Search Results (759)

Objectives: Evidence suggests that COVID-19 infection contributes to elevated risks of psychiatric disorders, including depression and anxiety, however, this association remains underexplored. This study aimed to examine the incidence of depression and anxiety in individuals with COVID-19 compared to those without any infection. Method: Using the Utah All Payers Claims Database (2019 to 2021), we examined adult patients with continuous insurance enrollment. Individuals with pre-existing depression or anxiety were excluded. COVID-19 infection in 2020 was identified using diagnostic and procedural codes. The Least Absolute Shrinkage and Selection Operator (LASSO) method was applied to select covariates, followed by entropy balancing to adjust for baseline differences. Weighted logistic regression models were used to estimate the association between COVID-19 infection and incident mental health diagnoses in 2021. Results: Among 356,985 adults included in the final analytic sample for depression analysis, 37.6 percent had a documented COVID-19 infection in 2020. Individuals with prior infection had significantly higher odds of receiving a depression diagnosis in 2021 compared to those without infection (OR = 1.48, p < 0.01). A similar pattern was observed for anxiety: among 371,491 adults, 38.1 percent had a COVID-19 infection, and infected individuals had 46 percent greater odds of receiving an anxiety diagnosis (OR = 1.46, p < 0.01), after adjusting for demographic and clinical characteristics. Conclusions: This study highlights the elevated risk of depression and anxiety among patients who had been infected with COVID-19, emphasizing the importance of addressing the mental health needs of individuals affected by the virus. Full article

Background: The aim of the study is to determine whether environmental and climatic factors (air quality, precipitation rates, and air temperatures) alongside specific public health measures (social distancing and vaccination) have influenced total number of SARS CoV-2 positive cases (TOTAL CASES) and deaths (TOTAL DEATHS) from COVID-19 infection in the Republic of Serbia (RS). Method: An observational, retrospective study was conducted, covering the following three-year period in the RS: I (1 March 2020–1 March 2021); II (1 March 2021–1 March 2022); and III (1 March 2022–1 March 2023). Air quality was expressed as the values of the air quality index (AQI) and the concentrations of particulate matter 2.5 µm (PM_2.5). Precipitation rates (PREC) were expressed as the average monthly amount of rainfall (mm), while average air temperatures (AIR TEMP) were expressed in °C. Data were collected from relevant official and publicly available national and international resources. Data regarding the COVID-19 pandemic were collected from the World Health Organization. Results: No differences between the periods were observed for the average values of AIR TEMP (11.2–12.2 °C), PREC (56.1–66.8 mm), and AQI (57.2–58.8), while the average values of PM_2.5 significantly decreased in the III period (21.2 compared to 25.2, p = 0.03). Both TOTAL CASES and TOTAL DEATHS from COVID-19 infection showed positive correlation with the AQI and PM_2.5 and a negative correlation with the AIR TEMP. The correlation coefficient was strongest between TOTAL DEATHS and the AIR TEMP in the II period (r = −0.7; p = 0.007). The extent of rainfall and vaccination rates did not affect any of the observed variables. No differences in TOTAL CASES and TOTAL DEATHS were observed between the periods of increased social measures and other months, while both statistically significantly increased during the vaccination period compared to months without the vaccination campaign (p < 0.02, for both). Conclusions: Air quality, more precisely AQI and PM_2.5 and average air temperatures, but no precipitation rates, influenced the number of TOTAL CASES and TOTAL DEATHS from COVID-19 infection. These were the highest during the vaccination period, but vaccination could be considered as a confounding factor since the intensive vaccination campaign was conducted during the most severe phase of the COVID-19 pandemic. Social distancing measures did not reduce the number of TOTAL CASES or TOTAL DEATHS during the COVID-19 pandemic. Full article

