Since winter 2019, SARS-CoV-2 has emerged, spread, and evolved all around the globe. We explore 4 y of evolutionary epidemiology of this virus, ranging from the applied public health challenges to the more conceptual evolutionary biology perspectives. Through this review, we first present the spread and lethality of the infections it causes, starting from its emergence in Wuhan (China) from the initial epidemics all around the world, compare the virus to other betacoronaviruses, focus on its airborne transmission, compare containment strategies ("zero-COVID" vs. "herd immunity"), explain its phylogeographical tracking, underline the importance of natural selection on the epidemics, mention its within-host population dynamics. Finally, we discuss how the pandemic has transformed (or should transform) the surveillance and prevention of viral respiratory infections and identify perspectives for the research on epidemiology of COVID-19.

The emergence of the SARS-CoV-2 virus worldwide led to the call for the development of effective and safe vaccines to contain the spread and effects of COVID-19. Using information from 40 publications, including clinical trials and observational studies from 2019 to 2024, this review assesses the effectiveness, safety, and limitations of four major vaccines: Sinopharm (BBIBP-CorV), Moderna (mRNA-1273), Pfizer-BioNTech (BNT162b2), and CoronaVac. Pfizer-BioNTech and Moderna's mRNA vaccines proved to be more effective than others; Moderna's vaccines showed an efficacy of 94.1 % against symptomatic infection, while Pfizer-BioNTech's vaccines showed an efficacy of up to 95 %, against severe diseases and hospitalization. These vaccinations, which included protection against Omicron and Delta variants, offered notable protection against serious illness, hospitalization, and mortality. Severe adverse events were rare while most adverse events were mild to moderate, such as headaches, fatigue, and localized reactions. In contrast, inactivated virus vaccines such as Sinopharm and CoronaVac with efficacies ranging from 50 to 79 % against symptomatic infection showed lower levels of effectiveness. In Phase 3 trial, Sinopharm showed 72.8 % efficacy, whereas CoronaVac demonstrated roughly 67 % efficacy in population against hospitalization and severe disease. Booster doses were required for adequate immunological response, especially against novel strains, as these vaccinations proved to be less effective in older populations. They showed considerable safety profiles, with mild side effects, but their low immunogenicity is concerning. This review emphasizes the importance of continuously evaluating vaccines in response to the evolving virus, essential for improving international immunization programs.

The US Centers for Disease Control and Prevention (CDC) has responded to criticism claiming that the agency's COVID-19 response was lacking by proposing internal reforms intended to improve its performance during the next pandemic. The reforms are aimed at improving surveillance, analytic capacity, and agency communications. This article conducts a counterfactual analysis of the CDC's proposed reforms to ask how they might have changed outcomes in four cases of guidance controversy during the pandemic if they had been completed in advance of COVID-19. Although the CDC's planned reforms have merit, they are predicated on the ability to come to scientific closure in a highly charged political environment. To improve outcomes in a future pandemic, the agency should consider how it plans to communicate with the public when recovering from error and when addressing controversy spurred by criticism from credible experts. However, the ability of future presidents to limit CDC performance and communications in the next pandemic and the lack of political consensus around the value of independent public health expertise are likely to threaten any effort to improve pandemic response.

The World Health Organization (WHO) has determined a series of guidelines to contain the advance and spread of COVID-19 and other influenza viruses. Among them, frequent hand hygiene has been widely recommended, resulting in an increased consumption of alcohol-based antiseptic products or synthetic molecules. However, when used in excess, these products might cause adverse consequences for human health, such as dermatitis, and for the environment, i.e., the selection of resistant bacterial genotypes. One of the alternatives to overcome this problem is the replacement of common antiseptics by formulations based on natural bioactive compounds with antimicrobial/antiviral activity. In addition, by nanostructuring formulations, it is possible to increase the bioavailability, stability, solubility, and absorption of bioactives in biological systems. In this sense, this study aimed to develop an antiseptic nanoemulsion based on natural bioactive compounds with virucidal activity against SARS-CoV-2. For that, oil-in-water (O/W) nanoemulsions were prepared, being the oil phase composed by Melaleuca alternifolia essential oil, quercetin, PEG400, and surfactants, while the aqueous phase presented carrageenan and purified water. Physicochemical characterization and stability studies were developed to evaluate the viability of the formulations over time. In addition, bactericidal activities against Staphylococcus aureus and antiviral activity against SARS-CoV-2 were determined by in vitro assays. As a result, the average size of the nanoparticles was recorded at 150 nm, with a Polydispersity Index (PdI) of 0.2 and a zeta potential around -10.0 mV. The stability of nanoformulations indicated the occurrence of quercetin-dependent creaming and sedimentation. In addition, the products presented a minimum shelf-life of 3 months. Regarding the bactericidal activity, a minimum inhibition concentration of 1.25 % for S. aureus was found. The cytotoxicity and antiviral assays revealed that the nano-based products showed 100 % of viral replication inhibition and proved to be safe for epithelial cells. In conclusion, two antiseptic nanoformulations with high anti-SARS-CoV-2 activity and great industrial and pharmacological potential were developed.

Infectious diseases can sometimes lead to pandemics, often transmitted through public and social gatherings, including in-person hospital visits. Consequently, there is an urgent need for innovative approaches to prevent their spread. Taking COVID-19 as an example, we have explored a remote, contactless hospital online model that offers the public online medical consultations, professional psychological counseling, and chronic disease management consultations, thereby mitigating the risk of new transmissions resulting from hospital visits. This model was implemented, validated, and practiced at West China Hospital in China from 29 January 2020, to 12 March 2020. It was also applicable to other infectious diseases, such as influenza A. In this research, we utilized the hospital's internet platform, supplemented by telephone services, to offer the following to the public: 1) General medical education and consultation related to epidemics and psychological anxiety; 2) Online screening for at-risk populations; 3) Online prescription and medication delivery services for patients with chronic diseases. Consequently, over a period of more than 1 month, the online epidemic platform completed a total of 32,755 cases, including 8,783 internet consultations and 1,082 telephone consultations for the public, as well as 22,890 internet consultations for chronic disease patients. Among these, 289 high-risk individuals were identified, with 3 cases confirmed as COVID-19 during follow-up diagnoses, while no infections were detected in the remaining individuals. In conclusion, this innovative medical model serves as a significant supplement to existing healthcare systems and has the potential to be expanded to other hospitals and other infectious diseases. It is particularly beneficial in scenarios where medical resources are limited, populations are under quarantine, and there is a large demand for medical services and anxiety management during infectious disease pandemics.

