Clinical Characteristics of COVID-19 Reinfection: A Retrospective Study in China (preprint)

Purpose The number of patients with COVID-19 reinfection is gradually increasing.In this study, we aimed to investigate the clinical characteristics of individuals who experienced COVID-19 reinfection.Methods A retrospective data analysis was conducted involving patients diagnosed with COVID-19 between April 1, 2023, and June 20, 2023. The patients were categorized into two groups: the observation group, consisting of individuals with reinfection, and the control group, comprising those with primary infection.Results A Total 905(905/1025) patients were included in the study,with 407 in the observation group and 498 in the control group. The top three clinical symptoms in both groups were fever, cough with expectoration, and dizziness with fatigue (p < 0.001). The clinical classification of patients in the observation group primarily consisted of non-severe cases, (p<0.001). The proportion of hospitalized patients was lower in the observation group than in the control group (p < 0.001). The observation group exhibited a shorter clinical symptom recovery time than that of the control group (median, 5 d vs. 7 d,p < 0.001).Conclusion Patients experiencing COVID-19 reinfection were primarily classified as non-severe cases, with lower proportions of occurrence of severe and rare critical conditions. The severity was milder compared to that in patients with primary COVID-19 infections.

Identification of microplastic fibres released from COVID-19 test swabs with Raman imaging.

Background: COVID-19 pandemic is not yet over, and it has been generating lots of plastic wastes that become a big concern. To catch the virus, for example, no matter via antigen or PCR test, swab is generally used for sampling. Unfortunately, the swab tip is commonly made of plastics, and thus it can be a potential source of microplastics. This study aims to propose and optimise several Raman imaging to identify the microplastic fibres released from different COVID-19 test swabs. Results: The results show that Raman imaging can effectively identify and visualise the microplastic fibres released from the swabs. In the meantime, on the surface of the fibres, additives such as titanium oxide particles are also captured for some brands of swabs. To increase the result certainty, scanning electron microscope (SEM) is first employed to get the morphology of the released microplastic fibres, along with Energy-dispersive X-ray spectroscopy (EDS) to confirm the presence of titanium element. Then, Raman imaging is advanced to identify and visualise the microplastics and titanium oxide particles, from different characteristic peaks in the scanning spectrum matrix. To further increase the imaging certainty, these images can be merged and cross-checked using algorithms, or the raw data from the scanning spectrum matrix can be analysed and decoded via chemometrics, such as principal component analysis (PCA). Beyond the advantages, the disadvantages of the confocal Raman imaging (affected by focal height) and algorithms (non-supervised calculation) are also discussed and intentionally corrected. In brief, the imaging analysis (particularly the combined SEM with Raman) is recommended to avoid the possible result bias that might be generated from the single spectrum analysis at a selective but random position. Conclusions: Overall, the results indicate that Raman imaging can be a useful tool to detect microplastics. The results also send us a strong warning that, if we worry about the potential microplastics contamination, we should be cautious to select the suitable COVID-19 testing kits. Supplementary Information: The online version contains supplementary material available at 10.1186/s12302-023-00737-0.

Scoping Review: Ultrasonographic evidence of intraabdominal manifestations of COVID-19 infection.

COVID-19 is an infectious disease caused by the novel SARS-CoV-2 coronavirus that in the majority of patients will only cause mild symptoms. The most common serious complication is COVID-19 pneumonia, however, gastrointestinal (GI) COV-ID-19 is also a frequent presentation and likely due to the high expression of the ACE2 receptor in the GI tract. As diagnostic ultrasound has been frequently used in the management of this patient cohort, we conducted a literature search with the aim to present and review the currently published evidence of using ultrasound examinations in the management of intraabdominal manifestations of COVID-19. Our analysis showed that sonographic abnormalities of the hepatobiliary system are the most commonly reported findings in adults, while gastrointestinal abnormalities are the most common findings in children. The most severe complications are related to thromboembolic complications in the intensive care unit.

Immunogenicity of COVID-19 vaccines in chronic liver disease patients and liver transplant recipients: A systematic review and meta-analysis.

