{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T20:15:50Z","timestamp":1770495350457,"version":"3.49.0"},"reference-count":46,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"COMPETE 2020\u2014COVID-19","award":["AAC 02\/SAICT\/2020"],"award-info":[{"award-number":["AAC 02\/SAICT\/2020"]}]},{"name":"COMPETE 2020\u2014COVID-19","award":["UIDB\/04539\/2020"],"award-info":[{"award-number":["UIDB\/04539\/2020"]}]},{"name":"COMPETE 2020\u2014COVID-19","award":["UIDP\/04539\/2020"],"award-info":[{"award-number":["UIDP\/04539\/2020"]}]},{"name":"COMPETE 2020\u2014COVID-19","award":["LA\/P\/0058\/2020"],"award-info":[{"award-number":["LA\/P\/0058\/2020"]}]},{"name":"European Regional Development Fund (ERDF), through the COMPETE 2020\u2014Operational Programme for Competitiveness and Internationalisation and Portuguese national funds via FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["AAC 02\/SAICT\/2020"],"award-info":[{"award-number":["AAC 02\/SAICT\/2020"]}]},{"name":"European Regional Development Fund (ERDF), through the COMPETE 2020\u2014Operational Programme for Competitiveness and Internationalisation and Portuguese national funds via FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UIDB\/04539\/2020"],"award-info":[{"award-number":["UIDB\/04539\/2020"]}]},{"name":"European Regional Development Fund (ERDF), through the COMPETE 2020\u2014Operational Programme for Competitiveness and Internationalisation and Portuguese national funds via FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UIDP\/04539\/2020"],"award-info":[{"award-number":["UIDP\/04539\/2020"]}]},{"name":"European Regional Development Fund (ERDF), through the COMPETE 2020\u2014Operational Programme for Competitiveness and Internationalisation and Portuguese national funds via FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["LA\/P\/0058\/2020"],"award-info":[{"award-number":["LA\/P\/0058\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Multiple factors, from socioeconomic development to genetic background, can affect the regional impact of some diseases, and this has also been seen during the COVID-19 pandemic. The objective of this retrospective study was to characterize a population in the interior of Portugal regarding health status and COVID-19 epidemiology. Between October 2021 and January 2023, 1553 subjects residing in Beira Baixa, Portugal, were included. Using a self-report approach, demographic and clinical data were obtained. Blood group, blood pressure, peripheral oxygen saturation and anti-spike protein immunoglobulin concentration were also analyzed. Statistical analysis was performed using IBM SPSS Statistics. The average age of the participants was 48.95 (\u00b114.43) years, with 64% being male and 36% being female. The most prevalent comorbidities were hypertension (19.2%), dyslipidemia (12.6%) and diabetes mellitus (6.6%). Half of the population was overweight, and more than half of the subjects had no history of tobacco consumption. Among the participants, 33% were infected with SARS-CoV-2: 70.1% had mild disease, 14.1% moderate disease and 1.4% severe disease. There was a very significant adherence to vaccination (97%). Previously infected or vaccinated people had higher anti-spike protein immunoglobulin values; this value depended on the vaccine administered (p &lt; 0.001). Patients with autoimmune diseases and smokers had lower levels of anti-S IgG antibodies (p = 0.030 and p = 0.024, respectively). The severity of COVID-19 did not affect the concentration of anti-S IgG (p = 0.430). This study highlights the general health statuses and the impact of COVID-19 on a population in the Portuguese interior. Knowledge of the circulation and impact of the virus in this specific population can alert and assist in better interventions being conducted by health authorities.<\/jats:p>","DOI":"10.3390\/ijerph21081033","type":"journal-article","created":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T11:54:19Z","timestamp":1722945259000},"page":"1033","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Health Status and COVID-19 Epidemiology in an Inland Region of Portugal: A Retrospective Study"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1771-2349","authenticated-orcid":false,"given":"Jorge","family":"Lindo","sequence":"first","affiliation":[{"name":"FMUC\u2014Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"CNC-UC\u2014Centre for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"CIBB\u2014Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Dermatology Department, Coimbra\u2019s Hospital and University Center, Unidade Local