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Life
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Human Health Before, During, and After COVID-19
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Human Health Before, During, and After COVID-19

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Epidemiology".

Deadline for manuscript submissions: closed (25 March 2025) | Viewed by 34625

Special Issue Editor

Dr. Alessia Verduri

E-Mail Website
Guest Editor
Respiratory Unit, Department of Surgical and Medical Sciences, University of Modena and Reggio Emilia, Hospital Policlinico, Modena, Italy
Interests: COPD; dyspnea; frailty; ageing; COVID-19; asthma; interstitial lung disease; pleural disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It has been more than three years since COVID-19 was declared a global pandemic. Since that point, we have experienced profound changes in the ways that we work, socialise, and learn. The severity of this transformation has allowed us to examine daily practices, social norms, institutions, and the positive and negative aspects of our former lifestyles. The pandemic compelled us to appreciate the precious details of our lives that we have taken for granted: workplaces, human touch, parties, travel, and access to and the utilisation of healthcare facilities. We are thus able to reflect on the ways we live now in order to modify our cultures and find different ways to improve the quality of life for future generations. Many trends that had already started before COVID-19 have been accelerated by the impact of the pandemic. Examples include the digital economy, with the rise of telemedicine in the healthcare delivery services.

One of the hardest things to deal with in this period was maintaining physical distance. Physical interactions are an essential part of human social experience, and they are particularly important for the development of young people. Social distancing, school closures, and physical isolation from friends have been especially challenging for adolescents. Some have subsequently experienced feelings of loneliness, hopelessness, and sadness. Remote learning and homeworking under lockdown have also impacted the wellbeing of university students and young workers. Over the course of the pandemic, people of all ages reported symptoms consistent with anxiety and depression, regardless of severity of any viral infection. Additionally, increasing evidence of post-COVID long-term effects has been reported in the literature. Long COVID describes a range of symptoms, including fatigue, dyspnea, brain fog, and mental health disorders.

COVID is becoming endemic, which means that we will live with it as we do with the flu, i.e., without consequences as severe as those seen in the first three years. However, while some countries have reported a decline in COVID-19 cases and deaths, largely due to high vaccination coverage, there is still a relevant public health concern about refugees and unvaccinated people in many developing countries. The behaviour we all exhibit and the epidemiology of the virus itself are extremely important. New SARS-CoV-2 variants show increasing levels of concern and are likely to impact the epidemiological situation worldwide.

This Special Issue aims to provide a collection of high-quality data and new insights into COVID-19. We invite healthcare professionals and researchers involved in COVID-19 to submit original research articles or reviews to Life. Papers will be peer-reviewed by experts in the field.

You may choose our Joint Special Issue in Healthcare.

Dr. Alessia Verduri
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19
  • telemedicine
  • pandemic-related anxiety
  • pandemic-related depression
  • long COVID
  • unvaccinated people
  • new SARS-CoV-2 variants

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Published Papers (24 papers)

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13 pages, 1363 KiB  
Article
The Effects of the COVID-19 Pandemic on Trends and Types of Pediatric Burn Injuries: Lessons from a National Burn Center and the Role of Strategic Resource Allocation
by Raluca Tatar, Dan Mircea Enescu, Doina Iulia Nacea, Gabriela Viorela Nițescu, Andreea Lescaie, Mihaela Pertea, Petruța Mitrache and Laura Sorina Diaconu
Life 2025, 15(4), 544; https://doi.org/10.3390/life15040544 - 26 Mar 2025
Viewed by 251
Abstract
The COVID-19 pandemic had a huge global impact on healthcare systems that affected all medical services, including burn care facilities. This paper analyzes the effects of this medical crisis on pediatric burn injuries by comparing patient data from 2019 (pre-pandemic) and 2020 (during [...] Read more.
The COVID-19 pandemic had a huge global impact on healthcare systems that affected all medical services, including burn care facilities. This paper analyzes the effects of this medical crisis on pediatric burn injuries by comparing patient data from 2019 (pre-pandemic) and 2020 (during the pandemic) at a national burn center in Romania. The study included, overall, 676 patients, out of which 412 were admitted in 2019. In 2020, the admissions decreased by 35.9% (n = 264). However, moderate and severe burns remained constant and burn severity increased in 2020, with a larger total body surface area affected on average. Surgical management rates and hospital stay duration increased in 2020 from 18% to 39% and from 7 days to 11 days, respectively. Admissions to the intensive care unit and mortality rates remained similar between 2019 and 2020. Scalds were the leading cause of burns in both years; however, in 2020, they affected a larger total body surface area. Contact burns decreased significantly in 2020 from 10.9% to 5.2%, likely due to reduced outdoor activities. The concomitant presence of SARS-CoV-2 infection and burn injuries did not have a negative impact on complication rates, surgical management approaches, or duration of hospitalization. These findings emphasize the need to preserve dedicated burn care human and material resources during global health crises in order to offer access to the best quality of care, thus ensuring optimal patient outcomes, regardless of fluctuations in admission rates. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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12 pages, 430 KiB  
Article
Physical Activity and Mental Health After COVID-19 Recovery: Age and Sex Differences
by Miloš Stamenković, Saša Pantelić, Saša Bubanj, Emilija Petković, Bojan Bjelica, Nikola Aksović, Lazar Toskić, Constantin Sufaru, Gabriel-Stănică Lupu, Daniel-Lucian Dobreci, Tatiana Dobrescu and Mihai-Adrian Sava
Life 2025, 15(4), 531; https://doi.org/10.3390/life15040531 - 24 Mar 2025
Viewed by 546
Abstract
(1) Background: The relationship between physical activity (PA) and mental health remains a topic of significant interest, particularly in populations recovering from COVID-19. This study aimed to examine the differences in PA levels and mental health parameters (anxiety, depression, and stress) across sex [...] Read more.
(1) Background: The relationship between physical activity (PA) and mental health remains a topic of significant interest, particularly in populations recovering from COVID-19. This study aimed to examine the differences in PA levels and mental health parameters (anxiety, depression, and stress) across sex and age groups following COVID-19 recovery; (2) Methods: The sample of participants (n = 288) was selected using a random sampling method and consisted of participants of different ages and both sexes. Participants’ self-reported PA was assessed using the International Physical Activity Questionnaire (IPAQ), while the Depression, Anxiety, and Stress Scale (DASS) was used to measure negative emotional states. The influence of COVID-19 recovery on PA and mental health (depression, anxiety, stress) was analyzed using MANOVA and follow-up univariate tests by age and sex. Statistical significance was set at p < 0.05, with SPSS (v23.0) used for data analysis; (3) Results: A statistically significant difference was observed between the initial and final measurements in PA levels (Wilk’s Lambda = 0.95; p = 0.000) and mental health (Wilk’s Lambda = 0.96; p = 0.000) with older individuals—particularly women—demonstrating improved PA levels and better mental health outcomes. In contrast, younger women exhibited a decline in both domains, with increased anxiety, depression, and stress symptoms. While younger men showed increased PA, their mental health parameters were slightly elevated, though still within normal ranges; (4) Conclusions: Our findings suggest that older individuals were better adapted to post-COVID challenges due to maturity and life experience, while younger populations may require additional support. The study underscored the complexity of the PA–mental health relationship and highlighted the need for further research, particularly among younger individuals recovering from COVID-19. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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20 pages, 4514 KiB  
Article
Exploring Age, Gender and Pandemic Dynamics: A Retrospective Analysis of the Impact of SARS-CoV-2 on Human Health
by Diana Vrabie, Beatrice-Aurelia Abalașei and Marius Neculăeș
Life 2025, 15(3), 355; https://doi.org/10.3390/life15030355 - 24 Feb 2025
Viewed by 369
Abstract
Background: The deaths due to the SARS-CoV-2 virus increased rapidly over a short period of time. From the beginning of the pandemic until September 2024, the number of COVID-19 cases reached 776,205,140 cases, with 7,064,380 deaths worldwide. The total number of deaths recorded [...] Read more.
