Consequences of Corona Pandemic in Jordanian Society: an Analytical Social Study

The study aimed at identifying the social, economic, health, and psychological consequences of Corona pandemic in Jordanian society, and identifying the predictive value of demographic, social, and economic variables in explaining the different repercussions of Corona pandemic on the members of Jordanian society. In order to achieve the objectives of the study, a data collection scale was designed. The sample consisted of 2570 respondents chosen randomly. The study was based on the social survey methodology. The study revealed the depth of consequences left by the pandemic on Jordanian society. They all have high averages and they are arranged in a row from the highest: Economic followed by psychological, health, and social. The study also revealed that there is a statistical effect of demographic variables on all aspects of life. This indicates the obvious impact of the independent variables included in the (regression equation) on all aspects of life: social, economic, health, and psychological life during the Corona pandemic. © 2023 DSR Publishers/ The University of Jordan.

Analyzing the Effect of COVID-19 on Education by Processing Users' Sentiments

COVID-19 infection has been a major topic of discussion on social media platforms since its pandemic outbreak in the year 2020. From daily activities to direct health consequences, COVID-19 has undeniably affected lives significantly. In this paper, we especially analyze the effect of COVID-19 on education by examining social media statements made via Twitter. We first propose a lexicon related to education. Then, based on the proposed dictionary, we automatically extract the education-related tweets and also the educational parameters of learning and assessment. Afterwards, by analyzing the content of the tweets, we determine the location of each tweet. Then the sentiments of the tweets are analyzed and examined to extract the frequency trends of positive and negative tweets for the whole world, and especially for countries with a significant share of COVID-19 cases. According to the analysis of the trends, individuals were globally concerned about education after the COVID-19 outbreak. By comparing between the years 2020 and 2021, we discovered that due to the sudden shift from traditional to electronic education, people were significantly more concerned about education within the first year of the pandemic. However, these concerns decreased in 2021. The proposed methodology was evaluated using quantitative performance metrics, such as the F1-score, precision, and recall. © 2023 by the authors. Licensee MDPI, Basel, Switzerland.

Analysis of pharmacovigilance databases for spontaneous reports of adverse drug reactions related to substandard and falsified medical products: A descriptive study.

Introduction: The public health threat of substandard and falsified medicines has been well known in the last two decades, and several studies focusing on the identification of products affected and preventing consumption have been published. However, the number of these products reaching patients and causing health consequences and adverse drug reactions is not a well-researched area. Objectives: Our aim was to identify and describe the characteristics of cases that are related to adverse drug reactions potentially originating from counterfeit medication using publicly available pharmacovigilance data. Methods: A descriptive study was performed based on pharmacovigilance data retrieved from Individual Case Safety Reports (ICSRs) identified in the European Medicines Agency's EudraVigilance and FDA Adverse Event Reporting System (FAERS) databases in April 2022 using selected MedDRA preferred terms: counterfeit product administered, product counterfeit, product label counterfeit, product packaging counterfeit, suspected counterfeit product, adulterated product, product tampering, and suspected product tampering. ICSRs were analyzed by age and gender, by year of reporting, region of origin, reporter's profession, and severity of the outcome. The disproportionality method was used to calculate pharmacovigilance signal measures. Results: A total of 5,253 cases in the FAERS and 1,049 cases in the EudraVigilance database were identified, generally affecting middle-aged men with a mean age of 51.055 (±19.62) in the FAERS and 64.18% of the cases between 18 and 65 years, while the male to female ratios were 1.18 and 1.5. In the FAERS database, we identified 138 signals with 95% confidence interval including sildenafil (n = 314; PRR, 12.99; ROR, 13.04; RRR, 11.97), tadalafil (n = 200; PRR, 11.51; ROR, 11.55; RRR, 10.94), and oxycodone (n = 190; PRR, 2.47; ROR, 2.14; RRR, 2.47). While in the EV data 31, led by vardenafil (n = 16, PRR = 167.19; 101.71-274.84; 95% CI, RRR = 164.66; 100.17-270.66; 95% CI, ROR = 169.47; 103.09-278.60; 95% CI, p < 0.001), entecavir (n = 46, PRR = 161.26, RRR = 154.24, ROR = 163.32, p < 0.001), and tenofovir (n = 20, PRR = 142.10, RRR = 139.42, ROR = 143.74, p < 0.001). Conclusion: The application of pharmacovigilance datasets to identify potential counterfeit medicine ADRs can be a valuable tool in recognition of potential risk groups of consumers and the affected active pharmaceutical ingredients and products. However, the further development and standardization of ADR reporting, pharmacovigilance database analysis, and prospective and real-time collection of potential patients with health consequences are warranted in the future.

