Prolonged COVID-19 Research Articles

Translation and cultural adaptation of the Long Coronavirus Disease (COVID) Symptom and Impact Tools for the Chilean population.

The Long Coronavirus Disease (COVID) Symptom and Impact Tools (ST and IT) were published in English in 2022 to monitor the symptoms and impact of persistent COVID-19. ST includes 53 symptoms selected by the patient. IT includes six aspects of life that the patient must rate from 1 to 10 points. We aim to report the results of the cultural adaptation of both instruments for the Chilean population, together with the content validity of the adapted instrument. The cultural adaptation was carried out in five steps: 1) translation from English to Spanish, 2) synthesis, 3) back-translation, 4) review by the editorial board, and 5) testing the questionnaire with ten patients; they answered both questionnaires and seven questions assessing their understanding of the TI and their opinion on whether the instrument reflected the impact of prolonged COVID-19 on their lives. The content validity of the final version of the IT was assessed by 14 experts. The main outcome is the two final questionnaires adapted for use in Chile. Most patients responded with the best concept or approval for all items. Content validity showed acceptable results, with an average content validity index of 0.9 and Aiken's V for the relevance of the questionnaire in general of 0.83 (95% CI 0.69 to 0.92). For one item, Aiken's V was less than 0.7 (95% CI 0.5 to 0.8). This study provides Chilean health authorities and health providers with an instrument for assessing the impact of prolonged COVID-19 on core aspects of people's lives.

Exploring the Status and Experiences of School Nurses’ Response to the COVID-19 Pandemic: A Mixed Method Study

PurposeThis study aimed to provide a deeper understanding of the response status and school nurses’ experience of the prolonged COVID-19 pandemic in Korea. MethodRecognizing the limitations of existing tools in capturing prolonged COVID-19 response, we divided the COVID-19 pandemic into different wave periods and adopted a mixed-methods design enrolling school nurses in elementary, middle, and high schools in Korea to gain a comprehensive view. A quantitative survey was conducted among 153 school nurses nationwide and in-depth interviews were conducted with nine, using Van Kaam’s phenomenological analysis. ResultsIn 56.9% of the cases, multiple persons in charge of COVID-19 management were not designated, and there was no significant difference in response by school level. Excessive work, coping with civil complaints, unilateral work burden, difficulties communicating with related organizations, lack of concreteness in manuals, lack of cooperation among school members, and frequent changes in guidelines were continuous difficulties encountered during the pandemic. From the in-depth interviews, we extracted 189 meaningful statements, 22 subthemes, and 8 themes. The eight themes were divided into three categories: beginning of COVID-19 response, process of response to COVID-19, and lessons learned from the COVID-19 response experience. ConclusionA specific and systematic infectious disease response manual should be established, as well as an educational and training program to strengthen the capacity of educational personnel to cope with new infectious diseases.

Post-COVID syndrome and type 2 diabetes mellitus in Kazakhstan: clinical manifestations and vaccine efficacy.

In this article, we report the results of a survey investigating post-coronavirus disease 2019 (COVID-19) syndrome in patients with type 2 diabetes mellitus and the impacts of vaccination on long-term manifestations. From February 2022 to April 2023, a survey of patients with type 2 diabetes and people without diabetes who were treated for a coronavirus infection was conducted in Kazakhstan. Participants were invited via social media to voluntarily participate in this study. A total of 417 surveys were included in this study, comprising 212 patients with type 2 diabetes and 205 without diabetes. We compared persistent complaints after recovery in patients with and without diabetes mellitus (DM), as well as vaccination status. The results of this study on self-reported symptoms of prolonged COVID show that more than half of those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Kazakhstan have at least one persistent symptom after recovery. Based on the list of prolonged COVID-19 symptoms reported by patients with type 2 DM (T2DM), exertional dyspnoea, fatigue, respiratory discomfort, headaches, and sleep disturbances are among the most common ongoing conditions, and in many cases last more than 3 months after COVID-19. Patients with T2DM experience more severe and prolonged symptoms than those without diabetes. Additionally, vaccination lowers COVID-19 hospitalization risk and decreases the need for adjusting hypoglycemic therapy, such as insulin treatment, after recovering from SARS-CoV-2 infection.

