Search Results (2,342)

Background: Healthcare workers (HCWs) are at occupational risk from COVID-19. Understanding the profile of infected HCWs is important to guide workplace protections. Objectives: To describe the demographic and clinical characteristics of HCWs infected with COVID-19 and to examine factors associated with vaccination status among infected HCWs. Methods: The study design was cross-sectional, using medical records from health workers working in a tertiary teaching facility in Gauteng, South Africa, from 12 May 2021 to 11 May 2022. The data were analysed using univariate and multiple logistic regression analysis. Statistical significance was set at p < 0.05. Results: A total of 1235 HCW records were included. The age ranged from 17 to 64 years. The median age was 38 years (IQR: 32–48). Nurses accounted for the largest proportion of cases, followed by healthcare assistants and physicians. Female sex, older age, and comorbidity were associated with higher odds of being vaccinated among infected HCWs. Conclusions: This study provides a descriptive profile of HCWs infected with COVID-19 during the third and fourth wave transition in South Africa. The findings highlight demographic and clinical factors linked to vaccination status among infected HCWs and underscore the continued need for infection prevention and control measures to protect frontline staff. Full article

Background/Objectives: The COVID-19 pandemic significantly disrupted healthcare systems and blood supply chains. This study aimed to analyze blood transfusion trends across three distinct clinical departments in a Hungarian tertiary care clinical center and to examine the relationship between these trends and the pandemic waves. Methods: A retrospective analysis of hospitalization and transfusion data from the Departments of Anesthesiology and Intensive Therapy, Surgery, and the Division of Hematology at the University of Pécs Clinical Centre was performed between 1 January 2020, and 31 December 2023. Generalized additive models were employed to assess the association between available predictors and the odds and volume of red blood cell transfusions. Results: At the Department of Anesthesiology and Intensive Therapy, the median weekly ratio of transfused patients fell from 50% (pre-pandemic) to 9.76% (third wave of pandemic). COVID-19 diagnosis was associated with lower odds of receiving transfusion (OR: 0.23) and with a lower incidence rate ratio of transfused red blood cells (IRR: 0.22). At the Department of Surgery, the median weekly ratio of transfused patients was consistently low and stable (9–10%) throughout the study period. The number of patients remained relatively stable at the Division of Hematology during the study period, expressing a higher odds of receiving transfusion during the second (OR: 2.63) and fourth (OR: 1.52) pandemic waves. Conclusions: The pandemic’s impact on transfusion practice, driven by indirect various consequences of patient redirection and protocol modifications, was most expressed at the Department of Anesthesiology and Intensive Therapy. Similar changes in transfusion practice may be anticipated in the event of another pandemic outbreak. Full article

Intergenerational contact is a key component of the informal support systems that contribute to the wellbeing of older adults. As societies age and migration patterns diversify family structures, understanding how contact is sustained across generations becomes increasingly relevant for health equity and the sustainability of care systems. In this study, we conceptualise sustainability not in environmental terms but as social and health-system sustainability—that is, the long-term ability of families and care systems to maintain intergenerational ties, ensure equitable access to support, and remain resilient under demographic and social pressures. Drawing on theories of intergenerational solidarity and social capital, this study situates contact as both a resource for individual wellbeing and a pillar of care sustainability in diverse societies. We examine the frequency of contact between parents and adult children among adults aged 50 and above, comparing migrant and non-migrant populations across 25 European countries. Using data from Waves 7, 8, and the COVID-19 wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), we assess both in-person and digital forms of contact before and during the pandemic. Results show that older migrants have less frequent contact with parents but more frequent contact with children than do non-migrants, with similar patterns attested across repeated cross-sections (2017, 2019, 2021). The strong contact observed in each cross-section, facilitated by digital tools, implies resilient family ties under public-health stress. However, resilience is uneven: weaker contact with parents among migrant populations reflects structural barriers such as visa restrictions, caregiving responsibilities, discrimination, language barriers, and unequal digital access. Moreover, differences in access and proficiency with digital tools suggest that digital contact did not compensate equally across groups. These findings underscore the importance of sustainable and inclusive strategies in ageing and health policy. Specifically, targeted digital literacy programmes for older migrants, policies supporting transnational caregiving, affordable internet access, mobility solutions, and anti-discrimination measures in family visitation are crucial to reducing inequities. Full article

