@article {pmid41626364,
year = {2025},
author = {de Jong, M and de Korne-Elenbaas, J and Fanoy, E and Medema, G and de Graaf, M and Prins, M and van der Loeff, MFS and Daams, J and Husman, AMR and Heijne, JCM},
title = {Public health actions in response to pathogen detection in wastewater and the environment: a scoping review.},
journal = {Frontiers in public health},
volume = {13},
number = {},
pages = {1675742},
pmid = {41626364},
issn = {2296-2565},
support = {U24 AI183840/AI/NIAID NIH HHS/United States ; },
mesh = {Humans ; *Wastewater/microbiology/virology ; *Public Health ; COVID-19/prevention & control ; *Environmental Monitoring/methods ; SARS-CoV-2/isolation & purification ; },
abstract = {INTRODUCTION: Rapid detection of infectious disease agents is crucial for timely public health responses. Wastewater and environmental surveillance (WES) offers a complementary approach by detecting pathogens shed by infected individuals, including asymptomatic cases. This scoping review provides an overview of reported public health actions in response to WES for human pathogens. It also summarizes sampling and analysis methods and offers insights for future implementation.

METHODS: The protocol for this review was registered in the PROCEED open-access registry. A systematic search was conducted in MEDLINE, EMBASE, and Web of Science for peer-reviewed literature published up to 31 July 2024. Studies were included if they reported public health actions in response to WES related to infectious diseases in human populations. Two reviewers independently screened studies and extracted data on public health responses, sampling, and analytical methods.

RESULTS: Of the 6,630 articles screened, 49 met the inclusion criteria. Most studies (92%) were published between 2021 and 2024, with SARS-CoV-2 as the primary focus (82%), followed by poliovirus (16%). Research was largely conducted in high-income regions: North America (51%), Asia (22%), and Europe (14%). Target populations included urban residents (57%) and on-campus students (31%) and local authorities were more often involved in WES efforts than national agencies (51% vs. 33%). In 75% of studies, at least two public health actions were implemented, and 20% reported five or more. The most common actions related to reactive disease control (n = 69), including testing, isolation, and contact tracing. Proactive disease control actions (n = 33) and public health communication (n = 22) were also described. Weekly sampling (57%) and composite methods (67%) were most used. Manhole sampling, despite equal frequency with treatment plant sampling (35%), led to significantly more public health actions (61 vs. 35). Long-term surveillance was often reported but rarely sustained. Quantitative and molecular analyses dominated; sequencing was rarely used (4%).

CONCLUSION: While reporting on public health actions following WES remains limited, this review illustrates its potential to inform timely, local interventions. Future studies should broaden pathogen targets, embed public health action planning in study design, and expand WES use in low-resource settings.},
}

Humans
*Wastewater/microbiology/virology
*Public Health
COVID-19/prevention & control
*Environmental Monitoring/methods
SARS-CoV-2/isolation & purification

@article {pmid41626890,
year = {2026},
author = {Maxwell, L and Shreedhar, P and Merson, L and Levis, B and Debray, TPA and de Jong, VMT and Ximenes, RAA and Jaenisch, T and Gustafson, P and Carabali, M},
title = {How to conduct an individual participant data meta-analysis in response to an emerging pathogen: Lessons learned from Zika and COVID-19.},
journal = {Research synthesis methods},
volume = {17},
number = {1},
pages = {1-29},
pmid = {41626890},
issn = {1759-2887},
support = {01886-000//Institute of Genetics/ ; 825746//H2020 Health/ ; },
mesh = {Humans ; *Zika Virus Infection/epidemiology/virology ; *COVID-19/epidemiology ; Zika Virus ; SARS-CoV-2 ; *Meta-Analysis as Topic ; Data Interpretation, Statistical ; Research Design ; *Communicable Diseases, Emerging ; },
abstract = {Sharing, harmonizing, and analyzing participant-level data is of central importance in the rapid research response to emerging pathogens. Individual participant data meta-analyses (IPD-MAs), which synthesize participant-level data from related primary studies, have several advantages over pooling study-level effect estimates in a traditional meta-analysis. IPD-MAs enable researchers to more effectively separate spurious heterogeneity related to differences in measurement from clinically relevant heterogeneity from differences in underlying risk or distribution of factors that modify disease progression. This tutorial describes the steps needed to conduct an IPD-MA of an emerging pathogen and how IPD-MAs of emerging pathogens differ from those of well-studied exposures and outcomes. We discuss key statistical issues, including participant- and study-level missingness and complex measurement error, and present recommendations. We review how IPD-MAs conducted during the COVID-19 response addressed these statistical challenges when harmonizing and analyzing participant-level data related to an emerging pathogen. The guidance presented here is based on lessons learned in our conduct of IPD-MAs in the research response to emerging pathogens, including Zika virus and COVID-19.},
}

Humans
*Zika Virus Infection/epidemiology/virology
*COVID-19/epidemiology
Zika Virus
SARS-CoV-2
*Meta-Analysis as Topic
Data Interpretation, Statistical
Research Design
*Communicable Diseases, Emerging

@article {pmid41627487,
year = {2026},
author = {Malik, J and Singh, S and Shrivastav, D and Verma, VV and Pal, RK and Mishra, MK and Sharma, VK},
title = {Therapeutic milestones against multidrug resistant Acinetobacter baumannii: from legacy antibiotics to Zosurabalpin.},
journal = {Archives of microbiology},
volume = {208},
number = {4},
pages = {177},
pmid = {41627487},
issn = {1432-072X},
mesh = {*Acinetobacter baumannii/drug effects/genetics ; *Drug Resistance, Multiple, Bacterial/drug effects ; *Anti-Bacterial Agents/therapeutic use/pharmacology ; Humans ; *Acinetobacter Infections/drug therapy/microbiology ; },
abstract = {Antimicrobial resistance (AMR) in Acinetobacter baumannii represents a critical global health challenge, particularly in intensive care settings where the pathogen causes severe, refractory infections. As a leading member of the ESKAPE group, A. baumannii has accumulated extensive resistance to multiple antibiotic classes, including carbapenems, resulting in the widespread emergence of multidrug-resistant (MDR), extensively drug-resistant (XDR), and pan-drug-resistant (PDR) strains. This review provides a chronological overview of the evolution of antimicrobial therapies used against A. baumannii, spanning the early era of penicillins and tetracyclines to contemporary agents such as eravacycline and ceftazidime-avibactam. We delineate the molecular mechanisms underlying resistance development, including carbapenemase production, robust RND efflux systems, horizontal gene transfer, biofilm formation, and the global dissemination of high-risk international clones (IC1-IC9). The compounding impact of the COVID-19 pandemic on the spread of carbapenem-resistant A. baumannii (CRAB) is also examined. A special emphasis is placed on Zosurabalpin, a first-in-class macrocyclic peptide antibiotic with a unique mechanism of action that targets the LptB2FG complex essential for lipooligosaccharide (LOS) transport and outer membrane assembly. Preclinical data and emerging clinical findings highlight its potent activity against highly resistant CRAB strains and its ability to circumvent conventional resistance pathways, marking it as a promising candidate in the antimicrobial pipeline. Finally, we evaluate the limitations of current treatment modalities and explore emerging strategies, including phage therapy, novel target discovery, and non-traditional therapeutics, offering a forward-looking perspective on restoring and sustaining effective anti-Acinetobacter interventions.},
}

*Acinetobacter baumannii/drug effects/genetics
*Drug Resistance, Multiple, Bacterial/drug effects
*Anti-Bacterial Agents/therapeutic use/pharmacology
Humans
*Acinetobacter Infections/drug therapy/microbiology

@article {pmid41627575,
year = {2026},
author = {Abu-Raddad, LJ and Chemaitelly, H and Wald, A and Johnston, C},
title = {Herpes Simplex Virus Type 2 Screening in Persons with and Without HIV: Evidence, Challenges, and Future Directions.},
journal = {Current HIV/AIDS reports},
volume = {23},
number = {1},
pages = {3},
pmid = {41627575},
issn = {1548-3576},
abstract = {PURPOSE OF REVIEW: Herpes simplex virus type 2 (HSV-2) infection is one of the most prevalent sexually transmitted infections worldwide, with implications for HIV acquisition, transmission, and disease progression. This review synthesizes current evidence and guidance on HSV-2 serologic screening, emphasizing its relevance for HIV prevention and care.

RECENT FINDINGS: International guidelines advise against routine general population-level serologic screening for HSV-2 in asymptomatic persons. Key limitations include poor test specificity, the absence of potent antivirals or therapeutic vaccines, lack of curative therapy, no demonstrated population-level benefit, and psychosocial harms associated with diagnosis. Current practice instead emphasizes diagnostic testing in symptomatic persons and targeted screening in defined contexts—such as among people with HIV in specific clinical situations, sex partners of those with HSV-2 infection, certain pregnant women, persons seeking sexual health care, and persons with recurrent or atypical symptoms—where results may directly inform management. Emerging technologies, including highly specific assays, novel potent antivirals, therapeutic vaccines, and curative strategies, may eventually shift the cost–benefit balance of general screening. 

SUMMARY: Evidence supports targeted rather than general population-level screening to maximize clinical benefit while minimizing harm. New evidence demonstrating that interventions can achieve measurable population-level reductions in disease burden or transmission, together with future advances in diagnostics and therapeutics, may eventually justify integrating routine HSV-2 screening into broader contexts, including into HIV prevention and care.},
}

@article {pmid41629068,
year = {2026},
author = {Kshatriya, M and Syal, R and Als, D and Muralidharan, O and Akindole, B and Padhani, ZA and Das, J and Bhutta, ZA},
title = {Implementation of health and health-related sustainable development goals: progress, challenges and opportunities-a systematic literature review update.},
journal = {BMJ global health},
volume = {11},
number = {2},
pages = {},
pmid = {41629068},
issn = {2059-7908},
mesh = {*Sustainable Development ; Humans ; *Global Health ; COVID-19 ; Goals ; Pandemics ; },
abstract = {INTRODUCTION: A prior systematic review assessed progress in health and health-related sustainable development goals (HHSDGs) from 2015 to 2019, identifying an important need for countries to strengthen implementation of multisectoral work, capacity building, financial stability and data availability. We undertook an updated systematic review to assess additional progress, challenges and opportunities for HHSDG implementation from 2019 to 2025, including the pandemic periods. This update aims to assess where countries are presently in HHSDG implementation and if further recommendations can be made in the final stretch to the 2030 targets.

METHODS: We followed a comparable comprehensive search strategy as the first review, focusing on implementation and acceleration strategies for HHSDGs. We undertook a qualitative synthesis from peer-reviewed and grey literature for specific databases, including studies and reports published from June 2019 to January 2025.

RESULTS: A total of 192 publications were included in the review of which 150 provided national-level information and 42 provided multicountry or regional information. Findings suggest a high level of political commitment in most countries and many HHSDG efforts being aligned with existing national development strategies. There was a noteworthy shift towards decentralised, subnational approaches to provide contextually relevant interventions. Multisectoral, multistakeholder, integrated approaches for implementation are increasing and proving to be effective. Diverse monitoring and evaluation strategies were employed, and (cross-country) knowledge sharing was instrumental to SDG policy and programme planning. Service disruptions incurred by the COVID-19 pandemic, lack of quality data and obtaining sustainable funding were frequently cited challenges to implementation.

CONCLUSIONS: Ensuring continuous financial investments and strengthening data availability are essential to accelerate HHSDG implementation. Recommendations for progress include strengthening primary healthcare, fostering multisectoral collaboration and addressing deep-rooted societal perceptions around gender inequity. Future research should examine the interplay of multiple SDGs, and the impact of factors such as cost-effective cross-regional approaches for project implementation.},
}

*Sustainable Development
Humans
*Global Health
COVID-19
Goals
Pandemics

@article {pmid41629862,
year = {2026},
author = {Meşe, EA and Basmaci, F and Bulut, AC and Topallı, D and Şenel, F and Cagiltay, NE},
title = {The role of extended reality technologies in hygiene education and training: a systematic review of applications, benefits, and challenges.},
journal = {BMC infectious diseases},
volume = {26},
number = {1},
pages = {272},
pmid = {41629862},
issn = {1471-2334},
abstract = {BACKGROUND: The emergence of the Metaverse and Extended Reality (XR) technologies, including Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR), has created innovative opportunities for healthcare education and training. These immersive technologies show promise in enhancing infection prevention and control, especially during infectious disease outbreaks.

OBJECTIVES: This systematic review aims to evaluate the current application of XR technologies in infection control education, identifying key trends, benefits, and limitations of VR and AR-based interventions.

METHODS: A comprehensive literature search was conducted on January 12, 2025, for the Web of Science and PubMed databases using keywords related to hygiene, infection prevention, and XR technologies. An initial pool of 162 articles was screened, resulting in 38 studies that met inclusion criteria. These studies were descriptively analyzed to assess their contributions, focus areas, and outcomes.

RESULTS: The review indicates most studies show XR tools effectively improve practical skills, behaviors, or attitudes, while a smaller number reveal limited or no significant gains, especially in knowledge and compliance. This result shows that XR tools have the potential to improve knowledge retention, practical skills, and provide real-time feedback, outperforming traditional training methods. XR tools specifically enhanced hand hygiene, proper use of personal protective equipment, and emergency response training, areas critical during outbreaks like COVID-19. Nevertheless, widespread adoption remains limited due to the need for more long-term efficacy data and strategies for integrating XR into standard curricula. To fully realize this potential, it is essential to address existing limitations related to cost, safety, and validation, while establishing robust frameworks for curriculum integration and policy implementation.

CONCLUSION: XR technologies play a crucial role in advancing infection control education by offering potential benefits for healthcare training and education. Future research should prioritize evaluating long-term outcomes and developing effective implementation strategies to facilitate broader adoption, maximize their educational impact and, and mitigate potential barriers.

CLINICAL TRIAL NUMBER: Not applicable.},
}

@article {pmid41630128,
year = {2026},
author = {Halabi, S and Arora, N and Durran, A and Qian, Q and Ummer, S and Ginsbach, K and Aneja, K},
title = {No fault vaccine injury compensation after COVID-19: A systematic literature review and proposed typology.},
journal = {Human vaccines & immunotherapeutics},
volume = {22},
number = {1},
pages = {2620849},
pmid = {41630128},
issn = {2164-554X},
mesh = {Humans ; *Compensation and Redress/legislation & jurisprudence ; *COVID-19/prevention & control ; *COVID-19 Vaccines/adverse effects/economics ; *Liability, Legal ; SARS-CoV-2 ; },
abstract = {The COVID-19 pandemic brought about a unique and rapid period of global vaccine innovation. It revealed structural challenges not only in global vaccine affordability and distribution but in the liability and indemnity structures that can both impede access and affect fair outcomes for the small number of people who suffer severe side effects. This review examines vaccine injury and compensation mechanisms, including no-fault compensation schemes, aimed at addressing both the liability and indemnity concerns of developers and the compensation due those suffering severe side effects. The ultimate aim of the review is to provide a classification of systems for those countries that are considering adopting NFCS as part of their broader public health readiness and preparedness strategies.},
}

Humans
*Compensation and Redress/legislation & jurisprudence
*COVID-19/prevention & control
*COVID-19 Vaccines/adverse effects/economics
*Liability, Legal
SARS-CoV-2

@article {pmid41630161,
year = {2026},
author = {Quagliarini, E and Pozzi, D and Caracciolo, G},
title = {From RNA to DNA: How Cargo Identity Reprograms Lipid Nanoparticle Architecture and Function.},
journal = {Advanced healthcare materials},
volume = {15},
number = {16},
pages = {e05261},
pmid = {41630161},
issn = {2192-2659},
mesh = {*Nanoparticles/chemistry ; Humans ; *Lipids/chemistry ; *DNA/chemistry ; *RNA/chemistry ; SARS-CoV-2 ; COVID-19/prevention & control ; Animals ; Liposomes/chemistry ; COVID-19 Vaccines/chemistry ; },
abstract = {Lipid nanoparticles (LNPs) have become the leading platform for delivering genetic material, gaining global recognition through the success of mRNA-based COVID-19 vaccines such as mRNA-1273 (SpikeVax, Moderna) and BNT162b2 (Comirnaty, BioNTech/Pfizer). Yet, while RNA-LNPs have reached clinical maturity, their DNA counterparts remain comparatively underexplored, despite holding great promise for gene replacement and genome-editing therapies. In this review, we turn the spotlight on DNA-loaded LNPs, examining how their structure, composition, and biological behavior differ from RNA-LNPs, their natural point of reference, and from earlier lipid-based systems such as cationic liposome/DNA complexes (lipoplexes). DNA-LNPs tend to form larger, more heterogeneous, and often multilamellar particles due to the intrinsic stiffness and high charge density of DNA. These distinctive features call for dedicated design strategies, including the use of cationic lipids, pre-condensation agents, and optimized PEGylation schemes. Moreover, DNA profoundly influences the biomolecular corona that forms in biological fluids, which in turn shapes immune recognition, circulation, and tissue targeting. By highlighting these unique physical and biological challenges, this review underscores the need to move beyond simply adapting RNA-based formulations. Instead, a cargo-informed design approach will be key to unlocking the full therapeutic potential of DNA-LNPs in next-generation gene delivery.},
}

*Nanoparticles/chemistry
Humans
*Lipids/chemistry
*DNA/chemistry
*RNA/chemistry
SARS-CoV-2
COVID-19/prevention & control
Animals
Liposomes/chemistry
COVID-19 Vaccines/chemistry

@article {pmid41630899,
year = {2026},
author = {Nicolai, M and Ullrich, A and Ruck, J and Jaspers, B and Bialobrzeski, A and Degutsch, R and Oechsle, K and Radbruch, L and Gágyor, I and Hettich-Damm, N},
title = {Unraveling the complexities: A scoping review of the collateral effects on informal caregivers during and beyond the COVID-19 pandemic.},
journal = {Palliative care and social practice},
volume = {20},
number = {},
pages = {26323524251399233},
pmid = {41630899},
issn = {2632-3524},
abstract = {Due to the COVID-19 pandemic, various infection control measures were introduced that had a profound effect on caregiving dynamics and created burdens in the daily lives of informal caregivers (ICs). A scoping review was conducted to identify burden and support factors for ICs during and beyond the pandemic. Studies were included when they examined ICs' care work during the official time period of the COVID-19 pandemic (March 2020-May 2023) and care hours worked per day or week were specified. Only studies with adult participants and studies in German or English language were incorporated. The scoping review considered quantitative cross-sectional and longitudinal studies involving randomized/quasi-randomized controlled trials, cohort studies, case studies, mixed-methods, and qualitative studies as well as reviews and meta-analyses. The electronic databases PubMed, the Cochrane COVID-19 Study Register, and EBSCO Host were systematically searched. The search was limited to articles published between 2020 and 2024. The scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Overall, 42 studies with 51,183individuals met the inclusion criteria and were included in the scoping review. Main findings suggested that the pandemic-related measures caused additional care burden for ICs and worsened the already poor situation of informal care. In particular, the lack of support from health services and the increase in care hours were described as burdensome. Additionally, studies indicated an increase in rates of depression and overall poor mental health, particularly affecting female ICs. Social and formal care support were mentioned as main support factors. Consequently, preparation of future crises should focus on formal health services and structures to promote social support and mental health of ICs during pandemics.},
}

@article {pmid41631378,
year = {2026},
author = {Berger do Rosário, M and da Silva, DW and Wawrzeniak, IC and Ziegelmann, PK and Rios Vieira, SR and Boniatti, MM and Teixeira, C and Oliveira, VM},
title = {Extended Prone Positioning in ARDS: A Systematic Review and Meta-Analysis.},
journal = {Respiratory care},
volume = {71},
number = {4},
pages = {417-425},
doi = {10.1177/19433654251405270},
pmid = {41631378},
issn = {1943-3654},
mesh = {Humans ; Prone Position ; *Respiratory Distress Syndrome/therapy/mortality/etiology ; *Respiration, Artificial/methods ; *Patient Positioning/methods ; *COVID-19/complications/therapy ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Prone positioning is a recommended therapy for patients with moderate-to-severe ARDS; however, the optimal duration of this maneuver is still unknown.

METHODS: We performed a systematic review and meta-analysis comparing clinical outcomes of extended (≥24 h) versus traditional prone positioning (16-24 h) of adults with moderate-to-severe ARDS receiving invasive mechanical ventilation.

RESULTS: Ten studies involving 2,412 subjects met the inclusion criteria, including one randomized controlled trial and 9 observational studies, all with COVID-19-related ARDS. Extended prone positioning was associated with reduced mortality compared with the traditional approach (risk ratio [RR]: 0.76, 95% CI 0.66-0.86, I[2] = 12.8%). Sensitivity and subgroup analyses confirmed consistency across risk of bias, baseline PaO2/FiO2, and PEEP levels. No differences were found in duration of mechanical ventilation (mean difference [MD]: 2.43 days, 95% CI -1.06 to 5.92, I[2] = 70%) or ICU stay (MD: 1.31 days, 95% CI -1.07 to 3.68, I[2] = 55%). The extended strategy was associated with a higher incidence of pressure injuries (RR: 1.30, 95% CI 1.02-1.65, I[2] = 56%) but no differences in device displacement or hemodynamic instability. Certainty of evidence was rated as low to very low.

CONCLUSIONS: Extended prone positioning was associated with reduced mortality in ARDS but increased risk of pressure injuries, without impact on ventilator duration or ICU stay. While this strategy appears feasible and potentially beneficial, further randomized trials are warranted to confirm its role in routine practice.

TRIAL REGISTRATION: PROSPERO no. CRD42024529311.},
}

Humans
Prone Position
*Respiratory Distress Syndrome/therapy/mortality/etiology
*Respiration, Artificial/methods
*Patient Positioning/methods
*COVID-19/complications/therapy
SARS-CoV-2

@article {pmid41631916,
year = {2026},
author = {Goss, AL},
title = {Neurologic Complications of Drug and Alcohol Use.},
journal = {Continuum (Minneapolis, Minn.)},
volume = {32},
number = {1},
pages = {277-309},
doi = {10.1212/cont.0000000000001676},
pmid = {41631916},
issn = {1538-6899},
mesh = {Humans ; *Substance-Related Disorders/complications ; *Nervous System Diseases/etiology/chemically induced ; COVID-19 ; Male ; Female ; *Alcoholism/complications ; },
abstract = {OBJECTIVE: This article reviews the neurologic syndromes associated with substance use and suggests an approach for identifying and managing substance use disorders.

LATEST DEVELOPMENTS: Substance use and overdose mortality, largely associated with fentanyl, rose sharply during the COVID-19 pandemic. Although recent data indicate modest decreases, current rates of overdose remain higher than before the pandemic. A wide variety of opioid-related toxic encephalopathies have been identified recently. Many novel psychoactive substances are unregulated and easily obtained online or in stores; several have been associated with seizures and other neurologic complications. The use of cannabis and hallucinogens is rising as more states legalize or decriminalize their use, and some studies suggest an independent association between cannabis use and ischemic stroke.

ESSENTIAL POINTS: Neurologists often encounter severe complications of substance use and have an opportunity to guide patients with substance use disorders toward treatment.},
}

Humans
*Substance-Related Disorders/complications
*Nervous System Diseases/etiology/chemically induced
COVID-19
Male
Female
*Alcoholism/complications

@article {pmid41633725,
year = {2026},
author = {Cavanna, AE},
title = {Clinical presentation of tics and Gilles de la Tourette syndrome.},
journal = {Handbook of clinical neurology},
volume = {215},
number = {},
pages = {11-27},
doi = {10.1016/B978-0-443-13554-5.00013-4},
pmid = {41633725},
issn = {0072-9752},
mesh = {Humans ; *Tourette Syndrome/diagnosis/physiopathology ; *Tics/diagnosis ; *Tic Disorders/diagnosis ; COVID-19 ; },
abstract = {Tics are the most common hyperkinetic manifestations during development. The clinical phenomenology of motor tics ranges from mild twitches affecting a single facial muscle to orchestrated contractions of different muscular districts resembling purposeful behaviors. Likewise, the repertoire of vocal tics (also called phonic tics) covers the whole spectrum between isolated grunting noises and meaningful strings of words. Simple and complex tics arguably sit on a continuum of symptom severity and respond to the same treatment interventions. The diagnosis of Gilles de la Tourette syndrome (GTS) is based on the presence of multiple motor tics plus at least one vocal tic, with onset before the age of 18 years and chronic course. It has been argued that the different tic disorders belong to a spectrum of increasing complexity, from the transient form (provisional tic disorder), through persistent motor or vocal tic disorder, to GTS. However, the clinical phenotype of GTS stands out because of the frequent association with specific behavioral problems, ranging from tic-related obsessive-compulsive disorder to other neurodevelopmental conditions. The diagnosis of tic disorders is based on clinical observation and requires expertise. The recent outbreak of functional tics, documented across several countries during the COVID-19 pandemic, introduced unprecedented challenges to the differential diagnosis of neurodevelopmental tics.},
}

Humans
*Tourette Syndrome/diagnosis/physiopathology
*Tics/diagnosis
*Tic Disorders/diagnosis
COVID-19

@article {pmid41633747,
year = {2026},
author = {Alruwaita, AA and Lang, AE and Ganos, C},
title = {Functional tics and tic-like behaviors.},
journal = {Handbook of clinical neurology},
volume = {215},
number = {},
pages = {55-62},
doi = {10.1016/B978-0-443-13554-5.00017-1},
pmid = {41633747},
issn = {0072-9752},
mesh = {Humans ; *Tic Disorders/diagnosis/therapy/physiopathology ; *Tics/diagnosis/therapy ; COVID-19 ; },
abstract = {Functional tics and tic-like behaviors belong to the wide spectrum of functional movement disorders. Until the early 2010s, functional tic disorders were rather uncommon in the differential diagnosis of tics, and only few cases describing their features had been published. However, over the past 10 years there has been a steady increase in the frequency of these cases that peaked throughout the COVID-19 pandemic. On the one hand, the rise in functional tic cases created new challenges of diagnosis and treatment. At the same time, it also pushed the field forward to delineate helpful clinical clues, as well as to work toward specific consensus diagnostic criteria for functional tics and tic-like behaviors. Here, we first provide a historical summary on the debate between neurodevelopmental and functional tics. We then track relevant literature on functional tics and tic-like cases and discuss their salient features, such as an acute onset with severe symptoms and complex repetitive behaviors that typically occur in late adolescence or early adulthood, a large variability of symptoms including spontaneous symptom remissions and re-emergence, and a high prevalence of phonations and vocalizations with the common use of swearwords or variable sentences. In addition, it is common to see an overlap with additional functional neurologic symptoms, such as functional tremor or nonepileptic seizures. In diagnostically challenging cases, neurophysiologic evaluation, including surface electromyography and electroencephalography, may be useful, and markers such as the premotor potential (Bereitschaftspotential) and event-related desynchronization/synchronization may hold promise. Effective management of functional tics begins with an accurate diagnosis and often requires a multidisciplinary approach. Cognitive-behavioral therapy and the Comprehensive Behavioral Intervention for Tics may be particularly useful, alongside addressing comorbid psychiatric conditions. Currently there is an absence of standardized treatment protocols; individualized care plans tailored to each patient's specific needs are generally the most effective approach.},
}

Humans
*Tic Disorders/diagnosis/therapy/physiopathology
*Tics/diagnosis/therapy
COVID-19

@article {pmid41634606,
year = {2026},
author = {Migliaccio-Walle, K and Mugwagwa, T and Cha-Silva, AS and Gong, CL and Campbell, D and Quercia, R and Bergroth, T and Veenstra, DL and Moran, MM and Dzingina, M},
title = {Real-world untreated risk of hospitalization and death in a nirmatrelvir/ritonavir treatment-eligible population with mild-to-moderate COVID-19 in the United States: a systematic literature review.},
journal = {BMC infectious diseases},
volume = {26},
number = {1},
pages = {},
pmid = {41634606},
issn = {1471-2334},
abstract = {BACKGROUND: No study has systematically reviewed published estimates of real-world risk of hospitalization and death among untreated COVID-19 patients. We aimed to characterize the risk of hospitalization and death in real-world US clinical practice for untreated patients at high-risk for progression to severe COVID-19 and critically assess differences in patient populations.