Background: The deaths due to the SARS-CoV-2 virus increased rapidly over a short period of time. From the beginning of the pandemic until September 2024, the number of COVID-19 cases reached 776,205,140 cases, with 7,064,380 deaths worldwide. The total number of deaths recorded from the beginning of the pandemic until September 2024 represents a share of 0.09% of the total world population and 0.91% of the total infected population. Methods: The data in this study were collected from the Ministry of Internal Affairs of Romania, Eurostat, NIS and WHO sites, and analyzed using Microsoft Excel and SPSS 22 in order to detect the evolution trends during the state of emergency, the share of infection and deaths among the European countries and worldwide, differences between gender categories or age groups and to identify factors that can be related to the incidence of infection and mortality due to COVID-19. Results: Males registered a significant higher number of deaths compared to women in Romania, a trend that aligns with global tendencies (p < 0.05). Also, the 70–79 age group had the highest mortality rate, followed by the over 80 age group and the 60–69 age group. Therefore, the risk of death from COVID-19 increases significantly with age. A good health education may be essential in order to promote a high life expectancy. A higher life expectancy correlated with a lower rate of mortality. BMI can be a factor contributing to the increased comorbidities, and may influence the fatality levels of COVID-19. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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9 pages, 201 KiB  
Article
Dependence in Activities of Daily Living as a Predictor of In-Hospital Mortality During COVID-19 in Older Individuals
by Jan Ilkowski, Katarzyna Wieczorowska-Tobis and Przemyslaw Guzik
Life 2025, 15(2), 271; https://doi.org/10.3390/life15020271 - 11 Feb 2025
Viewed by 465
Abstract
Activities of Daily Living (ADL) are fundamental tasks for individuals to manage their basic needs. Our study aims to examine ADL at admission (adADL) and the Pre-COVID-19 to Admission ADL Difference (ADL-change) as potential predictors of in-hospital mortality. This is a retrospective analysis [...] Read more.
Activities of Daily Living (ADL) are fundamental tasks for individuals to manage their basic needs. Our study aims to examine ADL at admission (adADL) and the Pre-COVID-19 to Admission ADL Difference (ADL-change) as potential predictors of in-hospital mortality. This is a retrospective analysis of clinical data (including the Katz index for ADL) from 141 older patients aged at least 65 years hospitalized in a COVID-19-dedicated unit (not requiring ICU) from September 2021 until January 2022 in Poznań, Poland. Thirty patients (21.3% of all) died during hospitalization. Non-survivors were older than survivors, exhibited lower oxygen saturation, more severe inflammation, higher D-dimer concentrations, and were more commonly prescribed antibiotics. The AUC for in-hospital mortality was for adADL: 0.7417 (95% CI: 0.6478–0.8357; p < 0.0001) and for ADL-change: 0.6869 (95% CI: 0.579–0.7928; p = 0.0018). The corresponding cut-offs were 0 for adADL and 3 for ADL-change. Cox proportional hazard models yielded hazard ratios of 3.57 (95% CI 1.57–8.10; p = 0.0024) for adADL and 3.78 (95% CI 1.49–9.54; p = 0.005) for ADL-change. ADL assessment offers valuable insights into in-hospital mortality among older COVID-19 patients. Monitoring ADL in these patients indicates high-risk individuals for in-hospital death. Integrating ADL into routine clinical practice might enhance care for older patients. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
12 pages, 1589 KiB  
Article
Respiratory Muscle Dysfunction and Associated Risk Factors Following COVID-19-Related Hospitalisation
by Alessia Verduri, Roberto Tonelli, Pierluigi Donatelli, Jonathan Hewitt, Giovanni Guaraldi, Jovana Milić, Valentina Ruggieri, Cristina Mussini, Enrico Clini and Bianca Beghè
Life 2025, 15(2), 194; https://doi.org/10.3390/life15020194 - 28 Jan 2025
Viewed by 776
Abstract
Background: Studies have highlighted long-term respiratory muscle dysfunction in COVID-19 survivors, although the underlying risk factors remain unclear. This single-centre study assessed respiratory muscle function and individual associated factors at follow-up in patients hospitalised with COVID-19 and related acute respiratory failure. Methods: Data [...] Read more.
Background: Studies have highlighted long-term respiratory muscle dysfunction in COVID-19 survivors, although the underlying risk factors remain unclear. This single-centre study assessed respiratory muscle function and individual associated factors at follow-up in patients hospitalised with COVID-19 and related acute respiratory failure. Methods: Data were collected for consecutive patients, aged ≥ 18 years, at the post-COVID outpatient service of Hospital Policlinico in Modena (Italy) in the time frame of 3 to 6 months after discharge. Data were analysed using single and multiple logistic regression models. Correlations among MIP/MEP, hand-grip values, and lung function were further explored. Results: Out of 223 patients (mean age 67 years, 69% male) 121 (54.3%) exhibited MIP or MEP dysfunction, which was found to be associated with the use of non-invasive ventilation (aOR = 1.91 [1.07–3.49], p = 0.04) and female gender (aOR = 1.76 [1.09–4.16], p = 0.03) as independent risk factors. A positive correlation was observed between MIP dysfunction and hand-grip strength (p = 0.03 and 0.01), whereas both MIP and MEP were significantly associated with FEV1, FVC, TLC, and DLCO. Conclusions: Respiratory muscle dysfunction is consistently prevalent and parallels peripheral muscle weakness and the lung function level in patients at follow-up after severe COVID-19. The need for non-invasive ventilation during the acute phase and female gender might represent risk factors. MIP/MEP assessment should be recommended to observe respiratory muscle dysfunction in severe post-COVID survivors. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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12 pages, 215 KiB  
Article
Physical Activity Types Among School-Aged Children During COVID-19 Pandemic in Saudi Arabia: A Cross-Sectional Study
by Mshari Alghadier, Reem M. Basuodan, Afnan Gmmash and Reem A. Albesher
Life 2025, 15(1), 91; https://doi.org/10.3390/life15010091 - 14 Jan 2025
Viewed by 740
Abstract
Background: The COVID-19 pandemic may have had long-lasting detrimental effects on children’s physical health. Previous studies have shown that children’s participation in physical activity (PA) declined during the pandemic. This study examined the effect of the COVID-19 pandemic on PA type selection and [...] Read more.