This study aims to propose a plausible application of a novel electrochemical biosensing system for detecting antibodies against SARS-CoV-2 (anti-rS) in serum samples. The uniqueness of this study lies in the biosensor utilizing recombinant spike glycoprotein (SCoV2-rS) immobilized on an indium tin oxide (ITO) electrode modified with (3-aminopropyl)triethoxysilane (APTES). The electrochemical performance was evaluated using square wave voltammetry (SWV), demonstrating a linear relationship between the current density and anti-rS concentration. The limit of detection (LOD) was found to be 113 ng/mL (0.75 nM), and the limit of quantitation (LOQ) was equal to 338 ng/mL (2.25 nM). The reported electrochemical biosensor offers a straightforward and efficient method for evaluating the immune status of individuals who have recovered from COVID-19 and been vaccinated against this virus without the need for any redox probe. Full article

Background/Objectives: Monitoring community health and tracking SARS-CoV-2 evolution were critical priorities throughout the COVID-19 pandemic. However, widespread shortages of personal protective equipment, the necessity for social distancing, and the redeployment of healthcare personnel to clinical duties presented significant barriers to traditional sample collection. Methods: In this study, we evaluated the feasibility of using self-collected saliva specimens for the qualitative detection of SARS-CoV-2 infection. Following confirmation of reliable viral detection in saliva, we established a large-scale surveillance program in Arizona, USA, to enable clinical diagnosis and genomic sequencing from self-collected samples. Between April 2020 and December 2023, we tested approximately 1.4 million saliva samples using RT-PCR, identifying 94,330 SARS-CoV-2 infections. Whole genome sequencing was performed on 69,595 samples, yielding 54,040 high-quality consensus genomes. Results: This surveillance approach enabled real-time monitoring of general infection trends that matched regional case counts. We monitored multiple wave-like introductions of viral lineages over the course of the pandemic. We identified three periods of S gene target failure on a commercial assay and assessed its ability to make fast, genotyping assignment during the pandemic (PPV = 0.98, 95% CI = 0.97–0.99; NPV = 0.94, 95% CI = 0.94–0.96). The co-location of clinical testing and sequencing capabilities within the same facility resulted in low turnaround time from the sample collection to the generation of sequencing data (median = 12 days, IQR: 9.0–19.75). Conclusions: Our findings support the use of self-collected saliva as a scalable, cost-effective, and practical strategy for infectious disease surveillance in future pandemics. Full article

