RevDate: 2026-08-13
CmpDate: 2026-07-29

Cairney P, S Intropido (2025)

The pursuit of equity in COVID-19 policy and policymaking: A qualitative systematic review.

Open research Europe, 5:167.

BACKGROUND: The COVID-19 pandemic produced a devastating and unequal effect on global population health and wellbeing. Although research demonstrated multiple COVID-19 inequalities, the pursuit of equity (to address unfair inequalities) remained politically contested and overshadowed by higher priority crisis responses. It is essential to learn from these experiences to inform future crisis responses and anticipate the lack of proportionate and sustained attention to inequalities. We seek to understand how COVID-19 equity research defines this policy problem, offers solutions, and considers their feasibility in complex and political policy processes.

METHODS: We conducted a qualitative systematic review (2024) to identify peer reviewed journal articles on COVID-19, policymaking, and equity in three databases (Web of Science, Scopus, Proquest). We sought articles providing a non-trivial reference to policymaking concepts, including 55 texts that meet the inclusion criteria, and adding 30 texts by snowballing. We used an immersive and inductive approach to identify key themes and show how the use of policy concepts and theories informs an overall narrative of COVID-19 equity research.

RESULTS: This research documents the unequal impact of the COVID-19 pandemic and policy, then identifies potential policy solutions and some hopes that governments will support them. However, it highlights a major gap between this aspiration for change versus political reality, and identifies barriers to the production and use of lessons for future crises.

CONCLUSION: Most governments appear to have learned few lessons about inequalities from their COVID-19 experiences. The literature suggests that most governments will contribute to very similar unfair inequalities in their responses to the next crisis.

RevDate: 2026-08-13
CmpDate: 2026-07-06

Ponnachan P, Dhawlarker A, Yasmin H, et al (2026)

Mechanisms and impact of long COVID: pathophysiology, neuropsychiatric effects and vaccination.

Frontiers in immunology, 17:1710777.

Long COVID or post-acute sequelae of COVID-19 is defined as an after-effect of acute COVID-19 infection. Its broad clinical symptoms include brain fog, shortness of breath, fatigue, joint, chest, or muscle pain, dysautonomia and neuropsychiatric symptoms such as anxiety, depression and post-traumatic stress disorder. It is estimated that 1 in every 5 COVID-19 survivors exhibit symptoms within the Long COVID bracket. An array of risk factors such as smoking habit, age, obesity, female sex, and prior hospitalization may increase the probability of a person developing Long COVID. While the underlying mechanisms of Long COVID remain elusive, we examine the various possible pathophysiologies involved in Long COVID. We take up impactful neuropsychiatric issues as another spectrum of Long COVID symptoms and the likely effect of various forms of COVID-19 vaccines. In this review, the focus will be on the main mechanisms associated with the development of long COVID, which include latent Epstein-Barr virus reactivation, molecular mimicry, virus persistence, autoantibodies, and mitochondrial dysfunction. Understanding these mechanisms shed light on the continued persistence of COVID-19 related symptoms long after the resolution of acute infection. For instance, the reactivation of Epstein-Barr virus in the immunocompromised context seen post-acute SARS-CoV-2 infection could lead to the symptoms commonly observed in Long COVID such as fatigue and brain fog. The Epstein-Barr virus could possibly disrupt mitochondrial function, explaining the fatigue commonly observed in Long COVID patients. Other factors such as continued presence of viral particles in specific areas such as the gut may result in continued inflammation, leading to manifestations such as fatigue, cognitive impairment and gastrointestinal dysfunction. Additionally, heightened and persistent presence of autoantibodies post-acute infection results in persistent symptoms and could potentially trigger the onset of autoimmune disorders. We also aim to revisit the diverse and prolonged effects of the COVID-19 pandemic that continue to affect the well-being and quality of human life.

RevDate: 2026-08-13
CmpDate: 2026-07-06

Oh SJ, Shin OS, JY Hur (2026)

From infection to dysfunction: viral triggers and antiviral immune factors in Alzheimer's disease pathology.

Frontiers in immunology, 17:1839357.

Neurodegenerative diseases and neurocognitive disorders increasingly appear to share a common and underappreciated contributor: the viral-immune axis in the brain. This review presents current evidence linking neurotropic viruses and host antiviral immunity to the onset and progression of neurodegeneration and neurocognitive dysfunction. We explore how viral infections, particularly by Herpesviruses, Severe Acute Respiratory Syndrome Coronavirus 2, and Human Immunodeficiency Virus, disrupt neural homeostasis through neuroinflammation, amyloidosis, tauopathy, and autophagy dysregulation in neurodegeneration including Alzheimer's disease (AD). Simultaneously, host antiviral mechanisms, including type I interferons and interferon regulatory factors, often amplify neuronal damage when dysregulated. By examining viral and immune interactions within the neurodegenerative diseases, this review aims to broaden our understanding of the viral-immune axis in the brain and inspire novel approaches to prevention and treatment.

RevDate: 2026-09-26
CmpDate: 2026-07-06

Wyszynski DF, Renz C, Espinueva A, et al (2026)

Remdesivir Use During Pregnancy: Findings From the Prospective COVID-19 International Drug Pregnancy Registry and Narrative Literature Review.

Journal of pregnancy, 2026(1):e8700344.

BACKGROUND AND AIMS: Remdesivir (RDV), an inhibitor of coronavirus replication including SARS-CoV-2, has been approved for the treatment of COVID-19. Nevertheless, its use during pregnancy lacks specific efficacy and safety data due to the exclusion of pregnant patients from clinical trials. Authorization for compassionate use in pregnant women was granted during the conduct of the Phase 3 clinical trials in adult patients hospitalized with moderate or severe COVID-19. Available evidence from prior studies suggests that no consistent safety concern has been identified, although available data remain limited. The most commonly reported adverse event (AE) is transaminitis, which rarely necessitates treatment discontinuation.

METHODS: Safety data for RDV exposure during pregnancy were collected by the COVID-19 International Drug Pregnancy Registry (COVID-PR) between December 2021 and November 2023. Information was obtained through self-administered online questionnaires completed during pregnancy and up to 1 year after live birth, with medical record corroboration when available.

RESULTS: Nine women reported a total of 15 AEs, with an additional seven AEs reported in three infants. Ten of these AEs were considered serious and included a life-threatening hypersensitivity episode. No consistent pattern of AEs suggestive of a specific safety concern was identified.

CONCLUSIONS: This study contributes additional observational safety data regarding RDV use during pregnancy. However, due to the small size of the study population and various study limitations, definitive conclusions about the safety of this treatment in pregnant populations cannot be drawn.

PLAIN LANGUAGE SUMMARY: RDV is a drug used to treat COVID-19 by blocking the virus from multiplying in the body. However, since pregnant women were not included in early clinical trials, we did not have much information about how safe and effective this drug is for them. During the pandemic, some pregnant women with severe COVID-19 were allowed to receive RDV through compassionate use programs, and our study is aimed at collecting data on their experiences. We looked at 23 pregnant women who took RDV between December 2021 and November 2023. Out of these, eight were followed through the end of their pregnancy, resulting in seven live births and one miscarriage. Some women and their babies experienced side effects, with the most common being temporary increases in liver enzyme levels, and one woman had a serious allergic reaction. Overall, no consistent pattern of adverse pregnancy or infant outcomes was identified. However, because only a small number of pregnancies were available for analysis and many participants were lost to follow-up, larger studies are needed to better understand the safety of RDV use during pregnancy.

RevDate: 2026-08-13
CmpDate: 2026-07-06

Zarrinpanah T, Mashhadi Abolghasem Shirazi M, Modarressi SMH, et al (2026)

Next-generation vaccine adjuvants: Integrating nanotechnology, systems immunology, and computational approaches for precision vaccinology.

Human vaccines & immunotherapeutics, 22(1):2684345.

Vaccines based on purified antigens, recombinant proteins, and nucleic acid platforms increasingly depend on adjuvants to induce robust, durable, and appropriately polarized immune responses in humans. While classical adjuvants such as aluminum salts and oil-in-water emulsions have enabled the success of many licensed vaccines, their largely empirical design limits adaptability to emerging pathogens and population-specific needs. This review presents a translational framework for next-generation vaccine adjuvant development by integrating nanotechnology-based delivery systems, innate immune signaling mechanisms, and systems-level computational strategies relevant to human vaccination. We summarize the mechanisms and clinical relevance of licensed and advanced adjuvants, including alum, MF59, AS01/AS04, saponins, toll-like receptor agonists, and lipid nanoparticles, with emphasis on influenza, HPV, herpes zoster, and COVID-19 vaccines. By linking immunological mechanisms with delivery engineering and predictive modeling, this review highlights rational strategies to support safer and more effective human vaccines.

RevDate: 2026-07-06

Ahuja S, Kanwar D, Silakari P, et al (2026)

Medicinal Chemistry Perspectives on Drug Repurposing: Innovative Approaches and Therapeutic Breakthrough.

Therapeutic innovation & regulatory science [Epub ahead of print].

Drug repurposing involves the discovery of new therapeutic uses of existing drugs that have already been approved by the regulatory authorities. It provides an alternative with more efficient approaches to traditional drug discovery, leveraging already known safety profiles, shortened development and financial costs. Current advances in computational biology, artificial intelligence and big-data analytics have expanded the range of opportunities for systematic repurposing, but the successful translation of these opportunities is increasingly dependent on the holistic input of medicinal chemistry. The therapeutic relevance of medicinal chemistry-guided repurposing is being investigated over a range of unmet medical conditions, such as complicated diseases, rare diseases and new health crises, such as the COVID-19 pandemic. In this review, we underscore the critical importance of medicinal chemistry, including structure-activity relationship analysis, molecular optimization, target engagement assay, and ADMET refinement, in supporting the efficacy and safety of repurposed candidates. We further discuss the co-existence of these strategies with in silico predictions of the target, virtual screening, and phenotypic assays to narrow down lead compounds and improve translational success. Additionally, the role of medicinal chemistry in personalized medicine is also taken into account, where special attention is paid to the possibility of modifying pharmacological characteristics to patient-specific molecular and biological phenotypes. The study aims to encourage researchers and clinicians to adopt the revolutionary potential of drug repurposing to enhance treatment decisions and overall health outcomes among a large number of patients. Moreover, in a medical landscape that is becoming more complex, drug repurposing can transform the pharmaceutical industry, accelerate the process of making viable therapy available, and facilitate the delivery of quality healthcare.