An Automated Data-Driven Approach for Product Design Strategies to Respond to Market Disruption Following COVID-19

Abstract Online reviews provide a source to identify customer needs. While many studies have analyzed online reviews during the pandemic, it is worth noting that many customer preference studies in this period were not conducted within a product design context. The societal challenges presented by the prolonged COVID-19 pandemic, spanning nearly three years, have significantly impacted all facets of the population in a manner unparalleled in recent decades. Therefore, this research delves into the post-COVID-19 landscape, examining shifts in consumer preferences for diverse product features through an analysis of online reviews. Our framework unfolds in five stages: First, it collects online reviews and second, delves into customer interest in product features. Third, it analyzes customer sentiments toward these features. Fourth, employing interpretable machine learning techniques, it determines the significance of each feature. Fifth, an importance-performance analysis (IPA) and Kano models are utilized to formulate and analyze product strategies. The developed method is assessed on two real-world datasets—smartphone and laptop reviews. The results reveal that after the pandemic, customer satisfaction for the screen and camera in smartphones decreased, whereas it increased for those in laptops. In addition, the importance of battery features in smartphones and laptops has increased. These insights will aid companies in promptly formulating strategies to navigate dynamic market environments.

Managerial Support Matters: Predictors of Nurses’ Turnover Intentions During the COVID-19 Pandemic in The Bahamas

Amidst the prolonged COVID-19 pandemic, nurses in The Bahamas faced challenges such as exacerbation of severely limited job resources and heightened job demands. Anecdotal evidence suggested that these conditions jeopardized nurses’ well-being and increased their turnover intentions. An incomplete understanding of factors influencing Bahamian nurses’ turnover intentions, during periods of crises limits our ability to formulate appropriate retention strategies. The purpose of this study was to 1) examine the influence of job demands and job resources on nurses’ turnover intentions, and 2) identify key predictors of turnover intentions of nurses employed in a public acute care hospital in The Bahamas during the COVID pandemic. Data were collected from regulated nurses between January and April 2022 using a cross-sectional, descriptive, survey design. Stepwise multiple linear regression analysis was used to predict relationships among turnover intentions and job demands and job resources. The study found that managerial support was a statistically significant job resource that predicted nurses’ turnover intentions (B = -.25, p= 0.19). Support from immediate nursing supervisors was a key predictor of nurses’ turnover intentions among Bahamian nurses. It is essential for nurse managers and other stakeholders to be aware of the importance of managerial support for reducing nurse turnover intentions, especially during crises.

The effectiveness of nirmatrelvir/ritonavir regimen in hospitalized renal transplant patients with prolonged COVID-19 infection: a multicenter clinical experience

Objectives Effectiveness of nirmatrelvir/ritonavir (NR) in kidney transplant recipients (KTRs) infected COVID-19 for more than 5 days has not been evaluated. Methods In this multicenter retrospective study, 85 KTRs with COVID-19 were enrolled, including 50 moderate, 21 severe, and 14 critical patients. Results The median time from onset to starting NR treatment was 14 (IQR, 11–19) days. Before NR treatment, 96.5% patients reduced use of antimetabolites. They also stopped using calcineurin inhibitors (CNI) 12–24 hours before NR treatment, with CNI concentrations well-controlled during NR treatment. The use of intravenous corticosteroids increased with COVID-19 severity. The median time to reach viral negative conversion was 5 (IQR, 4–8) days for all patients. For moderate and severe COVID-19 patients, they had a low rate of ICU admission (1.4%), exacerbation requiring upgraded oxygen therapy (5.6%), and dialysis (2.8%); no intubation and mechanical ventilation, and no deaths were observed. Patients with critical COVID-19 had a low mortality rate (7.1%). Conclusions A regimen including NR for clearing SARS-CoV-2 along with reducing immunosuppressants and using intravenous corticosteroids is associated with lower rates of exacerbation and mortality in KTRs who have moderate to critical SARS-CoV-2 infection and the virus still present after 5 days.