The SARS-CoV-2 pandemic presents a broad clinical spectrum from asymptomatic cases to severe respiratory failure with high mortality. Severe COVID-19 is characterized by immune dysregulation, including lymphopenia and alterations in the counts of T, B, and NK cells in peripheral blood. Due to the limited data on long-term outcomes related to immune dysregulation, we aimed to analyze immunologic features at baseline in severe and mild COVID-19 cases and assess follow-up characteristics associated with later mortality and long-COVID signs. We included adult patients consecutively hospitalized with COVID-19 between June and November 2020 at the University Hospital in Kraków, corresponding to the first and second waves of COVID-19 in Poland. We enrolled only those who had been thoroughly assessed in terms of clinic and laboratory data, including immunological workups, and survived the acute phase of the disease. In 2025, between February and April (median time of follow-up: 54 months), we conducted a telephone questionnaire on long-COVID symptoms among survivors who had given their consent. Statistical analyses were performed to compare groups with severe and mild disease in terms of dysregulation in lymphocyte subpopulations and the follow-up outcomes. The study included 103 COVID-19 patients, comprising 53 severe (based on the need for at least high-flow nasal oxygen therapy) and 50 mild cases, with no differences in age, sex, and body mass index. Severe COVID-19 patients compared to mild cases had lower CD3+ T cells (count and percentage), CD4+ T cells (count and percentage), CD8+ T cells (count), and NK cells (count), but higher CD19+ B cells (percentage) at baseline (p < 0.05, all). At the time of follow-up, we evaluated 80 patients (77.7% of the baseline participants), with 23 (22.3%) patients lost to follow-up. Among patients analyzed in the follow-up, 23 (28.8%) had died, and 29 of the 57 survivors (50.9%) reported persistent long-COVID symptoms. Patients who died had significantly lower baseline counts of CD3+ T cells (377 vs. 655 cells/µL), CD4+ T cells (224 vs. 372 cells/µL), CD8+ T cells (113 vs. 188 cells/µL), and NK cells (118 vs. 157 cells/µL) compared to survivors (p < 0.05, all). Notably, the percentage of CD19+ B cells was higher in deceased individuals (19.2% vs. 13.5%; p = 0.049). In contrast, we did not document differences in baseline immunological data among survivors with and without long-COVID signs. Our study suggests that dysregulation in lymphocyte subpopulations during the COVID-19 acute phase may be associated with increased late mortality, but not with the persistence of long-COVID symptoms. Full article

Background: Rapid aging and dietary Westernization in Korea have raised concerns about shifting nutrition and lifestyle patterns. Objectives: This study examined 10-year trends in nutrient intake, biochemical indicators, meal-related behaviors, and sedentary time among Korean adults, stratified by age group. Methods: Data were drawn from the 6th–9th waves (2013–2022) of the Korea National Health and Nutrition Examination Survey (KNHANES) for a cross-sectional analysis, including 61,688 participants (18–39 years: 17,225; 40–64 years: 28,045; ≥65 years: 16,218). Survey-weighted linear and logistic regression analyses were used to test linear trends and between-period contrasts (2013–2015 vs. 2020–2022). Results: Total energy intake declined significantly from 2087 kcal in 2013–2015 to 1823 kcal in 2022 (p for trend < 0.001), accompanied by a decrease in carbohydrate share (62.8% to 58.3%, p < 0.001) and increases in protein (13.8% to 15.4%, p < 0.001) and fat (19.0% to 23.4%, p < 0.001). Saturated fat and cholesterol intake increased significantly, particularly among older adults (+50.9% and +46.4%, respectively; both p < 0.001). The proportion of breakfast skippers increased significantly, more than 35% in 2022 (p < 0.001). Conversely, the frequency of eating out decreased (p < 0.001), with a particularly pronounced decline during the COVID-19 period. Sedentary time steadily and significantly increased over the decade (p < 0.001). Conclusions: Over the past decade, Korean adults have shifted toward lower energy and carbohydrate intake, higher protein and fat consumption, and more sedentary lifestyles. Differences in vulnerability by age emphasize the need for personalized public health strategies: promoting protein intake and reducing sedentary time for older adults, while improving dietary patterns and managing weight for younger generations. Full article