RevDate: 2026-10-19
CmpDate: 2026-07-06

Mirchevska G (2026)

The Emerging Global Threat of Candida auris: A Call for Enhanced Public Health Policy and Regional Coordination.

Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki), 47(2):73-83 pii:prilozi-2026-0020.

Antimicrobial resistance represents a paramount challenge to global public health in the 21st century. The multidrug-resistant fungal pathogen Candida auris poses a critical and escalating threat to global public health. Characterized by rapid nosocomial transmission, persistent environmental contamination, and resistance to multiple antifungal classes, C. auris challenges healthcare systems worldwide. Its independent emergence across distinct geographic clades and exponential rise in cases, exacerbated by the COVID-19 pandemic, underscore the urgent need for robust, coordinated response. This review synthesizes the current knowledge on C. auris with a focus on its implications for public health policy, particularly in the European and Balkan healthcare settings, where surveillance gaps and cross-border transmission risks remain pronounced. We analyze the key drivers of spread, including diagnostic misidentification, extensive antifungal resistance, and lapses in infection control, and evaluate the strain on surveillance and hospital preparedness. Effective mitigation is fundamentally dependent on implementing comprehensive, multi-faceted infection prevention and control strategies, guided by antifungal stewardship and rapid diagnostics. We conclude that addressing the C. auris threat requires an urgent, coordinated international and regional response focused on strengthening surveillance networks, standardizing diagnostic and infection prevention and control protocols, and fostering data sharing across borders to contain this resilient pathogen.

RevDate: 2026-07-30
CmpDate: 2026-07-06

Mugwagwa T, Marcano Belisario J, Hartley L, et al (2026)

Evaluation of nirmatrelvir/ritonavir treatment for COVID-19 on health-related outcomes: a global economic value systematic literature review.

Journal of medical economics, 29(1):1875-1897.

AIMS: Nirmatrelvir/ritonavir (NMV/r)[i] is an antiviral drug indicated for the treatment of patients with mild to moderate coronavirus disease 2019 (COVID-19) who are at high risk of progressing to severe disease. We performed an updated economic systematic literature review (eSLR) of NMV/r to build upon evidence reported in our previous eSLR and additionally examine the health-related outcomes associated with NMV/r and any potential effect of long COVID.

METHODS: A systematic search of Embase, PubMed, Cochrane, and EconLit and of conference and health technology assessment agency websites was performed to identify economic analyses published between January 2022 and October 2025.

RESULTS: Of the 33 included economic evaluations, most were cost-utility analyses (n = 16) and used an analysis of a short-term decision tree with a long-term Markov model (n = 11). Several types of health-related endpoints were reported by studies, with most including hospital-related endpoints (n = 20), quality-adjusted life-years (QALYs) (n = 18), and death-related endpoints (n = 18). Positive health-related outcomes were associated with NMV/r treatment, including reductions in hospitalizations and deaths and an increase in QALYs. NMV/r treatment was also associated with a reduced number of patients with long COVID complications.

LIMITATIONS: Most studies were conducted in high-income countries, were based on different COVID-19 variants, and were limited in data on the long COVID population.

CONCLUSION: In addition to monetary benefits, NMV/r provides short-term and long-term health-related benefits to patients with mild to moderate COVID-19. This study provides further support for NMV/r as a cost-effective treatment option.

RevDate: 2026-08-11
CmpDate: 2026-08-11

Kachanov A, Brezgin S, Kostyusheva A, et al (2026)

Safeguarding nanovesicles and their payload: A framework for stable storage.

Colloids and surfaces. B, Biointerfaces, 267:115956.

Recent advances in biomedical science have shifted therapeutic strategies toward biologics, nucleic acid-based medicines, and precision gene regulation, demanding equally sophisticated delivery and preservation vehicles. This shift is epitomized by the breakthrough of RNA therapeutics during the COVID-19 pandemic, which are now advancing into oncology, autoimmune disorders, and inflammatory diseases, alongside powerful gene-editing, and gene-regulation tools. Biological nanoparticles and, in particular, (EVs) are uniquely positioned to enable targeted delivery of these advanced strategies. Their favorable biodistribution, biocompatibility, biodegradability, and high loading capacity make them an ideal delivery platform. However, a critical translational gap remains: while experimental innovation accelerates, the practical knowledge of selecting appropriate dosage forms, storage conditions, and necessary stabilizers is lacking. This challenge extends beyond maintaining vehicle integrity to the crucial preservation of the therapeutic payload's activity. This review examines current advancements in EVs storage methods and conditions, highlighting the challenges for preserving functional activity of the payload. By evaluating preservation strategies and their effects on EV integrity and cargo stability, we discuss critical insights to enhance storage, ensuring both structural preservation of EVs and functionality of bioactive cargo.

RevDate: 2026-08-13
CmpDate: 2026-07-07

O'Donnell J, R Fenn (2026)

Respiratory Support in the Emergency Department: An Updated Systematic Review and Meta-Analysis.

Worldviews on evidence-based nursing, 23(4):e70165.

BACKGROUND: An estimated 20% of emergency department (ED) patients require respiratory support (RS). Evidence suggests that nasal high flow (NHF) reduces RS need.

AIMS: This is an update of a published review comparing NHF to non-invasive ventilation (NIV) or to conventional oxygen therapy (COT) in adult ED patients.

METHOD: This updated systematic review (SR) and meta-analysis (MA) methods reflect the Cochrane Collaboration's methodology. The search of six databases was first completed in July 2023 and then repeated in November 2025. Databases were searched for randomized controlled trials (RCTs) comparing NHF to COT or NIV in the ED. Three summary estimates were reported: (1) need to escalate care, (2) mortality, and (3) adverse events (AEs).

RESULTS: The updated search identified three new studies, bringing the total to 21 eligible RCTs (n = 2158). One of the six MA conclusions was statistically significant. Compared with COT, NHF showed no SS difference in the risk of escalation (RR 0.65; 95% CI [0.41, 1.04]; p = 0.07), mortality (RR 1.05; 95% CI [0.74, 1.51]; p = 0.77), and AE (RR was 0.98; 95% CI [0.6, 1.6]; p = 0.94) outcomes were found. Compared with NIV, NHF increased the risk of escalation by 86% (RR 1.86; 95% CI [1.26, 2.75]; p = 0.001), but mortality risk was not SS (RR 1.33; 95% CI [0.86, 2.06]; p = 0.20).

LINKING EVIDENCE TO ACTION: Evidence suggests NHF therapy may be an alternative to COT in managing RS in EDs. While NHF may not be as effective as NIV at preventing escalation, it does not increase mortality risk, offering a nuanced approach to RS tailored to patient-specific needs. This evidence-informed decision-making can enhance patient outcomes. However, further research is needed, especially given the COVID-19 pandemic's impact on ED research.

RevDate: 2026-07-07

Liu W, Wang B, Cosco TD, et al (2026)

Prevalence of anxiety and depressive symptoms among older adults during COVID-19 lockdowns: a systematic review and meta-analysis.

Aging & mental health [Epub ahead of print].

BACKGROUND: The COVID-19 lockdowns presented an unprecedented challenge to public mental health. The impact of these lockdowns on older adults remains unclear. To quantify the prevalence of anxiety and depressive symptoms among older adults during COVID-19 lockdowns, we conducted this systematic review and meta-analysis.

METHODS: We systematically searched nine electronic databases for relevant literature published in English or Chinese, covering the period from January 1, 2020, to November 29, 2024. The Joanna Briggs Institute Critical Appraisal tool was used to assess the risk of bias. A random-effects model was used to calculate the overall pooled prevalence.

RESULTS: A total of 51 articles, encompassing 57 studies, satisfied the inclusion criteria and included data from 26,616 participants across 23 countries. The estimated prevalence of anxiety and depressive symptoms was 12.82% (95% CI: 9.13-17.72) and 15.01% (95% CI:11.61-19.19), respectively. Factors significantly associated with anxiety symptom prevalence included the proportion of females, study quality, lockdown duration, international travel control policies, workplace closure policies, and changes in human mobility across six categories of location. Factors significantly associated with depressive symptom prevalence included study quality, international travel control policies, and public transport closure policies.

CONCLUSIONS: This study enhances our understanding of anxiety and depression symptoms among older adults during COVID-19 lockdowns, notably revealing the moderating effects of human mobility on anxiety symptoms. The findings offer tentative insights for comprehending and addressing the psychological impact of major public health emergencies on older adults.

RevDate: 2026-09-10
CmpDate: 2026-07-31

Almulla AF, Zhang Y, Tunvirachaisakul C, et al (2026)

Increased Insulin Resistance and Hyperglycaemia in Long COVID: A Systematic Review and Meta-Analysis.

Expert reviews in molecular medicine, 28:e38.

BACKGROUND: Accumulating evidence suggests that long COVID (LC) is mediated by chronic immune activation, oxidative stress and metabolic dysregulation. These processes may impair glucose homeostasis and promote insulin resistance (IR). However, no prior meta-analysis has systematically and quantitatively evaluated IR indices and related biomarkers in LC compared with normal controls.

OBJECTIVES: To systematically review and meta-analyse IR indices including HOMA-IR, HOMA-%B, HOMA-%S, insulin, fasting and random blood sugar (FBG, RBS), glycated haemoglobin (HbA1c), C-peptide and adipokine levels in individuals with LC compared with normal controls.