Background/Objectives: The COVID-19 pandemic has placed intensive care unit (ICU) nurses under intense psychological pressure, increasing emotional and psychological stress. Two constructs—difficulties in emotion regulation and psychological inflexibility (i.e., low contact with the present moment and a lack of committed action based on personal values)—have been associated with increased perceived stress levels but remain underexplored in this population. Aims: This study investigated whether psychological inflexibility mediates the relationship between emotion regulation difficulties and perceived stress in ICU nurses. It also examined whether years of ICU work experience moderate the direct relationship between emotion regulation difficulties and perceived stress. Methods: A cross-sectional study was conducted with 210 ICU nurses (65.2% women; 34.8% men; mean age = 40.25 years ± 11.36) from Italian public hospitals. The participants completed the Difficulties in Emotion Regulation Scale, the Acceptance and Action Questionnaire-II, and the Perceived Stress Scale. A moderated mediation model was tested to examine whether psychological inflexibility mediates the relationship between emotion regulation difficulties and perceived stress and whether years of ICU work experience moderate the path between these variables. Results: Higher difficulties in emotion regulation predicted greater psychological inflexibility, which, in turn, predicted higher perceived stress. Psychological inflexibility fully mediated the relationship between emotion regulation difficulties and perceived stress. Additionally, years of ICU work experience significantly moderated the direct link between emotion regulation difficulties and perceived stress. This relationship was strongest for nurses with 1–15 years of ICU experience. The model explained 33% of the variance in perceived stress. Conclusions: This study highlights the importance of the novel construct of psychological inflexibility in the context of healthcare professionals and its role in shaping perceived stress. Addressing psychological inflexibility through targeted interventions may help mitigate stress and promote well-being among ICU nurses. Full article

Background: Psychological impacts of the coronavirus disease 2019 (COVID-19) pandemic on individuals with chronic medical conditions remain understudied. Chronic kidney disease (CKD) is one of the chronic conditions associated with an increased risk of severe COVID-19 outcomes. The aim of this study was to define the psychological burden of individuals with CKD during the COVID-19 pandemic. Methods: In this cross-sectional study, 219 individuals with CKD were recruited from the Nephrology Outpatient Unit at the University Hospital Essen, Germany, and completed anonymous surveys incorporating validated psychological assessment tools for generalized anxiety (GAD-7) and depressive symptoms (PHQ-2), along with self-generated items addressing COVID-19-specific concerns and behavioral changes. These participants were propensity score matched with controls from the general German population. Results: Individuals with CKD exhibited lower levels of generalized anxiety and depressive symptoms compared to the general population. However, they reported significantly greater risk perceptions regarding the likelihood of experiencing symptoms, a severe disease course, and death from COVID-19. COVID-19-related fear and associated behavioral changes were more frequently reported among CKD patients. Adherent and dysfunctional safety behaviors predominated among the CKD cohort. Conclusions: This study underscores psychological challenges faced by individuals with CKD during the COVID-19 pandemic. The increased risk perceptions and fears of severe disease and mortality from COVID-19 emphasize the need for mental health interventions aimed at improving coping strategies alongside physical health management in this vulnerable population. Full article

Background: Inflammatory and angiogenic mediators play a key role in post-COVID-19 syndrome pathophysiology. These mediators might be of prognostic value for pulmonary function in this syndrome. Objectives: To determine interleukin-6, -12, and -17, macrophage inflammatory protein-1A (MIP-1A), the vascular endothelial growth factor-A (VEGF-A) gene expression levels, the matrix metalloproteinase-9 (MMP-9) plasma levels, and the association of clinical data with pulmonary function in patients with post-COVID-19 syndrome with normal and abnormal spirometry results. Methods: Demographic/clinical data and blood samples were collected (45 patients). Pulmonary function was evaluated (spirometry), and the gene expression levels of inflammatory and angiogenic mediators (IL-6, IL-12, IL-17, MIP-1A, and VEGF-A) were determined in PBMCs (qPCR). MMP-9 plasma levels were determined (ELISA). Results: Seventeen out of forty-five patients with post-COVID-19 syndrome had abnormal spirometry values, which were associated with arterial hypertension, pneumonia, previous hospitalization, and disease severity (p < 0.05). IL-6, IL-12, and VEGF-A gene expression was upregulated in patients with post-COVID-19 syndrome compared with healthy controls. In patients with normal spirometry values, IL-17 and VEGF-A gene expression was upregulated (p < 0.05), but MIP-1A was downregulated (p < 0.05) (vs. the abnormal spirometry group). MMP-9 serum levels were increased in the normal spirometry group compared with the abnormal one (p < 0.05). Conclusions: Post-COVID-19 syndrome has a complex immune pathophysiology, but potential inflammatory and angiogenic biomarkers, such as IL-6, IL-12, IL-17, MIP-1A, and VEGF-A, are differentially expressed in this syndrome and might be prognostic predictors of post-COVID-19 syndrome associated with pulmonary function alterations. Full article

