the COVID-19 pandemic has posed significant epidemiological challenges globally, with marked regional variations in transmission, severity, and outcomes. In Côte d'Ivoire, disparities in healthcare infrastructure, testing capacity, and demographics have influenced SARS-CoV-2 infection dynamics. This study aims to describe the epidemiological and clinical characteristics of SARS-CoV-2 infection, as well as to identify the risk factors associated with the severity of the infection.

a study was conducted using nasopharyngeal samples collected between January and December 2020, as part of Côte d'Ivoire's national COVID-19 response. The study included individuals from all socio-professional groups across urban and rural areas. Sampling was performed in various settings, including hospitals, testing centres, and community-based screenings. The testing was voluntary, systematic, and based on several factors, including both symptomatic and asymptomatic individuals, contacts of confirmed cases, suspected individuals, hospitalised patients, and participation in public health campaigns. All individuals who underwent testing were included without any specific selection process. The study population was generally representative of the national population, although a higher proportion of urban individuals were included due to limited testing in rural areas. SARS-CoV-2 was detected by real-time RT-PCR. Statistical analyses included chi-squared tests, logistic regression, and Multiple Correspondence Analysis (MCA) to identify factors associated with positivity, hospitalisation, and mortality.

the study included 240,599 individuals, with a mean age of 38 years (SD = 13.97). Of the total, 93,391 (39%) were women and 147,208 (61%) were men. The SARS-CoV-2 prevalence was 9.31% (95% CI: [0.89 - 0.97]), with higher prevalence in women (10.07%) compared to men (8.83%) (X² = 102.47, df = 1, P < .001). Positivity rate varied by age, ranging from 5.76% in children (0-5 years) to 11.13% in the elderly (60+ years) (X² = 233.41, df = 5, P < .001). In multivariable analysis of hospitalisation, each additional year of age increased the probability of hospitalisation by 2.3% (aOR = 1.023, 95% CI: [1.014 - 1.032], P < .001). Patients with cough were 4.15 times more likely to be hospitalised (aOR = 4.15, 95% CI: [3.18 - 5.39], P < .001). Gastrointestinal symptoms (diarrhoea or vomiting) increased the likelihood of hospitalisation by 367 times (aOR = 367, 95% CI: [68.01 - 1686.00], P < .001). For mortality, each additional year of age increased mortality risk by 16% (aOR = 1.16, 95% CI: [1.15 - 1.16], P < .001). Patients with cough had 64.67 times higher risk of death (aOR = 64.67, 95% CI: [62.92 - 66.47], P < .001).

this study identifies key factors influencing hospitalisation and mortality in SARS-CoV-2-positive patients. Age, cough, and gastrointestinal symptoms (diarrhoea or vomiting) were strongly associated with an increased likelihood of hospitalisation, while age and cough were significant predictors of mortality. These findings highlight the importance of early identification and monitoring of patients with these characteristics, particularly in settings with limited healthcare infrastructure.

the COVID-19 pandemic severely disrupted adolescents´ daily lives, affecting their psychosocial well-being. This study aimed to explore how the pandemic influenced mental health, social interactions, and coping strategies among adolescents in the KwaDukuza community, South Africa.

a qualitative exploratory study was conducted using semi-structured interviews with sixteen adolescents selected through purposive sampling. Data were analyzed thematically using Braun and Clarke´s six-step framework to identify patterns in their experiences and coping mechanisms.

adolescents reported heightened stress, anxiety, depression, social isolation, and grief due to the loss of loved ones. Lockdown restrictions disrupted education and routines, while fear of infection and stigma were prevalent. Despite these challenges, participants demonstrated resilience through family support, spiritual practices, skill development, reading, and lifestyle adaptations.

the study highlights the importance of family connectedness, community engagement, and culturally sensitive mental health interventions to strengthen adolescent resilience in under-resourced settings during public health crises.

Diaphragmatic dysfunction and oxidative stress are central pathophysiological alterations in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Evidence is lacking regarding early pulmonary rehabilitation protocols stratified by objective disease severity and their physiological effects. This study aimed to evaluate the impact of an individualized, severity-graded exercise rehabilitation program on diaphragmatic function and oxidative stress biomarkers in these patients.