Background: The COVID-19 pandemic may have had long-lasting detrimental effects on children’s physical health. Previous studies have shown that children’s participation in physical activity (PA) declined during the pandemic. This study examined the effect of the COVID-19 pandemic on PA type selection and the influence of gender, number of siblings, residence type, and caregiver education level on PA. Methods: Parents of Saudi children (ages 6–9 years) were recruited through convenience sampling and completed an online survey between July and August 2020. The parent-reported survey included demographics and PA types across three time periods (pre-, during, and post-lockdown). Chi-squared tests and logistic regression with pairwise comparisons were used to analyze the differences. Results: Parents reported that children (n = 361, mean age 7.7 ± 1.1 years) selected different PA types pre-COVID-19 pandemic more often than during the COVID-19 lockdown, such as swimming (16.9% vs. 12.8%), high-intensity jumping (9.8% vs. 6.6%), cycling (12.8% vs. 9.6%), football (14.3% vs. 6.1%), running (9.3% vs. 5.5%), virtual gaming exercise (5% vs. 3.2%), and playground activity (11.3% vs. 5.8%) (p < 0.05). Additionally, PA type was shown to be influenced by gender and residence type, with girls being 55% more likely to be physically active during COVID-19 compared to boys, and participants living in houses without private yards being less physically active compared to those who lived in houses with private yards. Conclusions: Children’s gender (boy vs. girl) and residence type (with private yards vs. without private yards) affected their PA level during the COVID-19 lockdown. These findings suggest that more effort should be directed toward understanding the influence of gender and house types in the selection of PA types. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
12 pages, 266 KiB  
Article
Hair Cortisol/DHEA-S Ratios in Healthcare Workers and Their Patients During the COVID-19 Pandemic: A Case Study
by Isabella Pividori, Tanja Peric, Antonella Comin, Alessio Cotticelli, Mirco Corazzin, Alberto Prandi and Massimo Domenico Mascolo
Life 2024, 14(12), 1582; https://doi.org/10.3390/life14121582 - 1 Dec 2024
Viewed by 1309
Abstract
Background: Unlike psychological distress, which has been extensively studied during the COVID-19 pandemic, the impact of the pandemic on stress hormones has been overlooked. The aim of this study is to examine the hair cortisol/dehydroepiandrosterone sulfate (DHEA-S) ratios as markers of HPA axis [...] Read more.
Background: Unlike psychological distress, which has been extensively studied during the COVID-19 pandemic, the impact of the pandemic on stress hormones has been overlooked. The aim of this study is to examine the hair cortisol/dehydroepiandrosterone sulfate (DHEA-S) ratios as markers of HPA axis dysregulation in healthcare workers and their patients. Methods: A total of 200 healthcare workers and 161 “patients” patients with special healthcare needs due to chronic illness or motor disabilities were included in this study. The hormone concentrations were measured using a radioimmunoassay. Results: Our results show that the patients had significantly higher cortisol/DHEA-S ratios than the workers. A high cortisol/DHEA-S ratio in the patients reflects higher cortisol concentrations (p < 0.001) and lower DHEA-S (p < 0.05) concentrations compared to those of the healthcare workers, suggesting that they may be exposed to a greater degree of stress and a decrease in their ability to cope with their disease. The cut-off value of the hair cortisol/DHEA-S ratio in our study for detecting people with needs that require special consideration and attention was 1.46 (p ≤ 0.01). Conclusions: Assessing the hair cortisol/DHEA-S ratios in both healthcare workers and the patients allowed us to identify a non-homeostatic condition that could lead to disease and to understand psychophysical well-being during the COVID-19 pandemic. They also play a crucial role in preventive and personalized medicine. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
15 pages, 825 KiB  
Article
Assessing Type 2 Diabetes Risk in the Post-Pandemic Era: A Pharmacy-Led FINDRISC Screening Study
by Victoria Bell, Ana Rita Rodrigues, Vera Costa, Catarina Dias, Márcia Alpalhão, Inês Martins and Mário Forrester
Life 2024, 14(12), 1558; https://doi.org/10.3390/life14121558 - 27 Nov 2024
Cited by 1 | Viewed by 907
Abstract
Diabetes mellitus (DM) is a major global health issue, with type 2 diabetes (T2D) accounting for over 90% of cases. Community pharmacies, given their accessibility, are well positioned to assist in early detection and management of T2D. This study evaluated post-pandemic T2D risk [...] Read more.
Diabetes mellitus (DM) is a major global health issue, with type 2 diabetes (T2D) accounting for over 90% of cases. Community pharmacies, given their accessibility, are well positioned to assist in early detection and management of T2D. This study evaluated post-pandemic T2D risk in a Portuguese population using the Finnish Diabetes Risk Score (FINDRISC) across five community pharmacies. A total of 494 participants aged 40 or older without a prior diagnosis of diabetes were assessed. The mean FINDRISC score was 12.3, and 29.8% were identified as high or very high-risk, with 8.7% referred to general practitioners for follow-up based on elevated glycated hemoglobin (HbA1c). Key risk factors include age, body mass index, waist circumference, lack of physical activity, and family history of diabetes. Lower educational levels were also associated with higher diabetes risk. Community pharmacies are shown to play an essential role in screening and educating at-risk populations, emphasizing the importance of physical activity, healthy diets, and regular monitoring. These findings reinforce the value of community pharmacists in mitigating T2D risk and enhancing public health outcomes through cost-effective, validated screening tools like FINDRISC. Finally, pre-pandemic FINDRISC studies discussed show similar results suggesting that the COVID-19 pandemic did not significantly impact the overall risk profile for T2D. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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15 pages, 1079 KiB  
Article
Patterns of C1-Inhibitor Plasma Levels and Kinin–Kallikrein System Activation in Relation to COVID-19 Severity
by Silvia Berra, Debora Parolin, Chiara Suffritti, Andrea Folcia, Andrea Zanichelli, Luca Gusso, Chiara Cogliati, Agostino Riva, Antonio Gidaro and Sonia Caccia
Life 2024, 14(12), 1525; https://doi.org/10.3390/life14121525 - 21 Nov 2024
Viewed by 1143
Abstract
Background: Although more than four years have passed since the pandemic began, SARS-CoV-2 continues to be of concern. Therefore, research into the underlying mechanisms that contribute to the development of the disease, especially in more severe forms, remains a priority. Sustained activation of [...] Read more.
