Wave Of Pandemic Research Articles

Healthcare worker burnout during a persistent crisis: a case-control study.

During the immediate outbreak of the COVID-19 pandemic, burnout symptoms increased among healthcare workers. Knowledge is needed on how early symptoms developed during the persistent crisis that followed the first pandemic wave. To investigate if high levels of burnout symptoms during the first pandemic wave led to high burnout and depressive symptoms up to a year later, and if participation in psychological support was related to lower levels of symptoms. A longitudinal case-control study followed 581 healthcare workers from two Swedish hospitals. Survey data were collected with a baseline in May 2020 and three follow-up assessments until September 2021. The case group was participants reporting high burnout symptoms at baseline. Logistic regression analyses were performed separately at three follow-ups with case-control group assignment as the main predictor and burnout and depression symptoms as outcomes, controlling for frontline work, changes in work tasks and psychological support participation. One out of five healthcare workers reported high burnout symptoms at baseline. The case group was more likely to have high burnout and depressive symptoms at all follow-ups. Participation in psychological support was unrelated to decreased burnout and depressive symptoms at any of the follow-ups. During a persistent crisis, healthcare organizations should be mindful of psychological reactions among staff and who they place in frontline work early in the crisis. To better prepare for future healthcare crises, preventive measures on burnout are needed, both at workplaces and as part of the curricula in medical and nursing education.

The effect of risk of contracting and fear of COVID-19 on burnout and job satisfaction in Polish teachers

BackgroundFear of COVID-19 and its related complications can negatively affect well-being and contribute to less effective daily and professional functioning. Based on Maslach’s burnout concept, this study aimed to verify the relationship between risk of contracting and fear of COVID-19, occupational burnout and job satisfaction in Polish teachers during the second wave of the COVID-19 pandemic.Participants and procedureThree hundred fifty-two teachers, aged between 22 and 68, participated in this study. In the studied sample, 252 people worked remotely, 41 in-person and 59 were hybrid workers. The Risk of Contracting COVID-19 Scale, the Fear of COVID-19 Scale, the Maslach Burnout Inventory and the Brief Job Satisfaction Scale were used.ResultsRisk of contracting COVID-19 was positively related to fear of COVID-19 and emotional exhaustion. Moreover, fear of COVID-19 was negatively related to personal accomplishment and positively related to emotional exhaustion. Lastly, all three dimensions of occupational burnout were significantly related to job satisfaction. There was no direct relationship between fear of COVID-19 and job satisfaction. This relation was mediated by two scales of occupational burnout: personal accomplishment and emotional exhaustion. All three subscales of occupational burnout were significant predictors of job satisfaction, explaining 53% of its variance.ConclusionsThe current study showed a relationship between the risk perception of COVID-19, occupational burnout and job satisfac-tion in Polish teachers during the second wave of the COVID-19 pandemic. The results obtained in the study may contrib-ute to the understanding of the effects of the pandemic for the professional group of educators.

Integrating Wastewater-Based Epidemiology and Mobility Data to Predict SARS-CoV-2 Cases

Wastewater-based epidemiology has garnered considerable research interest, concerning the COVID-19 pandemic. Restrictive public health interventions and mobility limitations are measures to avert a rising case prevalence. The current study integrates WBE monitoring strategies, Google mobility data, and restriction information to assess the epidemiological development of COVID-19. Various SARIMAX models were employed to predict SARS-CoV-2 cases in Liechtenstein and two Austrian regions. This study analyzes four primary strategies for examining the progression of the pandemic waves, described as follows: 1—a univariate model based on active cases; 2—a multivariate model incorporating active cases and WBE data; 3—a multivariate model considering active cases and mobility data; and 4—a sensitivity analysis of WBE and mobility data incorporating restriction policies. Our key discovery reveals that, while WBE for SARS-CoV-2 holds immense potential for monitoring COVID-19 on a societal level, incorporating the analysis of mobility data and restriction policies enhances the precision of the trained models in predicting the state of public health during the pandemic.