METHODS: We conducted a systematic literature review to identify US real-world evidence studies (December 21, 2021 – January 30, 2024) of patients aged 12 years and older diagnosed with mild-to-moderate COVID-19, at high risk for progression to severe COVID-19, and treated with nirmatrelvir/ritonavir (NMV/r) or untreated/best supportive care. Primary outcomes were reported risks of all-cause hospitalization, death, and hospitalization or death at 1 month. To account for heterogeneity across studies and confounding within studies, outcomes were estimated as: 1) observed risk, untreated risk as reported, 2) within-study adjusted risk, applying an adjusted treatment effect within studies to calculate risk in the untreated population, and 3) adjusted and standardized estimate, using the relative risk reduction for all-cause hospitalization or death from the study with highest validity.

RESULTS: Of 1023 studies screened, we retained 23 for data extraction after applying inclusion and exclusion criteria (384,793 NMV/r patients from 22 studies; 1,062,757 no treatment from 14 studies). Studies were heterogenous, primarily retrospective, utilizing claims (e.g., TriNetX) and integrated health system data (e.g., Veterans Affairs). Most (n = 21, 91%) were US only; 20 (87%) were cohorts from December 2021 onward. Risk of all-cause hospitalization ranged from 0.9–7.7% (observed), 0.8–2.0% (within-study adjusted), and 2.3–6.9% (adjusted and standardized). Hospitalization or death ranged from 0.6–10.2% (observed), 0.4–5.6% (within-study adjusted), and 1.0–15.6% (adjusted and standardized). Death risk ranged from 0.1–3.1% (observed) and 0.0–0.9% (within-study adjusted).

CONCLUSIONS: Estimating the risk of hospitalization and death for untreated high-risk COVID-19 patients from the literature is limited by inherent differences in study designs, patient populations, and reporting. Observed risk of hospitalization ranges from 1 to 8%, and the risk of death from 0 to 3%. Understanding the hospitalization risk among untreated patients provides context for the clinical and economic value of current antiviral treatments. This study was sponsored by Pfizer, Inc.},
}

@article {pmid41634728,
year = {2026},
author = {Tang, Z and Zha, L and Liang, R and Li, T},
title = {Lung cancer vaccines to enhance immune checkpoint inhibitor therapy: evidence and future perspectives.},
journal = {Journal of hematology & oncology},
volume = {19},
number = {1},
pages = {15},
pmid = {41634728},
issn = {1756-8722},
support = {I01 BX003895/BX/BLRD VA/United States ; CU000157/L0008//VA-Lung Precision Oncology Program/ ; I01BX003895//Office of Research and Development/ ; },
mesh = {Humans ; *Immune Checkpoint Inhibitors/therapeutic use ; *Cancer Vaccines/therapeutic use/immunology ; *Lung Neoplasms/immunology/therapy/drug therapy ; *Immunotherapy/methods ; Tumor Microenvironment/immunology ; Antigens, Neoplasm/immunology ; Animals ; },
abstract = {Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape of lung cancer over the past decade, markedly improving antitumor responses, overall survival, and quality of life. However, durable clinical benefit is achieved in only a subset of patients, and resistance to ICIs remains a major clinical challenge. Mechanistically, resistance arises from multiple, often overlapping processes, including inadequate tumor antigen presentation, dysfunctional T-cell priming and expansion, and the presence of physical and immunosuppressive barriers within the tumor microenvironment that limit immune cell infiltration and effector function. Cancer vaccines have re-emerged as a rational immunotherapeutic strategy to overcome these obstacles by inducing de novo or amplifying pre-existing tumor-specific immune responses, thereby enhancing long-term immunological memory while maintaining a favorable safety profile. Advances in antigen discovery, neoantigen prediction, and vaccine platforms have accelerated the development of both personalized and off-the-shelf neoantigen vaccines. Although personalized neoantigen vaccines have gained considerable attention following the success of mRNA-based COVID-19 vaccines, off-the-shelf approaches offer advantages in scalability, cost, and manufacturing timelines, facilitating broader clinical implementation. Accumulating preclinical and clinical evidence suggests that cancer vaccines are more effective in the adjuvant setting than in the metastatic setting, where high tumor burden and an immunosuppressive tumor microenvironment constrain vaccine-induced immune responses. Consistent with their limited efficacy as monotherapy, contemporary clinical trials increasingly evaluate cancer vaccines in combination with ICIs or other immunotherapeutic agents to enhance T-cell activation, reverse immune suppression, and restore antitumor immunity. This review synthesizes current mechanistic insights, highlights ongoing clinical efforts, and discusses future directions for rational cancer vaccine development in lung cancer, with an emphasis on overcoming resistance to ICI.},
}

Humans
*Immune Checkpoint Inhibitors/therapeutic use
*Cancer Vaccines/therapeutic use/immunology
*Lung Neoplasms/immunology/therapy/drug therapy
*Immunotherapy/methods
Tumor Microenvironment/immunology
Antigens, Neoplasm/immunology
Animals

@article {pmid41635308,
year = {2025},
author = {Liu, G and Tan, R and Wu, Y and Wang, M and Huang, B and Tan, W},
title = {Advances in the development of infectious clones of human coronaviruses and related applications.},
journal = {Biosafety and health},
volume = {7},
number = {1},
pages = {59-73},
pmid = {41635308},
issn = {2590-0536},
abstract = {Coronaviruses can infect humans, mammals, and birds, leading to respiratory, gastrointestinal, and neurological diseases. These viruses are significant zoonotic pathogens with nine known types capable of infecting humans. The coronavirus genome, approximately 30 kb in size, is the largest known ribonucleic acid (RNA) virus genome, and its complexity makes assembly and manipulation time-consuming and labor-intensive. Reverse genetic systems are widely used to engineer recombinant viruses that can be adapted at Biosafety Level 2 (BSL-2) for studying viral gene function, replication, pathogenesis, vaccines, and therapeutics. The infectious clones, which enabled the recovery of various viruses after DNA recombinant technology, were indispensable tools for the reverse genetics of viruses. Various techniques for constructing infectious clones of human coronaviruses (HCoV) have been developed, encompassing methods such as vaccinia virus vectors method, in vitro ligation, bacterial artificial chromosome systems, yeast artificial chromosome systems, circular polymerase extension reaction, and the recently reported infectious sub-genomic amplicons technology. This review summarizes the status of various techniques for constructing infectious clones of human coronaviruses and related applications.},
}

@article {pmid41635346,
year = {2026},
author = {Pawar, B and Loganathan, S and Mukkatira Belliappa, K and Ranganathan, LB and Thekdi, KP and Hiware, SD},
title = {A Comprehensive Review of Vaccine Development: From Traditional Platforms to Messenger RNA (mRNA) Technologies.},
journal = {Cureus},
volume = {18},
number = {1},
pages = {e100608},
pmid = {41635346},
issn = {2168-8184},
abstract = {The trend of vaccine development over the last few years is that the traditional platform has been abandoned and moved towards newer modalities, and the current COVID-19 pandemic has accelerated this shift. Classical approaches (such as inactivated, live attenuated, and recombinant) can be shown to have reduced the burden of infectious diseases; however, they are also limited by their inability to scale production and prolonged development, as well as cold-chain limitations. The lacks became apparent through the pandemic and drove the demand for more agile, adaptive technology that COVID-19 has highlighted. The current review questions the goal of streamlining the immunization approaches in the face of emerging pathogens through a structured narrative comparison of immunogenicity, safety, efficacy, and platform stability of modern vaccination platforms within a narrative review framework. This analysis is anchored by a narrative synthesis of immunological, regulatory, and clinical literature between 2018 and 2025. Messenger RNA (mRNA)-based vaccines have demonstrated strong immunogenicity and practical efficacy in the real world, as well as varying safety profiles across platforms and the potential of new modalities that will be developed both to treat infectious diseases and to be applied in other contexts. The discussion also dwells upon the flexibility of regulation, unequal distribution, and surveillance-based pharmacovigilance. This review can be used to compile a thoroughly comparative view of modern vaccines, based on bringing together mechanistic insights and implementation barriers, which can guide future innovation and policy reconciliation and global resilience. It makes inferences in support of the more progressive, equity-based paradigm of pandemic preparedness and immunization strategy in the 21st century. This review highlights how mRNA technology has transformed the landscape of vaccinology, offering a foundation for faster, safer, and more equitable global immunization strategies in the post-pandemic era.},
}

@article {pmid41635704,
year = {2025},
author = {Montgomery, MP and Praphasiri, P and Ditsungnoen, D and Akarasewi, P and Chittaganpitch, M and Puthavathana, P and Limpakarnjanarat, K and Wirachwong, P and Chotpitayasunondh, T and Sawanpanyalert, N and Sonthichai, C and Davis, WW and Olsen, SJ and Chunsuttiwat, S},
title = {Influenza surveillance and vaccine policy in Thailand-a historical perspective.},
journal = {The Lancet regional health. Southeast Asia},
volume = {41},
number = {},
pages = {100663},
pmid = {41635704},
issn = {2772-3682},
abstract = {Prior to 2000, influenza burden in Thailand and other low- and middle-income countries was underappreciated, and influenza vaccination was uncommon. For the last two decades, Thailand Ministry of Public Health (MOPH) and U.S. Centers for Disease Control and Prevention have collaborated to understand influenza burden and the costs and benefits of influenza vaccination in Thailand. Built on a long-standing national disease notification system, Thailand MOPH established robust surveillance platforms for pneumonia and influenza, which provided insights into seasonality, disease incidence, and populations at risk for severe disease. In 2004, human cases of avian influenza brought attention to influenza's pandemic potential. Concern for an influenza pandemic combined with evidence of the cost effectiveness of influenza vaccination accelerated vaccine policy. Surveillance and vaccination policy were leveraged for and strengthened by the 2009 influenza H1N1 and COVID-19 pandemics. This personal view documents Thailand's experience in developing influenza surveillance and influenza vaccination policy.},
}

@article {pmid41637169,
year = {2026},
author = {Göldel, JM and Warschburger, P},
title = {Psychological adjustment in parents of children and adolescents with chronic health conditions during the COVID-19 pandemic - a meta-analysis.},
journal = {Health psychology review},
volume = {},
number = {},
pages = {1-29},
doi = {10.1080/17437199.2026.2616461},
pmid = {41637169},
issn = {1743-7202},
abstract = {Caring for a child with a chronic health condition (CC) involves numerous challenges, which may have multiplied during the COVID-19 pandemic. Therefore, this meta-analysis aimed (1) to quantify the prevalence of clinically elevated anxiety, depression, general stress, and parenting stress symptoms in afflicted parents, (2) to examine potential moderator variables, and (3) to compare the outcomes between parents of children with and without CCs. A systematic literature search was conducted across four databases (PsycInfo, PubMed, CENTRAL, PSYNdex). A total of 79 studies were included. The pooled prevalence estimates of clinically elevated anxiety, depression, general and parenting stress symptoms were 31.04%, 27.37%, 64.27%, and 26.70%, respectively. Significant moderators were identified only for anxiety symptoms, namely geopolitical region, child CC, and child age. Anxiety and depression, but not general and parenting stress, were significantly higher in parents of children with than without CCs. Compared to published data from before the pandemic, prevalence rates of clinically elevated anxiety and depression symptoms decreased, while stress levels no longer differed between parents of children with and without CCs. We hypothesise that parents of children with CCs experienced some beneficial effects during the COVID-19 pandemic and had already acquired resilience to buffer its psychosocial impact.},
}

@article {pmid41637737,
year = {2026},
author = {Siegel, ZM and Quinkert, E and Pai, J and Miller, CH and Lewis, MW},
title = {Lessons Learned About Digital Health Tool Acceptability Among Rural Older Adults: Systematic Review Guided by the Technology Acceptance Model.},
journal = {JMIR aging},
volume = {9},
number = {},
pages = {e70012},
pmid = {41637737},
issn = {2561-7605},
mesh = {Humans ; *Telemedicine ; Aged ; *Rural Population/statistics & numerical data ; *COVID-19/epidemiology ; *Patient Acceptance of Health Care/statistics & numerical data ; SARS-CoV-2 ; Middle Aged ; Digital Health ; },
abstract = {BACKGROUND: Digital health tools are increasingly vital in rural health care due to widespread hospital closures and the rapid adoption of telehealth during the COVID-19 pandemic. Rural older adults, a uniquely vulnerable population, face barriers to accessing these tools due to rurality and usability challenges. Although a growing body of literature examines the acceptability and usability of digital tools among rural older adults, no study has synthesized this research to establish best practices.

OBJECTIVE: This study aims to review existing literature on digital health tools for rural older adults, highlighting key lessons learned about their acceptability and identifying strategies to improve usability for this population.

METHODS: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, this study reviewed literature that investigated the role of digital health tools on the health outcomes of rural older adults (ie, at least 60 years old). The literature was retrieved from 5 electronic databases through June 2023. This study and all reviewed literature were conducted in the United States. Guided by a systematic process, 2 reviewers assessed relevant articles for eligibility, analyzed data, and extracted relevant content. The extracted findings were organized according to the evidence-based technology acceptance model, which assesses the acceptability of a technology by its usefulness, ease of use, and intention to use.

RESULTS: The preliminary title review produced 7728 results, and 38 eligible manuscripts were included in the final review. Studies included both rural older adults and providers of rural older adults as participants. Digital health tools included, but were not limited to, videoconferencing, phone calls, telehealth monitoring, telemedicine appointments, and computer-based interventions. Findings on the usefulness of digital health tools by rural older adults were mixed. While digital health tools were useful for overcoming barriers to accessing care, these tools were less useful for rural older adults with limited digital literacy. Additionally, some studies described that the technology was easy but difficult to use when faced with environmental barriers, equipment issues, and discomfort with the technology. Rural older adults often reported an intention to use the technology after the study. Yet, on a few occasions, participants who preferred in-person care visits or did not have buy-in on the technology reported no intention to use the technology again.

CONCLUSIONS: Our review highlights that rural older adults and their providers generally view digital health tools as acceptable for delivering care and, in some cases, as a viable alternative to in-person clinic visits. While certain barriers impacted the acceptance of these tools among rural older adults, many of these challenges were not directly linked to their age or rural location; thus, they are potentially applicable to urban older adults.

TRIAL REGISTRATION: PROSPERO CRD42021287924; https://www.crd.york.ac.uk/PROSPERO/view/CRD42021287924.},
}

Humans
*Telemedicine
Aged
*Rural Population/statistics & numerical data
*COVID-19/epidemiology
*Patient Acceptance of Health Care/statistics & numerical data
SARS-CoV-2
Middle Aged
Digital Health

@article {pmid41638514,
year = {2026},
author = {Jalili, M and Jalilian, FA},
title = {A review of targeting microRNAs as potential therapeutic strategies against respiratory viruses: Current insights and future directions.},
journal = {Microbial pathogenesis},
volume = {213},
number = {},
pages = {108346},
doi = {10.1016/j.micpath.2026.108346},
pmid = {41638514},
issn = {1096-1208},
mesh = {*MicroRNAs/genetics ; Humans ; SARS-CoV-2 ; Animals ; COVID-19 ; Antiviral Agents/therapeutic use/pharmacology ; *Respiratory Tract Infections/virology/therapy ; Host-Pathogen Interactions ; Virus Replication ; Immunity, Innate ; },
abstract = {Respiratory viruses such as influenza viruses, respiratory syncytial virus (RSV), and coronaviruses continue to impose a global health burden due to their high transmissibility and limited antiviral options. MicroRNAs (miRNAs) have emerged as critical regulators of host pathogen interactions by modulating innate immunity, inflammatory signaling, and viral replication. This review focuses on respiratory RNA and DNA viruses that primarily infect the airways, including influenza viruses, RSV, human metapneumovirus, rhinoviruses, adenoviruses, and SARS-CoV-2. Several miRNAs, including miR-155 and miR-146a, are upregulated during infections with SARS-CoV-2, influenza, and RSV, where they fine-tune interferon and NF-κB signaling pathways. In contrast, downregulation of miR-21, miR-223, and let-7 family members has been linked to enhanced viral replication and dysregulated immune responses. Moreover, miR-122, miR-29a, and miR-124 have gained attention as potential therapeutic targets or prognostic biomarkers due to their roles in modulating viral load, cytokine production, and tissue injury. This review synthesizes current evidence on miRNA-mediated regulation of respiratory viruses, evaluates their promise as therapeutic candidates and diagnostic tools, and discusses delivery systems designed for targeted miRNA modulation. Despite promising advances, challenges remain in achieving tissue-specific delivery, avoiding immune off-target effects, and validating efficacy in clinical settings. Most of the available data are derived from in vitro or animal models and heterogeneous clinical cohorts, so conclusions about causality and therapeutic efficacy should be viewed as provisional and highlight significant translational gaps. Finally, we outline major challenges and future research directions needed to translate miRNA-targeted therapies into clinically viable antiviral strategies. Insights from these emerging studies position miRNA-targeted interventions as a potential new class of antiviral therapeutics and underscore the need for rigorous, translational research to realize their clinical utility.},
}

*MicroRNAs/genetics
Humans
SARS-CoV-2
Animals
COVID-19
Antiviral Agents/therapeutic use/pharmacology
*Respiratory Tract Infections/virology/therapy
Host-Pathogen Interactions
Virus Replication
Immunity, Innate

@article {pmid41638540,
year = {2026},
author = {Nuber-Champier, A and Bréville, G and Lalive, PH and Assal, F and Péron, JA},
title = {Immune-cognitive relationships across viral infections: A transnosological systematic review.},
journal = {Neuroscience and biobehavioral reviews},
volume = {184},
number = {},
pages = {106588},
doi = {10.1016/j.neubiorev.2026.106588},
pmid = {41638540},
issn = {1873-7528},
mesh = {Humans ; *Virus Diseases/immunology/psychology ; *COVID-19/immunology/psychology ; *Cognition/physiology ; Cytokines/immunology ; },
abstract = {The emergence of SARS-CoV-2 has renewed interest in the relationship between immunity and cognition. Despite decades of work, the impact of viral exposure, mainly in the field of HIV, herpes and hepatitis infections, on distinct cognitive processes remains unclear, as most studies use global screening tools (e.g., MoCA) in isolation in each infectious context. This systematic narrative review adopts a transnosological approach, summarizing previously reported immune-cognition relationships across viral infections. Of 931 studies, 32 met inclusion criteria (N = 25,325) spanning SARS-CoV-2, HIV, herpes, hepatitis, Epstein-Barr virus, and multiple infections. Reported studies on immuno-cognitive relationships reveal several consistent findings. Elevated circulating CD14[+]CD16[+] intermediate monocytes correlated with slower processing speed, reduced episodic memory and mental flexibility. Higher CD4[+] T cells were associated with better processing speed, while reduced T cells and B cells levels together with elevated IgG predicted deficits in memory and attention. Most proinflammatory cytokines (e.g., IL-6, TNF-α, IFN-γ) were associated with impairments in overlapping cognitive domains (e.g., memory), whereas IL-10, an anti-inflammatory cytokine, consistently supported executive and memory performance.},
}

Humans
*Virus Diseases/immunology/psychology
*COVID-19/immunology/psychology
*Cognition/physiology
Cytokines/immunology

@article {pmid41639496,
year = {2026},
author = {Berra, L and Kamenshchikov, N and Tal, A and Safaee Fakhr, B and Rezoagli, E and Thomson, R and Yu, B and , },
title = {The therapeutic potential of high-dose inhaled nitric oxide for antimicrobial effects: a narrative review and future directions.},
journal = {Intensive care medicine experimental},
volume = {14},
number = {1},
pages = {13},
pmid = {41639496},
issn = {2197-425X},
abstract = {Inhaled nitric oxide (iNO), long used as a selective pulmonary vasodilator, has demonstrated potential antimicrobial and antiviral properties when administered at high concentrations (> 20 parts per million, ppm). While definitive evidence is still lacking, this narrative review synthesizes the emerging clinical and mechanistic properties supporting high-dose iNO as a potential therapeutic strategy for lower respiratory tract infections, including drug-resistant bacterial pneumonias, COVID-19, nontuberculous mycobacteria, and bronchiolitis. We summarize safety data from laboratory studies, Phase I trials, clinical findings from 27 predominantly early-phase studies, and highlight its as both hospital-based and home-based therapy. High-dose iNO acts through multiple pathways, including direct microbial killing, biofilm disruption, immune modulation, and mucociliary enhancement, and holds promise in addressing unmet needs in respiratory infection management. We also propose a roadmap for future research to optimize dosing, delivery, and efficacy endpoints in well-defined patient populations.},
}

@article {pmid41639776,
year = {2026},
author = {Aboulwafa, A and Lebbe, A and Khalil, A and Bayraktar, N and Mushannen, B and Ayoub, S and Sarker, S and Abdalla, MN and Laws, S and Mohammed, I and Yagan, L and Mushannen, M and Zakaria, D},
title = {New onset of severe and long-term hepatobiliary diseases post-COVID-19 infection: a systematic review.},
journal = {BMC infectious diseases},
volume = {26},
number = {1},
pages = {253},
pmid = {41639776},
issn = {1471-2334},
abstract = {BACKGROUND: The COVID-19 pandemic has resulted in a surge of reports linking the virus to various systemic complications, including hepatobiliary disorders. Understanding the spectrum and severity of hepatobiliary diseases following COVID-19 infection is crucial for comprehensive patient management and long-term health outcomes.

METHODS: A systematic review was conducted to identify studies reporting on hepatobiliary manifestations post-COVID-19 infection. PubMed, Medline, Embase, Scopus, Web of Science, Science Direct and Cochrane Library databases were searched in October 2023, with set inclusion and exclusion criteria in place to select papers documenting new onset hepatobiliary diseases following COVID-19 infection.

RESULTS: A total of 23 studies met the inclusion criteria, covering a diverse range of hepatobiliary conditions such as acute hepatitis, cholestasis, autoimmune liver diseases, and gallbladder pathology.

CONCLUSION: This systematic review underscores the emerging evidence of severe and long-term hepatobiliary diseases following COVID-19 infection. Healthcare providers should maintain a high index of suspicion for hepatobiliary complications in patients recovering from COVID-19, emphasizing the need for prolonged monitoring and specialized management strategies to mitigate long-term morbidity and mortality."