Health Consequences of University Employees Post-COVID-19 Vaccination at Palestinian Universities.

Introduction: The control of vaccine hesitancy comes with key protective measures against coronavirus disease (COVID-19) and excellent efficacy in clinical trials and effectiveness in real-world data. However, some people believe that vaccination is ineffective and it causes health problems. This study aimed to assess the health consequences of university employees' post-COVID-19 vaccination at Palestinian universities. Method: A cross-sectional study was conducted between February and June 2021. A total of 310 university employees participated from six universities in Palestine. A self-reported questionnaire was used for data collection and included the following: personal characteristics of university employees, knowledge about COVID-19 vaccination, medical background of the participant, and their perception regarding receiving the COVID-19 vaccination. Results: The results revealed that 32.6% and 43.2%of the participants had fever post the first and second doses, respectively. Also, 49.0% and 39.4% of them complained of exhaustion or fatigue and headache post the first dose and 58.1% and 46.1% had exhaustion or fatigue and pain in their muscles post the second dose, respectively. In addition, 29.2% and 16.7% of them had respiratory and digestive problems post the first dose and 38.9% and 19.0% had problems in respiratory and digestive respectively post the second dose. Furthermore, the analysis revealed that fever, symptoms at (the injection site), and exposure to physical symptoms have significant differences between the first dose and second doses of the vaccine (p < .001). Conclusion: This study confirmed that the respiratory and digestive problems are the main problems post-COVID-19 vaccination. Also, this study confirmed that fever, symptoms at (the injection site), and exposure to physical symptoms have significant differences between the first dose and second dose of the vaccine.

A Dynamic Model for Analyzing the Public Health Policy of the Mexican Government During the COVID-19 Pandemic

The COVID-19 Pandemic has been one of the most significant health problems in the world. Several academic studies focus on health consequences. However, only a few studies have paid attention to analyzing government strategies as general public guidelines. In this work, we use a Susceptible-Infected-Recovered-Deceased (SIRD) model to assess infection rate, mortality rate, and the effects of the Mexican government intervention during the three waves of the COVID-19 pandemic. We carry out Bayesian inferences on the proposed model using a Robust Adaptive Metropolis (RAM) algorithm. Essentially, the proposed methodology allows appreciating the effects of quarantine on the three pandemic wave's mortality rate. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Evaluation of work conditions of nurses employed in a shift system in hospital wards during the COVID-19 pandemic.

BACKGROUND: Nurses work in a shift system that determines the provision of round-the-clock care of a patient in hospital conditions; however, it entails health consequences. OBJECTIVE: The aim of the study was the evaluation of work conditions of nurses engaged in shift work in hospital wards during the COVID-19 pandemic. METHODS: The study was conducted in 2020, and included 108 nurses working in a shift system in hospital wards. The research method was a diagnostic survey, using an author-constructed questionnaire. RESULTS: 88.9% nurses reported a negative effect of shift work on their physical health: 'musculoskeletal pain', 'elevated arterial blood pressure', and 'hormonal disorders' - 54.5% of respondents used pharmacological treatment. The causes of physical disorders were: 'microclimate', 'physical effort', 'noise', and 'forced body position'. Shift work exerted a negative effect on psychological health of the majority of respondents (75.0%): 'deconcentration', 'sleep disorders', 'feeling of occupational burnout' - treatment in 38.9% of respondents. Psychological health disorders were caused by: 'circadian rhythms disturbance by shift work', 'chronic stresses', and 'conflicts at work'. 69.7% of respondents reported that their shift work was disturbed by organizational factors, including: a 'badly planned work schedule', 'enhanced pace of work due to staff shortage', 'ambiguous division of duties, rights, responsibilities', 'shortages of equipment at the workplace'. CONCLUSION: The examined nurses experienced a negative effect of shift work on their physical and psychological health which, for some of them, was the cause of pharmacological treatment. Many organizational factors hindered the work of nurses in a shift system in hospital wards.

