Diagnosis Of COVID-19 Research Articles

Exploring $\<i>beta$</i>-Basic Rough Sets and Their Applications in Medicine

Advancements in the rough set theory of Pawlak have opened new avenues for enhancing decision-making processes, particularly in identifying disease risk factors in medical diagnoses. While traditional rough set methodologies have provided a solid foundation, there is a continuous need for improvements to increase accuracy and reliability. This study introduces mathematical techniques grounded in basic rough sets, incorporating $\beta$-open concepts to enhance precision. We present nearly basic rough sets and $\beta$-basic-approximations ($\beta _b$-approximations), examining their core properties and interrelationships. Our findings reveal that these novel constructs offer superior accuracy compared to traditional methods. Both theoretical analysis and practical examples support this, with our approach achieving a 100% accuracy rate in the medical diagnosis of COVID-19. This significant improvement highlights the potential of the methods of us to outperform existing ones in terms of precision and reliability. The introduction of $\beta _b$-approximations represents a significant advancement in rough set theory, offering enhanced accuracy in decision-making applications. Our results indicate that these methods can substantially outperform traditional techniques, especially in critical areas such as medical diagnosis. Additionally, we provide a mathematical algorithm suitable for implementation in programming languages, facilitating future research and applications across various theoretical and applied fields. This work lays the groundwork for further exploration and utilization of advanced rough set methodologies in diverse domains.

Balance and Health-Related Quality of Life After 1 Year of COVID-19 Social Restriction Measures: A Cross-Sectional Study in Two Samples from Spain.

The COVID-19 pandemic significantly impacted the well-being of the general population. However, more information is needed regarding the relationship between participation-related outcomes. This study aimed to analyze the impact of the pandemic on occupational balance (OB) and health-related quality of life (HRQoL) before and after social restrictions and to explore their relationship with COVID-19 diagnosis. We conducted a study among individuals diagnosed with COVID-19, assigning a healthy control group with the same sociodemographic characteristics using the EQ-5D-5L and the Occupational Balance Questionnaire (OBQ). The final sample size consisted of 61 participants in the COVID-19 diagnosis group (50.8% male; mean age 34.6 ± 14.17 years) and 57 healthy participants (50.8% male; mean age 33.7 ± 13.77 years). There were no differences in the sociodemographic variables between the groups. Significant differences were found between groups both before the pandemic and 1 year after confinement measures in HRQoL and OBQ (p < 0.005). The regression model indicated significant associations (p < 0.001) between HRQoL and both current OB and COVID-19 diagnosis. However, the OBQ scores from before the pandemic did not show a significant association with HRQoL (p = 0.336). In conclusion, social restrictions from the COVID-19 pandemic negatively impacted HRQoL in our sample even 1 year after confinement, with COVID-19 diagnosis and occupational imbalance predicting worse outcomes, highlighting the need for targeted interventions not only for the current situation but also for possible future public health crises.

Fear of COVID-19 Diagnosis and Cannabis Use Patterns Among Adults with Chronic Health Conditions: Results from COVID-19 Cannabis Health Study

ABSTRACT Given the scarcity of literature regarding COVID-19 impacts on cannabis consumers with chronic illnesses who widely use cannabis to manage their health conditions, we aim to assess the effect of COVID-19 on cannabis use patterns among adults living with chronic diseases. Cannabis consumers with a chronic disease (N = 1,466) from COVID-19 Cannabis Health Study were included in this analysis. The primary outcomes were change in cannabis dosage, past 30-day cannabis usage, and change in route of cannabis administration, with the main exposure being self-reported fear of COVID-19 diagnosis. Significant differences were found between changes in cannabis dose by fear of COVID-19 diagnosis (p = .03) where 41.5% of adults fearing diagnosis reported an increase in their cannabis dosage since the pandemic. Multinomial logistic regression showed that individuals who feared COVID-19 diagnosis had 50% greater odds [aOR = 1.50, 95% CI: 1.02–2.24 of decreasing their cannabis in reference to their dose staying the same, than those without fear of COVID-19, adjusting for socio-demographics. Our findings highlight the significant association between fear of COVID-19 diagnosis and changes in cannabis usage patterns among adults with chronic diseases. This underscores the pandemic’s impact on health-related behaviors and the role of cannabis as a coping mechanism during uncertain times.

The Impact of Comorbidity and Age on the Risk of Hospitalization and Mortality in Patients with Previous COVID-19 Infection-Based on Nationwide Data.