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-025-11840-3.},
}

@article {pmid41639918,
year = {2026},
author = {Carpenteri, F and Cilloniz, C and Torres, A},
title = {Corticosteroids in severe community-acquired pneumonia: friend, foe or both?.},
journal = {Pneumonia (Nathan Qld.)},
volume = {18},
number = {1},
pages = {5},
pmid = {41639918},
issn = {2200-6133},
support = {CIBERES CB06/06/0028//Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública/ ; },
abstract = {In most patients with CAP, corticosteroids should be avoided due to complications such as immunosuppression and hyperglycaemia. Studies of hydrocortisone have shown corticosteroids might be of benefit in patients with severe CAP and high inflammation measured by CRP. Differences in results between trials of corticosteroid therapy suggest heterogenicity in study populations and the need for future studies in standardized populations. Scientific evidence shows corticosteroid use can reduce short-term mortality and the need for mechanical ventilation in hospitalized patients with severe CAP. However, this approach should not be generalized to all patients with CAP. Use should be guided by biomarkers such as CRP to identify patients who will benefit the most. Corticosteroids should not be routinelly used in viral pneumonia, with the exception of hypoxemic SARS-CoV-2 pneumonia, in which their benefit is well established.},
}

@article {pmid41640416,
year = {2025},
author = {Pompilio, A and Di Bonaventura, G},
title = {The COVID-19 pandemic: an underlying factor for increased Stenotrophomonas maltophilia infections-A literature review and case study analysis.},
journal = {Frontiers in microbiology},
volume = {16},
number = {},
pages = {1746742},
pmid = {41640416},
issn = {1664-302X},
abstract = {Stenotrophomonas maltophilia is increasingly recognized as a major cause of healthcare-associated infections in intensive care units. It presents serious risks for immunocompromised patients and can cause severe lung infections in individuals with cystic fibrosis. Recent studies have documented a rising occurrence of S. maltophilia infections among hospitalized COVID-19 patients. However, understanding of these infections in this setting remains limited or inconsistent, with only one review specifically examining S. maltophilia infections in COVID-19 patients. This review critically evaluates all relevant studies from the literature, along with a case series, to explore the clinical significance of S. maltophilia infections in patients with COVID-19. In particular, the review discusses the prevalence, risk factors, phenotypic traits, clinical consequences, and treatment options for S. maltophilia infections in this clinical context.},
}

@article {pmid41640608,
year = {2026},
author = {Velikova, T and Ali, H and Batselova, H and Chervenkov, L and Miteva, D and Peruhova, M and Gulinac, M and Tomov, L and Mitova-Mineva, Y and Velev, V},
title = {Interplay between viral infections and gut microbiota dysbiosis: Mechanisms and therapeutic potential.},
journal = {World journal of gastroenterology},
volume = {32},
number = {3},
pages = {112437},
pmid = {41640608},
issn = {2219-2840},
mesh = {Humans ; *Dysbiosis/therapy/immunology/microbiology ; *Gastrointestinal Microbiome/immunology ; Probiotics/therapeutic use ; Fecal Microbiota Transplantation ; *COVID-19/immunology/microbiology/complications/therapy ; SARS-CoV-2 ; Prebiotics/administration & dosage ; *Virus Diseases/immunology/microbiology/therapy ; Animals ; },
abstract = {Viral infections, particularly those triggered by emerging pathogens like severe acute respiratory syndrome coronavirus 2, are increasingly recognized for their profound impact on the gut microbiota, causing dysbiosis, a condition characterized by an imbalance in microbial communities. Recent studies suggest that alterations in gut microbiota can influence disease progression, immune responses, and clinical outcomes. The bidirectional relationship between the gut microbiota and the host immune system is crucial in shaping responses to infection. Furthermore, dysbiosis has been linked to exacerbated inflammation, impaired mucosal barrier function, and altered drug metabolism, thereby complicating both disease pathogenesis and treatment efficacy. This review examines the interplay between viral infections and gut microbiota dysbiosis, with a focus on the underlying mechanisms and potential therapeutic strategies to modulate host immunity. We also evaluate the potential of microbiome-based interventions, such as probiotics, prebiotics, and fecal microbiota transplantation, as therapeutic strategies for restoring microbial balance and mitigating the severity of infections. The paper underscores the need for further research to optimize microbiota-targeted therapies and integrate them into clinical practice, offering a comprehensive approach to managing dysbiosis in viral infectious diseases.},
}

Humans
*Dysbiosis/therapy/immunology/microbiology
*Gastrointestinal Microbiome/immunology
Probiotics/therapeutic use
Fecal Microbiota Transplantation
*COVID-19/immunology/microbiology/complications/therapy
SARS-CoV-2
Prebiotics/administration & dosage
*Virus Diseases/immunology/microbiology/therapy
Animals

@article {pmid41641003,
year = {2025},
author = {Leclerc, L and Poudrier, J and Power, C and Lam, GY and Falcone, EL},
title = {Intestinal barrier compromise, viral persistence, and immune dysregulation converge on neurological sequelae in Long COVID.},
journal = {Frontiers in aging neuroscience},
volume = {17},
number = {},
pages = {1744415},
pmid = {41641003},
issn = {1663-4365},
abstract = {Long COVID (LC) is a multisystem, post-infectious conditions diagnosed ≥3 months after acute SARS-CoV-2 infection and marked by relapsing, persistent, or progressive symptoms, especially fatigue, post-exertional symptom exacerbation and neuropsychiatric syndromes. We synthesized evidence suggesting that LC arises from intersecting pathways including viral persistence, intestinal dysbiosis and barrier compromise with microbial translocation, innate immune activation with neutrophil extracellular traps (NET) and thromboinflammation, and immune dysregulation with features of exhaustion and autoimmunity. These processes adversely impact blood-brain barrier (BBB) function and lead to neuroinflammation. We propose a mechanistic model in which viral antigens and translocated microbial products amplify pro-inflammatory networks promoting immunothrombosis and tissue hypoperfusion. Hematogenous and gut-brain pathways may then deliver inflammatory mediators to the central nervous system (CNS), resulting in BBB disruption and glial activation that underpin nervous system disorders in LC. Treatment regimens aimed at lowering antigen load, restoring mucosal barrier integrity and modulating myeloid/coagulation pathways may warrant investigation as novel therapeutic strategies to treat LC.},
}

@article {pmid41641244,
year = {2025},
author = {Wang, D and Yang, T and Cui, Y and Qu, Y and Feng, C and Sun, Z and Zhang, M},
title = {From tradition to healing: the promise of acupuncture in managing chronic fatigue syndrome.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1724290},
pmid = {41641244},
issn = {2296-858X},
abstract = {Chronic fatigue syndrome (CFS) is a global public health problem affecting more than 65 million patients worldwide. The combined prevalence rate of CFS was 45.2% after 4 weeks in patients with novel coronavirus. Women, people over 40 years of age, and low-income people are susceptible groups, which have a significant impact on immune, nervous, endocrine, and other system functions. First, from the perspective of epidemiology, this paper reviews the global epidemic trend of CFS, the differences in incidence and prevalence in different regions and populations, and risk factors such as heredity, infection, and childhood trauma. Second, the development of diagnostic techniques for CFS, including the evolution of clinical diagnostic criteria, research progress on immune and metabolic biomarkers, and the application of MRI and other imaging techniques in the diagnosis of CFS, is described, followed by an in-depth discussion of the genetics of CFS, including genetic susceptibility, genomic association, and familial aggregation. The pathophysiological mechanism of CFS was also analyzed, revealing abnormalities in NK cell function and immune factors in the immune system, dysfunction of the hypothalamic-pituitary-adrenal axis in the neuroendocrine system, and disorders of energy and lipid metabolism in the metabolic system. This paper focuses on the study of acupuncture and moxibustion treatment of CFS, traces back to the historical application of acupuncture and moxibustion treatment of CFS, analyzes the relationship between the pathological mechanism of CFS and acupuncture and moxibustion intervention, expounds the theoretical basis of traditional Chinese medicine and modern mechanism of action of acupuncture and moxibustion treatment, and introduces the results of clinical trials, efficacy evaluation methods, and individualized treatment strategies for acupuncture and moxibustion treatment of CFS. The innovative application of acupuncture techniques, such as electroacupuncture and acupoint catgut embedding, as well as the synergistic effect of acupuncture combined with traditional Chinese medicine and psychotherapy, are shown. At the same time, disputes and challenges in the efficacy, safety, and ethics of acupuncture treatment for CFS were pointed out, and future research directions, potential breakthroughs, and international cooperation opportunities of acupuncture treatment for CFS are discussed. This study provides a comprehensive reference for clinical treatment and research on CFS.},
}

@article {pmid41641375,
year = {2026},
author = {Zhang, J and Liu, Y and Ren, S and Wang, Z and Li, Y and Peng, L and Fang, R},
title = {Natural Products as Potential Resource Library for Control of Major Swine Enteric Viruses.},
journal = {Transboundary and emerging diseases},
volume = {2026},
number = {},
pages = {4368881},
pmid = {41641375},
issn = {1865-1682},
mesh = {Animals ; Swine ; *Biological Products/pharmacology/therapeutic use ; *Swine Diseases/virology/prevention & control/drug therapy ; *Antiviral Agents/pharmacology ; Transmissible gastroenteritis virus/drug effects ; Porcine epidemic diarrhea virus/drug effects ; Rotavirus/drug effects ; Deltacoronavirus/drug effects ; },
abstract = {Major swine enteric viruses (SEVs), including porcine epidemic diarrhea virus (PEDV), porcine deltacoronavirus (PDCoV), transmissible gastroenteritis virus (TGEV), swine acute diarrhea syndrome coronavirus (SADS-CoV), and porcine rotavirus (PoRV), cause severe gastrointestinal diseases in pigs, leading to huge economic losses to the swine industry around the world. In the absence of specific drugs and vaccines for controlling SEVs in the pig production, this review summarizes the inhibitory effects of natural products against these major porcine enteric viruses. Specifically, it focuses on recent studies regarding the anti-SEVS activities of traditional Chinese medicine (TCM) compound formulas, herbal extracts, pharmaceutical monomers, and natural metabolites. The review elaborates on how these natural products exert antiviral activities against SEVs, highlighting their potential as alternative or complementary agents for controlling porcine enteric viral infections. Overall, this work provides a comprehensive overview of the research progress in natural products against porcine enteric viruses and demonstrates the new strategies for medicine discovery, which will be helpful for further development of effective antiviral strategies in the swine industry.},
}

Animals
Swine
*Biological Products/pharmacology/therapeutic use
*Swine Diseases/virology/prevention & control/drug therapy
*Antiviral Agents/pharmacology
Transmissible gastroenteritis virus/drug effects
Porcine epidemic diarrhea virus/drug effects
Rotavirus/drug effects
Deltacoronavirus/drug effects

@article {pmid41643087,
year = {2026},
author = {Di Líbero, E and Duarte, A and Kaneshiro, V and Gañete, M and Aronson, S and López Furst, MJ},
title = {[Management of Community-Acquired Pneumonia in Adults - Argentine Society of Infectious Diseases].},
journal = {Medicina},
volume = {86},
number = {1},
pages = {145-165},
pmid = {41643087},
issn = {1669-9106},
mesh = {Humans ; *Community-Acquired Infections/drug therapy/diagnosis/therapy/microbiology ; Argentina ; Anti-Bacterial Agents/therapeutic use ; Adult ; *Pneumonia/drug therapy/diagnosis ; Community-Acquired Pneumonia ; },
abstract = {Community-acquired pneumonia (CAP) is responsible for substantial morbidity and mortality worldwide. Epidemiological surveillance indicates that Streptococcus pneumoniae remains the most frequent etiological agent and the leading cause of mortality. However, with the advent of new diagnostic techniques, viral etiology has gained priority. Chest X-ray is considered mandatory to confirm the diagnosis and establish the spread. Microbiological, antigen, molecular, biomarker, and carriage tests have specific indications and a role to play in reconsidering empirical treatments. Severity scales are useful for defining the site of care, and the most validated prognostic models are PSI and CURB-65. When antibacterial treatment is appropriate, aminopenicillins ± beta-lactamase inhibitors are the preferred treatment, with the addition of a macrolide in severe cases. Pseudomonas and methicillin-resistant Staphylococcus aureus should be considered primarily in patients with a history of prior infection/colonization or severe structural lung disease. Shortened courses have gained support in the literature, and once clinical stability is achieved, it is suggested that treatment be continued for 3-5 days for CAP managed in an outpatient/general ward setting, and 5-7 days for CAP requiring intensive care. The role of corticosteroids in reducing mortality has been documented in severe forms. The benefit of neuraminidase inhibitors for influenza is of low certainty and relatively marginal. Treatments that have had an impact on reducing mortality from severe-critical COVID-19 are corticosteroids, IL-6 receptor blockers, and baricitinib.},
}

Humans
*Community-Acquired Infections/drug therapy/diagnosis/therapy/microbiology
Argentina
Anti-Bacterial Agents/therapeutic use
Adult
*Pneumonia/drug therapy/diagnosis
Community-Acquired Pneumonia

@article {pmid41643088,
year = {2026},
author = {Beltramino, MF and Gasser, FB and Stassi, AF and Ortega, HH and Baravalle, ME},
title = {[Evaluation of reproductive and developmental toxicity: its importance in the preclinical phase of new vaccines].},
journal = {Medicina},
volume = {86},
number = {1},
pages = {166-178},
pmid = {41643088},
issn = {1669-9106},
mesh = {Animals ; Drug Evaluation, Preclinical/methods ; Female ; *Reproduction/drug effects ; Humans ; *COVID-19 Vaccines/adverse effects/toxicity ; Pregnancy ; COVID-19/prevention & control ; Embryonic Development/drug effects ; },
abstract = {Preclinical trials in laboratory animals, particularly those aimed at evaluating potential effects on reproduction and offspring development, have gained importance in recent years due to the development of new drugs and vaccines intended for both children and individuals of reproductive age. The current challenge lies in the need for reliable and rapidly obtainable data to enable the transition of new compounds to clinical phases and eventual approval. Since pregnant and breastfeeding women are often excluded from clinical vaccine trials, including those assessing toxicity, there is limited knowledge about this vulnerable population and their offspring. In this context, preclinical studies designed to assess the effects of vaccine and therapeutic candidates on reproduction and development must rely on in vivo models that accurately replicate key aspects of the pathogenesis observed in human disease. When evaluating the reproductive toxicity of vaccines, it is essential not only to assess potential effects on fertility, embryogenesis, development, and reproduction, but also to consider the interactions of the vaccine with the immune system of both the mother and her offspring. This review updates and describes preclinical studies in laboratory animals for new vaccines, particularly those developed against COVID-19, highlighting published studies on reproductive and developmental toxicity, as well as the current regulatory framework governing such studies.},
}

Animals
Drug Evaluation, Preclinical/methods
Female
*Reproduction/drug effects
Humans
*COVID-19 Vaccines/adverse effects/toxicity
Pregnancy
COVID-19/prevention & control
Embryonic Development/drug effects

@article {pmid41643233,
year = {2026},
author = {Anderson, SA and Smith, ER and Wan, Z and Amend, KL and Secora, A and Djibo, DA and Kazemi, K and Song, J and Parlett, LE and Seeger, JD and Selvam, N and McMahill-Walraven, CN and Hu, M and Chillarige, Y and Forshee, RA},
title = {Febrile seizure risk following monovalent COVID-19 mRNA vaccination in US children aged 2-5 years.},
journal = {Vaccine},
volume = {75},
number = {},
pages = {128225},
doi = {10.1016/j.vaccine.2026.128225},
pmid = {41643233},
issn = {1873-2518},
mesh = {Humans ; *Seizures, Febrile/epidemiology/etiology ; Child, Preschool ; Male ; Female ; United States/epidemiology ; *COVID-19/prevention & control ; *Vaccination/adverse effects ; Incidence ; SARS-CoV-2/immunology ; BNT162 Vaccine/adverse effects ; 2019-nCoV Vaccine mRNA-1273/adverse effects ; *COVID-19 Vaccines/adverse effects/administration & dosage ; },
abstract = {OBJECTIVE: To evaluate febrile seizure risk following monovalent COVID-19 mRNA vaccination among children aged 2-5 years.

METHODS: The primary analysis evaluated children who had a febrile seizure outcome in the 0-1 days following COVID-19 vaccination. A self-controlled case series analysis was performed in three commercial insurance databases to compare the risk of seizure in the risk interval (0-1 days) to a control interval (8-63 days). The exposure of interest was receipt of dose 1 and/or dose 2 of monovalent COVID-19 mRNA vaccinations. The primary outcome was febrile seizure (0-1 day risk interval). A conditional Poisson regression model was used to compare outcome rates in risk and control intervals and estimate incidence rate ratios (IRR) and 95% confidence intervals (CIs). Meta-analyses were used to pool results across databases.

RESULTS: The primary meta-analysis found a statistically significant increased incidence of febrile seizure, in the 0-1 days following mRNA-1273 vaccination compared to the control interval (IRR: 2.52, 95% CI: 1.35 to 4.69, risk difference (RD)/100,000 doses = 3.22 (95% CI -0.31 to 6.75)). For the BNT162b2 vaccination, the IRR was elevated but not statistically significant (IRR: 1.41, 95% CI: 0.48 to 4.11, RD/100,000 doses = -0.25 (95% CI -2.75 to 2.24).

CONCLUSIONS: Among children aged 2-5 years, the analysis showed a small elevated incidence rate ratio of febrile seizures in the 0-1 days following the mRNA-1273 vaccination.},
}

Humans
*Seizures, Febrile/epidemiology/etiology
Child, Preschool
Male
Female
United States/epidemiology
*COVID-19/prevention & control
*Vaccination/adverse effects
Incidence
SARS-CoV-2/immunology
BNT162 Vaccine/adverse effects
2019-nCoV Vaccine mRNA-1273/adverse effects
*COVID-19 Vaccines/adverse effects/administration & dosage

@article {pmid41644038,
year = {2026},
author = {Ogoti, B and Riitho, V and Wildemann, J and Mutono, N and Mureithi, M and Oyugi, J and Rodon, J and Corman, VM and Drosten, C and Thumbi, SM and Müller, MA},
title = {Epidemiology and genomic features of MERS coronavirus in Africa: a systematic and meta-analysis review.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {165},
number = {},
pages = {108456},
doi = {10.1016/j.ijid.2026.108456},
pmid = {41644038},
issn = {1878-3511},
mesh = {Humans ; *Middle East Respiratory Syndrome Coronavirus/genetics ; Africa/epidemiology ; Camelus/virology ; *Coronavirus Infections/epidemiology/virology/veterinary ; Animals ; Genome, Viral ; Seroepidemiologic Studies ; RNA, Viral ; Prevalence ; Phylogeny ; },
abstract = {OBJECTIVES: We explored factors contributing to the low human MERS-CoV prevalence in Africa by assessing MERS-CoV epidemiological and genomic features.

METHODS: We followed the PRISMA guidelines. We searched for articles on epidemiological and virological MERS-CoV characteristics in humans and camels in Africa until August 2025. We used a generalised linear mixed-effects model to calculate pooled proportions. We identified relevant polymorphisms in African MERS-CoV lineages compared with the prototypic EMC/2012 and contemporary Arabian MERS-CoV (clade B5).

RESULTS: We included 53 articles, with 31 used in the meta-analysis. Kenya, Egypt, and Ethiopia contributed to 66.03% of all included studies. Pooled MERS-CoV RNA positivity in African dromedaries was 6.09%, with juveniles (15.29%) having a higher incidence than adults (4.51%). The pooled MERS-CoV seroprevalence was 73.67%, with adults (80.96%) higher than juveniles (36.02%). In human-focused studies, only nine PCR-confirmed MERS cases were reported, six travel-associated and three autochthonous cases, despite a pooled seroprevalence of 2.4%. Genomic analyses identified MERS-CoV clade C-specific polymorphisms in the Spike and accessory genes with putative phenotypic impact.

CONCLUSION: We found the highest MERS-CoV RNA positivity in young dromedaries. Elevated MERS-CoV seroprevalence in mainly asymptomatic camel-exposed humans suggests an underestimation of MERS-CoV infections in Africa. The ongoing MERS-CoV evolution emphasises the need for active genomic surveillance to monitor signatures of human adaptation.},
}

Humans
*Middle East Respiratory Syndrome Coronavirus/genetics
Africa/epidemiology
Camelus/virology
*Coronavirus Infections/epidemiology/virology/veterinary
Animals
Genome, Viral
Seroepidemiologic Studies
RNA, Viral
Prevalence
Phylogeny

@article {pmid41644304,
year = {2026},
author = {Fung, IC and Liang, H and Pierce, KJ and Kraay, ANM and Kwok, KO and Akhmetzhanov, AR and Baiden, FE and Unwin, HJT and Kengne, FB and Alhassan, F and Chowell, G},
title = {Excess mortality in Mainland China after the end of the Zero COVID policy: A systematic review.},
journal = {Epidemiology and infection},
volume = {154},
number = {},
pages = {e29},
pmid = {41644304},
issn = {1469-4409},
mesh = {Humans ; *COVID-19/mortality/prevention & control/epidemiology ; China/epidemiology ; SARS-CoV-2 ; *Health Policy ; },
abstract = {After the Zero COVID policy ended on December 7, 2022, ~90% of mainland Chinese were infected in a COVID-19 wave. This systematic review synthesized research estimating excess mortality during that wave in mainland China. We searched seven databases in May 2024 and updated our search in July-August 2025. Peer-reviewed research (Chinese or English), published since January 1, 2023, estimating excess deaths in the COVID-19 wave post-Zero-COVID was included. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. Two authors independently conducted abstract screening, full-text review, data extraction, and risk-of-bias assessment. Seven articles were included. Two studies analysed the death records of a town and a district in Shanghai, estimating the excess mortality rates of 153.6% and 174.3%, respectively. Using indirect methods, four studies estimated national excess mortality (range: 0.71-1.87 million). Another study estimated excess mortality in Taiyuan. Studies used diverse methods to estimate excess deaths, resulting in widely varying and uncertain estimates. Choice of reference period, seasonality, and other factors affect expected mortality estimates.},
}

Humans
*COVID-19/mortality/prevention & control/epidemiology
China/epidemiology
SARS-CoV-2
*Health Policy

@article {pmid41645272,
year = {2026},
author = {Tamrakar, VK and Sharma, K and Singh, P and Bhargava, A and Negi, SS},
title = {Cervical cancer elimination in India: Repurposing diagnostics, vaccination, and accelerating policy for the 2030 target.},
journal = {Cancer},
volume = {132},
number = {4},
pages = {e70292},
doi = {10.1002/cncr.70292},
pmid = {41645272},
issn = {1097-0142},
support = {IIRP-2023-3960/F1.//Indian Council of Medical Research/ ; },
mesh = {Humans ; *Uterine Cervical Neoplasms/prevention & control/diagnosis/epidemiology/virology ; India/epidemiology ; Female ; *Papillomavirus Infections/prevention & control/diagnosis/epidemiology/virology ; *Papillomavirus Vaccines/administration & dosage ; Vaccination ; Early Detection of Cancer/methods ; COVID-19/epidemiology/prevention & control ; Health Policy ; Disease Eradication ; },
abstract = {Cervical cancer remains one of the most significant yet preventable causes of cancer-related mortality among women in India. Current estimates indicate that the country reports approximately 127,000 new cases and nearly 80,000 deaths annually, accounting for about one fifth of the global burden. Despite advances in vaccination, screening, and molecular diagnostics, coverage remains critically low: fewer than 2% of women undergo screening, and less than 1% have received a human papillomavirus (HPV) vaccine. The introduction of the indigenous quadrivalent vaccine Cervavac in 2023 has provided renewed momentum; however, limitations in infrastructure, public awareness, and stratic barrier to implementation continue to hinder progress toward achieving the World Health Organization's 2030 elimination targets. This opinion article highlights the epidemiological landscape, diagnostic and programmatic barriers, and emphasis to repurpose India's vast coronavirus disease-era reverse transcriptase-polymerase chain reaction network for HPV molecular testing. Integrating HPV vaccination into the Universal Immunization Program and incorporating the HPV Nucleic Acid Amplification Test (NAAT) into the National Essential Diagnostics List (NEDL) are critical steps for accelerating India's pathway to cervical cancer elimination by 2030.},
}

Humans
*Uterine Cervical Neoplasms/prevention & control/diagnosis/epidemiology/virology
India/epidemiology
Female
*Papillomavirus Infections/prevention & control/diagnosis/epidemiology/virology
*Papillomavirus Vaccines/administration & dosage
Vaccination
Early Detection of Cancer/methods
COVID-19/epidemiology/prevention & control
Health Policy
Disease Eradication

@article {pmid41645649,
year = {2026},
author = {Loubet, P and Fourati, S},
title = {An evaluation of sipavibart for pre-exposure prophylaxis of COVID-19 in immunocompromised individuals.},
journal = {Expert review of anti-infective therapy},
volume = {24},
number = {1},
pages = {89-96},
doi = {10.1080/14787210.2026.2624614},
pmid = {41645649},
issn = {1744-8336},
mesh = {Humans ; *COVID-19/prevention & control/immunology/virology ; *Immunocompromised Host ; *SARS-CoV-2/immunology ; *Pre-Exposure Prophylaxis/methods ; Spike Glycoprotein, Coronavirus/immunology ; *Antibodies, Monoclonal/administration & dosage/adverse effects/pharmacology ; *Antibodies, Monoclonal, Humanized/administration & dosage/adverse effects/pharmacology ; *COVID-19 Drug Treatment ; Antibodies, Neutralizing/immunology/administration & dosage ; },
abstract = {INTRODUCTION: The COVID-19 pandemic has disproportionately affected immunocompromised individuals, who remain at risk for severe disease despite widespread vaccination efforts. Poor vaccine-induced humoral responses in this population necessitate additional preventive strategies. Sipavibart (AZD3152) is a next-generation long-acting monoclonal antibody designed to target the receptor-binding domain (RBD) of the SARS-CoV-2 Spike protein and provide broad-spectrum neutralization against divergent variants.

AREAS COVERED: This review evaluates sipavibart's preclinical pharmacology, pivotal and supportive clinical trial data, and early real-world evidence, including the SUPERNOVA Phase 3 trial and national early-access programs. We discuss its safety profile, variant-specific activity, and resistance challenges.

EXPERT OPINION: Sipavibart was the first monoclonal antibody to show efficacy and safety in preventing symptomatic COVID-19 among immunocompromised individuals, protecting for up to six months. However, the widespread circulation of variants harboring S:F456L currently limits its clinical utility, and use should be restricted. Maintaining access to Sipavibart remains justified, as future antigenic shifts could restore its activity. Its deployment should rely on genomic surveillance and local epidemiology. At the same time, next-generation mAbs should prioritize conserved spike regions and multi-epitope cocktails to counter viral evolution and prolong therapeutic value.},
}

Humans
*COVID-19/prevention & control/immunology/virology
*Immunocompromised Host
*SARS-CoV-2/immunology
*Pre-Exposure Prophylaxis/methods
Spike Glycoprotein, Coronavirus/immunology
*Antibodies, Monoclonal/administration & dosage/adverse effects/pharmacology
*Antibodies, Monoclonal, Humanized/administration & dosage/adverse effects/pharmacology
*COVID-19 Drug Treatment
Antibodies, Neutralizing/immunology/administration & dosage

@article {pmid41646510,
year = {2026},
author = {Melo-Oliveira, MES and Lourenço, RA and Louzada, EB and Moutinho, M and Barbosa, AF and Moreira, VG and Porto, LC},
title = {Systematic Review of Dyspnea and Chronic Fatigue in Patients With Long COVID: Clinical Characteristics and Associated Laboratory Parameters.},
journal = {Pulmonary medicine},
volume = {2026},
number = {},
pages = {5426125},
pmid = {41646510},
issn = {2090-1844},
mesh = {Humans ; *Dyspnea/etiology/physiopathology/virology/epidemiology ; *COVID-19/complications/physiopathology ; Quality of Life ; *Fatigue/etiology/physiopathology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; *Fatigue Syndrome, Chronic/etiology ; },
abstract = {ABSTRACT: Dyspnea and chronic fatigue stand out as prevalent manifestations in the postacute phase of COVID, resulting in substantial adverse effects on patients' quality of life and functional capacity. Although these symptoms have been widely documented, there is no clear consensus on the pathophysiological mechanisms that underlie them. The available literature reveals a dispersion of clinical and laboratory data, and the variability in the methods of assessment of fatigue and dyspnea, as well as in the laboratory variables examined, limits the standardized understanding of this complex condition.

OBJECTIVE: This study was aimed at identifying and synthesizing the evidence on the main clinical and laboratory characteristics related to dyspnea and fatigue in patients during long COVID from 2021 onwards.

METHODS: The main databases used to select the studies were PubMed and Medline, also using LitCovid and Embase.

RESULTS: A total of 42 articles that met the inclusion criteria were included, covering a total population of 30,682 patients diagnosed with COVID-19. The findings underscore the significant impact of long COVID on patients' quality of life, with persistent symptoms such as fatigue and dyspnea affecting a considerable proportion of individuals for durations ranging from 1 to 24 months.