Features of the course of COVID-19 in children with the spread of the Omicron variant

The aim of the study was to assess the symptoms and identify risk factors for prolonged and complicated COVID-19 during the spread of the Omicron variant in children aged 1 month to 18 years. Materials and methods. The study included 110 children with confirmed COVID-19 of mild or moderate severity at the time of the first examination. The average age of the patients was 6.86±5.09 years. The clinical symptoms, duration of each of the identified symptoms, and complications were evaluated. Acomparative analysis of possible risk factors for prolonged course and development of pneumonia was carried out. Results. The most common cases in children with COVID-19 were an increase in body temperature (in93%), runny nose (in65%), cough (in59%), hyperemia of the posterior pharyngeal wall (in95%) and tonsils (in93%), an increase in regional lymph nodes - in 43%. Among children with the duration of COVID-19 for 10 days or more, astatistically significant late request for medical help (onaverage, by 8.26±5.46 days, compared with 3.00 ± 1.32 days with the duration of the disease up to 10 days). Pneumonia is most often registered among preschool children. The average age in the group of children diagnosed with pneumonia is significantly less than in children who did not have signs of pneumonia of this complication (4.66 ±4.78 and 7.17±4.81, respectively). Conclusions: With the spread of the Omicron variant COVID-19 in children, infection with the SARS-CoV-2 coronavirus is accompanied by symptoms of acute respiratory infection with an increase in body temperature, sore throat, hyperemia of the posterior wall of the pharynx and tonsils. Often there is an increase in regional lymph nodes, runny nose, cough, vomiting, less often - diarrhea. The prolonged course is facilitated by the late onset of adequate therapy. During the study, pneumonia was detected in 25% of children.

Loneliness and Social Isolation Factors Under the Prolonged COVID-19 Pandemic in Japan: 2-Year Longitudinal Study.

Worsening loneliness and social isolation during the COVID-19 pandemic have become serious public health concerns worldwide. Despite previous research reporting persistent loneliness and social isolation under repeated emergency declarations and prolonged pandemics, long-term studies are needed to identify the actual conditions of loneliness and social isolation, and the factors that explain them. In this study, 3 web-based surveys were conducted at 1-year intervals during the 2 years after the first state of emergency to examine changes in loneliness and social isolation and the psychosocial factors associated with them in the Japanese population. The first survey (phase 1, May 11-12, 2020) was conducted at the end of the first emergency declaration period, the second survey (phase 2, June 14-20, 2021) was conducted at the end of the third emergency declaration period, and the third survey (phase 3, May 13-30, 2022) was conducted when the state of emergency had not been declared but many COVID-19-positive cases occurred during this period. We collected data on 3892 inhabitants (n=1813, 46.58% women; age: mean 50.3, SD 13.4 y) living in the 4 prefectures where emergency declaration measures were applied in phases 1 and 2. A linear mixed model analysis was performed to examine the association between psychosocial variables as explanatory variables and loneliness scores as the dependent variable in each phase. While many psychosocial and physical variables showed improvement for the 2 years, loneliness, social isolation, and the relationship with familiar people deteriorated, and the opportunities for exercise, favorite activities, and web-based interaction with familiar people decreased. Approximately half of those experiencing social isolation in phase 1 remained isolated throughout the 2-year period, and a greater number of people developed social isolation than those who were able to resolve it. The results of the linear mixed model analysis showed that most psychosocial and physical variables were related to loneliness regardless of the phase. Regarding the variables that showed a significant interaction with the phase, increased altruistic preventive behavior and a negative outlook for the future were more strongly associated with severe loneliness in phase 3 (P=.01 to <.001), while the association between fewer social networks and stronger loneliness tended to be more pronounced in phase 2. Although the interaction was not significant, the association between reduced face-to-face interaction, poorer relationships with familiar people, and increased loneliness tended to be stronger in phase 3. This study found that loneliness and social isolation remained unresolved throughout the long-term COVID-19 pandemic. Additionally, in the final survey phase, these issues were influenced by a broader and more complex set of factors compared to earlier phases.

Post COVID-19 syndrome among 5248 healthcare workers in England: longitudinal findings from NHS CHECK

ObjectivesThe objectives of this study were to examine post COVID-19 syndrome (PCS) among healthcare workers (HCWs) in England and explore risk factors for the condition.MethodsData were collected by National Health...