Objectives: The influence of comorbidity on long-term hospitalization and mortality after COVID-19 in adults (40-59 years) and older adults (≥60 years) is yet to be explored. Methods: This is a Danish population-based cohort study of patients with a first-time positive PCR test for COVID-19 from 1 March 2020, to 28 February 2022 (N = 1,034,103). Exposed cohorts were patients with 1) a Charlson Comorbidity Index (CCI) score of 1-2 and 2) a CCI score ≥3, who were compared to patients without comorbidity (CCI of zero) within the groups of adults (67.9%) and older adults (32.1%) for the risk of hospitalization and mortality. Next, within the age groups, each disease category of the CCI was considered as an exposed cohort and compared to patients who did not have the specific disease of interest. Adjusted hazard ratios (HR) for hospitalization and mortality were estimated by Cox regression models adjusted for confounders. Results: The highest HRs were in adult patients with a CCI score of ≥3. The adjusted HR was 4.54 (95%CI: 4.38-4.70) for hospitalization, and among older adults it was 3.05 (95%CI: 2.99-3.11). The adjusted HR for mortality among adults with a CCI score ≥3 was 21.04 (95%CI: 18.86-23.47), and the adjusted HR for mortality among older adults was 4.61 (95%CI: 4.44-4.78). The underlying disease influenced the risk estimates among adults and older adults, and "dementia" had the highest impact on mortality. Conclusion: A CCI score of 1 or above increases the risk of hospitalization and mortality up to 2 years after a positive PCR test of COVID-19 for adults and older adults. Further, the type of underlying disease in older adults highly influences the risk of hospitalization and mortality.

Usage of Information technology for the success of managing various stages of the COVID-19 pandemic

This study explores the crucial role of Information and Communication Technology (ICT) in managing the COVID-19 pandemic, focusing on its impact on surveillance, contact tracing, patient monitoring, telemedicine, artificial intelligence (AI), vaccination logistics, communication, and public education. ICT has facilitated the collection and analysis of real-time data, enabling authorities to make informed decisions about containment strategies. Digital contact tracing systems have been instrumental in limiting the virus's spread, while remote patient monitoring and telemedicine have allowed healthcare services to continue with minimal transmission risk. AI and machine learning have enhanced the speed and accuracy of COVID-19 diagnosis, and ICT has streamlined vaccine distribution and monitoring to ensure equitable access. Additionally, online platforms have played a key role in public education, fostering collaboration among researchers and promoting interdisciplinary research efforts. The study emphasizes that the continued integration of ICT into healthcare systems is critical for addressing future global health crises. However, policymakers must invest in ICT infrastructure, bridge the digital divide, and ensure that marginalized populations have equitable access to these technologies. The findings highlight the importance of ongoing ICT development to improve healthcare outcomes in future pandemics and suggest that collaboration across sectors is essential for maximizing the potential of these digital tools. Ultimately, ICT has been pivotal in the effective management of the COVID-19 pandemic and will be vital in future crisis preparedness.

Advancing CRISPR-Based Solutions for COVID-19 Diagnosis and Therapeutics.

Since the onset of the COVID-19 pandemic, a variety of diagnostic approaches, including RT-qPCR, RAPID, and LFA, have been adopted, with RT-qPCR emerging as the gold standard. However, a significant challenge in COVID-19 diagnostics is the wide range of symptoms presented by patients, necessitating early and accurate diagnosis for effective management. Although RT-qPCR is a precise molecular technique, it is not immune to false-negative results. In contrast, CRISPR-based detection methods for SARS-CoV-2 offer several advantages: they are cost-effective, time-efficient, highly sensitive, and specific, and they do not require sophisticated instruments. These methods also show promise for scalability, enabling diagnostic tests. CRISPR technology can be customized to target any genomic region of interest, making it a versatile tool with applications beyond diagnostics, including therapeutic development. The CRISPR/Cas systems provide precise gene targeting with immense potential for creating next-generation diagnostics and therapeutics. One of the key advantages of CRISPR/Cas-based therapeutics is the ability to perform multiplexing, where different sgRNAs or crRNAs can target multiple sites within the same gene, reducing the likelihood of viral escape mutants. Among the various CRISPR systems, CRISPR/Cas13 and CARVER (Cas13-assisted restriction of viral expression and readout) are particularly promising. These systems can target a broad range of single-stranded RNA viruses, making them suitable for the diagnosis and treatment of various viral diseases, including SARS-CoV-2. However, the efficacy and safety of CRISPR-based therapeutics must be thoroughly evaluated in pre-clinical and clinical settings. While CRISPR biotechnologies have not yet been fully harnessed to control the current COVID-19 pandemic, there is an optimism that the limitations of the CRISPR/Cas system can be overcome soon. This review discusses how CRISPR-based strategies can revolutionize disease diagnosis and therapeutic development, better preparing us for future viral threats.