Introduction: Long COVID (LC) is associated with an increase in cardiovascular risk and chronic inflammation, whereas the Mediterranean Diet (MD) seems to improve the aforementioned factors. The aim of this study is to analyse the relationship between MD and its components with vascular structure, function, and aging in patients diagnosed with LC globally and by sex. Methods: This study was a cross-sectional study with 304 subjects diagnosed with LC; 207 were women and 97 men. Adherence to MD was evaluated with a validated MEDAS questionnaire, composed of 14 items. The vascular structure was assessed using carotid intima-media thickness (cIMT). Three measurements were carried out to evaluate vascular function: cardio-ankle vascular index (CAVI), brachial-ankle pulse wave velocity (baPWV), and carotid-femoral pulse wave velocity (cfPWV). Vascular aging index (VAI) was estimated. Results: The MD score was 7.80 ± 2.33, with no difference between sexes. Vascular function and aging parameter values were higher in men than in women. Use of olive oil as the principal source of fat for cooking, and consuming <1 serving of butter/day and <1 sugar-sweetened beverage/day showed >90% adherence. Logistic regression analysis displayed associations between cIMT < 0.625 and use of olive oil in the global analysis (OR = 0.148) and among men (OR = 0.120), and <2 commercial pastries/week in global (OR = 0.536). cfPWV < 7.400 m/s was associated with DM score ≥ 8 in global (OR = 0.444) and in women, as well as with <2 pastries/week in women (OR = 0.405). baPWV < 12.315 m/s was associated with ≥3 servings of pulses/week in global (OR = 0.481) and among women, as was <2 pastries/week in global (OR = 0.471) and in women. CAVI < 7.450 was associated with ≥4 tablespoons of olive oil/day in men. VAI < 63.693 was associated with DM score ≥ 8 in global (OR = 0.458) and in women, as well as <2 pastries/week in global (OR = 0.392). Conclusions: Adherence to MD was associated with lower cfPWV and VAI measures in the global analysis and among women. In particular, several of the components were associated with a better vascular profile in LC patients. Full article

COVID-19 severity is frequently linked to exacerbated inflammation, with the inflammasome pathway playing a key role in activating inflammatory interleukins. This observational post-mortem study evaluated the expression of inflammasome-associated molecules in patients who died from COVID-19 during the second wave. Minimally invasive autopsies were performed on patients from the first (n = 24) and second (n = 18) waves. Lung tissue samples underwent immunohistochemical staining for ACE-2, TLR-4, NF-κB, TNF-α, NOX4, NLRP3, ASC, CASPASE-1, IL-1β, IL-18, GSDMD, and CASPASE-9. Additionally, genetic polymorphisms within inflammasome-related genes were assessed via real-time polymerase chain reaction. Lung tissue expressions of TLR-4, NLRP3, and IL-18 were significantly higher in patients from the second wave compared to those from the first, with expression levels of 26.3 versus 12.1, 13.9 versus 6.4, and 25.6 versus 3.8, respectively. The A allele at rs4648090 of NFKB1 and the T allele at rs317155 of NOX4 were associated with increased corresponding protein expression by factors of 5.1 and 8.9, respectively. Notably, IL-18 demonstrated substantial immunological relevance, correlating strongly with elevated expression linked to these genetic variants in second wave cases. These findings suggest that the inflammasome pathway harbors biologically meaningful molecules implicated in severe COVID-19, meriting further investigation for their potential as diagnostic or therapeutic targets. Full article

The COVID-19 pandemic has placed a considerable psychological burden on healthcare workers, potentially leading to increased burnout and anxiety. This study aimed to evaluate burnout and anxiety levels among healthcare workers compared to non-healthcare professionals during the pandemic. We initially recruited 438 adults; 351 (217 HCWs and 134 non-HCWs) provided complete responses across all three survey waves and were analyzed. Burnout was assessed using the Maslach Burnout Inventory, and anxiety with the State–Trait Anxiety Inventory. Data were collected through an online self-administered survey at three different time points during the pandemic, and analyzed with non-parametric tests and effect sizes. Healthcare workers exhibited significantly higher levels of emotional exhaustion, depersonalization, overall burnout, and anxiety compared to non-healthcare workers across all three periods (p < 0.05). Of 438 consented individuals, 351 (80.1%) completed all waves, allowing within-population longitudinal comparisons. Within the healthcare worker group, women, individuals living alone, those working night shifts, and those considering a career change had notably higher burnout and anxiety scores. No significant differences were observed in personal accomplishment scores. Healthcare workers experienced greater psychological distress than non-healthcare workers during the COVID-19 pandemic. Identifying vulnerable subgroups and implementing supportive strategies are essential to protect the mental health and well-being of healthcare professionals during pandemics and similar crises. Full article