Long COVID.

The pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was primarily focused on the involvement of the respiratory system, as the most common clinical manifestation of the disease. Currently, also long COVID poses a significant problem for medicine and public health worldwide. It is characterized by persistent symptoms from various organs or systems, often present for several weeks and months after acute phase of SARS-CoV-2 infection. Currently, the most frequently used description for long COVID referred to symptoms that last more than three months after the onset. Numerous data confirm long-term effects of COVID-19, including pulmonary, cardiovascular, neurological, renal, hematologic, gastrointestinal, endocrine and psychosocial manifestations. It is necessary to monitor patients after acute phase of COVID-19 to detect and treat possible multi-organ long-term consequences of SARS-CoV-2 infection.

Effects of a multilayered crisis on psychiatric hospitalizations in a university hospital in Lebanon; a retrospective study.

Lebanon is struggling with a multilayered crisis following the COVID-19 breakout, the economic crisis, and the Beirut port explosion. The aim of this article is to assess the effect of these crisis on the characteristics of patients hospitalized in psychiatry. This is a retrospective study conducted at the psychiatric ward of Hotel Dieu de France in Beirut between January 2017 and march 2022. The population was divided into three groups according to specific time events indicating the start of a certain crisis. Data regarding patients' demographics, psychiatric history and their present hospitalization was collected. A total of 1655 patient files were included in the study. Overall, the rate of hospitalized women increased following the Beirut port explosion, together with the rate of patients younger than 18 years old. Moreover, during the COVID-19 breakout and the start of the economic crisis, alcohol use decreased, as well as the length of stay in the hospital. In conclusion, in the event of a multilayered crisis children and adolescents, as well as women are the most at risk of being affected in terms of mental health.

A Survey-Based Study on the Impact of Post-Covid 19 Symptoms among Indians

Background The entire world is combating COVID-19;however, a significant proportion of patients demonstrate the persistence of some COVID-19 symptoms, new symptom development, or exaggeration of pre-existing disease after a negative viral load. They are referred to as a post-COVID-19 syndrome. According to various researches, COVID-19 has a wide range of long-term effects on virtually all systems, including the respiratory, cardiovascular, gastrointestinal, neurological, mental, and dermatological systems. Finding the various symptoms of post-acute and chronic is critical since they might have a significant impact on the patients' everyday functioning. As a result, we aimed to distinguish the symptoms immediately after the initial phase in which the symptoms affected them for more than three weeks.The symptoms prolonged for a few weeks in post covid time are referred to as acute COVID-19 and the symptoms that persist with the affected individuals for more than three months are referred to as chronic COVID - 19. This paper was written as a review report to provide an overview of the nature and frequency of symptoms observed by patients with mild COVID-19 after the first three weeks. We also envisionedlooking at the various incidences and factors that contribute to the development of post-COVID-19 syndrome in different patient groups, as well as the chances of overcoming it. Objective The objective of this review paper is as follows: To establish the prevalence and characteristics of the post-COVID 19 syndrome in COVID-19 survivors, as well as the factors associated with persistent symptoms. To increase community knowledge about the type and frequency of persistent symptoms experienced by patients post serious and moderate COVID-19 infection. Methods The three-session questionnaire, which includes patient demographic data, vaccination status, and patient status during COVID-19, and post-COVID-19 syndrome, was provided to the public who recovered from COVID-19 and received their responses as primary data. The responses were evaluated to show the relationship between numerous factors that induce post-COVID-19 syndrome. Results A total of 136 responses were obtained and evaluated. This literature review comprised ten publications. As a result, the frequency of persistent symptoms in individuals following mild COVID-19 infection ranged from 15% to 45%. Symptoms reported in mild COVID-19 infected people can be classified as physical, mental, or social. Weakness was the most frequently mentioned consistent symptom. Dyspnea, cough, chest pain, headache, poor mental and cognitive state, and olfactory impairment were also reported as persistent symptoms. There was a significant impact seen in their employment and the daily functioning of the patients. Copyright © 2022, Anka Publishers. All rights reserved.

