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Human Health Before, During, and After COVID-19

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Coronaviruses (CoV) and COVID-19 Pandemic".

Deadline for manuscript submissions: 25 March 2025 | Viewed by 12648

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Dr. Alessia Verduri

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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
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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 Healthcare. Papers will be peer-reviewed by experts in the field.

You may choose our Joint Special Issue in Life.

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. Healthcare is an international peer-reviewed open access semimonthly 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 2700 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 (12 papers)

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11 pages, 244 KiB

Open AccessArticle

Predictors of Long COVID Among Symptomatic US Adults Testing Positive for SARS-CoV-2 at a National Retail Pharmacy

by Xiaowu Sun, Manuela Di Fusco, Laura L. Lupton, Alon Yehoshua, Mary B. Alvarez, Kristen E. Allen, Laura Puzniak, Santiago M. C. Lopez and Joseph C. Cappelleri

Healthcare 2024, 12(23), 2321; https://doi.org/10.3390/healthcare12232321 - 21 Nov 2024

Viewed by 328

Abstract

Background: Long COVID remains a significant public health concern. This study investigated risk factors for long COVID in outpatient settings. Methods: A US-based prospective survey study (clinicaltrials.gov NCT05160636) was conducted in 2022 and replicated in 2023. Symptomatic adults testing positive for SARS-CoV-2 at CVS Pharmacies were recruited. CDC-based long COVID symptoms were collected at Week 4, Month 3, and Month 6 following SARS-CoV-2 testing. Logistic regression was used to develop a predictive model for long COVID using data from the 2022 cohort. The model was validated with data from the 2023 cohort. Model performance was evaluated with c-statistics. Results: Patients characteristics were generally similar between the 2022 (N = 328) and 2023 (N = 505) cohorts. The prevalence of long COVID defined as ≥3 symptoms at Month 6 was 35.0% and 18.2%, respectively. The risk factors associated with long COVID were older age, female sex, lack of up-to-date vaccination, number of acute symptoms on the day of SARS-CoV-2 testing, increase in symptoms at Week 1, underlying comorbidities and asthma/chronic lung disease. The c-statistic was 0.79, denoting good predictive power. Conclusions: A predictive model for long COVID was developed for an outpatient setting. This research could help differentiate at-risk groups and target interventions. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

10 pages, 217 KiB

Open AccessArticle

Unmet Needs for Dental Care Before and During the COVID-19 Pandemic in Greece: A Cross-Sectional Study

by Christos Ntais, Athina Charalampaki, Michael A. Talias, Nikolaos Kontodimopoulos and John Fanourgiakis

Healthcare 2024, 12(22), 2286; https://doi.org/10.3390/healthcare12222286 - 15 Nov 2024

Viewed by 335

Abstract

Background/Objectives: Unmet dental needs involve cases wherein someone needed dental care and did not receive it. Published data on unmet dental needs are limited. This cross-sectional study investigates unmet dental needs in Greece before and during the COVID-19 pandemic. Methods: For this study, a questionnaire was created and distributed to a non-random sample. It was completed by 277 individuals. The questionnaire was based on the European Union Statistics on Income and Living Conditions (EU-SILC) tool, which is used to investigate unmet health needs. It was enriched with questions about unmet dental needs before and during the COVID-19 pandemic. Results: Of the 277 participants, 23.1% reported unmet dental needs before the onset of the COVID-19 pandemic, which decreased to 13.4% after the onset of the pandemic. However, a significant proportion of the sample (48.3%) reported no need for dental care after the onset of the COVID-19 pandemic. It is also worth noting that there were instances of dental visit avoidance, both when symptoms were present and for standard check-up/follow-up purposes, at rates of 17% and 27.8%, respectively. Conclusions: Unmet dental needs occurred at lower rates after the onset of the COVID-19 pandemic than those recorded before the pandemic. The main reasons for unmet needs before the pandemic were the cost of dental services and fear of treatment procedures or the visit to the dentist, while after the onset of the COVID-19 pandemic, lack of time and fear of coronavirus transmission were added. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

18 pages, 523 KiB

Open AccessArticle

Determinants of Doctor–Patient Communication in Terms of Patient Rights During the COVID-19 Pandemic

by Kamila Jaroń, Mateusz Grajek and Joanna Kobza

Healthcare 2024, 12(21), 2198; https://doi.org/10.3390/healthcare12212198 - 4 Nov 2024