Prenatal physical activity (PA) has well-established benefits for maternal mental health. However, PA levels are generally low among pregnant individuals and were even lower during the COVID-19 pandemic. Since walking is the most popular form of prenatal PA, we aimed to examine associations between walking in the third trimester of pregnancy and mental health symptoms of depression, anxiety, pregnancy-related anxiety and perceived stress during the pandemic. Relevant pandemic-related factors (e.g., COVID-19 waves, population density) associated with walking were also studied. Pregnant individuals were recruited across Quebec (Canada) between October 2020 and September 2022, as part of the Resilience and Perinatal Stress during the Pandemic (RESPPA) study. Analyses were conducted on data collected via online questionnaires during the third trimester (n = 1086). Results revealed that higher levels of walking were significantly associated with lower symptoms of generalized anxiety (β = −0.06, p = 0.035), and perceived stress (β = −0.07, p = 0.007). Living in a more densely populated area, living with fewer children at home and having a university degree were associated with higher levels of walking. Those who completed their questionnaire in the second pandemic wave also reported higher levels of walking. Our results highlight the potential of walking in the third trimester to support maternal mental health. Full article

Background/Objectives: Retail workers may have been at an increased risk of contracting SARS-CoV-2 during the COVID-19 pandemic. To better understand this group, we set up a longitudinal cohort to document the occurrence of SARS-CoV-2 infection, vaccination uptake and to study immune response. Methods: Participants were enrolled between 20 April and 22 October 2021 and attended up to 5 visits over 48 weeks. Information collected was: participant characteristics, SARS-CoV-2 detection tests performed, COVID-19 symptoms, and vaccination (influenza and SARS-CoV-2). Findings: We included 304 participants aged 18 to 75; of those, 117 had a first positive SARS-CoV-2 test, mostly (85.5%) during Omicron wave. Forty-two (13.8%) participants got seasonal influenza vaccine within the year (2020–2021) prior to the first visit, and 95.9% had received the primary series of 2 doses of SARS-CoV-2 vaccine by the beginning of Omicron wave. Participants vaccinated for influenza (adjusted hazard ratio (aHR) 2.48; 95% confidence interval (CI): 1.54–3.98) and older patients (aHR 2.39; 95% CI: 1.40–4.10), were more likely to get a first booster of SARS-CoV-2 vaccine compared to those who did not receive influenza vaccine. In contrast, participants who traveled (aHR 0,62; 95% CI: 0.43–0.91) or participated in frequent gatherings (aHR 0.58; 95% CI: 0.39–0.85) were less likely to be boosted. Conclusions: Variations in vaccine uptake that are usually observed within populations had little effect on completion of the primary SARS-CoV-2 vaccine series. However, these differences became apparent for booster doses, at a period during which most infections in this cohort were recorded. Full article

Background/Objectives: The post-COVID-19 condition frequently includes dysphonia. We aimed to assess objective and subjective voice disorders and short-term responses to multimodal therapy in patients with isolated post-COVID-19 dysphonia. Methods: This retrospective, single-center pre–post study screened 244 post-COVID-19 patients; a subset of 14 with isolated dysphonia underwent standardized assessment at baseline and at 1-month follow-up. Patient-reported outcomes (Voice Handicap Index, VHI; Voice-Related Quality of Life, V-RQOL) and endoscopic evaluation were performed using videolaryngostroboscopy (LVS) and high-speed videoendoscopy (HSV) with kymographic analysis to quantify parameters describing vocal fold oscillations. The treatment included short-term systemic corticosteroids, inhaled corticosteroids, hyaluronic-acid inhalations, and structured voice therapy. Results: At baseline, HSV revealed signs of glottal insufficiency—irregular and asymmetric vocal fold motion, reduced amplitude and pliability, a disrupted mucosal wave, and an increased open quotient. At follow-up, HSV showed increased oscillation, amplitude, and cycle regularity with reduced left–right asymmetry and phase differences; phonovibrograms displayed clearer and more structured patterns. Perturbation indices decreased across jitter and shimmer measures, and the mean fundamental frequency was lower. Improvements in instrumental measures aligned with better VHI and V-RQOL scores. Conclusions: In patients with persistent dysphonia after acute SARS-CoV-2 infection, comprehensive ENT evaluation with instrumental laryngeal assessment is warranted. Short-term multimodal management was associated with improvements in both HSV-derived measures and patient-reported outcomes; confirmation in controlled studies is needed. Full article