Findings Associated with Prolonged COVID-19 Recovery among Boston Healthcare Workers.

To evaluate the long-term, symptomatic recovery of healthcare workers from acute COVID-19 infections up to three years after the initial COVID-19 outbreak. Cross-sectional study among employees of a community-based healthcare system in Massachusetts who had a recorded positive COVID-19 test. Survey responses were collected between September 2022 and January 2023. The survey included validated questionnaires: WHOQOL-BREF, EQ-5D-5 L, DASS-21, FCV-19S, K6+, and the Insomnia Severity Index. We compared the long COVID (i.e., symptoms lasting>28 days) and non-long COVID groups. Among the 280 respondents (15.2% response rate), those with long COVID (73.4%) reported significantly worse quality of life and greater levels of depression, anxiety, and stress metrics. However, no significant difference was found between the two groups' fear of COVID-19. Targeted support for healthcare workers with prolonged symptoms after COVID-19 is warranted.

Characteristics and Impact of Long COVID at a Neurology Clinic

Introduction: Long COVID can also lead to neurological sequelae that affect existing diseases. This study explored how COVID-19 infection affects neurological patients and the relationship between long COVID and exacerbating factors. Methods: This retrospective study was conducted on 85 patients with neurological diseases after COVID-19 at the Neurology Department, Inje University Busan Paik Hospital, Korea. The data were collected between August and October 2022. The patients had a medical history, including COVID-19 infection, and completed symptom questionnaires. A long COVID questionnaire consisting of 35 inquiries in 10 categories was completed. Anxiety, depression, fatigue, functional difficulties, QOL, and health status changes were assessed. Results: The analysis comprised 85 participants (age: 56.4 ± 15.2 years; 63.5% women). Of the categories, neurological symptoms (68.2%) were the most prevalent, followed by systemic symptoms (64.7%) and cardiopulmonary symptoms (56.5%). Anxiety, depression, and fatigue symptoms were reported by 36.5%, 34.1%, and 42.4% of the participants. Subjective neurological deterioration after COVID-19 was reported in 28 participants (28/81, 34.6%). Anxiety, depression, and fatigue were influenced by long COVID symptoms and the subjective deterioration of neurological conditions. Conclusion: This study analyzed the long COVID symptoms in patients with preexisting neurological conditions and their impact on mental health and quality of life. One-third of the participants reported a subjective worsening of their preexisting neurological conditions. This study highlights the need for comprehensive follow-ups and a multidisciplinary approach for patients with neurological conditions and prolonged COVID-19 symptoms.

Effect of auriculotherapy on persistent fatigue in recovered patients from the acute phase of COVID-19: a double-blind randomized clinical trial

ABSTRACT Background: Fatigue is a common problem following the acute phase of COVID-19. Potential interventions to reduce fatigue and improve quality of life are appropriate. Objective: The study aimed to investigate the effect of auriculotherapy on persistent fatigue in recovered patients from acute phase COVID-19. Methods: This double-blind clinical trial was conducted in 2022 in Kashan, Iran on 52 recovered patients reporting persistent fatigue following acute phase COVID-19. A convenience sample was selected and randomly assigned to sham and intervention groups. The intervention group received four weeks of auriculotherapy with Vaccaria seeds attached to six fatigue-related auriculotherapy points on both ears. In the sham group, adhesive tapes were attached to the same points. Fatigue was assessed by the Chalder Fatigue Scale before (T0), after (T1), and four weeks after (T2) the intervention. Both per-protocol and intention-to-treat analyses were used. Results: The two groups differed on financial status and hospitalization history (p < 0.05). The time-group interaction effect was significant for fatigue after adjusting for confounders (p < 0.0001). Fatigue scores of the intervention group were significantly lower than the sham group at T1 and T2 (p < 0.0001). In addition, fatigue scores in the intervention group decreased significantly over time, while in the sham group, fatigue first decreased briefly and then increased (p < 0.05). Conclusion: This initial trial suggested that auriculotherapy may reduce intensity of fatigue and therefore could potentially be integrated into rehabilitation programs for patients with prolonged COVID-19. Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20100211003329N9.