METHODS: PubMed, SCOPUS, SciFinder and Google Scholar databases were searched for relevant studies from inception to September 2025. Fifty-six eligible studies were included, comprising 9623 participants, 5340 LC patients and 4283 normal controls.

RESULTS: LC disease is characterized by elevated HOMA-IR (standardized mean difference, SMD = 0.539; 95% confidence interval, CI: 0.311; 0.766), insulin (SMD = 0.424; 95% CI: 0.113; 0.735), FBG and RBS (SMD = 0.734; 95% CI: 0.190; 1.277, SMD = 0.325; 95% CI: 0.133; 0.517). Furthermore, reduced HOMA-%S was observed in LC patients versus normal controls. Publication bias was generally low, though evidence of small-study effects was observed for several outcomes. The Immunological Confounder Scale was employed to evaluate study quality, revealing an overall intermediate methodological quality.

CONCLUSIONS: Our results show that LC is associated with multiple abnormalities in glucose homeostasis, including increased HOMA-IR, hyperglycaemia and impaired insulin sensitivity indices, sustained metabolic disturbances beyond the acute phase.

RevDate: 2026-10-05
CmpDate: 2026-10-05

Zhang Y, Chen J, Li J, et al (2026)

Advances in Antiviral Drug Development Targeting Viral Proteases.

Medicinal research reviews, 46(6):1871-1896.

Viral proteases are critical targets in antiviral drug development due to their essential role in the viral lifecycle and high conservation across viral strains. This review summarizes the recent progress of antiviral drugs based on protease structures, with a focus on the structural characteristics and inhibitor design strategies targeting Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Enterovirus 71 (EV71), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV). Based on the three-dimensional structure of proteases, various types of protease inhibitors such as peptidomimetic, non-peptidic, and natural product-derived inhibitors are discussed. Given the critical challenge of drug resistance in antiviral therapies, we address the mechanisms of protease inhibitor resistance and explore advanced strategies, including allosteric inhibition, dual-target inhibition, and Proteolysis-Targeting Chimeras (PROTAC) to overcome drug resistance. This review also explores the cutting-edge applications of artificial intelligence (AI) for viral protease-based antiviral drug discovery, providing valuable insights for the rational design and development of antiviral drugs.

RevDate: 2026-08-28
CmpDate: 2026-08-07

Kumar V, Qadri SH, Nardelli da Silva AB, et al (2026)

Ivabradine in the Treatment of POTS Before and After COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

Journal of cardiovascular pharmacology, 88(2):115-122.

Postural orthostatic tachycardia syndrome (POTS) is a debilitating autonomic disorder characterized by excessive orthostatic tachycardia and significant functional impairment. Conventional therapies, including beta-blockers, often provide incomplete relief or are poorly tolerated. Ivabradine, a selective If channel inhibitor, reduces heart rate without affecting blood pressure or myocardial contractility, making it a promising option, particularly in post-COVID-19 POTS. This systematic review and meta-analysis evaluated the efficacy and safety of ivabradine in patients with POTS. PubMed, Embase, and the Cochrane Library were searched through August 2025 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD420251073600). Eligible studies included randomized controlled trials, observational studies, and case series reporting ivabradine outcomes in POTS. Primary outcomes were changes in standing and supine heart rate; secondary outcomes included symptom burden, quality of life, and adverse events. A random-effects model was used, heterogeneity was assessed through sensitivity analyses, and certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development, and Evaluation. Nine studies involving 245 patients were included. Ivabradine significantly reduced standing heart rate (-18.5 bpm; 95% confidence interval -23.3 to -13.8) and supine heart rate (-9.7 bpm; 95% confidence interval -13.4 to -6.1). Symptom improvement particularly palpitations, lightheadedness, and exercise intolerance was consistently reported across classic, pediatric, hyperadrenergic, and post-COVID-19 subgroups. Adverse events were infrequent and mild, most commonly transient visual disturbances, with no reports of severe bradycardia or hypotension. Heterogeneity was high, largely driven by pediatric and post-COVID-19 cohorts. In conclusion, ivabradine seems to provide meaningful heart rate reduction and symptomatic improvement in POTS with a favorable safety profile. However, evidence is limited by small, heterogeneous, predominantly observational studies, underscoring the need for large, multicenter randomized controlled trials.

RevDate: 2026-09-10
CmpDate: 2026-08-26

Goldberg-Bockhorn E, Reich A, Vahl JM, et al (2026)

[Otorhinolaryngologic infections in the post-pandemic context: What can we learn from the literature?].

HNO, 74(9):590-598.

BACKGROUND: The epidemiology of various respiratory infections changed due to the impact of the COVID-19 pandemic. Lockdowns and other containment measures (nonpharmacologic interventions, NPI) led to a decline in virus circulation, resulting in fewer cases at hospitals and practices. Once restrictions were eased, a rebound effect was observed worldwide, resulting in an increase in viral and severe invasive bacterial infections.

OBJECTIVE: Various case series on different ear, nose, and throat (ENT) infections have been conducted in the context of the pandemic in Germany. These studies should be summarized and interpreted in the context of currently available data.

MATERIALS AND METHODS: The literature review focuses particularly on studies from Germany before, during, and after the pandemic, supplemented by European and international data.

RESULTS: Following the lifting of NPIs, a general increase in severe bacterial ENT infections was observed worldwide, particularly among children. Evidence from the underlying retrospective data from Germany is limited. For mastoiditis and complicated sinus infections, cohort studies showed no change in the bacterial spectrum or in the complication rate. Microbiological data for peritonsillar abscesses are currently lacking. Necrotizing fasciitis in the head and neck region increased globally. Reliable data from Germany are currently unavailable.

CONCLUSION: The increased susceptibility due to low exposure to pathogens during the pandemic and the simultaneous surge in post-pandemic virus circulation is believed to be the main cause of the rise in infections. The current data do not prove a direct influence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Vaccinations, strict hygiene measures, patient education, and monitoring could help to mitigate the severity of such phenomena in the future.

RevDate: 2026-08-13
CmpDate: 2026-07-07

Dai Y, Li S, He X, et al (2026)

Recent advances in functional studies of coronavirus NSP13 helicase and challenges in inhibitor development.

Virulence, 17(1):2696653.

Coronavirus helicase NSP13 is essential for viral replication and transcription and is a promising target for broad-spectrum anti-coronavirus drugs due to its high sequence conservation and structural homology. This review summarizes NSP13 sequence features, structural organization, and functional activities across the seven human-infecting coronaviruses. We outline key enzymatic properties, including duplex RNA/DNA unwinding and NTP hydrolysis, and describe how NSP13 cooperates with other nonstructural proteins to drive replication and transcription. Beyond canonical helicase roles, we discuss the genomic distribution of G-quadruplex (G4) elements in coronaviruses and potential functional connections between G4 structures and NSP13 in regulating the viral life cycle. Finally, we highlight recent progress in developing NSP13-targeting inhibitors and consider their potential utility against COVID-19 and other emerging coronaviruses, providing a rationale for broad-spectrum antiviral design.

RevDate: 2026-10-10
CmpDate: 2026-07-29

Vidal D, Castro ÍA, CB López (2026)

Implications of RNA virus persistence for post-acute sequelae and chronic inflammatory syndromes.

Nature immunology, 27(8):1553-1562.

Viral persistence refers to the ability of a virus to remain in its host for an extended period. Although most non-retroviral RNA viruses are traditionally known for causing acute, self-limiting infections, accumulating evidence of the detection of viral products long after the infectious virus is cleared suggests that RNA viruses can establish persistent infections. Persistent viral products include replication-competent viral genomes, viral proteins, mutated viruses or non-standard viral genomes. The persistence of viral products entails a continuous interaction with the host and is often associated with prolonged tissue inflammation and chronic disease. Here, we discuss emerging evidence of the persistence of viral products from viruses commonly considered to cause acute infections. We explore the known requirements for virus persistence and the implications for the development of post-acute sequelae and predisposition to chronic inflammatory syndromes.

RevDate: 2026-10-20
CmpDate: 2026-09-30

Parent-Lamarche A, Beauregard N, Blanc MÈ, et al (2026)

Teleworking and its impact on health and well-being: a systematic review of longitudinal studies considering the psychosocial work environment (2005-2024).

BMC public health, 26(1):.

BACKGROUND: Teleworking expanded dramatically during the COVID-19 pandemic and is expected to remain widespread. While it offers benefits such as greater autonomy and improved work-life balance, teleworking also poses challenges related to workload, social isolation, and blurred boundaries between work and personal life, shaped by the psychosocial work environment. These contrasting effects raise questions about whether teleworking promotes or undermines workers' health. This systematic review synthesizes longitudinal evidence on the relationship between teleworking and workers' health, with particular attention to the role of the psychosocial work environment as an explanatory framework. Specifically, it addresses two questions: (1) What is the impact of teleworking on health (physical and mental) when psychosocial work environment factors are considered? (2) How have longitudinal studies examined the relationship between teleworking and health, including direct, mediation, and moderation effects, and how the role of teleworking in these relationships has been studied?

METHODS: This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42024599518). We searched five electronic databases (Embase, Medline, PsycInfo, Web of Science, CINAHL Plus) and bibliographies for longitudinal studies published between 2005 and 2024 in OECD countries. Eligible studies examined teleworking and workers' health (physical and/or psychological) in combination with psychosocial work environment factors. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment Tool. Data from 20 studies published between 2017 and 2024 were extracted and synthesized based on study and psychosocial work environment characteristics, as well as the nature of the association between telework and health outcomes.

