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Article
A Survey of Changes in the Psychological State of Individuals with Social Withdrawal (hikikomori) in the Context of the COVID Pandemic
COVID 2023, 3(8), 1158-1172; https://doi.org/10.3390/covid3080082 - 08 Aug 2023
Viewed by 97
Abstract
Background: The coronavirus disease (COVID) 2019 pandemic has been reported to have resulted in psychological disturbances. The Japanese term “hikikomori” refers to a state of preferring to stay at home. The COVID pandemic provided an opportunity to extend our current understanding of hikikomori [...] Read more.
Background: The coronavirus disease (COVID) 2019 pandemic has been reported to have resulted in psychological disturbances. The Japanese term “hikikomori” refers to a state of preferring to stay at home. The COVID pandemic provided an opportunity to extend our current understanding of hikikomori by examining the psychological states of individuals who were in this state under lockdown, during which, paradoxically, their condition may have been adaptive. Methods: We administered a questionnaire to examine psychological changes among 600 people with hikikomori traits in Japan. The Hospital Anxiety and Depression Scale (HADS), Subjective Stress Scale, and Stigma Questions for hikikomori were administered retrospectively at three time points. We also collected descriptive data regarding the participants’ coping strategies. Results: The participants’ sense of stigma regarding hikikomori was improved during the pandemic, whereas depression and anxiety worsened. The participants with ‘definite’ hikikomori (they met the diagnostic criteria) reported more severe depression and anxiety than those with ‘possible’ hikikomori. Their coping strategies were adaptive to the pandemic situation. Conclusion: Although the sense of stigma against hikikomori was improved and adaptive strategies were employed, the participants with hikikomori experienced a worsening of depression and anxiety during the COVID lockdowns. The improvement of stigma and the participants’ indoor adaptive coping strategies could not ameliorate the mental state of hikikomori. Therapeutic interventions should be considered in the future for definite hikikomori meeting the criteria. Full article
(This article belongs to the Special Issue COVID and Post-COVID: The Psychological and Social Impact of COVID-19)
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Systematic Review
The Health System’s Response to and the Impact of COVID-19 on Health Services, Providers, and Seekers: A Rapid Review in the Wake of the Pandemic
COVID 2023, 3(8), 1106-1157; https://doi.org/10.3390/covid3080081 - 01 Aug 2023
Viewed by 655
Abstract
Background: The COVID-19 pandemic disrupted global healthcare systems, requiring rapid adaptations. This study evaluates the impact on health systems and services in India during the peak of the first wave and its aftermath. It analyses disruptions, adaptive measures, and challenges faced by healthcare [...] Read more.
Background: The COVID-19 pandemic disrupted global healthcare systems, requiring rapid adaptations. This study evaluates the impact on health systems and services in India during the peak of the first wave and its aftermath. It analyses disruptions, adaptive measures, and challenges faced by healthcare providers and seekers to enhance future preparedness. Methods: Primary studies conducted in India exploring the impact of COVID-19 on health services provision, utilisation, availability, and the well-being of providers and seekers were included. Electronic searches were conducted in six databases: PubMed, MEDLINE, Embase, Global Health, CINAHL, and the WHO database on COVID-19. The results were analysed using narrative synthesis. Results and Conclusion: The review examined 38 articles with 22,502 subjects. Health service provision, utilisation, and availability were significantly impacted, particularly in outpatient departments (n = 19) and elective services (n = 16), while emergency services remained sub-optimal (n = 20). Adaptations were made in precautionary measures, protocols, staff allocation, training, personal protective equipment (PPE), infrastructure, and resources. Providers faced mental health challenges including depression, stress (n = 14), fear of infection (n = 9), stigmatisation (n = 5), and financial repercussions (n = 5). Seekers also encountered notable challenges (n = 13). Future preparedness necessitates improved healthcare infrastructure, resource optimisation, and comprehensive protocols. Lessons should inform strategies to mitigate disruptions and prioritise the well-being of providers and seekers in future outbreaks. Full article
(This article belongs to the Special Issue How COVID-19 and Long COVID Changed Individuals and Communities)
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Review
COVID-19 and Chronic Kidney Disease: A Narrative Review
COVID 2023, 3(8), 1092-1105; https://doi.org/10.3390/covid3080080 - 31 Jul 2023
Viewed by 263
Abstract
The coronavirus disease-2019 (COVID-19) pandemic has had a profound impact on the world, causing loss of life, economic damage, and social disruption. Individuals with chronic kidney disease (CKD) are prone to complications and increased mortality related to COVID-19. Efforts have been made to [...] Read more.