BACKGROUND AND AIMS: Chronic liver disease (CLD) patients and liver transplant (LT) recipients have an increased risk of morbidity and mortality from coronavirus disease 2019 (COVID-19). The immunogenicity of COVID-19 vaccines in CLD patients and LT recipients is poorly understood. The present study aimed to evaluate the immunogenicity of COVID-19 vaccines in CLD patients and LT recipients. METHODS: We searched electronic databases for eligible studies. Two reviewers independently conducted the literature search, extracted the data and assessed the risk of bias of included studies. The rates of detectable immune response were pooled from single-arm studies. For comparative studies, we compared the rates of detectable immune response between patients and healthy controls. The meta-analysis was conducted using the Stata software with a random-effects model. RESULTS: In total, 19 observational studies involving 4191 participants met the inclusion criteria. The pooled rates of detectable humoral immune response after two doses of COVID-19 vaccination in CLD patients and LT recipients were 95% (95% confidence interval [CI] = 88%-99%) and 66% (95% CI = 57%-74%) respectively. After two doses of vaccination, the humoral immune response rate was similar in CLD patients and healthy controls (risk ratio [RR] = 0.96; 95% CI = 0.90-1.02; p = .14). In contrast, LT recipients had a lower humoral immune response rate after two doses of vaccination than healthy controls (RR = 0.68; 95% CI = 0.59-0.77; p < .01). CONCLUSIONS: Our meta-analysis demonstrated that COVID-19 vaccination induced strong humoral immune responses in CLD patients but poor humoral immune responses in LT recipients.

Nanofiber-Based Odor-Free Medical Mask Fabrication Using Polyvinyl Butyral and Eucalyptus Anti Odor Agent.

Following the 2020 COVID-19 worldwide outbreak, many countries adopted sanitary and safety measures to safeguard public health such as wearing medical face mask. While face masks became a necessity for people, disadvantages impede their long period wearing such as uncomfortable breathability and odor. The intermediate layer of the medical face mask is composed of porous non-woven fabric to block external particles while maintaining breathability. To overcome aforementioned limitation, this study uses electrospinning to design and fabricate odorless face masks via the use of aromatic oil. Eucalyptus essential oil is encapsulated through mixing and layer-by-layer by hydrophobic polyvinyl butyral and further used to fabricate the medical mask intermediate layer. We found that adding 0.2 g of eucalyptus into polyvinyl butyral fabric through mixing results in the deodorization rate of 80% after 2 h, with fabric thickness of 440.9 µm, and melt-blown non-woven fabric thickness of 981.7 µm. The Particle Filtration Efficiency of 98.3%, Bacterial Filtration Efficiency above 99.9%, and the differential pressure of 4.7 mm H2O/cm2 meet the CNS 14774 standard on medical face masks. Therefore, this study successfully proved that this type of masks' middle layer not only effectively protects against coronavirus, but also provides better scents and makes it more comfortable for consumers.

Fire releases micro- and nanoplastics: Raman imaging on burned disposable gloves.

Raman imaging can effectively characterise microplastics and nanoplastics, which is validated here to capture the items released from the plastic gloves when subjected to a mimicked fire. During the COVID-19 pandemic, large quantities of personal protective equipment (PPE) units have been used, such as the disposable gloves. If discarded and poorly managed, plastics gloves might break down to release secondary contaminants. The breakdown process can be accelerated by burning in a bushfire or at the incineration plants. During the burning process, the functional groups on the surface can be burned differently due to their different thermal stabilities. The different degrees of burning can be distinguished and visualised via Raman imaging. In the meantime, at the bottom of the burned plastics, microplastics and nanoplastics can be generated at a significant amount. The possible false Raman imaging on microplastics and nanoplastics is also discussed, by effectively extracting and distinguishing the weak signal from the background or noise. Overall, these findings confirm the importance of effectively working waste incineration plants and litter prevention, and suggest that Raman imaging is a suitable approach to characterise microplastics and nanoplastics.

Microplastics and nanoplastics released from a PPE mask under a simulated bushfire condition.

Due to COVID-19, large amounts of personal protective equipment (PPE) have been used, and many PPE units are made of plastics, such as face masks. The masks can be burned naturally in a bushfire or artificially at the incineration plants, and release microplastics and nanoplastics from the mask plastic fibres. A fire can cause the plastic, such as polypropylene (PP) fibres, to be molten and stick to the solid surface, such as glass, soil, concrete or plant, as films or islands, due to the binding property of the molten plastic material. Once the films or islands are peeled off in the processes such as weathering, ageing, or treatment and clean-up, there are residuals leftover, which are identified as nanoplastics and microplastics via Raman imaging, with the significant release amount of ~1100 nanoplastics / 10 µm2 or ~11 billion / cm2, and ~50 microplastics / 420 µm2 or ~12 million / cm2. Moreover, surface group is deviated on the plastic surface, which can also be distinguished and visualised as well via Raman imaging, down to nano size. This test validates the Raman imaging approach to capture microplastics and nanoplastics, and also provides important information about the fate and transportation of PPE mask in the environment, particularly when subjected to a fire. Overall, Raman imaging can be an effective option to characterise the microplastics and nanoplastics, along with the deviated surface group.