In this single-center randomized controlled trial, 132 AECOPD patients were first stratified into three severity grades (I, II, III) based on predefined clinical and physiological criteria, then randomly assigned to either a study group (n=66, receiving severity-graded rehabilitation) or a control group (n=66, receiving conventional rehabilitation).Diaphragmatic function was assessed by bedside ultrasonography measuring excursion (DE), end-inspiratory thickness (DTei), and end-expiratory thickness (DTee). Serum levels of malondialdehyde (MDA), superoxide dismutase (SOD), and total antioxidant capacity (TAOC) were determined. All measurements were taken before and after the intervention. The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2500106687).

Compared to the control group, the study group showed significant improvements in all diaphragmatic function parameters (all p<0.001). Furthermore, increases in SOD and TAOC levels were significantly greater in the study group (p=0.005 and p=0.025, respectively). Subgroup analysis revealed that patients with mild disease exhibited the most pronounced improvement in DE (p=0.044), and oxidative stress responses were heterogeneous across severity grades. Partial correlation analysis indicated that improvements in DE were significantly negatively correlated with improvements in all oxidative stress biomarkers only in the study group (r range: -0.314 to -0.331, all p<0.05).

Severity-graded exercise rehabilitation effectively improves diaphragmatic function and enhances endogenous antioxidant capacity in hospitalized AECOPD patients. The improvement in diaphragmatic excursion was significantly correlated with favorable changes in oxidative stress biomarkers, suggesting a potential physiological association. These findings support the efficacy of severity-graded rehabilitation but warrant further mechanistic studies.

Early identification of Pre-chronic obstructive pulmonary disease (pre-COPD) is vital for preventing irreversible lung damage. However, despite its high prevalence, there is a lack of practical tools to predict which individuals will progress to spirometry-defined COPD. This study aimed to identify independent risk factors and develop a clinical nomogram to quantify the risk of disease progression in a pre-COPD population.

We conducted a multicenter, retrospective cohort study in Southwest China (2019-2023), enrolling 1088 participants with pre-COPD. Baseline data, including demographic information, smoking status, comorbidities, lung function, and hematological and biochemical indicators, were analyzed. Independent predictors were identified via multivariate logistic regression, and a risk-prediction nomogram was constructed and validated.

During follow-up, 54.6% of participants progressed to COPD. The final prediction model identified six independent risk factors: age (OR=1.043), hypertension (OR=2.331), diabetes (OR=2.412), hemoglobin level (OR=1.016), lymphocyte count (OR=0.639), and basophil count (OR=1.411). The nomogram demonstrated robust discriminative ability, with an AUC of 0.758 in the training set and 0.718 in the validation set. Calibration curves showed high consistency, and Decision Curve Analysis (DCA) confirmed significant clinical net benefit.

Progression from pre-COPD to spirometry-defined COPD is highly prevalent and driven by age, comorbidities, and systemic inflammatory markers. Our validated nomogram provides a precise, non-invasive tool for clinicians to identify high-risk individuals, enabling targeted early intervention and optimized resource allocation in COPD prevention.

The gut-lung axis is increasingly recognized. This study aimed to find out whether and how the gut microbiome involved in the pathogenesis of chronic obstructive pulmonary disease (COPD).

Gut microbiota was characterized via 16S rRNA gene sequencing in COPD patients and a smoking-induced mouse model. Gut dysbiosis was induced by antibiotic cocktail (ABX) and restored by fecal microbiota transplantation (FMT). Plasma metabolomics was conducted using liquid chromatography-mass spectrometry (LC-MS), and pathway analysis was performed with MetaboAnalyst 5.0. Differentially expressed genes were identified by RNA sequencing and functionally interpreted through gene set enrichment analysis (GSEA).

Both COPD patients and mice showed altered gut microbiota, characterized by a unique microbial composition and reduced diversity. ABX induced gut dysbiosis exacerbated pathological lung changes, impaired lung function, and promoted Treg cell exhaustion in COPD mice. Restoration of gut homeostasis via FMT attenuated these alterations. Higher plasma levels of acetylcholine (ACh) were observed in COPD mice, while the highest ACh levels were found in ABX treated COPD mice compared to controls. Notably, ACh levels correlated positively with genus Parasutterella, which was more abundant in COPD mice, and inversely with genera Candidatus Saccharimonas and Lactobacillus, which were predominant in control mice. Metabolomic pathways analysis revealed enrichment in unsaturated fatty acids biosynthesis and purine metabolism in COPD mice relative to controls.

These findings highlight the involvement of the gut microbiome in COPD development and suggest that maintaining gut homeostasis may represent a novel therapeutic strategy for COPD.

There is a need for a patient-centered tool that can quantitatively identify acute exacerbations of COPD. This study aims to develop and validate a digital tool that enables such care by providing a quantifiable severity score.