Background/Objectives: Proinflammatory cytokines have been associated with poor prognosis in community-acquired and COVID-19 pneumonia. There is a paucity of reports on the cytokine release syndrome, also called cytokine storm in the Mexican population with pneumonia and COVID-19; therefore, our objective was to compare proinflammatory cytokine levels in Mexican patients without COVID-19 (non-COVID-19) and those with moderate, severe, and critical COVID-19 pneumonia. Methods: This study included 30 patients with non-COVID-19 pneumonia and 57 with COVID-19 pneumonia. Disease diagnosis and severity were determined using the radiographic pulmonary edema assessment (RALE) score. Quantification of IL-6, IL-10, and TNF-α was performed using multiplex immunoassays. A receiver operating characteristic curve was constructed to classify subjects with elevated cytokine levels. Logistic regression was used to find associations between elevated cytokine levels and the presence of COVID-19 pneumonia. Results: The severity classification of patients with COVID-19 pneumonia was as follows: moderate (n = 20), severe (n = 19), and critical (n = 18). The proinflammatory cytokines IL-6 and IL-10 were significantly increased in COVID-19 patients compared to non-COVID-19 patients (p < 0.005), while TNF-α levels were lower in critically ill patients with COVID-19 pneumonia. High levels of IL-6 and IL-10, adjusted for age, sex, the presence of comorbidities, and the neutrophil-to-lymphocyte ratio (NLR), showed an elevated risk (OR IL-6 = 4.02; OR IL-10 = 9.36) of presenting pneumonia and COVID-19 compared to pneumonia without COVID-19 in patients. Likewise, 61% of COVID-19 patients with elevated proinflammatory cytokines (IL-6 and IL-10) had a fatal outcome. Conclusions: Elevated levels of both IL-6 and IL-10 are a differential risk factor for developing COVID-19 pneumonia. These elevated levels were more frequently observed in Mexican COVID-19 pneumonia patients who died at the onset of the COVID-19 pandemic. It is important that they are monitored from initial diagnosis as they may be markers of a fatal outcome in severe and critical COVID-19 patients. Full article

Background/Objectives: Vaccine hesitancy has increased during the coronavirus pandemic, a period marked by the spread of disinformation and conspiracy theories about COVID-19 vaccines. This qualitative study aimed to explore the beliefs and attitudes of Spaniards towards COVID-19 vaccines and analyze the role of information sources in this process. Methods: Semi-structured interviews were conducted with 35 residents of Spain who exhibited varying levels of vaccine hesitancy. Through thematic content analysis, the narratives supporting vaccination-related decisions, as well as the influence and trust in information sources, were examined. Results: Reasons for getting vaccinated included perceptions of it being “almost an obligation” and “fear of illness and death”. Conversely, reasons for not getting vaccinated included “uncertainty about vaccines”, the belief that “the risk is not real”, and the perception that “vaccination is a personal decision”. Regarding vaccine-related information sources, interviewees expressed distrust of the media, particularly television, as they considered news about vaccine effectiveness and characteristics to be contradictory and constantly changing, which created uncertainty about its reliability. Most interviewees were unsure if social media influenced their decision not to get vaccinated. However, those who acknowledged its impact mentioned trusting sources such as people with a university education. Additionally, close contacts—particularly healthcare professionals—had a significant influence on the decision not to get vaccinated. Conclusions: This study shows that the decision not to vaccinate is shaped by personal beliefs and sources of information—particularly social media and close acquaintances, including healthcare professionals. Full article