The coronavirus disease-2019 (COVID-19) pandemic has had a profound impact on the world, causing loss of life, economic damage, and social disruption. Individuals with chronic kidney disease (CKD) are prone to complications and increased mortality related to COVID-19. Efforts have been made to increase understanding of the effects of COVID-19 in individuals with CKD. This paper aims to gather and discuss the state-of-the-art in the COVID-19 and CKD literature, involving the early history of COVID-19, the immunological aspects of CKD (such as abnormalities in neutrophilicand dendritic cells functions), the mechanisms of kidney injury by SARS-CoV-2 (for example, viral tropism to kidney tissue and direct cytotoxicity), the clinical course of the disease and consequences for CKD individuals (including kidney transplant recipients), and the emerging treatments (such as the use of Remdesivir, nirmatrelvir, and monoclonal neutralizing antibodies) and immunization for the CKD population. Full article
(This article belongs to the Special Issue COVID-19 in Nephrology)
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Article
Government Restriction Efficiency on Curbing COVID-19 Pandemic Transmission in Western Europe
COVID 2023, 3(8), 1079-1091; https://doi.org/10.3390/covid3080079 - 28 Jul 2023
Viewed by 286
Abstract
The World Health Organization (WHO)-confirmed pandemic (March 2020) of the new Coronavirus 2 severe acute respiratory syndrome infection (SARS-CoV-2) originated in Wuhan, China, in December 2019 (first reported cases), then spread to Italy and successively around the world. The objective of this study [...] Read more.
The World Health Organization (WHO)-confirmed pandemic (March 2020) of the new Coronavirus 2 severe acute respiratory syndrome infection (SARS-CoV-2) originated in Wuhan, China, in December 2019 (first reported cases), then spread to Italy and successively around the world. The objective of this study is to evaluate the effectiveness of the restrictions implemented by different governments from a statistical point of view. We quantitatively evaluated how restrictions influenced the temporal evolution of the distribution of the weekly number of hospitalized patients in the intensive care unit (ICU) for different countries that applied different levels of restrictions, which can be summarized with the average stringency index, a synthetic index that represents a metric for quantifying the severity of the restrictions applied. We found that the stringency index is strongly correlated with the distribution skewness, while standard deviation and kurtosis are poorly and moderately influenced. Furthermore, we compared the values of the skewness of the distribution of hospitalized patients during several pre-pandemic influenza outbreaks in Italy (data not available for other countries). Analysis shows that for normal flu, there is a substantial difference in skewness (as much as 70%) in the distribution with respect to the first COVID-19 pandemic outbreak, where social restrictions were applied. This large difference highlights that the restrictions implemented modify the symmetry of the peak of the distribution of the hospitalized patient in the ICU. Therefore, skewness can be used as a valid indicator to assess whether restriction has any effect on pandemic transmission and can be used as a support for decision makers. Full article
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Article
Retrospective Evaluation of the Effectiveness of COVID-19 Control Strategies Implemented by the Victorian Government in Melbourne—A Proposal for a Standardized Approach to Review and Reappraise Control Measures
COVID 2023, 3(8), 1063-1078; https://doi.org/10.3390/covid3080078 - 28 Jul 2023
Viewed by 300
Abstract
In evaluating the effectiveness of COVID-19 control measures, we propose a standardized approach to assess the impact of COVID-19 management on flattening the curve by analyzing the case data of Victoria, Australia. Its capital, Melbourne, is considered the most lock-downed city in the [...] Read more.
