COVID, Volume 4, Issue 9 (September 2024) – 11 articles

This study explores the impact of the COVID-19 pandemic on the motivation of medical students using a mixed-method, user-led approach with students as both participants and researchers. Data were collected in 2021 through essays describing students’ motivation during the pandemic. The essays were coded, categorized, quantified, and statistically analyzed for gender-based differences. Results showed that while 71% of students reported increased motivation, female students more often experienced fluctuating motivation levels. Key motivational factors included career aspirations and educational purpose, whereas demotivational factors involved disruptions to college life and mental health struggles. Notably, female students disproportionately expressed doubts about the medical profession. The study also utilized a collaborative autoethnographic method to explore the researchers’ own pandemic experiences, revealing long-term positive effects and resonating with initial findings. This research contributes to understanding the pandemic’s long-term impact on medical students and offers insights into nurturing resilient future doctors capable of handling healthcare crises. Full article

Objectives: This study aims to examine the serological and infectious characteristics of the Xokós indigenous community in Brazil, both prior to and following COVID-19 immunization; Methods: Immunofluorescence assays were employed to identify the SARS-CoV-2 viral antigen, while IgM and IgG antibody tests for COVID-19 were utilized to assess the participants’ infectious and serological profiles in July 2020, before the commencement of the COVID-19 vaccination campaign, and in March 2022, during the booster dose vaccination campaign; Results: The majority of participants (n = 22) were female, with an average age of 42.20 years. The most prevalent comorbidity was hypertension (60%; n = 9), followed by hypertension associated with diabetes (20%; n = 3). No statistically significant correlation was found between the timing of vaccination and the levels of antigens or IgM. However, the prevalence of reactive antigens and IgM was 13.3% (n = 4) in the pre-vaccination group and 3.3% (n = 1) in the post-vaccination group. A statistically significant difference in IgG production was observed before and after vaccination (χ²(1) = 39.095, p < 0.01), as well as differences in IgG antibody detection before and after vaccination and in the vaccines used. Participants showed a higher probability of reactive IgG antibodies following vaccination; Conclusions: Our data demonstrate the beneficial effects of vaccination on the indigenous community, highlighting that continued immunization is a crucial step in protecting indigenous health and preventing severe outbreaks and deaths associated with the disease. Full article

Purpose: This study aimed to explore how race and the socioeconomic index (SES) of residential zip codes influenced COVID-19 testing rates in St. Louis during the early and peak phases of the pandemic. Method: An ecological study was conducted using COVID-19 testing data from March to November 2020 in St. Louis City, including 16,915 tests from 30 residential zip codes. Geographical mapping identified areas lacking testing, descriptive statistics characterized testing rates by race and SES, and robust linear regression modeled the association between testing rates and race, controlling for SES. Results: The overall testing rate was 303.97 per 10,000 population. Testing rates among Blacks, Whites, American Indians/Alaskan Natives, and Asians were 374.26, 247.77, 360.63, and 242.41 per 10,000, respectively. Higher rates were observed in low- and middle-SES zip codes compared with high-SES areas. Adjusted for SES, testing rates per 10,000 were higher by 125 (1.25%), 448 (4.48%), and 32 (0.32%) among Blacks, American Indians/Alaskan Natives, and Asians compared with Whites. Testing rates decreased by 56 (0.56%) per unit SES improvement. There was statistically significant SES finding and that of the difference between American Indians/Alaskan Natives and Whites. Geographical mapping showed higher rates in the inner core and lower rates in the periphery of St. Louis. Conclusions: Race and SES influence testing rates. Targeted interventions are needed in areas with low testing rates in St. Louis. Full article