Background: In-stent restenosis of coronary arteries is a significant problem in interventional cardiology. Inflammatory processes in the arterial intima play a key role among the well-known risk factors for restenosis. The COVID-19 pandemic has contributed to the development of inflammation and the activation of the coagulation system. The aim of this study was to assess the risk factors for coronary artery restenosis and patient survival during the COVID-19 pandemic. Materials and Methods: We performed a cross-sectional study on a targeted sample of patients with coronary artery disease who underwent repeat myocardial revascularization (931 patients). The main study group, consisting of patients with coronary artery stent restenosis, included 420 patients (38.5% had previous COVID-19). The control group included 511 patients without stent restenosis (20.9% had COVID-19). Results: The results of multiple logistic regression analysis showed that the odds ratio (OR) for COVID-19 was 2.29 (95% CI 2.78–3.19) (p < 0.001), and the OR for C-reactive protein (CRP) was 1.08 (95% CI 1.002–1.013). The average hospital survival time for subjects with prior COVID-19 (N = 269) was 9.53 ± 0.106 days (95% CI 9.32–9.74), while for those without COVID-19 (N = 662), it was 9.89 ± 0.032 days (95% CI 9.83–9.96) (p < 0.001). The one-year survival time was 316.7 ± 6.982 days (95% CI 303.0–330.4) for the COVID-19 group and 340.14 ± 3.243 days (95% CI 333.8–346.5) for the non-COVID-19 group (p < 0.001). Conclusions: The main risk factors for in-stent restenosis were COVID-19 and elevated CRP levels. The average survival time in the group with prior COVID-19 was statistically significantly lower than in patients without COVID-19, both during the hospital stay and within one year after repeated revascularization. Full article

Background: The COVID-19 pandemic has exacerbated mental health challenges across occupational sectors, disproportionately affecting workers in essential and public-facing roles. Objectives: This study ai to identify the occupational sectors in Spain most affected by mental health-related Temporary Work Incapacity due to Common Contingencies during the first COVID-19 lookdown (14 March–21 June 2020) to examine sex-based differences and to analyze the associate economic burden. Methods: A descriptive, retrospective cross-sectional study was conducted using data from salaried workers affiliated with Asepeyo, a major Social Security mutual insurance provider in Spain. The sample comprised 5135 workers granted Temporary Work Incapacity due to mental health diagnoses during the lockdown period. Variables analyzed included sex, age, ICD-10 diagnosis, occupational sector, duration of medically certified leave, and estimated direct economic cost. A focused subsample of 2123 workers from the ten most affected sectors was also examined. Results: Generalized Anxiety Disorder was the most prevalent diagnosis (69.17%), followed by adjustment disorders and depressive episodes. Women accounted for 63.5% of the total sample and 80.6% of the most affected sectors, which included elderly care, retail, education, cleaning, and healthcare. The average cost per episode was EUR 2465.7, with longer leave durations observed in sectors characterized by high emotional and social exposure. Conclusions: Mental health-related disorders during the COVID-19 lockdown revealed marked sex-based disparities and sectoral vulnerabilities. Public-facing and care-related occupations experienced a disproportionate burden. These findings support the need to recognize certain mental health conditions as occupational diseases to develop targeted, gender-informed workplace mental health strategies. Full article

Background: The COVID-19 pandemic had a significant impact on nursing students by intertwining academic demands with health concerns, a situation that had effects on their emotional well-being and academic engagement. Factors such as sociodemographic characteristics and health status determined their experiences. Understanding these dynamics is crucial, especially in the context of the Spanish health and education systems. The present study aimed to adapt and assess the psychometric properties of the AMICO scale in the context of nursing students in Spain. Methods: Cross-sectional descriptive study. The study was carried out in University Nursing Centers in Spain using a non-probabilistic snowball sampling method. The total sample consisted of 1197 nursing students. Sociodemographic variables were included, as well as questions related to general health and some more specific questions about COVID-19. For the reliability study, Cronbach’s alpha was calculated. An exploratory factor analysis using principal components and varimax rotation was applied, excluding items with loadings below 0.05. Results: In this study, 1197 nursing students residing in Spain participated, of whom 85% were female, with a mean age of 22.35 years. Despite 73.9% of the students being isolated due to exposure to COVID-19, they rated their general health positively (7.86). Females reported higher levels of anxiety. The AMICO scale revealed significant differences according to gender, health, and vaccination history, showing high reliability (Cronbach’s alpha = 0.913). Conclusions: The two-factor structure of the AMICO scale was validated, confirming its suitability for assessing anxiety and fear among nursing students in Spain. The study revealed significant emotional distress during the COVID-19 pandemic, particularly among women, high-risk individuals, and those fully vaccinated. These findings accentuate the need for higher education institutions to implement targeted mental health interventions during public health emergencies. Future longitudinal research should examine the evolving psychological impact of such crises and the mitigating roles of quality of life, sleep, and physical activity. Full article

