Lessons learned must be integrated into epidemic preparedness and response programs against future emerging or re-emerging infectious diseases. Full article

(This article belongs to the Special Issue COVID and Public Health)

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21 pages, 290 KiB

Open AccessArticle

Examining the Relationships Between Workplace Policies and Practices, PTSD, and Distress Among Working Parents During the COVID-19 Crisis

by Samantha A. Meeker, Alicia Modestino, Jamie Ladge, Beth E. Molnar and Alisa K. Lincoln

COVID 2025, 5(3), 28; https://doi.org/10.3390/covid5030028 - 22 Feb 2025

Viewed by 528

Abstract

While the COVID-19 pandemic’s impact on mortality and morbidity is becoming more understood, the severity of the long-term effects remains unknown: this includes medical sequelae of long COVID but also the impact of the social and economic upheaval on population health. Working parents [...] Read more.

While the COVID-19 pandemic’s impact on mortality and morbidity is becoming more understood, the severity of the long-term effects remains unknown: this includes medical sequelae of long COVID but also the impact of the social and economic upheaval on population health. Working parents faced many challenges during the pandemic, and the impact of these on the mental health and well-being of parents has been demonstrated. However, the extent of trauma-related symptoms among working parents who have faced unique challenges related to the virus itself and the social and structural consequences of containment efforts remains underexamined. Using data from a national panel survey of fworking parents (n = 1941), we explored the relationship between workplace policies and practices and COVID-19-related PTSD and psychological distress. Results demonstrate that nearly 50% of working parents experienced COVID-19-related PTSD as measured by the Impact of Events Scale-6, and over 60% had moderate to high levels of psychological distress. We examined mechanisms to understand the impact of job support on employees’ levels of PTSD and distress and found that both socio-demographic factors and workplace support related to levels of PTSD and distress among working parents. Our study highlights the distress and PTSD levels experienced by working parents in the early stages of the pandemic, underscoring the impact of workplace support on mental health outcomes. Full article

(This article belongs to the Special Issue COVID and Public Health)

14 pages, 832 KiB

Open AccessArticle

Can Self-Reported Symptoms Be Relied on for COVID-19 Screening in Low-Resource Settings?

by Suraj Singh Senjam, Garima Goel, Neiwete Lomi, Yatan Pal Singh Balhara, Yashdeep Gupta and Animesh Ray

COVID 2025, 5(2), 15; https://doi.org/10.3390/covid5020015 - 27 Jan 2025

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Abstract

Background: Understanding the extent of the disease penetration and assessing its impact is critical during a pandemic. However, laboratory-based COVID-19 estimation can be resource-intensive and may not be feasible during an emergency, particularly in low-resource settings. Aim: To investigate whether self-reported symptoms can [...] Read more.

Background: Understanding the extent of the disease penetration and assessing its impact is critical during a pandemic. However, laboratory-based COVID-19 estimation can be resource-intensive and may not be feasible during an emergency, particularly in low-resource settings. Aim: To investigate whether self-reported symptoms can be used for COVID-19 screening to estimate the burden among individuals aged 18 years and above in a rural setting. Methods: A community-based cross-section study was conducted in a rural district of Haryana, a state in north India, using a self-reported semi-structured questionnaire developed on a digital platform. Information on COVID-19 manifestations as essential and non-essential, confirmed laboratory tests, and disability data using Washington Groups of Short Set were obtained. The sensitivity of the COVID-19 symptoms was estimated against laboratory-confirmed true positives. A chi-square or Fisher exact test for association and a multivariable regression to determine the predictors of the prevalence was carried out. Results: In total, 2954 respondents (79.8%), out of 3700 enumerated, were interviewed. The mean age of respondents was 42 years (SD 17.2), with 54.8% female respondents. The prevalence of COVID-19 based on self-reported symptoms was 6.2% (95%CI: 5.3–7.1). The age-adjusted prevalence was 6.04% (95%CI: 5.9–6.1). Of the total COVID-19 cases, 170 (5.7%, 95%CI: 4.9–6.5) revealed a laboratory-confirmed test. Given three essential symptoms to declare provisionally COVID-19 cases, the sensitivity was 82.9% (141/170), but considering two or more essential symptoms along with two or more non-essential, the sensitivity reached up to 91.8% (156/170). The multivariable analysis showed that increased age, higher education attainment, students, entrepreneurs, persons working in private sectors, and participants with poor hygiene were predictors. Conclusions: A symptoms-based identification of COVID-19 cases can give a reliable estimate and valuable insight into the extent of the penetration, especially in low-middle-income countries, and can be a supplement, not a replacement, to a laboratory test. Full article