The effect of the COVID-19 pandemic on the well-being of dental professionals and patients has been difficult to track and quantify. X (formerly known as Twitter) proved to be a useful infoveillance tool for tracing the impact of the COVID-19 pandemic worldwide.

This study aims to investigate the use of X to track COVID-19 infections and deaths associated with dental practices.

English Tweets reporting infections or deaths associated with the dental practice were collected from January 1, 2020, to March 31, 2021. Tweets were searched manually using the X Pro search engine (previously known as TweetDeck [X Corp], Twitter Inc, and TweetDeck Ltd) and automatically using a tweet crawler on the X Academic Research application programming interface. Queries included keywords on infection or death of dental staff and patients caused by COVID-19. Tweets registering events on infection or death of dentists, dental staff, and patients as part of their conversation were included.

A total of 5641 eligible tweets were retrieved. Of which 1583 (28.1%) were deemed relevant after applying the inclusion and exclusion criteria. Of the relevant tweets, 311 (19.6%) described infections at dental practices, where 1168 (86.9%) infection cases were reported among dentists, 134 (9.9%) dental staff, and 41 (3.1%) patients. The majority of reported infections occurred in the United States, India, and Canada, affecting individuals aged 20-51 years. Among the 600 documented deaths, 253 (42.2%) were dentists, 22 (3.7%) were dental staff, and 7 (1.2%) were patients. The countries with the highest number of deaths were the United States, Pakistan, and India, with an affected age range of 23-83 years.

The data suggest that analyses of X information in populations of affected areas may provide useful information regarding the impact of a pandemic on the dental profession and demonstrate a correlation with suspected and confirmed infection or death cases. Platform X shows potential as an early predictor for disease spread. However, further research is required to confirm its validity.

We study the effect of education on vaccination against COVID in Germany in a sample of individuals above the age of 60. In ordinary least squares regressions, we find that, in this age group, one more year of education goes along with a 0.7 percentage point increase in the likelihood to get a COVID vaccination. In two stage least squares regressions where changes in compulsory schooling laws are used as exogenous variation for education, the effect of an additional year of education is estimated to be zero. The results hold for the compliers to the policy change which are older individuals at the lowest margin of education.

In this article, we discuss the qualitative analysis and develop an optimal control mechanism to study the dynamics of the novel coronavirus disease (2019-nCoV) transmission using an epidemiological model. With the help of a suitable mathematical model, health officials often can take positive measures to control the infection. To develop the model, we assume two disease transmission sources (humans and reservoirs) keeping in view the characteristics of novel coronavirus transmission. We formulate the model to study the temporal dynamics and determine an optimal control mechanism to minimize the infected population and control the spreading of the novel coronavirus disease propagation. In addition, to understand the significance of each model parameter, we compute the threshold quantity and perform the sensitivity analysis of the basic reproductive number. Based on the temporal dynamics of the model and sensitivity analysis of the threshold parameter, we develop a control mechanism to identify the best control policy for eradicating the disease. We then conduct numerical experiments using large-scale numerical simulations to validate the theoretical findings.

SARS-CoV-2 is a global problem nowadays. Based on studies, some human receptors are involved in binding to SARS-CoV-2. Thus, the inhibition of these receptors can be effective in the treatment of Covid-19. Because of the proven benefits of antimicrobial peptides (AMPs) and the side effects of chemical drugs, they can be known as an alternative to recent medicines. RCSB PDB to obtain PDB id, StraPep and PhytAMP to acquire Bio-AMPs information and 3-D structure, and AlgPred, Toxinpred, TargetAntiAngio, IL-4pred, IL-6pred, ACPred and Hemopred databases were used to find the best score peptide features. HADDOCK 2.2 was used for molecular docking analysis, and UCSF Chimera software version 1.15, SWISS-MODEL and BIOVIA Discovery Studio Visualizer4.5 were used for mutation and structure modeling. Furthermore, MD simulation results were achieved from GROMACS 4.6.5. Based on the obtained results, the Moricin peptide was found to have the best affinity for ACE2. Moreover, Bacteriocin leucocin-A had the highest affinity for GRP78, Cathelicidin-6 had the best affinity for AT1R, and Bacteriocin PlnK had the best binding affinity for TMPRSS2. Additionally, Bacteriocin glycocin F, Bacteriocin lactococcin-G subunit beta and Cathelicidin-6 peptides were the most common compounds among the four receptors. However, these peptides also have some side effects. Consequently, the mutation eliminated the side effects, and MD simulation results indicated that the mutation proved the result of the docking analysis. The effect of AMPs on ACE2, GRP78, TMPRSS2 and AT1R receptors can be a novel treatment for Covid-19.Communicated by Ramaswamy H. Sarma.

The Chinese level 2 hospital (CHH L2) deployed in Bukavu provides medical supports to peacekeepers in MONUSCO. This study aimed to statistically analyze the types of oral and maxillofacial problems and corresponding treatments provided from October 2018 to September 2022, and to describe the trends of dental service pre and post COVID-19 outbreak.

The medical records of all patients visited to the CHN L2 during the 48 months were collected and were accessed for the research purposes between October 2018 and September 2022. Dental visitors were counted and identified with nationality and occupations. Dental service was categorized as emergency, routine and evacuation. Diagnosis and treatments provided were statistically analyzed.