Endothelial ß-Catenin Deficiency Causes Blood-Brain Barrier Breakdown via Enhancing the Paracellular and Transcellular Permeability.

Disruption of the blood-brain barrier (BBB) causes or contributes to neuronal dysfunction and several central nervous system (CNS) disorders. Wnt/ß-catenin signaling is essential for maintaining the integrity of the adult BBB in physiological and pathological conditions, including stroke. However, how the impairment of the endothelial Wnt/ß-catenin signaling results in BBB breakdown remains unclear. Furthermore, the individual contributions of different BBB permeability-inducing mechanisms, including intercellular junction damage, endothelial transcytosis, and fenestration, remains unexplored. Here, we induced ß-catenin endothelial-specific conditional knockout (ECKO) in adult mice and determined its impact on BBB permeability and the underlying mechanism. ß-catenin ECKO reduced the levels of active ß-catenin and the mRNA levels of Wnt target genes in mice, indicating downregulation of endothelial Wnt/ß-catenin signaling. ß-catenin ECKO mice displayed severe and widespread leakage of plasma IgG and albumin into the cerebral cortex, which was absent in wild-type controls. Mechanistically, both the paracellular and transcellular transport routes were disrupted in ß-catenin ECKO mice. First, ß-catenin ECKO reduced the tight junction protein levels and disrupted the intercellular junction ultrastructure in the brain endothelium. Second, ß-catenin ECKO substantially increased the number of endothelial vesicles and caveolae-mediated transcytosis through downregulating Mfsd2a and upregulating caveolin-1 expression. Interestingly, fenestration and upregulated expression of the fenestration marker Plvap were not observed in ß-catenin ECKO mice. Overall, our study reveals that endothelial Wnt/ß-catenin signaling maintains adult BBB integrity via regulating the paracellular as well as transcellular permeability. These findings may have broad applications in understanding and treatment of CNS disorders involving BBB disruption.

A COVID-19 vaccine candidate composed of the SARS-CoV-2 RBD dimer and Neisseria meningitidis outer membrane vesicles.

SARS-CoV-2 infection is mediated by the interaction of the spike glycoprotein trimer via its receptor-binding domain (RBD) with the host's cellular receptor. Vaccines seek to block this interaction by eliciting neutralizing antibodies, most of which are directed toward the RBD. Many protein subunit vaccines require powerful adjuvants to generate a potent antibody response. Here, we report on the use of a SARS-CoV-2 dimeric recombinant RBD combined with Neisseria meningitidis outer membrane vesicles (OMVs), adsorbed on alum, as a promising COVID-19 vaccine candidate. This formulation induces a potent and neutralizing immune response in laboratory animals, which is higher than that of the dimeric RBD alone adsorbed on alum. Sera of people vaccinated with this vaccine candidate, named Soberana01, show a high inhibition level of the RBD-ACE2 interaction using RBD mutants corresponding to SARS-CoV-2 variants of concern and wild-type expressed using the phage display technology. To our knowledge, this is the first time that the immunostimulation effect of N. meningitidis OMVs is evaluated in vaccine candidates against SARS-CoV-2.

Machine learning for emerging infectious disease field responses.

Emerging infectious diseases (EIDs), including the latest COVID-19 pandemic, have emerged and raised global public health crises in recent decades. Without existing protective immunity, an EID may spread rapidly and cause mass casualties in a very short time. Therefore, it is imperative to identify cases with risk of disease progression for the optimized allocation of medical resources in case medical facilities are overwhelmed with a flood of patients. This study has aimed to cope with this challenge from the aspect of preventive medicine by exploiting machine learning technologies. The study has been based on 83,227 hospital admissions with influenza-like illness and we analysed the risk effects of 19 comorbidities along with age and gender for severe illness or mortality risk. The experimental results revealed that the decision rules derived from the machine learning based prediction models can provide valuable guidelines for the healthcare policy makers to develop an effective vaccination strategy. Furthermore, in case the healthcare facilities are overwhelmed by patients with EID, which frequently occurred in the recent COVID-19 pandemic, the frontline physicians can incorporate the proposed prediction models to triage patients suffering minor symptoms without laboratory tests, which may become scarce during an EID disaster. In conclusion, our study has demonstrated an effective approach to exploit machine learning technologies to cope with the challenges faced during the outbreak of an EID.