Background: Although more than four years have passed since the pandemic began, SARS-CoV-2 continues to be of concern. Therefore, research into the underlying mechanisms that contribute to the development of the disease, especially in more severe forms, remains a priority. Sustained activation of the complement (CS), contact (CAS), and fibrinolytic and kinin–kallikrein systems (KKS) has been shown to play a central role in the pathogenesis of the disease. Since the C1 esterase inhibitor (C1-INH) is a potent inhibitor of all these systems, its role in the disease has been investigated, but some issues remained unresolved. Methods: We evaluated the impact of C1-INH and KKS on disease progression in a cohort of 45 COVID-19 patients divided into groups according to disease severity. We measured plasma levels of total and functional C1-INH and its complexes with kallikrein (PKa), reflecting KKS activation and kallikrein spontaneous activity. Results: We observed increased total and functional plasma concentrations of C1-INH in COVID-19 patients. A direct correlation (positive Spearman’s r) was observed between C1-INH levels, especially functional C1-INH, and the severity of the disease. Moreover, a significant reduction in the ratio of functional over total C1-INH was evident in patients exhibiting mild to intermediate clinical severity but not in critically ill patients. Accordingly, activation of the KKS, assessed as an increase in PKa:C1-INH complexes, was explicitly observed in the mild categories. Conclusions: Our study’s findings on the consumption of C1-INH and the activation of the KKS in the less severe stages of COVID-19 but not in the critical stage suggest a potential role for C1-INH in containing disease severity. These results underscore the importance of C1-INH in the early phases of the disease and its potential implications in COVID-19 progression and/or long-term effects. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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14 pages, 1007 KiB  
Article
Insights into the Risk Factors and Outcomes of Post-COVID-19 Syndrome—Results from a Retrospective, Cross-Sectional Study in Romania
by Ioana Bejan, Corneliu Petru Popescu and Simona Maria Ruta
Life 2024, 14(11), 1519; https://doi.org/10.3390/life14111519 - 20 Nov 2024
Viewed by 2164
Abstract
Post-Coronavirus Disease 2019 (post-COVID-19) syndrome represents a cluster of persistent symptoms following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection that can severely affect quality of life. The pathogenic mechanisms and epidemiology in different regions are still under evaluation. To assess the outcomes [...] Read more.
Post-Coronavirus Disease 2019 (post-COVID-19) syndrome represents a cluster of persistent symptoms following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection that can severely affect quality of life. The pathogenic mechanisms and epidemiology in different regions are still under evaluation. To assess the outcomes of post-COVID-19 syndrome, we performed a questionnaire-based, cross-sectional study in previously infected individuals. Out of 549 respondents, (male:female ratio: 0.32), 29.5% had persistent symptoms at 3 months, 23.5% had persistent symptoms at 6 months, and 18.3% had persistent symptoms at 12 months after the initial infection. The most common symptoms included fatigue (8.7%), sleep disturbances (7.1%), and cognitive impairment (6.4%). The risk of developing post-COVID-19 syndrome increased for those with more symptoms in the acute phase (OR 4.24, p < 0.001) and those experiencing reinfections (OR 2.405, p < 0.001), while SARS-CoV-2 vaccination halved the risk (OR = 0.489, p = 0.004). Individuals with post-COVID-19 syndrome had a 5.7-fold higher risk of being diagnosed with a new chronic condition, with 44% reporting cardiovascular disease, and a 6.8-fold higher likelihood of needing medical care or leave. Affected individuals reported significant impairments in mobility, pain/discomfort, and anxiety/depression, with 20.7% needing to adjust their work schedules. Overall, patients with post-COVID-19 syndrome require ongoing monitoring and rehabilitation, and further socio-economic impact studies are needed. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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13 pages, 1285 KiB  
Article
Age Differences and Prevalence of Comorbidities for Death and Survival in Patients with COVID-19: A Single-Center Observational Study in a Region of Southern Italy
by Biagio Santella, Silvana Mirella Aliberti, Luigi Fortino, Antonio Donato, Vincenzo Andretta, Emanuela Santoro, Gianluigi Franci, Mario Capunzo and Giovanni Boccia
Life 2024, 14(11), 1376; https://doi.org/10.3390/life14111376 - 25 Oct 2024
Viewed by 1592
Abstract
The SARS-CoV-2 outbreak has resulted in a considerable number of deaths worldwide. The virus damages the pulmonary artery endothelium, leading to a condition known as microvascular pulmonary inflammatory thrombotic syndrome (MPITS), which can be fatal and cause multiple organ failure. The presence of [...] Read more.
The SARS-CoV-2 outbreak has resulted in a considerable number of deaths worldwide. The virus damages the pulmonary artery endothelium, leading to a condition known as microvascular pulmonary inflammatory thrombotic syndrome (MPITS), which can be fatal and cause multiple organ failure. The presence of preexisting comorbidities has been shown to significantly impact the severity and prognosis of patients with SARS-CoV-2 infection. The objective of this study was to compare the age groups of patients with coronavirus disease 2019 (COVID-19) and to identify the prevalence of comorbidities associated with death and survival in an area of southern Italy. The data set consisted of 1985 patients with confirmed cases of SARS-CoV-2 infection who were admitted to the A.O.U. San Giovanni di Dio e Ruggi d’Aragona Hospital in Salerno between January 2021 and December 2022. The results were presented for the overall population and stratified by outcome and age group. All analyses were performed using the XLSTAT (Lumivero, 2024, Paris, France) and STATA software (release 16.1, StataCorp LLG, College Station, TX, USA, 2019) packages. In the study, population, 636 cases (32%) resulted in death, with a higher prevalence in the 60–79 age group, followed by the ≥80 and 30–59 age groups. The most prevalent diseases among deceased and surviving patients with confirmed cases of SARS-CoV-2 infection were those affecting the circulatory system (61.5% vs. 55.5%), the respiratory system (55.8% vs. 26.2%), and the metabolic system (25.9% vs. 25.4%). In patients aged 30–79, respiratory diseases were the primary cause of mortality, whereas in those aged ≥80, circulatory system diseases were more prevalent. Among survivors, cardiovascular diseases were the most common comorbidities across all age groups, followed by respiratory diseases and endocrine, metabolic, and immune disorders. Moreover, these comorbidities were associated with an elevated risk of mortality. The study emphasizes the substantial influence of age and comorbidities on the mortality associated with SARS-CoV-2 infection. These findings highlight the necessity for targeted interventions to manage comorbid conditions in patients with SARS-CoV-2 infection, particularly in older adults. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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11 pages, 1283 KiB  
Article
Mortality Impact of Severe COVID-19 in the ICU: A Study from the Târgu Mureș Support Unit
by Janos Szederjesi, Irina Săplăcan, Marius Petrișor, Alexandra-Maria Șerdean and Bianca-Liana Grigorescu
Life 2024, 14(10), 1232; https://doi.org/10.3390/life14101232 - 26 Sep 2024
Viewed by 1004
Abstract
(1) Background: Since the onset of the COVID-19 pandemic, it has been recognized that a considerable proportion of critically ill patients may die of this disease. The current study aims to assess the overall 1-year outcomes within the UMFST COVID-19 Unit, providing valuable [...] Read more.