952/3,913 (24.33%) of the visitors to CHN L2 during this period were referred to dentistry, including 50 females (5.25%) and 902 males (94.75%). The proportion of UN military personnel is 91.39% (870/952). A total of 1,116 teeth and mucosa problems were treated. Dental emergencies represented 13.98% percent (156/1, 116). 2,180 dental treatments (2.29 procedures per patient) were provided: dental radiographs taken (618, 28.30%), local anesthesia (448, 20.55%), RCT (373, 15.14%), resin composite filling (330, 15.14%), extraction (248, 11.38%) and other treatments (164, 7.52%). The number of monthly visitors was significantly affected by the COVID-19 epidemic (p < 0.05), pre-COVID-19 (total 151 ± 51, dental 33 ± 13) and post-COVID-19 (total 51 ± 21, dental 13 ± 8), the lowest number was in July 2020, 6 months after the COVID-19 outbreak (total 16 and dental 3).

Dentistry is the most frequently visited department in the CHH L2 in Bukavu, and the number of visitors were affected by the COVID-19 epidemic. Treatments related to dental caries, pulpitis, apical periodontitis, and wisdom teeth problems account for the majority of dental service. The variety and severity of dental problems demonstrate the urgent need for training in multiple specialized skills for deployed military dental personnel.

Type I interferons (IFN-I) are crucial for the initial defense against viral infections. TBK1 serves as a key regulator in the production of IFN-I, with its phosphorylation being essential for the regulation of its activity. However, the regulatory mechanisms governing its activation remain incompletely elucidated. In this study, we validated the function of Fyn-related kinase (Frk) in the antiviral innate immune response and identified the direct target molecule of Frk in the IFN-β signaling pathway. Furthermore, we elucidated the mechanism by which Frk phosphorylates TBK1 during infection and the role of Frk in IFN-β production. We discovered that Frk enhances the activation of the IFN-I production pathway by targeting TBK1. Mechanistically, Frk promotes the K63 ubiquitination of TBK1 and subsequent activation of the transcription factor IRF3 by phosphorylating TBK1 at tyrosine residues 174 and 179, thereby enhancing the production of IFN-β in macrophages. Employing both in vivo and in vitro viral infection assays, we demonstrated that IFN-β mediated by Frk inhibits the replication of VSV or HSV-1 and alleviates lung lesions. Our findings indicate that Frk functions as a key regulator of TBK1 to strengthen antiviral immunity and represents a promising target for the development of antiviral drugs.

To protect healthcare workforce during the COVID-19 pandemic, rigorous efforts were made to reduce infection rates among healthcare workers (HCWs), especially prior to vaccine availability. This study aimed to investigate the prevalence of SARS-CoV-2 infections among HCWs and identify potential risk factors associated with transmission. We searched MEDLINE, Embase, and Google Scholar from 1 December 2019 to 5 February 2024. From 498 initial records, 190 articles were reviewed, and 63 studies were eligible. ROBINS-E tool revealed a lower risk of bias in several domains; however, some concerns related to confounding and exposure measurement were identified. Globally, 11% (95% confidence interval (CI) 9-13) of 283,932 HCWs were infected with SARS-CoV-2. Infection rates were associated with a constellation of risk factors and major circulating SARS-CoV-2 variants. Household exposure (odds ratio (OR) 7.07; 95% CI 3.93-12.73), working as a cleaner (OR 2.72; 95% CI 1.39-5.32), occupational exposure (OR 1.79; 95% CI 1.49-2.14), inadequate training on infection prevention and control (OR 1.46; 95% CI 1.14-1.87), insufficient use of personal protective equipment (OR 1.45; 95% CI 1.14-1.84), performing aerosol generating procedures (OR 1.36; 95% CI 1.21-1.52) and inadequate hand hygiene (OR 1.17; 95% CI 0.79-1.73) were associated with an increased SARS-CoV-2 infection. Conversely, history of quarantine (OR 0.23; 95% CI 0.08-0.60) and frequent decontamination of high touch areas (OR 0.52; 95% CI 0.42-0.64) were protective factors against SARS-CoV-2 infection. This study quantifies the substantial global burden of SARS-CoV-2 infection among HCWs. We underscore the urgent need for effective infection prevention and control measures, particularly addressing factors such as household exposure and occupational practices by HCWs, including cleaning staff.

Monocytes and macrophages, as important constituents of the innate immune system, are equipped with multiple Toll-like-receptors (TLRs) to recognize invading pathogens, such as SARS-CoV-2, and mount an antiviral response. Nevertheless, their uncontrolled activation can lead to hyperinflammation seen in severe COVID-19. Surprisingly, we observed that recombinant SARS-CoV-2 Spike (S) and Nucleocapsid (N) proteins triggered only a weak proinflammatory response in human peripheral blood monocytes. By employing THP-1 and Jurkat NF-κB::eGFP reporter cell lines expressing specific TLRs, various TLR ligands and blocking antibodies, we determined that surface TLRs, including TLR2/1, TLR2/6 and TLR4 do not play a major role in SARS-CoV-2 sensing. However, monocytes are potently activated by the replication-competent SARS-CoV-2, and the response correlates with the viral uptake that is observed only in monocytes, but not in lymphocytes. We show that monocyte activation involves two distinct steps. Firstly, SARS-CoV-2 infects monocytes in a process independent of the S protein and the prime SARS-CoV-2 receptor angiotensin-converting enzyme 2. Instead, the alternative SARS-CoV-2 receptor CD147, which is highly expressed on monocytes, recognizes its well-known interaction partners cyclophilins A and B that are incorporated into SARS-CoV-2 virions. Secondly, upon viral uptake via the cyclophilin-CD147 interaction, that can be inhibited by specific CD147 blocking antibodies or competition with recombinant human cyclophilin A and B, SARS-CoV-2 RNA is recognized by TLR7/8 in endosomes, leading to upregulation of tumor necrosis factor (TNF), interleukin (IL)-1β and IL-6, comprising the core hyperinflammatory signature. Taken together, our data reveal a novel mechanism how human monocytes sense SARS-CoV-2 and suggest that targeting the cyclophilin-CD147 axis might be beneficial to alleviate overt myeloid-driven inflammation triggered by SARS-CoV-2 infection.