(This article belongs to the Special Issue COVID and Public Health)

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15 pages, 531 KiB

Open AccessArticle

Coping with Stress During the COVID-19 Pandemic: Resilience and Mental Health Among Latino Day Laborers

by Sylvia A. Ayieko, John Atkinson, Anna Llamas and Maria E. Fernandez-Esquer

COVID 2025, 5(1), 1; https://doi.org/10.3390/covid5010001 - 24 Dec 2024

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Abstract

Resilience, the successful process of growth and adaptation in the face of adversity, stress, or trauma, is crucial for optimal well-being. During the COVID-19 pandemic, Latino day laborers (LDLs) faced multiple stressors, making them vulnerable to poor mental health outcomes. Using a cross-sectional [...] Read more.

Resilience, the successful process of growth and adaptation in the face of adversity, stress, or trauma, is crucial for optimal well-being. During the COVID-19 pandemic, Latino day laborers (LDLs) faced multiple stressors, making them vulnerable to poor mental health outcomes. Using a cross-sectional study design, we examine the association between situational stressors, mental health, and resilience among LDLs during the COVID-19 pandemic. Data included sociodemographic information and measures of situational stressors, mental health (depression, anxiety, and stress), and resilience. Positive and negative resilience subscales were analyzed separately due to a high correlation. A total of 300 male participants completed the surveys, with a mean age of 45.1 years. Almost half had never been married (48%) and had completed nearly eight years of school. The results indicated no significant associations between stressors, positive resilience, and mental health outcomes (B = 0.023, NS) but a significant association between negative resilience, mental health outcomes, and some stressors, such as lack of money (B = 0.103; p < 0.05). The implications of this study include the need to further investigate the use of negatively worded items and how resilience is demonstrated among other vulnerable populations or cultural groups. Full article

(This article belongs to the Special Issue COVID and Public Health)

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11 pages, 4219 KiB

Open AccessArticle

COVID-19 Trends in a Northeastern Brazilian State from the Start of the Pandemic: Exploring an Alternative Time Series Method

by Matheus Paiva Emidio Cavalcanti, Jorge de Oliveira Echeimberg, Tassiane Cristina Morais, Blanca Elena Guerrero Daboin, Fernando Augusto Marinho dos Santos Figueira, Carlos Mendes Tavares and Luiz Carlos de Abreu

COVID 2024, 4(12), 1960-1970; https://doi.org/10.3390/covid4120138 - 11 Dec 2024

Cited by 1 | Viewed by 1189

Abstract

Pernambuco, a northeastern Brazilian state, suffered significantly during the COVID-19 pandemic. The incidence, mortality, and fatality rates were incredibly high; these outcomes were a direct failure of the public health system to manage the COVID-19 pandemic. We developed an efficient method to analyze [...] Read more.

Pernambuco, a northeastern Brazilian state, suffered significantly during the COVID-19 pandemic. The incidence, mortality, and fatality rates were incredibly high; these outcomes were a direct failure of the public health system to manage the COVID-19 pandemic. We developed an efficient method to analyze the trends in incidence, mortality, and lethality indicators of COVID-19 and the dynamics of their main determinants in the state of Pernambuco from March 2020 to March 2022. This was a time series ecological study. We calculated the lethality, mortality, and incidence rates with official and public data from the Health Department of this state. The effective reproduction number (Rt) was estimated, and then the periods were delimited, thus creating the efficiency model. Differences were considered significant when p < 0.05. We found 585,551 cases and 18,233 deaths from COVID-19. January 2022 was the month with the highest number of cases (6312) and, in May 2020, we recorded the highest number of deaths (149). Our method was efficient in analyzing periods of COVID-19, noting a contrast between the early and most recent periods, with the latter showing a stable number of new cases and patient deaths. Full article