(1) Background: Since the onset of the COVID-19 pandemic, it has been recognized that a considerable proportion of critically ill patients may die of this disease. The current study aims to assess the overall 1-year outcomes within the UMFST COVID-19 Unit, providing valuable insights into the efficacy of specialized care facilities in managing severe cases of COVID-19. (2) Methods: This is a retrospective monocentric observational study including 294 patients confirmed to have SARS-CoV-2 infection. Demographic data and clinical and paraclinical parameters were assessed. Survival probabilities were estimated using Kaplan–Meier curves. (3) Results: Overall, the 1-year mortality was 89.4%. All deaths occurred in-hospital, with two patients dying after 28 days. Diabetes mellitus, chronic kidney failure, cerebrovascular disease, and atrial fibrillation were more prevalent in deceased patients. Thirty percent of patients needed endotracheal intubation during the first 24 h. The incidence of hospital-acquired pneumonia was higher among deceased patients. The SOFA score was significantly different between deceased vs. survivors. The survival analysis showed that the use of noradrenaline increased the likelihood of surviving COVID-19. (4) Conclusions: The severe comorbidities of the patients were the primary factors contributing to the increased mortality rate in the COVID-19 unit. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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15 pages, 279 KiB  
Article
Relationship of Non-Invasive Arterial Stiffness Parameters with 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Post-COVID-19 Patients—The Results of a Cross-Sectional Study
by Danuta Loboda, Beata Sarecka-Hujar, Marta Nowacka-Chmielewska, Izabela Szoltysek-Boldys, Wioleta Zielinska-Danch, Michal Gibinski, Jacek Wilczek, Rafal Gardas, Mateusz Grabowski, Mateusz Lejawa, Andrzej Malecki and Krzysztof S. Golba
Life 2024, 14(9), 1105; https://doi.org/10.3390/life14091105 - 2 Sep 2024
Cited by 3 | Viewed by 1742
Abstract
This study evaluated the relationship of non-invasive arterial stiffness parameters with an individual 10-year risk of fatal and non-fatal atherosclerotic cardiovascular disease (ASCVD) events in the cohort post-coronavirus disease 2019 (COVID-19). The study group included 203 convalescents aged 60.0 (55.0–63.0) and 115 (56.7%) [...] Read more.
This study evaluated the relationship of non-invasive arterial stiffness parameters with an individual 10-year risk of fatal and non-fatal atherosclerotic cardiovascular disease (ASCVD) events in the cohort post-coronavirus disease 2019 (COVID-19). The study group included 203 convalescents aged 60.0 (55.0–63.0) and 115 (56.7%) women. The ASCVD risk was assessed as low to moderate to very high based on medical history (for 62 participants with pre-existing ASCVD/diabetes/chronic kidney disease in the entire cohort) or calculated in percentages using the Systemic Coronary Risk Evaluation 2 (SCORE2) algorithm based on age, sex, smoking status, systolic blood pressure (BP), and non-high-density lipoprotein cholesterol (for 141 healthy participants). The stiffness index (SI) and reflection index (RI) measured by photoplethysmography, as well as pulse pressure (PP), calculated as the difference between systolic and diastolic BP, were markers of arterial stiffness. Stiffness parameters increased significantly with the increase in ASCVD risk in the entire cohort. In 30 (14.8%) patients in the low- to moderate-risk group, the median SI was 8.07 m/s (7.10–8.73), RI 51.40% (39.40–65.60), and PP 45.50 mmHg (40.00–57.00); in 111 (54.7%) patients in the high-risk group, the median SI was 8.70 m/s (7.40–10.03), RI 57.20% (43.65–68.40), and PP 54.00 mmHg (46.00–60.75); and in 62 (30.5%) patients in the very-high-risk group, the median was SI 9.27 m/s (7.57–10.44), RI 59.00% (50.40–72.40), and PP 60.00 mmHg (51.00–67.00). In healthy participants, the SI ≤ 9.0 m/s (sensitivity of 92.31%, area under the curve [AUC] 0.686, p < 0.001) based on the receiver operating characteristics was the most sensitive variable for discriminating low to moderate risk, and PP > 56.0 mmHg (sensitivity of 74.36%, AUC 0.736, p < 0.001) was used for discriminating very high risk. In multivariate logistic regression, younger age, female sex, PP ≤ 50 mmHg, SI ≤ 9.0 m/s, and triglycerides < 150 mg/dL had the best relationship with low to moderate SCORE2 risk. In turn, older age, currently smoking, PP > 56.0 mmHg, RI > 68.6%, and diastolic BP ≥ 90 mmHg were related to very high SCORE2 risk. In conclusion, arterial stiffness is significantly related to ASCVD risk in post-COVID-19 patients and can be helpful as a single risk marker in everyday practice. Cut-off points for arterial stiffness parameters determined based on SCORE2 may help make individual decisions about implementing lifestyle changes or pharmacological treatment of ASCVD risk factors Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
16 pages, 1240 KiB  
Article
Motor and Respiratory Tele-Rehabilitation in Patients with Long COVID-19 after Hospital Discharge: An Interventional Study
by Serena Cerfoglio, Federica Verme, Paolo Capodaglio, Paolo Rossi, Viktoria Cvetkova, Gabriele Boldini, Manuela Galli and Veronica Cimolin
Life 2024, 14(7), 864; https://doi.org/10.3390/life14070864 - 10 Jul 2024
Cited by 1 | Viewed by 1340
Abstract
The persistence of symptoms following COVID-19 infection represents a significant challenge in healthcare management. During the outbreak, tele-rehabilitation emerged as a new tool to support healthcare structures in providing rehabilitation services. This study assessed the effectiveness and the feasibility of a 3-week home-based [...] Read more.
The persistence of symptoms following COVID-19 infection represents a significant challenge in healthcare management. During the outbreak, tele-rehabilitation emerged as a new tool to support healthcare structures in providing rehabilitation services. This study assessed the effectiveness and the feasibility of a 3-week home-based motor and respiratory rehabilitation program for individuals with long COVID-19 after traditional rehabilitation. Twenty-three patients completed the program and underwent functional tests at different time points (i.e., baseline, at discharge from in-hospital rehabilitation and after tele-rehabilitation). Motor function was evaluated using the instrumented Six-Minutes Walking Test (i6MWT), with monitored heart rate and oxygen saturation. Additionally, respiratory function was measured via forced vital capacity (FVC) and maximal voluntary ventilation (MVV) tests. Significant improvements (p < 0.05) in motor and respiratory function were observed throughout the intervention, including an 18.3% increase in walked distance from the baseline. The findings suggest that the proposed home-based tele-rehabilitation shows potential in enhancing motor and respiratory function in patients with long COVID. Despite limitations such as the small sample size, lack of control group and the preliminary nature of the outcomes observed, the overall findings seem to support the feasibility of the proposed tele-rehabilitation program in managing long COVID symptoms and promoting functional recovery. Nevertheless, further research is needed to validate these findings and explore tele-rehabilitation’s potential in broader and different patient populations Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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7 pages, 538 KiB  
Article
Management of Peritoneal Dialysis-Associated Emergencies during the COVID-19 Pandemic: The Experience of a Center of Excellence
by Cristian Iorga, Cristina Raluca Iorga, Iuliana Andreiana, Simona Hildegard Stancu, Iustinian Bengulescu, Traian Constantin and Victor Strambu
Life 2024, 14(7), 805; https://doi.org/10.3390/life14070805 - 26 Jun 2024
Viewed by 1381
Abstract
The COVID-19 pandemic struck unexpectedly; emergency services and chronic care institutions, including dialysis centers, were overloaded. A significant problem was the care of COVID-positive patients alongside the care of chronically dialyzed patients who presented emergencies. In our hospital, which became a COVID support [...] Read more.