Viewed by 598

Abstract

Background. Today, the public does not want to be just a passive consumer of health services. Patients often expect to be informed and involved in decisions about their health. With better doctor–patient communication, patients are more likely to follow treatment recommendations. Material and methods. The study was conducted using a face-to-face survey method on a group of 203 adult, independent patients from 2021 to 2022 at a medical facility, i.e., a rehabilitation clinic. Objective. The purpose of this study was to assess the determinants of doctor–patient communication in terms of patient rights. One of patients’ rights is the right to information about their health condition and treatment methods and the right to ask questions when the doctor does not provide details about the treatment or diagnosis or when it is not understandable. Doctors providing information to the patient and the opportunity for the patient to ask questions are key elements in the process of making informed decisions regarding further medical treatment. Therefore, patients were divided into two groups: active (+) and passive in communication (−) with doctors. Results. Patients who were active in communication (33%) wanted to ask questions or had the opportunity to ask the doctor questions, and thus, they were able to take an active part in the discussion with the doctor. In contrast, patients who were passive in communication (67%) did not want to ask questions or did not have the opportunity to ask the doctor questions, and therefore, their active participation in the discussion and thus their right to ask questions may have been limited. The authors’ survey shows that respondents with active communication were significantly more likely than patients with passive communication (almost 100% vs. 86%) to obtain information about their condition (p = 0.002), diagnostic methods (p = 0.003), therapeutic methods (p = 0.00007), treatment results, and prognosis (p = 0.0008). Moreover, almost all respondents with active communication as opposed to respondents with passive communication (95% vs. 52%) rated communication with doctors highest (on a scale from 0 to 5), including credible and professional approach to patients (p < 0.0001), providing information in clear and simple language (p < 0.0001), answering questions asked by patients (p < 0.0001), openness and kindness (p < 0.0001), maintaining professional confidentiality (p < 0.0001), or emotional support (p < 0.0001). Conclusions. Hence, the primary key element of the medical consultation is appropriate amount and content of information given to the patient, providing explanations and answering questions. Also importantly, according to the results, active communication between patients and doctors was significantly influenced by female gender, higher education, and a positive evaluation of communication with doctors. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

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20 pages, 506 KiB

Open AccessArticle

Innovative Regional Services and Heterogeneous Communication Channels: Results from the Nationwide German egePan Project for Pandemic Management

by Simon Kugai, Benjamin Aretz, Yelda Krumpholtz, Manuela Schmidt, Daniela Süssle, Linda Steyer, Adrienne Henkel, Katrin Bender, Felix Girrbach, Sebastian Stehr, Katrin Balzer and Birgitta Weltermann

Healthcare 2024, 12(21), 2192; https://doi.org/10.3390/healthcare12212192 - 4 Nov 2024

Viewed by 529

Abstract

Background: In the COVID-19 pandemic, novel regional services and communication channels emerged across all sectors of the German healthcare system. To contribute to pandemic preparedness, this study aims to describe newly established services in response to the COVID-19 pandemic from a stakeholder perspective and to examine the interprofessional communication channels, applying a nationwide cross-sectional approach. Methods: A nationwide sample of German healthcare stakeholders comprising general practitioners, associations of statutory health insurance physicians, hospital medical directors, local health departments, rescue coordination centres, medical directors of emergency services, outpatient nursing services, nursing homes, community care access centres, and hospital nursing managers was surveyed. A web-based questionnaire asked for their level of participation in newly implemented regional COVID-19 services and communication channels. Stakeholders’ level of recommendation was measured using the Net Promotor Score (NPS), a metric that assesses their satisfaction towards the services surveyed. Results: In total, 1312 healthcare stakeholders participated in the survey. Diagnostic centres (23.0–90.9%), COVID-19 wards in hospitals (40.5–92.1%), emergency medical vehicles designated solely for COVID-19 patients (16.5–68.4%), and crisis intervention teams (11.6–30.6%) exhibited the highest rates of engagement. The services receiving the highest recommendation for future use were COVID-19 focus practices (NPS: 33.4–43.7), COVID-19 wards in hospitals (NPS: 47.6–84.4), transportation of COVID-19 patients exclusively by predefined professional groups (NPS: 12.5–36.4), and newly implemented digitally supported nursing services (NPS: 58.3–100.0). Telephones emerged as the most frequently used communication channel (58.0–96.7%), while email was the primary digital channel (23.7–81.5%). Conclusions: During the COVID-19 pandemic, Germany experienced significant variation in the implementation of pandemic-related services across healthcare sectors, with stakeholders prioritising services built on existing healthcare structures. Developing a proactive digital infrastructure to connect healthcare professionals from different sectors is crucial for better future pandemic management. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