Serum metabolomic abnormalities in survivors of non-severe COVID-19.

Metabolic reprogramming is a distinctive characteristic of SARS-CoV-2 infection, which refers to metabolic changes in hosts triggered by viruses for their survival and spread. It is current urgent to understand the metabolic health status of COVID-19 survivors and its association with long-term health consequences of infection, especially for the predominant non-severe patients. Herein, we show systemic metabolic signatures of survivors of non-severe COVID-19 from Wuhan, China at six months after discharge using metabolomics approaches. The serum amino acids, organic acids, purine, fatty acids and lipid metabolism were still abnormal in the survivors, but the kynurenine pathway and the level of itaconic acid have returned to normal. These metabolic abnormalities are associated with liver injury, mental health, energy production, and inflammatory responses. Our findings identify and highlight the metabolic abnormalities in survivors of non-severe COVID-19, which provide information on biomarkers and therapeutic targets of infection and cues for post-hospital care and intervention strategies centered on metabolism reprogramming.

Long-Term Health Consequences of SARS-CoV-2: Assumptions Based on SARS-CoV-1 and MERS-CoV Infections.

Coronavirus Disease-2019 (COVID-19) is one of the worst pandemics in the history of the world. It is the third coronavirus disease that has afflicted humans in a short span of time. The world appears to be recovering from the grasp of this deadly pandemic; still, its post-disease health effects are not clearly understood. It is evident that the vast majority of COVID-19 patients usually recovered over time; however, disease manifestation is reported to still exist in some patients even after complete recovery. The disease is known to have left irreversible damage(s) among some patients and these damages are expected to cause mild or severe degrees of health effects. Apart from the apparent damage to the lungs caused by SARS-CoV-1, MERS-CoV, and SARS-CoV-2 infection, COVID-19-surviving patients display a wide spectrum of dysfunctions in different organ systems that is similar to what occurs with SARS-CoV-1 and MERS diseases. The major long COVID-19 manifestations include the following aspects: (1) central nervous system, (2) cardiovascular, (3) pulmonary, (4) gastrointestinal, (5) hematologic, (6) renal and (7) psycho-social systems. COVID-19 has a disease display manifestation in these organs and its related systems amongst a large number of recovered cases. Our study highlights the expected bodily consequences of the pandemic caused by SARS-CoV-2 infection based on the understanding of the long-term effects of SARS-CoV-1 and MERS-CoV.

Experiences, Emotions, and Health Consequences among COVID-19 Survivors after Intensive Care Unit Hospitalization.

Literature suggested that COVID-19 patients experienced hospitalization as a physically and psychologically stressful event, with the risk to develop post-traumatic stress symptoms. The study aimed to understand psychological experiences of COVID-19 survivors with severe complications during and after ICU hospitalization, and any relevant health consequences. From October 2020 to January 2021, a qualitative study was conducted in Italy via semi-structured interviews by phone or video call addressed to COVID-19 survivors, randomly enrolled among people who released their stories publicly on newspapers, television, or social media. Fifteen individuals (three women and twelve men with average age of 56.4 years) were interviewed. Four main themes emerged: (i) emotion of fear; (ii) isolation and loneliness; (iii) unawareness about the gravity of the situation as a protective factor; (iv) "Long COVID" as consequences of the disease on physical and psychological health. During hospitalization, 66.7% of participants had mild or moderate values of anxiety and depression. After discharge, 86.7% moved to normal values. The results suggest that long-COVID is an important problem to manage to improve patients' quality of life. It is essential to guarantee a holistic take in charge starting before the discharge and continuing care after discharge in the community where they live.

The prevalence of inverse health consequences of COVID-19 vaccines: A post-vaccination study.