CONCLUSION: The heterogeneity in research approaches highlights the urgent need for collaborative initiatives to elucidate the determinants of long COVID symptomatology and create more consistent evaluation protocols.},
}

Humans
*Dyspnea/etiology/physiopathology/virology/epidemiology
*COVID-19/complications/physiopathology
Quality of Life
*Fatigue/etiology/physiopathology
Post-Acute COVID-19 Syndrome
SARS-CoV-2
*Fatigue Syndrome, Chronic/etiology

@article {pmid41646984,
year = {2025},
author = {Müller, L and Gebicka, P and Handtke, S and Schönborn, L and Thiele, T},
title = {Advances in our understanding of anti-PF4 related immunothrombosis.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1724207},
pmid = {41646984},
issn = {1664-3224},
mesh = {Humans ; *Platelet Factor 4/immunology ; *Thrombosis/immunology ; *Autoantibodies/immunology/blood ; *SARS-CoV-2/immunology ; *COVID-19/immunology ; *Purpura, Thrombocytopenic, Idiopathic/immunology ; COVID-19 Vaccines/adverse effects/immunology ; Blood Platelets/immunology ; Receptors, IgG/immunology ; *Thrombocytopenia/immunology ; Platelet Activation/immunology ; Animals ; Heparin/adverse effects ; },
abstract = {This article focuses on the central role of antibodies against platelet factor 4 (PF4) in mediating immunothrombosis, from classical heparin-induced thrombocytopenia (HIT) to vaccine-induced immune thrombocytopenia and thrombosis (VITT). The latter condition gained international attention during the rollout of vaccines against SARS-CoV-2. Since then, an increased awareness for anti-PF4 mediated disorders arose and patients were recognized with anti-PF4 disorders occurring without prior heparin or adenoviral vector vaccine exposure. These disorders include various acute and chronic VITT-like conditions, i.e. post-viral VITT, diaplacentally transmitted anti-PF4 antibodies in neonatal stroke, monoclonal gammopathies of thrombotic significance (MGTS) and chronic autoimmune VITT of unknown origin. All anti-PF4 related disorders share key serological and immunopathological features with VITT, such as the formation of immune complexes and platelet activation via the Fcγ receptor IIA (FcγRIIA). Via their activation, platelets form procoagulant, aggregatory and secretory phenotypes shaping their interplay with neutrophils, monocytes, and coagulation factors to amplify thrombotic responses. Integrating recent mechanistic insights, clinical observations and diagnostic developments, this review proposes an updated conceptual framework for anti PF4-related immunothrombosis. We aim to raise awareness among clinicians and researchers, to promote early diagnosis and encourage further translational research towards improved therapeutic strategies in this clinically significant area.},
}

Humans
*Platelet Factor 4/immunology
*Thrombosis/immunology
*Autoantibodies/immunology/blood
*SARS-CoV-2/immunology
*COVID-19/immunology
*Purpura, Thrombocytopenic, Idiopathic/immunology
COVID-19 Vaccines/adverse effects/immunology
Blood Platelets/immunology
Receptors, IgG/immunology
*Thrombocytopenia/immunology
Platelet Activation/immunology
Animals
Heparin/adverse effects

@article {pmid41647062,
year = {2025},
author = {Ghorbani Shirkouhi, S and Khatami, SS and Niroomand, Z and Sadigh-Eteghad, S and Yousefzadeh-Chabok, S and Andalib, S},
title = {Molecular and Cellular Mechanisms Underlying Neurological and Neuropsychological Manifestations of COVID-19.},
journal = {Innovations in clinical neuroscience},
volume = {22},
number = {10-12},
pages = {14-23},
pmid = {41647062},
issn = {2158-8333},
abstract = {OBJECTIVE: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with a wide range of neurological symptoms and neuropsychiatric conditions. SARS-CoV-2 shows various degrees of neurotropism. SARS-CoV-2 primarily targets respiratory and gastrointestinal tracts; however, it can affect other organs. Neurological and neuropsychological manifestations of COVID-19 have been reported. Several mechanisms are involved in these manifestations in COVID-19. Therefore, the present narrative review will take account of mechanisms underlying the neurological and neuropsychological manifestations in COVID-19.

METHODS: A literature search for relevant articles in different databases was made with a focus on recent publications for this narrative review.

RESULTS: Inflammation and thrombosis have been suggested to be mechanisms contributing to these manifestations. Also, renin-angiotensin system (RAS), transmembrane serine protease 2 (TMPRSS2), cathepsin B and L, furin, neuropilin-1 (NRP1), and sterile alpha motif and HD domain-containing protein 1 (SAMHD1) have been proposed to be involved in pathogenesis of SARS-CoV-2. Moreover, cluster of differentiation 147 (CD147) and dipeptidyl peptidase 4 (DPP4) have been suggested to have a role in SARS-CoV-2 entry into the central nervous system (CNS).

CONCLUSION: Further investigation on the underlying mechanisms leading to SARS-CoV-2-associated neurological and neuropsychological manifestations is pivotal. Insights into these mechanisms will help the treatment strategies for patients with COVID-19 and such manifestations.},
}

@article {pmid41648868,
year = {2026},
author = {Zhu, T and Wang, L and Yan, C},
title = {Local and systemic host responses to influenza and concurrent or sequential SARS-CoV-2 infection.},
journal = {Frontiers in cellular and infection microbiology},
volume = {16},
number = {},
pages = {1725731},
pmid = {41648868},
issn = {2235-2988},
mesh = {Humans ; *COVID-19/immunology/pathology/complications ; *Influenza, Human/immunology/complications/pathology/virology ; *Coinfection/immunology/virology/pathology ; SARS-CoV-2 ; Lung/pathology/virology/immunology ; Inflammation ; },
abstract = {Influenza is an acute respiratory infectious disease caused by the influenza virus, which has been circulating in humans for over a century. In contrast, COVID-19, caused by the novel SARS-CoV-2, emerged recently in December 2019. Following nearly four years of pandemic, the acute phase of SARS-CoV-2 has transitioned towards an endemic state, suggesting a trend of long-term coexistence with humans. Concurrent or sequential coinfection with influenza and SARS-CoV-2 has been clinically observed to exacerbate pulmonary pathology and systemic inflammation in affected individuals. This review discusses the impact and elucidates the potential underlying mechanisms by which influenza and SARS-CoV-2 coinfection aggravates local lung injury and systemic host responses, aiming to inform improved prevention and clinical management strategies.},
}

Humans
*COVID-19/immunology/pathology/complications
*Influenza, Human/immunology/complications/pathology/virology
*Coinfection/immunology/virology/pathology
SARS-CoV-2
Lung/pathology/virology/immunology
Inflammation

@article {pmid41648943,
year = {2026},
author = {Song, F and Liu, Y and Zhao, Z and Shang, X and Wang, Y and Lai, M and He, M and Chen, Y},
title = {Clinical manifestations, prevalence, and risk factors of asthenopia: a systematic review and meta-analysis.},
journal = {Journal of global health},
volume = {16},
number = {},
pages = {04053},
pmid = {41648943},
issn = {2047-2986},
mesh = {Humans ; Risk Factors ; Prevalence ; *Asthenopia/epidemiology/etiology ; *COVID-19/epidemiology ; Adult ; },
abstract = {BACKGROUND: This meta-analysis aims to determine the clinical manifestations, prevalence, and risk factors of asthenopia across diverse populations.

METHODS: We systematically searched PubMed up to April 2024 for studies published within the last five years on asthenopia, without language or design restrictions. Reference lists were also reviewed. The study quality was evaluated using the Newcastle-Ottawa Scale. A random-effects meta-analysis was conducted to calculate proportions, prevalence rates, odds ratios (ORs) and their 95% confidence intervals (CIs).

RESULTS: Overall, 63 studies were included. The pooled prevalence of asthenopia detected via questionnaires or symptom report was 51% (95% CI = 50%, 52%). Subgroup analyses showed high prevalence among digital device users (90%) and computer workers (77%). During the COVID-19 pandemic, prevalence rose among adults (39%-45%), university students (36%-57%), and school-aged children (45%-64%). The most frequent ocular symptoms were eye tiredness (65%, 95% CI = 46%, 84%), eye strain (47%, 95% CI = 37%, 58%), and burning/irritation (43%, 95% CI = 35%, 51%). Musculoskeletal symptoms, including neck pain (45%, 95% CI = 28%, 62%) and shoulder pain (30%, 95% CI = 12%, 48%) were also prevalent. Neuropsychological symptoms included headache (50%, 95% CI = 41%, 59%) and difficulty concentrating (44%, 95% CI = 32%, 56%). Risk factors included short sleep duration (OR = 1.28; 95% CI = 1.04, 1.57), prior eye disease (OR = 2.59; 95% CI = 1.43, 4.69), prolonged screen time (OR = 1.15; 95% CI = 1.09, 1.21), and ambient conditions like air conditioning use (OR = 23.02; 95% CI = 4.94, 107.18). Protective measures included anti-glare filters (OR = 0.34; 95% CI = 0.19, 0.64), regular breaks (OR = 0.21; 95% CI = 0.09, 0.51), and computer use knowledge (OR = 0.20; 95% CI = 0.13, 0.30).

CONCLUSIONS: Asthenopia is prevalent across diverse populations, characterised by a wide range of symptoms and influenced by modifiable risk factors. Our findings support a unified definition to improve clinical recognition and offer preliminary evidence to help shape future research on preventive strategies.

REGISTRATION: PROSPERO: CRD42024536841.},
}

Humans
Risk Factors
Prevalence
*Asthenopia/epidemiology/etiology
*COVID-19/epidemiology
Adult

@article {pmid41650498,
year = {2026},
author = {Keenan Chong, WH and Dan Ong, WJ and Khan, FA and Sajeed, S and Souza, JD and Kansal, MG and Kansal, A},
title = {Clinical benefits of prolonged versus standard prone positioning in mechanically ventilated COVID-19 patients with acute respiratory distress syndrome: A systematic review, meta-analysis, and trial-sequential analysis.},
journal = {Australian critical care : official journal of the Confederation of Australian Critical Care Nurses},
volume = {39},
number = {2},
pages = {101531},
doi = {10.1016/j.aucc.2026.101531},
pmid = {41650498},
issn = {1036-7314},
mesh = {Humans ; Prone Position ; *COVID-19/therapy/mortality ; *Respiratory Distress Syndrome/therapy/mortality ; *Respiration, Artificial/methods ; *Patient Positioning/methods ; SARS-CoV-2 ; Randomized Controlled Trials as Topic ; Time Factors ; },
abstract = {OBJECTIVES: The optimal duration of prone positioning for improving outcomes in acute respiratory distress syndrome remains uncertain. This meta-analysis compared clinical outcomes of prolonged versus standard prone positioning in adult coronavirus disease 2019 patients with moderate-to-severe acute respiratory distress syndrome.

METHODS: PubMed, SCOPUS, and Cochrane databases were systematically searched for randomised controlled trials (RCTs) and observational studies. Prolonged prone positioning was defined as a mean duration >24 h per session and standard as ≤ 24 h. Outcomes included mortality, pressure injuries, oxygenation, and respiratory parameters. A trial sequential analysis was conducted for mortality and pressure injuries.

RESULTS: Seven studies (six observational and one RCT) involving 996 patients (592 prolonged and 404 standard) were included in the study. Prolonged prone positioning showed a nonsignificant trend towards lower mortality (33.8% vs. 39.8%, RR: 0.81, 95% confidence interval: 0.60-1.09; P = 0.16) and a borderline increase in pressure injuries (30.2% vs. 26.2%; relative risk (RR) 1.27, 95% confidence interval: 1.00-1.62; P = 0.05). The trial sequential analysis indicated that current evidence is insufficient to confirm benefit or harm. No significant differences were observed in intensive care unit length of stay (mean difference [MD]: 2.74 days; P = 0.13) or changes in positive end-expiratory pressure or driving pressure in both groups. Oxygenation improved significantly during (partial pressure of arterial oxygen-to-fraction of inspired oxygen ratio MD: 17.42 mmHg; P = 0.003) and after prone positioning (partial pressure of arterial oxygen-to-fraction of inspired oxygen ratio MD: 23.83 mmHg; P = 0.008).

CONCLUSION: Prolonged prone positioning was associated with trends towards lower mortality and higher frequency of pressure injury risk, but evidence remains inconclusive. While oxygenation improved, clinical outcomes of intensive care unit length of stay and respiratory parameters were unchanged. Additional high-quality RCTs are needed to clarify the balance of benefits and risks and guide future recommendations.},
}

Humans
Prone Position
*COVID-19/therapy/mortality
*Respiratory Distress Syndrome/therapy/mortality
*Respiration, Artificial/methods
*Patient Positioning/methods
SARS-CoV-2
Randomized Controlled Trials as Topic
Time Factors

@article {pmid41650532,
year = {2026},
author = {Labied, S and Atifi, F and Wahnou, H and Mabrouk, M and Jeddoub, O and Allaoui, A and Jalali, F and Zaid, Y},
title = {Megakaryocytes and afucosylated IgG in post-acute COVID-19: Bridging immune dysregulation and vascular pathology - A narrative review.},
journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie},
volume = {196},
number = {},
pages = {119049},
doi = {10.1016/j.biopha.2026.119049},
pmid = {41650532},
issn = {1950-6007},
mesh = {Humans ; *COVID-19/immunology/pathology/complications ; *Immunoglobulin G/immunology/metabolism ; *Megakaryocytes/immunology/pathology/metabolism ; SARS-CoV-2/immunology ; Post-Acute COVID-19 Syndrome ; Glycosylation ; Glycoproteins ; },
abstract = {Post-acute sequelae of SARS-CoV-2 infection (PASC), also referred to as long COVID, encompasses a constellation of persistent symptoms lasting for at least three months after acute SARS-CoV-2 infection and not explained by alternative diagnoses. The multifactorial pathophysiology underlying PASC remains incompletely understood, limiting the development of effective management strategies. Increasing evidence suggests that both immune dysregulation and hemostatic imbalance play central roles in post-COVID-19 complications. Megakaryocytes, key regulators of platelet production and coagulation, have emerged as potential contributors to sustained thrombo-inflammatory processes following SARS-CoV-2 infection. In parallel, afucosylated IgG antibodies have been strongly implicated in exaggerated immune activation and hyperinflammatory responses during acute COVID-19. The persistence of such antibody glycosylation patterns beyond the acute phase raises the possibility that they may also contribute to chronic immune and vascular alterations observed in PASC. This narrative review explores the potential interplay between megakaryocyte dysfunction and afucosylated IgG antibodies in the pathogenesis of PASC. By examining mechanisms identified during acute SARS-CoV-2 infection, we discuss how prolonged immune-hemostatic crosstalk may promote persistent inflammation, endothelial dysfunction, and microvascular abnormalities. Understanding these interconnected pathways may provide mechanistic insight into the heterogeneity of PASC manifestations and help identify novel therapeutic targets for long-term post-COVID-19 sequelae.},
}

Humans
*COVID-19/immunology/pathology/complications
*Immunoglobulin G/immunology/metabolism
*Megakaryocytes/immunology/pathology/metabolism
SARS-CoV-2/immunology
Post-Acute COVID-19 Syndrome
Glycosylation
Glycoproteins

@article {pmid41651428,
year = {2026},
author = {Wang, Y and Zhao, F and Zhao, Q and Du, S and Wen, Y and Wu, R and Cao, S and Cong, F and Huang, X},
title = {Cell entry mechanisms of porcine enteric coronaviruses.},
journal = {The Journal of biological chemistry},
volume = {302},
number = {3},
pages = {111250},
pmid = {41651428},
issn = {1083-351X},
mesh = {Animals ; Swine ; *Virus Internalization ; *Porcine epidemic diarrhea virus/physiology ; *Transmissible gastroenteritis virus/physiology ; Humans ; *Deltacoronavirus/physiology ; *Coronavirus Infections/virology/metabolism ; *Swine Diseases/virology/metabolism ; Receptors, Virus/metabolism ; Spike Glycoprotein, Coronavirus/metabolism ; Alphacoronavirus ; *Coronavirus/physiology ; Gastroenteritis, Transmissible, of Swine/virology ; },
abstract = {Porcine enteric coronaviruses, including transmissible gastroenteritis virus (TGEV), porcine epidemic diarrhea virus (PEDV), swine acute diarrhea syndrome coronavirus (SADS-CoV), and porcine deltacoronavirus (PDCoV), cause severe watery diarrhea, vomiting, dehydration, and high mortality in piglets, leading to enormous economic losses in the swine industry worldwide. They have the capability to infect a variety of cell lines from pigs, humans, and other animals, with high risks of interspecies transmission and potential threats to public health. These viruses employ their spike glycoproteins to engage with various receptors, coreceptors, cofactors, and other host factors that further mediate membrane fusion to accomplish the entry process. This review summarizes the recent findings regarding the pathways, receptors, coreceptors, cofactors, and other host factors utilized by TGEV, PEDV, SADS-CoV, and PDCoV for cellular entry. Several important targets for antiviral therapeutics and some key aspects of the entry process for these viruses that await discovery are highlighted. A comprehensive understanding of the entry mechanisms of porcine enteric coronaviruses will provide new insight into the development of novel antiviral therapeutic strategies.},
}

Animals
Swine
*Virus Internalization
*Porcine epidemic diarrhea virus/physiology
*Transmissible gastroenteritis virus/physiology
Humans
*Deltacoronavirus/physiology
*Coronavirus Infections/virology/metabolism
*Swine Diseases/virology/metabolism
Receptors, Virus/metabolism
Spike Glycoprotein, Coronavirus/metabolism
Alphacoronavirus
*Coronavirus/physiology
Gastroenteritis, Transmissible, of Swine/virology

@article {pmid41652425,
year = {2026},
author = {Halder, P and Khaiwal, R and Goel, S and Kumar, N and Sarkar, M and Soni, M and Nongkynrih, B and Prabhakar, MC and Mamgai, A and Rathor, S},
title = {Burden of chronic obstructive pulmonary disease among Indian adults: systematic review and meta‑analysis.},
journal = {BMC pulmonary medicine},
volume = {26},
number = {1},
pages = {},
pmid = {41652425},
issn = {1471-2466},
abstract = {BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a long-standing respiratory illness marked by ongoing airflow obstruction and inflammation. It continues to be a major contributor to global disease, and death, with low- and middle-income countries (LMICs) experiencing a disproportionate impact. India, as one of the largest LMICs, plays a significant role in global COPD-related mortality and disability-adjusted life years (DALYs). In India, COPD continues to be underrecognized owing to limited spirometry availability, inconsistent diagnostic approaches, and weak surveillance systems. Previous prevalence estimates are both outdated and methodologically inconsistent, while the COVID-19 pandemic may have further shifted disease trends. This systematic review and meta-analysis seeks to bridge these gaps by delivering current, standardized, and comprehensive prevalence data.

OBJECTIVE: To estimate the pooled prevalence of spirometry-confirmed COPD among Indian adults and identify key demographic and environmental correlates through a systematic review and meta-analysis of observational studies.

METHODS: This systematic review and meta-analysis aimed to determine the prevalence of spirometry-confirmed COPD among Indian adults. The study was registered in PROSPERO (CRD420251140678) and conducted in accordance with PRISMA guidelines. Literature searches were carried out in PubMed, EMBASE, Scopus, and Web of Science up to June 9, 2025, using relevant MeSH terms and keywords on COPD, prevalence, and India. Eligible studies included observational designs reporting spirometry-based COPD prevalence in adults; studies relying on non-spirometry diagnosis, qualitative designs, interventions, or non-English publications were excluded. Three reviewers independently screened records, extracted study and population data, and evaluated methodological quality using the Joanna Briggs Institute (JBI) checklist. Pooled prevalence was calculated using a random-effects model. Heterogeneity was assessed with I[2] and Cochran’s Q, complemented by Baujat and Galbraith plots. Subgroup and sensitivity analyses examined variations by diagnostic criteria, demographics, and exposures, while publication bias was tested using funnel plots, Egger’s and Begg’s methods, and trim-and-fill analysis.

RESULTS: Twenty-three studies comprising 27,319 Indian adults were included. The pooled prevalence of COPD was 13% (95% CI: 9%–18%), with substantial heterogeneity (I[2] = 99.8%). Higher prevalence was observed among smokers (37%), elderly adults (≥ 60 years: 27%), males (16%), and biomass fuel users (8%). Studies using GOLD criteria reported a higher prevalence (15%) than those using FEV₁/FVC < LLN (10%). Hospital-based studies showed a greater prevalence (27%) than community-based ones (12%). Regional variation was notable, with North India reporting the highest prevalence (19%) and West India the lowest (7%). Sensitivity analyses confirmed the robustness of findings; publication bias was minimal and did not significantly affect pooled estimates.

CONCLUSION: COPD remains a significant and underrecognized public health challenge in India. As all included studies were appraised as good quality using the JBI tool, the evidence base is strong and supports reliable pooled estimates. Therefore, our conclusions emphasize the importance of routine spirometry-based screening, targeted interventions for high-risk groups, and integration of COPD surveillance into India’s NCD framework, while reinforcing gender-sensitive strategies and clean fuel initiatives as evidence-based measures to reduce disease burden and guide policy planning.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-026-04134-0.},
}

@article {pmid41653012,
year = {2026},
author = {Asis, A and Rodríguez, A and Reyes, LF and Díaz, E and Nseir, S and Martín-Loeches, I},
title = {The double threat: bacterial and fungal co-/superinfection in viral pneumonia.},
journal = {Expert review of respiratory medicine},
volume = {},
number = {},
pages = {1-12},
doi = {10.1080/17476348.2026.2629003},
pmid = {41653012},
issn = {1747-6356},
abstract = {INTRODUCTION: Respiratory viral pneumonias are a leading cause of severe respiratory failure and intensive care unit (ICU) admission worldwide. Although viral infection itself drives significant morbidity and mortality, secondary bacterial and fungal superinfections represent a critical 'double threat' in critically ill adults, exacerbating lung injury, prolonging organ dysfunction, and complicating antimicrobial management. Experience from the Influenza A (H1N1) pdm09 and SARS-CoV-2 pandemics highlights a persistent mismatch between low documented bacterial co-infection rates and widespread empiric antibiotic exposure, underscoring diagnostic uncertainty and antimicrobial stewardship challenges in the ICU.

AREAS COVERED: This review examines the epidemiology, immunopathogenesis, and diagnostic approaches to bacterial and fungal superinfection in adult ICU patients with severe viral pneumonia. Evidence is synthesized from large ICU cohorts, pandemic data, and established consensus definitions for influenza- and COVID-19-associated pulmonary aspergillosis (IAPA, CAPA). The review discusses advances in molecular diagnostics, lower respiratory tract sampling, bronchoalveolar lavage - based mycology, and biomarker-guided strategies, with a focused literature search of ICU-specific studies.

EXPERT OPINION: Bacterial and fungal superinfections, while infrequent, carry substantial clinical impact in severe viral pneumonia. A multimodal, ICU-adapted diagnostic strategy integrating pathogen detection with host-response assessment is essential to support timely therapy, enable antimicrobial de-escalation, and align superinfection management with stewardship principles.},
}

@article {pmid41653115,
year = {2026},
author = {Hu, Q and Mai, Z and Wang, B and Sun, N and Zhu, W and Wang, J and Ge, J and Gao, M},
title = {Trained Immunity Empowers Vaccine Design and Application.},
journal = {ACS infectious diseases},
volume = {12},
number = {3},
pages = {913-936},
doi = {10.1021/acsinfecdis.5c00840},
pmid = {41653115},
issn = {2373-8227},
mesh = {Humans ; *COVID-19 Vaccines/immunology ; *COVID-19/prevention & control/immunology ; *Vaccine Development/methods ; SARS-CoV-2/immunology ; Adjuvants, Immunologic ; Animals ; Cross Protection ; Trained Immunity ; },
abstract = {The COVID-19 pandemic has exposed the limitations of traditional vaccine development models: these approaches rely excessively on pathogen-specific antigen design, feature lengthy development cycles, and struggle to address threats from rapidly mutating pathogens and emerging pathogens. Even before the pandemic, certain traditional vaccines (such as BCG) demonstrated "cross-protection" effects beyond their target diseases. The trained immunity (TRIM) theory offers a promising path to develop broad-spectrum, effective, and durable vaccines. This review summarizes core advances in TRIM within vaccinology, systematically outlining vaccine design strategies based on this concept for the first time. These strategies encompass vaccine-mediated cross-protection, methods to enhance vaccine potency and persistence, pathways to achieve broad-spectrum effects, and regulatory characteristics involving immune recognition, antigen delivery, safety, and tolerability. This study explores the synergistic effects and application prospects of TRIM adjuvants such as β-glucan and Toll-like receptor (TLR) agonists. The impact of transgenerational immune effects on offspring immune function provides a crucial direction for future research. It also highlights current limitations in studies regarding persistence, individual variability, and risks of excessive inflammation. Existing vaccines capable of inducing TRIM will inspire next-generation vaccine development. Innovative applications of this vaccine category can propel the advancement of trained immunity-based vaccines (TIbVs). This review proposes an innovative approach─the "Vaccine Immunity Foundation Hypothesis." This lays the groundwork for designing next-generation vaccines and advancing the clinical translation of TRIM therapies, establishing a theoretical foundation for developing broad-spectrum, highly effective, durable, and safe immune protection strategies.},
}

Humans
*COVID-19 Vaccines/immunology
*COVID-19/prevention & control/immunology
*Vaccine Development/methods
SARS-CoV-2/immunology
Adjuvants, Immunologic
Animals
Cross Protection
Trained Immunity

@article {pmid41653615,
year = {2026},
author = {Honchar, O and Мykhailenko, O and Holovchenko, O and Georgiyants, V},
title = {Pelargonium sidoides - from ethnopharmacology to evidence-based medicine: a systematic review.},
journal = {Phytomedicine : international journal of phytotherapy and phytopharmacology},
volume = {153},
number = {},
pages = {157880},
doi = {10.1016/j.phymed.2026.157880},
pmid = {41653615},
issn = {1618-095X},
mesh = {*Pelargonium/chemistry ; Humans ; *Plant Extracts/pharmacology/chemistry/therapeutic use ; Ethnopharmacology ; Evidence-Based Medicine ; Phytotherapy ; Phytochemicals/pharmacology ; COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; Ethnobotany ; },
abstract = {BACKGROUND: Pelargonium sidoides DC. (Geraniaceae) has a long history of traditional use among indigenous peoples of Southern Africa for treating respiratory and gastrointestinal disorders. Its transformation into the modern pharmaceutical product Umckaloabo (EPs® 7630) exemplifies the transition from traditional medicine to evidence-based therapeutics.

PURPOSE: To provide a systematic analysis of P. sidoides, spanning from its botanical characteristics and ethnobotanical roots to its development as a regulated phytomedicine. The review focuses on the plant's unique phytochemical profile and provides a detailed synthesis of its molecular and systems-biological mechanisms of action, cultivation sustainability, and clinical efficacy in managing respiratory tract infections.

STUDY DESIGN AND METHODS: A systematic search was conducted across PubMed, Scopus, and Cochrane Library up to December 2025 following PRISMA guidelines. Sources included scientific articles, pharmacopoeias, patents, and ethnobotanical records in English and Ukrainian.

RESULTS: The systematic synthesis of identified records characterizes the chemical diversity of P. sidoides, focusing on specialized metabolites such as highly substituted benzopyranones, prodelphinidins, and unique coumarin sulfates. The review discusses modern cultivation practices, sustainability issues, and comparative extraction techniques, while analytical methods such as HPLC, LC-MS, and TLC for standardization are summarized. The pharmacological profile is defined by multi-target activity, encompassing immunomodulatory, antibacterial, and antiviral effects, including studies on SARS-CoV-2 and other respiratory pathogens. Analysis of available clinical data validates the therapeutic use of P. sidoides root preparations for managing acute bronchitis, rhinosinusitis, and tonsillopharyngitis.