RESULTS: All 20 studies were rated fair or good in methodological quality. Teleworking effects on health were heterogeneous and context-dependent, increasing psychological distress, exhaustion, and anxiety under high psychosocial risk (i.e., adverse work conditions such as high workload or work intensification, low autonomy, limited social support, job insecurity, reduced psychological detachment, and blurred work-nonwork boundaries) or mandatory arrangements, but protective with autonomy, supportive psychosocial conditions, or individual resources. Psychosocial work environment factors such as autonomy, job security, workload, and social support emerged as central determinants of health outcomes. Effects operated through moderation and mediation involving psychosocial work environment factors. Important gaps remain, particularly the limited investigation of physical health outcomes.

CONCLUSIONS: Teleworking is neither uniformly beneficial nor harmful. Its health impact depends on psychosocial work environment factors, individual characteristics, and contextual conditions. Longitudinal research should expand the range of psychosocial work environment factors examined, consider physical health outcomes, and investigate effects across pre-, during-, and post-pandemic periods. These insights are critical to inform evidence-based workplace interventions and organizational policies that promote employee health.

RevDate: 2026-10-09
CmpDate: 2026-10-01

Tsehay A, Menkir S, T Hailegebriel (2026)

Prevalence and associated risk factors of malaria in Amhara National Regional State: a systematic review and meta-analyses.

Malaria journal, 25(1):.

BACKGROUND: Malaria is a major parasitic infectious disease caused by Plasmodium species and remains a significant public health challenge in sub-Saharan African, including Ethiopia. The Amhara National Regional State is among the most malaria-affected region in Ethiopia. However, comprehensive evidence on the pooled prevalence of malaria and its associated risks in the region has been limited. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of malaria and identify its associated risk factors in Amhara National Regional State.

METHODS: A systematic search of studies published between 2013 to March 3, 2023, was conducted using PubMed, Springer nature, Science Direct, and Google Scholar. Eligible studies were selected based on predefined inclusion criteria. Data were extracted using Microsoft Excel and analysed with Stata version 17. Heterogeneity among studies was assessed using the inverse variance (I[2]) statistic, while publication bias was evaluated using Egger's regression test and funnel plot.

RESULTS: Out of 2,743 records initially identified, 43 studies met the inclusion criteria. The pooled prevalence of malaria in the Amhara National Regional State was 14% (95% CI 12.0-17.0%). Subgroup analysis showed that the highest (17%, 95% CI 4.0-30.0%) pooled prevalence was from South and North Gonder Zones, whereas the lowest (8%, 95% CI 5.0-11.0%) prevalence was observed in East Gojjam Zone. Malaria prevalence estimate varied according to the diagnostic methods; with microscopy reporting a prevalence of 16%; 95% CI 13.0-18% and combination of microscopy with RDT reporting 9%; 95% CI 4.0-14.0%. The prevalence increased from 13% (95% CI 10.0-17%) before the onset of COVID-19 pandemic to 15% (95% CI 14.0-10.0%) after the onset. Plasmodium falciparum was the predominant species, accounting 9% (95% CI 6-11%) of the infection followed by P. vivax at 5% (95% CI 4-5%). Significant predictors of malarial infection included, the presence of stagnant water near residences (OR = 2.64; 95% CI 2.09-3.34), engagement in outdoor night activities (OR = 1.69; 95% CI 1.33-2.16), and lack of insecticide treated net (ITN) utilization (OR = 2.05; 95% CI 1.71-2.46).

CONCLUSION: This systematic review and meta-analysis revealed that malaria remained a considerable public health burden in the Amhara National Regional State with Plasmodium falciparum as the dominant species. Malaria prevalence varied across administrative zones, diagnostic methods, study seasons, and study periods. Environmental and behavioural factors significantly contributed to malaria transmission, highlighting the need for a strengthened and targeted malaria prevention and controlled interventions in the region.

RevDate: 2026-10-09
CmpDate: 2026-10-08

Sewell PE, C Jensen (2026)

Clinical rationale for thymic restoration in adult immunosenescence.

Immunity & ageing : I & A, 23(1):.

Age-related thymic involution is a central feature of immunosenescence and intersects with multiple "hallmarks of aging", including genomic instability, telomere attrition, mitochondrial dysfunction, and chronic inflammation. The decline in thymic epithelial integrity and FOXN1-driven thymopoiesis reduces naïve T-cell output, contracts TCR repertoire diversity, and perturbs central tolerance, contributing to increased susceptibility to infection, cancer, and autoimmunity. These changes occur alongside broader immune-aging phenomena such as inflammaging and frailty and are reflected in poorer vaccine responses and altered outcomes to novel pathogens such as SARS-CoV‑2. This review integrates mechanistic, preclinical, and human data to reassess the adult thymus as a therapeutic target. Higher-confidence domains for thymic restoration include cancer immunosurveillance, infectious disease vulnerability, vaccine responsiveness, and post-treatment immune reconstitution, supported by modeling of age-related disease incidence, transplant and HIV cohorts, and new observational links between radiographic thymic health, mortality, and immunotherapy outcomes. High-plausibility but less directly validated domains include autoimmunity, chronic herpesvirus control, HIV immunological non-responders, and post-acute infection syndromes such as long COVID, which share convergent patterns of T-cell dysfunction and persistent immune activation. The translational landscape spans hormonal and somatotropic modulation (sex steroid ablation, growth hormone/ghrelin), cytokine and growth-factor strategies (IL‑7, IL‑22, KGF/BMP4, FGF21), cell- and tissue-engineering approaches leveraging thymic epithelial stem cells and FOXN1-reprogrammed stromal cells, and gene-therapy concepts such as intrathymic AAV delivery of FOXN1, AIRE, chemokines, and stromal-support pathways. Collectively, these data support the biological plausibility of adult thymus restoration but highlight that robust, domain-specific clinical benefits have not yet been demonstrated in controlled trials. Future work should prioritize harmonized structural and functional biomarkers, domain-focused interventional studies in high-risk populations, and combined strategies that situate thymus-directed interventions within broader efforts to modify immune and organismal aging.

RevDate: 2026-10-20
CmpDate: 2026-07-08

Aldana BI, K Freude (2026)

Chemokines in Alzheimer's Disease: Early Defence, Late Damage and the Impact of Sex and Infection.

Basic & clinical pharmacology & toxicology, 139(2):e70273.

Chemokines constitute a versatile signalling network maintaining homeostasis and glia-neuron communication in the healthy brain but become progressively dysregulated during aging and Alzheimer's disease (AD). This review examines how chemokine systems transition from tightly regulated homeostatic signals to drivers of chronic neuroinflammation in AD. We describe the major chemokine families (CC, CXC, CX3C) and their dominant central nervous system (CNS) receptors (CCR2, CXCR3, CX3CR1), which activate canonical inflammatory pathways including NF-κB, JAK/STAT and PI3K-AKT. In AD, chemokine dysregulation occurs in a coordinated manner across multiple functional modules, including recruitment-associated (CCL2, CXCL1), interferon-inducible (CXCL10), loss-of-restraint (CX3CL1) and vascular-associated chemokines. These alterations shift the network from regulated immune communication to self-sustaining inflammatory circuits perpetuating chronic neuroinflammation. These networks reprogram microglia and astrocytes into disease-associated phenotypes, amplify peripheral immune cell infiltration and destabilise synaptic function. Biological sex profoundly influences neuroinflammatory trajectories, with females exhibiting enhanced microglial senescence and interferon signalling, while males show accelerated complement activation. Viral pathogens, particularly neurotropic viruses (HSV-1, HHV-6, VZV) and SARS-CoV-2, actively reprogram chemokine networks, linking infection to amyloid-β accumulation, tau pathology and neurodegeneration. Therapeutically, chemokine axes represent precision targets requiring stage-matched, sex-stratified interventions rather than broad anti-inflammatory approaches. Understanding chemokine network dynamics offers mechanistic insights into AD pathogenesis and could provide pointers for therapeutic strategies.

RevDate: 2026-07-30
CmpDate: 2026-07-08

Kılıç S (2026)

Effectiveness of manual detorsion in the treatment of testicular torsion: systematic review and meta-analysis.

The Canadian journal of urology, 33(3):505-514.

OBJECTIVES: Testicular torsion is the most common surgical cause of an acute scrotum. Manuel detorsion renewed attention as a practical initial treatment, particularly in the COVID-19 pandemic. This study aims to systematically review and meta-analyze the current literature to determine whether manual detorsion offers a viable alternative to immediate surgery in improving testicular salvage rates.

METHODS: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD420251039489). Studies including ≥30 male patients comparing manual detorsion and surgical exploration were included. Searches were performed in PubMed/MEDLINE, Scopus, TR Index, and Web of Science. Risk of bias was assessed using a predefined scoring system based on methodology, sample size, and follow-up objectivity. Data were synthesized using RevMan 5.4 to calculate pooled risk ratios.

RESULTS: Eight retrospective studies involving a total of 670 patients were included. Patients were divided into a manual detorsion group (G1, n = 394) and a surgical exploration group (G2, n = 316). Success rates of manual detorsion ranged from 15% to 76%, while orchiectomy rates were lower in G1 (0% to 10.3%) compared to G2 (0% to 43.8%). The pooled success rate of manual detorsion was 75.7%. Although orchiectomy rates appeared numerically lower in the manual detorsion group (3.8% vs. 29.2%), the pooled analysis did not demonstrate a statistically significant overall difference between the two groups (risk ratio [RR] = 1.23; 95% CI: 0.82-1.84; p = 0.31).

CONCLUSION: Manual detorsion appears time-saving and effective maneuver. To our knowledge, this is the first meta-analysis focused exclusively on manual detorsion, and it supports its consideration as an initial management strategy in selected clinical scenarios.

RevDate: 2026-08-13
CmpDate: 2026-07-08

Kusunoki H, Sakai R, Watanabe Y, et al (2026)

Persistent excess mortality in post-pandemic Japan: current evidence, methodological limitations, and future directions.

Frontiers in public health, 14:1878166.