A total of 161 AECOPD patients and 130 stable COPD patients from Henan Provincial People's Hospital were enrolled. Demographics, clinical symptoms, pulmonary function parameters and admission laboratory data for patients were collected. The COPD Exacerbation Recognition Tool (CERT) was quantified using a 4-point Likert scale (0-3) to derive the Quantitative-CERT (Q-CERT) score. Effectiveness of the CERT and Q-CERT in identifying AECOPD was assessed.

The CERT demonstrated strong diagnostic performance for recognizing AECOPD, with a sensitivity of 85.7%, specificity of 80.8%, and accuracy of 83.5%. The quantitative Q-CERT score further optimized diagnostic accuracy. At a cutoff of 5 points, the Q-CERT provided optimal sensitivity (89.4%) and specificity (83.8%) combination, with an AUC of 0.956 (95% CI: 0.937-0.976, P< 0.001). Q-CERT scores were significantly higher in patients with AECOPD than in those with stable COPD (8 vs. 0 points, P< 0.001). Furthermore, elevated Q-CERT scores correlated negatively with pulmonary function parameters, including FEV1%pred, FEV1/FVC, MEF75%pred, MEF50%pred, and MMEF%pred (r = -0.406 to -0.358, all P < 0.001), with the strongest associations observed in small airway metrics. Conversely, higher Q-CERT scores showed positive correlations with the neutrophil-to-lymphocyte ratio (NLR) (r = 0.181, P<0.05) and platelet-to-lymphocyte ratio (PLR) (r = 0.245, P<0.05).

Q-CERT enhanced the original CERT's ability to identify AECOPD. And total score was correlated with pulmonary function impairment and systemic inflammation, making it an efficient and reliable tool for clinical practice.

The COVID-19 pandemic adversely affected several aspects of daily life and seriously threatened public health. The main aim of this study was to investigate the differences in human response to SARS-CoV-2 virus infection depending on sex, based on emergency medical team (EMT) interventions. The study was conducted in north-eastern Poland and were based on 12,110 EMT interventions, in which SARS-CoV-2 virus infection was indicated as an ICD-10 codification-based diagnosis. The study used descriptive statistics, Mann-Whitney U, and Chi-square tests. Patients infected with SARS-CoV-2 accounted for 4.6% of all EMT interventions during the period under analysis. Younger males were more likely to acquire infection than females (p < 0.001)-the median (Me) age was 68.0 vs. 71.0. In infected males, a life-threatening condition was diagnosed more frequently than in females (p < 0.001; 53.6% vs. 48.6%). Females remained at the place of call more often (p < 0.001; 46.2% vs. 39.6%), whereas males were more frequently transported to hospital (p < 0.001; 59.3% vs. 53.3%) and were more likely to be declared dead (p = 0.002; 0.8% vs. 0.4%). In males, the predominant complaints included dyspnoea (p < 0.001; 47.2% vs. 38.4%), abnormalities of breathing (p = 0.001; 40.1% vs. 37.2%) and cyanosis (p < 0.001; 3.2% vs. 2.1%), whereas, in females, these included vomiting (p < 0.001; 9.4% vs. 4.4%), diarrhoea (p < 0.001; 7.8% vs. 5.0%) and collapse (p = 0.034; 8.6% vs. 7.5%). The blood oxygen saturation value (SpO₂) (p < 0.001) in males (Me = 92.0) was significantly lower than that in females (Me = 94.0). Oxygen therapy (p < 0.001; 29.0% vs. 24.0%) was more frequently associated with males. The course of the COVID-19 infection depends on the sex of the patient, and male sex is a risk factor for its severe course. Therefore, public health strategies and actions should take into account sex as an important factor in the disease process, prevention and the fight against the pandemic.

Respiratory infectious disease epidemics challenge global public health. Critically ill patients need specialized care, making interhospital transfer pivotal for resource optimization; however, it carries substantial risks. The objective of the current study was to identify the risk factors for interhospital transfer of critically ill patients with respiratory infectious diseases and formulate response strategies.

Semistructured interviews were conducted with 12 research subjects, and the interview contents were analyzed via NVIVO11.0 software in accordance with Colaizzi's method.

Five major risk factors have been identified: Insufficient organizational and policy support; Shortage of staffing capacity and allocation; Obstacles in task execution and communication; Limitations of transport tools and equipment; and Limitations of environment and patient status. Moreover, five corresponding coping strategies were proposed.