Non-Invasive Ventilation Support during Hospitalization for SARS-CoV-2 and the Risk of Venous Thromboembolism

Background/Objectives: Although SARS-CoV-2 infection is a significant risk factor for venous thromboembolism (VTE), data on the impact of the use of non-invasive ventilation support (NIVS) to mitigate the risk of VTE during hospitalization are scarce. Methods: Data for 1471 SARS-CoV-2 patients, hospitalized in a single hub during the first pandemic wave, were collected from clinical records, including symptom duration and type, information on lung abnormalities on chest computed tomography (CT), laboratory parameters and the use of NIVS. Determining VTE occurrence during hospital stays was the main endpoint. Results: Patients with VTE (1.8%) had an increased prevalence of obesity (26% vs. 11%), diabetes (41% vs. 21%), higher CHA2DS2VASC score (4, IQR 2–5 vs. 3, IQR 1–4, age- and sex-adjusted, p = 0.021) and cough (65% vs. 44%) and experienced significantly higher rates of NIVS (44% vs. 8%). Using a stepwise multivariate logistic regression model, the prevalence of electrocardiogram abnormalities (odds ratio (OR) 2.722, 95% confidence interval (CI) 1.039–7.133, p = 0.042), cough (OR 3.019, 95% CI 1.265–7.202, p = 0.013), CHA2DS2-VASC score > 3 (OR 3.404, 95% CI 1.362–8.513, p = 0.009) and the use of NIVS (OR 15.530, 95% CI 6.244–38.627, p < 0.001) were independently associated with a risk of VTE during hospitalization. NIVS remained an independent risk factor for VTE even after adjustment for the period of admission within the pandemic wave. Conclusions: Our study suggests that NIVS is a risk factor for VTE during hospitalization in SARS-CoV-2 patients. Future studies should assess the optimal prophylactic strategy against VTE in patients with a SARS-CoV-2 infection candidate to non-invasive ventilatory support.

Exploring the interplay between individual and family functioning during the COVID-19 pandemic: a cross-sectional study

AbstractFamily relationships are central to an individual’s development and influence their emotional, relational, and social trajectories. Optimal family functioning, encompassing emotional connections, communication patterns, and coping mechanisms, is pivotal to the well-being of individual family members, especially during challenging periods such as the COVID-19 pandemic. From this perspective, this study, conducted during the second wave of the COVID-19 pandemic in Italy, assessed the interplay between individual and family functioning. Utilizing Hill's ABC-X model, we explored how the pandemic (stressor) impacted family dynamics (resources), perceived individual affectivity and family efficacy (perception), thereby influencing family quality of life (outcome). Four hundred and four participants completed a battery of standardized questionnaires to evaluate perceived individual affectivity during the pandemic, family quality of life, family dynamics (cohesion, flexibility, and communication), family conflict, family efficacy, and family coping strategies. Positive affectivity was associated with better family quality of life and more adaptive family coping strategies. The sample reported a low family quality of life and low family cohesion, flexibility, and communication during the pandemic. A positive sense of family cohesion, flexibility, and communication was associated with better individual well-being, better family quality of life and efficacy, and less conflict. Family communication was the strongest predictor of family quality of life in the study sample. In conclusion, our results emphasize the importance of strengthening family and individual resilience in transforming post-pandemic challenges into psychological and familial growth opportunities.

Objective and subjective cognitive status after intensive care unit treatment for COVID-19

PurposeIntensive care unit (ICU) survivors can experience wide-ranging and long-lasting symptoms after hospital discharge. Cognitive impairment has received increased attention in relation to the COVID-19 pandemic and can affect patients’ long-term quality of life. This study aimed to investigate the prevalence of cognitive impairment using an objective neurocognitive test 6 and 12 months following ICU admission and possible predictive factors for scoring below the defined cut-off. We also explored the prevalence of subjective cognitive complaints at 12 months, including the associated factors. MethodsThis was a prospective observational study of a national cohort of COVID-19 ICU survivors during the three first pandemic waves in Norway. Data was collected by the Norwegian Intensive Care and Pandemic Registry and the study group. ResultsAt the six-month follow-up, 23.1% (95% CI [18.2─28.5]) of the 273 respondents scored below the cut-off on the Mini-MoCA, indicating mild cognitive impairment. At the 12-month follow-up, the prevalence declined to 11.1% (95% CI [7.5─15.6]) in 253 respondents. Older age (OR 1.06, 95% CI [1.02─1.12]) and depression (OR 1.25, 95% CI [1.07─1.55]) were associated with cognitive impairment at six months. At 12 months, almost half of the patients reported subjective cognitive complaints. Symptoms of mental health problems and fatigue were associated with subjective cognitive complaints in our exploratory analyses. ConclusionCognitive impairment declined significantly from 6 to 12 months in this cohort of COVID-19 ICU patients, while subjective cognitive complaints remained high at 12 months, perhaps attributed to a high total symptom burden.