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14 pages, 272 KiB

Open AccessArticle

Stress among Nursing Students in the Era of the COVID-19 Pandemic

by Grzegorz Kobelski, Katarzyna Naylor, Aleksandra Kobelska and Mariusz Wysokiński

Healthcare 2024, 12(18), 1885; https://doi.org/10.3390/healthcare12181885 - 20 Sep 2024

Viewed by 1300

Abstract

Introduction: The COVID-19 pandemic has significantly impacted stress levels across various professions, particularly in the medical field. This increase in stress has also affected medical students, including nursing students, who faced unprecedented and challenging circumstances. Nursing students, in particular, experienced added pressure due to observing the frontline experiences of nurses and the new demands placed upon them. Aim: This study aimed to assess whether the COVID-19 pandemic affected an increase in stress levels among nursing students in Poland during the pandemic. We also attempt to determine whether there is a correlation between the stress level of students and factors such as gender, age, place of residence, marital status, and level of education. Assuming that the stress level will be higher among women of increasing age and bachelor’s students, we also assumed, however, that lower stress levels would occur among people in relationships and living in the countryside. Materials and Methods: The study was conducted from 27 April 2022 to 12 May 2022. We chose that period as it was the final one of the COVID-19 pandemic, and there was an increasing amount of discussion concerning its cessation, with the public accustomed to its presence in our everyday lives. Since we wanted to determine the stress level experienced by students, we decided to use the standardized Perceived Stress Scale (PSS-10). We enriched the study with sociodemographic questions to investigate the potential impact of these characteristics on the degree of stress experienced. Results: The average score obtained by respondents on the PSS-10 was 19.57 ± 6.03. Of the respondents, 49% reported experiencing a high level of stress. No statistically significant differences were found between the mean PSS-10 scores and the gender (Z = 0.169; p = 0.865), age (F = 1.282, p = 0.281), marital status (Z = −0.776, p = 0.437), or place of residence (urban vs. rural) (Z = −0.784, p = 0.433) of the respondents. The mean PSS-10 scores were also analyzed regarding the level of education (bachelor’s vs. master’s). Bachelor’s students had an average PSS-10 score of 18.95 ± 6.42, while master’s students scored 20.05 ± 5.70. Again, no statistically significant differences were found (t = −1.102, p = 0.2720). Conclusions: The study indicated that nursing students experience high stress levels regardless of gender, age, marital status, place of residence, or level of education. High stress levels were reported among both bachelor’s and master’s students. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

10 pages, 228 KiB

Open AccessArticle

How Were European GPs/FPs Involved in the COVID-19 Vaccination Campaign? A European Questionnaire Study about the Experiences of the Vaccinations in 2021

by Imre Rurik and Péter Torzsa

Healthcare 2024, 12(17), 1785; https://doi.org/10.3390/healthcare12171785 - 6 Sep 2024

Cited by 1 | Viewed by 760

Abstract

Background: The SARS-CoV-2 pandemic has become the greatest public health challenge worldwide. Soon after the appearance of the virus in 2019, intensive efforts to develop vaccines were initiated, and by late 2020, delivery of vaccines for the targeted population as a campaign had started. Aim: Collect information from European Union countries regarding how and to what extent were family physicians (FPs)/general practitioners (GPs) involved in the vaccination campaigns in 2021 and how these were organized at the national level. Method: A short questionnaire was distributed through the secretariats of WONCA (World Organization of Family Doctors) Europe and the European Forum for Primary Care (EFPC). Results: In most of the countries, participation of FPs/GPs was compulsory. The vaccination was usually centrally organized by governmental authorities. In the beginning, registration (web-based) of patients was required, mainly at the national level. By the middle of 2021, vaccination on a walk-in basis became available in almost every country for the first immunization as well as for the booster injections. The remunerations of GPs/FPs differed; in some countries, no extra payments were offered. The Pfizer vaccine was used in all countries, while in nine countries, non-European Medicines Agency (EMA)-approved vaccines were also given in primary care settings and at vaccination centers. In some countries, professional homepages helped the GPs. The involvement of primary health care (PHC) providers did not correlate to the vaccination coverage of the entire population of the respective countries. It was the highest in the more developed countries with higher living standards, where participation of GPs was voluntary and appropriate financial incentives were offered to them. Conclusions: The vaccination campaign was a professional and logistic challenge and an excellent performance of PCH providers. Experiences gained could be used in the future to manage similar pandemic challenges. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