These findings underscore the perceived importance of organizational support, standardized protocols, specialized training, and optimized equipment in enhancing transfer safety, providing a foundation for refining clinical practices. Future research is needed to empirically validate the effectiveness of these strategies across diverse healthcare settings and scale their implementation.

Patients with alcohol use disorder (AUD) are at higher risk for long-term Coronavirus Disease 2019 (COVID-19) related consequences, due to bidirectional relationship and shared biological pathways between chronic alcohol use and COVID-19 disease. However, they are significantly underrepresented in the literature examining adverse outcomes associated with COVID-19 disease.

Therefore, we comprehensively examined the initial group differences between AUD patients who experienced symptomatic COVID-19 disease and AUD patients without a history of COVID-19 disease. We investigated differences between COVID-19 and non-COVID-19 groups in AUD severity (alcohol use, alcohol craving), cognitive functions (assessed by the Montreal Cognitive Assessment), and basic blood parameters.

This pilot study was conducted in two study points 6 months apart. Participants were 32 COVID-19 AUD patients and 31 non-COVID-19 AUD patients, who met rigorous inclusion and exclusion criteria. Sociodemographic questionnaire, COVID-19 interview and validated measurement instruments (5.0.0. Mini International Neuropsychiatric Interview, M.I.N.I.; Penn Alcohol Craving Scale, PACS; Alcohol Use Disorders Identification Test, AUDIT; Montreal Cognitive Assessment, MoCA; Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised, CIWA-Ar) were assessed. Also, blood parameters were measured: erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) as inflammatory; alanine transaminase (ALT), aspartate transaminase (AST) and gamma-glutamyl transferase (GGT) as biochemical; total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG) as lipid parameters.

In the COVID-19 group, 93.7 % of participants had a mild form of the disease. There was significant difference between the two groups in cognitive functions which improved in the non-COVID-19 group, whereas they remained unchanged in the COVID-19 group [F _{(1, 56.157)} = 6.875, p = 0.011]. TC showed distinct pattern over time in the COVID-19 group [F _{(1, 49.997)} = 18.234, p = < 0.001]. CRP showed a weak negative relationship with the time since recovery from COVID-19 (b = -0.025, p = 0.009). The non-relapse group also showed an improvement in cognitive functions after six months, in contrast to the relapse group [F _{(1, 56.157)} = 6.879, p = 0.011]. In all participants, HDL levels increased after six months [F _{(1, 58.036)} = 4.604, p = 0.036].

Cognitive functions and blood parameters require long-term follow-up in COVID-19 AUD patients. Better clinical and blood outcomes in non-relapse group support the overall benefits of reduction in alcohol use.

Pneumoconiosis is the most prevalent occupational disease in China, with migrant workers being its primary victims. However, migrant workers with pneumoconiosis generally exhibit low health belief, which is associated with a decline in their quality of life. Organizational contextual stimuli are an important variable associated with the health belief of these workers. Perceived health status also plays a crucial role in this process. This study examines the associations among health belief, organizational contextual stimuli, and perceived health status among migrant workers with pneumoconiosis. It also explores factors associated with their health belief.

This study is based on 1,109 valid samples completed by migrant workers with pneumoconiosis across eight Chinese provinces. It employed one-way analysis of variance (ANOVA) and independent samples t-tests to investigate differences in health belief and associated factors among these workers across various sociodemographic characteristics. Additionally, structural equation modeling (SEM) was utilized to examine the associative pathways linking organizational contextual stimuli, health belief, and perceived health status among these workers.

Results from one-way ANOVA and independent samples t-tests indicate differences in health belief and associated factors among migrant workers with pneumoconiosis across all sociodemographic characteristics except gender. SEM analysis reveals that organizational contextual stimuli are significantly associated with health belief among these workers (β = 0.287, p < 0.001) and perceived health status (β = 0.267, p < 0.001). Perceived health status is also significantly associated with health belief (β = 0.379, p < 0.001). Furthermore, perceived health status plays a statistically significant but modest mediating role in the relationship between organizational contextual stimuli and health belief among this population (indirect effect = 0.056, 95% CI: 0.041-0.096). The model exhibited acceptable fit (CMIN/DF = 1.972, RMSEA = 0.048, CFI = 0.931).

It is suggested to strengthen organizational support and protection, enhance the health atmosphere and emotional well-being of migrant workers with pneumoconiosis, and cultivate health initiative among this population. In turn, this is associated with increased endogenous motivation for health belief in this population, is continuously associated with the strengthening of health belief, and improves the construction of health services for these workers.