Multicentral Agent-Based Model of Six Epidemic Waves of COVID-19 in the Nizhny Novgorod Region of Russian Federation

Relevance. To investigate the characteristics of the COVID-19 pandemic and introduce timely and effective measures, there is a need for models that can predict the impact of various restrictive actions or characteristics of disease itself on COVID-19 spread dynamics. Employing agent-based models can be attractive because they take into consideration different population characteristics (e.g., age distribution and social activity) and restrictive measures, laboratory testing, etc., as well as random factors that are usually omitted in traditional modifications of the SIR-like dynamic models. Aim. Improvement of the previously proposed agent-based model [23,24] for modeling the spread of COVID-19 in various regions of the Russian Federation. At this stage, six waves of the spread of COVID-19 have been modeled in the Nizhny Novgorod region as a whole region, as well as in its individual cities, taking into account restrictive measures and vaccination of the population. Materials and Methods. In this paper we extend a recently proposed agent-based model for Monte Carlo-based numerical simulation of the spread of COVID-19 with consideration of testing and vaccination strategies. Analysis is performed in MATLAB/ GNU Octave. Results. Developed multicentral model allows for more accurate simulation of the epidemic dynamics within one region, when a patient zero usually arrives at a regional center, after which the distribution chains capture the periphery of the region due to pendulum migration. Furthermore, we demonstrate the application of the developed model to analyze the epidemic spread in the Nizhny Novgorod region of Russian Federation. The simulated dynamics of the daily newly detected cases and COVID-19-related deaths was in good agreement with the official statistical data both for the region as whole and different periphery cities. Conclusions. The results obtained with developed model suggest that the actual number of COVID-19 cases might be 1.5–3.0 times higher than the number of reported cases. The developed model also took into account the effect of vaccination. It is shown that with the same modeling parameters, but without vaccination, the third and fourth waves of the epidemic would be united into one characterized by a huge rise in the morbidity rates and the occurrence of natural individual immunity with the absence of further pandemic waves. Nonetheless, the number of deaths would exceed the real one by about 9–10 times.

Changes in mental distress among employees during the three years of the COVID-19 pandemic in Germany.

The COVID-19 pandemic changed the future of work sustainably and led to a general increase in mental stress. A study conducted during the second and third pandemic wave with a retrospective survey of the first wave among 1,545 non-healthcare workers confirmed an increase in anxiety and depression symptoms and showed a correlation with the occupational SARS-CoV-2 infection risk. This online follow-up survey aims to examine changes in mental distress as the pandemic progressed in Germany and to identify factors influencing potential changes. Longitudinal data from 260 subjects were available for this analysis. Mental distress related to anxiety and depression symptoms, assessed by the Patient Health Questionnaire-4 (PHQ-4), and occupational risk factors were solicited at the end of 2022 and retrospectively at the fifth wave. Categorized PHQ-4 scores were modelled with mixed ordinal regression models and presented with odds ratios (OR) and 95% confidence intervals (95% CI). A previous diagnosis of a depressive or anxiety disorder was a strong risk factor for severe symptoms (OR 3.49, 95% CI 1.71-7.11). The impact of occupational SARS-CoV-2 infection risk on mental distress was increased, albeit failing to reach the formal level of statistical significance (high risk OR 1.83, 95% CI 0.59-5.63; probable risk OR 1.72, 95% CI 0.93-3.15). Mental distress was more pronounced in those with a previous diagnosis of anxiety and depression. Confirmed occupational risk factors were protective measures against occupational SARS-CoV-2 infection perceived as inadequate, chronic work-related stress, overcommitment, reduced interactions with fellow-workers, and work-privacy conflicts. The pandemic had a negative impact on anxiety and depression symptoms among the studied non-healthcare workers, particularly early in the pandemic, although this effect does not appear to be permanent. There are modifiable risk factors that can protect workers' mental health, including strengthening social interactions among employees and reducing work-privacy conflicts.