COVID-19: LUNG INVOLVEMENT FROM CHEST CT SCANNINGS IN INFECTED PATIENTS IN A MUNICIPALITY IN SOUTHERN SC

The study analyzes lung involvement in patients diagnosed with COVID-19, using chest tomography to assess lung lesions among 332 individuals in a municipality in southern Santa Catarina. The research identifies the severity of respiratory infections and their association with clinical manifestations. Although tomography is useful for monitoring, it is not recommended for the initial diagnosis of COVID-19.

Development of a triplex endpoint PCR assay for the detection of SARS-CoV-2: insights on cost-efficiency and method design.

Lower respiratory tract infections, including COVID-19, have a substantial global impact, making the development of diagnostic tests crucial. The study aimed to develop a new, accurate, fast, and cost-effective PCR-based detection method for SARS-CoV-2, applicable in limited settings and capable of detecting all current variants and potential future pathogens. The study was conducted between 2020 and 2022 at the molecular biology department of Mures County Clinical Hospital, Romania. Initially, pharyngeal and nasal secretions were collected and processed using the real-time qRT-PCR method for routine COVID-19 diagnosis. Ninety-two samples were randomly selected to develop the assay, including samples from different infection periods and negative controls. Complementary DNA (cDNA) was prepared from the selected samples, and the presence and integrity of the extracted RNA were evaluated by amplifying the GAPDH housekeeping gene. Primers for three specific viral genes (N, ORF1ab, and S) were designed, and their efficiency was evaluated using endpoint PCR and sequencing. Finally, the method was optimized and implemented as a one-step triplex PCR assay for routine diagnostic use. The molecular laboratory at the Mures County Clinical Hospital (MCCH) analyzed a total of 41,818 samples between June 2020 and December 2022. Among these samples, 26.15% tested positive for SARS-CoV-2, while 70.9% were negative and 2.95% were inconclusive or invalid. Three peaks of positive tests were observed in November 2020, April 2021, and February 2022. The study selected 92 preserved RNA samples for triplex-PCR assay development, validating the primers' specificity and confirming the quality of the nucleic acids. The comparative analysis showed the efficiency and accuracy of the endpoint reverse-transcription triplex-PCR method (RT-PCR), indicating its potential as a cost-effective alternative to real-time reverse-transcription PCR (qRT-PCR) in low-income countries with limited infrastructure for COVID-19 testing. This method has the potential to facilitate large-scale diagnosis of SARS-CoV-2 infections, allowing for rapid and appropriate therapeutic management and ongoing monitoring of patients. Additionally, the method can be easily adapted for the detection of other pathogens.

Ethnic disparities in clinical severity of COVID-19 as predictor of long COVID

Abstract Background Recent studies from Europe have shown a higher incidence of long COVID among ethnic minorities compared to the majority population. Little is known of these disparities, but they might be related to factors such as COVID-19 disease severity, barriers in access to health and individual factors such as working and living conditions. This study will elucidate possible predictors of long COVID related to COVID-19 disease severity in an ethnic diverse hospitalised cohort. Methods A retrospective cohort study of 1648 patients admitted with COVID-19 at three hospitals in Copenhagen, Denmark, between 1st February 2020 and 31st May 2022. Clinical data was extracted from health care records, and subsequently linked to data from Statistics Denmark on long COVID diagnosis (ICD-10 “DB948A”) as well as migration status. Results 1361 patients were discharged alive and of those, 113 (8,3%) patients got a long COVID diagnosis. Preliminary analyses show no excess risk of getting a long COVID diagnosis as a migrant compared to patients of Danish origin (RR = 1,20, p = 0,35). Some ethnic disparities are seen in disease severity among all patients discharged alive. Patients with migrant background were admitted to the hospital later (6,8 vs 5,6 days, p &amp;lt; 0,0001), and at a greater risk of needing high flow oxygen administration upon admission (RR = 1,46, p = 0,0012) compared to patients of Danish origin. Furthermore, a higher degree of systemic inflammation is seen among migrants with regards to lactate dehydrogenase (LDH) compared to patients of Danish origin (349,7 vs 317,2 U/L, p = 0,0014). No significant differences in c-reactive protein (CRP) levels (92,8 vs 85,9 mg/L, p = 0,11). Conclusions Preliminary analyses indicates possible ethnic disparities in COVID-19 disease severity among patients discharged alive possibly playing a role as predictors of long COVID. Low health literacy or language barriers might partly explain this. Further analyses are needed. Key messages • In preliminary analyses of 1381 patients previously admitted with COVID-19, we find no excess risk of a long COVID diagnosis (DB 948B) among patients with migrant background. • Preliminary analyses show some ethnic disparities in COVID-19 disease severity that might act as possible predictors of long COVID.