SARS-CoV-2 RBD-Tetanus Toxoid Conjugate Vaccine Induces a Strong Neutralizing Immunity in Preclinical Studies.

Controlling the global COVID-19 pandemic depends, among other measures, on developing preventive vaccines at an unprecedented pace. Vaccines approved for use and those in development intend to elicit neutralizing antibodies to block viral sites binding to the host's cellular receptors. Virus infection is mediated by the spike glycoprotein trimer on the virion surface via its receptor binding domain (RBD). Antibody response to this domain is an important outcome of immunization and correlates well with viral neutralization. Here, we show that macromolecular constructs with recombinant RBD conjugated to tetanus toxoid (TT) induce a potent immune response in laboratory animals. Some advantages of immunization with RBD-TT conjugates include a predominant IgG immune response due to affinity maturation and long-term specific B-memory cells. These result demonstrate the potential of the conjugate COVID-19 vaccine candidates and enable their advance to clinical evaluation under the name SOBERANA02, paving the way for other antiviral conjugate vaccines.

Lung ultrasound in children, WFUMB review paper (part 2).

Ultrasound (US) is an ideal diagnostic tool for paediatric patients owning to its high spatial and temporal resolution, real-time imaging, and lack of ionizing radiation and bedside availability. In the current World Federation of Societies for Ultra-sound in Medicine and Biology (WFUMB) paper series so far (part I) the topic has been introduced and the technical require-ments explained. In the present paper the use of US in the lung in paediatric patients is analysed. Lung diseases including the interstitial syndrome, bacterial pneumonia and viral infections, CoViD findings, atelectasis, lung consolidation, bronchiolitis and congenital diseases of the respiratory system including congenital pulmonary airway malformation (CPAM) and sequester but also pneumothorax are discussed.

Incidence of psychological illness after coronavirus outbreak: a meta-analysis study.

BACKGROUND: The COVID-19 has had an enormous impact worldwide and is still spreading. Globally confirmed infections have surpassed 41.1 million, of which more than 1 million resulted in deaths. Considering the relationship between public health disasters and emotional disorders, it is essential to examine psychological well-being related to this pandemic. METHOD: We performed a systematic search on psychological problems from PubMed to 10 October 2020, and conducted a meta-analysis using Comprehensive Meta-Analysis V.3 software. RESULTS: The results showed a 19.4% and 26.8% pooled incidence for depression and post-traumatic stress disorder (PTSD), respectively, during the SARS and Middle East Respiratory Syndrome (MERS)-related coronavirus outbreaks. However, overall prevalence of depression was somewhat higher at 27.0% during the COVID-19 period. The pooled incidence of PTSD during COVID-19 compared with SARS and MERS outbreaks, was lower, at 16.4%. CONCLUSION: The results suggest that there are shared and distinct psychological responses following SARS, MERS and COVID-19, and show pessimistic estimates of a wide range of potentially upcoming psychological problems.

Pulmonary Embolism and Deep Vein Thrombosis in COVID-19: A Systematic Review and Meta-Analysis.

Background The association of pulmonary embolism (PE) with deep vein thrombosis (DVT) in patients with coronavirus disease 2019 (COVID-19) remains unclear, and the diagnostic accuracy of D-dimer tests for PE is unknown. Purpose To conduct meta-analysis of the study-level incidence of PE and DVT and to evaluate the diagnostic accuracy of D-dimer tests for PE from multicenter individual patient data. Materials and Methods A systematic literature search identified studies evaluating the incidence of PE or DVT in patients with COVID-19 from January 1, 2020, to June 15, 2020. These outcomes were pooled using a random-effects model and were further evaluated using metaregression analysis. The diagnostic accuracy of D-dimer tests for PE was estimated on the basis of individual patient data using the summary receiver operating characteristic curve. Results Twenty-seven studies with 3342 patients with COVID-19 were included in the analysis. The pooled incidence rates of PE and DVT were 16.5% (95% CI: 11.6, 22.9; I2 = 0.93) and 14.8% (95% CI: 8.5, 24.5; I2 = 0.94), respectively. PE was more frequently found in patients who were admitted to the intensive care unit (ICU) (24.7% [95% CI: 18.6, 32.1] vs 10.5% [95% CI: 5.1, 20.2] in those not admitted to the ICU) and in studies with universal screening using CT pulmonary angiography. DVT was present in 42.4% of patients with PE. D-dimer tests had an area under the receiver operating characteristic curve of 0.737 for PE, and D-dimer levels of 500 and 1000 µg/L showed high sensitivity (96% and 91%, respectively) but low specificity (10% and 24%, respectively). Conclusion Pulmonary embolism (PE) and deep vein thrombosis (DVT) occurred in 16.5% and 14.8% of patients with coronavirus disease 2019 (COVID-19), respectively, and more than half of patients with PE lacked DVT. The cutoffs of D-dimer levels used to exclude PE in preexisting guidelines seem applicable to patients with COVID-19. © RSNA, 2020 Supplemental material is available for this article. See also the editorial by Woodard in this issue.