Long COVID comprises persistent symptoms that extend beyond four weeks post-SARS-CoV-2 infection. The potential association between long COVID and the endorsement of COVID-19 conspiracy theories has not been explored, particularly in Arab countries, where high endorsement of these theories has been reported. This study aimed to explore the association between endorsing COVID-19 conspiracy theories and the prevalence of self-reported long COVID symptoms among adults in Jordan and Kuwait in addition to other Arab countries. The study employed a cross-sectional design using Computer-Assisted Web Interviewing (CAWI), conducted in Arabic. Recruitment utilized convenience-based snowball sampling via social media and the survey was distributed in July 2024. Long COVID manifestations were assessed across ten recognized symptoms, and belief in conspiracy theories was measured using a five-point Likert scale across five items. The final study sample comprised 755 respondents, the majority of whom self-reported a history of confirmed COVID-19 diagnosis at least once (n = 493, 65.2%). The results indicated a neutral average attitude towards COVID-19 conspiracy theories (mean score = 15.18 ± 4.64 out of 30.00). Participants with high COVID-19 conspiracy theories scores were more likely to report high (aOR = 6.85, p < 0.001) or middle long COVID symptoms (aOR = 2.82, p = 0.008) compared to those with lower scores. Additional predictors of higher long COVID reporting included female sex, lower household income, frequent COVID-19 infections, and hospitalizations. The study results revealed a significant correlation between the endorsement of COVID-19 conspiracy theories and a higher frequency and magnitude of long COVID symptom reporting. The findings also highlighted the influence of sociodemographic factors and COVID-19 infection history on long COVID reporting, which suggests that public health strategies should address these factors to mitigate long COVID challenges effectively. Full article

Since the WHO declared COVID-19 a pandemic, prominent social actors and institutions have warned about the threat of misinformation, calling for policy action to address it. However, neither the premises underlying expert claims nor the standards to separate truth from falsehood have been appraised. We conducted a scoping review of the medical and social scientific literature, informed by a critical policy analysis approach, examining what this literature means by misinformation. We searched academic databases and refereed publications, selecting a total of 68 articles for review. Two researchers independently charted the data. Our most salient finding was that verifiability relied largely on the claims of epistemic authorities, albeit only those vetted by the establishment, to the exclusion of independent evidentiary standards or heterodox perspectives. Further, “epistemic authority” did not depend necessarily on subject matter expertise, but largely on a new type of “expertise”: in misinformation itself. Finally, policy solutions to the alleged threat that misinformation poses to democracy and human rights called for suppressing unverified information and debate unmanaged by establishment approved experts, in the name of protecting democracy and rights, contrary to democratic practice and respect for human rights. Notably, we identified no pockets of resistance to these dominant meanings and uses. We assessed the implications of our findings for democratic public policy, and for fundamental rights and freedoms. Full article

The global pandemic sparked by the emergence of SARS-CoV-2 and its variants has imposed a substantial burden of morbidity and mortality. Central to the battle against these viral threats is the immune response, with a spotlight on the pivotal role played by neutralizing antibodies. This comprehensive review delves into current research, unravelling the dual functionality of neutralizing antibodies acting as formidable barriers to viral replication and crucial facilitators of adaptive immune memory. Beyond this dual purpose, the review illuminates the nuanced variability characterizing neutralizing antibody responses to SARS-CoV-2. Emphasizing the dynamic nature of these responses, the review advocates for the plausible challenges in targeted therapeutic interventions. This review also attempts to compare various vaccination approaches and their impact on SARS-CoV-2, as well as offer insights into various Omicron variations. Recognizing the ever-evolving viral landscape, this exploration underscores the necessity of flexible approaches to address the diverse challenges posed by SARS-CoV-2 and its variants, contributing valuable insights to the ongoing global efforts in pandemic mitigation and public health safeguarding. Full article

Subjective well-being (SW) is understood as the personal judgment that an individual has about their value, perception, and level of satisfaction with respect to his or her life and existence. The present study had the purpose of understanding how pandemics have affected subjective well-being; therefore, the objective was to determine the subjective well-being of the staff at a teaching dental center in a COVID-19 epidemiological surveillance system between the years 2020 and 2022. A cross-sectional design was applied and was based on data from two records of the Centro Dental Docente of the Universidad Peruana Cayetano Heredia, Lima, Peru, between the years 2021 and 2022. The results show that the mean SW did not significantly vary (p = 0.114) between 2021 (69.32; SD = 19.92) and 2022 (63.16; SD = 29.87). At a bivariate level, significant associations were also observed between SW and multiple variables such as the diagnosis and type of COVID-19, vaccination, contact with COVID-19 patients, systemic conditions, body mass index, educational level, gender, and age. Meanwhile, according to the regression analysis, not having COVID-19 was positively associated with higher levels of subjective well-being. This study highlights the impact of the COVID-19 pandemic on the mental and emotional states of dental healthcare personnel, emphasizing the need for strategies to mitigate stress and anxiety in such critical work environments. Full article