(This article belongs to the Special Issue COVID and Public Health)

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11 pages, 247 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on the Oral Hygiene Status of Children with High Caries Risk and Their Parents

by Zeliha Hatipoğlu Palaz, Nagehan Aktaş and Didem Atabek

COVID 2024, 4(12), 1897-1907; https://doi.org/10.3390/covid4120133 - 28 Nov 2024

Viewed by 1243

Abstract

Background: People consumed more sugary foods and neglected oral hygiene during the lockdowns due to the coronavirus disease (COVID-19) pandemic. The study aimed to compare the oral hygiene status and dietary habits of children with high caries risk and their parents before and [...] Read more.

Background: People consumed more sugary foods and neglected oral hygiene during the lockdowns due to the coronavirus disease (COVID-19) pandemic. The study aimed to compare the oral hygiene status and dietary habits of children with high caries risk and their parents before and after COVID-19. Methods: The study was conducted with the parents of 155 children aged 3–5 years. A questionnaire including both the children’s and parents’ dietary and oral hygiene habits was completed by the parents. Decay, missing, filling teeth (dmft/DMFT) status of the children was recorded before and after COVID-19. Results: A significant decrease was observed in the parents’ tooth brushing frequency (p = 0.028), while no difference was observed in the children’s brushing frequency before and after COVID-19 (p = 0.216). Both children and parents ate significantly more frequently (p = 0.047, p = 0.043). dmft/DMFT values increased significantly after COVID-19 (p = 0.005). Conclusions: The study showed that the COVID-19 pandemic had a limited effect on tooth brushing habits in children with high caries risk. Additionally, it resulted in increased consumption of sugary foods among both children and parents, exacerbating caries in children aged 3–5 years. Healthcare professionals and parents can work together to mitigate the negative effects of the COVID-19 pandemic on oral health, especially for high-caries-risk children. Full article

(This article belongs to the Special Issue COVID and Public Health)

24 pages, 3042 KiB

Open AccessArticle

Exploring the Role of News Outlets in the Rise of a Conspiracy Theory: Hydroxychloroquine in the Early Days of COVID-19

by Robert Dickinson, Dominique Makowski, Harm van Marwijk and Elizabeth Ford

COVID 2024, 4(12), 1873-1896; https://doi.org/10.3390/covid4120132 - 27 Nov 2024

Viewed by 2011

Abstract

Improper use of hydroxychloroquine to treat COVID-19 has been linked to 17,000 preventable deaths. This content analysis study investigates the emergence of this conspiracy theory, the role of the news media in perpetuating and disseminating it, and whether coverage differed by outlet political [...] Read more.

Improper use of hydroxychloroquine to treat COVID-19 has been linked to 17,000 preventable deaths. This content analysis study investigates the emergence of this conspiracy theory, the role of the news media in perpetuating and disseminating it, and whether coverage differed by outlet political alignment. We searched Nexis for relevant media from 17–31 March 2020. A total of 128 media pieces were coded qualitatively and thematically analysed. The news media amplified the voices of right-wing political elites and used a variety of manipulative tactics in reporting on hydroxychloroquine. Powerful ingroup/outgroup mechanisms polarised the American public and created a schism between Trump supporters and the public health apparatus that reflected the political asymmetry in reporting on hydroxychloroquine. The widespread use of optimistic framings and anecdotal evidence contributed to public misunderstandings of the evidence. Therefore, strategic and interventionist public health efforts are required to combat misinformation. This study informs discussions of how politicised media coverage catalyses conspiracism. Full article

(This article belongs to the Special Issue COVID and Public Health)

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9 pages, 396 KiB

Open AccessBrief Report

Neutrophil-to-Lymphocyte Ratio Predicts COVID-19 Mortality in the Yucatecan Maya Population: A Retrospective Cohort Study

by Adriel Ismael Alonso Batun, Vania Janet Tello Romero, Onel Abraham Pacheco Polanco and Nina Mendez-Dominguez

COVID 2025, 5(7), 96; https://doi.org/10.3390/covid5070096 - 26 Jun 2025

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Abstract

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 [...] Read more.