Risk of long COVID and associated symptoms after acute SARS-COV-2 infection in ethnic minorities: a Danish nationwide cohort study

Abstract Background and aim Ethnic minorities living in high-income countries have been disproportionately affected by COVID-19 in terms of infection rates, hospitalisations, and deaths; however, less is known about long COVID in these populations. Our aim was to examine the risk of long COVID and associated symptoms among ethnic minorities. Methods We used Danish nationwide register-based cohort data on individuals diagnosed with COVID-19 aged ≥18 years (n = 2 334 271) between January 2020 and August 2022. We calculated the risk of long COVID diagnosis and long COVID symptoms among ethnic minorities compared with native Danes using multivariable Cox proportional hazard regression and logistic regression, respectively. Results Of the diagnosed COVID-19 cases, 1 973 998 (84.6%) were native Danes and 360 273 (15.4%) were ethnic minorities. After adjustment for age, sex, civil status, education, family income, and Charlson comorbidity index, ethnic minorities from North Africa (adjusted hazard ratio [aHR] 1.41, 95% CI [1.12,1.79]), Middle East (aHR 1.38, 95% CI [1.24,1.55]), Eastern Europe (aHR 1.35, 95% CI [1.22,1.49]), and Asia (aHR 1.23, 95% CI [1.09,1.40]), had significantly greater risk of long COVID diagnosis than native Danes. In the analysis by largest countries of origin, the greater risks of long COVID diagnosis were found in Iraqis (aHR 1.56, 95% CI [1.30,1.88]), Turks (aHR 1.42, 95% CI [1.24,1.63]), and Somalis (aHR 1.42, 95% CI [1.07,1.91]). A significant factor associated with an increased risk of long COVID diagnosis was COVID-19 hospitalisation. Conclusions Migrants and ethnic minorities had higher risk of long-COVID compared to native Danes.

Long-term mental health impairments in survivors of critical illness

Abstract Background Survivors of critical illness frequently suffer from long-term disabilities, including physical, cognitive, and mental impairments (post-intensive care syndrome). However, long-term studies are scarce and healthcare services for critical illness survivors are limited, not only in Germany. Therefore, we followed-up on anxiety, depression, and post-traumatic stress disorder (PTSD) during post-intensive care unit (ICU) rehabilitation and up to 1 year after critical illness onset. Methods Patients at Schoen Clinic Bad Aibling in Germany were eligible for this prospective cohort study after receiving ≥5 days of mechanical ventilation. The Hospital Anxiety and Depression Scale (HADS; subcategory score ≥8) was conducted after ICU discharge (V1), at discharge from inpatient rehabilitation (V2) and 1 year after critical illness onset (V3). The Impact of Event Scale-6 (score ≥1.75) was conducted to assess PTSD at V3. Multiple logistic regressions were performed. Results We included 250 patients (62±14 years, 34% female, median stay on ICU 55 days, median duration of rehabilitation 65 days). 10% died before V3. Anxiety decreased during rehabilitation (effect size r = 0.35, p&amp;lt;.001), but increased again until V3 (r = 0.42, p&amp;lt;.001). At V3, 54% suffered from anxiety. Depression also decreased during rehabilitation (r = 0.46, p&amp;lt;.001), and increased again until V3 (r = 0.39, p&amp;lt;.001). At V3, 44% showed depressive symptoms and 38% suffered from PTSD. COVID-19 diagnosis was associated with increased anxiety (p&amp;lt;.001), depression (p=.068), and PTSD at V3 (p=.028), compared to non-COVID-19 patients. Furthermore, longer duration of mechanical ventilation was associated with increased anxiety (p=.041) and depression (p=.019) at V3. Conclusions Mental health impairments frequently occur in critical illness survivors, and they seem to worsen after rehabilitation. As these impairments can significantly impact daily functioning and quality of life, tailored healthcare services are urgently needed. Key messages • Anxiety, depression, and PTSD are frequent in critical illness survivors, even 1 year after critical disease onset. This calls for tailored healthcare services. • Patients with COVID-19 and longer mechanical ventilation suffer from more severe mental health impairments.