Background and Objectives: The COVID-19 pandemic has had severe and far-reaching repercussions for health systems and societies, creating a global mental health crisis that has persisted after the pandemic. This study examined differences in mental health (i.e., psychological distress and well-being) by gender and pandemic period (i.e., lockdown, second and third pandemic waves, the last year of the pandemic, and the post-pandemic period) among Spanish individuals in two stages of adulthood: established adulthood and midlife. The second objective was to identify the risk and protective factors for psychological distress and well-being during the post-pandemic period. Materials and Methods: The study design was repeated cross-sectionally. The non-probability sample included 3677 people (66.2% women) from the general Spanish population, aged 30 to 59 years. Participants were assessed between 1 June 2020 and 23 May 2024 using the following self-reports: the General Health Questionnaire-12 item version, the Scale of Positive and Negative Experience, the Brief Inventory of Thriving, the Satisfaction with Life Scale, the Rosenberg Self-Esteem Scale, the Social Support Scale, the Stressful Events Questionnaire, the Brief Resilience Scale, and the Perceived Vulnerability to Disease Questionnaire. Results: Although rates of psychological distress varied across pandemic periods, women consistently experienced higher rates than men. During the post-pandemic period, the rates of psychological distress were 47.5% for women in established adulthood and 34.7% for midlife women, compared to 28.6% and 22% for men, respectively. Low self-esteem was the main predictor of greater psychological distress and lower well-being for both genders and age groups in the post-pandemic period. Another significant predictor was lower stress resilience. Conclusions: The COVID-19 pandemic threatened women’s mental health and well-being more than men’s, and this threat persists after the pandemic, especially among women in established adulthood. The study’s findings are relevant for the design of policies, programs, and strategies to achieve better mental health and well-being among citizens and greater gender equality. Full article

Background/Objectives: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted cardiac surgery, limiting patient access and altering care quality. This study evaluates changes in cardiovascular disease severity, types, and postoperative complications in patients qualifying for coronary artery bypass grafting (CABG) during the pandemic. Methods: We performed a retrospective analysis of 1499 CABG patients at our institution between March 2018 and February 2022. Patients were categorised into two groups: pre-pandemic (March 2018 to February 2020, N = 853) and pandemic (March 2020 to February 2022, N = 646). We analysed and detailed data across three major COVID-19 waves in Poland. Results: During the COVID-19 pandemic, 646 patients underwent CABG, a 24.3% decline from 853 pre-pandemic procedures. Urgent procedures increased from 37.6% to 44%, and life-saving procedures rose from 2.9% to 5.2% (p < 0.05). The use of cardiopulmonary bypass increased, along with longer procedure times (median of 279.7 min vs. 315 min; p < 0.001). The duration of mechanical ventilation increased during the pandemic period (median 12 h vs. 11 h; p < 0.05). No significant differences in postoperative complications were noted. Analysis during the three COVID-19 waves showed consistent baseline characteristics. In the second wave, life-saving CABG procedures reached 11.4%, with 17.5% of patients presenting acute coronary symptoms. Conclusions: The COVID-19 pandemic reduced CABG procedures, prioritising urgent cases. Short-term mortality odds rose, despite unchanged patient risk profiles. More multicentre research is needed to understand resource constraints on cardiac surgical outcomes and to establish guidelines for patient prioritisation in future pandemics. Full article