Background: COVID-19 vaccinations are intended to help produce neutralizing antibodies which target surface spike protein to combat the SARS-Cov-2 virus. Similarly, COVID-19 recovered patients exhibit high levels of SARS-CoV-2 neutralizing antibodies, which predominantly target the surface spike protein and are associated with the occurrence of health consequences in survivors. Objective: The aim of the study is to explore the long-term health consequences of the COVID-19 vaccines. Methodology: A prospective, exploratory observational study conducted both online and offline using various questionnaires with all immunized individuals who had been inoculated for at least a month following their last COVID-19 vaccine either AZD1222® or BBV152® vaccines. Results: We evaluated 258 individuals who had taken the COVID vaccine and found that females made up the majority (54.3%) and that the mean age was 24 years. Post-vaccination long-term health issues were reported by 36.05% (93) of the participants, with 37.86% (53) of females and 33.9% (40) of males (p = 0.292). Myalgia was reported by 20.15% (52), fatigue was 13.95% (36), paresthesia was 1.16% (3), ageusia was 0.77% (2), sadness/irritability was 2.31% (6), and lack of concentration/excessive worry was 3.1% (8). Conclusions: Myalgia, fatigue, paresthesia, ageusia, coughs and colds, dyspnea, sadness/irritability, and lack of concentration/excessive worry are health consequences related to the COVID-19 vaccination which follow a similar pattern of post-COVID syndrome.

Antecedentes: El objetivo de las vacunas frente a la COVID-19 es el de ayudar a producir anticuerpos neutralizantes dirigidos a la proteína de la espícula para combatir el virus SARS-Cov-2. De igual modo, los pacientes que se recuperan de la COVID-19 exhiben grandes niveles de anticuerpos neutralizantes de SARS-CoV-2, que se dirigen predominantemente a la superficie de la proteína de la espícula, y están asociados a la incidencia de consecuencias para la salud de los sobrevivientes. Objetivo: El objetivo del estudio es explorar las consecuencias para la salud a largo plazo de las vacunas frente a la COVID-19. Metodología: Estudio prospectivo, exploratorio y observacional realizado tanto online como offline, utilizando diversos cuestionarios con todos los individuos vacunados a quienes se había inoculado en el plazo de al menos un mes, tras la última vacuna frente a la COVID-19, bien fueran las vacunas AZD1222® o BBV152®. Resultados: Evaluamos a 258 individuos que habían recibido la vacuna frente a la COVID, y encontramos que la mayoría eran mujeres (54,3%) con una edad media de 24 años. Las cuestiones de salud a largo plazo, tras la vacuna, fueron reportadas por un 36,05% (93) de los participantes, con un 37,86% (53) de mujeres y un 33.9% (40) de varones (p = 0,292). Se reportó mialgia en el 20,15% (52) de los casos, fatiga en el 13,95% (36), parestesia en el 1,16% (3), ageusia en el 0,77% (2), tristeza/irritabilidad en el 2,31% (6), y falta de concentración/preocupación excesiva en el 3,1% (8). Conclusiones: Mialgia, fatiga, parestesia, ageusia, tos y resfriado, disnea, tristeza/irritabilidad, y falta de concentración/preocupación excesiva son las consecuencias de salud relacionadas con la vacuna frente a la COVID-19, y siguen un patrón similar al del síndrome post-COVID.

Men Tackling Isolating Gender Violence to Fight against Sexual Harassment.

Scientific literature has shown that both suffering gender-based violence and taking a stand against it could provoke severe retaliation from bystanders, including negative consequences on health. Together with some women, several men-defined as New Alternative Masculinities-have also contributed to fighting against sexual violence in several contexts, also suffering dramatic consequences, known as Isolating Gender Violence (IGV). This article fills the gap on inquiring how men suffering IGV due to intervening in supporting survivors has affected the men's health. Six in-depth interviews were conducted with men from different contexts and countries and men of different social profiles. The findings reveal how men's health is better protected when they build networks of support while overcoming the fear of retaliation in achieving to empower direct survivors. In addition, the results recognize men as crucial actors in the struggle against GBV and overcoming IGV, as women potentially do. This may inspire other men to intervene and break the silence regarding GBV in societies and institutions, as it shows that men and women together are needed to fight against GBV.