Epidemiological, clinical, paraclinical, evolutionary, and therapeutic aspects of hypertensive patients infected by COVID-19: about 702 patients in our city

Abstract Introduction Hypertension (HT) is a major cardiovascular risk factor frequently observed in COVID-19 patients. This study aimed to determine the frequency of hypertensive patients infected with COVID-19 at a national hospital, describe their epidemiological, clinical, paraclinical, and therapeutic profile, their disease progression, and identify factors associated with death. Methodology A retrospective, descriptive, and analytical study was conducted over 24 months and 4 days, from 27 March 2020 to 30 March 2022, at national hospital. Included were hospitalized patients at a hospital with a confirmed COVID-19 diagnosis, known hypertensives, regardless of gender, and with a hospitalization record. COVID-19 diagnosis was based on a positive SARS-CoV-2 RT-PCR or a positive COVID Rapid Diagnostic Test. Data were collected using a survey form, with a p-value less than 0.05 considered statistically significant for bivariate analysis. Results The study enrolled 702 patients, a hospital frequency of 23.95%. The average age was 65.14 ± 12.24 years with a sex ratio of 0.81. Comorbidities were predominantly diabetes (40.5%) and dyslipidemia (4.8%). Common symptoms included cough (65%), dyspnea (42.3%), fever (47.4%), and asthenia (35.9%). Blood pressure was normal in 15.2%, high-normal in 16.8% of patients. HT was Grade I in 12.1%, Grade II in 10%, and Grade III in 6.8% of the population, with blood pressure unmeasurable in 0.3% of known hypertensive patients. SARSCOV2 infection was mild in 34.2% and moderate in 42.8% of cases. CT scans showed extensive (31.8%), severe (25.9%), moderate (25.6%), critical (8.5%), and minimal (7.9%) lung damage. Treatment mainly consisted of ACE inhibitors (29%), ACE inhibitors in combination with another antihypertensive (8.4%), and ARBs in combination with an antihypertensive (). The average hospital stay was 12.85 days with a favorable outcome in 81% and a mortality rate of 15.5%. Factors associated with death included not being vaccinated against COVID-19 (HR: 11.70; 95% CI: 1.324-103.519), critical clinical form (HR: 11.70; 95% CI: 1.324-103.519), pulmonary consolidation (HR: 8.87; 95% CI: 7.539-24.207), high creatinine (HR: 4.69; 95% CI: 1.360-16.181), critical CT thoracic level (HR: 2.42; 95% CI: 1.020-5.745), and not taking ARBs (HR: 6.02; 95% CI: 2.812-12.889). Conclusion HT can be associated with COVID-19, impacting the disease's prognosis with significant mortality. Preventing its incidence and morbidity/mortality is crucial.

Risk of long COVID in migrants and the contribution of vaccinations, disease severity, social inequalities and preexisting health: A nationwide register study in Sweden

Abstract Background and aim A number of studies have found higher COVID-19 infection rates, hospitalizations and deaths in migrants and ethnic minorities throughout the Corona Pandemic. Some recent evidence also suggests higher risk of long COVID in migrants although less is known about the risk factors for long COVID in this population. The objective of our study is to examine the risk of long COVID in migrants and to examine whether preexisting health conditions, disease severity, social inequalities and vaccinations contribute to the association. Methods We used linked Swedish administrative registers to estimate the risk of a long COVID diagnosis in the population that had a confirmed COVID-19 infection. Poisson regressions were used to calculate incidence rate ratios between the Swedish born and migrant groups. Adjustments for preexisting health conditions, disease severity, vaccinations and social inequalities were separately introduced. Results Higher risks of long COVID were found among migrants from Africa, Asia, Eastern Europe, Finland, Middle-East and South America. While the contribution of vaccinations and social inequalities were modest, we found that disease severity (i.e. whether the person was hospitalized or treated in an intensive care unit) primarily contributed to the higher risk of long COVID found in migrants. Conclusions The greater exposure and impact of the COVID-19 virus among migrants during the pandemic also affected the longer-term consequences of infection in this at-risk population.