12 pages, 282 KiB

Open AccessArticle

Post-COVID-19 Condition: How Sociodemographic Factors, Physical Well-Being and Functionality Influence Quality of Life and Mental Health Symptoms

by Mᵃ Pilar Rodríguez-Pérez, Marta Pérez-de-Heredia-Torres, Pilar Rodríguez-Ledo, Gemma Fernández-Gómez, Cristina García-Bravo, Roberto Cano-de-la-Cuerda and Patricia Sánchez-Herrera-Baeza

Healthcare 2024, 12(15), 1551; https://doi.org/10.3390/healthcare12151551 - 5 Aug 2024

Viewed by 1527

Abstract

Background: Long COVID-19 syndrome remains a global public health problem, with more than 145 million people affected with multisystemic symptoms. Addressing the requirements of individuals impacted by a syndrome characterised by a complex and variable clinical presentation is of utmost importance. Identifying the variables that can exert influence and understanding their progression is essential for directing treatment strategies aimed at enhancing both independence and quality of life. Therefore, the aim of this study was to analyse the influence of sociodemographic and clinical variables on existence and their relationship with asthenia, anxiety symptoms and low mood. Methods: An analytical study secondary to an observational cross-sectional descriptive study. Results: Logistic regression showed significant univariate effects on asthenia [sex (p = 0.034); age (p = 0.042); Activities of Daily Living Questionnaire [ADQL (p = 0.002)] [physical functioning (p < 0.001) and general health (p = 0.014)] and multivariate [sex (p = 0.019), adult age (p = 0.01) and physical functioning (p = 0.04)]]; low mood [time of evolution (p = 0.028) and multivariate [time course (p = 0.007), ADLQ (p = 0.011), role physical (p = 0.013) and general health (p = 0.001)]] and anxiety [physical functioning (p = 0.046) and multivariate [physical functioning (p = 0.034), age (p = 0.011), time of evolution (p = 0.001) and ADQL (p = 0.011)]]. Conclusions: Increased age, gender and longer evolution time seem to favour the prevalence and occurrence of mental health symptoms; greater independence and good physical functioning are protective factors with respect to the occurrence of mental health-related symptoms in patients affected by post-COVID-19 condition. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

17 pages, 688 KiB

Open AccessArticle

Long COVID among Brazilian Adults and Elders 12 Months after Hospital Discharge: A Population-Based Cohort Study

by Maria Aparecida Salci, Lígia Carreira, Natan Nascimento Oliveira, Natan David Pereira, Eduardo Rocha Covre, Giovanna Brichi Pesce, Rosana Rosseto Oliveira, Carla Franciele Höring, Wanessa Cristina Baccon, Jesús Puente Alcaraz, Giovana Alves Santos, Ludmila Lopes Maciel Bolsoni, Andrés Gutiérrez Carmona, João Ricardo Nickenig Vissoci, Luiz Augusto Facchini and Carlos Laranjeira

Healthcare 2024, 12(14), 1443; https://doi.org/10.3390/healthcare12141443 - 19 Jul 2024