de Sa\u00fade de Coimbra, 3004-561 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9862-0691","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Coelho","sequence":"additional","affiliation":[{"name":"Sport Physical Activity and Health Research & Innovation Center (Sprint), Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6011-5016","authenticated-orcid":false,"given":"Catarina","family":"Gavinhos","sequence":"additional","affiliation":[{"name":"IPCB\/ESALD\u2014Instituto Polit\u00e9cnico de Castelo Branco, Escola Superior Agr\u00e1ria, UID-QRural, 6000-084 Castelo Branco, Portugal"}]},{"given":"Manuel","family":"Martins","sequence":"additional","affiliation":[{"name":"IPCB\/ESALD\u2014Instituto Polit\u00e9cnico de Castelo Branco, Escola Superior Agr\u00e1ria, UID-QRural, 6000-084 Castelo Branco, Portugal"}]},{"given":"Joana","family":"Liberal","sequence":"additional","affiliation":[{"name":"IPC\/ESTSC\u2014Instituto Polit\u00e9cnico de Coimbra, Escola Superior Tecnologia da Sa\u00fade de Coimbra, 3046-854 Coimbra, Portugal"}]},{"given":"Ant\u00f3nio Jorge","family":"Ferreira","sequence":"additional","affiliation":[{"name":"FMUC\u2014Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"CIBB\u2014Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9347-0535","authenticated-orcid":false,"given":"Teresa","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"FMUC\u2014Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"CNC-UC\u2014Centre for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"CIBB\u2014Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8405-4249","authenticated-orcid":false,"given":"Francisco","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Sport Physical Activity and Health Research & Innovation Center (Sprint), Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E33","DOI":"10.5888\/pcd18.210055","article-title":"Global Perspectives on Improving Chronic Disease Prevention and Management in Diverse Settings","volume":"18","author":"Airhihenbuwa","year":"2021","journal-title":"Prev. Chronic Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1038\/s41586-018-0457-8","article-title":"Facing up to the global challenges of ageing","volume":"561","author":"Partridge","year":"2018","journal-title":"Nature"},{"key":"ref_3","unstructured":"(2024, April 02). Instituto Nacional de Estat\u00edstica. Available online: https:\/\/www.ine.pt\/ngt_server\/attachfileu.jsp?look_parentBoui=628511465&att_display=n&att_download=y."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.pulmoe.2022.12.001","article-title":"Asthma hospitalizations: A call for a national strategy to fight health inequities","volume":"29","author":"Vieira","year":"2023","journal-title":"Pulmonology"},{"key":"ref_5","first-page":"S1169","article-title":"Excess weight and obesity in a region of the interior of Portugal","volume":"14","author":"Coelho","year":"2019","journal-title":"J. Hum. Sport Exerc."},{"key":"ref_6","unstructured":"Ordem dos M\u00e9dicos (2023, December 13). Estat\u00edsticas Nacionais. Available online: https:\/\/ordemdosmedicos.pt\/wp-content\/uploads\/2023\/01\/ESTATISTICAS-por-DISTRITO_2022.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Borges, I.J., O\u2019Math\u00fana, D.P., von Groote, T.C., Abdulazeem, H.M., Weerasekara, I., Marusic, A., Puljak, L., Civile, V.T., Zakarija-Grkovic, I., and Pericic, T.P. (2021). Coronavirus disease (COVID-19) pandemic: An overview of systematic reviews. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06214-4"},{"key":"ref_8","unstructured":"(2023, November 22). Available online: https:\/\/www.who.int\/europe\/news-room\/fact-sheets\/item\/post-covid-19-condition."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100443","DOI":"10.1016\/j.imu.2020.100443","article-title":"Understand variability of COVID-19 through population and tissue variations in expression of SARS-CoV-2 host genes","volume":"21","author":"Chen","year":"2020","journal-title":"Inf. Med. Unlocked"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.52225\/narra.v1i3.48","article-title":"Global prevalence of persistent neuromuscular symptoms and the possible pathomechanisms in COVID-19 recovered individuals: A systematic review and meta-analysis","volume":"1","author":"Fajar","year":"2021","journal-title":"Narra J."