In evaluating the effectiveness of COVID-19 control measures, we propose a standardized approach to assess the impact of COVID-19 management on flattening the curve by analyzing the case data of Victoria, Australia. Its capital, Melbourne, is considered the most lock-downed city in the world. We used the daily case data from Victoria and their first time derivative and compared the dates when the six lockdowns were imposed with the start and end of the effective period, i.e., the period between the maximum and minimum acceleration. Lockdowns 1, 2 (Level 4 restrictions), 3, and 4 were found to be implemented too late, as they were expected to come into effect at the end or after the effective phase, and they were therefore ineffective. It was determined that Lockdown 2 (Level 3 restrictions) did not initiate the effective phase, and it was therefore ineffective, too. Lockdown 5 was expected to take effect in the second half of the effective phase, but showed no changes in the acceleration curve, and it was therefore also ineffective. Lockdown 6, implemented well before the effective period, did not flatten the curve, and was thus also found to be ineffective. The mask mandate between Lockdown 2 (Level 3 and 4 restrictions) initiated the effective phase (likely along with Lockdown 2, Level 3 restrictions), and was therefore found to effectively flatten the curve. The temporal relationship between the assumed cause (control measure) and the observed effect (flattening of the curve) is thus a crucial parameter for assessing the effect of control measures. Full article
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Communication
COVID Pandemics and Inland Transportation in the Brazilian Amazon: A Note on the Risks of Infection in Typical Passenger Vessels
COVID 2023, 3(8), 1052-1062; https://doi.org/10.3390/covid3080077 - 27 Jul 2023
Viewed by 316
Abstract
Located in the center of the largest river basin in the world, the State of Amazonas in Brazil has an extensive network of more than 20 thousand kilometers of navigable waterways, which is the main mode of transportation between localities, both for cargo [...] Read more.
Located in the center of the largest river basin in the world, the State of Amazonas in Brazil has an extensive network of more than 20 thousand kilometers of navigable waterways, which is the main mode of transportation between localities, both for cargo and passengers. The region is practically disconnected from the rest of the country due to the lack of roads. Thus, the Amazon River network acted as an efficient means of transmission of the new coronavirus (COVID-19), rapidly transforming the region into an epicenter of the pandemic with one of the highest infection rates in Brazil. Despite the adoption of national and state measures to combat new infections, the situation continued to deteriorate for reasons still under investigation. Given this scenario, this work aims to identify possible infection risks in typical passenger vessels used in the Brazilian Amazon. Three case studies of different passenger vessels were considered, discussing possible scenarios that could allow the spread of COVID and proposing some recommendations for infection prevention. It is hoped that this communication will contribute to the dissemination of information related to the typical means of long-distance passenger transport in the Amazon, to the planning of infectious disease prevention strategies on board regional ships and to ensure a sustainable future for the Amazonian population. Furthermore, this research aims to contribute to the sustainable development goals of the United Nations 2030 Agenda on health and well-being. Full article
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Article
Associations between Socio-Demographic Characteristics and Maternal Attitudes towards Childhood Vaccination in Cyprus—A Cross-Sectional Survey
COVID 2023, 3(7), 1042-1051; https://doi.org/10.3390/covid3070076 - 21 Jul 2023
Viewed by 357
Abstract
Background: As vaccination acceptance is dynamic, the current COVID-19 pandemic may have changed maternal perceptions towards childhood vaccination and influenced their decision to vaccinate their children. This study aimed to examine the associations between socio-demographic characteristics and maternal attitudes towards childhood vaccination at [...] Read more.
Background: As vaccination acceptance is dynamic, the current COVID-19 pandemic may have changed maternal perceptions towards childhood vaccination and influenced their decision to vaccinate their children. This study aimed to examine the associations between socio-demographic characteristics and maternal attitudes towards childhood vaccination at the beginning of the COVID-19 pandemic in Cyprus. Methods: A web-based cross-sectional study was conducted between April and June 2020 using a self-administered survey. Adult mothers with at least one child under the age of 18 were included in this study. Results: Overall, 703 mothers were included, with the majority of them strongly agreeing or agreeing that all vaccinations included in the National Vaccination Program should be available to children (89.3%), recognizing the usefulness of vaccines (91.4%) and their ability to provide protection (90%), acknowledging that the benefits of vaccination outweigh potential risks (86.6%), and being aware that some vaccines may cause adverse reactions (84.1%). Socio-demographic factors, particularly marital status, single-parent status, and employment status, have a significant impact on maternal attitudes and perceptions regarding childhood vaccination. Conclusions: Public health policies should be designed to overcome structural and healthcare system barriers specifically related to socio-demographic factors, ensuring effective and comprehensive strategies to improve childhood vaccination uptake. Full article
Brief Report
Extraction-Free RT-PCR Surveillance Testing and Reporting for SARS-CoV-2
COVID 2023, 3(7), 1031-1041; https://doi.org/10.3390/covid3070075 - 21 Jul 2023
Viewed by 432
Abstract
The COVID-19 pandemic necessitated sensitive, fast, and inexpensive testing for the virus in 2020 prior to the widespread availability of vaccines. Early testing efforts were limited by bottlenecks on reagents, low-throughput testing options, and the slow return of test results. In this paper, [...] Read more.