The impact of the COVID-19 pandemic on 397 631 elective dental admissions among the under-25s in England: a retrospective study.

COVID-19 caused widespread disruptions to health services worldwide, including reductions in elective surgery. Tooth extractions are among the most common reasons for elective surgery among children and young people (CYP). It is unclear how COVID-19 affected elective dental surgeries in hospitals over multiple pandemic waves at a national level. Elective dental tooth extraction admissions were selected using Hospital Episode Statistics. Admission trends for the first 14 pandemic months were compared with the previous five years and results were stratified by age (under-11s, 11-16s, 17-24s). The most socioeconomically deprived CYP comprised the largest proportion of elective dental tooth extraction admissions. In April 2020, admissions dropped by >95%. In absolute terms, the biggest reduction was in April (11-16s: -1339 admissions, 95% CI -1411 to -1267; 17-24s: -1600, -1678 to -1521) and May 2020 (under-11s: -2857, -2962 to -2752). Admissions differed by socioeconomic deprivation for the under-11s (P<0.0001), driven by fewer admissions than expected by the most deprived and more by the most affluent during the pandemic. Elective tooth extractions dropped most in April 2020, remaining below pre-pandemic levels throughout the study. Despite being the most likely to be admitted, the most deprived under-11s had the largest reductions in admissions relative to other groups.

Urban-rural disparities in COVID-19 hospitalisations and mortality: A population-based study on national surveillance data from Germany and Italy.

Recent literature has highlighted the overlapping contribution of demographic characteristics and spatial factors to urban-rural disparities in SARS-CoV-2 transmission and outcomes. Yet the interplay between individual characteristics, hospitalisation, and spatial factors for urban-rural disparities in COVID-19 mortality have received limited attention. To fill this gap, we use national surveillance data collected by the European Centre for Disease Prevention and Control and we fit a generalized linear model to estimate the association between COVID-19 mortality and the individuals' age, sex, hospitalisation status, population density, share of the population over the age of 60, and pandemic wave across urban, intermediate and rural territories. We find that in what type of territory individuals live (urban-intermediate-rural) accounts for a significant difference in their probability of dying given SARS-COV-2 infection. Hospitalisation has a large and positive effect on the probability of dying given SARS-CoV-2 infection, but with a gradient across urban, intermediate and rural territories. For those living in rural areas, the risk of dying is lower than in urban areas but only if hospitalisation was not needed; while for those who were hospitalised in rural areas the risk of dying was higher than in urban areas. Together with individuals' demographic characteristics (notably age), hospitalisation has the largest effect on urban-rural disparities in COVID-19 mortality net of other individual and regional characteristics, including population density and the share of the population over 60.

Revisiting the interdependences across global base metal futures markets: Evidence during the main waves of the COVID-19 pandemic

This paper examines the correlation and connectedness across global base metal futures markets in the periods before and during the COVID-19 pandemic. We find that the impacts of the pandemic shock on the dynamic correlations between global commodity exchanges vary across futures markets, with significant structural breaks being detected in the underlying dynamic correlations at different stages of the pandemic. We document that stronger price signals were generated in the aggregate markets due to the pandemic shock, and the roles of copper and zinc futures as the pricing center in the global base metal markets increased during the pandemic period. Moreover, our findings show that the leading position of the London Metal Exchange in the global base metal futures pricing declined, while the pricing authority of the Shanghai Futures Exchange improved significantly during the pandemic time. Leveraging post-pandemic data, we identify interdependence structures amid some crucial geopolitical conflicts.

The experience of surgical cancer patients during the COVID-19 pandemic at a large cancer centre in London.