Background: Ego-resiliency could play a protective role, especially in stressful situations. Such a situation is certainly the period of the COVID-19 pandemic. The beginning of the pandemic period was a source of significant stress for many people. Students, especially of medical faculties, were one of the social groups that could be particularly affected by the reorganization of everyday functioning. Effective coping with stress during this period could have been important for minimizing its negative effects. Aim: The aim of this study was to assess ego-resiliency as a factor enhancing life satisfaction and a protective factor against symptoms of anxiety and depression in a group of health students during the COVID-19 pandemic. Methods and Material: This study was conducted in the period from October 2020 to June 2021. The study group included 362 students of the medical faculty and 249 students of the Academy of Physical Education (APhE). The Ego Resiliency Scale (ER89-R12), the Life Satisfaction Scale (SWLS) and the Anxiety and Depression Scale (HADS) were used in this study. Among the statistical methods, the Mann–Whitney U test and Spearman’s rank correlation coefficient were used. Results: In the study group, medical students obtained an average score of 34.96 ± 5.19 points and APhE students obtained 36.49 ± 5.22 points on the ER-89-R12; the difference was statistically significant (p = 0.003). On the SWLS, the mean score was 23.65 ± 5.9 points for medical students and 22.35 ± 5.67 points for students of the APhE; the difference was also statistically significant (p = 0.005). In the assessment of anxiety, medical students obtained an average of 8.43 ± 4.34 points and students of the APhE 7.60 ± 4.27 points; the difference was statistically significant (p = 0.012). In the assessment of depression, medical students achieved 5.10 ± 3.77 points and students of APhE obtained about 4.77 ± 3.26 points; the difference was not statistically significant. There were significant, negative correlations in the scope of the results obtained on the ER-89-R12 with the results of anxiety and depression, and positive correlations with the results obtained on the SWLS scale for both groups. Conclusions: Life during the pandemic was assessed by students of pro-health faculties as moderately satisfactory. The severity of symptoms of anxiety and depression correlated negatively with life satisfaction. Ego-resiliency may be a factor enhancing life satisfaction and may be a protective factor against anxiety and depression symptoms. Full article

Background: Contact tracing (CT) is a primary means of controlling infectious diseases, such as coronavirus disease 2019 (COVID-19), especially in the early months of the pandemic. Objectives: This work is a systematic review of mathematical models used during the COVID-19 pandemic that explicitly parameterise CT as a potential mitigator of the effects of the pandemic. Methods: This review is registered in PROSPERO. A comprehensive literature search was conducted using the PubMed, EMBASE, Cochrane Library, CINAHL, and Scopus databases. Two reviewers independently selected the title/abstract, full text, data extraction, and risk of bias. Disagreements were resolved through discussion. The characteristics of the studies and mathematical models were collected from each study. Results: A total of 53 articles out of 2101 were included. The modelling of the COVID-19 pandemic was the main objective of 23 studies, while the remaining articles evaluated the forecast transmission of COVID-19. Most studies used compartmental models to simulate COVID-19 transmission (26, 49.1%), while others used agent-based (16, 34%), branching processes (5, 9.4%), or other mathematical models (6). Most studies applying compartmental models consider CT in a separate compartment. Quarantine and basic reproduction numbers were also considered in the models. The quality assessment scores ranged from 13 to 26 of 28. Conclusions: Despite the significant heterogeneity in the models and the assumptions on the relevant model parameters, this systematic review provides a comprehensive overview of the models proposed to evaluate the COVID-19 pandemic, including non-pharmaceutical public health interventions such as CT. Prospero Registration: CRD42022359060. Full article

