COVID, Volume 5, Issue 1 (January 2025) – 12 articles

Data dashboards provide a means for sharing multiple data products at a glance and were ubiquitous during the COVID-19 pandemic. Data dashboards tracked global and country-specific statistics and provided cartographic visualizations of cases, deaths, vaccination rates and other metrics. We examined the role of geospatial data on COVID-19 dashboards in the form of maps, charts, and graphs. We organize our review of 193 COVID-19 dashboards by region and compare the accessibility and operationality of dashboards over time and the use of web maps and geospatial visualizations. We found that of the dashboards reviewed, only 17% included geospatial visualizations. We observe that many of the COVID-19 dashboards from our analysis are no longer accessible (66%) and consider the ephemeral nature of data and dashboards. We conclude that coordinated efforts and a call to action to ensure the standardization, storage, and maintenance of geospatial data for use on data dashboards and web maps are needed for long-term use, analyses, and monitoring to address current and future public health and other challenging issues. Full article

Background: The coronavirus disease 2019 (COVID-19) pandemic has generated profound health, societal, and economic consequences, which have been further compounded by long-term sequelae commonly referred to as post-COVID-19 or long-COVID syndrome. Understanding the real-world impact of post-COVID-19 mortality is therefore critical for effective healthcare planning and resource allocation. Methods: A descriptive epidemiological study was conducted using data from the US National Center for Health Statistics 2018–2024 to identify deaths attributed to the post-COVID-19 condition, as classified by the ICD-10 code U09.9, from October 2021 to December 2024. Demographic factors such as gender, age, and place of death were also extracted. Results: By December 2024, 2653 US deaths were classified under the ICD-10 code U09.9, corresponding to an age-adjusted mortality rate of 0.089 × 100,000. Mortality was significantly higher in males compared to females (0.098 vs. 0.081 × 100,000; p < 0.001). A clear age-related mortality gradient was observed, with rates increasing almost linearly with advancing age. The largest fraction of post-COVID-19 deaths occurred at home (33.0%), followed by nursing homes (26.3%) and medical facilities (24.1%). Conclusions: These findings highlight the substantial yet complex impact of the post-COVID-19 condition on mortality, with higher rates observed in males, older adults, and individuals at home, highlighting the need for targeted healthcare interventions and resource allocation, particularly for these higher-risk groups. Full article

In Melbourne, Australia, strict ‘lockdowns’ were implemented in 2020 to suppress COVID-19, significantly disrupting daily life. Young people (<18 years) with medical conditions have an elevated risk of mental health problems and may have been disproportionately affected by the distress associated with the COVID-19 restrictions. To investigate this, we conducted a single-site, longitudinal cohort study involving the parents of 135 children and adolescents with medical conditions. Using an adapted version of the CoRonavIruS Health Impact Survey (CRISIS), parents rated their child’s mental health, activities and healthcare experiences pre-COVID-19 (retrospectively), during lockdown and 6 months post-lockdown. General linear mixed models revealed that mental health symptoms, including anxiety, fatigue, distractibility, sadness, irritability, loneliness and worry, were higher during lockdown compared to pre-COVID-19. Notably, anxiety, sadness and loneliness remained elevated 6 months post-lockdown. Covariates such as older child age, increased parent stress and child screen time contributed to greater mental health difficulties. While most mental health symptoms resolved post-lockdown, the persistence of anxiety, sadness and loneliness highlights the need for ongoing clinical monitoring for young people with medical conditions during periods of community stress and restrictions. Full article

SARS-CoV-2 placental infection, also known as placentitis (SP), is an established cause of stillbirth; however, this pathology is rare and its incidence across different viral variants is unknown. We report two new cases of SP-associated stillbirth in the third trimester of pregnancy. The cases were identified by a retrospective review of 84 fetal autopsies performed at our institution from 1 March 2020 to 1 March 2024. In one case, the mother was previously healthy and asymptomatic for COVID-19. In the second case, the mother had a history of multiple sclerosis (MS) and suffered recurrent moderate-to-severe COVID-19. In both cases, the placentas showed SP with massive perivillous fibrin deposition (PVFD), involving more than 90% of placental discs, resulting in placental insufficiency and lethal hypoxic–ischemic injury to the fetuses. Placental tissues were positive for SARS-CoV-2 by in situ hybridization (ISH) and immunohistochemistry (IHC). Sequencing revealed the delta variant in Case 1 and omicron XBB.1.515 in Case 2. The data demonstrate that SP, albeit rare, continues to cause intrauterine fetal demise (IUFD) across viral variants regardless of the clinical severity of the infection. The persistence of rare cases of SP as COVID-19 becomes globally endemic emphasizes the importance of disease prevention in pregnancy. Full article