CONCLUSION: This study demonstrates that the integration of P. sidoides into modern healthcare is supported by the synergy between traditional knowledge and molecular and clinical validation. By mapping the developmental trajectory - from wild harvesting to systems-biological evidence - this review identifies P. sidoides as a model for the pharmaceutical translation of ethnobotanical resources into standardized, evidence-based phytomedicines.},
}

*Pelargonium/chemistry
Humans
*Plant Extracts/pharmacology/chemistry/therapeutic use
Ethnopharmacology
Evidence-Based Medicine
Phytotherapy
Phytochemicals/pharmacology
COVID-19 Drug Treatment
SARS-CoV-2/drug effects
Ethnobotany

@article {pmid41654195,
year = {2026},
author = {Shan, Z and Li, J and Ye, Z and Chen, Y and Chen, J and Chen, Y and Wang, X and Gao, C and Jiang, S and Zhang, N},
title = {Advances in human respiratory organoid models for studying the pathogenesis and intervention strategies of COVID-19.},
journal = {Virologica Sinica},
volume = {41},
number = {1},
pages = {23-34},
pmid = {41654195},
issn = {1995-820X},
mesh = {Humans ; *Organoids/virology/pathology ; *COVID-19/pathology/virology ; *SARS-CoV-2/pathogenicity/physiology ; *Respiratory System/virology/pathology ; COVID-19 Drug Treatment ; },
abstract = {Coronavirus Disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), affects multiple organ systems, with the respiratory system being the primary target. Respiratory organoids, which closely mimic the structure and function of the human respiratory tract, have emerged as essential tools for studying SARS-CoV-2 infection. This review summarizes current methods for generating various respiratory organoids, including nasal, tonsil, airway, bronchial, and alveolar organoids, and highlights their application in investigating the mechanism of SARS-CoV-2 infection and evaluating potential therapeutic agents. Meanwhile, this review also introduces respiratory organoid-on-a-chip technology, which can precisely regulate culture conditions and incorporate vascularization and immune cells to enhance physiological complexity, thereby providing crucial support for investigating SARS-CoV-2-induced lung injury, immune responses, and conducting high-throughput drug screening. The aim of this review is to provide valuable insights for further research into the pathogenesis and intervention strategies of COVID-19.},
}

Humans
*Organoids/virology/pathology
*COVID-19/pathology/virology
*SARS-CoV-2/pathogenicity/physiology
*Respiratory System/virology/pathology
COVID-19 Drug Treatment

@article {pmid41655454,
year = {2026},
author = {Chen, K and Xu, Q and Li, J and Wu, G and Wu, H and Tie, X and Xu, J and Li, J and Zhang, Y},
title = {Cytokine storm divergence in viral infections of the upper respiratory tract.},
journal = {Cytokine & growth factor reviews},
volume = {88},
number = {},
pages = {108-123},
doi = {10.1016/j.cytogfr.2026.01.008},
pmid = {41655454},
issn = {1879-0305},
mesh = {Humans ; *Cytokine Release Syndrome/immunology/virology ; *Respiratory Tract Infections/immunology/virology/complications ; *Cytokines/immunology ; COVID-19/immunology ; SARS-CoV-2/immunology ; *Virus Diseases/immunology ; Respiratory Syncytial Virus Infections/immunology ; },
abstract = {Cytokine storm (CS) is a pathological state of dysregulated, hyperactive host immunity that arises in the context of infection, malignancy, or immunotherapy. CS is characterized by the sustained, markedly elevated release of multiple pro-inflammatory mediators, ultimately leading to tissue damage and multi-organ dysfunction. Upper respiratory viral infections, including SARS, MERS, SARS-CoV-2, influenza, adenovirus, and respiratory syncytial virus (RSV), are among the most prominent CS triggers. Inflammatory storms triggered by different pathogens exhibit distinct variations in their cytokine profiles and downstream immune signaling pathways. Underlying comorbidities-such as diabetes, obesity, and cardiovascular disease-together with complications such as coagulopathies and secondary infections, can profoundly alter both the threshold and the magnitude of the cytokine storm. This review systematically compares cytokine profiles elicited by distinct upper respiratory pathogens, with population stratification by age and underlying comorbidities, to clarify how these patterns relate to disease severity and complication risk. Collectively, the available evidence supports a shared inflammatory backbone across respiratory virus-induced cytokine storms, overlaid by pathogen-specific cytokine fingerprints and host-dependent plasticity that shapes clinical trajectories and outcomes.},
}

Humans
*Cytokine Release Syndrome/immunology/virology
*Respiratory Tract Infections/immunology/virology/complications
*Cytokines/immunology
COVID-19/immunology
SARS-CoV-2/immunology
*Virus Diseases/immunology
Respiratory Syncytial Virus Infections/immunology

@article {pmid41656017,
year = {2026},
author = {Temte, JL},
title = {Primary Care Clinics and Surveillance of Infectious Diseases.},
journal = {Primary care},
volume = {53},
number = {1},
pages = {17-29},
doi = {10.1016/j.pop.2025.09.003},
pmid = {41656017},
issn = {1558-299X},
mesh = {Humans ; *Primary Health Care/organization & administration ; *Communicable Diseases/epidemiology ; Influenza, Human/epidemiology ; *Public Health Surveillance/methods ; *Ambulatory Care Facilities/organization & administration ; },
abstract = {Public health surveillance for infectious diseases is highly compatible with the practice of primary care medicine and is enhanced by contextual and population-based elements when grounded in primary care. Moreover, there have been long and successful partnerships between primary care and public health for influenza monitoring. Surveillance programs can be based on sentinel, laboratory, or mechanistic approaches and need to reflect the needs of clinicians and the realities of the primary care environment. Participation in, and access to, surveillance information improves patient care through situational awareness, improving diagnostic acuity, and improving antimicrobial stewardship.},
}

Humans
*Primary Health Care/organization & administration
*Communicable Diseases/epidemiology
Influenza, Human/epidemiology
*Public Health Surveillance/methods
*Ambulatory Care Facilities/organization & administration

@article {pmid41656465,
year = {2025},
author = {Kazachinskaia, EI and Zibareva, LN and Kononova, YV and Shestopalov, AM and Voevoda, MI and Chepurnov, AA},
title = {Antiviral Activity of Plant-Based Preparations against SARS-CoV-2 and Herpes Simplex Virus Type 2 In Vitro: A Review of Experimental Findings.},
journal = {Bulletin of experimental biology and medicine},
volume = {180},
number = {1},
pages = {1-10},
pmid = {41656465},
issn = {1573-8221},
mesh = {*Herpesvirus 2, Human/drug effects ; *SARS-CoV-2/drug effects ; *Antiviral Agents/pharmacology/chemistry ; *Plant Extracts/pharmacology/chemistry ; Humans ; *COVID-19 Drug Treatment ; COVID-19/virology ; Plant Leaves/chemistry ; Vero Cells ; },
abstract = {We reviewed published data on the efficacy of plant-derived preparations, including the authors' original in vitro findings on the antiviral activity of aqueous and dry ethanol extracts against the RNA virus SARS-CoV-2 and the DNA virus herpes simplex virus type 2 (HSV-2). The study evaluates the activity of an aqueous extract prepared from fermented leaves of Epilobium angustifolium L., as well as dry ethanol extracts obtained from clove spice (Syzygium aromaticum L.), black and green tea (Camellia sinensis L.), leaves of Rhaponticum carthamoides, the basidiomycete fungus chaga (Inonotus obliquus (Ach. ex Pers.) Pil.), and four lichen species: Cetraria islandica L., Usnea L., Pseudevernia furfuracea L., and Cladonia stellaris Opiz. HPLC analysis of several dry ethanol extracts suggests that their antiviral activity may be attributed to polyphenolic compounds and ecdysteroids. These findings may serve as a basis both for the identification of individual bioactive plant-derived compounds and for the development of cost-effective therapeutic or prophylactic agents against COVID-19 and for reducing the recurrence rate of chronic genital herpes.},
}

*Herpesvirus 2, Human/drug effects
*SARS-CoV-2/drug effects
*Antiviral Agents/pharmacology/chemistry
*Plant Extracts/pharmacology/chemistry
Humans
*COVID-19 Drug Treatment
COVID-19/virology
Plant Leaves/chemistry
Vero Cells

@article {pmid41656612,
year = {2026},
author = {Gauffin, K},
title = {Who is worthy of protection? Revisiting a theoretical model on the social origins of health inequities during the COVID-19 pandemic.},
journal = {Scandinavian journal of public health},
volume = {},
number = {},
pages = {14034948261415806},
doi = {10.1177/14034948261415806},
pmid = {41656612},
issn = {1651-1905},
abstract = {AIMS: This article examines how the Diderichsen model has been used and adapted in research on health inequalities during COVID-19, and explores how the pandemic has prompted further theoretical development. This review therefore addresses the question of how a well-established theoretical framework has helped researchers understand pandemic-related health inequalities and what opportunities exist for its continued refinement.

METHODS: A narrative literature review was conducted using Google Scholar, Web of Science, PubMed and Scopus. Included studies cited a key publication presenting the Diderichsen model and addressed COVID-19 as a central topic. After screening 298 articles, 24 were included for full analysis. The studies were categorised by how they engaged with the model - conceptually, empirically or through further development.

RESULTS: The Diderichsen model was commonly used to frame discussions of health inequality or to interpret pandemic-related disparities in exposure, vulnerability and outcomes. Several studies emphasised occupational and housing-related exposure, class-based comorbidities and the unequal social consequences of COVID-19. A smaller number of studies proposed expanded frameworks, incorporating multilevel and temporal dimensions and introducing new mechanisms related to pandemic responses. These adaptations often focused on migrants, ethnic minorities and other particularly affected groups.

CONCLUSIONS: The review confirms the ongoing relevance of the Diderichsen model in pandemic health inequality research. It argues that the model can be further strengthened by explicitly incorporating concepts of political decision-making, symbolic recognition and social justice. This would improve its capacity to capture the full complexity of health inequalities in times of crisis.},
}

@article {pmid41656850,
year = {2026},
author = {Hatchett, RJ},
title = {Best Practices in Preparing for the Worst Case.},
journal = {Disaster medicine and public health preparedness},
volume = {20},
number = {},
pages = {e34},
doi = {10.1017/dmp.2025.10201},
pmid = {41656850},
issn = {1938-744X},
mesh = {Humans ; *Disaster Planning/methods/standards/trends ; COVID-19/epidemiology/prevention & control ; *Civil Defense/methods/standards/trends ; Pandemics/prevention & control ; },
abstract = {The convergence of nuclear and radiological preparedness with epidemic and pandemic response, reveals valuable opportunities for cross-disciplinary learning and capability development. Insights from the extensive career of Dr. C. Norman Coleman illustrate how methodologies from radiation medical countermeasures can inform strategies for managing emerging infectious diseases. While nuclear incidents are infrequent, infectious disease outbreaks occur regularly, underscoring the need for sustained, adaptable capabilities to detect and respond to such threats. To draw on some examples, case studies on the development and deployment of vaccines against filoviruses highlight measurable advances in response speed and efficacy, while persistent challenges related to equitable access to medical countermeasures during public health emergencies can be addressed drawing lessons from the COVID-19 pandemic. Iterative improvement, strategic planning and performance optimization is very important, as is, the value of understanding the structure of a problem to find its solution.},
}

Humans
*Disaster Planning/methods/standards/trends
COVID-19/epidemiology/prevention & control
*Civil Defense/methods/standards/trends
Pandemics/prevention & control

@article {pmid41656855,
year = {2026},
author = {Lazarus, R and Williams, V and Cochrane, H and Rees, S and Seale, H},
title = {Attitudes to vaccine co-administration in adults: A scoping review of qualitative evidence.},
journal = {Human vaccines & immunotherapeutics},
volume = {22},
number = {1},
pages = {2616140},
pmid = {41656855},
issn = {2164-554X},
mesh = {Humans ; Adult ; *Vaccination/psychology/methods ; *Vaccines/administration & dosage ; *Health Knowledge, Attitudes, Practice ; Qualitative Research ; },
abstract = {Providing multiple vaccinations to adults at a single appointment, known as co-administration, could help increase vaccine coverage by making the process more convenient for the public. Despite vaccine co-administration policies, there are many missed opportunities to offer multiple vaccines. A qualitative understanding of the public attitude to co-administration may allow the development of interventions to increase implementation of co-administration policies. We undertook a scoping review following the Joanna Briggs Institute framework to collate the available qualitative literature to identify barriers, and facilitators to vaccine co-administration as well as potential research gaps. We created and used an iterative search strategy to retrieve articles published between 1/10/2010 and 11/12/2024 in three scientific databases. None of the articles retrieved fulfilled the inclusion criteria. There were nine articlesthat used quantitative surveys to measure attitudes, barriers and facilitators. Qualitative studies to understand barriers and facilitators to vaccine co-administration are needed to inform future policy implementation.},
}

Humans
Adult
*Vaccination/psychology/methods
*Vaccines/administration & dosage
*Health Knowledge, Attitudes, Practice
Qualitative Research

@article {pmid41656902,
year = {2026},
author = {Biswas, R and Roy, A and Kayal, T and Basu, S and Ghosh, S and Ramaiah, S and Anbarasu, A},
title = {Waning immunity and the future of booster vaccination strategies in global vaccine programs post COVID-19.},
journal = {Human vaccines & immunotherapeutics},
volume = {22},
number = {1},
pages = {2626088},
pmid = {41656902},
issn = {2164-554X},
mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology/administration & dosage ; *Immunization, Secondary/methods/trends ; *Immunization Programs ; SARS-CoV-2/immunology ; Global Health ; Vaccine Efficacy ; Vaccination ; },
abstract = {The problem of waning immunity is a major global concern of vaccine programs, with immunity against diseases such as COVID-19 (reduction in efficacy by ~25% in six months), pertussis (waning in 4-12 y), and influenza (annual updates needed) expected to decrease with time. While boosters reduce serious results in high-risk categories, these effects are short-term (4-6 months) and encourage global imbalances, where low-income areas lag in primary vaccination (<2%). Computational models have shown that primary vaccination in underserved regions prevents ~60% of hospitalizations worldwide, surpassing booster-focused measures (~47%). To maintain protection, variant-responsive boosters, rapid booster-design pipelines, universal vaccine platforms (including pan-coronavirus vaccines), and equity-based solutions (decentralized production) need to be integrated. Aligning with frameworks like the Immunization Agenda 2030 of the World Health Organization, plans should balance the expansion of high-risk groups while broadening primary access, providing infrastructure investment, and real-time surveillance to address evolving pathogens and systemic disparities.},
}

Humans
*COVID-19/prevention & control/immunology
*COVID-19 Vaccines/immunology/administration & dosage
*Immunization, Secondary/methods/trends
*Immunization Programs
SARS-CoV-2/immunology
Global Health
Vaccine Efficacy
Vaccination

@article {pmid41657321,
year = {2026},
author = {Zhang, Z and Ong, YH and Yang, B and Fan, B and Yang, YY and Ni, Q},
title = {Chemical engineering strategies to enhance mRNA-LNP stability for therapeutic applications.},
journal = {Biomaterials science},
volume = {14},
number = {6},
pages = {1370-1392},
doi = {10.1039/d5bm01635e},
pmid = {41657321},
issn = {2047-4849},
mesh = {Humans ; *RNA Stability ; *RNA, Messenger/chemistry/genetics ; *Chemical Engineering/methods ; SARS-CoV-2/genetics/immunology ; COVID-19/prevention & control ; RNA, Circular/chemistry ; *COVID-19 Vaccines/chemistry/immunology/genetics ; },
abstract = {The inception of mRNA vaccines for COVID-19 has catalyzed a transformative shift in the field of vaccination, offering expeditious, scalable, and potent countermeasures to a global health emergency. Despite significant advances, mRNA remains inherently unstable under physiological conditions due to its susceptibility to degradation by ubiquitous ribonucleases and physicochemical factors, making its storage, transport and clinical application challenging. This review explores the critical determinants influencing mRNA stability and discusses how chemical engineering strategies are suited to enhance mRNA stability, including 5' cap modification, poly(A) tail engineering, optimization of untranslated regions, as well as coding sequence refinements, reversible 2'-OH acylation, the development of circular RNA constructs and self-amplifying RNA systems. We also discuss efforts towards mRNA immunogenicity regulation and advanced mRNA delivery systems, along with progress in storage and transport solutions, which have further contributed to addressing stability concerns. Finally, we discuss the remaining challenges in clinical translation and provide forward-looking perspectives on emerging mRNA-based technologies.},
}

Humans
*RNA Stability
*RNA, Messenger/chemistry/genetics
*Chemical Engineering/methods
SARS-CoV-2/genetics/immunology
COVID-19/prevention & control
RNA, Circular/chemistry
*COVID-19 Vaccines/chemistry/immunology/genetics

@article {pmid41657453,
year = {2026},
author = {Yang, T and Hu, Y and Bao, Y},
title = {Psychological impact and intervention strategies for unaccompanied patients in pediatric intensive care units: a narrative review.},
journal = {Translational pediatrics},
volume = {15},
number = {1},
pages = {20},
pmid = {41657453},
issn = {2224-4344},
abstract = {BACKGROUND AND OBJECTIVE: The pediatric intensive care unit (PICU) is a high-stress medical environment. Family-Centered Care (FCC), which ensures parental presence and participation, is recognized as the standard of practice to mitigate psychological distress and trauma in critically ill children. However, infection control mandates [most notably during the coronavirus disease 2019 (COVID-19) pandemic] and resource limitations often necessitate restrictive visitation policies, leaving children in an "unaccompanied" state. This separation from parents constitutes a significant deviation from the standard care model and poses a unique psychological risk. A systematic synthesis of the specific psychological impacts of this parental absence and adaptive strategies to effectively intervene within this context remains underdeveloped. This narrative review aims to analyze the primary psychological consequences of parental absence for children in the PICU and to explore the intervention strategies adapted to mitigate these effects.

METHODS: We reviewed journal articles from the past 15 years (2010-2024) that analyze and discuss the psychological impact and intervention strategies of unaccompanied patients in pediatric intensive care units.

KEY CONTENT AND FINDINGS: Our analysis indicates that an unaccompanied state is a significant, independent risk factor for psychological morbidity in PICU patients, markedly exacerbating separation anxiety, fear, loneliness, and depressive symptoms, which may also impede physiological recovery. Effective interventions must focus on mitigating the trauma of separation. The core strategy identified is "Virtual Family-Centered Care" (e.g., re-establishing family connection and participation in rounds via video technology). Other critical interventions include alternative socio-emotional support from the healthcare team (especially Child Life Specialists), professional psychological therapies, and environmental optimization to reduce threat perception.

CONCLUSIONS: We conclude that while parental presence is irreplaceable, PICUs must adopt innovative interventions, particularly technology-assisted virtual connections, to protect the psychological well-being of unaccompanied children whenever visitation is necessarily restricted.},
}

@article {pmid41657702,
year = {2026},
author = {Liu, S and Zhou, T and Wang, M and Xiang, W and Wu, J},
title = {Global landscape of mRNA vaccine clinical trials: a systematic analysis of ClinicalTrials.gov data.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1738942},
pmid = {41657702},
issn = {2296-2565},
mesh = {Humans ; *Clinical Trials as Topic/statistics & numerical data ; *COVID-19/prevention & control ; *Registries/statistics & numerical data ; *COVID-19 Vaccines ; SARS-CoV-2 ; Global Health ; *mRNA Vaccines ; },
abstract = {mRNA vaccines, as a novel vaccine platform, have rapidly become a global research hotspot driven by the COVID-19 pandemic. This study employs a systematic analysis method based on clinical trial registries to conduct a descriptive statistical analysis of mRNA vaccine-related trials registered in the ClinicalTrials.gov database from March 2000 to July 2025. We compared characteristics such as the number of trials, geographical distribution, study type, funding sources, trial design, and indications, and used chi-square tests and Fisher's exact tests for inter-group difference analysis. The results show that the number of mRNA vaccine clinical trials has experienced explosive growth after the pandemic, presenting obvious pandemic-driven characteristics and geographical differences. There are significant differences in registration characteristics and trial design among China, the United States, and Europe (p<0.01). Indications have rapidly expanded from infectious diseases to multiple fields such as tumors, autoimmune diseases, and metabolic diseases, indicating that mRNA technology is transforming from an infectious disease prevention tool into a platform technology with broad therapeutic potential. From the perspective of clinical trial registration, this study provides empirical evidence for understanding the global research status, regional strategy differences, and future development directions of mRNA vaccines. It offers insights for vaccine development planning, international regulatory coordination, and global clinical trial strategic planning, assisting researchers, enterprises, and policymakers in making optimal decisions.},
}

Humans
*Clinical Trials as Topic/statistics & numerical data
*COVID-19/prevention & control
*Registries/statistics & numerical data
*COVID-19 Vaccines
SARS-CoV-2
Global Health
*mRNA Vaccines

@article {pmid41658241,
year = {2026},
author = {Gil Arias, BS and Blandón Andrade, JC and Sidorov, G and Morales-Ríos, A},
title = {Computational methods for the identification of suicidal ideation: a systematic review.},
journal = {Frontiers in artificial intelligence},
volume = {9},
number = {},
pages = {1704818},
pmid = {41658241},
issn = {2624-8212},
abstract = {INTRODUCTION: Suicide is one of the leading causes of death among young people, to the extent that in many countries it is considered a public health issue. It is important to attempt to reduce the growth of this trend, especially among susceptible individuals, considering that it increased because of the COVID-19 pandemic. Natural language processing (NLP) provides various tools that allow for the analysis of texts to predict the presence of suicidal ideation. This work aims to conduct a systematic literature review to extract the computational techniques for identifying suicidal ideation in texts written in natural language.

METHODS: The PRISMA 2020 method was used, which was divided into nine phases, and three inclusion criteria and two exclusion criteria were established for the selection of studies. The searches were conducted through high-level academic databases such as Scopus, IEEE Xplore, ACM Digital Library, Springer, and Web of Science. The risk of bias was assessed using AMSTAR 2. Potential biases identified include a lack of linguistic and cultural diversity and the predominance of data from social networks. A narrative synthesis was used to analyze and compare the findings qualitatively.

RESULTS: In the end, 25 studies related to computational methods for detecting suicidal ideation in texts written in natural language were identified. The techniques mainly focus on transformer-based models such as BERT and hybrid methods, which combine this architecture with neural networks such as CNN and LSTM. There are also approaches with hierarchical attention mechanisms. Some studies employed additional techniques such as feature extraction with TF-IDF and pre-trained embeddings to improve model performance.

DISCUSSION: Limitations in the evidence include the lack of linguistic and cultural diversity and the predominance of data from social networks. These results indicate that computational techniques have high potential to support early prevention strategies for suicidal ideation. However, expanding the diversity of linguistic contexts and improving understanding of the models among non-experts, such as physicians and other interested individuals, is necessary.},
}

@article {pmid41658735,
year = {2026},
author = {Lakhani, HA and Baidya, OP and Alex, A and Binorkar, SV and Das, D and Hazra, A},
title = {New-Onset and Flare Episodes of Adult-Onset Still's Disease Following COVID-19 Vaccination: A Systematic Review of Published Case Reports.},
journal = {Cureus},
volume = {18},
number = {1},
pages = {e100889},
pmid = {41658735},
issn = {2168-8184},
abstract = {This systematic review provides a descriptive synthesis of published case reports documenting new-onset or flare episodes of adult-onset Still's disease (AOSD) temporally occurring after COVID-19 vaccination. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar identified 13 eligible case reports published between 2020 and 2024. Because all available evidence consisted solely of individual case descriptions without comparator groups, the review followed PRISMA 2020 guidelines and employed qualitative narrative synthesis rather than meta-analysis. Across the included cases, patients consistently presented with hallmark features of AOSD, including high spiking fever, arthritis or arthralgia, markedly elevated ferritin levels, and, in several instances, the characteristic salmon-colored rash. Symptom onset typically occurred within four to fifteen days following vaccination. Although these cases demonstrate recognisable clinical patterns, the absence of denominator data, lack of population-based studies, and inherent publication bias prevent estimation of incidence or risk, and no causal relationship with vaccination can be inferred. All reported patients responded favorably to corticosteroids, with some requiring biologic therapy for disease control. These findings highlight the importance of clinician awareness when evaluating persistent febrile or inflammatory symptoms in recently vaccinated individuals, while emphasising that COVID-19 vaccination remains overwhelmingly safe. Larger registries, pharmacovigilance data, and controlled studies are needed to clarify potential risk factors and guide future revaccination decisions.},
}

@article {pmid41660233,
year = {2026},
author = {Sakkos, A and Saint-John, B and Tyml, T and Myskova, E and Aureli, L and Inman, JL and Snijders, AM and Mouncey, NJ and Mukundan, H and Schulz, F},
title = {Agnostic capture of pathogens for the detection and diagnostics of emerging threats.},
journal = {iScience},
volume = {29},
number = {2},
pages = {114684},
pmid = {41660233},
issn = {2589-0042},
abstract = {The continued emergence of pathogens, whether novel, re-emerging, or engineered, poses a persistent global biosecurity and public health challenge. Recent outbreaks, including COVID-19, Lassa fever, Marburg virus, mpox, and avian influenza, underscore the urgent need for robust systems that enable rapid surveillance, early diagnosis, and timely countermeasures before widespread human transmission occurs. In this article, we focus on early detection technologies and systematically evaluate current diagnostic and sensing modalities. We highlight sequencing and spectroscopy as two complementary approaches capable of providing broad, agnostic detection and rich biological insight. Our analysis emphasizes that scientific innovation alone is insufficient: effective preparedness also requires improved data curation, integration, and sharing to build AI-ready resources that accelerate future responses. We argue for coordinated advances in both technological capabilities and supporting infrastructure to enable the rapid identification and characterization of emerging pathogens and to fully leverage modern science against evolving infectious threats.},
}

@article {pmid41661491,
year = {2026},
author = {Garg, RK and Jain, A and Pandey, S and Paliwal, V and Suresh, V and Singhal, S},
title = {Infection-associated Opsoclonus: A Systematic Review.},
journal = {Cerebellum (London, England)},
volume = {25},
number = {1},
pages = {16},
pmid = {41661491},
issn = {1473-4230},
}