Long COVID impacts: the voices and views of diverse Black and Latinx residents in Massachusetts

ObjectiveTo understand how Long COVID is impacting the health and social conditions of the Black and Latinx communities.BackgroundEmerging research on Long COVID has identified three distinct characteristics, including multi-organ damage, persistent symptoms, and post-hospitalization complications. Given Black and Latinx communities experienced significantly higher COVID rates in the first phase of the pandemic they may be disproportionately impacted by Long COVID.MethodsEleven focus groups were conducted in four languages with diverse Black and Latinx individuals (n = 99) experiencing prolonged symptoms of COVID-19 or caring for family members with prolonged COVID-19 symptoms. Data was analyzed thematically.ResultsMost participants in non-English language groups reported they were unfamiliar with the diagnosis of long COVID, despite experiencing symptoms. Long COVID impacts spanned financial and housing stability to physical and mental health impacts. Participants reported challenging encounters with health care providers, a lack of support managing symptoms and difficulty performing activities of daily living including work.ConclusionsThere is a need for multilingual, accessible information about Long COVID symptoms, improved outreach and healthcare delivery, and increased ease of enrollment in long-term disability and economic support programs.

Association between COVID-19 infection and uveitis flare in patients with Behcet's disease, a retrospective multicenter cohort study.

To explore if COVID-19 infection and its subsequent immunosuppressant adjustment as well as previous vaccination status are associated with higher risks of uveitis flare in patients with Behcet's disease. This retrospective multicenter cohort study was conducted in January 2023 among patients with Behcet's uveitis, during the second wave of the COVID-19 pandemic in China, with an anticipated sample size of 250. The primary objective was to examine the association between COVID-19 infection and the occurrence of uveitis flare. The potential impact of other exposures, including the patient's vaccination status and treatment adjustments to the risk of uveitis flare and the course of COVID-19 infection were also analyzed. 207 patients with COVID-19 infection and 47 patients without COVID-19 infection were included. A total of 127 uveitis flares occurred in the observational period (14.29 events per 100 person-month). COVID-19 infection was found to be significantly associated with a higher rate of uveitis flare (adjusted rate ratio = 4.8, 95% CI 3.7 to 6.3, P < 0.001). However, neither systemic immunosuppressive adjustment nor COVID-19 vaccination status showed a significant association with uveitis flare or the course of COVID-19 infection. This study provides evidence of an association between COVID-19 infection and an increased risk of uveitis flare in patients with Behcet's disease. However, there was no significant evidence to support that baseline immunosuppressive therapy regimens, treatment adjustment after COVID-19 infection, or vaccination status were associated with higher risks of uveitis flare or prolonged COVID-19 course.

Evaluating the protective effectiveness and risk factors of ursodeoxycholic acid on COVID-19 among outpatients.

