ABSTRACT
Background: The massive adoption of e-learning in academic education during the coronavirus disease (COVID-19) pandemic may be beneficial to digitally skilled individuals, such as Generation Z (Gen Z) members. However, some studies have underscored its negative psychological impact on the mental health of the young adults. We aimed to examine the psychological impact of prolonged e-learning on emotional adaptation among undergraduate students. A secondary objective was to identify key components for preventive interventions targeted toward the academic community by investigating the buffering effect of e-leaning on the impact of negative life events experienced during the pandemic. Methods: The participants were 529 Italian undergraduate students aged 18-26 years. We administered measures of personality traits, anxiety symptoms, peritraumatic dissociation, stress, and affinity for e-learning. This study examined emotional adaptation among Gen Z members who were subjected to prolonged academic e-learning during the 2nd COVID-19 lockdown in Italy. Results: Dysfunctional anxiety was not a major issue among our participants. This is indicative of the adoption of effective anxiety management skills during the pandemic. Nevertheless, the findings also underscored the vulnerability of the Gen Z population. Further, coronavirus anxiety significantly predicted mental health through the mediating effect of personality traits. Conclusions: Therefore, health care professionals should design and implement interventions and programmes that focus on coronavirus anxiety and psychological distress.
ABSTRACT
OBJECTIVE: COVID-19, the newly emerging infectious disease, has been associated with acute liver injury, often related to progression to severe pneumonia. The association between moderate-severe liver injury and more severe clinical course of COVID-19 has suggested that liver injury is prevalent in severe than in mild cases of COVID-19, while no difference in liver involvement has been reported between survivors and non-survivors. The spectrum of liver involvement during COVID-19 ranges from an asymptomatic elevation of liver enzymes to severe hepatitis. Only rarely, cases with acute hepatitis have been reported in the absence of respiratory symptoms. Both epithelial and biliary cells possess the angiotensin-converting enzyme-2 receptors that SARS-CoV-2 uses to be internalized. However, to our knowledge, no ultrastructural identification of the virus in liver cells has been reported to date. Here we provide evidence of SARS-CoV-2 in the liver of two patients, a 34-year-old woman and a 60-year-old man with COVID-19. PATIENTS AND METHODS: We investigated two patients with COVID-19 showing several virions within cytoplasmic vacuoles of cholangiocytes and in endothelial cells of hepatic sinusoids. In both patients, we performed histological and ultrastructural examinations by liver biopsy. After two months, both patients were free of symptoms, and the SARS-CoV-2 infection had resolved. RESULTS: Liver biopsy histological and ultrastructural examination showed liver injury and several virions within cytoplasmic vacuoles of cholangiocytes and in endothelial cells of hepatic sinusoids. CONCLUSIONS: Although most studies in COVID-19 have been focused on the lungs, recently, cholestatic liver pathology has been introduced in the spectrum of pathological changes related to COVID-19. To the best of our knowledge, those presented in this paper are the first images of hepatic SARS-CoV-2 infected liver cells. Our findings suggest a role for cholangiocytes and biliary structures in the COVID-19.