@article {pmid41661551,
year = {2026},
author = {Sundaram, ME},
title = {Vaccine safety for individuals receiving immune checkpoint inhibitor therapy: A narrative review of current literature and recommendations for future research.},
journal = {Human vaccines & immunotherapeutics},
volume = {22},
number = {1},
pages = {2607893},
pmid = {41661551},
issn = {2164-554X},
mesh = {Humans ; *Immune Checkpoint Inhibitors/adverse effects/therapeutic use ; *Neoplasms/drug therapy/immunology ; *COVID-19 Vaccines/adverse effects/administration & dosage/immunology ; *Influenza Vaccines/adverse effects/administration & dosage ; COVID-19/prevention & control ; Vaccination/adverse effects ; SARS-CoV-2/immunology ; },
abstract = {Some individuals with cancer may receive immunomodulatory treatment such as immune checkpoint inhibitors (ICIs). ICIs are now part of standard of care for many cancers and have improved survival for cancer patients. However, they are also associated with immune-related adverse events (irAEs), which can affect any organ or system, and can range from mild to severe. It has been hypothesized that vaccination of these individuals could increase the risk of irAEs or other vaccine-associated adverse events. This narrative review of 28 primary research articles presents findings from existing literature on vaccine safety for individuals receiving ICIs, and makes recommendations for future research on this topic. The existing evidence suggests that influenza and COVID-19 vaccines are safe for individuals receiving ICIs and do not pose additional risks of irAEs beyond baseline risks associated with ICI therapy.},
}

Humans
*Immune Checkpoint Inhibitors/adverse effects/therapeutic use
*Neoplasms/drug therapy/immunology
*COVID-19 Vaccines/adverse effects/administration & dosage/immunology
*Influenza Vaccines/adverse effects/administration & dosage
COVID-19/prevention & control
Vaccination/adverse effects
SARS-CoV-2/immunology

@article {pmid41662196,
year = {2026},
author = {Sirohi, A and Trivedi, YV and Katoch, T and Walters, B and Bansal, V and Pahal, S and Jain, R},
title = {The resurgence of Tuberculosis in the United States: Health implications, pathophysiological and clinical insights, emerging trends, strategic responses, and post-COVID-19 challenges.},
journal = {Chronic illness},
volume = {22},
number = {1},
pages = {17-35},
doi = {10.1177/17423953261417345},
pmid = {41662196},
issn = {1745-9206},
mesh = {Humans ; *COVID-19/epidemiology ; United States/epidemiology ; *Tuberculosis/epidemiology/diagnosis/therapy/drug therapy ; Health Services Accessibility ; Social Determinants of Health ; Latent Tuberculosis/epidemiology/diagnosis ; SARS-CoV-2 ; Social Stigma ; Healthcare Disparities ; },
abstract = {ObjectivesTo address the challenges of tuberculosis (TB) control in the United States post-COVID-19, focusing on high-risk populations, current diagnostic and treatment strategies, and the importance of addressing clinical and social determinants of health to achieve TB elimination goals.MethodsA review of the latest evidence-based guidelines and literature on TB diagnostics, treatment regimens, and latent TB infection (LTBI) management was conducted. Key public health challenges and interventions targeting socioeconomic disparities, stigma, and healthcare access among high-risk populations were analyzed.ResultsHigh-risk groups, including immigrants and ethnic minorities, continue to bear a disproportionate burden of TB due to socioeconomic disparities and comorbidities. Advancements in diagnostic modalities and treatment regimens offer promising outcomes, but gaps remain in LTBI screening and management. Addressing social determinants, such as healthcare access and stigma, is essential for enhancing TB control efforts.DiscussionEffective TB elimination requires collaborative efforts among healthcare professionals, policymakers, and communities to implement evidence-based strategies. Prioritizing both clinical precision and social interventions is critical for overcoming barriers and achieving national TB control and elimination goals.},
}

Humans
*COVID-19/epidemiology
United States/epidemiology
*Tuberculosis/epidemiology/diagnosis/therapy/drug therapy
Health Services Accessibility
Social Determinants of Health
Latent Tuberculosis/epidemiology/diagnosis
SARS-CoV-2
Social Stigma
Healthcare Disparities

@article {pmid41662535,
year = {2026},
author = {Valabhji, J},
title = {Banting memorial lecture 2025: Aligning clinical practice, policy and research.},
journal = {Diabetic medicine : a journal of the British Diabetic Association},
volume = {},
number = {},
pages = {e70245},
doi = {10.1111/dme.70245},
pmid = {41662535},
issn = {1464-5491},
abstract = {National clinical leadership, on a background of clinical practice and clinical research, provides unique perspectives. I have focused the Banting Memorial Lecture 2025 on the implementation of national programmes across England since 2013, for which, along with colleagues at NHS England, I successfully made the case for investment, led the implementation of interventions applied at scale across the country and used routinely collected healthcare data to demonstrate clinical effectiveness in the real world. Through specific examples of implemented programmes, including the NHS Diabetes Prevention Programme and the NHS Type 2 Diabetes Path to Remission Programme, I highlight important fundamental principles when making the case for, and implementing, national policy. First, ensure granular data collection to support evaluation and exploit data linkages to harness the power of real-world datasets. Second, where good evidence exists, implement evidence-based policy; where good evidence does not exist but political pressures to implement are being brought to bear, pilot and evaluate. Third, when the opportunity arises, rapidly translate new high-quality evidence into policy and practice. And fourth, support and protect the workload of healthcare professionals, particularly of those working in primary care. Then, through an epidemiological lens, I highlight: how the COVID-19 pandemic further unlocked the potential of national routinely collected electronic healthcare datasets; how, through application of these datasets, it has been possible to demonstrate improvements in diabetes complications and mortality through routine care delivery; and how it has been possible to demonstrate the next epidemiological transition in the global diabetes epidemic to multimorbidity/multiple long-term conditions.},
}

@article {pmid41662710,
year = {2026},
author = {Sommer, I and Dobrescu, A and Gadinger, A and Sharifan, A and Pinte, L and Fangmeyer, M and Klerings, I and Gartlehner, G},
title = {Outpatient Treatment of Confirmed COVID-19: A Living, Rapid Review for the American College of Physicians (Version 3).},
journal = {Annals of internal medicine},
volume = {179},
number = {4},
pages = {524-534},
doi = {10.7326/ANNALS-25-03691},
pmid = {41662710},
issn = {1539-3704},
mesh = {Humans ; *Antiviral Agents/therapeutic use/adverse effects ; *COVID-19 Drug Treatment ; COVID-19 ; SARS-CoV-2 ; *Ambulatory Care ; Ritonavir/therapeutic use/adverse effects ; Proline/analogs & derivatives/therapeutic use ; Pyrazines/therapeutic use ; Amides/therapeutic use ; Drug Combinations ; Cytidine/analogs & derivatives ; Hydroxylamines ; },
abstract = {BACKGROUND: Clinicians and patients need updated information on antiviral treatments for COVID-19.

PURPOSE: To provide a final update on the benefits and harms of COVID-19 antiviral treatments in adult outpatients.

DATA SOURCES: Ovid/MEDLINE, Epistemonikos COVID-19 L·OVE platform, and iSearch COVID-19 portfolio (22 January 2025); Ovid/MEDLINE (24 September 2025).

STUDY SELECTION: Two reviewers screened 20% of abstracts and full texts, then single screening. Randomized controlled trials were included for benefits and harms, and cohort studies were included for harms.

DATA EXTRACTION: One reviewer extracted data and assessed risk of bias and certainty of evidence (CoE); a second reviewer verified.

DATA SYNTHESIS: Seven studies from the Omicron period were included. 125 mg of ensitrelvir may not reduce time to recovery and may result in no difference in serious adverse events (both low CoE) but may increase adverse events (44.2% vs. 24.8%; low CoE). Molnupiravir probably improves recovery (31.8% vs. 22.6%) and reduces time to recovery (9 vs. 15 median days) and persistent symptoms from 3 to 6 months (8.5% vs. 11.0%), with no effect on mortality, hospitalization, serious adverse events, and adverse events (all moderate CoE). Nirmatrelvir-ritonavir may increase recovery (70.7% vs. 53.6%; low CoE) and reduce time to recovery (no data, P = 0.011; low CoE) but probably increases adverse events (1.3% vs. 1.0%; moderate CoE). Simnotrelvir-ritonavir reduces time to recovery (-35.8 median hours; high CoE) and probably increases adverse events (28.9% vs. 21.6%; moderate CoE). There was no difference in recovery between molnupiravir and favipiravir (high CoE) and nirmatrelvir-ritonavir and molnupiravir (low CoE).

LIMITATION: Evidence for many outcomes is limited.

CONCLUSION: Three COVID-19 antivirals improved or accelerated recovery, with varying adverse event profiles. Molnupiravir probably offers long-term benefits.

PRIMARY FUNDING SOURCE: American College of Physicians. (PROSPERO: CRD420251029146; OSF: https://osf.io/ywp6u).},
}

Humans
*Antiviral Agents/therapeutic use/adverse effects
*COVID-19 Drug Treatment
COVID-19
SARS-CoV-2
*Ambulatory Care
Ritonavir/therapeutic use/adverse effects
Proline/analogs & derivatives/therapeutic use
Pyrazines/therapeutic use
Amides/therapeutic use
Drug Combinations
Cytidine/analogs & derivatives
Hydroxylamines

@article {pmid41662713,
year = {2026},
author = {Qaseem, A and Obley, AJ and Yost, J and Abraham, GM and Andrews, RA and Jokela, JA and Miller, MC and Humphrey, LL and , and Haeme, R and Krain, A and Poonacha, T and Saini, SD and Wilt, TJ and Carroll, K and Etxeandia-Ikobaltzeta, I and Harrod, CS and Shamliyan, T and Vigna, C},
title = {Outpatient Treatment of Confirmed COVID-19 in Symptomatic Adults: Living, Rapid Practice Points From the American College of Physicians (Version 3).},
journal = {Annals of internal medicine},
volume = {179},
number = {4},
pages = {559-563},
doi = {10.7326/ANNALS-25-03766},
pmid = {41662713},
issn = {1539-3704},
mesh = {Humans ; *Antiviral Agents/therapeutic use ; *COVID-19 Drug Treatment ; Ritonavir/therapeutic use ; *Ambulatory Care ; COVID-19 ; Adult ; SARS-CoV-2 ; Drug Combinations ; Antibodies, Monoclonal, Humanized/therapeutic use ; },
abstract = {DESCRIPTION: The American College of Physicians (ACP) maintains living, rapid practice points on antiviral treatment in the outpatient setting for COVID-19.

METHODS: The Population Health and Medical Science Committee (PHMSC) developed this version 3 based on evidence from a focused update of a living, rapid review conducted by the ACP Center for Evidence Reviews at Cochrane Austria. This version addresses the SARS-CoV-2 Omicron variant and reaffirms previous practice points on the use of antiviral treatments of confirmed COVID-19 in unvaccinated or vaccinated and symptomatic patients in the outpatient setting.

PRACTICE POINT 1: Consider nirmatrelvir-ritonavir combination therapy to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease.

PRACTICE POINT 2: Consider molnupiravir to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease.

PRACTICE POINT 3: Do not use ivermectin to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.

PRACTICE POINT 4: Do not use sotrovimab to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.

RETIREMENT FROM LIVING STATUS: The PHMSC is retiring this topic from living status considering that this update and previous surveillance have not yielded important changes to the practice points.},
}

Humans
*Antiviral Agents/therapeutic use
*COVID-19 Drug Treatment
Ritonavir/therapeutic use
*Ambulatory Care
COVID-19
Adult
SARS-CoV-2
Drug Combinations
Antibodies, Monoclonal, Humanized/therapeutic use

@article {pmid41663803,
year = {2026},
author = {Karimi, F and Rajaie, S and Azari, S and Abbaszadeh, MS and Karimi, Z},
title = {Economic evaluation of direct oral anticoagulants (DOACs) for venous thromboembolism with different etiologies: a systematic review.},
journal = {Health economics review},
volume = {16},
number = {1},
pages = {},
pmid = {41663803},
issn = {2191-1991},
abstract = {BACKGROUND: Venous thromboembolism (VTE) imposes significant clinical and economic burdens. While direct oral anticoagulants (DOACs) offer favorable efficacy and safety, their cost-effectiveness across diverse VTE etiologies remains incompletely synthesized.

OBJECTIVE: To systematically evaluate the cost-effectiveness of DOACs versus comparators for VTE management stratified by etiology.

METHODS: A PRISMA-compliant systematic search was conducted in MEDLINE, Web of Science, Scopus, and NHS EED (2020–2025). Economic evaluations reporting cost-effectiveness or cost-utility outcomes were included. Study quality was assessed using the Drummond checklist.

RESULTS: Twenty studies were included (9 CAT, 3 post-surgical, 6 hospitalized VTE, 2 COVID-19). DOACs were cost-effective or dominant in 18/20 studies. For cancer-associated thrombosis (CAT), DOACs dominated LMWHs and were cost-effective versus placebo (ICERs: $5,794–$11,947/QALY). DOACs were also dominant for post-surgical prophylaxis and in general hospitalized VTE (ICERs: -$1,862/QALY to $125.68/QALY), while rivaroxaban was cost-effective for post-COVID-19 prophylaxis (ICER: $5,386/QALY).

CONCLUSION: DOACs, particularly apixaban and rivaroxaban, are an economically dominant strategy for VTE across most etiologies. Their adoption as a first-line therapy can improve patient outcomes while significantly reducing healthcare costs.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13561-026-00741-z.},
}

@article {pmid41665282,
year = {2026},
author = {Oda, M and Yoshimori, Y and Yamada, T and Amagasa, S and Fukuda, Y},
title = {Health of teleworkers: a scoping review on the assessment of the work-from-home environment.},
journal = {Journal of occupational health},
volume = {68},
number = {1},
pages = {},
pmid = {41665282},
issn = {1348-9585},
mesh = {Humans ; *COVID-19/epidemiology ; *Teleworking ; *Workplace/psychology ; *Occupational Health ; SARS-CoV-2 ; },
abstract = {OBJECTIVES: Inappropriate telework environments, including work-from-home (WFH) settings, have been linked to physical and mental health problems. However, no systematic assessment has been conducted regarding the WFH environment (WFH-E). The aim of this study was to clarify the current methods used to assess the WFH-E and its association with health- and work-related outcomes through a scoping review.

METHODS: We searched PubMed, Web of Science, and Ichushi for literature published since 2010 on WFH-E assessment. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, assessment methods were summarized using 18 items categorized into 9 domains. Additionally, associations between the WFH-E and health- and work-related outcomes were reviewed.

RESULTS: Of 1669 articles collected, 37 studies published from 2020 were ultimately included in this review. Thirty-four articles involved subjective assessments, and 9 involved objective assessments. The most frequently assessed item was artificial lighting, followed by thermal conditions and noise. Items such as color, greenery, building materials, and odor were rarely assessed. Most studies showed significant associations between the WFH-E and health- and work-related outcomes.

CONCLUSIONS: Studies on the WFH-E increased following the COVID-19 pandemic, showing significant associations between the WFH-E and health- and work-related outcomes. However, most assessments were subjective, with objective assessments remaining rare. Additionally, the assessment items were limited and biased, indicating that interior design elements were insufficiently assessed. Developing additional objective and comprehensive methods for assessing the WFH-E is needed.},
}

Humans
*COVID-19/epidemiology
*Teleworking
*Workplace/psychology
*Occupational Health
SARS-CoV-2

@article {pmid41665459,
year = {2026},
author = {Gomez Rial, J and Redondo, E and Rivero-Calle, I and Mascarós, E and Ocaña, D and Jimeno, I and Gil, Á and Linares, M and Onieva-García, MÁ and González-Romo, F and Yuste, J and Martinón-Torres, F},
title = {Immunofitness in the elderly: The role of vaccination in promoting healthy aging.},
journal = {Human vaccines & immunotherapeutics},
volume = {22},
number = {1},
pages = {2624234},
pmid = {41665459},
issn = {2164-554X},
mesh = {Humans ; Aged ; *Vaccination/methods ; *Healthy Aging/immunology ; Immunosenescence ; COVID-19 Vaccines/immunology/administration & dosage ; COVID-19/prevention & control/immunology ; Influenza Vaccines/immunology/administration & dosage ; Aged, 80 and over ; Pneumococcal Vaccines/immunology/administration & dosage ; *Aging/immunology ; },
abstract = {Aging reshapes immunity through immunosenescence and inflammaging, increasing susceptibility to infection, exacerbating chronic conditions, and blunting vaccine responses. This review frames "immunofitness" as a practical goal of healthy aging and examines how adult vaccination builds immune resilience. Vaccination strengthens adaptive memory, leverages adjuvants to optimize antigen presentation, and can reprogramme innate cells (trained immunity), yielding heterologous benefits beyond target pathogens. We integrate evidence in older adults for influenza, respiratory syncytial virus, pneumococcal, COVID-19, and recombinant zoster vaccines, including reductions in respiratory events, cardiovascular outcomes, hospitalization, and mortality. We highlight emerging platforms and precision vaccinology to tailor schedules by immune age, comorbidity, and frailty. Integrating routine, age-appropriate vaccination with lifestyle measures is a feasible, high-impact strategy to promote immunofitness.},
}

Humans
Aged
*Vaccination/methods
*Healthy Aging/immunology
Immunosenescence
COVID-19 Vaccines/immunology/administration & dosage
COVID-19/prevention & control/immunology
Influenza Vaccines/immunology/administration & dosage
Aged, 80 and over
Pneumococcal Vaccines/immunology/administration & dosage
*Aging/immunology

@article {pmid41665756,
year = {2026},
author = {Karaçam, Z and Ofei, P and Uzunoğlu, G and Güneş Öztürk, G},
title = {The effect of prenatal education on the fear of childbirth: A systematic review and meta-analysis.},
journal = {Archives of women's mental health},
volume = {29},
number = {1},
pages = {37},
pmid = {41665756},
issn = {1435-1102},
mesh = {Humans ; Female ; *Fear/psychology ; Pregnancy ; *Parturition/psychology ; *Prenatal Education/methods ; *Pregnant People/psychology ; COVID-19/psychology ; *Prenatal Care ; *Delivery, Obstetric/psychology ; },
abstract = {PURPOSE: To evaluate the effect of prenatal education on the fear of childbirth among pregnant women based on previously conducted studies.

METHODS: A systematic review and meta-analysis of randomized controlled trials and quasi-experimental studies was conducted following the PRISMA guidelines. The data were pooled through meta-analysis. ROBINS-I and RoB2 were used to assess the quality of the studies. The GRADE approach was used for evaluating the certainty of evidence.

RESULTS: The meta-analysis included 28 studies and the total sample size of the studies was 3073. The results showed that statistically, prenatal education significantly reduced the fear of childbirth during both the antepartum and postpartum period (SMD: -1.12, z = 9.14, p < 0.001; MD: -24.35, z = 6.18, p < 0.001 respectively). The meta-regression performed indicated that the study design, the course of the COVID-19 pandemic, data collection tools, the countries of the studies and features of education had no effect on the results of fear of childbirth in pregnancy. Moreover, the meta-analyses showed that prenatal education increased the likelihood of vaginal birth and the preference for vaginal birth approximately by two times and three times respectively (OR: 2.00, z = 4.82, p < 0.001; OR: 2.87, z = 3.89, p = 0.001 respectively). The certainty of evidence was low for fear of childbirth during pregnancy, moderate for fear of childbirth in the postpartum period and high for vaginal birth and preference for vaginal birth.

CONCLUSION: This study revealed that prenatal education was effective for reducing the fear of childbirth and therefore, increasing vaginal births.

REGISTRATION NUMBER: CCRD42022378547.},
}

Humans
Female
*Fear/psychology
Pregnancy
*Parturition/psychology
*Prenatal Education/methods
*Pregnant People/psychology
COVID-19/psychology
*Prenatal Care
*Delivery, Obstetric/psychology

@article {pmid41666787,
year = {2026},
author = {Cao, Q and Du, S and Yang, K and Liu, M and Xiao, L and Wang, Q and Fu, J and Zhu, H},
title = {Assessing the impact of SARS-CoV-2 infection and vaccination on fertility and assisted reproductive techniques outcomes: an umbrella review.},
journal = {Vaccine},
volume = {76},
number = {},
pages = {128293},
doi = {10.1016/j.vaccine.2026.128293},
pmid = {41666787},
issn = {1873-2518},
mesh = {Humans ; *COVID-19/prevention & control ; Male ; Female ; *Reproductive Techniques, Assisted ; *Fertility ; Semen Analysis ; Pregnancy ; SARS-CoV-2 ; *COVID-19 Vaccines/adverse effects ; *Vaccination/adverse effects ; Sperm Motility ; Sperm Count ; },
abstract = {OBJECTIVE: To assess the impact of SARS-CoV-2 infection and vaccination on fertility and assisted reproductive technology (ART) outcomes.

STUDY DESIGN: This is an Umbrella Review of Meta-analyses. We searched major databases until December 30, 2023. The quality of evidence was assessed by a Measurement Tool to Assess Systematic Reviews and the Grading of Recommendations, Assessment, Development and Evaluation.

RESULTS: Of 647 studies identified, 14 studies with 40 outcomes were included. COVID-19 infection may decrease semen quality in men, including semen volume (WMD, -0.48 ml; 95% CI, -0.59 to -0.36 ml), total sperm count (WMD, -34.84 × 10^6; 95% CI, -43.51 to -26.17 × 10^6), sperm concentration (WMD, -16.23 × 10^6/ml; 95% CI, -25.56 × 10^6 to -6.89 × 10^6), viability (SMD, -0.66; 95% CI, -1.27 to -0.06), and total sperm motility (SMD, -0.61; 95% CI, -0.96 to -0.25), and elevated levels of estradiol (SMD 0.652; 95% CI, 0.254 to 1.049; p = 0.001) and prolactin (SMD 0.305; 95% CI, 0.045 to 0.566; p = 0.022). However, it did not significantly affect testosterone levels. Notably, even after recovery (over 90 days), sperm concentration and motility remained lower compared to uninfected individuals. Conversely, COVID-19 showed minimal impact on female ovarian reserve (including antral follicle count, AMH) or ART outcomes (including oocyte number and quality, embryo quality, implantation rates, clinical pregnancy rates and miscarriage rates). Vaccination also had minimal effects on both sexes. Evidence quality was generally very low, highlighting the need for high-quality, long-term studies.

CONCLUSION: SARS-CoV-2 infection primarily affects male fertility, leading to reductions in sperm quality, count, and motility. However, female fertility and ART outcomes show little to no impact. COVID-19 vaccination shows minimal impact on fertility and ART outcomes. The quality of evidence is rated as very low to low. High-quality prospective studies with longer follow-up periods are needed.},
}

Humans
*COVID-19/prevention & control
Male
Female
*Reproductive Techniques, Assisted
*Fertility
Semen Analysis
Pregnancy
SARS-CoV-2
*COVID-19 Vaccines/adverse effects
*Vaccination/adverse effects
Sperm Motility
Sperm Count

@article {pmid41666990,
year = {2026},
author = {Mahroum, N and Elsalti, A and Alsharif, M and Jabri, A and Ouban, A},
title = {Autoimmunity in the era of immune checkpoint inhibitors: the evolving epidemiology of autoimmune diseases and the possible impact of COVID-19.},
journal = {Autoimmunity reviews},
volume = {25},
number = {3},
pages = {104002},
doi = {10.1016/j.autrev.2026.104002},
pmid = {41666990},
issn = {1873-0183},
mesh = {Humans ; *Immune Checkpoint Inhibitors/adverse effects/therapeutic use ; *COVID-19/immunology/epidemiology/complications ; *Autoimmune Diseases/epidemiology/immunology ; *SARS-CoV-2/immunology ; *Autoimmunity/drug effects ; *Neoplasms/drug therapy/immunology ; Female ; },
abstract = {Immune checkpoint inhibitors (ICIs) have markedly improved the prognosis of previously fatal malignancies, as evidenced by substantial gains in overall and progression-free survival in multiple clinical trials. The mechanism of action of ICIs is based on altering the immune response while the reported side effects display clear autoimmune features. Designated as immune-related adverse events (irAEs) affect nearly every organ system, including the gastrointestinal tract, liver, and thyroid gland, and share features with autoimmune disorders of the same organs. The severity of irAEs ranges from mild to life-threatening reactions. Many cases require systemic corticosteroids, hospitalization, and in many instances the discontinuation of ICI therapy. In this review, we present the history of ICIs, their indications, and the reported irAEs in a systematic manner. We then focus on the autoimmune nature of these side effects, with particular attention to the epidemiology of autoimmune diseases, including their female preponderance in certain age groups. In the final sections, we discuss how irAEs may be altering the epidemiology of autoimmune disease and address the possible effect of COVID-19 as a potential trigger.},
}

Humans
*Immune Checkpoint Inhibitors/adverse effects/therapeutic use
*COVID-19/immunology/epidemiology/complications
*Autoimmune Diseases/epidemiology/immunology
*SARS-CoV-2/immunology
*Autoimmunity/drug effects
*Neoplasms/drug therapy/immunology
Female

@article {pmid41668135,
year = {2026},
author = {Mayers, T and Terunuma, Y and Inokuchi, R and Guantai, F and Ring, HZ and Akashi, J},
title = {Barriers and facilitators to healthcare access for refugee, immigrant, and migrant populations during the COVID-19 pandemic: an overview of reviews.},
journal = {BMC health services research},
volume = {26},
number = {1},
pages = {},
pmid = {41668135},
issn = {1472-6963},
abstract = {BACKGROUND: Refugee, immigrant, and migrant (RIM) populations experienced unique obstacles to healthcare during the COVID-19 pandemic. Already facing displacement, insecure legal status, and economic instability, RIM populations were further affected by service disruptions, discrimination, and systemic weaknesses. The objective of this overview of reviews was to synthesize evidence on barriers and facilitators to healthcare access for RIM populations during the COVID-19 pandemic.

METHODS: This review followed the PRISMA 2020 guidelines and the protocol was registered in PROSPERO (CRD42024552590). Systematic searches of Embase, CINAHL, MEDLINE, PubMed, CENTRAL, Web of Science, and Google Scholar (January 2020 onward) identified systematic reviews addressing healthcare access for RIM during COVID-19. Two reviewers independently screened studies, extracted data, and assessed methodological quality using AMSTAR 2. Narrative synthesis was used to categorize barriers and facilitators into cross-cutting domains following a socio-ecological model framework.

RESULTS: Nine systematic reviews (published 2021–2024) met inclusion criteria, encompassing 14–256 primary studies each, and spanning low-, middle-, and high-income settings across the Americas, Europe, Africa, the Middle East, and Asia. Nine interacting domains of barriers and facilitators emerged involving legal constraints, economic concerns, service provision, physical and digital access, trust and confidence, information and communication, cultural and social influences, psychological and perceptual factors, and structural/systemic weaknesses. Common barriers included fear of deportation, exclusion from national health or social protection systems, job and income loss, high direct and indirect costs, service closures, overcrowded housing, discrimination, and misinformation. Facilitators included suspension of exclusionary policies, telemedicine and digital tools, mobile clinics, multilingual and culturally appropriate communication, messaging from trusted clinicians and community leaders, and civil society engagement.