Objective: This study aimed to assess the chemopreventive effect of ursodeoxycholic acid (UDCA) against COVID-19 and to analyze infection risk factors, symptoms, and recovery in outpatients with UDCA exposure. Methods: The study enrolled outpatients prescribed UDCA from the Second Affiliated Hospital of Chongqing Medical University, China, between 01 July 2022, and 31 December 2022. Data on demographics, comorbidities, and drug combinations were collected using electronic medical records. COVID-19 infection, symptoms, severity, prognosis, vaccinations, and UDCA administration were surveyed by telephone interviews. UDCA non-users served as controls and were matched in a 1:2 ratio with UDCA users using propensity score matching with the nearest neighbor algorithm. Infection rates, symptomatology, severity, and prognosis were compared between matched and control cohorts, and risk factors and infection and recovery symptoms were analyzed in UDCA-exposed outpatients. Results: UDCA-exposed outpatients (n = 778, 74.8%) and matched UDCA users (n = 95, 74.2%) showed significantly lower SARS-CoV-2 infection rates than control patients (n = 59, 92.2%) (p < 0.05). The matched UDCA group exhibited substantially lower fever, cough, sore throat, and fatigue rates than controls (p < 0.05). Participants with UDCA exposure generally experienced mild symptoms, while those without UDCA had moderate symptoms. The matched UDCA group also had significantly shorter durations of fever and cough (p < 0.05). Risk factors such as age over 60, less than 1month of UDCA administration, diabetes mellitus, and coronary artery disease significantly increased SARS-CoV-2 infection rates (p < 0.05), while smoking led to a decrease (p < 0.05). Hypertension was associated with a prolonged COVID-19 recovery (p < 0.05), while smoking, vaccination, and fatty liver disease were associated with shorter recovery periods (p < 0.05). The main symptoms in the full UDCA cohort were fever, cough, and sore throat, with fatigue, cough, and hyposthenia being the most persistent. Conclusion: UDCA demonstrated chemopreventive effect against SARS-CoV-2 in outpatients by significantly reducing infection incidence and mitigating COVID-19 symptoms, severity, and recovery duration. Old age, short UDCA course, and comorbidities such as diabetes mellitus and CAD increased infection rates, while hypertension prolonged recovery. Smoking, vaccination, and fatty liver disease reduced infection rates and shortened recovery. UDCA had minimal impact on symptom types. Larger and longer-term clinical studies are needed further to assess UDCA's effectiveness in COVID-19 prevention or treatment.

Visualized and pH-responsive hydrogel antibacterial coating for ventilator-associated pneumonia

Ventilator-associated pneumonia (VAP) is a common healthcare-acquired infection often arising during artificial ventilation using endotracheal intubation (ETT), which offers a platform for bacterial colonization and biofilm development. In particular, the effects of prolonged COVID-19 on the respiratory system. Herein, we developed an antimicrobial coating (FK-MEM@CMCO-CS) capable of visualizing pH changes based on bacterial infection and releasing meropenem (MEM) and FK13-a1 in a controlled manner. Using a simple dip-coating process with controlled loading, chitosan was cross-linked with sodium carboxymethyl cellulose oxidation (CMCO) and coated onto PVC-based ETT to form a hydrogel coating. Subsequently, the coated segments were immersed in an indicator solution containing bromothymol blue (BTB), MEM, and FK13-a1 to fabricate the FK-MEM@CMCO-CS coating. In vitro studies have shown that MEM and FK13-a1 can be released from coatings in a pH-responsive manner. Moreover, anti-biofilm and antibacterial adhesion results showed that FK-MEM@CMCO-CS coating significantly inhibited biofilm formation and prevented their colonization of the coating surface. In the VAP rat model, the coating inhibited bacterial growth, reduced lung inflammation, and had good biocompatibility. The coating can be applied to the entire ETT and has the potential for industrial production.

Prolonged COVID-19's Double Impact: Stress and Male Fertility

Abstract: Till now, 642 million COVID-19 cases have been confirmed, claiming around 6.62 million lives. The impact of SARS-CoV-2 on the male reproductive system, both short and long-term, remains a mystery. This study aims to scrutinize how SARS-CoV-2 affects sexual function, considering potential mediators such as psychological stress. Results reveal that the infection intensifies metabolic stress, directly or indirectly impacting male fertility and causing psychological distress with heightened ROS generation. The exclusive presence of Angiotensin-converting enzyme 2 (ACE2) in type II pneumocytes, serving as the virus receptor, suggests lungs as the primary target. In conclusion, SARS-CoV-2 infection potentially diminishes male fertility, primarily due to psychological stress, raising concerns about COVID-19-induced male infertility amid other factors. Despite limited therapeutic options for COVID-19 and ongoing vaccine efforts, the persistent threat of diverse strains poses a long-term risk to global population health.