The Network of Expertise on Long COVID as a means to synthesise intelligence and improve our response to long COVID at EU level

Abstract To promote international collaboration and strengthen EU and national-level responses to Long COVID, the Commission set up the Network of Expertise on Long COVID (NELC) in 2023. It brings together national institutions involved in Long COVID work, nominated by the Public Health Expert Group (PHEG) representatives of each Member State. The network provides a platform for exchanges of national experiences on diagnosis, treatment, and management of long COVID. The Commission and the NELC agreed on eight specific actions to be implemented to manage Long COVID. The development of a Long COVID definition is complex due to the diverse range of symptoms experienced by patients, and so working towards a unified EU case definition is the first action proposal. This will allow the development and implementation of a surveillance system on national and EU level to foster the knowledge on the actual scale and the symptomatology of Long COVID across the EU leading to a better comparability of health data at Union level. The proposal to develop and implement a training programme for healthcare professionals at EU level will allow for the exchange of expertise/training on Long COVID across Member States. The provision of clinical guidelines based on evidence to Member States will help manage Long COVID, and international collaboration will allow for the sharing of valuable information and data with third countries that have experience with Long COVID. The Commission will use the EU Health Policy Platform to create an open stakeholder group. This group will allow stakeholders and patient groups to express their point of view, and to share experiences. Assessing the far-reaching social and economic consequences of Long COVID across the EU will allow for more targeted social and economic policy responses from Member States. It is important that priority is given to research responding to the most urgent needs of health care systems, which is why the Commission aims to identify research needs.

Memory impairment after one year of the acute episode of Covid-19 infection

Abstract Introduction Memory impairment is one of the most frequently reported sequelae of COVID-19 infection. The aim of our study was to estimate the risk of memory disorders one year after the acute episode of COVID-19 infection in the Tunisian population of Monastir. Methods This is a cohort study conducted in Monastir University Hospital. The study included two groups: Exposed subjects were randomly selected among those with a positive diagnosis of COVID-19 between September 2021 and January 2022. The non exposed group was selectd among subjects with a negative COVID-19 diagnosis during the same period and who had no COVID infection during the following year. The Mac Nair scale was used to assess memory impairment after one year of follow up. Results Our study included 140 subjects diagnosed with Covid-19 and 139 subjects who had never been in contact with this virus. The incidence rate of memory impairment at one year post-Covid-19 infection was 17.9% (IC95% [11.5 - 24.2%]), whereas in the non exposed group it was 9.4% (IC95% [4.45% -14.5%]). Multivariate analysis revealed that the group exposed to Covid-19 had a significantly higher Mac-Nair Total score after one year of the acute episode of infection compared with the non exposed group (exp β = 1.25, IC95% [1.10; 1.42]). The other main predictors of memory impairment in the study population were age (exp β = 1.006, IC95% [1.001; 1.01]), diabetes (exp β = 1.67, IC95% [1.44; 1.95]), history of anxiety and depression ((exp β = 1.71, IC95% [1.35; 2.17]) and obesity (exp β = 1.25, IC95% [1.10; 1.42]), whereas vaccination with two or more doses prior to COVID-19 infection (exp β = 0.84, IC95% [0.74; 0.96]) and male gender (exp β = 0.65, IC95% [ 0.57; 0.73]) were found to be protective against these disorders. Conclusions Our study allowed us to estimate the risk of long-term memory disorders following Covid-19 infection. This could help better guide preventive measures to reduce the incidence of these disorders. Key messages • The incidence rate of memory impairment at one year post-Covid-19 infection was 17.9%. • The main other predictors of memory impairment were age, female gender, diabetes, history of anxiety and depression and obesity whereas vaccination prior to COVID-19 infection was a protective factor.