Viewed by 1330

Abstract

The persistence of symptoms for more than three months following infection with severe acute respiratory syndrome coronavirus 2 is referred to as “Long COVID”. To gain a deeper understanding of the etiology and long-term progression of symptoms, this study aims to analyze the prevalence of Long COVID and its associated factors in a cohort of Brazilian adults and elders, twelve months after hospital discharge. An observational, prospective, and follow-up study was performed with a cohort of adults and older adults diagnosed with COVID-19 in 2020 in the State of Paraná, Brazil. Twelve months after hospital discharge, patients answered a phone questionnaire about the persistence of symptoms after three levels of exposure to COVID-19’s acute phase (ambulatory, medical ward, and intensive care unit). According to the characteristics of participants, the prevalence of Long COVID-19 was calculated, and logistic regression analyses were conducted. We analyzed data from 1822 participants (980 adults [≥18–<60 years] and 842 older people [≥60 years]) across three exposure levels. The overall Long COVID prevalence was 64.2%. Long COVID was observed in 646 adults (55%; of which 326 were women) and 523 older people (45%; of which 284 were women). Females had a higher prevalence of long-term symptoms (52%) compared with men. The most common post-COVID-19 conditions in the 12-month follow-up were neurological (49.8%), followed by musculoskeletal (35.1%) and persistent respiratory symptoms (26.5%). Male individuals were less likely to develop Long COVID (aOR = 0.50). Other determinants were also considered risky, such as the presence of comorbidities (aOR = 1.41). Being an adult and having been hospitalized was associated with the development of Long COVID. The risk of developing Long COVID was twice as high for ward patients (aOR = 2.53) and three times as high for ICU patients (aOR = 3.56) when compared to non-hospitalized patients. Presenting clinical manifestations of digestive (aOR = 1.56), endocrine (aOR = 2.14), cutaneous (aOR = 2.51), musculoskeletal (aOR = 2.76) and psychological systems (aOR = 1.66) made adults more likely to develop Long COVID. Long COVID was present in a large proportion of people affected by the SARS-CoV-2 infection. Presence of Long COVID symptoms displayed a dose–response relationship with the level of disease exposure, with a greater prevalence of symptoms associated with the severe form in the acute period. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

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19 pages, 258 KiB

Open AccessArticle

Risk Groups and Psychosocial Factors for the Pandemic (COVID-19)

by Elif Yöyen, Ümmühan Deniz Sinanoğlu and Tülay Güneri Barış

Healthcare 2024, 12(13), 1241; https://doi.org/10.3390/healthcare12131241 - 21 Jun 2024

Viewed by 812

Abstract

COVID-19, which started in 2019 and affected the whole world, has affected everyone at different intensities and in different ways. COVID-19, which is considered a pandemic, has turned into a major public health problem in terms of its consequences and has affected people biopsychosocially. However, people in risk groups may be affected more. This study was conducted to reveal the risk groups for the pandemic and to determine the psychosocial factors. Data were collected online using the relational screening model and snowball sampling methods. A Sociodemographic Information Form, COVID-19 Pandemic Psychosocial Impact Scale (C19-PPIS), and International Personality Inventory Short Form (IPISV) were sent online to 826 participants. Data were analysed using an independent sample t-test, a one-way ANOVA test, and the Pearson Correlation analysis. According to the results, young adults (

\bar{X}

= 2.77), women (

\bar{X}

= 2.79), singles (

\bar{X}

= 2.78), those who are unemployed (

\bar{X}

= 2.89), and those who had to change their home or city due to the pandemic (

\bar{X}

= 2.89) were more affected by the pandemic. Psychological support was the support system needed the most during the pandemic (

\bar{X}

= 3.04). In addition, a negative relationship was found between an extroverted personality and psychosocial impact from the pandemic (r = −0.148 and p < 0.01). A positive relationship was found between introversion (r = 0.183 and p < 0.01), agreeableness (r = 0.078 and p < 0.05), hostility (r = 0.094 and p < 0.01), disorganisation (r = 0.237 and p < 0.01), openness to development (r = 0.80 and p < 0.05), closed off to development (r = 0.070 and p < 0.05), emotional instability personality (r = 0.498 and p < 0.01), and psychosocial impact from the pandemic. This study has revealed important results regarding who has been most affected psychosocially by COVID-19. It is thought that the results obtained can guide state policies on what should be done in the field of preventive community mental health in another possible epidemic. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

11 pages, 229 KiB

Open AccessArticle

Psychological Distress Associated with Enforced Hospital Isolation Due to COVID-19 during the “Flatten the Curve” Phase in Morocco: A Single-Center Cross-Sectional Study

by Sarra Chadli, Rhita Nechba Bennis, Naoufel Madani, ElMostafa El Fahime, Redouane Abouqal and Jihane Belayachi

Healthcare 2024, 12(5), 548; https://doi.org/10.3390/healthcare12050548 - 26 Feb 2024