The COVID-19 pandemic necessitated sensitive, fast, and inexpensive testing for the virus in 2020 prior to the widespread availability of vaccines. Early testing efforts were limited by bottlenecks on reagents, low-throughput testing options, and the slow return of test results. In this paper, we detail the testing pipeline we established at the University of Wisconsin-Madison for rapid, inexpensive, and sensitive surveillance testing for SARS-CoV-2, and we highlight the strengths of the platform that would allow it to be applied to other disease surveillance projects, SARS-CoV-2 variant testing, or future pandemics. This pipeline can be quickly established for further accreditation and clinical application. Full article
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Opinion
Does Long COVID Exist in Sub-Saharan Africa?
COVID 2023, 3(7), 1024-1030; https://doi.org/10.3390/covid3070074 - 17 Jul 2023
Viewed by 393
Abstract
Billions of people have been impacted by the SARS-CoV-2 pandemic with over 600 million infections worldwide. Researchers have turned their attention to describing the post-viral phenomenon known commonly as “Long COVID”. While post-viral syndromes have been documented after other viral pandemics, the scale [...] Read more.
Billions of people have been impacted by the SARS-CoV-2 pandemic with over 600 million infections worldwide. Researchers have turned their attention to describing the post-viral phenomenon known commonly as “Long COVID”. While post-viral syndromes have been documented after other viral pandemics, the scale of the SARS-CoV-2 pandemic provides a unique opportunity to study and understand both the epidemiology and pathophysiology of the long COVID syndrome. While the pandemic impacted populations from all continents, there is a significant gap in what is known about long COVID on the sub-Saharan African continent. We review what is known about long COVID and highlight the need for further research within the African population. Full article
Article
Training Modifications in Endurance Athletes Due to COVID-19 Restrictions
COVID 2023, 3(7), 1011-1023; https://doi.org/10.3390/covid3070073 - 12 Jul 2023
Viewed by 414
Abstract
The aim of this study was to determine which characteristics of recreational, collegiate, and professional endurance athletes were associated with training changes due to COVID-19 safety restrictions. A Qualtrics survey was distributed to endurance athletes around the world from June 2020 to February [...] Read more.
The aim of this study was to determine which characteristics of recreational, collegiate, and professional endurance athletes were associated with training changes due to COVID-19 safety restrictions. A Qualtrics survey was distributed to endurance athletes around the world from June 2020 to February 2021. Significant differences between athlete characteristics and changes in training status were determined using a Chi-squared test (significance p < 0.05). Approximately 66% of the 331 endurance athletes changed their training due to restrictions. Significant group differences were found for age, sex, prior coaching status, prior use of a training program, and athlete primary sport compared to the whole sample. Understanding these factors may allow athletes/coaches to approach training in a different way to help minimize or prevent the effects of detraining for a greater portion of athletes should a COVID-19 variant or any other pandemic emerge in the future. Full article
Article
Detection of Neutralizing Antibodies in COVID-19 Patients from Steve Biko Academic Hospital Complex: A Pilot Study
COVID 2023, 3(7), 999-1010; https://doi.org/10.3390/covid3070072 - 03 Jul 2023
Viewed by 687
Abstract
A correlation between neutralization activity after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination and protection against coronavirus disease 2019 (COVID-19) has been demonstrated by several studies. Here, we detect SARS-CoV-2 neutralizing antibody (NAB) production in COVID-19 patients from the Steve Biko Academic [...] Read more.
