COVID

The COVID-19 pandemic lockdown restrictions had significant impacts on the well-being and academic functioning of students worldwide. When universities closed campuses and moved teaching and learning online, students faced numerous challenges. The researchers conducted a study to establish which factors most affected South African students’ academic competence during the initial months of lockdown and the shift to online learning. Using an online survey that focused on students’ wellness, perceived academic competence and coping behaviour, data were collected from 3239 university students. Multiple linear regression showed that students’ subjective sense of intellectual wellness, coping behaviour, satisfaction with support from the university, and mental health were strong predictors of academic competence. Other factors that influenced students’ academic competence were emotional and spiritual wellness, perceptions of safety and security, and hopefulness. Females, undergraduates, and Faculty of Law students reported higher perceptions of academic competence. These findings have practical implications for universities as they identify factors that contribute to students’ academic competence, especially during times of crisis and online learning. Academic and support services staff at universities may find the findings valuable when developing policies to provide appropriate resources and services to promote and sustain students’ academic functioning. Full article

This bibliometric review analyzes global research on COVID-19 vaccine side effects, focusing on publication trends, collaborations, and key topic areas. Using VOSviewer and Bibliometrix for data analysis and visualization, this study examines 1353 unique papers indexed in Scopus and Web of Science (2020–2024). The results indicate a significant increase in publications in 2021 and 2022, with the United States, China, and Europe contributing the most. While many studies focused on common side effects, such as headache, fatigue, and injection-site pain, rare but serious adverse events, such as myocarditis, thrombocytopenia, Guillain–Barré syndrome, pericarditis, and thrombosis, were also reported. However, regions with limited research infrastructure, particularly in developing countries, remain underrepresented despite the critical need for vaccine safety studies in these areas. Additionally, journals such as Vaccines, Vaccine, and Human Vaccines and Immunotherapeutics, all ranked Q1, dominate the publication volume, ensuring wide dissemination through open-access availability. This analysis also highlights global collaboration networks, identifying key authors and regions with high levels of co-authorship. Thematic mapping distinguishes niche topics focused on rare and severe side effects from driving topics addressing more common reactions. This review, therefore, underscores the importance of scaling up research efforts in underrepresented regions and strengthening global collaborations to ensure effective pharmacovigilance. Finally, future research should prioritize the long-term, ongoing monitoring of side effects and address disparities in scientific output, particularly in developing countries where vaccine safety data are urgently needed. Full article

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

This study scrutinizes the influence of “blame attribution” and the Theory of Planned Behaviour (TPB) on compliance with COVID-19 public health measures in Australia. This study elucidates that blaming individuals rather than governments surprisingly augments support for governmental regulations, highlighting the complexities of blame attribution in shaping public adherence to health policies. It underscores the nuanced roles of TPB elements like subjective norms and behavioural control, revealing that feelings of empowerment, social responsibility, and recognizing personal roles in pandemic control enhance the inclination to support governmental directives. The outcomes emphasize the criticality of understanding blame attribution and TPB dynamics for devising efficacious communication and management strategies, promoting societal adherence to essential regulations and actions during health crises, and fostering a more resilient societal infrastructure for dealing with pandemics. Full article

The association between family violence and the COVID-19 pandemic remains complex. This meta-analysis aimed to determine trends in the observed changes in family violence comparing the pre-pandemic period to the pandemic period. A systematic search was performed in electronic databases to identify all relevant research reporting on COVID-19 and family violence. There was a statistically significant increase in family violence after the first lockdown. The odds ratio for the prevalence of physical and sexual violence together was 7.24 (95% CI = 4.74, 11.03 p < 0.001). A small marginal increase in the prevalence of various types of family violence leading to hospitalization was found, however, the result was not statistically significant (OR = 1.91, 95% CI = 0.91, 3.96, p = 0.09). A small significant increase in the prevalence of victims with a perception of increased violence during the pandemic lockdown was observed (proportion = 33%, 95% CI = 15.72%, 50.34%, p = 0.002). This meta-analysis found that during the COVID-19 lockdown, there was an increase in the prevalence of overall family violence, a small, non-significant, increase in the prevalence of hospitalizations due to family violence, as well as an increase in the perception of family violence by victims. These results are clinically relevant for implementing effective measures of violence prevention to safeguard vulnerable populations. Full article

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

Refusals and delay in receiving COVID-19 vaccines due to vaccine hesitancy present major barriers to optimal vaccine uptake and thus epidemic control, with crisis-affected populations facing additional challenges. International Medical Corps conducted a cross-sectional survey to evaluate knowledge, attitudes, and perceptions regarding COVID-19 and identify determinants of COVID-19 vaccine hesitancy among 413 healthcare workers (HCW) working at 90 national primary healthcare centers in Lebanon, just prior to widespread vaccine rollout. Logistic regression was used to assess predictors of vaccine acceptance using the health belief Model. More than half (56.9%) of HCWs were categorized as being vaccine-hesitant, while 43.1% reported they would receive a vaccine when available. Perceived benefits, cues to action, and social norms were positively associated with vaccine acceptance. More than half (56.4%) believed the national health system was not capable of ensuring safe administration of the COVID-19 vaccine. Targeted interventions that emphasize the benefits of COVID-19 vaccination, highlight cues to vaccinate, and promote vaccination as a social norm are critical in motivating HCWs to get vaccinated. Increasing HCW trust in Lebanon’s national health system is critical to building confidence toward COVID-19 vaccines and has implications for the success of future responses to infectious disease outbreaks. Full article

After first appearing in December 2019, coronavirus disease 2019 (COVID-19) spread rapidly, leading to global effects and significant risks to health systems. The virus’s high replication competence in the human lung accelerated the severity of lung pneumonia cases, resulting in a catastrophic death rate. Variable observations in the clinical testing of virus-related and patient-related cases across different populations led to ambiguous results. Medical and epidemiological studies on the virus effectively use imaging and scanning devices to help explain the virus’s behavior and its impact on the lungs. Varying equipment resources and a lack of uniformity in medical imaging acquisition led to disorganized and widely dispersed data collection worldwide, while high heterogeneity in datasets caused a poor understanding of the virus and related strains, consequently leading to unstable results that could not be generalized. Hospitals and medical institutions, therefore, urgently need to collaborate to share and extract useful knowledge from these COVID-19 datasets while preserving the privacy of medical records. Researchers are turning to an emerging technology that enhances the reliability and accessibility of information without sharing actual patient data. Federated learning (FL) is a technique that learns distributed data locally, sharing only the weights of each local model to compute a global model, and has the potential to improve the generalization of diagnosis and treatment decisions. This study investigates the applicability of FL for COVID-19 under the impact of data heterogeneity, defining the lung imaging characteristics and identifying the practical constraints of FL in medical fields. It describes the challenges of implementation from a technical perspective, with reference to valuable research directions, and highlights the research challenges that present opportunities for further efforts to overcome the pitfalls of distributed learning performance. The primary objective of this literature review is to provide valuable insights that will aid in the formulation of effective technical strategies to mitigate the impact of data heterogeneity on the generalization of FL results, particularly in light of the ongoing and evolving COVID-19 pandemic. Full article