Research on age-friendly cities and communities (AFCC) has primarily taken a qualitative approach. This article extends insights from a quantitative perspective to understand the international perspectives of community living and well-being during the COVID-19 pandemic. Employing an intersectional approach, this online survey aimed to understand human behaviour within AFCC. This article contextualises the digital practices and the impact of technology experienced through the age-friendly city lens of adults aged 18–50+ years living in different types of communities. Using an original dataset collected from 2020 to 2021 across 11 sites and in 13 languages, the study gathered responses from a sample size of 3422 participants. Findings indicate that adults aged 50+ years reported significantly lower loneliness scores, and higher well-being scores compared to adults aged below 40. Factors including gender, education level, and marital and employment status were found to impact loneliness and well-being significantly. From a community perspective, individuals living in rural areas and small towns reported significantly lower loneliness scores and higher well-being scores than those living in metros and cities. These findings contribute to the ongoing discourse in AFCC and have the potential to aid policy responses intended to reduce loneliness and improve well-being through public health and pandemic preparedness planning. Full article

Background: COVID-19 infection can have a protracted course in many survivors, with varied sociodemographic and medical characteristics, exhibiting a plethora of symptoms that have consequential impacts on their quality of life. This study sought to gather pertinent data about the prevalence of Long-Haul COVID (LC), the predisposing factors to this condition and the burden on the quality of life of Mauritian survivors. Research Setting: A cross-sectional study was performed using an adapted online questionnaire, using two definitions of Long COVID, namely the WHO and NICE, SIGN and RCGP definitions. Associations between LC and categorical variables were employed to explore relationships between LC and ratio (FAS, FSS, PCS-12, MCS-12) variables. Simple and multivariable logistic regression models were used to assess the predictors and outcomes associated with LC. Findings: Of 285 Mauritians with a confirmed history of COVID-19 infection, 64.2% developed Long COVID (WHO LC-38.9%, NICE, SIGN and RCGP LC-55.8%). The most prevalent symptoms were fatigue or muscle weakness (88.0%), cough (57.4%), difficulty concentrating (55.2%), trouble remembering or memorising (49.7%), insomnia or sleep disturbance (43.7%), amongst others. Statistically significant associations were determined between LC and age, gender, vaccination status, severity of acute illness, reinfections, self-perception of disease and having more than five acute symptoms. Long COVID positively correlated with fatigue. Both Long COVID and severe fatigue (F = 73.266, p < 0.001) negatively impacted PCS-12. Fatigue had no significant impact on MCS-12. Conclusions: This study demonstrated the presence of Long COVID in the Mauritian population. Long COVID manifests as a complex and long-lasting affliction that affects even young adults with disabling outcomes, owing to multiple lingering symptoms but, most importantly, fatigue. The latter brings about distressing declines in physical and overall quality of life that thump both individual and societal health and productivity. Full article

Researching COVID to Enhance Recovery (RECOVER) is a National Institutes of Health initiative to improve our understanding of recovery after SARS-CoV-2 infection and to prevent and treat Long COVID. For almost two years, I worked with a RECOVER Task Force called Commonalities with Other Post Viral Syndromes, whose scope was the overlap of Long COVID symptoms and possible pathways with other post-viral syndromes, including Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and other dysautonomias. In this article, I review how I was selected to be on this Commonalities task force, and my role as chairperson of a subcommittee that accomplished some specific goals, such as being able to introduce ME/CFS-specific symptoms and ways to assess them in the adult and pediatric RECOVER battery. An effort to have a study funded to collect an independent sample of patients diagnosed with ME/CFS before the pandemic was not successful. This commentary outlines the process of working with this Long COVID task force, including steps such as questionnaire development, protocol design, reviews, and policy initiatives. The outcomes of this task force and subcommittee are reviewed, and lessons learned are presented for those with an interest in working toward policy and structural change. Full article