A correlation between neutralization activity after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination and protection against coronavirus disease 2019 (COVID-19) has been demonstrated by several studies. Here, we detect SARS-CoV-2 neutralizing antibody (NAB) production in COVID-19 patients from the Steve Biko Academic Hospital complex (SBAH), South Africa (SA). Samples from COVID-19 patients (mild to severe) were collected. SARS-CoV-2 rapid assays, genotyping (Delta and Omicron variants) and enzyme-linked immunosorbent assays (ELISA) were performed. IBM® Statistical Package for the Social Sciences (SPSS®) version 28 was used for inferential statistical analysis, and the data were presented using the Prism9 software (version 9.4.1). A total of 137 laboratory-confirmed COVID-19 patients, 12 vaccine recipients and 8 unvaccinated participants were evaluated. The production of SARS-CoV-2 NABs was observed in some of the COVID-19 cases, mainly in severe cases, although this should be noted with caution due to the small sample size of this pilot study. NABs were also observed in asymptomatic participants, with the most being found in recipients (n = 6) of the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine. We found a strong presence of NABs in COVID-19 patients, specifically in mild and severe cases. Severe infection was associated with higher NAB production (82%). Full article
(This article belongs to the Special Issue Immune Responses in Coronavirus Disease)
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Review
Home Isolation and Online Support Strategies during Mild COVID-19 Pandemic Waves in Thailand: A Scoping Review
COVID 2023, 3(7), 987-998; https://doi.org/10.3390/covid3070071 - 30 Jun 2023
Viewed by 461
Abstract
Objectives: In 2021, Thailand experienced its fourth and fifth waves of COVID-19, overwhelming the nation’s public health system. The significant gap between health resources and the demand for services from patients was one of the primary challenges in responding to the catastrophic COVID-19 [...] Read more.
Objectives: In 2021, Thailand experienced its fourth and fifth waves of COVID-19, overwhelming the nation’s public health system. The significant gap between health resources and the demand for services from patients was one of the primary challenges in responding to the catastrophic COVID-19 pandemic. Hospitals were inundated with a surge in new patients, leading to a growing backlog of individuals suffering delayed care or even rejection from the healthcare system. To tackle this issue, strategies such as “outpatient self-isolation” (SI), “home-based isolation” (HI), and “community-based isolation” (CI) were implemented to stabilize COVID-19 cases with mild to moderate symptoms. This review aimed to explore the experiences in the management of COVID-19 care in patients with mild to moderate symptoms and identify challenges after the initial response of the Thailand health system to the pandemic. Methods: This study was conducted during the Delta pandemic (June–November 2021) and the Omicron pandemic (December 2021–15 March 2022). We present the lessons learned from the management of the HI system based on experiences gained at a university hospital, which provided remote professional-to-patient support during the pandemic. The study involved retrospective data from electronic medical records and qualitative analysis of responses provided during the pandemic using the HI system. Results: Data from a total of 2704 and 1912 participants were included in the analysis. The vast majority of patients were assigned to HI immediately after being diagnosed with COVID-19. This system facilitated remote consultations, provision of necessary medications, and delivery of survival kits to patients’ homes. Qualitative reviews indicated several key factors that could contribute to successful COVID-19 management under the HI system: (1) effective management and vaccine status, (2) establishment of home isolation using the find-test-trace-isolate-support system, and (3) adherence to home isolation guidelines and system support. Challenges included the digitalization of tools for securing isolation, team preparedness and adequate support system during HI, as well as hospital policies for psychological support for healthcare workers and measures to alleviate their workload. Conclusions: Our investigation suggests that the HI teleconsultation system was an effective approach to managing COVID-19. It allowed for a prompt response to patients’ needs and provided timely access to medical support, particularly for individuals with mild to moderate symptoms. Full article
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Review
Harnessing Antiviral Peptides as Means for SARS-CoV-2 Control
COVID 2023, 3(7), 975-986; https://doi.org/10.3390/covid3070070 - 29 Jun 2023
Viewed by 479
Abstract
Several times during the past two decades, epidemic viral diseases created global challenges. Although many solutions have been proposed to deal with this tight spot, it is still believed that public vaccination represents the most effective strategy to handle it. So far, various [...] Read more.