Care for the chronically ill in Germany - The challenges during the COVID-19 pandemic.

The COVID-19 pandemic is posing major challenges to the health care sector. This scoping review compiles evidence concerning changes to health care service availability and utilisation as well as possible impacts on health for selected groups of chronically ill people in Germany. The focus is on cancer, cardiovascular diseases, diabetes mellitus and mental disorders. Most empirical data available concerned inpatient care and showed a clear decline in the utilisation of inpatient treatments in March and April 2020 in the areas of oncology and cardiology as well as in mental health. For cardiovascular emergencies such as heart attack and stroke, a decline was observed especially regarding less serious cases. Although there were indications of treatment delays, there was no evidence thus far that emergency care had been generally compromised due to adjustments to inpatient care capacities. In the outpatient setting, extensive adjustments to health care services availability were observed for all disease groups considered. Overall, very limited empirical data were available. In particular, hardly any data were available on how changes in care impacted population health. There is an urgent need for continuous surveillance and evaluation based on health care and epidemiological data.

Longitudinal Assessment of Health and Quality of Life of COVID-19 Patients Requiring Intensive Care-An Observational Study.

Long-term health consequences in survivors of severe COVID-19 remain unclear. Eighteen COVID-19 patients admitted to the intensive care unit at the University Hospital Rechts der Isar, Munich, Germany, between 14 March and 23 June 2020, were prospectively followed-up at a median of 36, 75.5, 122 and 222 days after discharge. The health-related quality of life (HrQoL) (36-item Short Form Health Survey and St. George's Respiratory Questionnaire, SGRQ), cardiopulmonary function, laboratory parameters and chest imaging were assessed longitudinally. The HrQoL assessment revealed a reduced physical functioning, as well as increased SGRQ impact and symptoms scores that all improved over time but remained markedly impaired compared to the reference groups. The median radiological severity scores significantly declined; persistent abnormalities were found in 33.3% of the patients on follow-up. A reduced diffusion capacity was the most common abnormal pulmonary function parameter. The length of hospitalization correlated with role limitations due to physical problems, the SGRQ symptom and the impact score. In conclusion, in survivors of severe COVID-19, the pulmonary function and symptoms improve over time, but impairments in their physical function and diffusion capacity can persist over months. Longer follow-up studies with larger cohorts will be necessary to comprehensively characterize long-term sequelae upon severe COVID-19 and to identify patients at risk.

Examining the Neighborhood Attributes of Recently Housed Partner Violence Survivors in Rapid Rehousing.

Survivors' considerations for re-housing following intimate partner violence (IPV) are understudied despite likely neighborhood-level influences on women's safety. We assess housing priorities and predictors of re-housing location among recent IPV survivors (n = 54) in Rapid Re-housing (RRH) in the Baltimore-Washington Metropolitan Area. Choropleth maps depict residential location relative to census tract characteristics (neighborhood deprivation index (NDI) and residential segregation) derived from American Community Survey data (2013-2017). Linear regression measured associations between women's individual, economic, and social factors and NDI and segregation. In-depth interviews (n = 16) contextualize quantitative findings. Overall, survivors re-housed in significantly more deprived and racially segregated census tracts within their respective regions. In adjusted models, trouble securing housing (B = 0.74, 95% CI: 0.13, 1.34), comfortability with proximity to loved ones (B = 0.75, 95% CI: 0.02, 1.48), and being unsure (vs unlikely) about IPV risk (B = -0.76, 95% CI: -1.39, -0.14) were significantly associated with NDI. Economic dependence on an abusive partner (B = -0.31, 95% CI: -0.56, -0.06) predicted re-housing in segregated census tracts; occasional stress about housing affordability (B = 0.39, 95% CI: 0.04, 0.75) predicted re-housing in less segregated census tracts. Qualitative results contextualize economic (affordability), safety, and social (familiarity) re-housing considerations and process impacts (inspection delays). Structural racism, including discriminatory housing practices, intersect with gender, exacerbating challenges among survivors of severe IPV. This mixed-methods study further highlights the significant economic tradeoffs for safety and stability, where the prioritization of safety may exacerbate economic devastation for IPV survivors. Findings will inform programmatic policies for RRH practices among survivors.

Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study.

BACKGROUND: While the leading symptoms during coronavirus disease 2019 (COVID-19) are acute and the majority of patients fully recover, a significant fraction of patients now increasingly experience long-term health consequences. However, most data available focus on health-related events after severe infection and hospitalisation. We present a longitudinal, prospective analysis of health consequences in patients who initially presented with no or minor symptoms of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection. Hence, we focus on mild COVID-19 in non-hospitalised patients. METHODS: 958 Patients with confirmed SARS-CoV-2 infection were observed from April 6th to December 2nd 2020 for long-term symptoms and SARS-CoV-2 antibodies. We identified anosmia, ageusia, fatigue or shortness of breath as most common, persisting symptoms at month 4 and 7 and summarised presence of such long-term health consequences as post-COVID syndrome (PCS). Predictors of long-term symptoms were assessed using an uni- and multivariable logistic regression model. FINDINGS: We observed 442 and 353 patients over four and seven months after symptom onset, respectively. Four months post SARS-CoV-2 infection, 8•6% (38/442) of patients presented with shortness of breath, 12•4% (55/442) with anosmia, 11•1% (49/442) with ageusia and 9•7% (43/442) with fatigue. At least one of these characteristic symptoms was present in 27•8% (123/442) and 34•8% (123/353) at month 4 and 7 post-infection, respectively. A lower baseline level of SARS-CoV-2 IgG, anosmia and diarrhoea during acute COVID-19 were associated with higher risk to develop long-term symptoms. INTERPRETATION: The on-going presence of either shortness of breath, anosmia, ageusia or fatigue as long-lasting symptoms even in non-hospitalised patients was observed at four and seven months post-infection and summarised as post-COVID syndrome (PCS). The continued assessment of patients with PCS will become a major task to define and mitigate the socioeconomic and medical long-term effects of COVID-19. FUNDING: COVIM:"NaFoUniMedCovid19"(FKZ: 01KX2021).

The 40 health systems, COVID-19 (40HS, C-19) study.

BACKGROUND: The health, social and economic consequences of the severe acute respiratory syndrome coronavirus (SARS-CoV-2, henceforth COVID-19) pandemic have loomed large as every national government made decisions about how to respond. The 40 Health Systems, COVID-19 (40HS, C-19) study aimed to investigate relationships between governments' capacity to respond (CTR), their response stringency, scope of COVID-19 testing and COVID-19 outcomes. METHODS: Data over March and April 2020 were extracted for 40 national health systems on prepandemic government CTR (Global Competitiveness Index), stringency measures (Oxford COVID-19 Government Response Tracker Stringency Index), approach to COVID-19 testing and COVID-19 cases and deaths (Our-World-in-Data). Multidimensional scaling (MDS) and cluster analysis were applied to examine latent dimensions and visualize country similarities and dissimilarities. Outcomes were tested using multivariate and one-way analyses of variances and Kruskal-Wallis H tests. RESULTS: The MDS model found three dimensions explaining 91% of the variance and cluster analysis identified five national groupings. There was no association between national governments' prepandemic CTR and the adoption of early stringent public health measures or approach to COVID-19 testing. Two national clusters applied early stringency measures and reported significantly lower cumulative deaths. The best performing national cluster (comprising Australia, South Korea, Iceland and Taiwan) adopted relatively early stringency measures but broader testing earlier than others, which was associated with a change in disease trajectory and the lowest COVID-19 death rates. Two clusters (one with high CTR and one low) both adopted late stringency measures and narrow testing and performed least well in COVID-19 outcomes. CONCLUSION: Early stringency measures and intrinsic national capacities to deal with a pandemic are insufficient. Extended stringency measures, important in the short term, are not economically sustainable. Broad-based testing is key to managing COVID-19.