The COVID-19 pandemic struck unexpectedly; emergency services and chronic care institutions, including dialysis centers, were overloaded. A significant problem was the care of COVID-positive patients alongside the care of chronically dialyzed patients who presented emergencies. In our hospital, which became a COVID support center for dialysis patients with severe forms of the disease, we had to care for PD patients with dialysis-related emergencies. We present two cases of patients managed on an outpatient basis or 1-day hospitalization who were treated successfully without compromising the quality of the care provided. We used remote monitoring, worked in a multidisciplinary team, and shortened the duration of the patients’ hospitalization (and implicitly the risk of contact). In pandemic conditions, the advantage of PD was the possibility of patient isolation; in the first 6 months of the pandemic, we recorded no deaths in this category of patients. In hemodialysis patients, infection and mortality rates were high. Although we expected an increase in the number of peritoneal dialysis patients in the post-pandemic period, this did not happen. We continue to plead for the popularization of the PD method among patients and doctors, which has proven advantages in pandemic conditions. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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8 pages, 233 KiB  
Article
Temporal Variations in Convergence Insufficiency Symptomatic Status among University Students before and after COVID-19: A Longitudinal Analysis from 2018 to 2023
by Hugo Pena-Verdeal, Veronica Noya-Padin, Jacobo Garcia-Queiruga, Noelia Nores-Palmas, Maria J. Giraldez and Eva Yebra-Pimentel
Life 2024, 14(7), 800; https://doi.org/10.3390/life14070800 - 26 Jun 2024
Cited by 1 | Viewed by 1343
Abstract
The present study aimed to assess the symptomatic status of Convergence Insufficiency (CI) in university students from 2018 to 2023 considering the educational environment pre- and post-COVID-19 pandemic confinements. A Convergence Insufficiency Symptom Survey (CISS) was conducted annually from 2018 to 2023, excluding [...] Read more.
The present study aimed to assess the symptomatic status of Convergence Insufficiency (CI) in university students from 2018 to 2023 considering the educational environment pre- and post-COVID-19 pandemic confinements. A Convergence Insufficiency Symptom Survey (CISS) was conducted annually from 2018 to 2023, excluding 2020, in an initial group of 217 third-year Optics and Optometry degree university student participants. In the final group (178 participants), the statistical differences in CISS scores between years were analysed, both overall and by questionnaire subgroup, along with associations between CISS diagnostic categories before and after 2020. Significant differences were found between years in the subscale and total score analyses (Kruskal–Wallis, both p ≤ 0.049). Pairwise comparisons showed significant differences for the performance subgroup in 2021 vs. 2019 and 2018 (Mann–Whitney, both p ≤ 0.004), while in terms of the total score, there was a statistical difference in 2021 vs. 2018 (Mann–Whitney, p < 0.001). The distribution analysis indicated a significant difference between groups (Chi, p = 0.004), with participants from 2021 or later more likely to exhibit higher CISS scores (OR = 3.47, 95%CI 1.04–8.58). The present study shows significant temporal increments in symptomatic status related to CI among university students from 2018 to 2023, indicating a potential impact of the COVID-19 pandemic educational landscape on these outcomes. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
11 pages, 1734 KiB  
Article
SARS-CoV-2 Positivity in Foreign-Born Adults: A Retrospective Study in Verona, Northeast Italy
by Virginia Lotti, Gianluca Spiteri, Gulser Caliskan, Maria Grazia Lourdes Monaco, Davide Gibellini, Giuseppe Verlato and Stefano Porru
Life 2024, 14(6), 663; https://doi.org/10.3390/life14060663 - 22 May 2024
Viewed by 1049
Abstract
We compared SARS-CoV-2 positivity between the foreign-born adult working population and Italians living in the Verona area to investigate whether being a foreign-born adult could confer an increased risk of infection or lead to a diagnostic delay. The present study included 105,774 subjects, [...] Read more.
We compared SARS-CoV-2 positivity between the foreign-born adult working population and Italians living in the Verona area to investigate whether being a foreign-born adult could confer an increased risk of infection or lead to a diagnostic delay. The present study included 105,774 subjects, aged 18–65 years, tested for SARS-CoV-2 by nasopharyngeal swabs and analyzed at the University Hospital of Verona between January 2020 and September 2022. A logistic regression model was used, controlling for gender, age, time of sampling, and source of referral. A higher proportion of SARS-CoV-2 positivity in Italian (30.09%) than in foreign-born (25.61%) adults was reported, with a higher proportion of SARS-CoV-2 positivity in men than women in both cohorts analyzed. The difference in swab positivity among Italian and foreign-born adults was the highest in people aged 18–29 years (31.5% vs. 23.3%) and tended to disappear thereafter. Swab positivity became comparable between Italian and foreign-born adults during the vaccination campaign. Multivariable analysis confirmed the lower risk of swab positivity among foreign-born adults (OR = 0.85, 95% CI 0.82–0.89). In the Verona area, foreign-born adults showed a lower rate of SARS-CoV-2 positivity than the native population, likely because of underdiagnosis. Hence, public health should increase attention toward these particularly vulnerable populations. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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12 pages, 795 KiB  
Article
Assessing the Association between Biomarkers and COVID-19 Mortality Using the Joint Modelling Approach
by Matteo Di Maso, Serena Delbue, Maurizio Sampietro, Monica Ferraroni, Annalisa Modenese, Maria Dolci, Federico Ambrogi and Pasquale Ferrante
Life 2024, 14(3), 343; https://doi.org/10.3390/life14030343 - 6 Mar 2024
Cited by 1 | Viewed by 1440
Abstract
We evaluated the association between biomarkers and COVID-19 mortality. Baseline characteristics of 403 COVID-19 patients included sex and age; biomarkers, measured throughout the follow-up, included lymphocytes, neutrophils, ferritin, C-reactive protein, glucose, and LDH. Hazard ratios (HRs) and corresponding 95% credible intervals (CIs) were [...] Read more.