Prevalence of COVID-19 Status among the People of Different Strata

Background: Coronavirus disease (COVID-19) is an irresistible illness caused by the SARS-CoV-2 infection. Most individuals who drop wiped out with COVID-19 will involvement gentle to direct side effects and recoup without uncommon treatment. Some will become seriously ill and require medical attention. However, it is preventable through obeying some measures of personal hygiene. Methods: This descriptive cross-sectional study was conducted to determine COVID-19 status among people of different strata in Uttara and Savar. A total of 1200 conveniently selected respondents were interviewed face-to-face using a semi-structured questionnaire. Results: Mean age was 38.59 years with standard deviation ±14.117 years. Majority (63.33%) were male. Among them 20.7% were housewives, 11.5% were students, 15.3% were businessmen and 9.3% were service holders. Most (98.6%) of the respondents mentioned to know about pandemic situation of COVID-19. Among the respondents 207 (17.3%) suffered from COVID-19. Among those who suffered from COVID-19 (207), 157 performed test for COVID-19 and was positive. The other 50 did not perform test and only assumed to be suffering from COVID-19 as they had symptoms. On the other hand, 993 respondents mentioned of not suffering from COVID-19. Among them, 803 had no symptom and 190 underwent COVID-19 test and were negative. Proportion of suffering from COVID-19 was found high among the doctors (64.1%), service holders (22.5%), students (21.7%) and teachers (21.1%). Conclusion: Measures to be undertaken to create awareness among the people to abide by the health rules so that we can reduce the incidence of COVID 19. EWMCJ Vol. 12, No. 1&amp;2, January-July 2024: 80-87

Exploring the Psychosocial Impact of Hospitalization for COVID-19: Insights from Patient Experiences

Abstract Background The COVID-19 pandemic has severely tested the organizational structure and operational effectiveness of healthcare systems. We aimed to explore the experiences of patients who have been hospitalized due to COVID-19. Methods Employing purposive sampling, semi-structured interviews were conducted covering eight topics: 1) the experience of COVID-19 diagnosis, 2) the most difficult moments during hospitalization, 3) difficulties related to hospital conditions and safety protocols, 4) interactions with healthcare professionals, 5) received support, 6) social stigma, 7) concerns about the future, and 8) post-COVID and long COVID syndrome. Twelve individuals (six women and six men; mean age 57.5 (SD = 13) years; mean length of stay 18.1 (SD = 3.1) days) participated. The data analysis was carried out using the phenomenological method according to Colaizzi. Results Patients reported a spectrum of emotions including loneliness, isolation, abandonment, disappointment, insecurity and fear of death. Interactions with healthcare professionals revealed a dichotomy: experiences of respectful, reassuring care contrasted with encounters lacking psycho-emotional support within an impersonal healthcare setting. Conclusions This study sheds light on the experiences of patients on the nursing wards and their psychosocial burden. Most of them reported negative emotions such as loneliness, isolation, sadness, fear and anxiety rather than positive experiences such as hope, interpersonal connectedness, self-identity, empathy, caring and safety. Key messages • The study highlights psychosocial challenges for COVID-19 patients, emphasizing the urgent need for robust support systems. • The study provides insights for future similar situations and highlights the need for adaptable care models based on principles such as empathy, safety and personalized approaches.

Income transfer and COVID-19 pandemic in Brazil: wrong and right at the same time

Abstract To alleviate the effects of socioeconomic inequalities and of the fall in economic activity on vulnerable populations during the COVID-19 pandemic, many countries have implemented or expanded income distribution programs. Brazil, amid the political and economic 2020 crisis, exacerbated by the pandemic, established Emergency Aid (EA). This longitudinal ecological study aimed to analyze whether the availability of EA contributed to the reduction of morbidity and mortality due to COVID-19 in the Brazilian 5,570 municipalities, from March 2020 to December 2021. The theoretical model considered as control covariates socioeconomic, sociodemographic and morbidity characteristics and access to health services, including COVID-19 testing availability and vaccination. Classical variable selection methods were applied considering the theoretical model, culminating in the adjustment of Bayesian hierarchical models with the inclusion of spatial and temporal effects. First dose COVID-19 vaccine coverage and EA had a protective effect against hospitalization (RR = 0.982 and RR = 0.986) and mortality (RR = 0.978 and RR = 0.976) due to COVID-19 in Brazil, when controlled by socioeconomic variables, access to health services and spatial-temporal effects. The results highlight the important role of income transfer in morbidity and mortality due to the disease, however, the way in which EA was implemented in Brazil presented a series of problems, the main ones being discontinued payment of aid, reduction in values throughout the duration of the benefit, in addition to the use of public resources to pay people who did not meet the eligibility criteria. Such problems might not have happened if the federal government had maintained the registration structure of Bolsa Familia Program (BFP), which did not happen. Furthermore, vaccination was started late for several reasons, that is, its role in reducing morbidity and mortality could have been even greater if started as soon as it become available. Key messages • Even with planning and execution problems, income transfer and specific vaccination were important in reducing COVID-19 morbidity and mortality in Brazil during the COVID-19 pandemic. • Income transfer during the COVID-19 pandemic in Brazil was not done in the best way possible, due to discontinued payment, reduction in values and payment to not eligible people.