The aim of this study was to analyze clinical strategies supported by validated references during two of the most frequent dental emergencies (i.e. restorative and endodontic treatment) in the COVID-19 pandemic. Coronavirus disease 2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of an emergency in the health system worldwide and a potentially fatal disease. Person-to-person transmission of SARS-CoV-2 through aerosol and droplets led to extensive preventive measures to contain COVID-19 outbreak. Dental care providers have been exposed to a high risk of SARS-CoV-2 infection, due to the face-to-face communication and the exposure to saliva, blood, and other body fluids during routine interventions; this can also contribute to a high risk for cross-infection, even though dentist usually cope with those situations in everyday practice. Restorative and endodontic emergencies represented a high proportion of dental emergencies, with prolonged exposure time for dentists/endodontists in contact with suspected or confirmed infected patients. Lack of knowledge and undefined progression controlled the decision-making in clinical dentistry. The dynamicity of the situation determined change of views and recommendations in dental setting. The implementation of strict restorative and endodontics protocols are aimed at preventing circumstances similar to those observed with COVID-19.

We constructed a rapid infection risk assessment model for contacts of COVID-19. The improved Wells-Riley model was used to estimate the probability of infection for contacts of COVID-19 in the same place and evaluate their risk grades. We used COVID-19 outbreaks that were documented to validate the accuracy of the model. We analyzed the relationship between controllable factors and infection probability and constructed common scenarios to analyze the infection risk of contacts in different scenarios. The model showed the robustness of the fitting (mean relative error = 5.89%, mean absolute error = 2.03%, root mean squared error = 2.03%, R2 = 0.991). We found that improving ventilation from poorly ventilated to naturally ventilated and wearing masks can reduce the probability of infection by about two times. Contacts in places of light activity, loud talking or singing, and heavy exercise, oral breathing (e.g., gyms, KTV, choirs) were at higher risk of infection. The model constructed in this study can quickly and accurately assess the infection risk grades of COVID-19 contacts. Simply opening doors and windows for ventilation can significantly reduce the risk of infection in certain places. The places of light activity, loud talking or singing, and heavy exercise, oral breathing, should pay more attention to prevent and control transmission of the epidemic.

The coronavirus disease 2019 (COVID-19) interventions in interrupting transmission have paid heavy losses politically and economically. The Chinese government has replaced scaling up testing with monitoring focus groups and randomly supervising sampling, encouraging scientific research on the COVID-19 transmission curve to be confirmed by constructing epidemiological models, which include statistical models, computer simulations, mathematical illustrations of the pathogen and its effects, and several other methodologies. Although predicting and forecasting the propagation of COVID-19 are valuable, they nevertheless present an enormous challenge. This paper emphasis on pandemic simulation models by introduced respiratory-specific transmission to extend and complement the classical Susceptible-Exposed-(Asymptomatic)-Infected-Recovered SE(A)IR model to assess the significance of the COVID-19 transmission control features to provide an explanation of the rationale for the government policy. A novel epidemiological model is developed using mean-field theory. Utilizing the SE(A)IR extended framework, which is a suitable method for describing the progression of epidemics over actual or genuine landscapes, we have developed a novel model named SEIAPUFR. This model effectively detects the connections between various stages of infection. Subsequently, we formulated eight ordinary differential equations that precisely depict the population's temporal development inside each segment. Furthermore, we calibrated the transmission and clearance rates by considering the impact of various control strategies on the epidemiological dynamics, which we used to project the future course of COVID-19. Based on these parameter values, our emphasis was on determining the criteria for stabilizing the disease-free equilibrium (DEF). We also developed model parameters that are appropriate for COVID-19 outbreaks, taking into account varied population sizes. Ultimately, we conducted simulations and predictions for other prominent cities in China, such as Wuhan, Shanghai, Guangzhou, and Shenzhen, that have recently been affected by the COVID-19 outbreak. By integrating different control measures, respiratory-specific modeling, and disease supervision sampling into an expanded SEI (A) R epidemic model, we found that supervision sampling can improve early warning of viral activity levels and superspreading events, and explained the significance of containments in controlling COVID-19 transmission and the rationality of policy by the influence of different containment measures on the transmission rate. These results indicate that the control measures during the pandemic interrupted the transmission chain mainly by inhibiting respiratory transmission, and the proportion of supervision sampling should be proportional to the transmission rate, especially only aimed at preventing a resurgence of SARS-CoV-2 transmission in low-prevalence areas. Furthermore, The incidence hazard of Males and Females was 1.39(1.23-1.58), and 1.43(1.26-1.63), respectively. Our investigation found that the ratio of peak sampling is directly related to the transmission rate, and both decrease when control measures are implemented. Consequently, the control measures during the pandemic interrupted the transmission chain mainly by inhibiting respiratory transmission. Reasonable and effective interventions during the early stage can flatten the transmission curve, which will slow the momentum of the outbreak to reduce medical pressure.

In the early days of the urban pandemic, many cities had personal protective equipment (PPE) shortages, which adversely affected urban pandemic governance. Using the COVID-19 strategies employed in Wuhan as the pivotal case study, this study sought to determine effective strategies to optimize city PPE distribution. System dynamics modeling was employed to explore the influence of PPE allocation strategies on pandemic control measures. It was found that the most effective method for controlling a pandemic was to supply PPE in a specific order: medical staff, patients, and out-of-home citizens. Further, prioritizing universal PPE access over adhering to recommended replacement frequencies was found to be more effective in protecting public health. These findings offer vital insights for policy formulation and pandemic preparedness planning to reduce infection rates and fatalities.