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its global spread have left an indelible mark, disrupting multiple aspects of human life. It is therefore crucial to retrospectively analyze the factors that have contributed more to the initial inefficiency of the global response, thus enhancing preparedness and proactively addressing the risk of similar events occurring in the future. Critical areas were identified based on our expertise. Relevant bibliographic references were subsequently gathered through an open search of scientific databases to substantiate the concepts discussed in this article. The key issues that hindered an effective response to coronavirus disease 2019 (COVID-19) are numerous and multifaceted, and some of these will be critically examined in this article, including delayed identification of the pathogen, inadequate public health preparedness, inadequate therapeutic management, and deficiencies in laboratory diagnostics. From this analysis, key areas for improvement emerge to ensure more efficient responses to future health crises, including (i) enhancing and strengthening health information systems, (ii) improving pandemic preparedness and response planning, (iii) developing a resilient healthcare workforce, (iv) increasing investment in research and development, (v) expanding the use of telemedicine and digital health, (vi) ensuring universal access to healthcare, and (vii) improving public health communication and trust. Full article

(1) Objectives: The burden of SARS-CoV-2 infection in people living with HIV (PLHIV) in Gabon is unknown. (2) Methods: We conducted a cross-sectional seroprevalence study of SARS-CoV-2 immunoglobulin (Ig) G/M antibodies in PLHIV in Libreville from April 2022 to April 2023 after the fourth wave of the pandemic. We used the WANTAI SARS-CoV-2 Ab ELISA targeting the SARS-CoV-2 spike, receptor-binding domain. (3) Results: Among 480 samples tested, the seroprevalence of IgG antibodies to SARS-CoV-2 spike protein was 87.5% (95% confidence interval (CI) 77.7–97.3%). History of SARS-CoV-2 diagnosis, ART treatment, and TCD4 lymphocyte count were not found to be associated with the presence of antibodies against SARS-CoV-2 among the study participants. However, having a detectable viral load (p = 0.0001), being vaccinated (COVID-19 vaccine, p = 0.04), and a history of COVID-19 (p < 0.0001) symptoms were associated with a higher risk of having anti-SARS-CoV-2 antibodies. (4) Conclusions: By early 2023, PLHIV in Gabon had high rates of SARS-CoV-2 seropositivity. To our knowledge, this is the first study to determine the seroprevalence of SARS-CoV-2 antibodies in PLHIV in Gabon. This study provides further evidence of anti-SARS-CoV-2 seroconversion in the absence of any vaccination in a particular target population. The surveillance of diseases of global health concern in PLHIV is crucial to estimate population-level exposure and inform public health responses. Full article

The emergence of SARS-CoV-2 has resulted in a significant impact on public health, particularly for individuals with underlying health conditions such as obesity and diabetes. While vaccination efforts have played a crucial role in reducing hospitalizations, it remains unclear whether the effectiveness of these vaccines varies among different population groups. In this study, we investigated the immune responses generated by various SARS-CoV-2 vaccine platforms in mouse models with obesity and diabetes, focusing on both cell-mediated and humoral immune responses. Our findings revealed diminished immune responses in diabetic and obese mice compared to healthy counterparts. After vaccination with adjuvanted subunit or mRNA lipid nanoparticle (LNP) vaccines, both humoral and cell-mediated responses were significantly reduced in diabetic mice. Obese mice also exhibited decreased immunogenicity, albeit to a lesser extent. However, it should be noted that mRNA vaccines demonstrated strong neutralizing responses across all metabolic states, while adjuvanted subunit vaccines elicited higher antibody avidity in mice with type 2 diabetes (T2D) and obesity compared to healthy mice. These results suggest that the impaired humoral and cell-mediated responses observed in altered metabolic states may be linked to chronic inflammation associated with obesity and suboptimal glycemic control in diabetes. Understanding the impact of these metabolic disturbances on vaccine immunogenicity is crucial for developing optimized vaccines that can effectively enhance immune responses and provide long-lasting protection against SARS-CoV-2, even in individuals with obesity and diabetes. By contributing these findings, we support efforts to improve vaccine efficacy in populations affected by metabolic disorders, advancing effective immunization against SARS-CoV-2. Full article

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