A comparative study of real-time RT-PCR based SARS-CoV-2 detection methods and its application to human derived and surface swabbed material (preprint)

Real-time reverse transcription polymerase chain reaction (RT-PCR) remains a gold standard in detection of various viral diseases. In the COVID-19 pandemic, multiple RT-PCR based tests were developed to screen for viral infection. As an emergency response to growing testing demand, we established a SARS-CoV-2 PCR diagnostics platform for which we compared different commercial and in-house RT-PCR protocols. We evaluated four commercial (CDC 2019-nCoV, Applied Biosystems 2019-nCoV Assay Kit v1 TF-SinglePlex, 2019-nCoV Assay Kit v2 TF-MultiPlex, and EURORealTime SARS-CoV-2), one customized (Institute Pasteur), and one in-house RT-PCR protocols with 92 SARS-CoV-2 positive and 92 SARS-CoV-2 negative samples. Furthermore, we compared economical and practical characteristics of these protocols. We also developed a highly sensitive digital droplet PCR (ddPCR) method. Finally, we conducted a local environmental study for the presence and infectivity of SARS-CoV-2 on different surfaces in a quarantined household using RT- and ddPCR methods. We found very low limits of detection (1 or 2 viral copies/L), high sensitivities (93.6-97.8%) and specificities (98.7-100%) for the tested RT-PCR protocols. We further demonstrated the feasibility of downscaling two of the commercial protocols, which could optimize testing capacity. In the local environmental study, only one surface sample tested positive for viral RNA, but without detectable infectivity in vitro. Tested commercial and customized RT-PCR detection kits show very good and comparable sensitivity, and specificity, and the kits could be further optimized for use on SARS-CoV-2 viral samples derived from human and surface swabbed samples.

Development and preliminary validation of questionnaire for infection process and prevention of 2019 novel coronavirus infection in medical staffs

Objective To develop the questionnaire and test its reliability for investigating route, prevention, and control of SARS-CoV-2 infection in medical staffs. Methods This questionnaire was development based on the COVID-19 relevant guidelines, official documents issued by the National Health Committee of the People's Republic of China, and published studies. The development group performed repeated discussions and drafted the first questionnaire, then performed expert consultation and revised the draft according to their suggestions. Eventually, some frontline medical staffs were invited to carry out pre-test investigation of the questionnaire and test its reliability. Results The first draft included 48 items;18 experts were invited in the first round questionnaire and 10 experts in the second round questionnaire. The positive coefficient of experts in these two rounds was both greater than 75%, and the authority coefficient of experts' opinions was greater than 0.70. The variation coefficient of these items was between 0.00 and 0.35, the coordination coefficient of experts was 0.193 (P<0.05). The experts of above two rounds put forward 14 suggestions for text modification or adjustment options of some items;after the development group held repeatedly discussions, a total of 8 items were performed secondary consultation and finally reached consensus. The final questionnaire included two domains of questionnaire before and after confirmed diagnosis. The domain "before confirmed diagnosis" covered 4 sections and 29 items involving infectious cause, plan and knowledge of prevention and control, and psychological symptoms. The domain "after confirmed diagnosis" covered 5 sections and 21 items, included symptoms, treatment, and psychological status after diagnosis;impact on the surrounding environment and people, and awareness of protection after infection. The pre-test results showed that the total items were considerably numerous, some items were difficult to understand, some laboratory results and treatment conditions were ambiguous, etc. After modification and re-testing, the test-re-test reliability of each domain was between 0.74 and 0.93, and the overall re-test reliability of the questionnaire content was 0.82. Conclusions This research has developed a questionnaire for investigating infection process, prevention and control of SARS-CoV-2 infection in medical staff, and the items considered two domains prior to and after confirmed diagnosis. The reliability and practicability of the questionnaire are acceptable.