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

(This article belongs to the Special Issue COVID and Public Health)

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7 pages, 206 KiB

Open AccessBrief Report

Adherence to Pelvic Floor Physical Therapy During COVID-19: A Retrospective Study

by Nicole P. Jenkins, Gregory W. Vurture, Amber Wai-San Chan, Stephanie Sansone, Nina Jacobson and Scott W. Smilen

COVID 2025, 5(5), 64; https://doi.org/10.3390/covid5050064 - 27 Apr 2025

Viewed by 306

Abstract

COVID-19 introduced widespread challenges in healthcare access and was demonstrated to be a significant stressor for patients with pelvic floor dysfunction (PFD). Pelvic Floor Physical Therapy (PFPT) is a first line behavioral modification to address PFD. The impact of COVID-19 on PFPT adherence [...] Read more.

COVID-19 introduced widespread challenges in healthcare access and was demonstrated to be a significant stressor for patients with pelvic floor dysfunction (PFD). Pelvic Floor Physical Therapy (PFPT) is a first line behavioral modification to address PFD. The impact of COVID-19 on PFPT adherence rates in a urogynecologic population is unknown; therefore, a retrospective chart review was conducted looking at “pre-pandemic” (referring to before 1 March 2020) and “pandemic” (referring to after 1 March 2020) cohorts. A total of 173 women met the inclusion criteria (93 pre-pandemic vs. 80 pandemic). The PFPT adherence rates were similar between the pre-pandemic and pandemic groups (20.0% vs. 18.8%, p = 0.85). Patient-reported barriers to initiation included insurance coverage, transportation, and time commitment. When looking for clinical correlates associated with non-adherence, patients who utilized an internal referral to a hospital-associated PFPT facility were 4.9-fold more likely to adhere to PFPT for PFD (95% confidence interval: 1.31–18.23, p = 0.018). While COVID-19 was not identified as a barrier to PFPT adherence, identifying barriers preventing patients from attending PFPT remains an area for improvement. Increasing the utilization of an internal referral system to a hospital-associated PFPT facility may be an effective solution for increasing patient adherence. Full article

(This article belongs to the Special Issue COVID and Public Health)

11 pages, 187 KiB

Open AccessBrief Report

Multi-Stakeholder Perspectives on COVID-19 Vaccine Acceptance: A Qualitative Study from African, Caribbean, and Black Communities in Ottawa, Ontario, Canada

by Josephine Etowa, Ubabuko Unachukwu, Sylvia Sangwa, Egbe B. Etowa, Haoua Inoua, Ruby Edet, Emmanuella Okolie, Erica Kamikazi, Emana Ifeoma Emiko, Luc Malemo and Biswajit Ghose

COVID 2025, 5(5), 62; https://doi.org/10.3390/covid5050062 - 25 Apr 2025

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Abstract

Through engagement with multi-stakeholders—including African, Caribbean, and Black (ACB) community members and leaders, as well as service providers in Ottawa, Ontario, Canada—this study explores in-depth narratives and first-hand accounts of their lived experiences in the context of COVID-19 vaccine promotion. A thematic analysis [...] Read more.

Through engagement with multi-stakeholders—including African, Caribbean, and Black (ACB) community members and leaders, as well as service providers in Ottawa, Ontario, Canada—this study explores in-depth narratives and first-hand accounts of their lived experiences in the context of COVID-19 vaccine promotion. A thematic analysis of the focus group discussions, conducted in NVivo, revealed that vaccine acceptance among ACB communities is shaped by factors such as racial discrimination, COVID-19 knowledge, misconceptions, communication strategies and barriers, preference for alternative medicines, and community resilience. These findings highlight several implications for policymakers and provide directions for future research. Full article

(This article belongs to the Special Issue COVID and Public Health)

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