More than six years after the emergence of COVID-19, Japan continues to experience persistently elevated excess mortality despite entering a post-pandemic phase. Excess mortality, defined as the difference between observed and expected deaths, reflects both direct and indirect effects of the pandemic, including healthcare disruption, delayed care, and broader social changes. In Japan, mortality decreased slightly in 2020 but increased markedly from 2022 onward, with annual excess deaths approaching 100,000, despite widespread vaccination and the predominance of the less virulent Omicron variant. Multiple factors may underlie this sustained increase, including population aging, changes in healthcare access, delayed diagnosis and treatment, regional disparities, and psychosocial stress. Some ecological and observational studies have reported a statistical association between repeated COVID-19 booster vaccination and excess mortality in Japan; however, these findings do not establish causality, and a causal relationship cannot currently be concluded. Against this background, this narrative review examines persistent excess mortality in Japan, uses the literature on repeated booster vaccination as an illustrative example to highlight methodological limitations, and discusses the need for nationwide, linked individual-level data infrastructure and appropriate analytical frameworks for more robust future evaluations.

RevDate: 2026-08-13
CmpDate: 2026-07-08

You Q, Li J, Yang L, et al (2026)

Prevalence of secondary traumatic stress in nurses: a meta-analysis of observational studies.

Frontiers in public health, 14:1877091.

BACKGROUND: The reported prevalence of secondary traumatic stress (STS) among nurses varies considerably across studies, ranging from 22. 1 to 84.4%. This meta-analysis aimed to estimate the pooled prevalence of STS and identify potential moderating factors among nurses.

METHODS: From the inception of each target database to April 2026, a comprehensive search was performed across PubMed, Web of Science, Scopus, Embase, Cochrane Library, CINAHL, and PsycINFO. We calculated the pooled prevalence of STS using a random-effects model and assessed heterogeneity using the I[2] statistic. Subgroup analyses and meta-regression were conducted to explore potential sources of heterogeneity.

RESULTS: A total of 28 studies comprising 7,090 nurses were included. The pooled prevalence of STS in nurses was 57.3% (95% CI: 49.7-64.9%). STS prevalence was significantly associated with mean age (β = -0.064, p = 0.023), work experience (β = -0.080, p = 0.040), publication year (during COVID-19: β = 0.979, p = 0.024; after COVID-19: β = 0.848, p = 0.030), and geographic region (North America: β = -0.881, p = 0.019; Europe: β = -1.031, p = 0.005).

CONCLUSIONS: Our findings indicated that STS was very prevalent in nurses, and the prevalence is moderated by mean age, work experience, publication year, and geographic region. Regular STS assessments and multi-level support systems, such as early warning, peer support, and mental health training, are recommended to reduce STS risk and enhance the wellbeing of nurses.

RevDate: 2026-08-13
CmpDate: 2026-07-08

Sun C, Chen Q, Wang Y, et al (2026)

A visualization analysis of Traditional Chinese Medicine for influenza prevention and treatment: advances, hotspots, and future trends.

Frontiers in medicine, 13:1852941.

OBJECTIVES: As an acute respiratory infectious disease, influenza continues to impose a substantial public health burden worldwide. This study aims to systematically review the progress of research on the treatment of influenza with Traditional Chinese Medicine (TCM) from 2005 to 2025, identify current research hotspots, and forecast future development trends, in order to provide a clear and systematic reference framework for subsequent research.

METHODS: A bibliometric and scientometric analysis was conducted using the Web of Science Core Collection (WOSCC), PubMed, and Scopus databases. Following the PRISMA 2020 guidelines, the retrieved records underwent a comprehensive deduplication process and stringent quality control checks. By comprehensively applying CiteSpace, VOSviewer, and the R-based Bibliometrix package, metrics and visualization were performed across multiple dimensions, including publication volume, geographical contribution, annual trends, national/regional influence, core authors and institutions, and keywords.

RESULTS: A total of 1,527 publications were included in this study. Since 2014, publication output in this field has shown significant growth, with a rapid upward trend emerging after 2020. At the national and institutional level, China ranked first globally in both the number of publications and total citation frequency. Research institutions in China not only serve as the dominant force in this field but also act as hubs for international collaboration. Notable contributions were made by institutions such as the Chinese Academy of Sciences, Beijing University of Chinese Medicine, and the China Academy of Chinese Medical Sciences. Journal analysis revealed that the Journal of Ethnopharmacology is the most influential journal in this domain. In terms of scholarly impact, Yang Zifeng ranked first in both h-index and publication output, establishing them as the most prolific and influential core scholar in the field. Keyword analysis indicated that research focuses on core themes such as "herbal medicine" and "antiviral activity." The evolutionary trajectory demonstrates a shift from traditional clinical practice toward modern mechanistic investigation. Driven by emerging public health events such as COVID-19, the field has rapidly integrated cutting-edge methodologies like network pharmacology, reflecting distinct characteristics of contemporary responsiveness and interdisciplinary convergence.

CONCLUSION: This analysis confirms that TCM for influenza has matured into a structured and interdisciplinary research field. Substantial evidence supports its multi-component and multi-target therapeutic model as a clinically effective strategy against influenza. Future efforts should prioritize the integration of mechanistic insights with standardized clinical translation to enhance global antiviral preparedness.

RevDate: 2026-08-13
CmpDate: 2026-07-08

Kim SJ, KS Choi (2026)

Vaccination-driven evolution of infectious bronchitis virus in Korea: implication for the control of other coronavirus infections.

Frontiers in veterinary science, 13:1859772.

Infectious bronchitis virus (IBV) remains a major pathogen in global poultry production due to its extensive genetic diversity and rapid evolutionary capacity. Antigenic diversification driven by mutation, homologous recombination, and sustained immune selection pressure complicates long-term control and reduces vaccine effectiveness. Increasing evidence suggests that IBV evolution is largely driven by the selective expansion of pre-existing variants under changing ecological and immunological conditions, rather than by the de novo emergence of novel lineages. South Korea provides a valuable model for understanding these processes within intensive poultry systems characterized by high host density, extensive farm connectivity, widespread vaccination, and long-term molecular surveillance. Since its first isolation in 1986, IBV in Korea has undergone repeated cycles of lineage emergence, diversification, and replacement, culminating in the predominance of nephropathogenic GI-19 viruses, including KM91 and QX-like variants. Persistent co-circulation of multiple lineages, together with frequent recombination and regional viral introduction, has shaped a highly dynamic viral population. Within this environment, vaccination plays a central yet paradoxical role. While essential for disease control, widespread vaccination imposes continuous immune selection pressure and may contribute to co-circulation of vaccine-derived and field strains, facilitating recombination and the emergence of immune escape variants. These processes drive lineage turnover and antigenic mismatch between circulating viruses and vaccine strains, forming a vaccination-driven evolutionary cycle. This review integrates global IBV diversity with insights from the Korean system to propose an evolution-centered framework in which viral genetic plasticity, host population dynamics, and vaccination practices interact. These findings have important implications for optimizing vaccination strategies and provide broader insights into the evolutionary dynamics of rapidly evolving RNA viruses under sustained immune pressure.

RevDate: 2026-08-21
CmpDate: 2026-08-21

Gong H, C Cai (2026)

Plastic antibodies that see viruses: optical sensing with molecularly imprinted polymers.

Chemical communications (Cambridge, England), 62(57):14113-14125.

The need for rapid, sensitive, and selective detection of viral pathogens has never been more apparent. Molecularly imprinted polymers have emerged as robust synthetic receptors that rival biological antibodies in affinity and specificity, while offering superior chemical stability, low cost, and design flexibility. This Feature Article focuses on recent advances in the integration of virus-imprinted polymers with optical transducers, creating powerful platforms for viral diagnostics. We discuss key imprinting strategies including solid-phase synthesis, epitope imprinting, and nanogel approaches that enable precise recognition of whole viruses or their surface proteins. The optical readout mechanisms-fluorescence, resonance light scattering, colorimetric/visual detection, and surface plasmon resonance-are critically reviewed, with emphasis on signal amplification, multiplexing, and point-of-care deployment. Special attention is paid to the work of our group and others in engineering paper-based sensors, ratiometric probes, and smartphone-readable devices that detect viruses from Hepatitis A and B to SARS-CoV-2 and influenza at femtomolar or even attomolar levels. Current challenges and future directions for virus-imprinted optical sensors are discussed, highlighting the road toward commercial and clinical translation.

RevDate: 2026-07-08
CmpDate: 2026-07-08

Bendoumou M, Langlet P, T Gustot (2026)

Auto-immune hepatitis following COVID-19 Vaccination and SARS-COV2 infection : A narrative Review.

Acta gastro-enterologica Belgica, 89(2):341-354.

BACKGROUND AND OBJECTIVES: Since the onset of the COVID-19 pandemic, both SARS-CoV-2 infection and vaccination have been implicated as potential triggers for de novo autoimmune hepatitis (AIH). This review summarizes published cases, outlining clinical and biological features, treatment approaches, and outcomes.

METHODS: A PubMed search identified reports of new-onset AIH following SARS-CoV-2 infection or COVID-19 vaccination up to February 1, 2025. Inclusion criteria encompassed case reports, series, and reviews. Data were extracted on demographics, vaccine type, onset timing, laboratory findings, histology, treatments, and outcomes.

RESULTS: A total of 74 post-vaccination AIH cases and 22 post-infection cases were included. Post-vaccination AIH predominantly affected older women (median age 62) and occurred mainly after mRNA vaccines, with a median onset of 14 days. Most patients showed marked transaminase elevation, high IgG, and positive ANA (74.3%). Liver biopsies (performed in 92% of cases) showed features compatible with AIH. A total of 80% of the 50 cases of our study with available serology and liver histology were classified as probable / definite AIH, according to the simplified AIH score. Corticosteroid therapy was effective in most cases (survival 95.9%). Post-infection AIH cases showed similar features but affected younger individuals (median age 47), with uniformly favorable responses to immunosuppression.