The use of contrast-enhanced ultrasound in COVID-19 lung imaging.

Lung ultrasound has become an essential tool for rapid bedside assessment in critically unwell patients, proving helpful in assessment of COVID-19 due to logistics of cross-sectional imaging. Contrast enhanced ultrasound (CEUS) further characterizes sonographic features of COVID-19 as multiple areas of infarction, a finding not reproducible on other widely available imaging modalities. CEUS also has the benefit of being cheap, radiation-free, without risk of nephrotoxicity, and can be performed at the bedside. It is predicted that lung CEUS in COVID-19 may help guide prognosis and management. We describe three cases of CEUS in COVID-19.

The Effect of Corticosteroids on Severe Patients of COVID-19: A retrospective study (preprint)

Background The effect of corticosteroids on COVID-19 remains controversial. This study aims to clarify the potential roles of corticosteroids in severe COVID-19 patients.Methods In the current retrospective single-center study, we collected data of 214 severe patients with confirmed COVID-19 in Wuhan Union Hospital from Feb 20th to Mar 1st, 2020. Epidemiological, clinical and treatment were analyzed between patients treated with corticosteroids or not.Results Corticosteroids used patients have higher levels of lactate dehydrogenase (LDH), interleukin-6 (IL-6), CD4+/CD8+ cells, C-reactive protein (CRP) and procalcitonin (PCT). Virus clearance time and hospital length of stay in corticosteroids group were also significantly higher. The antiviral treatment and antibiotics treatment in patients given corticosteroids were both significantly higher. Antibiotics treatment duration was significantly longer in corticosteroids group. And the usage of multiple antibiotics in corticosteroid group was also significantly higher. And patients who treated by corticosteroids beyond 5 days showed a significantly longer antibiotics duration. Whereas there were no differences on virus clearance time and multiple antibiotics between the patients treated with corticosteroids beyond 5 days and less than 5 days. Multivariate analysis showed that patients with sputum production and higher IL-6 at admission, or treated with corticosteroid therapy were associated with prolonged virus clearance time and lianhua qingwen capsule may contributed to shorten virus clearance time.Conclusions The use of corticosteroids could prolong the virus clearance. The benefits and harms should be carefully weighed in the COVID-19 patients who intend to use corticosteroids. The dosage should be low-to-moderate (≤ 0.5-1 mg/kg per day methylprednisolone or equivalent) and the duration should be short (≤ 5 days) to avoid secondary infections.

Psychological morbidities and fatigue in patients with confirmed COVID-19 during disease outbreak: prevalence and associated biopsychosocial risk factors (preprint)

Objective: The coronavirus disease 2019 (COVID-19) - a novel and highly infectious pneumonia - has now spread across China and beyond for over four months. However, its psychological impact on patients is unclear. We aim to examine the prevalence and associated risk factors for psychological morbidities and fatigue in patients with confirmed COVID-19 infection. Methods: Amidst the disease outbreak, 41 out of 105 COVID-19 patients in a local designated hospital in China were successfully assessed using a constellation of psychometric questionnaires to determine their psychological morbidities and fatigue. Several potential biopsychosocial risk factors (including pre-existing disabilities, CT severity score of pneumonia, social support, coping strategies) were assessed through multivariable logistic regression analyses to clarify their association with mental health in patients. Results: 43.9% of 41 patients presented with impaired general mental health, 12.2% had post-traumatic stress disorder (PTSD) symptoms, 26.8% had anxiety and/or depression symptoms, and 53.6% had fatigue. We did not find any association between pneumonia severity and psychological morbidities or fatigue in COVID-19 patients. However, high perceived stigmatization was associated with an increased risk of impaired general mental health and high perceived social support was associated with decreased risk. Besides, negative coping inclination was associated with an increased risk of PTSD symptoms; high perceived social support was associated with a decreased risk of anxiety and/or depression symptoms. Conclusions: Psychological morbidities and chronic fatigue are common among COVID-19 patients. Negative coping inclination and being stigmatized are primary risk factors while perceived social support is the main protective factor.