In the year 2019, a highly virulent coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged, precipitating the outbreak of the illness known as coronavirus disease 2019 (COVID-19). The commonly employed reverse transcription polymerase chain reaction (RT-qPCR) methodology serves to estimate the viral load in each patient's sample by employing a standard curve. However, it is imperative to recognize that this technique exhibits limitations with respect to clinical diagnosis and therapeutic applications, since an advancement of the conventional polymerase chain reaction methods, digital polymerase chain reaction (digital PCR or DDPCR), enables the direct quantification and clonal amplification of nucleic acid strands. The primary divergence between dPCR and traditional PCR resides in their approaches to measuring nucleic acid quantities. In this study, we investigated the viral loads of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) within 461 participants. By employing both RT-qPCR and DDPCR techniques, we established a comparison between the quantification methodologies of the two approaches. Our findings illustrate that the quantification through DDPCR affords a superior means of monitoring viral load within lower respiratory tract samples, thus enhancing the assessment of disease progression, particularly in scenarios characterized by low viral loads.

The purposes of this study were to determine whether positive work environments affect clinician wellbeing and mental health, and to identify participants' priority interventions to improve clinician wellbeing. This study was designed to determine the potential benefit of modifying the aforementioned factors for clinicians and hospitals to impact positive patient outcomes.

The SARS-CoV-2 virus pandemic has become one of the leading causes of death in the United States and worldwide, and has exacerbated widespread burnout among health care professionals. This has resulted in negative collateral implications for the stability of the clinician workforce. A Clinician Wellbeing study (CWS) was launched in two Magnet®-designated hospitals in the southeast. The CWS was part of a multi-site collaborative research project led by the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing.

A cross-sectional observational study design was implemented. Data were collected through anonymous surveys of 708 registered nurses (RNs) and advanced practice providers (APPs) working in two Magnet hospitals in the southeastern United States. Each participant completed 8 surveys.

Clinicians' self-reported level of burnout was higher for both RNs and APPs at Emory University Hospital than Emory Saint Joseph's Hospital including intent to leave and dissatisfaction with their jobs. RNs and APPs self-reported their overall health to be good or excellent and they reported sleep quality as fair. Both groups in both hospitals indicated that they experienced anxiety, depression, and stress. The APPs reported a higher percent that their work did not leave enough time for personal and family life. Data also indicated that the primary work environment concern was related to inadequate nurse staffing.

The data illuminated opportunities for the two hospitals to employ continuous improvement interventions to positively transform the work environment.

This study analyzes immune responses to SARS-CoV-2 vaccination and infection, including asymptomatic cases, focusing on infection risks during the Omicron wave, particularly among high-risk healthcare workers. In the KoCo-Impf study, we monitored 6088 vaccinated participants in Munich aged 18 and above. From 13 May to 31 July 2022, 2351 participants were follow-uped. Logistic regression models evaluated primary, secondary, and breakthrough infections (BTIs). Roche Elecsys® Anti-SARS-CoV-2 assays detected prior infections (via anti-Nucleocapsid antibodies) and assessed vaccination/infection impact (via anti-Spike antibodies) using dried blood spots. Our findings revealed an anti-Nucleocapsid seroprevalence of 44.1%. BTIs occurred in 38.8% of participants, with reinfections in 48.0%. Follow-up participation was inversely associated with current smoking and non-vaccination, while significantly increasing with age and receipt of three vaccine doses. Larger household sizes and younger age increased infection risks, whereas multiple vaccinations and older age reduced them. Household size and specific institutional subgroups were risk factors for BTIs. The anti-Nucleocapsid value prior to the second infection was significantly associated with reinfection risk. Institutional subgroups influenced all models, underscoring the importance of tailored outbreak responses. The KoCo-Impf study underscores the importance of vaccination, demographic factors, and institutional settings in understanding SARS-CoV-2 infection risks during the Omicron wave.

In this review, we successively present the methods for phenomenological modeling of the evolution of reported and unreported cases of COVID-19, both in the exponential phase of growth and then in a complete epidemic wave. After the case of an isolated wave, we present the modeling of several successive waves separated by endemic stationary periods. Then, we treat the case of multi-compartmental models without or with age structure. Eventually, we review the literature, based on 260 articles selected in 11 sections, ranging from the medical survey of hospital cases to forecasting the dynamics of new cases in the general population. This review favors the phenomenological approach over the mechanistic approach in the choice of references and provides simulations of the evolution of the number of observed cases of COVID-19 for 10 states (California, China, France, India, Israel, Japan, New York, Peru, Spain and United Kingdom).

This paper presents a thorough examination of COVID-19 symptomatology among healthcare workers from All India Institute of Medical Sciences (AIIMS), Nagpur, India. Through meticulous analysis spanning from May 2020 to October 2020, we enrolled 73 healthcare workers engaged in COVID-19 screening, care and testing. Our study aimed to elucidate the spectrum of symptoms, adherence to protective measures and implications for early detection and intervention. Key findings revealed a diverse range of symptoms, including body ache, fatigue, headache, sore throat, fever, cough and loss of taste, among others. Notably, 21% of all positive cases were asymptomatic, underscoring the variability in clinical presentation. Adherence to personal protective measures varied across work areas, highlighting the importance of stringent compliance. Our discussion emphasizes the significance of early identification and tailored monitoring systems for mitigating transmission risks and ensuring healthcare worker safety. Additionally, addressing the mental health needs of healthcare workers is crucial for comprehensive pandemic management. Overall, this study contributes essential insights into COVID-19 symptomatology among healthcare workers, offering valuable guidance for infection control and prevention strategies in the pandemic.

The 2022 African Cup of Nations (AFCON) took place in Cameroon from January 9th to February 5th, 2022, including Garoua in the north. We aimed to measure the impact of this event on the local COVID-19 epidemic given the implementation of a preventive strategy based on a health pass.

All players, staff and fans involved in the AFCON event were screened with PCR tests. Symptomatic cases were also continuously monitored in the general population and screened for variants of concern. Daily numbers of confirmed cases were compared to neighboring countries numbers retrieved from a public domain source.