Viewed by 1185

Abstract

(1) Background: although much research has highlighted the mental health challenges faced by patients in hospital isolation during the COVID-19 pandemic, data from low–middle-income countries, including Morocco, are lacking. The main objective of this study was to assess the psychological distress of patients undergoing enforced hospital isolation during the initial phase of the COVID-19 pandemic in Morocco. (2) Methods: we conducted a cross-sectional study between 1 April and 1 May 2020, among patients hospitalized in isolation for suspected or confirmed COVID-19 at the Ibn Sina University Hospital of Rabat, Morocco. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Binary logistic regression was performed to identify variables associated with anxiety and depression, with a cutoff of ≥8 used for both scales to create dichotomous variables. (3) Results: among 200 patients, 42.5% and 43% scored above the cut-off points for anxiety and depression, respectively. Multiple logistic regression identified female gender, a higher education level, a longer duration of isolation, and a poor understanding of the reasons for isolation as significant factors associated with anxiety. Conversely, female gender, chronic disease, a longer duration of isolation, and a poor understanding of the reasons for isolation were factors significantly associated with depression. (4) Conclusions: our study underscores high rates of anxiety and depression among patients forced into hospital isolation during the initial phase of COVID-19 in Morocco. We identified several factors associated with patients experiencing psychological distress that may inform future discussions on mental health and psychiatric crisis management. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

12 pages, 3569 KiB

Open AccessArticle

Advance Monitoring of COVID-19 Incidence Based on Taxi Mobility: The Infection Ratio Measure

by Jesus S. Aguilar-Ruiz, Roberto Ruiz and Raúl Giráldez

Healthcare 2024, 12(5), 517; https://doi.org/10.3390/healthcare12050517 - 21 Feb 2024

Viewed by 1344

Abstract

The COVID-19 pandemic has had a profound impact on various aspects of our lives, affecting personal, occupational, economic, and social spheres. Much has been learned since the early 2020s, which will be very useful when the next pandemic emerges. In general, mobility and virus spread are strongly related. However, most studies analyze the impact of COVID-19 on mobility, but not much research has focused on analyzing the impact of mobility on virus transmission, especially from the point of view of monitoring virus incidence, which is extremely important for making sound decisions to control any epidemiological threat to public health. As a result of a thorough analysis of COVID-19 and mobility data, this work introduces a novel measure, the Infection Ratio (IR), which is not sensitive to underestimation of positive cases and is very effective in monitoring the pandemic’s upward or downward evolution when it appears to be more stable, thus anticipating possible risk situations. For a bounded spatial context, we can infer that there is a significant threshold in the restriction of mobility that determines a change of trend in the number of infections that, if maintained for a minimum period, would notably increase the chances of keeping the spread of disease under control. Results show that IR is a reliable indicator of the intensity of infection, and an effective measure for early monitoring and decision making in smart cities. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

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13 pages, 258 KiB

Open AccessReview

Tailored Physical Activity Interventions for Long COVID: Current Approaches and Benefits—A Narrative Review

by Guhua Jia and Chun-Hsien Su

Healthcare 2024, 12(15), 1539; https://doi.org/10.3390/healthcare12151539 - 3 Aug 2024

Viewed by 1444

Abstract

This narrative review explores the essential role of physical activity in managing long COVID, which is characterized by persistent symptoms such as fatigue, breathlessness, and cognitive impairments following SARS-CoV-2 infection. In this context, “physical activity” includes various exercises, such as aerobic and resistance training, as well as flexibility and balance exercises, thereby encompassing the subset known as “exercise”. The methodology involved a comprehensive literature search across PubMed, EBSCO (EDS), and Google Scholar, selecting peer-reviewed articles from December 2019 to June 2024 focusing on long COVID physical activity interventions. The review highlights that tailored exercise programs, adjusted to individual health status and abilities, significantly alleviate symptoms and enhance psychological well-being. Key findings emphasize the importance of personalized exercise prescriptions due to the variability in patient responses and the need for a multidisciplinary approach in developing and monitoring interventions. Despite promising outcomes, the review identifies research gaps, including the need for long-term studies, randomized controlled trials, and deeper mechanistic insights. It suggests that standardized reporting, templates like the Consensus on Exercise Reporting Template (CERT), and integrating digital health tools are essential for optimizing interventions. Overall, the review advocates including personalized physical activity or exercise programs in standard care for long COVID to improve patient outcomes and quality of life. Full article

(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)

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