Post-infection symptoms up to 24 months after COVID-19: a matched cohort study in Berlin, Germany

Abstract Background Long-term health consequences after mild COVID-19 are not well described. Our aim was to estimate their prevalence and describe the time course of signs and symptoms for a period of up to 24 months after confirmed SARS-CoV-2 infection. Methods We conducted a cohort study matched for age, sex, and test week among individuals who had attended the public COVID-19 test center at Charité - Universitätsmedizin Berlin, Germany. In early 2022, 576 former COVID-19 patients (&amp;gt;95% non-hospitalised) and 302 uninfected individuals responded to a questionnaire on retrospective monthly symptoms since the test date up to 24 months after. Results Symptoms compatible with long COVID were present in 42.9% (247/576) of former COVID-19 patients, compared with 21.2% (64/302) in the uninfected group. In former patients, unadjusted odds ratios (OR) were highest for disturbed taste/smell (OR 9.1 [95% CI: 4.0 - 21.1]), memory difficulties (OR 5.1 [95% CI: 2.9 - 8.9]) and shortness of breath at rest (OR 4.5 [95% CI: 1.9 - 10.6]). Whilst in most former COVID-19 patients, symptoms occurred in one coherent period and resolved after a median of 6.5 months, taste/smell disturbance and neurological/cognitive symptoms showed longer times until recovery and 28.7% (31/108) still reported long COVID-compatible symptoms 18 months after initial COVID-19. Factors associated with long COVID-compatible symptoms included hospitalisation (OR 4.2 [95% CI: 1.7 - 10.8], symptomatic COVID-19 infection (OR 3.4 [95% CI: 1.9 - 6.3], low household income (OR 1.8 [95% CI: 1.2 - 2.7], and female sex (OR 1.7 [95% CI: 1.2 - 2.4]). Conclusions Post-infection symptoms in mild COVID-19 mostly persist for about half a year, but sometimes longer. Among uninfected individuals who never experienced COVID-19, 21.2% also reported long COVID-compatible symptoms. The current long COVID definition might require revision to prevent misclassification and over-reporting, and to improve diagnosis and prevalence estimates. Key messages • A more precise definition of long COVID is needed to prevent over-reporting of symptoms compatible with long COVID, and to improve diagnosis, prevalence estimates and research harmonisation. • Post-infection symptoms after mild COVID-19 are common, mostly persist for about half a year but sometimes longer for more than 20 months.

Child COVID-19 rates and migrant status: A quantitative study in the Lisbon area (Mar 2020-Jun 2022)

Abstract Introduction According to OECD data, immigrant children were over-represented among COVID-19 cases compared to non-immigrant children. However, evidence is missing on whether their migrant status is associated with testing positive for COVID-19. Therefore, we aimed to estimate COVID-19 positivity rates among children residing in five municipalities of the Lisbon metropolitan area, Portugal, and to analyze migrant status as a determinant of health. Methods We conducted a prospective cross-sequential cohort study with 989 children born in 2015, 2018, and 2020 (48.5% non-immigrants; 51.5% immigrants). Sociodemographic data were collected through interview-based questionnaires, and the child’s birth weight and gestational age were obtained from the primary health center’s information system (SClinico). COVID-19 test results (conducted between March 2020 and June 2022) were obtained from the national surveillance system (SINAVE Lab) and categorized into two primary outcomes: ever positive for COVID-19 (yes/no) and positivity frequency for COVID-19 (count). Robust and standard Poisson regressions were used to estimate the association between primary outcomes and demographic, socioeconomic, and clinical variables. We estimate relative risks (RR) and prevalence ratios (PR) with 95% confidence intervals. Results The positivity rate is lower for immigrant children (12% vs 17%). Compared with non-immigrant, and adjusting for other factors, immigrant children are 52% less likely to be ever positive for COVID-19 (PR = 0.482; IC 95%: 0.392-0.594), and the estimated number of positive tests is 54% lower (RR = 0.456; IC 95%: 0.362-0.574). Conclusions Being an immigrant is a protective factor against testing positive for COVID-19, aligning with the well-known immigrant paradox. These results underscore the need for further research into the immunological profiles of this population and are crucial for guiding strategies to manage emerging public health crises. Key messages • Immigrant children living in the Lisbon metropolitan area may have a protective factor against testing positive for COVID-19, consistent with the well-known immigrant paradox. • Understanding COVID-19 positivity rates and associated factors in children is crucial for guiding effective strategies to manage and mitigate emerging public health crises.