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Leong, D.P., Loeb, M., Mony, P.K., Rangarajan, S., Mushtaha, M., Miller, M.S., and Dias, M. (2024). Risk factors for recognized and unrecognized SARS-CoV-2 infection: A seroepidemiologic analysis of the Prospective Urban Rural Epidemiology (PURE) study. Microbiol. Spectr., 12.","DOI":"10.1128\/spectrum.01492-23"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4585","DOI":"10.2147\/IJGM.S434968","article-title":"Can Patients with Asymptomatic\/Mild Illness and Moderate Illness COVID-19 Have White Matter Damage?","volume":"16","author":"Wei","year":"2023","journal-title":"Int. J. Gen. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/CRD.0000000000000458","article-title":"Mild-to-Moderate COVID-19 Infection and Myocarditis: A Review","volume":"31","author":"Bailey","year":"2023","journal-title":"Cardiol. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e2323349","DOI":"10.1001\/jamanetworkopen.2023.23349","article-title":"Clinical and Demographic Factors Associated With COVID-19, Severe COVID-19, and SARS-CoV-2 Infection in Adults: A Secondary Cross-Protocol Analysis of 4 Randomized Clinical Trials","volume":"6","author":"Theodore","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_15","first-page":"e1003-17","article-title":"Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: A modelling study","volume":"8","author":"Andrew","year":"2020","journal-title":"Lancet Glob. Health"},{"key":"ref_16","unstructured":"(2024, January 10). Available online: https:\/\/www.pordata.pt\/censos\/resultados\/populacao-beira+baixa-538."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/S0140-6736(21)01755-4","article-title":"1-year outcomes in hospital survivors with COVID-19: A longitudinal cohort study","volume":"398","author":"Huang","year":"2021","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e062332","DOI":"10.1136\/bmjopen-2022-062332","article-title":"Life after COVID-19: The road from intensive care back to living\u2014A prospective cohort study","volume":"12","author":"Wiertz","year":"2022","journal-title":"BMJ Open"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/S2213-8587(22)00165-6","article-title":"Europe\u2019s obesity burden on the rise: WHO report","volume":"10","author":"Balakrishnan","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1159\/000491754","article-title":"Body Mass Index Categories and Attained Height in Portuguese Adults","volume":"11","author":"Barros","year":"2018","journal-title":"Obes. Facts"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s00134-019-05594-1","article-title":"Obesity in the critically ill: A narrative review","volume":"45","author":"Schetz","year":"2019","journal-title":"Intensive Care Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.hrtlng.2022.07.006","article-title":"Fat mass to fat-free mass ratio and its associations with clinical characteristics in asthma","volume":"56","author":"Rugila","year":"2022","journal-title":"Heart Lung"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s40292-022-00506-9","article-title":"Hypertension and COVID-19: Current Evidence and Perspectives","volume":"29","author":"Gallo","year":"2022","journal-title":"High Blood Press. Cardiovasc. Prev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.repc.2019.04.003","article-title":"Recommendations for reducing tobacco consumption in the Portuguese-speaking countries","volume":"38","author":"Oliveira","year":"2019","journal-title":"Rev. Port. Cardiol. (Engl. Ed.)"},{"key":"ref_25","unstructured":"(2023, December 12). Available online: https:\/\/sicad.pt\/PT\/EstatisticaInvestigacao\/EstudosConcluidos\/Paginas\/detalhe.aspx?itemId=183&lista=SICAD_ESTUDOS&bkUrl=\/BK\/EstatisticaInvestigacao\/EstudosConcluidos."},{"key":"ref_26","unstructured":"(2024, April 02). Available online: https:\/\/www.macrotrends.net\/global-metrics\/countries\/PRT\/portugal\/smoking-rate-statistics."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1177\/14034948221143421","article-title":"Assessing the long-term health impact of COVID-19: The importance of using self-reported health measures","volume":"51","author":"Huijts","year":"2023","journal-title":"Scand. J. Public Health"},{"key":"ref_28","first-page":"18","article-title":"Beira Baixa Blood Pressure Program\u2014Municipality of Castelo Branco","volume":"91","author":"Pinto","year":"2023","journal-title":"Revista Port. De Hipertens. E Risco Cardiovasc."},{"key":"ref_29","first-page":"16","article-title":"Programa da Press\u00e3o Arterial\u2014Idanha a Nova","volume":"95","author":"Fonseca","year":"2023","journal-title":"Rev. Port. De Hipertens. E Risco Cardiovasc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.repc.2018.03.013","article-title":"New approach to diabetes care: From blood glucose to cardiovascular disease. Revista portuguesa de cardiologia","volume":"38","author":"Aguiar","year":"2019","journal-title":"Rev. Port. De Cardiol. (Engl. Ed.)"