Endotheliopathy is suggested to be an important feature of COVID-19 in hospitalized patients. To determine whether endotheliopathy is involved in COVID-19-associated mortality, markers of endothelial damage were assessed in critically ill COVID-19 patients upon intensive care unit (ICU) admission. Thirty-eight critically ill COVID-19 patients were included in this observational study, 10 of whom died in the ICU. Endothelial biomarkers, including soluble (s)E-selectin, sP-selectin, angiopoietin 1 and 2 (Ang-1 and Ang-2, respectively), soluble intercellular adhesion molecule 1 (sICAM-1), vascular endothelial growth factor (VEGF), soluble vascular endothelial (VE)-cadherin, and von Willebrand factor (vWf), were measured upon ICU admission. The ICU cohort was subsequently divided into survivors and non-survivors; Kaplan–Meier analysis was used to explore associations between biomarkers and survival, while receiver operating characteristic (ROC) curves were generated to determine their potential prognostic value. sE-selectin, sP-selectin, Ang-2, and sICAM-1 were significantly elevated in ICU non-survivors compared to survivors, and also associated with a higher mortality probability in the Kaplan–Meier analysis. The prognostic values of sE-selectin, Ang-2, and sICAM-1 from the generated ROC curves were greater than 0.85. Hence, we conclude that in our cohort, ICU non-survivors had higher levels of specific endothelial markers compared to survivors. Elevated levels of these markers upon ICU admission could possibly predict mortality in COVID-19.

Workplace bullying is common among nurses and negatively affects several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data in February 2024. We used the Negative Acts Questionnaire—Revised, the Quiet Quitting Scale, and the Brief COPE to measure workplace bullying, quiet quitting, and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies were negative predictors of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses’ managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.

A damaged endothelium is an underlying condition of the many complications of COVID-19 patients. The increased mortality risk associated with diseases that have underlying endothelial dysfunction, such as acute respiratory distress syndrome (ARDS), suggests that endothelial (e) nitric oxide synthase (NOS)-derived nitric oxide could be an important defense mechanism. Additionally, intravenous recombinant angiotensin converting enzyme 2 (ACE2) was recently reported as an effective therapy in severe COVID-19, by blocking viral entry, and thus reducing lung injury. Very few studies exist on the prognostic value of endothelium-related protective molecules in severe COVID-19 disease. To this end, serum levels of eNOS, inducible (i) NOS, adrenomedullin (ADM), soluble (s) ACE2 levels, and serum (s) ACE activity were measured on hospital admission in 89 COVID-19 patients, hospitalized either in a ward or ICU, of whom 68 had ARDS, while 21 did not. In our cohort, the COVID-19-ARDS patients had considerably lower eNOS levels compared to the COVID-19 non-ARDS patients. On the other hand, sACE2 was significantly higher in the ARDS patients. iNOS, ADM and sACE activity did not differ. Our results might support the notion of two distinct defense mechanisms in COVID-19-derived ARDS; eNOS-derived nitric oxide could be one of them, while the dramatic rise in sACE2 may also represent an endogenous mechanism involved in severe COVID-19 complications, such as ARDS. These results could provide insight to therapeutical applications in COVID-19.

Nurses have experienced several psychological and work-related issues during the COVID-19 pandemic, including pandemic burnout and job burnout. The aim of this study was to examine the impact of social support and resilience on COVID-19 pandemic burnout and job burnout among nurses. We conducted a cross-sectional study in Greece. The study population included 963 nurses. We measured social support, resilience, COVID-19 pandemic burnout, and job burnout with the Multidimensional Scale of Perceived Social Support, Brief Resilience Scale, COVID-19 Burnout Scale, and Single-Item Burnout Measure, respectively. Nurses received high levels of social support, while their resilience was moderate. Additionally, nurses experienced moderate levels of COVID-19 burnout and job burnout. Increased social support and increased resilience were associated with reduced COVID-19 pandemic burnout. We found a negative relationship between social support and job burnout. A similar negative relationship was found between resilience and job burnout. Social support and resilience can act as protective factors against COVID-19 pandemic burnout and job burnout among nurses. Policy makers should develop and implement appropriate strategies to improve nurses’ social support and resilience since they are the backbone of healthcare systems worldwide.

Background: Innovation is a crucial issue in healthcare services since it can affect job-related variables such as productivity, satisfaction, and burnout. The aim of our study was to examine the impact of innovation support on quiet quitting, innovative behavior, and innovation outputs among nurses. Methods: We conducted a cross-sectional study in Greece during April 2024. We employed a convenience sample of nurses. We followed the reporting of observational studies in epidemiology (STROBE). We used the following instruments: (a) the innovation support inventory (ISI) to measure innovation support; (b) the quiet quitting scale (QQS) to measure quiet quitting; (c) the innovative behavior inventory (IBI) to measure innovative behavior; and (d) the innovation outputs (IO) scale to measure innovation outputs. Our study questionnaire was anonymous, and nurses gave their informed consent to participate. The Ethics Committee of the Faculty of Nursing, National and Kapodistrian University of Athens, approved our study protocol, while we followed the guidelines of the Declaration of Helsinki. Results: Our study population included 328 nurses with a mean age of 42.3 years (standard deviation: 9.7). Among them, 89.9% were females. Our multivariable analysis identified a negative relationship between innovation support and quiet quitting. Moreover, we found that managerial support and cultural support improved several aspects of innovative behavior, such as idea generation, idea search, idea communication, implementation starting activities, involving others, and overcoming obstacles. Additionally, managerial support improved innovation outputs. Conclusions: Our findings suggested the positive impact of innovation support on quiet quitting, innovative behavior, and innovation outputs among nurses. Organizations and nurses’ managers should establish an innovative working environment to improve nurses’ passion, motives, and productivity.

Physical and mental health problems among post-COVID-19 patients are common, even a year after infection. As there is no prior study available, we investigated the impacts of resilience and social support on anxiety, depression, and quality of life among patients with post-COVID-19 syndrome. We conducted a cross-sectional study with a convenience sample. The measures included the demographic and clinical characteristics of patients, the Brief Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Patient Health Questionnaire-4 (PHQ-4), and the EuroQol-5D-3L. The mean age of patients was 44.8 years. The total PHQ-4 score suggested that 32.8% of patients with post-COVID-19 syndrome experienced severe psychological distress, 32.8% experienced moderate distress, 23% experienced mild distress, and 11.5% had no distress. Moreover, 60.7% of patients had anxiety scores of ≥3 and 69.7% had depression scores of ≥3, indicating possible major anxiety or depression disorder. The mean EQ-5D-3L index value was 0.36, and the mean EQ-5D-3L VAS was 54.1. Multivariable analysis identified that resilience and social support reduced anxiety and depression among patients. Also, we found a significant positive relationship between resilience and social support, and quality of life. Our findings suggest that resilience and social support can be protective by reducing anxiety and depression and improving quality of life among patients with post-COVID-19 syndrome. Policymakers should develop and implement healthcare management programs to provide psychological support to these patients.