In total, 1479 and 2481 tests were performed in the general population and on asymptomatic AFCON attendees, respectively. From the latter, 12.5% were PCR-positive; 97% were infected with Omicron, with no significant difference compared to the passive program (G-test, P value = 0.162). Surveillance indicated the AFCON did not increase the number of symptomatic PCR-positive cases in the general population compared to neighboring countries.

Though the COVID-19 epidemic was fueled by asymptomatic cases infected with the Omicron variant at the time, the non-therapeutic preventive measures implemented for AFCON mitigated an increase in the epidemic in the local population.

The worldwide COVID-19 pandemic has changed people's lives and the diagnostic landscape. The nucleic acid amplification test (NAT) as the gold standard for SARS-CoV-2 detection has been applied in containing its transmission. However, there remains a lack of an affordable on-site detection system at resource-limited areas. In this study, a low cost "sample-in-answer-out" system incorporating nucleic acid extraction, purification, and amplification was developed on a single macrochannel-to-digital microfluidic chip. The macrochannel fluidic subsystem worked as a world-to-chip interface receiving 500-1000 μL raw samples, which then underwent bead-based extraction and purification processes before being delivered to DMF. Electrodes actuate an eluent dispensed to eight independent droplets for reverse transcription quantitative polymerase chain reaction (RT-qPCR). By reading with 4 florescence channels, the system can accommodate a maximum of 32 detection targets. To evaluate the proposed platform, a comprehensive assessment was conducted on the microfluidic chip as well as its functional components (i.e., extraction and amplification). The platform demonstrated a superior performance. In particular, using clinical specimens, the chip targeting SARS-CoV-2 and Flu A/B exhibited 100% agreement with off-chip diagnoses. Furthermore, the fabrication of chips is ready for scaled-up manufacturing and they are cost-effective for disposable use since they are assembled using a printed circuit board (PCB) and prefabricated blocks. Overall, the macrochannel-to-digital microfluidic platform coincides with the requirements of point-of-care testing (POCT) because of its advantages: low-cost, ease of use, comparable sensitivity and specificity, and availability for mass production.

The COVID-19 pandemic caused by the SARS-CoV-2 virus has been studied predominantly in terms of its immediate respiratory and systemic effects. However, emerging evidence suggests possible long-term effects, including its role in carcinogenesis. This comprehensive review explores the complex relationship between COVID-19 and cancer development, focusing on immune dysregulation, chronic inflammation, genetic and epigenetic alterations, and the impact of therapeutic interventions. We also focused on the molecular mechanisms by which SARS-CoV-2 may facilitate cancer progression, including the roles of angiotensin-converting enzyme 2 (ACE2), transmembrane serine protease 2 (TMPRSS2), and FURIN. Additionally, we examined the possible carcinogenic effects of long-term COVID-19 treatments and the interaction between co-infections and cancer risk. Our findings highlight the need for increased cancer surveillance in COVID-19 survivors. In the post-COVID-19 period, it can be thought that inflammation associated with excessive cytokine release, especially interleukin-6, genetic and epigenetic changes, and co-infections with oncogenic viruses such as Epstein-Barr virus or human papillomavirus may be effective in the development and progression of cancer. Further research is needed to explain the mechanisms underlying this relationship.

Wastewater-based epidemiology provides temporal and spatial information about the health status of a population. The objective of this study was to analyze and report the epidemiological dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the province of Tucumán, Argentina during the second and third waves of coronavirus disease 2019 (COVID-19) between April 2021 and March 2022. The study aimed to quantify SARS-CoV-2 RNA in wastewater, correlating it with clinically reported COVID-19 cases. Wastewater samples (n = 72) were collected from 16 sampling points located in three cities of Tucumán (San Miguel de Tucumán, Yerba Buena y Banda del Río Salí). Detection of viral nucleocapsid markers (N1 gene) was carried out using one-step reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Viral loads were determined for each positive sample using a standard curve. A positive correlation (p < 0.05) was observed between viral load (copies/mL) and the clinically confirmed COVID-19 cases reported at specific sampling points in San Miguel de Tucumán (SP4, SP7, and SP8) in both months, May and June. Indeed, the high viral load concurred with the peaks of COVID-19 cases. This method allowed us to follow the behavior of SARS-CoV-2 infection during epidemic outbreaks. Thus, wastewater monitoring is a valuable epidemiological indicator that enables the anticipation of increases in COVID-19 cases and tracking the progress of the pandemic. SARS-CoV-2 genome-based surveillance should be implemented as a routine practice to prepare for any future surge in infections.

COVID-19 infection can present in various clinical forms. Anosmia has been significantly associated with a positive RT-PCR, but it usually appears after four days and has also been observed among COVID-19 negative patients. Knowledge on the clinical course of COVID-19 can guide decision-making on screening, diagnostic testing, and quarantine/isolation procedures.

To describe the clinical course of healthcare workers (HCWs) with COVID-19-related exposure, symptoms, differential diagnoses, and time to return to work clearance.

This was a cross-sectional study involving HCWs diagnosed as COVID-19 contacts/suspects between April 2020 and April 2021. Information on demographics, time elapsed between clinical events, outcomes, and final diagnoses were collected from hospital records. Categorical data was presented in frequencies and percentages, while numerical data were reported as range and median values.

There were 4755 consultations for COVID-19-related symptoms or exposure that were included in the study. Symptoms developed at a median of one day post-exposure. Consultation was at two days following symptom onset or four days after exposure. RT-PCR was done on the day of consult. Symptoms resolved after a median of six days. Return to work (RTW) was seven days from consult. Common presenting symptoms were respiratory (56.71%) and systemic (34.04%). COVID-19 was positive in 13.79% of consults. Almost all HCWs recovered (99%) as outpatient (88%). Differential diagnoses were usually other respiratory infections (8.60%) and allergic rhinitis (2.37%).

The clinical course for HCWs who consulted for COVID-19-related symptoms or exposure lasted for two weeks from symptom onset or exposure until clearance for work resumption. The most common symptoms were respiratory and systemic in nature. Recovery was noted after six days. The most common alternative diagnoses for COVID-19 negative cases were respiratory infection and allergic rhinitis.