Several times during the past two decades, epidemic viral diseases created global challenges. Although many solutions have been proposed to deal with this tight spot, it is still believed that public vaccination represents the most effective strategy to handle it. So far, various kinds of vaccines including protein subunits, virus-like particles, inactivated, live attenuated, viral vectors, RNA, and DNA vaccines have been used in the prevention of COVID-19. Among the various categories of vaccines, peptide vaccines have created a new hope for quick and trustworthy access due to the development of proteomics equipment. This review specifically focuses on vaccines and peptide therapies in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). We consider here the efficacy and safety of subunit and synthetic peptides vaccine in clinical trial phases. Furthermore, monoclonal antibodies with the ability to suppress the development of SARS-CoV-2, those candidates that have entered into clinical trials until March 2023, were selected and evaluated. Full article
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Article
Assessing COVID-19 Effects on Inflation, Unemployment, and GDP in Africa: What Do the Data Show via GIS and Spatial Statistics?
COVID 2023, 3(7), 956-974; https://doi.org/10.3390/covid3070069 - 28 Jun 2023
Viewed by 395
Abstract
What are the effects of Corona Virus Disease 19 (COVID-19) on inflation, unemployment, and GDP in Africa? Using geo-coded cross-sectional data taken from the World Health Organization and International Monetary Fund, we investigate the spatial distribution of COVID-19 and its effects on inflation, [...] Read more.
What are the effects of Corona Virus Disease 19 (COVID-19) on inflation, unemployment, and GDP in Africa? Using geo-coded cross-sectional data taken from the World Health Organization and International Monetary Fund, we investigate the spatial distribution of COVID-19 and its effects on inflation, unemployment, and Gross Domestic Product (GDP) in Africa by employing the Geographic Information System (GIS), multivariate analysis of covariance (MANCOVA), and spatial statistics. The entire dataset was analyzed using Stata, ArcGIS, and R software. The result shows (1) that there is evidence of a spatial pattern of COVID-19 cases and death rate clustering behavior in Africa, verifying the existence of spatial autocorrelation. The result also reveals (2) that COVID-19 has a negative effect on unemployment, inflation, and GDP in Africa. We confirmed that (3) temperature, rainfall, and humidity were statistically significantly associated with the spread of the COVID-19 pandemic in Africa. The comparison of the GDP of African countries before and after the pandemic shows (4) a large decrease in GDP, the highest in Seychelles (23 percent). The result of the study shows (5) that there has been a significant increase in inflation and unemployment rates in all countries since the outbreak of the pandemic as compared to the time before the outbreak. There is also evidence that (6) there is a significant relationship between death rate due to COVID-19 and population density; temperature with COVID-19 cases and death rate; and precipitation with death rate due to COVID-19. Therefore, respective governments and the international community need to pay attention to controlling/reducing the impact of COVID-19 on inflation, unemployment, and GDP, focusing on the indicated demographic and environmental variables. Full article
(This article belongs to the Special Issue Analysis of Modeling and Statistics for COVID-19)
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Article
Agent-Based Modeling to Simulate Aerosolized Transmission of SARS-CoV-2 inside Small Ventilated Spaces
COVID 2023, 3(7), 937-955; https://doi.org/10.3390/covid3070068 - 24 Jun 2023
Viewed by 361
Abstract
Deterministic and stochastic models for aerosol virus spread have become aplenty in the last several years. We believe it is important to explore all avenues of models and look to expand the current repertoire of models in this domain using a simple stochastic [...] Read more.
Deterministic and stochastic models for aerosol virus spread have become aplenty in the last several years. We believe it is important to explore all avenues of models and look to expand the current repertoire of models in this domain using a simple stochastic agent-based method. The goal is to understand if this type of agent model is applicable to real-life scenarios and to discuss possible policy implications of our findings on disease spread through aerosols in small spaces with ventilation using our developed model. We apply our agent model to see how different spatial organizations of an infected individual impact infections and their distributions. We also perform some sensitivity analysis with regard to both how different vectors of infection change overall infectivity rates but also how different levels of ventilation and filtration can impact infectivity as well. Our findings show that the simple stochastic movement of particles should be explored further with regard to agent-based disease spread models, and that filtration plays a large role in determining the overall infection rate of people in small spaces with an infector. We also found that placement of the index infector with regard to other susceptible people and ventilation play an impactful role in how a disease may spread in a short time frame within small confines. Full article
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