(1) Background: The COVID-19 pandemic caused widespread upheaval, presenting unique challenges for pregnant and postpartum women, who were already in a particularly vulnerable phase. As the COVID-19 pandemic and its public health response unfolded, it became crucial for clinicians and researchers to explore postpartum depression within the context of a global crisis. (2) Methods: We used data from two cross-sectional surveys of postnatal women conducted in our tertiary academic public hospital during the SARS-CoV-2 pandemic and the post-pandemic period, based on the retrospective assessments of two samples of mothers, each including 860 postpartum women. Our research has been conducted with the scope of evaluating postpartum depression disorder during and after the COVID-19 pandemic by using comparable data across time. (3) Results: The prevalence of postpartum depression was significantly higher among women who gave birth during the COVID-19 pandemic (major postpartum depressive disorder: 54.19%, minor depressive disorder: 15.58%), compared to pre-pandemic rates (10% in developed countries and 21–26% in developing countries) and post-pandemic rates (major depressive disorder 10.12%, minor depressive disorder 10.93%). The results of our research indicate that the COVID-19 pandemic had a major negative impact on perinatal mental health and, moreover, might have sped up an existing trend of the increasing prevalence of postpartum depression, despite the fact that the risk factors for postpartum depression disease remained consistent before, during, and after the pandemic. (4) Conclusions: Strengthening support systems during periods of heightened risk, such as during a pandemic, is crucial; therefore, policymakers and health planners should prioritize the mental health of this vulnerable group during global health crises or natural disasters, ensuring the implementation of effective mental health screenings, identification, enhanced support, follow-up, and reassurance measures to better address the challenges faced by susceptible postpartum women in future similar situations. Full article

Background: Long COVID (LC) has emerged as a significant epidemiological and public health issue, affecting patients’ health-related quality of life (HRQoL). This study explored the impact of LC on HRQoL in COVID-19 survivors in the Eastern Province of Saudi Arabia and examined the sociodemographic and clinical factors that influence HRQoL. Methods: This cross-sectional study included 1024 participants, and data were collected through face-to-face interviews using a structured questionnaire that incorporated the EQ-5D-5L tool to assess HRQoL. Sociodemographic information, acute COVID-19 symptoms, and LC symptoms were recorded. Statistical analyses included bivariate analyses and multivariable generalized linear modelling. Results: Of all participants, 63.8% reported experiencing LC symptoms, with fatigue, cough, and anosmia being the most common. Participants with LC had significantly lower HRQoL scores (mean EQ-5D-5L index score, 0.93) than those without LC (mean score, 0.98; p < 0.001). The key factors influencing lower HRQoL included a higher number of LC symptoms, older age, the presence of pneumonia during acute COVID-19, and pre-existing conditions such as anxiety and hypertension. Conclusions: LC negatively impacts HRQoL, with older age, chronic diseases, and the number of LC symptoms being strong predictors of poor outcomes. Interventions targeting rehabilitation and psychosocial support are critical for improving the long-term health outcomes of patients with LC. Full article

Background/Objectives: Growing interest in post-viral conditions following COVID-19 infection has led researchers and clinicians to develop several definitions of post-COVID-19 syndrome. This study aimed to understand the meaning given to post-COVID-19 syndrome by individuals who survived the first wave of the pandemic two years after its onset. Methods: A descriptive qualitative study was performed according to the Standards for Reporting Qualitative Research guidelines. An inductive and content analysis were adopted on narratives collected via the interview of patients who had been infected with SARS-CoV-2 during the first pandemic wave in the Friuli Venezia Giulia Region (Italy). Results: This study included 230 patients, of whom 158 experienced post-COVID-19 syndrome, and 46 (29.1%) reported suffering from this condition 24 months after the infection. On average, patients experienced three symptoms, with most of them experiencing at least one. Seventy-five patients reported being familiar with the definition of the post-COVID-19 syndrome, mainly through media and the internet (28.9% and 28.2%, respectively). The post-COVID-19 syndrome was described as characterized by two themes: (a) the experience of interrelated physical and psychological symptoms and (b) the experience of fighting like warriors for a long time. Conclusions: The post-COVID-19 syndrome is highly prevalent but poorly understood. Patients rely on low-quality information rather than that offered by clinicians. The post-COVID-19 syndrome appears to be a complex syndrome encompassing physical and mental symptoms, as well as those disabling the person with an unclear trajectory. There is a need to focus on the long-term consequences of COVID-19, incorporating insights from individuals’ lived experiences. Full article