We evaluated the association between biomarkers and COVID-19 mortality. Baseline characteristics of 403 COVID-19 patients included sex and age; biomarkers, measured throughout the follow-up, included lymphocytes, neutrophils, ferritin, C-reactive protein, glucose, and LDH. Hazard ratios (HRs) and corresponding 95% credible intervals (CIs) were estimated through joint models (JMs) using a Bayesian approach. We fitted univariable (a single biomarker) and multivariable (all biomarkers) JMs. In univariable analyses, all biomarkers were significantly associated with COVID-19 mortality. In multivariable analysis, HRs were 1.78 (95% CI: 1.13–2.87) with a doubling of neutrophils levels, 1.49 (95% CI: 1.19–1.95) with a doubling of C-reactive protein levels, 2.66 (95% CI: 1.45–4.95) for an increase of 100 mg/dL of glucose, and 1.31 (95% CI: 1.12–1.55) for an increase of 100 U/L of LDH. No evidence of association was observed for lymphocytes and ferritin in multivariable analysis. Men had a higher COVID-19 mortality risk than women (HR = 1.75; 95% CI: 1.07–2.80) and age showed the strongest effect with a rapid increase from 60 years. These findings using JM confirm the usefulness of biomarkers in assessing COVID-19 severity and mortality. Monitoring trend patterns of such biomarkers can provide additional help in tailoring the appropriate care pathway. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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Review

Jump to: Research, Other

16 pages, 555 KiB  
Review
Pathophysiological Mechanisms Linking COVID-19 and Acute Surgical Abdomen: A Literature Review
by Andrei Modiga, Vlad-Olimpiu Butiurca, Cristian Marius Boeriu, Teodora Sorana Truta, Emilia Turucz, Vasile-Bogdan Halațiu, Ioana-Patricia Rodean, Paul Cristian Russu, Mircea Constantin Gherghinescu and Călin Molnar
Life 2025, 15(5), 707; https://doi.org/10.3390/life15050707 (registering DOI) - 27 Apr 2025
Viewed by 91
Abstract
Acute surgical abdomen is characterized by intense, sudden abdominal pain due to intra-abdominal conditions requiring prompt surgical intervention. The coronavirus disease 2019 (COVID-19) pandemic has led to various complications related to the disease’s complex pathophysiological mechanisms, hence the hypothesis of COVID-19-induced acute abdominal [...] Read more.
Acute surgical abdomen is characterized by intense, sudden abdominal pain due to intra-abdominal conditions requiring prompt surgical intervention. The coronavirus disease 2019 (COVID-19) pandemic has led to various complications related to the disease’s complex pathophysiological mechanisms, hence the hypothesis of COVID-19-induced acute abdominal surgical pathologies. The connection between acute surgical abdomen and COVID-19 involves two primary mechanisms. First, there is the presence of angiotensin-converting enzyme 2 (ACE2) receptors in multiple abdominal organs. This facilitates the cytokine storm through direct viral injury and inflammation. Second, the hypercoagulable state induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) increases the thrombotic risk within abdominal vessels, which can subsequently lead to ischemia. ACE2 receptors are notably expressed in the gastric, duodenal, and rectal epithelium, with SARS-CoV-2 viral RNA and nucleocapsid proteins detected in these tissues. The inflammatory response results in significant endothelial damage, activating coagulation pathways that cause monocellular infiltration, lymphocytic inflammation, and uncontrolled coagulation. These findings highlight the need for further research to clarify how COVID-19 leads to acute abdominal pathologies. Understanding these mechanisms is vital for improving clinical management and patient outcomes during future health crises and in the aftermath of the pandemic. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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37 pages, 4776 KiB  
Review
Neuropsychiatric Manifestations of Long COVID-19: A Narrative Review of Clinical Aspects and Therapeutic Approaches
by Olga Adriana Caliman-Sturdza, Roxana Gheorghita and Andrei Lobiuc
Life 2025, 15(3), 439; https://doi.org/10.3390/life15030439 - 11 Mar 2025
Viewed by 1356
Abstract
The COVID-19 (C-19) pandemic has highlighted the significance of understanding the long-term effects of this disease on the quality of life of those infected. Long COVID-19 (L-C19) presents as persistent symptoms that continue beyond the main illness period, usually lasting weeks to years. [...] Read more.
The COVID-19 (C-19) pandemic has highlighted the significance of understanding the long-term effects of this disease on the quality of life of those infected. Long COVID-19 (L-C19) presents as persistent symptoms that continue beyond the main illness period, usually lasting weeks to years. One of the lesser-known but significant aspects of L-C19 is its impact on neuropsychiatric manifestations, which can have a profound effect on an individual’s quality of life. Research shows that L-C19 creates neuropsychiatric issues such as mental fog, emotional problems, and brain disease symptoms, along with sleep changes, extreme fatigue, severe head pain, tremors with seizures, and pain in nerves. People with cognitive problems plus fatigue and mood disorders experience great difficulty handling everyday activities, personal hygiene, and social interactions. Neuropsychiatric symptoms make people withdraw from social activity and hurt relationships, thus causing feelings of loneliness. The unpredictable state of L-C19 generates heavy psychological pressure through emotional suffering, including depression and anxiety. Neuropsychiatric changes such as cognitive impairment, fatigue, and mood swings make it hard for people to work or study effectively, which decreases their output at school or work and lowers their job contentment. The purpose of this narrative review is to summarize the clinical data present in the literature regarding the neuropsychiatric manifestations of L-C19, to identify current methods of diagnosis and treatment that lead to correct management of the condition, and to highlight the impact of these manifestations on patients’ quality of life. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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31 pages, 811 KiB  
Review
Immune-Boosting and Antiviral Effects of Antioxidants in COVID-19 Pneumonia: A Therapeutic Perspective
by Stefano Sanduzzi Zamparelli, Alessandro Sanduzzi Zamparelli and Marialuisa Bocchino
Life 2025, 15(1), 113; https://doi.org/10.3390/life15010113 - 16 Jan 2025
Cited by 1 | Viewed by 1645
Abstract
The COVID-19 pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has profoundly impacted global health, with pneumonia emerging as a major complication in severe cases. The pathogenesis of COVID-19 is marked by the overproduction of reactive oxygen species (ROS) and an [...] Read more.