Approximately 31% of patients previously infected with SARS-CoV-2 are living with symptoms of long COVID in the United States. Long COVID significantly reduces quality of life and increases morbidity and disability; however, treatment options are limited. Enhanced External Counterpulsation (EECP) is an FDA-approved, non-invasive treatment for the management of cardiovascular symptoms with a mechanism of action which stimulates pathways that induce endothelial homeostasis, improving microvascular function, inflammation, and immune regulation, thereby potentially targeting the underlying etiology of long COVID. We recently reported that EECP improved symptoms in 231 patients with long COVID. Previous studies assessing the effects of EECP for long COVID have lacked a control group. As such, this analysis is the first comparing outcomes in patients with long COVID undergoing EECP (n = 33) to a non-treated group (control, n = 33). The patients were matched for baseline characteristics, and all patients completed patient-reported outcome assessments, including PROMIS Fatigue, the Duke Activity Status Index (DASI), and the Rose Dyspnea Scale (RDS), two times within a specified time interval. When comparing the average change from baseline in both groups, the EECP-treated patients’ improvement was significantly greater than the improvement in the control group across all measured endpoints, including PROMIS Fatigue (−15.0 ± 8.9 vs. −2.8 ± 5.9, p < 0.001) and DASI (+17.8 (11.8, 26.8) vs. +1.8 (−3.5, 5.5), p < 0.001), and there was an improvement of ≥1 in the RDS class (75.8% vs. 33.3%, p < 0.001). This study’s limitations include the small sample size and lack of information regarding concurrent treatments or interventions in the non-treated group; however, these preliminary data support EECP as a potential low-risk treatment option for patients with long COVID. Full article

The emergence of mRNA vaccines for SARS-CoV-2 has opened a new page in vaccine development. Nevertheless, concerns of experts have been expressed about unintentional side effects on the gut microbiota (GM). Previous studies showed that this virus acts as a bacteriophage, which infects and destroys specific bacterial strains in the GM. The present manuscript hypothesizes that the synthetic spike protein could create changes in the composition and the functioning of the GM by entering the intestinal cells after vaccination and impairing the symbiotic relationship between intestinal cells and the GM. An experimental protocol to test the hypothesis is suggested. Full article

Background: Multisystem inflammatory syndrome in children (MIS-C) occurs after SARS-CoV-2 infection, with gastrointestinal symptoms a prominent feature. This syndrome has been proposed to be triggered by persistent SARS-CoV-2 antigenemia due to increased intestinal epithelial permeability. We obtained evidence for this in this study. Methods: In a single-centre study, we recruited 83 children and analysed blood samples to quantify the circulating markers of increased intestinal permeability following SARS-CoV-2 infection. Publicly available proteomics MIS-C datasets were also accessed to assess the evidence for increased intestinal permeability. We further quantified SARS-CoV-2 antigenemia and the humoral response to SARS-CoV-2 spike protein. Results: Following SARS-CoV-2 infection, healthy children demonstrated no dysregulation of the intestinal epithelial barrier. In MIS-C, considerable increases in markers of epithelial dysfunction were observed, with similar increases noted in febrile controls. Furthermore, we found little evidence of persistent SARS-CoV-2 antigenemia in MIS-C. Conclusions: Our results suggest that although increased intestinal epithelial permeability is a feature of MIS-C, it is not unique to the condition, and persistent SARS-CoV-2 antigenemia does not occur. Full article

Human coronavirus 229E (HCoV-229E) is an alpha coronavirus that infects humans and bats. In common with all positive-strand RNA viruses, 229E infection causes rearrangements of the host’s intracellular membranes to form replication organelles, a highly conserved and vital step in the viral replication cycle. Here, we investigated the role of the ESCRT protein VPS4A in 229E infection. We found that functional VPS4A was required for the formation of replication organelles and localizing viral RNA to these structures in host cells to facilitate viral genome replication. We validated this effect using small molecule inhibitors to VPS4A, significantly reducing virus replication. We also showed that other ESCRTS, like CHMP4B, were required for the virus replication step, whereas VPS37A was involved in the post-replication stages. The absence of a functional VPS4A prevented the remodeling of membranes to form viral replication centers and, therefore, exposed the viral RNA, triggering an inflammatory immune response as indicated by elevated levels of IL-6. Interestingly, we observed the role of VPS4A to be similar for the OC43 coronavirus, indicating it could be conserved across all four coronavirus genera, including SARS-CoV-2. Understanding more about the replication of coronaviruses is imperative to finding more effective ways to control them. Full article