CONCLUSIONS: This overview shows that the pandemic both intensified long-standing barriers and prompted innovative solutions for RIM healthcare access. Lessons from the pandemic can help guide future sustainable, inclusive health systems for displaced populations.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-026-14138-5.},
}

@article {pmid41668138,
year = {2026},
author = {Parks, OB and Kalavacharla, A and Williams, JV},
title = {Respiratory virus immune response in the aged host.},
journal = {Immunity & ageing : I & A},
volume = {23},
number = {1},
pages = {10},
pmid = {41668138},
issn = {1742-4933},
support = {R21 AI180460/AI/NIAID NIH HHS/United States ; R01 AI085062/AI/NIAID NIH HHS/United States ; F30 HL159915/HL/NHLBI NIH HHS/United States ; HL159915/HL/NHLBI NIH HHS/United States ; AI085062//National Institute of Allergy and Infectious Diseases/ ; T32 GM008208/GM/NIGMS NIH HHS/United States ; },
abstract = {Viruses are a major cause of acute respiratory illness in older adults and pose a substantial burden as the elderly population continues to grow. In the current COVID-19 global health crisis, achieving a better understanding of the aging immune system proves to be an imperative step in preventing and treating respiratory viral infections in older patients. Furthermore, many common respiratory viruses infecting older adults, including human metapneumovirus and parainfluenza virus, do not have licensed vaccines, thereby increasing the risk of severe infection in the aged host. Moreover, given the slowed immune response of older adults, vaccine efficacy for respiratory viruses such as influenza in older adults is minimal, indicating the need to develop more potent vaccines. A better understanding of the aging immune system would allow vaccines to target immunological deficits in the aged host. Three aspects of the aging immune system affect the response to respiratory viruses and vaccines: [1] innate immunity [2], the “inflammaging” hypothesis, and [3] the adaptive immune response. Several innate immune cells (neutrophils, macrophages, dendritic cells, and natural killer cells) as well as adaptive immune cells (T and B lymphocytes) exhibit significant functional impairment in older adults. The inflammaging hypothesis bridges the innate and adaptive arms of the immune system. This review aims to consolidate current knowledge and fill gaps in our understanding of the aged immune response to respiratory viruses.},
}

@article {pmid41668155,
year = {2026},
author = {Tiwary, P and Oswal, K and Tzvetkov, NT and Litvinova, O and Atanasov, AG and Varghese, R},
title = {Travel microbiota: a novel frontier in travel medicine exploring microbial shifts across transportation modes.},
journal = {Tropical diseases, travel medicine and vaccines},
volume = {12},
number = {1},
pages = {9},
pmid = {41668155},
issn = {2055-0936},
abstract = {BACKGROUND: Between 2010 and 2019, international travel increased by approximately 52.2%, highlighting the world's dependence on transportation for global connectivity. Although travel enhances global interactions, it also poses risks to public health through the potential transmission of diseases. The rapid global transmission of infectious diseases, exemplified by the outbreaks of COVID-19 and Zika virus, underscores the critical need for in-depth research into travel-associated disease dissemination. When individuals travel, they are exposed to a variety of diverse microbial environments, which can affect their healthy microbiome. In this review, we introduce the concept of "travel microbiota" to encapsulate the dynamic shifts in human microbial communities induced by travel across different transportation modes. This disruption can affect metabolic and immune functions and potentially facilitate the spread of diseases. Given these implications, it is crucial to investigate how different modes of transportation affect the human microbiota. Our study reviews the impact of travel on the human microbiota, highlighting differences across transportation modes. The objective is to establish a framework for understanding travel health and the role of microbiota in managing travel-related health risks. A comprehensive understanding of this relationship is essential for developing preventive strategies to safeguard and restore the human microbiota.

METHODS: To provide the specific content, relevant publications were identified on Google Scholar, PubMed, and Science Direct using specific keywords such as dysbiosis, gut, health, microbiome, microbiota, pathogens, travel, and transportation. We did not add any limits to the publication date during the inclusion of papers. However, it is noteworthy that the initial reports, including the aforementioned keywords, have been published starting from 2015.

CONCLUSION: Travel has a profound impact on the human microbiota, and it is essential to consider the implications associated with various modes of transportation. Traveling through various modes of transportation, such as roadways, airways, and maritime, has significantly influenced human microbiota. Moreover, it acts as a dynamic interface for microbial exchange driving rapid shift in microbial diversity, community convergence, and the diversification of resistant genes. However, the underlying mechanism of these changes remains elusive. By integrating evidence across multiple modes of transportation, this review highlights travel as an underrecognized determinant of microbiome variability and introduces the term "Travel microbiota". Moreover, this review is pivotal for understanding the ways in which travel alters microbial diversity and developing effective interventions. It is imperative to conduct future research that focuses on conducting large-scale longitudinal studies to assess the effects of traveling on microbial composition and to develop potential preventive measures.},
}

@article {pmid41668172,
year = {2026},
author = {Kim, DY and Youn, J and Kang, N and Cho, SI and Ha, IH},
title = {Potential application of brain-gut axis-based treatments in Long COVID and ME/CFS: a case-based systematic review.},
journal = {Journal of translational medicine},
volume = {24},
number = {1},
pages = {},
pmid = {41668172},
issn = {1479-5876},
mesh = {Humans ; *COVID-19/complications/therapy/physiopathology ; *Fatigue Syndrome, Chronic/therapy/physiopathology ; Electroacupuncture ; SARS-CoV-2 ; *Brain-Gut Axis/physiology ; Male ; *Brain/physiopathology ; Adult ; Female ; Middle Aged ; },
abstract = {BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID share clinical features including persistent fatigue, post-exertional malaise (PEM), and gastrointestinal (GI) dysfunction. Growing evidence implicates brain-gut axis dysregulation, characterized by dysbiosis, neuroinflammation within the central nervous system (CNS), increased intestinal permeability, and microbial translocation in their pathophysiology. However, therapeutic strategies targeting these pathways remain poorly defined.

METHODS: We report a case of post-COVID ME/CFS successfully treated with electroacupuncture (EA)-based deep peroneal nerve stimulation which was employed to potentiate the vagal reflex. Fatigue trajectories were assessed using the Multidimensional Fatigue Inventory over 12 weeks. Based on the case, a systematic review of randomized controlled trials (RCTs) evaluating brain-gut axis-modulating interventions in ME/CFS or Long COVID was conducted.

RESULTS: The patient exhibited a significant reduction in total fatigue, with early improvements in motivation and mental fatigue, and delayed improvement in physical fatigue following transient systemic symptom flares. Across included RCTs (n = 8, 790 participants), four investigated gut microbiome-modulating therapies and four employed nerve stimulation. Synbiotic and herbal interventions demonstrated benefits for fatigue or PEM, accompanied by alterations in specific bacterial populations or CNS metabolisms. Regarding nerve stimulation, transcranial direct current stimulation (tDCS) combined with exercise program improved fatigue, whereas standalone tDCS, auricular or peripheral TENS showed limited efficacy.

CONCLUSION: Brain-gut axis-based interventions may alleviate fatigue in ME/CFS and Long COVID by potentially modulating neuroinflammation, restoring microbiome balance, and improving epithelial barrier function. EA-based vagal stimulation represents a feasible option for patients with severe or treatment-resistant symptoms. Larger mechanistic studies and rigorously designed RCTs are needed to establish therapeutic targets and optimize intervention strategies.},
}

Humans
*COVID-19/complications/therapy/physiopathology
*Fatigue Syndrome, Chronic/therapy/physiopathology
Electroacupuncture
SARS-CoV-2
*Brain-Gut Axis/physiology
Male
*Brain/physiopathology
Adult
Female
Middle Aged

@article {pmid41671715,
year = {2026},
author = {Antunez Martinez, OF and Vallejo Bustamante, YI and Varela Zuniga, NO},
title = {Mapping the advanced practice nursing in emergency and intensive care units: A scoping review.},
journal = {International emergency nursing},
volume = {85},
number = {},
pages = {101764},
doi = {10.1016/j.ienj.2026.101764},
pmid = {41671715},
issn = {1878-013X},
mesh = {Humans ; *Advanced Practice Nursing/methods/standards ; *Intensive Care Units/organization & administration ; *Emergency Service, Hospital/organization & administration ; COVID-19/nursing ; Clinical Competence/standards ; *Nurse's Role ; *Emergency Nursing ; },
abstract = {BACKGROUND: Advanced Practice Nurses (APNs), including Nurse Practitioners and Clinical Nurse Specialists, contribute significantly to quality, efficiency, and leadership in emergency departments (EDs) and intensive care units (ICUs). However, role variability, inconsistent regulation, and limited post-pandemic evidence remain challenges.

PURPOSE: To synthesize recent global evidence on APN roles, competencies, outcomes, and implementation challenges in EDs and ICUs, and identify strategies for effective integration.

METHOD: A scoping review, following Arksey and O'Malley's framework and PRISMA-ScR guidelines, searched six databases. Eligible sources focused on APNs in EDs or ICUs. Two reviewers independently screened, extracted, and synthesized data descriptively and thematically.

FINDINGS: Twenty-five studies were included, showing APNs' main competences as advanced clinical reasoning, procedural skills, leadership, and evidence-based practice. Challenges involved role ambiguity, regulatory gaps, and limited autonomy. Post-COVID-19 developments expanded APN responsibilities but exposed workforce and educational gaps. Solutions proposed included standardized competencies, policy reform, postgraduate education, and interprofessional collaboration.

CONCLUSIONS: APNs enhance outcomes and efficiency in EDs and ICUs, but variability in role definitions limits impact. The current body of evidence surrounding APN practice in ICUs and EDs is primarily based on studies with low levels of evidence. Future implementation should be accompanied by rigorous evaluations to generate robust statistical evidence that supports the transferability of APN-led models.},
}

Humans
*Advanced Practice Nursing/methods/standards
*Intensive Care Units/organization & administration
*Emergency Service, Hospital/organization & administration
COVID-19/nursing
Clinical Competence/standards
*Nurse's Role
*Emergency Nursing

@article {pmid41672424,
year = {2026},
author = {Gracidas, C and Levy, R and Varon, J and Halma, M},
title = {Lactate, Capnia, and Fat Oxidation as Therapeutic Axes for SARS-CoV-2 Spike Protein-Induced Sequelae.},
journal = {Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme},
volume = {58},
number = {3},
pages = {90-102},
doi = {10.1055/a-2794-9646},
pmid = {41672424},
issn = {1439-4286},
mesh = {Humans ; *COVID-19/metabolism/complications ; *Spike Glycoprotein, Coronavirus/metabolism ; Oxidation-Reduction ; *SARS-CoV-2/metabolism ; *Lactic Acid/metabolism ; Post-Acute COVID-19 Syndrome ; Fatty Acids/metabolism ; COVID-19 Vaccines/adverse effects ; },
abstract = {Metabolic alterations characterize a large subset of those with post-acute COVID-19 syndrome, and similar symptoms affect those with post-acute COVID-19 vaccination syndrome. These symptoms are characterized by the triumvirate of post-acute COVID-19 (vaccination) syndrome symptoms: post-exertional malaise, fatigue, and cognitive impairment, commonly referred to as brain fog. These symptoms can be recreated through perturbations that disrupt mitochondria, and spike protein has been observed to disrupt mitochondria in vitro, providing mechanistic support for this relationship. Post-acute COVID-19 (vaccination) syndrome patients suffer from a severely decreased lactate threshold and can experience symptoms of overexertion even at low power output. Furthermore, biopsies have revealed disrupted mitochondria, and energetics and physiological studies have shown that lipid oxidation constitutes a significantly reduced fraction of total energy production/consumption in post-acute COVID-19 (vaccination) syndrome patients. This review explores the therapeutic axes of lactate, carbon dioxide, and fatty acid oxidation for resolving the energy production challenges in post-acute COVID-19 (vaccination) syndrome, suggesting interventions that increase the lactate threshold, increase tissue oxygenation (paradoxically through increasing partial pressure of CO2), and increase the rates at which lipids are oxidized relative to carbohydrates. Analogies from the world of exercise science are introduced, comparing post-acute COVID-19 (vaccination) syndrome to an overabundance of fast-twitch muscle fibers, with oxygenation similar to that experienced at high altitude, and presenting as an inverse 'fat adaptation' phenomenon, as observed in endurance athletes, especially those adopting low-carbohydrate diets.},
}

Humans
*COVID-19/metabolism/complications
*Spike Glycoprotein, Coronavirus/metabolism
Oxidation-Reduction
*SARS-CoV-2/metabolism
*Lactic Acid/metabolism
Post-Acute COVID-19 Syndrome
Fatty Acids/metabolism
COVID-19 Vaccines/adverse effects

@article {pmid41673122,
year = {2026},
author = {Pan, Q and Wang, W and Janssen, HLA and Zhong, Z},
title = {Status and outlook of mRNA therapeutics for viral diseases.},
journal = {EMBO molecular medicine},
volume = {18},
number = {3},
pages = {861-872},
pmid = {41673122},
issn = {1757-4684},
support = {12K0323N//Fonds Wetenschappelijk Onderzoek (FWO)/ ; 91719300//ZonMw (Netherlands Organisation for Health Research and Development)/ ; },
mesh = {Humans ; *RNA, Messenger/genetics/therapeutic use/immunology ; COVID-19/prevention & control ; *Virus Diseases/therapy ; SARS-CoV-2 ; Animals ; Antiviral Agents/therapeutic use ; Antibodies, Neutralizing/immunology ; },
abstract = {Endemic and emerging viral diseases continue to impose significant health, economic, and societal burdens worldwide. Vaccines and therapeutics represent two key pillars in the fight against these threats. Since the clinical success of mRNA vaccines during the COVID-19 pandemic, mRNA therapeutics have rapidly evolved from a niche innovation into a validated and versatile medical platform. While early efforts focused primarily on vaccine development, recent advances have expanded the scope to antiviral applications of in vitro-transcribed mRNA. Emerging strategies include in vivo expression of neutralizing antibodies for passive immunization, delivery of innate immune effectors such as interferons and antiviral peptides, and programmable CRISPR-based antiviral systems. In parallel, progress in mRNA delivery technologies has enabled clinical translation, although challenges related to stability, specificity, and immunogenicity remain. In this Perspective article, we review recent preclinical and clinical advances in mRNA therapeutics for viral infections. We also highlight key scientific, technical, and regulatory challenges, and propose strategic solutions to address the pressing need for controlling endemic viral diseases and enhancing global pandemic preparedness.},
}

Humans
*RNA, Messenger/genetics/therapeutic use/immunology
COVID-19/prevention & control
*Virus Diseases/therapy
SARS-CoV-2
Animals
Antiviral Agents/therapeutic use
Antibodies, Neutralizing/immunology

@article {pmid41673927,
year = {2026},
author = {Gasmi, M and Torabinasab, K and Williams-Hooker, R and Marsigliante, S and Muscella, A},
title = {The neutrophil-to-lymphocyte ratio as a marker of immunosenescence and COVID-19 outcomes in the elderly: A narrative review.},
journal = {Physiological reports},
volume = {14},
number = {3},
pages = {e70682},
pmid = {41673927},
issn = {2051-817X},
mesh = {Humans ; *COVID-19/immunology/blood ; *Neutrophils/immunology ; *Immunosenescence ; Aged ; *Lymphocytes/immunology ; Biomarkers/blood ; SARS-CoV-2 ; *Aging/immunology ; Prognosis ; Lymphocyte Count ; Aged, 80 and over ; },
abstract = {Older adults are highly vulnerable to severe COVID-19. Unlike our previous work on broad immunosenescence, this review focuses on peripheral hematological markers as practical indicators of risk. To examine lymphopenia, neutrophilia, and the neutrophil-to-lymphocyte ratio (NLR) as clinically accessible markers of immune aging and COVID-19 severity in older adults. Literature search of PubMed, Scopus, and Web of Science (up to 2025) for studies on aging, immunosenescence, lymphopenia, neutrophilia, NLR, and COVID-19. These markers consistently correlate with worse COVID-19 outcomes; NLR is a simple, reliable indicator of immune dysregulation, systemic inflammation, and mortality risk. Lymphopenia, neutrophilia, and elevated NLR are low-cost, readily measurable markers associated with COVID-19 severity, highlighting their prognostic value and complementing prior immunosenescence research.},
}

Humans
*COVID-19/immunology/blood
*Neutrophils/immunology
*Immunosenescence
Aged
*Lymphocytes/immunology
Biomarkers/blood
SARS-CoV-2
*Aging/immunology
Prognosis
Lymphocyte Count
Aged, 80 and over

@article {pmid41674460,
year = {2026},
author = {McTiernan, K and Hughes, C and Gilheaney, Ó},
title = {Cognitive Communication, Voice and Swallowing Difficulties Experienced by Adults With Long-COVID: A Scoping Review.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {29},
number = {1},
pages = {e70595},
pmid = {41674460},
issn = {1369-7625},
mesh = {Humans ; *COVID-19/complications ; *Deglutition Disorders/etiology ; *Voice Disorders/etiology ; *Communication ; Adult ; SARS-CoV-2 ; *Communication Disorders/etiology ; },
abstract = {BACKGROUND: Adults with Long-COVID frequently experience impairments in cognitive-communication, voice and swallowing, however, few comprehensive reviews of the existing literature has yet to be conducted to map the current research landscape. To go some way toward addressing this gap, this scoping review collected and analysed relevant published studies to identify reported symptoms related to cognitive communication, voice and swallowing in post COVID-19 patients and the assessments used to identify these difficulties.

OBJECTIVE: This study aimed to systematically map the existing literature on cognitive-communication, voice and swallowing difficulties in individuals living with Long-COVID and the assessments used to identify these difficulties.

METHODS: Four databases were searched to identify original research articles aligned with the study's objectives. Studies meeting the inclusion criteria were selected, and the findings were analysed with a specific focus on three key symptom domains: cognitive-communication, voice and swallowing.

RESULTS: Nineteen studies met the inclusion criteria. A broad range of assessments were used, and a broad range of symptoms were identified related to cognitive-communication, voice and swallowing difficulties in patients with Long-COVID-19. The symptoms reported most frequently in the selected studies included memory deficits, incomplete or inefficient glottic closure, paradoxical vocal fold motion during inspiration, episodes of choking, globus sensation, premature spillage and pyriform sinus residue.

CONCLUSION: Despite limited prior research in this area, the findings underscore the significant impact that COVID-19 infection may have on cognitive communication, voice and swallowing functions. Post-COVID-19 patients report a wide array of challenges in these domains. As a result, further clinical research is essential to develop patient-centred care strategies and to equip healthcare professionals with the expertise required for effective management of this group of patients.},
}

Humans
*COVID-19/complications
*Deglutition Disorders/etiology
*Voice Disorders/etiology
*Communication
Adult
SARS-CoV-2
*Communication Disorders/etiology

@article {pmid41675121,
year = {2026},
author = {Elizabeth, L and Shanthi, B and Cherupanakkal, C and Joseph, JJ and Anirudhan, A and Vaidyanathan, K},
title = {Exploring the Interplay Between Micronutrients and Cytokine Storm in Children with Multisystem Inflammatory Syndrome: 'A Potential Mechanical Insight'.},
journal = {Indian journal of clinical biochemistry : IJCB},
volume = {41},
number = {1},
pages = {5-16},
pmid = {41675121},
issn = {0970-1915},
abstract = {Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition linked to SARS-CoV-2 infection. MIS-C is characterized by inflammation in several organ systems, including the heart, lungs, kidneys, brain, skin, and eyes. Although MIS-C symptoms can vary widely, typical symptoms include fever, stomach ache, nausea, vomiting, diarrhea, rash, red eyes, and exhaustion. Although the pathogenesis of MIS-C is not yet fully understood, studies have shown that an uncontrolled immunological response known as a "cytokine storm" may play a role in the development of MIS-C. Several studies have related micronutrient deficiencies to chronic immunological activation, increased inflammation, increased cytokine production, and increased chance of developing a persistent viral infection. Studies have shown that children with MIS-C had lower micronutrients, including vitamin D, C, and zinc, than do healthy kids. Deficits in these nutrients, which are crucial for controlling the immunological response, may make the immune system less able to fight off infections and cause MIS-C. In conclusion, research on the connection between MIS-C and micronutrient deficiencies is still in its early stages. Although there is some evidence linking the two, additional research is required to determine a cause and effect.},
}

@article {pmid41675728,
year = {2026},
author = {Ahsan, A and Ibrahim, O and Ayesha, M and Hassni, AA and Saif, S and Mahin, FE and Khan, S and Tague, C},
title = {Fusion of molecular mimicry, epigenetic predisposition, and new onset GBS: a narrative review of current understanding and future directions.},
journal = {Annals of medicine and surgery (2012)},
volume = {88},
number = {2},
pages = {1532-1540},
pmid = {41675728},
issn = {2049-0801},
abstract = {Guillain-Barré syndrome (GBS) is a severe immune-driven polyneuropathy marked by the acute onset of flaccid paralysis, areflexia, and in severe cases, life-threatening autonomic or respiratory failure. Although the clinical presentation and diagnostic criteria are widely established, the precise mechanisms underlying GBS are complex and poorly understood. This review summarizes current literature on the interplay of post-infectious triggers, molecular mimicry, and host susceptibility as influenced by genetic and epigenetic variables. Infectious pathogens such as Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, and, more recently, Zika and SARS-CoV-2 operate as initiators via molecular mimicry, in which pathogen antigens imitate peripheral nerve components, triggering the formation of autoreactive antibody and T-cell responses. Acute inflammatory demyelinating polyneuropathy (AIDP) is characterized by demyelination and inflammatory cytokine responses, whereas acute motor axonal neuropathy (AMAN) is associated with ganglioside-targeting antibodies and axonal loss. Genetic polymorphisms, such as those in HLA, TLR4, MMP9, and CD1A, influence vulnerability to the disease and its progression. Given that many patients experience persistent sensory, motor, and autonomic dysfunction despite treatment, the identification of long-term complications highlights the necessity of customized rehabilitation and long-term follow-up. Traditional therapeutic techniques, such as plasma exchange and intravenous immunoglobulin, remain in use, but current trials on complement inhibitors, antibody-degrading enzymes, and mesenchymal stem cell therapies indicate a move toward mechanism-driven approaches. Despite these advances, significant knowledge gaps remain regarding predictors of poor outcomes and underlying causes of persistent disabilities and complications, highlighting the need for continued translational and clinical research.},
}

@article {pmid41675944,
year = {2026},
author = {Madi, M},
title = {Viral Contributions to Periodontal and Peri-implant Disease: A Narrative Review.},
journal = {Saudi journal of medicine & medical sciences},
volume = {14},
number = {1},
pages = {14-22},
pmid = {41675944},
issn = {2321-4856},
abstract = {Periodontal diseases, particularly periodontitis, are chronic inflammation with complex microbial and immunological etiologies. While bacterial pathogens such as Porphyromonas gingivalis are well-known contributors, emerging evidence indicates the role of viruses, especially herpesviruses, in the onset and progression of periodontal tissue destruction. In this review, the interplay between viral infections and periodontal health was explored, with an emphasis on the immunopathological mechanisms in which different viruses such as human herpesvirus, Epstein-Barr virus, and human cytomegalovirus aggravate periodontal tissue destruction. These viruses impair host defenses, promote bacterial colonization, and alter cytokine responses, leading to periodontal tissue damage. The review also addresses the impact of systemic viral infections, such as HIV and COVID-19, on periodontal diseases. Elevation in inflammatory mediators, including interleukin-6, link periodontitis with adverse clinical outcomes in viral infections. Moreover, interactions between P. gingivalis and respiratory viruses suggest oral pathogens may also influence systemic disease severity. Advances in diagnosis using molecular technology have improved viral detection in periodontal tissues, and previous studies support the use of antiviral therapies and gene-targeted interventions as potential adjuncts to traditional periodontal care. The integration of preventive strategies, such as vaccination and enhanced oral hygiene, is crucial in reducing the systemic consequences of viral-periodontal interactions. This review highlights the need for interdisciplinary collaboration and continued research to fully comprehend the virological dimensions of periodontal disease and develop effective, targeted therapeutic approaches.},
}

@article {pmid41677601,
year = {2026},
author = {Muir, KC and Harris, DD and Kanuparthy, M and Hu, J and Nho, JW and Stone, C and Banerjee, D and Sellke, FW and Feng, J},
title = {Cellular and Molecular Mechanisms of SARS-CoV-2 Spike Protein-Induced Endothelial Dysfunction.},
journal = {Cells},
volume = {15},
number = {3},
pages = {},
pmid = {41677601},
issn = {2073-4409},
support = {P20GM103652/GF/NIH HHS/United States ; 1R56HL169501-01/GF/NIH HHS/United States ; R01HL179089/GF/NIH HHS/United States ; 1R01HL176640-01/GF/NIH HHS/United States ; T32HL16051703/GF/NIH HHS/United States ; R01HL46716/GF/NIH HHS/United States ; R01HL128831/GF/NIH HHS/United States ; },
mesh = {Humans ; *Spike Glycoprotein, Coronavirus/metabolism ; *COVID-19/virology/pathology/metabolism ; *SARS-CoV-2/metabolism ; Angiotensin-Converting Enzyme 2/metabolism ; Animals ; *Endothelium, Vascular/pathology/physiopathology/metabolism/virology ; Endothelial Cells/metabolism/pathology/virology ; },
abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is initiated by the viral spike proteins, which are key structural components that mediate host cell binding and entry and alter downstream signaling through multiple interactions with endothelial surface receptors. Endothelial dysfunction is a central consequence of COVID-19, contributing to vascular inflammation, barrier disruption, thrombosis, and multi-organ injury affecting the pulmonary, cardiovascular, cerebral, and renal systems. Emerging evidence demonstrates that spike protein-mediated effects, independent of productive viral infection, disrupt endothelial homeostasis through angiotensin-converting enzyme 2 (ACE2) dysregulation, integrin engagement, altered calcium signaling, junctional protein remodeling, oxidative stress, and pro-inflammatory and pro-apoptotic pathways. This review is intentionally focused on spike (S) protein-driven mechanisms of endothelial dysfunction; pathogenic vascular effects attributed to other SARS-CoV-2 structural proteins, including the nucleocapsid (N) protein, are beyond the scope of this discussion. In this review, we synthesize current experimental and translational data detailing the molecular mechanisms by which the SARS-CoV-2 spike protein drives endothelial dysfunction across multiple organ systems and discuss potential therapeutic strategies aimed at preserving endothelial integrity in acute COVID-19 and its long-term vascular sequela.},
}

Humans
*Spike Glycoprotein, Coronavirus/metabolism
*COVID-19/virology/pathology/metabolism
*SARS-CoV-2/metabolism
Angiotensin-Converting Enzyme 2/metabolism
Animals
*Endothelium, Vascular/pathology/physiopathology/metabolism/virology
Endothelial Cells/metabolism/pathology/virology