The COVID-19 pandemic has had an enormous impact on the experiences of patients across all health disciplines, especially those of cancer patients. The study aimed to understand the experiences of cancer patients who underwent surgery during the first two waves of the pandemic at Guy's Cancer Centre, which is a large tertiary cancer centre in London. A mixed-methods approach was adopted for this study. Firstly, a survey was co-designed by the research team and a patient study group. Patients who underwent surgery during the COVID-19 pandemic were invited to take part in this survey. Results were analysed descriptively. Three discussion groups were then conducted to focus on the main themes from the survey findings: communication, COVID-19 risk management and overall experience. These discussion groups were transcribed verbatim and underwent a thematic analysis using the NVivo software package. Out of 1657 patients invited, a total of 250 (15%) participants took part in the survey with a mean age of 66 (SD 12.8) and 52% females. The sample was representative of a wide range of tumour sites and was reflective of those invited to take part. Overall, the experience of the cancer patients was positive. They felt that the safety protocols implemented at the hospital were effective. Communication was considered key, and patients were receptive to a change in the mode of communication from in-person to virtual. Despite the immense challenges faced by our Cancer Centre, patients undergoing surgery during the first two waves of the COVID-19 pandemic had a generally positive experience with minimal disruptions to their planned surgery and ongoing care. Together with the COVID-19 safety precautions, effective communication between the clinical teams and the patients helped the overall patient experience during their surgical treatment.

Out-of-home activities during the COVID-19 pandemic in Sweden: Associations with subjective well-being and the moderating roles of age and personality

This study investigates the impact of the first wave of the COVID-19 pandemic on the reduction of frequency of out-of-home activities among Swedes, and its relationship with Subjective Well-Being (SWB), including Life Satisfaction (LS) and Emotional Well-Being (EWB). A considerable decrease in attending cultural events, dining out, shopping, and social activities was observed and to a lesser extent walking and exercise. Reduction in walking and exercise, but none of the other activities, correlated negatively with both LS and EWB. Our study suggests that activity reductions may have similar effects on both dimensions of SWB, rather than the typical finding in previous studies suggesting a stronger influence on EWB. Age moderated the impact of physical activities, indicating that reductions in physical activities were primarily detrimental for older individuals. High Neuroticism was found to moderate the relationship between social activities and SWB, suggesting that decreases in social activities had a slightly negative effect on SWB for people high in Neuroticism.

Mutations in the SARS-CoV-2 Spike proteins affected the ACE2-binding affinity during the development of Omicron pandemic variants.

Mutations in SARS-CoV-2 caused multiple waves of pandemics. To identify the function of such mutations, we investigated the binding affinity of the S protein with its receptor, ACE2. Omicron BA.1 showed significantly lower binding affinity with human ACE2 than prototype SARS-CoV-2 and Alpha strain, indicating that pre-Omicron to Omicron transition was not mediated by increasing the ACE2-binding affinity. Meanwhile, the later Omicron variants, BA.5 and XBB.1.5, showed significantly higher ACE2-binding affinity, suggesting that the increased ACE2-binding could be involved in the variant transition within Omicron strains. Furthermore, Alpha and Omicron variants, but not prototype SARS-CoV-2, bound mouse ACE2, which lead to a hypothesis that early Omicron strains evolved from Alpha strain by acquiring multiple mutations in mice.

Environmental Exposure and Element-by-Element Analysis of Pandemic Waves at the City Level: Exposome Algorithm for Analysis of Short-Term Temperature Drops on Surges in COVID-19-Associated Hospitalizations

Amid the COVID-19 pandemic, it is crucial to understand the complex network of factors that contribute to its pathogenesis and epidemiology in order to be able to prevent, predict, and minimize the consequences of the burden on urban services, particularly the critical surge in hospitalized patients.Based on a hypothesis of compromised airway epithelium, the principle of wave superposition, and mechanistic and causal interface approaches, this study aims to design a concept of element-by-element analysis of pandemic waves to isolate and analyze the impact of short-term drops in ambient temperature (as one important factor) on the spikes in hospitalizations due to the exacerbation of the disease course in SARS-CoV-2 infected individuals during the Omicron-associated wave.A new concept and analysis algorithm were proposed and tested. Results showed that every short-term drop in daily temperature of more than 3°C led to an increase in the number of hospitalizations due to a worsening of disease progression in infected individuals with a 1-3 day lag. The analysis also revealed an influence with a 7.6-day lag, which may indicate an incubation period in patients at risk, such as the elderly and patients with comorbidities.The findings have implications for public health initiatives and urban planning to prevent overwhelming the healthcare system. Further research is recommended.