Measures such as education, improving knowledge, attitude and taking preventive action to protect against COVID-19 are vital strategies for prevention. The aim of this study was to determine the predictability of Health Belief Model (HBM) constructs in performing preventive behaviors against COVID-19 among secondary school students in Chabahar, Iran. In this cross-sectional-analytical study, 400 secondary school students of Chabahar city were investigated by simple random sampling. The data collection tool was a questionnaire including demographic characteristics, knowledge, behavior, and Health Belief Model constructs' questions. Exploratory Factor Analysis (EFA) was used to evaluate the validity of HBM constructs, and the structural equation modeling (SEM) method was used to evaluate the direct and indirect effects of the relationship between knowledge, HBM constructs, and preventive behavior against COVID-19 based on the conceptual model. Based on the results of the structural modeling, the direct effect of knowledge on the constructs of the health belief model was positive and significant (β = 0.34, P-value < 0.001), and on the preventive behavior of students was insignificant (β = 0.12, P-value = 0.07) while the indirect effect of knowledge through increasing the constructs of the HBM on student behavior was positive and significant (β = 0.30, P < 0.001). The relationship between the constructs of the HBM constructs and student behavior was also positive and significant (β = 0.89, P-value < 0.001).Due to the fact that knowledge and HBM structures played a role in predicting the adoption of preventive behavior from COVID-19, it is possible to design appropriate interventions to increase knowledge, sensitivity, perceived severity, and self-efficacy, in order to recover from COVID-19 by adopting preventive behaviors.

COVID-19 is a new infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Since the outbreak in December 2019, it has caused an unprecedented world pandemic, leading to a global human health crisis. Although SARS CoV-2 mainly affects the lungs, causing interstitial pneumonia and severe acute respiratory distress syndrome, a number of patients often have extensive clinical manifestations, such as gastrointestinal symptoms, cardiovascular damage and renal dysfunction.

This review article discusses the pathogenic mechanisms of cardiovascular damage in COVID-19 patients and provides some useful suggestions for future clinical diagnosis, treatment and prevention.

An English-language literature search was conducted in PubMed and Web of Science databases up to 12th April, 2024 for the terms "COVID-19", "SARS CoV-2", "cardiovascular damage", "myocardial injury", "myocarditis", "hypertension", "arrhythmia", "heart failure" and "coronary heart disease", especially update articles in 2023 and 2024. Salient medical literatures regarding the cardiovascular damage of COVID-19 were selected, extracted and synthesized.

The most common cardiovascular damage was myocarditis and pericarditis, hypertension, arrhythmia, myocardial injury and heart failure, coronary heart disease, stress cardiomyopathy, ischemic stroke, blood coagulation abnormalities, and dyslipidemia. Two important pathogenic mechanisms of the cardiovascular damage may be direct viral cytotoxicity as well as indirect hyperimmune responses of the body to SARS CoV-2 infection.

Cardiovascular damage in COVID-19 patients is common and portends a worse prognosis. Although the underlying pathophysiological mechanisms of cardiovascular damage related to COVID-19 are not completely clear, two important pathogenic mechanisms of cardiovascular damage may be the direct damage of the SARSCoV-2 infection and the indirect hyperimmune responses.

Models are often employed to integrate knowledge about epidemics across scales and simulate disease dynamics. While these approaches have played a central role in studying the mechanics underlying epidemics, we lack ways to reliably predict how the relationship between virulence (the harm to hosts caused by an infection) and transmission will evolve in certain virus-host contexts. In this study, we invoke evolutionary invasion analysis-a method used to identify the evolution of uninvadable strategies in dynamical systems-to examine how the virulence-transmission dichotomy can evolve in models of virus infections defined by different natural histories. We reveal peculiar patterns of virulence evolution between epidemics with different disease natural histories (SARS-CoV-2 and hepatitis C virus). We discuss the findings with regards to the public health implications of predicting virus evolution, and in broader theoretical canon involving virulence evolution in host-parasite systems.

The COVID-19 pandemic has highlighted the need to use infection testing databases to rapidly estimate effectiveness of prior infection in preventing reinfection ($P{E}_S$) by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Mathematical modeling was used to demonstrate a theoretical foundation for applicability of the test-negative, case-control study design to derive $P{E}_S$. Apart from the very early phase of an epidemic, the difference between the test-negative estimate for $P{E}_S$ and true value of $P{E}_S$ was minimal and became negligible as the epidemic progressed. The test-negative design provided robust estimation of $P{E}_S$ and its waning. Assuming that only 25% of prior infections are documented, misclassification of prior infection status underestimated $P{E}_S$, but the underestimate was considerable only when > 50% of the population was ever infected. Misclassification of latent infection, misclassification of current active infection, and scale-up of vaccination all resulted in negligible bias in estimated $P{E}_S$. The test-negative design was applied to national-level testing data in Qatar to estimate $P{E}_S$ for SARS-CoV-2. $P{E}_S$ against SARS-CoV-2 Alpha and Beta variants was estimated at 97.0% (95% CI, 93.6-98.6) and 85.5% (95% CI, 82.4-88.1), respectively. These estimates were validated using a cohort study design. The test-negative design offers a feasible, robust method to estimate protection from prior infection in preventing reinfection.

Wastewater-based epidemiology has allowed tracking the magnitude and distribution of SARS-CoV-2 in communities, allowing public health officials to prepare for impending outbreaks. While many factors influence recovery of SARS-CoV-2 from wastewater, proper extraction, concentration, and purification of RNA are key steps to ensure accurate detection of viral particles. The aim of this study was to compare the efficiency of four commonly used RNA extraction methods for detection of the SARS-CoV-2 RNA genome in sewage samples artificially inoculated with the virus, in order to identify a protocol that improves viral recovery. These methods included CTAB-based, TRIzol-based, and guanidinium thiocyanate (GTC)-based extraction procedures coupled with silica spin column-based purification, and an automated extraction/purification protocol using paramagnetic particles. Following RNA extraction, virus recovery rates were compared using RT-qPCR-based detection. The CTAB-based approach yielded the highest recovery rates and was the only method to consistently demonstrate stable virus recovery percentages regardless of the specific physicochemical characteristics of the samples tested. The TRIzol method proved to be the second most effective, yielding significantly higher recovery rates compared to both the GTC-based and the automated extraction methods. These results suggest that the CTAB-based approach could be a useful tool for the recovery of viral RNA from complex wastewater matrices.