@article {pmid41678250,
year = {2026},
author = {Lebel, RD and Sanders, J and Menges, JI},
title = {Beyond positivity: A review of the functional outcomes of negative emotions at work.},
journal = {Journal of occupational health psychology},
volume = {31},
number = {1},
pages = {1-15},
doi = {10.1037/ocp0000422},
pmid = {41678250},
issn = {1939-1307},
mesh = {Humans ; *Emotions ; *COVID-19/psychology/epidemiology ; *Workplace/psychology ; SARS-CoV-2 ; },
abstract = {Organizational scholars examining the effects of emotions on employees generally assume that negative emotions produce negative outcomes. However, a nascent body of research challenges this view, suggesting that negative emotions can help employees navigate work demands arising from disruptive external events. We draw on the COVID-19 pandemic-a salient, prolonged event that stimulated widespread negative emotions-as a theoretically meaningful context to explore when and why negative emotions may yield beneficial outcomes. Specifically, we provide an integrative conceptual review synthesizing research from applied and social psychology conducted during the pandemic that identifies two pathways through which negative emotions produce functional individual-level outcomes at work. The first pathway captures direct effects driven by the unique action tendencies associated with discrete negative emotions. The second pathway, informed by the personality systems interaction theory, highlights contingent effects shaped by self-regulatory factors and external support from leaders, teams, or organizational policies. Our findings challenge and extend discrete emotion and affective shift theories by detailing how and under what conditions negative emotions from disruptive events can have functional outcomes. We bring necessary nuance to prevailing emotion theories and offer practical implications for leaders and organizations seeking to manage negative emotions during the times of hardship. (PsycInfo Database Record (c) 2026 APA, all rights reserved).},
}

Humans
*Emotions
*COVID-19/psychology/epidemiology
*Workplace/psychology
SARS-CoV-2

@article {pmid41678920,
year = {2026},
author = {Ogawa, T and Sunyi, J and Kawachi, K and Murakami, J and Masuta, S and Fukuchi, J and Yoshida, S and Sawanobori, K and Matsukura, Y},
title = {Regulatory approaches for platform-based vaccine development in Japan: Insights from PMDA's experience with COVID-19 and RSV vaccines.},
journal = {Vaccine},
volume = {76},
number = {},
pages = {128315},
doi = {10.1016/j.vaccine.2026.128315},
pmid = {41678920},
issn = {1873-2518},
mesh = {Humans ; Japan/epidemiology ; *COVID-19 Vaccines/immunology ; *Respiratory Syncytial Virus Vaccines/immunology ; *Vaccine Development/legislation & jurisprudence/methods ; *COVID-19/prevention & control ; *Respiratory Syncytial Virus Infections/prevention & control ; SARS-CoV-2/immunology ; Vaccines, Synthetic ; },
abstract = {The concept of a "platform" in vaccine development and regulatory evaluation has emerged as a strategic framework for accelerating responses to infectious disease outbreaks. By leveraging prior knowledge and applying consistent manufacturing and analytical procedures across multiple products-such as mRNA, viral vector and recombinant protein vaccines-platform approaches enable streamlined development and efficient regulatory reviews. This article presents a Japanese regulatory perspective on platform-based vaccine development, drawing on the Pharmaceuticals and Medical Devices Agency (PMDA)'s experience with both emergency and routine evaluations. Through case-based analyses of COVID-19 vaccines reviewed under emergency conditions and the subsequent post-pandemic evaluation of RSV vaccines under standard timelines, we illustrate how prior knowledge and regulatory flexibility supported timely and robust reviews. These insights contribute to the global dialogue on regulatory science and offer practical considerations for future vaccine innovation.},
}

Humans
Japan/epidemiology
*COVID-19 Vaccines/immunology
*Respiratory Syncytial Virus Vaccines/immunology
*Vaccine Development/legislation & jurisprudence/methods
*COVID-19/prevention & control
*Respiratory Syncytial Virus Infections/prevention & control
SARS-CoV-2/immunology
Vaccines, Synthetic

@article {pmid41678951,
year = {2026},
author = {Lailaturrahmi, L and Caliph, S and Vu, T and Larson, I},
title = {Teaching clinical skills online in pharmacy education: a scoping review.},
journal = {Currents in pharmacy teaching & learning},
volume = {18},
number = {5},
pages = {102607},
doi = {10.1016/j.cptl.2026.102607},
pmid = {41678951},
issn = {1877-1300},
mesh = {Humans ; *Education, Pharmacy/methods/trends ; *Education, Distance/methods/trends ; *Clinical Competence/standards ; Curriculum/trends ; COVID-19/epidemiology ; *Teaching/standards ; },
abstract = {Background The integration of online teaching and learning in pharmacy curricula has increased since the worldwide rapid transition to remote teaching during the COVID-19 pandemic. However, how clinical skills were taught online in pharmacy education, including the types of skills, approaches and technologies used, and the outcomes remain poorly understood. Objective To provide an overview of the types of clinical skills taught online in pharmacy education; and to identify the purposes, teaching strategies, technologies used, educational settings, enabling and limiting factors, and reported outcomes to inform future curriculum development in pharmacy education. Methods The scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) Scoping Review methodology. A systematic literature search was conducted in MEDLINE, CINAHL, and ERIC databases using predefined inclusion and exclusion criteria, and the records were independently screened by four reviewers. Any discrepancies during the screening process were resolved through discussion. The data were extracted and then analyzed using content analysis and thematic analysis. Results A total of 349 studies were retrieved and proceeded to title and abstract screening. After applying the inclusion and exclusion criteria, 152 full-text articles were assessed for eligibility, of which sixty-four articles were included in the final review. Online synchronous, asynchronous, and blended learning were implemented in pharmacy education to teach clinical skills, including communication skills and therapeutic decision-making skills. Clinical skills were most often taught online to improve the learning process. Learning outcomes measured by self-assessment or by educators were most commonly reported. Enablers, including institutional readiness and technology infrastructure, and barriers, including institutional unpreparedness and inadequate design, were also identified. Conclusion This scoping review provides guiding information to integrate online teaching and learning into pharmacy curricula, particularly for clinical skills development. By including multiple stakeholders' perspectives, this review offers useful insight for academics and faculty leaders to successfully teach clinical skills online to pharmacy students.},
}

Humans
*Education, Pharmacy/methods/trends
*Education, Distance/methods/trends
*Clinical Competence/standards
Curriculum/trends
COVID-19/epidemiology
*Teaching/standards

@article {pmid41681438,
year = {2026},
author = {Ibrahim, YM and Liu, C and Yu, Y and Yang, L and Chen, Q and Ma, W and Werid, GM and Li, S and Luo, J and Gao, S and Zhang, S and Fu, L and Wang, Y},
title = {Swine Enteric Coronaviruses: An Updated Overview of Epidemiology, Diagnosis, Prevention, and Control.},
journal = {Animals : an open access journal from MDPI},
volume = {16},
number = {3},
pages = {},
pmid = {41681438},
issn = {2076-2615},
support = {(cstc2022ycjh-bgzxm0183 and 22509C) and (2024YFHZ0110)//this work was supported by grants from the National Center of Technology Innovation for Pigs (NCTIP-XD/B19); the Chongqing Talent plan "contract system" project (cstc2022ycjh-bgzxm0183 and 22509C); the Sichuan Provincial Regional Innovation Cooperation Pr/ ; },
abstract = {Swine enteric coronaviruses (SECoVs), including transmissible gastroenteritis virus (TGEV), porcine epidemic diarrhea virus (PEDV), porcine deltacoronavirus (PDCoV), and swine acute diarrhea syndrome coronavirus (SADS-CoV), are major enteric pathogens causing severe diarrhea, dehydration, high neonatal mortality, and substantial global economic losses. Rapid viral evolution and recombination continually generate antigenically diverse variants that limit cross-protection and undermine vaccine efficacy, particularly for PEDV genogroup II strains that now dominate worldwide circulation. This review synthesizes current knowledge on epidemiology, diagnostic innovations, and emerging vaccine platforms, with emphasis on advances since 2022. Recent progress includes molecular surveillance tools, rapid point-of-care diagnostics, and next-generation vaccine technologies such as mRNA-based and virus-like particle platforms. However, significant knowledge gaps persist regarding viral evolution dynamics, co-infection synergies, and zoonotic spillover potential, particularly following documented human infections with PDCoV. Effective long-term control requires integrated genomic surveillance, strengthened farm-level biosecurity, rationally designed multivalent vaccines targeting conserved epitopes, and harmonized international surveillance systems to reduce outbreak risk and enhance pandemic preparedness at the human-animal interface.},
}

@article {pmid41682696,
year = {2026},
author = {Grosu, IA and Dobrin, ME and Marginean, C and Esanu, IM and Melinte, OE and Stavarache, IE and Dumitrache-Rujinski, S and Cioroiu, IB and Crisan-Dabija, RA and Vicol, C and Trofor, AC},
title = {Integrated Approach of Hematological Parameters and Glutathione as Predictors of Pulmonary TB Evolution: A Comprehensive Review.},
journal = {Journal of clinical medicine},
volume = {15},
number = {3},
pages = {},
pmid = {41682696},
issn = {2077-0383},
abstract = {In recent decades, the burden of TB has been gradually declining; however, with the emergence of COVID-19 and ongoing political conflicts, including the war in Ukraine, the proper functioning of healthcare services and TB control programs has been jeopardized. Recently, research has emphasized the importance of hematological parameters associated with inflammation, which can be easily analyzed through routine blood tests. Combining these parameters may have predictive value for various diseases, including pulmonary tuberculosis and even help monitor the effectiveness of treatment. Since there is no single hematological or inflammatory biomarker that provides precise and dynamic information about the success or failure of treatment, identifying individual markers or sets of biomarkers with higher sensitivity and specificity is essential. This is particularly important since sputum culture conversion at two months remains insufficiently sensitive and microscopy conversion has limited sensitivity and specificity in detecting treatment failure. Also, the analysis of the impact of the standard directly observed treatment, short-course regimen on pathogenic mechanisms also focuses on how it influences the interaction between inflammation and oxidative tissue degradation, by measuring plasma levels of glutathione. Utilizing a combination of hematological, inflammatory, and antioxidant biomarkers offers significant insights into systemic inflammatory responses in pulmonary tuberculosis patients, both before commencing treatment and during the entire duration of antituberculosis therapy. Combining different inflammatory parameters into a multiple biomarker can significantly enhance the accuracy of predicting prognosis and response to antibiotic chemotherapy. Identifying an optimal combination of biomarkers with predictive value is crucial for assessing treatment response and evaluating the effectiveness of anti-TB medication. Rather than developing or testing a composite prediction model, this review summarizes reported performance metrics from individual studies and highlights priorities for future prospective validation of integrated biomarker panels.},
}

@article {pmid41682807,
year = {2026},
author = {Carlini, F and Chiesa, AM and Verzina, M and Sassetti, C and Rigante, D and Esposito, S},
title = {Cutaneous Clues in Kawasaki Disease: Clinical Implications and Differential Diagnosis with Multisystem Inflammatory Syndrome in Children.},
journal = {Journal of clinical medicine},
volume = {15},
number = {3},
pages = {},
pmid = {41682807},
issn = {2077-0383},
abstract = {Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) are pediatric inflammatory conditions with overlapping mucocutaneous features that may complicate early diagnosis. We performed a narrative review of the literature to characterize and compare cutaneous manifestations reported in children with KD and MIS-C and to assess their diagnostic relevance. Published studies describing dermatologic findings in patients aged 0-18 years were reviewed. The analysis revealed a broad heterogeneity of skin manifestations in both conditions, ranging from classic polymorphous rash and acral erythema to atypical presentations, including annular, psoriasiform, vesiculobullous, urticarial, and erythema nodosum-like lesions. Reactivation at Bacillus Calmette-Guérin vaccination sites and associated mucocutaneous findings, such as conjunctivitis and oral changes, emerged as supportive diagnostic clues, particularly for incomplete KD. Considerable overlap in cutaneous phenotypes between KD and MIS-C was observed, especially in patients with persistent fever and systemic inflammation, highlighting the risk of diagnostic delay. These findings underscore the importance of recognizing atypical dermatologic patterns as part of an integrated diagnostic approach, as delayed identification may increase the risk of cardiovascular complications. Early recognition of cutaneous clues can support timely initiation of immunomodulatory therapy and improve clinical outcomes.},
}

@article {pmid41683451,
year = {2026},
author = {Wang, J and Xu, Y and Yang, Y and Zhang, B and Chen, S and Li, Z and Zhu, H and Yang, H and Wang, H and Zhou, Y and Cao, P and Zhai, B and Gong, Y},
title = {Structural Basis and Inhibitor Development of SARS-CoV-2 Papain-like Protease.},
journal = {Molecules (Basel, Switzerland)},
volume = {31},
number = {3},
pages = {},
pmid = {41683451},
issn = {1420-3049},
support = {KZ202210005001//R&D Program of Beijing Municipal Education Commission/ ; 242102311178//Science and technology project of Henan Province/ ; 252102520079//Henan Provincial International Science and Technology Cooperation Project/ ; },
mesh = {*SARS-CoV-2/enzymology/drug effects ; Humans ; *Coronavirus Papain-Like Proteases/antagonists & inhibitors/chemistry/metabolism ; *Antiviral Agents/chemistry/pharmacology ; *COVID-19 Drug Treatment ; *Protease Inhibitors/chemistry/pharmacology ; Ligands ; Binding Sites ; Protein Binding ; },
abstract = {Papain-like protease (PLpro), a crucial functional domain of the SARS-CoV-2 non-structural protein 3 (nsp3), plays a dual role in both hydrolyzing viral polyprotein precursors and modulating host immune responses. These critical functions position PLpro as a key target in the ongoing development of antiviral therapies for SARS-CoV-2. This review analyzes more than 100 PLpro-ligand co-crystal structures and summarizes the major binding modes between these ligands and PLpro. Most of these ligands bind to sites analogous to those targeted by the classical non-covalent inhibitor GRL0617, primarily involving the P3 and P4 subsites and the BL2 loop. Based on these structural insights, optimized inhibitors have expanded targeting beyond the canonical binding site to auxiliary regions such as the BL2 groove and the Val70 site, and in some cases toward the catalytic Cys111 buried within a narrow pocket. Certain ligands identified through various screening approaches bind to non-canonical or allosteric regions, such as the S1 and S2 sites or the zinc-finger domain, engaging PLpro through distinct interaction modes and thereby offering additional opportunities for PLpro inhibitor design. The review also discusses potential strategies for future PLpro inhibitor development informed by recent structural advances. Taken together, these structural and functional insights support ongoing efforts in the structure-guided design and optimization of PLpro inhibitors.},
}

*SARS-CoV-2/enzymology/drug effects
Humans
*Coronavirus Papain-Like Proteases/antagonists & inhibitors/chemistry/metabolism
*Antiviral Agents/chemistry/pharmacology
*COVID-19 Drug Treatment
*Protease Inhibitors/chemistry/pharmacology
Ligands
Binding Sites
Protein Binding

@article {pmid41683516,
year = {2026},
author = {Leka, K and Mamede, L and Vandeberg, E and Garigliany, MM and Ledoux, A},
title = {Natural Alkaloids as Antiviral Agents Against RNA Viruses: A Comprehensive and Mechanistic Review.},
journal = {Molecules (Basel, Switzerland)},
volume = {31},
number = {3},
pages = {},
pmid = {41683516},
issn = {1420-3049},
support = {40009257//Fund for Scientific Research/ ; 40021286//Fund for Scientific Research/ ; },
mesh = {*Antiviral Agents/pharmacology/chemistry/therapeutic use ; *Alkaloids/pharmacology/chemistry/therapeutic use ; Humans ; *RNA Viruses/drug effects ; Animals ; Virus Replication/drug effects ; SARS-CoV-2/drug effects ; RNA Virus Infections/drug therapy ; *Biological Products/pharmacology/chemistry ; },
abstract = {RNA viruses pose a persistent global threat due to their high mutation rates, zoonotic potential, and rapid adaptability. Emergence events have risen steadily, as demonstrated by major outbreaks caused by Influenza A, Ebola, Zika, and Chikungunya viruses, followed by the coronavirus epidemics of Severe Acute Respiratory Syndrome coronavirus (SARS-CoV-1) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and culminating in the COVID-19 pandemic. These characteristics frequently compromise the durability of existing vaccines and antiviral therapies, highlighting the urgent need for new antiviral agents. Alkaloids, a structurally diverse class of nitrogen-containing natural compounds, have gained attention for their ability to interfere with multiple stages of the viral life cycle, including entry, replication, protein synthesis, and host immune modulation. To our knowledge, this review compiles all currently reported alkaloids with antiviral activity against RNA viruses and summarizes their proposed mechanisms of action, distinguishing evidence from in vitro, in vivo, and in silico studies. Quaternary alkaloids are discussed separately because their permanent ionic charge enables distinctive interactions with membranes and host pathways. Although many findings are promising, clinical translation remains limited by incomplete mechanistic validation, scarce in vivo data, suboptimal bioavailability, narrow therapeutic windows, and inconsistent experimental methodologies. To advance the field, future research should prioritize RT-qPCR-based antiviral evaluation to accurately quantify viral replication, incorporate mechanistic assays to clarify modes of action, apply structure-activity relationship (SAR) approaches for rational optimization, and expand in vivo pharmacokinetic and efficacy studies to assess therapeutic feasibility. Overall, alkaloids represent a promising yet underdeveloped reservoir for next-generation antiviral discovery against rapidly evolving RNA viruses.},
}

*Antiviral Agents/pharmacology/chemistry/therapeutic use
*Alkaloids/pharmacology/chemistry/therapeutic use
Humans
*RNA Viruses/drug effects
Animals
Virus Replication/drug effects
SARS-CoV-2/drug effects
RNA Virus Infections/drug therapy
*Biological Products/pharmacology/chemistry

@article {pmid41683812,
year = {2026},
author = {Mahajan, S and Mahajan, S and Gusain, A},
title = {Interleukins in COVID-19 and SARS-CoV-2 Variants: Immunopathogenesis, Therapeutic Perspectives and Vaccine-Induced Immune Responses.},
journal = {International journal of molecular sciences},
volume = {27},
number = {3},
pages = {},
pmid = {41683812},
issn = {1422-0067},
mesh = {Humans ; *COVID-19/immunology/virology/therapy/pathology ; *SARS-CoV-2/immunology/genetics ; *COVID-19 Vaccines/immunology ; *Interleukins/immunology/metabolism/antagonists & inhibitors ; },
abstract = {The Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is characterized by profound immune dysregulation where interleukins play a central role in determining disease severity and response to interventions. This review summarizes the role of interleukins in the immunopathogenesis of COVID-19, with particular emphasis on differences observed across major SARS-CoV-2 variants. Pro-inflammatory interleukins like IL-1β, IL-6, IL-2, IL-17 and IL-18 are critically involved in cytokine storm, hyperinflammation, and acute respiratory distress syndrome, whereas anti-inflammatory cytokines like IL-10 contribute to immune regulation and resolution of inflammation. Elevated levels of IL-1α, IL-1β, IL-4, IL-8, IL-9, IL-16, IL-18 have been documented in the Delta variant as compared with the Omicron variant, with IL-6 being the most frequent interleukin reported to be increased across all SARS-CoV-2 variants relative to the ancestral Wuhan strain. Elevated IL-2, IL-4, IL-6, and IL-10 levels have been associated with Omicron sub-variants. The review encompasses interleukin-based therapeutic strategies, where several IL-1 and IL-6 inhibitors were studied across clinical trials, but only tocilizumab has shown some promise against severe COVID-19. IL-2, IL-6, IL-15 and IL-21 levels were positively correlated with IgG and neutralizing antibody activity after vaccination with longevity of post-vaccination immunity being determined by IL-2 and IL-7.},
}

Humans
*COVID-19/immunology/virology/therapy/pathology
*SARS-CoV-2/immunology/genetics
*COVID-19 Vaccines/immunology
*Interleukins/immunology/metabolism/antagonists & inhibitors

@article {pmid41683839,
year = {2026},
author = {Chen, JJ and Hsu, CW and Wang, HY and Stubbs, B and Chen, TY and Liang, CS and Chen, YW and Zeng, BS and Tseng, PT},
title = {Audiovestibular Dysfunction Related to Long COVID-19 Syndrome: A Systematic Review of Characteristics, Pathophysiology, Diagnosis, and Management.},
journal = {International journal of molecular sciences},
volume = {27},
number = {3},
pages = {},
pmid = {41683839},
issn = {1422-0067},
mesh = {Humans ; *COVID-19/complications/physiopathology/diagnosis ; SARS-CoV-2 ; *Vestibular Diseases/diagnosis/therapy/physiopathology/etiology ; Post-Acute COVID-19 Syndrome ; },
abstract = {Long COVID-19 syndrome (or so-called post-COVID-19) is indicated by miscellaneous symptoms, usually starting 3 months from the COVID-19 infection and lasting for at least 2 months, which cannot be explained by an alternative diagnosis. There has been more and more reports addressing the audiovestibular dysfunction related to long COVID-19 syndrome. Emerging evidence suggests that the linkage between audiovestibular dysfunction and long COVID-19 syndrome might rely on (a) direct inner ear system damage related to viral invasion and consequent inflammation, (b) micro thromboembolic events, which might result from the COVID-19-induced autoimmune reaction against endothelial cells, and consequent transient-ischemia and hypoxia of the auditory pathways, (c) the disturbed nerve conduction in vestibulocochlear nerves due to viral invasion, and finally (d) altered auditory cortex function, either imbalanced central gain or neurotransmitter disturbance. However, most of the aforementioned mechanism remained hypothetic and still needed further studies to approve or refute. This systematic review synthesizes current evidence on the characteristics, pathophysiology, diagnostic approaches, and management of audiovestibular dysfunction related to long COVID-19 syndrome. Literature searches across PubMed, Embase, ClinicalKey, Web of Science, and ScienceDirect (up to 15 December 2025) were conducted in accordance with PRISMA guidelines. Through this systematic review, we provided a schematic diagram of the physiopathology of long COVID-19 syndrome-related audiovestibular dysfunction. Further, we summarized the currently available diagnostic tools to explore the audiovestibular function in such patients. The currently available treatment, either pharmacotherapy or nonpharmacotherapy, mainly tackles idiopathic audiovestibular dysfunction but not specifically long COVID-19 syndrome-related audiovestibular dysfunction. Timely recognition and intervention may prevent progression to permanent hearing loss or vestibular disability, improving quality of life. Trial registration: PROSPERO CRD420251265741.},
}

Humans
*COVID-19/complications/physiopathology/diagnosis
SARS-CoV-2
*Vestibular Diseases/diagnosis/therapy/physiopathology/etiology
Post-Acute COVID-19 Syndrome

@article {pmid41684026,
year = {2026},
author = {Oh, H and Thi Thuy Tien, V and Ahmed, S and Choi, J and Ryu, KJ and Yang, J},
title = {Host Glycan-Lectin Interplay in SARS-CoV-2 Infection.},
journal = {International journal of molecular sciences},
volume = {27},
number = {3},
pages = {},
pmid = {41684026},
issn = {1422-0067},
support = {RS-2023-00219399//National Research Foundation of Korea/ ; RS-2025-02214302//Korea Health Industry Development Institute/Republic of Korea ; },
mesh = {Humans ; *Polysaccharides/metabolism/chemistry ; SARS-CoV-2/physiology ; *COVID-19/virology/metabolism ; *Lectins/metabolism/chemistry ; *Spike Glycoprotein, Coronavirus/metabolism/chemistry ; Virus Internalization ; Host-Pathogen Interactions ; Virus Attachment ; Receptors, Virus/metabolism ; *Betacoronavirus/physiology/metabolism ; },
abstract = {Glycan-mediated processes can be critical determinants of viral attachment and entry, yet for enveloped RNA viruses, including SARS-CoV-2, their mechanistic roles remain incompletely defined. This review synthesizes current structural and functional evidence for glycan engagement during SARS-CoV-2 attachment and entry. We describe the general viral entry pathways and their reliance on glycan recognition, followed by the interactions of the SARS-CoV-2 spike glycoprotein with host glycans, including ABO(H) blood group antigens, sialylated glycans, and endogenous lectins. Based on structural biology, glycobiology, and virology, we focus on how the spike protein exploits both glycan motifs and lectin receptors to enhance attachment, promote cellular uptake, or modulate host tropism. We contextualize these mechanisms by comparing glycan dependencies across other human viruses, including the influenza virus, HIV, and norovirus. Finally, we provide a comparative virological perspective to derive broad evolutionary insights into how enveloped viruses exploit the host glycans.},
}

Humans
*Polysaccharides/metabolism/chemistry
SARS-CoV-2/physiology
*COVID-19/virology/metabolism
*Lectins/metabolism/chemistry
*Spike Glycoprotein, Coronavirus/metabolism/chemistry
Virus Internalization
Host-Pathogen Interactions
Virus Attachment
Receptors, Virus/metabolism
*Betacoronavirus/physiology/metabolism

@article {pmid41684611,
year = {2026},
author = {Phanphairoj, K and Wisesrith, W and Chumwichan, S},
title = {Mapping research trends and competency domains in nursing-related digital and artificial intelligence technologies: A bibliometric analysis.},
journal = {International journal of nursing sciences},
volume = {13},
number = {1},
pages = {36-44},
pmid = {41684611},
issn = {2352-0132},
abstract = {OBJECTIVES: This study aimed to explore the research trends, thematic structures, and core competency domains in the field of nursing-related digital and artificial intelligence (AI) technologies.

METHODS: A bibliometric analysis was conducted in accordance with the PRISMA 2020 statement. Peer-reviewed articles published in English from 2015 to 2025 were retrieved from Scopus, Web of Science, and PubMed. Thematic clustering was conducted using the Louvain algorithm and cosine similarity. A subset of 66 frequently cited articles was then qualitatively synthesized to capture core competencies across clusters.

RESULTS: A total of 83,807 articles were included for bibliometric analysis. Of these, 66 articles were chosen for thematic analysis. Five major thematic clusters were identified: remote care in primary settings, oncology and palliative care, nurse education and training, safety and quality in nursing practice, and geriatric and dementia care. Additionally, four competency domains were identified: telehealth and remote communication, health systems and informatics, digital tools in practice, and AI-powered decision support. A clear shift in research focus was observed, with the emphasis transitioning from foundational digital skills before the COVID-19 pandemic to more advanced competencies during the post-pandemic digital transformation, encompassing ethical reasoning, immersive technology use, and AI integration.

CONCLUSIONS: Integrating digital and AI technologies is reshaping nursing practice across various thematic areas and competency domains, highlighting a transition from foundational digital tasks to AI-supported decision-making and ethically informed technology use. This study provides a structured overview of evolving competencies in digital nursing and synthesizes evidence to support future research, curriculum design, and policy planning.},
}