The COVID-19 pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has profoundly impacted global health, with pneumonia emerging as a major complication in severe cases. The pathogenesis of COVID-19 is marked by the overproduction of reactive oxygen species (ROS) and an excessive inflammatory response, resulting in oxidative stress and significant tissue damage, particularly in the respiratory system. Antioxidants have garnered considerable attention for their potential role in managing COVID-19 pneumonia by mitigating oxidative stress and modulating immune responses. This review provides a comprehensive overview of the literature on the use of antioxidants in hospitalized patients with mild-to-moderate COVID-19. Studies exploring antioxidants, including vitamins, trace elements, nitric oxide (NO), ozone (O3), glutathione (GSH), L-carnitine, melatonin, bromelain, N-acetylcysteine (NAC), and numerous polyphenols, have yielded promising outcomes. Through their ROS-scavenging properties, these molecules support endothelial function, reduce the thrombosis risk, and may help mitigate the effects of the cytokine storm, a key contributor to COVID-19 morbidity and mortality. Clinical evidence suggests that antioxidant supplementation may improve patient outcomes by decreasing inflammation, supporting immune cell function, and potentially shortening recovery times. Furthermore, these molecules may mitigate the symptoms of COVID-19 by exerting direct antiviral effects that inhibit the infection process and genomic replication of SARS-CoV-2 in host cells. Moreover, antioxidants may work synergistically with standard antiviral treatments to reduce viral-induced oxidative damage. By integrating findings from the literature with real-world data from our clinical experience, we gain a more profound understanding of the role of antioxidants in managing COVID-19 pneumonia. Further research combining comprehensive literature reviews with real-world data analysis is crucial to validate the efficacy of antioxidants and establish evidence-based guidelines for their use in clinical practice. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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13 pages, 509 KiB  
Review
Acute Myocardial Infarction during the COVID-19 Pandemic: Long-Term Outcomes and Prognosis—A Systematic Review
by Marius Rus, Adriana Ioana Ardelean, Felicia Liana Andronie-Cioara and Georgiana Carmen Filimon
Life 2024, 14(2), 202; https://doi.org/10.3390/life14020202 - 31 Jan 2024
Cited by 6 | Viewed by 3818
Abstract
Coronavirus disease 2019 (COVID-19) was a global pandemic with high mortality and morbidity that led to an increased health burden all over the world. Although the virus mostly affects the pulmonary tract, cardiovascular implications are often observed among COVID-19 patients and are predictive [...] Read more.
Coronavirus disease 2019 (COVID-19) was a global pandemic with high mortality and morbidity that led to an increased health burden all over the world. Although the virus mostly affects the pulmonary tract, cardiovascular implications are often observed among COVID-19 patients and are predictive of poor outcomes. Increased values of myocardial biomarkers such as troponin I or NT-proBNP were proven to be risk factors for respiratory failure. Although the risk of acute coronary syndromes (ACSs) was greater in the acute phase of COVID-19, there were lower rates of hospitalization for ACSs, due to patients’ hesitation in presenting at the hospital. Hospitalized ACSs patients with COVID-19 infection had a prolonged symptom-to-first-medical-contact time, and longer door-to-balloon time. The mechanisms of myocardial injury in COVID-19 patients are still not entirely clear; however, the most frequently implicated factors include the downregulation of ACE2 receptors, endothelial dysfunction, pro-coagulant status, and increased levels of pro-inflammatory cytokines. The aim of this paper is to evaluate the long-term outcomes and prognosis of COVID-19 survivors that presented an acute myocardial infarction, by reviewing existing data. The importance of the association between this infectious disease and myocardial infarction arises from the increased mortality of patients with SARS-CoV-2 infection and AMI (10–76%, compared with 4.6% for NSTEMI patients and 7% for STEMI patients without COVID-19). The literature review showed an increased risk of cardiovascular events in COVID-19 survivors compared with the general population, even after the acute phase of the disease, with poorer long-term outcomes. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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10 pages, 1452 KiB  
Case Report
The Legacy of COVID-19: Hospital Fear Led to the Delayed Diagnosis of an Ovarian Tumor with Massive Ascites and Extensive Abdominal Necrosis
by Janos Szederjesi, Calin Molnar, Claudiu Molnar-Varlam, Dorin Dorobanțu, Mihai Claudiu Pui and Matild Keresztes
Life 2025, 15(4), 638; https://doi.org/10.3390/life15040638 - 11 Apr 2025
Viewed by 214
Abstract
The COVID-19 pandemic has significantly impacted healthcare-seeking behaviors, leading to delayed cancer diagnoses due to hospital-related anxiety. This case highlights the severe consequences of delayed medical consultation in a patient with advanced ovarian cancer. A 47-year-old female presented with severe abdominal distension, massive [...] Read more.
The COVID-19 pandemic has significantly impacted healthcare-seeking behaviors, leading to delayed cancer diagnoses due to hospital-related anxiety. This case highlights the severe consequences of delayed medical consultation in a patient with advanced ovarian cancer. A 47-year-old female presented with severe abdominal distension, massive ascites, and extensive abdominal wall necrosis after avoiding medical care for months due to severe hospital-related anxiety, exacerbated by the loss of her husband during the COVID-19 pandemic. On admission, a CT scan could not be performed due to the patient’s inability to lie supine and extreme abdominal distension. To relieve pressure and improve respiratory function, an abdominal drain was inserted, releasing 72 L of ascitic fluid over five days. Following drainage, imaging confirmed a large ovarian tumor with peritoneal involvement, and a multidisciplinary team (surgeons, gynecologists, plastic surgeons, anesthetists, and intensive care specialists) determined the need for surgical intervention. Histopathology confirmed mucinous adenocarcinoma with pseudomyxoma peritonei (FIGO IIIB). This case underscores the critical impact of delayed oncological diagnosis and the need for enhanced patient education, mental health support, and structured screening programs to prevent similar late-stage presentations. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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20 pages, 829 KiB  
Systematic Review
Effects of Hyperbaric Oxygen Therapy on Long COVID: A Systematic Review
by Bing-Qi Wu, De-Yi Liu, Te-Chun Shen, Yu-Ru Lai, Tsai-Ling Yu, Hsiang-Li Hsu, Hsiu-Ming Lee, Wei-Chih Liao and Te-Chun Hsia
Life 2024, 14(4), 438; https://doi.org/10.3390/life14040438 - 26 Mar 2024
Cited by 2 | Viewed by 5601
Abstract
The coronavirus disease (COVID-19) pandemic has resulted in an increasing population that is experiencing a wide range of long-lasting symptoms after recovery from the acute infection. Long COVID refers to this specific condition and is associated with diverse symptoms, such as fatigue, myalgias, [...] Read more.
The coronavirus disease (COVID-19) pandemic has resulted in an increasing population that is experiencing a wide range of long-lasting symptoms after recovery from the acute infection. Long COVID refers to this specific condition and is associated with diverse symptoms, such as fatigue, myalgias, dyspnea, headache, cognitive impairment, neurodegenerative symptoms, anxiety, depression, and a sense of despair. The potential of hyperbaric oxygen therapy (HBOT) to improve chronic fatigue, cognitive impairments, and neurological disorders has been established; therefore, the use of HBOT to treat long COVID has also been studied. We conducted a literature search between 1 January 2019 and 30 October 2023, focusing on the clinical efficacy and utility of HBOT for treating long COVID and found ten clinical studies that fit the review topic, including one case report, five one-group pretest-posttest design studies, one safety report from a randomized controlled trial (RCT), and three complete reports of RCTs. Most studies found that HBOT can improve quality of life, fatigue, cognition, neuropsychiatric symptoms, and cardiopulmonary function. Although HBOT has shown some benefits for long COVID symptoms, further rigorous large-scale RCTs are required to establish precise indications, protocols, and post-treatment evaluations. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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