Critical illness, such as severe COVID-19, is heterogenous in presentation and treatment response. However, it remains possible that clinical course may be influenced by dynamic and/or random events such that similar patients subject to similar injuries may yet follow different trajectories. We deployed a mechanistic mathematical model of COVID-19 to determine the range of possible clinical courses after SARS-CoV-2 infection, which may follow from specific changes in viral properties, immune properties, treatment modality and random external factors such as initial viral load. We find that treatment efficacy and baseline patient or viral features are not the sole determinant of outcome. We found patients with enhanced innate or adaptive immune responses can experience poor viral control, resolution of infection or non-infectious inflammatory injury depending on treatment efficacy and initial viral load. Hypoxemia may result from poor viral control or ongoing inflammation despite effective viral control. Adaptive immune responses may be inhibited by very early effective therapy, resulting in viral load rebound after cessation of therapy. Our model suggests individual disease course may be influenced by the interaction between external and patient-intrinsic factors. These data have implications for the reproducibility of clinical trial cohorts and timing of optimal treatment.

Due to the drastically rising coronavirus disease (COVID-19) incidence since March 2020, social life was shut down across the globe, and most opera houses were closed. As a result, there are limited data on SARS-CoV-2 infections among artists. The Bavarian State Opera has been reopened in September 2020. This study aimed to identify the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among employees in the Bavarian State Opera. In addition, the various hygiene strategies for the work groups within the institution are described. During the study period from September 1, 2020 to July 31, 2021, 10,061 nasopharyngeal swabs were obtained from 1,460 artistic staff members in a rolling system. During the entire study period, 61 individuals tested positive for SARS-CoV-2. None of the patients had a severe disease course. Compared to the seven-day-incidence per 100,000 German inhabitants, the estimated corresponding incidence among employees was lower at 37 weeks and higher or equal at 9 weeks. Among the infected individuals, 58.3% were symptomatic, 23.3% were presymptomatic, and 18.3% were asymptomatic. Forty-five percent of employees reported that they had been infected in their private environment, 41.7% suspected that their colleagues were the main contact, and 13.3% were unsure about the origin of their infection. Twenty-four diseased employees were ballet dancers, eight from the orchestra, seven from the administration, seven from the choir singers, six from the costume department, 10 from technical support, and one guest solo singer. In the 2020/2021 theater season, increased SARS-CoV-2 infections and large disease outbreaks were avoided at the Bavarian State Opera. Hygiene strategies, that existed since the beginning, was specifically designed for various work areas in the opera. Regular, mandatory PCR testing and follow-up of positive cases with the issuance of quarantine were performed. Using this disease management approach, artistic work at and reopening of the Bavarian State Opera was feasible with a well-controlled risk.

During the COVID-19 pandemic, access to dental treatment by persons deprived of their liberty (PPL) was affected due to dentist-patient proximity and the risk of generation of aerosols in dental procedures and treatments. The risks of infection for oral health personnel are considered high, mainly from cross-infection between patients.

Differentiate between a true and false dental consultation emergency during the SARS-CoV-2 outbreak for a better and effective screening of inmates of the Social Rehabilitation Center (CERESO) of San Francisco Kobén (Campeche, Mexico).

An observational, cross-sectional, descriptive, and prospective study was designed for a sample of 100 inmates of the CERESO San Francisco Kobén, the data was collected in the prison's dental office, the participants signed a letter of informed consent to be voluntarily included in the study during the SARS-CoV-2 outbreak. The questionnaire "Assessment of a true Dental Emergency" previously validated for the Mexican population was applied, the personnel was standardized and an intra- examiner and inter-examiner reliability of k = 0.98 was obtained. To prepare the database and the analysis of the information collected, the Statistical Package for Social Science v. 21 (SPSS v.21) was used.

When evaluating emergencies at the dental clinic, 84% were determined according to the instrument as a false emergency and 16% were a true emergency.

In the population of CERESO of San Francisco Kobén, the figures for medical-dental care show that inmates face a proportionally low dental morbidity-mortality.

After living with the COVID-19 pandemic for more than 2 years, the impact of lockdown measures on preterm birth rates is inconsistent according to data from different countries. In this study, rates of preterm-born infants during the time of COVID-19-related lockdowns were analyzed in a tertiary perinatal center at Munich University, Germany.

We analyzed the number of preterm births, infants, and stillbirths before 37 weeks of gestation during the German COVID-19 lockdown period compared to the same time periods in the years 2018 and 2019 combined. Additionally, we expanded the analysis to Pre- and Post-Lockdown Periods in 2020 compared to the respective control periods in the years 2018 and 2019.

Our database shows a reduction in the rate of preterm infants during the COVID-19 lockdown period (18.6%) compared to the combined control periods in 2018 and 2019 (23.2%, p = 0.027). This was mainly based on a reduced rate of preterm multiples during the lockdown period (12.8% vs. 28.9%, p = 0.003) followed by a reversed effect showing a threefold rise in multiple births after the lockdown. In singletons, the rate of preterm births was not reduced during the lockdown. The rate of stillbirths was not affected by the lockdown measures as compared to the control period (0.9% vs. 0.7%, p = 0.750).

During the COVID-19 pandemic lockdown period, we found a reduced rate of preterm-born infants compared to a combined control period in the years 2018 and 2019 in our large tertiary University Center in Germany. Due to the predominant reduction in preterm multiples, we postulate that less physical activity might have led to the protective effect by lockdown measures.