},{"key":"ref_31","first-page":"683","article-title":"Incidence and prevalence of hypercholesterolemia in Portugal: A systemic review","volume":"22","author":"Costa","year":"2003","journal-title":"Port. J. Cardiol. Off. J. Port. Soc. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Arriaga, M., Francisco, R., Nogueira, P., Oliveira, J., Silva, C., C\u00e2mara, G., S\u00f8rensen, K., Dietscher, C., and Costa, A. (2022). Health Literacy in Portugal: Results of the Health Literacy Population Survey Project 2019-2021. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19074225"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"5896136","DOI":"10.1155\/2021\/5896136","article-title":"Oxidative Stress Links Aging-Associated Cardiovascular Diseases and Prostatic Diseases","volume":"2021","author":"Zhao","year":"2021","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"757","DOI":"10.2147\/CIA.S158513","article-title":"Oxidative stress, aging, and diseases","volume":"13","author":"Liguori","year":"2018","journal-title":"Clin. Interv. Aging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1038\/s41576-022-00478-5","article-title":"The human genetic epidemiology of COVID-19","volume":"23","author":"Niemi","year":"2022","journal-title":"Nat. Rev. Genet."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1126\/science.abm4915","article-title":"The changing epidemiology of SARS-CoV-2","volume":"375","author":"Koelle","year":"2022","journal-title":"Science"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1136\/bmjmilitary-2021-001819","article-title":"Symptomatology of COVID-19, rhinovirus and undifferentiated viral infections in a static military population","volume":"167","author":"Stachow","year":"2021","journal-title":"BMJ Mil. Health"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e437","DOI":"10.52225\/narra.v3i3.437","article-title":"Factors associated with small airway obstruction in COVID-19 survivors: A cross-sectional study among health-care providers","volume":"3","author":"Aritonang","year":"2023","journal-title":"Narra J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ijid.2021.03.068","article-title":"Emergence and outcomes of the SARS-CoV-2 M\u2018arseille-4\u2019 variant","volume":"106","author":"Fournier","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e23937","DOI":"10.1002\/jcla.23937","article-title":"Analysis of COVID-19 vaccines: Types, thoughts, and application","volume":"35","author":"Han","year":"2021","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"936","DOI":"10.3934\/mbe.2022043","article-title":"The impact of vaccination on the evolution of COVID-19 in Portugal","volume":"19","author":"Machado","year":"2022","journal-title":"Math. Biosci. Eng."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1111\/joim.13372","article-title":"Immunity to SARS-CoV-2 induced by infection or vaccination","volume":"291","author":"Ols","year":"2022","journal-title":"J. Intern. Med."},{"key":"ref_43","first-page":"n1088","article-title":"Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on COVID-19 related symptoms, hospital admissions, and mortality in older adults in England: Test negative case-control study","volume":"373","author":"Andrews","year":"2021","journal-title":"BMJ"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s00296-021-05046-4","article-title":"COVID-19 vaccination in autoimmune disease (COVAD) survey protocol","volume":"42","author":"Sen","year":"2022","journal-title":"Rheumatol. Int."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1990","DOI":"10.1038\/s41591-021-01507-2","article-title":"Cellular and humoral immune responses following SARS-CoV-2 mRNA vaccination in patients with multiple sclerosis on anti-CD20 therapy","volume":"27","author":"Apostolidis","year":"2021","journal-title":"Nat. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"78","DOI":"10.5582\/ddt.2022.01022","article-title":"Antibody response of smokers to the COVID-19 vaccination: Evaluation based on cigarette dependence","volume":"16","author":"Mori","year":"2022","journal-title":"Drug Discov. Ther."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/8\/1033\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:30:47Z","timestamp":1760110247000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/8\/1033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,6]]},"references-count":46,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["ijerph21081033"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21081033","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,6]]}}}