CONCLUSIONS: New-onset AIH can occur following both SARS-CoV-2 infection or vaccination. Although these events remain rare, recognition of this association is essential for timely diagnosis and management.

RevDate: 2026-07-08

Hovnanian A, Mondon G, M Titeux (2026)

History and future of RNA medicines.

The Journal of investigative dermatology pii:S0022-202X(26)01279-0 [Epub ahead of print].

RNA therapeutics are a versatile class of medicines that exploit different types of RNA molecules to prevent or treat a wide spectrum of diseases. Compared with traditional small-molecule drugs, protein drugs, or gene therapies, these therapies offer notable advantages, including faster, less expensive development, and simplified manufacturing. The field encompasses multiple modalities, such as antisense oligonucleotides, small interfering RNAs, microRNAs, mRNAs, and aptamers. The success of mRNA vaccines against SARS-CoV-2 has accelerated research and clinical translation of RNA approaches for conditions with limited treatment options, including chronic wounds, aggressive metastatic melanoma, and autoimmune and genetic skin diseases.

RevDate: 2026-08-13
CmpDate: 2026-07-08

Li Y, Yu W, Yun J, et al (2026)

Virus infections and cancers: from mechanisms to therapeutics.

Molecular biomedicine, 7(1):.

Viral infections are a major contributor to global cancer incidence and mortality. However, integrative reviews that connect viral classification, carcinogenic mechanisms, tumor microenvironment remodeling, and translational strategies remain limited. This review summarizes the classification and epidemiological characteristics of major oncogenic viruses, including human papillomavirus (HPV), Epstein-Barr virus (EBV), hepatitis B virus (HBV), hepatitis C virus (HCV), Merkel cell polyomavirus (MCPyV), human T-lymphotropic virus type 1 (HTLV-1), Kaposi's sarcoma-associated herpesvirus (KSHV), and human immunodeficiency virus (HIV), as well as emerging viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We then discuss the molecular basis of virus-associated carcinogenesis, including viral oncogenes, viral DNA integration, epigenetic remodeling, aberrant host signaling, and metabolic dysregulation. We further examine how chronic inflammation and fibrosis create oncogenic niches within the tumor microenvironment (TME), how viruses promote tumor progression through immune evasion and immune exhaustion, and how infected cells interact with stromal and immune components of the TME. At the preventive and therapeutic levels, we discuss antiviral therapies, vaccines, biomarker-based precision diagnostics, and prognostic strategies, with particular attention to the synergistic potential of emerging therapeutic approaches such as immune checkpoint inhibitors (ICIs), CAR-T therapy, and oncolytic viruses (OVs). Finally, we highlight how multi-omics approaches, single-cell transcriptomics, spatial transcriptomics, organoid models, and artificial intelligence can advance mechanistic studies and translational innovation in virus-associated cancers. Overall, this review provides an integrated framework for understanding, preventing, and treating virus-associated tumorigenesis.

RevDate: 2026-10-19
CmpDate: 2026-09-07

Tse WC, Ajluni T, Chene C, et al (2026)

Safeguarding medical empathy and cultivating compassion in contemporary medicine.

Internal medicine journal, 56(9):1660-1663.

Empathy and compassion are both fundamental to patient-centred care, enhancing satisfaction, adherence and outcomes while improving clinician well-being. However, certain aspects of medical culture may put these emotional qualities at risk. The preclinical-to-clinical transition exposes students to hierarchical structures, time constraints and performance expectations prioritising technical competence over interpersonal skills. Negative role modelling, rushed consultations and inadequate emotional support normalise emotional detachment. The COVID-19 pandemic intensified burnout and moral injury, while societal desensitisation through social media compounds these effects. Although medical humanities programmes show promise, meaningful change requires addressing both curricula and clinical environments through structured reflection, compassion-focused training and recognising empathy fatigue as an occupational hazard, reaffirming medicine's ethical foundations.

RevDate: 2026-10-08
CmpDate: 2026-07-09

Mosa KA, Khare T, Syed F, et al (2026)

Plant Biofactories for Vaccination: Progress in Edible Vaccine Technologies as a Sustainable Approach to Global Immunization.

Plant foods for human nutrition (Dordrecht, Netherlands), 81(3):.

Globally, the pathogen-driven enteric diseases remain a leading cause of morbidity and mortality, disproportionately affecting populations in low-income regions. While significant strides have been made in vaccine research, challenges such as high production costs, complex manufacturing processes, and inefficient distribution continue to hinder global vaccine accessibility. To overcome these challenges, plant-based edible vaccines have emerged as a promising and innovative alternative, offering advantages such as affordability, ease of administration, and reduced reliance on cold-chain infrastructure. This study presents a comprehensive overview of recent advances in the development of edible plant-derived vaccines, highlighting the strategic evolution from conventional genetic engineering to more refined and scalable biotechnological methods. In the work, various applications targeting diseases such as measles, hepatitis B, rabies, dengue, and norovirus, are discussed as well as veterinary vaccines for livestock and aquaculture. The significant progress in creating vaccines targeting prevalent human pathogens is examined and the discussion is extended to include edible vaccines developed for livestock, underscoring their role in both public and veterinary health. Furthermore, the review emphasizes the transformative potential of 'omics' technologies, such as genomics, proteomics, and metabolomics, as well as artificial intelligence in streamlining vaccine design, improving antigen expression, and accelerating development timelines. This assessment review was conducted by performing a comprehensive literature survey of peer-reviewed articles. By integrating multidisciplinary insights, the work underscores the feasibility and future prospects of edible plant vaccines as a sustainable solution to global immunization challenges, with practical applications in improving vaccine accessibility, enhancing outbreak preparedness, and supporting immunization efforts in resource-limited settings. It aims to inform and inspire continued research and collaborative innovation in this emerging field with significant implications for global public health.

RevDate: 2026-07-08
CmpDate: 2026-07-09

Zeng Y, Fu BM, JM Tarbell (2026)

Endothelial Surface Glycocalyx in Vascular Functions and Diseases.

Advances in experimental medicine and biology, 1512:1-42.

Endothelial cells (ECs), which form the inner lining of the vasculature, are perpetually exposed to mechanical stimuli from blood flow. Their capacity to sense and respond to these forces is essential for vascular homeostasis. A diverse array of mechanosensors operates on the EC surface, within the plasma membrane, and throughout the cytoskeleton. Among these, the endothelial surface glycocalyx (ESG)-uniquely positioned at the blood-endothelium interface and intimately linked to classical mechanosensory complexes-has emerged as a pivotal yet underappreciated regulator. Once viewed merely as a passive barrier, the ESG is now acknowledged as a primary mechanosensor that converts hemodynamic forces into biochemical signals critical for vascular health. This updated chapter from the first edition offers a comprehensive review of the ESG. We begin with its molecular composition, ultrastructural organization, and variable thickness, as elucidated by advanced imaging techniques such as immunolabeling, electron microscopy, and super-resolution microscopy. Next, we examine the ESG's biomechanical properties and its central role in endothelial mechanotransduction and barrier regulation. We then explore its dynamic remodeling in response to physiological and pathological stimuli, with a focus on degradation in major vascular diseases. ESG shedding is not only a hallmark but also a causal driver of pathophysiology in conditions including atherosclerosis, sepsis, diabetes, cancer metastasis, and COVID-19-associated endotheliopathy. Finally, we spotlight emerging diagnostic tools for evaluating ESG integrity and review promising therapeutic strategies to preserve or restore its structure and function.

RevDate: 2026-10-05
CmpDate: 2026-10-02

Nila FH, Villeneuve M, Chang KJ, et al (2026)

Service continuity of community-based health and social care organisations in times of disaster and health emergencies: a mapping review.

BMC health services research, 26(1):.

BACKGROUND: The physical and economic impacts of disaster and health emergencies have become a global concern that continues to generate discussion regarding disaster preparedness, response, and mitigation strategies. Maintaining continuity of services during these challenging and dynamic circumstances requires adequate organisational preparedness. This study aimed to map the existing research on the emergency management capabilities of community-based health and social care organisations and identify the factors that impact service continuity as a critical component of business continuity planning.

METHOD: This mapping review was carried out in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Eight databases were searched: Medline, PsycINFO, Embase, CINAHL, Scopus, ProQuest, Web of Science, EBSCOhost. Studies written in English and published between January 2000 and August 2022 were included. Eligible studies were primarily focused on business or service continuity of community-based health and social care organisations. Thematic analysis of data was conducted.

RESULTS: Out of 3,195 articles, 176 met the inclusion criteria, mostly conducted in developed countries. These studies investigated various natural hazard emergencies, disease outbreaks, and pandemics, using different study designs, offering valuable insights into emergency management capabilities of community-based health and social care organisations across the disaster cycle. The findings suggest that several factors can serve as both barriers and enablers to the continuity of care, depending on the context and the specific stage of the disaster cycle at which they are addressed. Limited research was found on organisational preparedness for at-risk clients, including the elderly and individuals with disabilities. Additionally, there is a scarcity of research on the prevention and recovery stages of the emergency management cycle.

CONCLUSION: This mapping review offers a comprehensive overview of the factors influencing service continuity, highlights existing research gaps and targeted recommendation for service providers and governments to inform effective planning that ensures continuity of service and supports for people whose health, safety and well-being can be compromised in emergency situations. Future research could focus on strengthening organisational resilience during the prevention phase, examine tools and approaches for optimising emergency management efforts, and investigate strategies to improve cross-sector collaboration across all stages of disaster management cycle.

RevDate: 2026-07-09
CmpDate: 2026-07-09

Carnevali F, Muollo MC, Biagini L, et al (2026)

Xenosialylation as immunological chimerism: a host-centered unifying model for viral and post-vaccination immune complications.

European cytokine network, 37(2):55-77.