G6PD deficiency mediated impairment of iNOS and lysosomal acidification affecting phagocytotic clearance in microglia in response to SARS-CoV-2

The glucose-6-phosphate dehydrogenase (G6PD) deficiency is X-linked and is the most common enzymatic deficiency disorder globally. It is a crucial enzyme for the pentose phosphate pathway and produces NADPH, which plays a vital role in regulating the oxidative stress of many cell types. The deficiency of G6PD primarily causes hemolytic anemia under oxidative stress triggered by food, drugs, or infection. G6PD-deficient patients infected with SARS-CoV-2 showed an increase in hemolysis and thrombosis. Patients also exhibited prolonged COVID-19 symptoms, ventilation support, neurological impacts, and high mortality. However, the mechanism of COVID-19 severity in G6PD deficient patients and its neurological manifestation is still ambiguous. Here, using a CRISPR-edited G6PD deficient human microglia cell culture model, we observed a significant reduction in NADPH level and an increase in basal reactive oxygen species (ROS) in microglia. Interestingly, the deficiency of the G6PD-NAPDH axis impairs induced nitric oxide synthase (iNOS) mediated nitric oxide (NO) production, which plays a fundamental role in inhibiting viral replication. Surprisingly, we also observed that the deficiency of the G6PD-NADPH axis reduced lysosomal acidification and free radical production, further abrogating the lysosomal clearance of viral particles. Thus, impairment of NO production, lysosomal functions, and redox dysregulation in G6PD deficient microglia altered innate immune response, promoting the severity of SARS-CoV-2 pathogenesis.

Minding the margins: Evaluating the impact of COVID-19 among Latinx and Black communities with optimal qualitative serological assessment tools.

COVID-19 disproportionately affected minorities, while research barriers to engage underserved communities persist. Serological studies reveal infection and vaccination histories within these communities, however lack of consensus on downstream evaluation methods impede meta-analyses and dampen the broader public health impact. To reveal the impact of COVID-19 and vaccine uptake among diverse communities and to develop rigorous serological downstream evaluation methods, we engaged racial and ethnic minorities in Massachusetts in a cross-sectional study (April-July 2022), screened blood and saliva for SARS-CoV-2 and human endemic coronavirus (hCoV) antibodies by bead-based multiplex assay and point-of-care (POC) test and developed across-plate normalization and classification boundary methods for optimal qualitative serological assessments. Among 290 participants, 91.4% reported receiving at least one dose of a COVID-19 vaccine, while 41.7% reported past SARS-CoV-2 infections, which was confirmed by POC- and multiplex-based saliva and blood IgG seroprevalences. We found significant differences in antigen-specific IgA and IgG antibody outcomes and indication of cross-reactivity with hCoV OC43. Finally, 26.5% of participants reported lingering COVID-19 symptoms, mostly middle-aged Latinas. Hence, prolonged COVID-19 symptoms were common among our underserved population and require public health attention, despite high COVID-19 vaccine uptake. Saliva served as a less-invasive sample-type for IgG-based serosurveys and hCoV cross-reactivity needed to be evaluated for reliable SARS-CoV-2 serosurvey results. The use of the developed rigorous downstream qualitative serological assessment methods will help standardize serosurvey outcomes and meta-analyses for future serosurveys beyond SARS-CoV-2.

The Effect of Coronavirus (COVID-19) on Job Satisfaction, Work Stress and Burnout of Healthcare Workers: A Systematic Review and Meta-Analysis.

We aimed to examine the job satisfaction (JS), work stress (WS) and burnout (B) levels of healthcare workers (HCWs), who are at the forefront of the fight against the coronavirus (COVID-19) epidemic process, which negatively affects the whole world, by meta-analysis. Articles, theses and papers in the literature before the COVID-19 (2014-2019) and during COVID-19 (2020-2022) were systematically reviewed. The sample size of 54 studies conducted from 13 countries was 49.139. Data analysis was performed with the Comprehensive Meta-analysis (CMA) 3.0 Version program. According to the random effect model analysis result, a negative, significant and low-level relationship was found between WS and JS, before and during COVID-19. There was a negative, significant and medium level relationship between JS and B. It was found positive, significant and high-level relationship between WS and B. Human development level (HDL) has a moderating effect on WS and B. In addition, sample size has moderating effect on WS and JS. During the prolonged COVID-19 pandemic, HCWs have experienced more burnout due to strict isolation, working conditions requiring overtime, fatigue, insomnia and concerns about virus transmission. Intense work tempo, inadequate health equipment, patient deaths, and low wages are the factors that decrease JS and increase WS and B. It is recommended to improve working conditions globally and provide financial support and mental health protection for HCWs.