Acceptance, Satisfaction, and Preference With Telemedicine During the COVID-19 Pandemic in 2021-2022: Survey Among Patients With Chronic Pain.

The COVID-19 pandemic has forced many health care providers to make changes in their treatment, with telemedicine being expanded on a large scale. An earlier study investigated the acceptance of telephone calls but did not record satisfaction with treatment or patients' preferences. This warranted a follow-up study to investigate acceptance, satisfaction, and preferences regarding telemedicine, comprising of phone consultations, among health care recipients. The primary aim was to assess the acceptance and satisfaction of telemedicine during the subsequent months of 2021-2022, after the initial wave of the COVID-19 pandemic in Switzerland. Furthermore, we aimed to assess patients' preferences and whether these differed in patients who had already experienced telemedicine in the past, as well as correlations between acceptance and satisfaction, pain intensity, general condition, perception of telemedicine, and catastrophizing. Finally, we aimed to investigate whether more governmental restrictions were correlated with higher acceptance. An anonymous cross-sectional web-based survey was conducted between January 27, 2021, and February 4, 2022, enrolling patients undergoing outpatient pain therapy in a tertiary university clinic. We conducted a descriptive analysis of acceptance and satisfaction with telemedicine and investigated patients' preferences. Further, we conducted a descriptive and correlational analysis of the COVID-19 stringency index. Spearman correlation analysis and a chi-square test for categorical data were used with Cramer V statistic to assess effect sizes. Our survey was completed by 60 patients. Telemedicine acceptance and satisfaction were high, with an average score of 7.6 (SD 3.3; on an 11-point Numeric Rating Scale from 0=not at all to 10=completely), and 8.8 (SD 1.8), respectively. Respondents generally preferred on-site consultations to telemedicine (n=35, 58% vs n=24, 40%). A subgroup analysis revealed that respondents who already had received phone consultation, showed a higher preference for telemedicine (n/N=21/42, 50% vs n/N=3/18, 17%; χ22 [N=60]=7.5, P=.02, Cramer V=0.354), as well as those who had been treated for more than 3 months (n/N=17/31, 55% vs n/N=7/29, 24%; χ22 [N=60]=6.5, P=.04, Cramer V=0.329). Acceptance of telemedicine showed a moderate positive correlation with satisfaction (rs{58}=0.41, P<.05), but there were no correlations between the COVID-19 stringency index and the other variables. Despite high acceptance of and satisfaction with telemedicine, patients preferred on-site consultations. Preference for telemedicine was markedly higher in patients who had already received phone consultations or had been treated for longer than 3 months. This highlights the need to convey knowledge of eHealth services to patients and the value of building meaningful relationships with patients at the beginning of treatment. During the COVID-19 pandemic, the modality of patient care should be discussed individually.

Profile of Multisystem Inflammatory Syndrome in Children (MIS-C) in Infants in North India during the Second Wave of SARS-CoV-2 Pandemic

Background: Multisystem inflammatory syndrome in children (MIS-C) secondary to severe acute respiratory syndrome coronavirus-2 has affected not only older children, adolescents, and adults but also infants, more so during the second wave of the global pandemic. Materials and Methods: All sequentially admitted infants hospitalized during 6 months who fulfilled the World Health Organization criteria for MIS-C or American Heart Association 2017 criteria for Kawasaki disease (KD) (and positive coronavirus disease-2019 [COVID-19] serology) were included in the present study. Results: A total of 19 infants were studied. Thirteen (68.3%) had evidence of recent COVID-19 infection. The median age of presentation was 2 months (interquartile range 25–75th, 0.5–3). The most common presenting symptoms were fever (68.4%), gastrointestinal complaints (63.1%), and edema (36.8%). Other predominant signs were shock (78.9%), myocarditis (52.6%), and neurological complaints (26.3%). Incomplete KD was present in 21% of patients. Elevated C-reactive protein, ferritin, D-Dimer, N-terminal prohormone of brain natriuretic peptide, and reduced fibrinogen were markers of severe illness. All subjects received intravenous immunoglobulin (IVIG) (100%), 31.5% received a second dose of IVIG, and 63.1% received pulse intravenous methylprednisolone. A total of 5 (26.3%) died as a result of the disease process. Conclusion: The spectrum of MIS-C in infants can be varied and is different from older children. A high index of suspicion is therefore needed in infants who present with critical illness and do not respond appropriately to conventional antibiotics and supportive care. The addition of IVIG and corticosteroids to the treatment regimen leads to a favorable outcome.