Severe immune-mediated complications following viral infections and vaccinations, including COVID-19 and anti-SARS-CoV-2 immunization, display remarkable clinical overlap despite occurring in distinct biological contexts. In a previous hypothesis-driven work, we proposed that metabolic incorporation of the non-human sialic acid N-glycolylneuraminic acid (Neu5Gc) into human glycoconjugates-defined as xenosialylation-may contribute to post-infectious and post-vaccination immune dysregulation. We further suggest that this phenomenon may represent a form of "immunological chimerism", in which host glycoconjugates incorporate non-self molecular structures that predispose the immune system to varying degrees of immune imbalance. In its most severe manifestation, this process may culminate in a profound state of immune dysregulation characterized by loss of immune tolerance, aberrant antibody responses, cytokine storm, and thrombo-inflammatory pathology, which we define as "immunological marasmus". In the present paper, we extend this conceptual framework by integrating glycobiology, Fc immunoglobulin glycosylation, endothelial biology, and sex-dependent immune regulation into a unified, testable immunopathogenic model. We hypothesize that interindividual differences in the extent, tissue distribution, and persistence of xenosialylation may influence susceptibility to exaggerated innate and adaptive immune responses following antigenic challenge. In this context, immune activation may unmask pre-existing xeno-sialylated self-structures embedded within host glycans, promoting varying degrees of glycan dysregulation, autoantibody production, immunothrombosis and chronic inflammatory sequelae. We further propose circulating anti-Neu5Gc antibodies as functional biomarkers for risk stratification and outline preventive strategies based on dietary modulation of xenosialic acid exposure. Taken together, this expanded model provides a potential mechanistic framework for understanding the shared immunological features of post-viral syndromes and vaccine-related adverse immune reactions, while offering a basis for experimental validation and future approaches to personalized risk mitigation.

RevDate: 2026-08-13
CmpDate: 2026-07-09

Li E, Shi M, S Huang (2026)

New-onset allergic diseases after SARS-CoV-2 infection: mechanistic hypotheses and emerging strategies for risk stratification.

Frontiers in immunology, 17:1879430.

Multinational cohort studies consistently associate SARS-CoV-2 infection with elevated incidence of allergic diseases, with hazard ratios of 2.25 for asthma and 1.23 for allergic rhinitis persisting beyond six months post-infection; whether this excess risk reflects de novo allergic sensitization or preferential unmasking of pre-existing subclinical atopy remains to be established. Yet mechanisms bridging acute viral illness to delayed allergic phenotypes remain incompletely understood. This review synthesizes recent advances across epithelial biology, immunology, and neuroimmune interactions to propose a unified mechanistic framework organized around three interconnected axes. First, epithelial injury during COVID-19 triggers passive IL-33 release while inducing active TSLP and IL-25 production. These alarmins act through mechanistically distinct pathways to converge on type 2 immune priming, which is established and reinforced by epigenetic memory in group 2 innate lymphoid cells and dendritic cells. Second, regulatory T cell depletion and, hypothetically, hematopoietic stem and progenitor cell epigenetic reprogramming driven by acute interleukin-6 elevation may generate immune cell progeny with persistently altered inflammatory responsiveness, while dendritic cells adopt Th2-polarizing phenotypes that lower the threshold for allergic sensitization; the direct contribution of hematopoietic reprogramming to Th2-skewed allergic outcomes remains to be demonstrated. Third, mast cells undergo direct spike protein-mediated activation via angiotensin-converting enzyme 2 receptors, and alarmin-primed mast cells establish bidirectional crosstalk with sensory neurons that amplifies neuroinflammation and links long COVID symptoms to heightened allergic susceptibility. Together, these axes define a post-infectious vulnerability window during which allergen encounters trigger exaggerated type 2 responses. Risk stratification incorporating disease severity, circulating biomarkers including immunoglobulin E and eosinophil counts, and genetic susceptibility variants may identify individuals requiring targeted surveillance, while mechanistically informed interventions such as low-dose interleukin-2, mast cell stabilizers, and alarmin-targeted biologics warrant prospective evaluation in convalescent cohorts.

RevDate: 2026-08-13
CmpDate: 2026-07-09

Liu A, Chen H, Liu Q, et al (2026)

Cardiovascular sequelae of Long COVID: immune dysregulation inflammation as central drivers.

Frontiers in immunology, 17:1815269.

Long coronavirus disease 2019 (Long COVID-19), also referred to as post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has emerged as a major global health challenge. Common manifestations include fatigue, dyspnea, cognitive dysfunction, and exercise intolerance. Beyond these systemic manifestations, the enduring cardiovascular manifestations are increasingly identified as core characteristics of Long COVID-19 syndromes secondary to SARS-CoV-2 infection, encompassing myocarditis, ischemic and non-ischemic heart disease, arrhythmias, heart failure, and thrombotic events. Accumulating evidence suggests that immune dysregulation and persistent inflammation are central drivers of cardiovascular injury in Long COVID. Persistent activation of innate and adaptive immune pathways fosters endothelial injury, thrombo-inflammation, and adverse myocardial remodeling. In this review, we focus on current clinical and experimental evidence to delineate the immune-mediated mechanisms underlying cardiovascular sequelae in Long COVID and explore potential therapeutic strategies targeting persistent inflammation and immune dysregulation.

RevDate: 2026-08-13
CmpDate: 2026-07-09

Bansal A (2026)

Proteomic landscapes of post-COVID condition: biomarkers and translational pathways.

Frontiers in immunology, 17:1783192.

Post-COVID condition is a heterogeneous, multi-system sequela of SARS-CoV-2 infection that imposes substantial socioeconomic burden and currently needs validated diagnostic biomarkers or established therapeutic pathways. This brief communication synthesises blood-based proteomic and targeted biomarker evidence and organises it into three overlapping pathophysiological domains: persistent immune dysregulation (IL-6, IL-20, MCP-1 and TNF- α), endothelial dysfunction and disordered haemostasis (VEGF-A, P-selectin, vWF, ICAM-1 and D-dimer); and neurological injury (NFL, GFAP, NAAA, LXN, NBL1, HAGH). Across studies, no single protein provides adequate diagnostic performance; phenotype-linked multi-analyte panels show the greatest promise. Researching post-COVID conditions requires harmonised case definitions, cross-platform validation, and the integration of coagulation assays and extracellular vesicle profiling to improve tissue signal detection.

RevDate: 2026-08-13
CmpDate: 2026-07-09

Ramesh RP, Premraj A, Yasmin H, et al (2026)

Delving into the innate and adaptive immunity of camelids: a paradigm of interspecies adaptation and evolutionary innovation.

Frontiers in immunology, 17:1833289.

Camelids have evolved to survive some of the most challenging climatic conditions on our planet and are resilient to physiological stress such as temperature extremes, drought, storms, intense ultraviolet radiation, dehydration, and starvation. They exhibit remarkable resistance to several diseases that severely affect other livestock including tetanus, foot-and-mouth disease, and bovine spongiform encephalopathy. The robust nature of the camelid immune system, which maintains functionality under extreme conditions, is remarkable. The special features of the camelid immune system include differences (when compared to ruminants) in the distribution and anatomy of their lymphoid organs. The innate immune system merits further investigation, though potent antimicrobial peptides have been identified in camelid milk. It is in the adaptive immune response that the most distinctive aspects of the camelid immune system are seen, especially, the presence of heavy chain-only antibodies, somatic hypermutation of T cell receptors; in the dromedary, a significant number of γδ T cells. In this review, the interplay between innate and adaptive immunity in camelids is examined, highlighting their functions in systemic and mucosal immune defense. An understanding of these adaptations is important for the development of innovative biomedical applications, such as nanobody-based diagnostics and therapeutics. In addition, dromedary camels are the main likely animal reservoir for the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), an emerging zoonotic pathogen with potential for large-scale human spillover. Finally, as climate change is likely to result in increased environmental stress worldwide, a comparison of how the immune system in different species has adapted to their environment will be important.

RevDate: 2026-08-13
CmpDate: 2026-07-09

Ha KM (2026)

A post-PHEIC review of cultural awareness in the COVID-19 response.

Public health reviews, 47:1608243.

OBJECTIVES: The PHEIC status of COVID-19 was officially lifted by the WHO on May 5, 2023. However, many nations continue to grapple with its impacts, particularly those that have not fully embraced the emergency culture. This study aims to explore ways to enhance emergency culture that rose during the COVID-19 response, ultimately contributing to effective pandemic management.

METHODS: A systematic literature review, including the PRISMA 2020 flow diagram and checklist, was used to compare cultural unawareness with cultural awareness across six nations: Japan, Sweden, South Africa, the United States, Brazil, and Australia.

RESULTS: To varying degrees, all six nations exhibited cultural unawareness during their COVID-19 responses, which manifested in issues such as personal responsibilities, herd immunity, inequalities, individualism, economic priorities, language barriers, and other factors.

CONCLUSION: These six nations must adaptively transform their cultural unawareness into cultural awareness while enhancing leadership, communication, cultural competence, emergency preparedness, and international cooperation. This study offers a comprehensive perspective on the emergency culture surrounding the coronavirus pandemic, emphasizing the critical importance of cultural awareness.

RevDate: 2026-08-13
CmpDate: 2026-07-09

Santis B, Baldo F, Vento G, et al (2026)

Impact of COVID-19 on Subsequent Lung Function in Childhood: A Systematized Review.

Health science reports, 9(7):e72793.

BACKGROUND AND AIMS: The SARS-CoV-2 infection can lead to transiently altered lung function in adults, but data is less clear in children. We aimed to summarize the available evidence about respiratory outcomes after COVID-19 in childhood.

METHODS: We conducted a literature search on post-COVID-19 lung function tests (LFT) on the Medline and Cochrane databases, including studies published between 2019 and 2025.