Violence on social networks related to the body image of young women and its repercussions on health.

Social networking sites perpetuate gender stereotypes, inequalities, and gender violence, generating adverse health effects. This study aimed to analyze the relationship between Instagram, alcohol consumption and effects on health, through interviews and discussion groups involving adolescents (high school or university students and workers), during the period from the third to the sixth wave of the COVID-19 pandemic. A total of 118 individuals participated in the study. Three coding clusters were identified: (1) Inequality in the representation of men and women on SNSs; (2) Violence towards women's bodies and sexual violence on SNSs; and (3) Health problems derived from violence against women's body image on SNSs. The main focus of our analysis was the exhibition of the female body, in which eroticization of the body prevails and gender roles are perpetuated. Violence is generated towards women in the form of misogynistic attacks for daring to challenge conventional stereotypes. Many interviewees coincide that the main health effects include low self-esteem, anxiety and eating disorders. The institutional response to the abuses and violence committed on SNSs against women is weak, and public policies are needed to protect women in these environments where they are especially vulnerable.

Association between SARS-CoV-2 gene specific Ct values and COVID-19 associated in-hospital mortality.

Since there are currently no specific SARS-CoV-2 prognostic viral biomarkers for predicting disease severity, there has been interest in using SARS-CoV-2 polymerase chain reaction (PCR) cycle-threshold (Ct) values to predict disease progression. This study assessed the association between in-hospital mortality of hospitalized COVID-19 cases and Ct-values of gene targets specific to SARS-CoV-2. Clinical data of hospitalized COVID-19 cases from Gauteng Province from April 2020-July 2022 were obtained from a national surveillance system and linked to laboratory data. The study period was divided into pandemic waves: Asp614Gly/wave1 (7 June-22 Aug 2020); beta/wave2 (15 Nov 2020-6 Feb 2021); delta/wave3 (9 May-18 Sept 2021) and omicron/wave4 (21 Nov 2021-22 Jan 2022). Ct-value data of genes specific to SARS-CoV-2 according to testing platforms (Roche-ORF gene; GeneXpert-N2 gene; Abbott-RdRp gene) were categorized as low (Ct < 20), mid (Ct20-30) or high (Ct > 30). There were 1205 recorded cases: 836(69.4%; wave1), 122(10.1%;wave2) 21(1.7%; wave3) and 11(0.9%;in wave4). The cases' mean age(±SD) was 49 years(±18), and 662(54.9%) were female. There were 296(24.6%) deaths recorded: 241(81.4%;wave1), 27 (9.1%;wave2), 6 (2%;wave3), and 2 (0.7%;wave4) (p < 0.001). Sample distribution by testing platforms was: Roche 1,033 (85.7%), GeneXpert 169 (14%) and Abbott 3 (0.3%). The median (IQR) Ct-values according to testing platform were: Roche 26 (22-30), GeneXpert 38 (36-40) and Abbott 21 (16-24). After adjusting for sex, age and presence of a comorbidity, the odds of COVID-19 associated death were high amongst patients with Ct values 20-30[adjusted Odds Ratio (aOR) 2.25; 95% CI: 1.60-3.18] and highest amongst cases with Ct-values <20 (aOR 3.18; 95% CI: 1.92-5.27), compared to cases with Ct-values >30. Although odds of COVID19-related death were high amongst cases with Ct-values <30, Ct values were not comparable across different testing platforms, thus precluding the comparison of SARS-CoV-2 Ct-value results.

Evaluation of Knowledge, Protection, and Participation of Medical Students in Facing Recurrent Waves of the COVID-19 Pandemic.

Evaluation of Knowledge, Protection, and Participation of Medical Students in Facing Recurrent Waves of the COVID-19 Pandemic.