RESULTS: Three hundred forty-seven publications were identified, and 20 were selected. Results are presented in two sections, based on the duration of follow-up. Most studies included spirometry, whereas many of them presented data from diffusing lung capacity for carbon monoxide, multiple breath nitrogen washout, fractional exhaled nitric oxide, impulse oscillometry, 6-minute walking test, and interrupter resistance. Five papers described no association between COVID-19 and respiratory outcomes, nor a link between the persistence of symptoms and the outcomes. Other authors reported a mild obstructive pattern which showed reversibility post bronchodilators, or a restrictive pattern, particularly when long-COVID was evident. Some papers showed that pulmonary function may be influenced by the initial severity of the SARS-CoV-2 infection.

CONCLUSION: Some studies reported no clear association between lung function impairment and previous history of COVID-19. Other authors reported mild, transient consequences. A small number of papers concluded that severe infection, which is relatively rare in children, might affect pulmonary function. The main limitation of this review was the high heterogeneity of the included studies, especially regarding the COVID-19 severity, the age groups, the LFT details, and the duration of follow-up.

RevDate: 2026-08-13
CmpDate: 2026-07-09

Garzón-Duque MO, Rodriguez-Ospina FL, Tobón ST, et al (2026)

Food insecurity, habits, and working conditions in subsistence workers during COVID-19 isolation, Medellin, Colombia, 2021.

Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT, 24:e20261279.

INTRODUCTION: Mandatory isolation and quarantine measures implemented between 2020 and 2021 had important repercussions on labor dynamics.

OBJECTIVES: To identify the characteristics of COVID-19 isolation, as well as the habits and working conditions that characterize food insecurity in subsistence workers in Medellin, Colombia, in 2021.

METHODS: Cross-sectional study using primary data sources. An interviewer-administered survey was conducted among 656 workers selected through snowball sampling.

RESULTS: Overall, 56.4% were men and 74.7% were aged ≥45 years. Furthermore, 89.9% of women were the primary household income provider, and 74.8% did not have a partner. Alcohol and tobacco use were more frequent among men, and 43.0% of women consumed two meals a day. Furthermore, 95.6% of participants underwent mandatory quarantine; 73.2% remained isolated > 12 weeks; and 77.0% received support during isolation. The prevalence of moderate/severe food insecurity was 44.1%, increasing to 51.4% among women. Conditions characterizing food insecurity included being female, consuming one meal a day, not having a partner, being the primary household income provider, lacking work permit, not receiving government food assistance, making payment arrangements with landlords, and receiving food assistance from a university.

CONCLUSIONS: Although food insecurity decreased by 10 percentage points, the conditions characterizing it reveal the subsistence circumstances experienced by workers, particularly women, whose social and occupational disadvantage deepened.

RevDate: 2026-10-08
CmpDate: 2026-08-28

Kianfar E (2026)

Vitamins impacting mental/physical well-being during viral pandemics: a mechanistic review based on COVID-19: a comprehensive review.

Inflammopharmacology, 34(8):4969-5012.

The emergence of novel strains of SARS-CoV-2 highlights the pressing need to investigate various strategies for enhancing pandemic resilience. Even though tried-and-true methods like social separation, masks, and vaccinations have proven effective, issues with immunizations make finding a global answer more complex. This paper underscores the pivotal connection between immunological resilience and vitamins, shedding light on the compromised immune response resulting from undernourishment. Vitamins become essential for protecting the body from viral invasion, particularly from SARS-CoV-2. Crucial roles in cellular activities are played by vitamin A, which is necessary for vision, and the B-vitamin complex, which supports energy synthesis and nerve function. In the context of viral infections, the significance of vitamin D, crucial for both immune system function and bone health, along with vitamin C and its ability to combat free radicals, becomes paramount.This research aims to to elucidate the specific effects and mechanisms by which essential vitamins (A, B, C, D, and E) contribute to the mitigation of COVID-19. By investigating the distinct roles of vitamins within the framework of the pandemic, this research seeks to clarify the potential benefits that these micronutrients may offer in mitigating the severity of COVID-19 and bolstering immune responses to combat viral infectons.

RevDate: 2026-08-13
CmpDate: 2026-07-09

Ruan B, Tian J, Wang X, et al (2026)

The Association Between eHealth Literacy and Health Behaviors During and Since the COVID-19 Pandemic: Systematic Review and Meta-Analysis.

Journal of medical Internet research, 28:e94233.

BACKGROUND: Since COVID-19, health information seeking, service navigation, and routine care have become increasingly digitally mediated. It remains unclear whether the association between eHealth literacy and health behaviors is consistent across behavioral domains, populations, and analytic frameworks.

OBJECTIVE: This systematic review and meta-analysis synthesized COVID-19 and post-COVID-19 evidence on the association between eHealth literacy and health behaviors and examined variation across study contexts.

METHODS: We conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020-compliant, PROSPERO-registered review (CRD420251009048). PubMed, Embase, Web of Science Core Collection, CINAHL Ultimate, and Scopus were searched from January 1, 2020, through March 27, 2026. Eligible observational studies assessed eHealth literacy and reported analyzable associations with health behavior outcomes collected in 2020 or later. Health behaviors were classified as health decision-making, health-promoting, or health management behaviors. Correlation coefficients, grouped odds ratios (ORs), and continuous ORs were synthesized separately using random-effects models with Knapp-Hartung adjustment. Certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework.

RESULTS: In total, 19 studies were included: 10 contributed correlation coefficients, 6 grouped ORs, and 3 continuous ORs. In the correlation-based synthesis, higher eHealth literacy was associated with more favorable health behaviors (pooled r=0.43, 95% CI 0.36-0.51; 95% prediction interval 0.22-0.61), with substantial heterogeneity (I2=80.50%). In the grouped OR synthesis, higher eHealth literacy was also associated with more favorable health behaviors (pooled OR 2.12, 95% CI 1.47-3.05; 95% prediction interval 1.11-4.06), with moderate heterogeneity (I2=46.33%). In the continuous OR synthesis, all 3 studies showed positive associations, but the pooled effect was not statistically significant (pooled OR 1.07, 95% CI 0.89-1.30; 95% prediction interval 0.84-1.37), with very high heterogeneity (I2=97.98%). Subgroup analyses showed a significant difference only by geriatric status in the grouped OR synthesis. Certainty was low for the grouped OR synthesis and very low for the other 2 syntheses.

CONCLUSIONS: Higher eHealth literacy was generally associated with more favorable health behaviors in the correlation-based and grouped OR syntheses, whereas evidence from the continuous OR synthesis was inconclusive. Given the predominantly cross-sectional evidence base, heterogeneity, risk-of-bias concerns, and low to very low certainty, the association should be interpreted as contextual and associative rather than causal or uniform. This review is innovative in synthesizing COVID-19 and post-COVID-19 evidence, applying a functional classification of health behaviors, and analyzing distinct effect measures separately. Unlike previous reviews that summarized the association more broadly, it avoids a single mixed pooled effect and provides a cautious, context-specific interpretation. In practice, interventions should pair eHealth literacy improvement with trustworthy digital services, clinician support, and behavior-specific conditions that help translate digital information into sustained health-related action.

RevDate: 2026-08-08
CmpDate: 2026-08-08

Etemadifar M, Salari M, Rezaei K, et al (2026)

Multiple sclerosis during an emergency or crisis: A narrative review focused on the effect of war and COVID-19 pandemic.

Multiple sclerosis and related disorders, 113:107361.

BACKGROUND: Armed conflict fractures the systems that multiple sclerosis (MS) care depends on, yet MS-specific guidance for war is scarce. The aim of this study is to synthesize evidence on MS care during armed conflict and other crises, and to develop practical, crisis-ready recommendations to maintain treatment continuity, reduce inequities, and guide clinicians and policymakers.

METHODS: We reviewed peer-reviewed literature (2000-2025) on MS during conflicts; when MS-war data were scarce, we utilized transferable evidence from COVID-19 MS studies.

RESULTS AND CONCLUSION: War disrupts disease-modifying therapies (DMT) supply, safety monitoring, rehabilitation, and continuity of care, widening inequities. A key controversy was whether to continue higher-risk DMTs with limited labs/MRI, and which monitoring to prioritize. Our recommendations established a five-action basis: create a single MS crisis hub (information, tele-access, patient passports), safeguard DMTs with lean pharmacovigilance and predefined substitutions, adopt tele-first care with a relapse pathway favoring high-dose oral steroids when appropriate, deliver equity-first outreach via mobile clinics and transport/fee support, and run a minimal data loop (stock, relapses, severe adverse events, hospitalizations, brief fatigue screening) for weekly course correction. Additionally, the basis of recommendations was transformed into a three-stage guideline figure.

RevDate: 2026-09-10
CmpDate: 2026-09-09

Hayes JE, Hayes SA, Wilkins D, et al (2027)

Olfaction as a diagnostic instrument - a review of current, and future medical applications.

Talanta, 311:130256.

The olfactory sense has evolved to provide environmental and physiological cues through the detection of volatile organic compounds. While historically a clinician's sense of smell was used to assist in diagnosing illness, with some notable exceptions, this has fallen out of favour with the advent of analytical tools. Recently, world events have shown that olfactory methodologies can be highly useful for diagnostic purposes. The emergence of the SARS-CoV-2 virus (causing COVID-19) presented a number of logistical issues with regards to establishing fast and accurate diagnosis-while the idea of detection dogs was proposed at the time, little in the way of routine clinical application was accomplished for this disease. The reasons for this are multifactored, but the use of olfaction as a diagnostic tool can be efficacious, provided appropriate methodological considerations are met. Here, the use of olfaction within a medical diagnostic framework is discussed; with olfactory diagnosis having the potential of very high sensitivity and specificity, but with a low diagnostic cost in terms of expense, time, and patient discomfort. This review will also discuss the ways in which olfactory medical diagnosis can be accomplished using humans, dogs, as well as other animals. Finally, this paper will outline recommendations of how future olfactory diagnostic options can be researched and implemented to ensure best practice.

RevDate: 2026-08-13
CmpDate: 2026-07-10

Lac J, Han S, Ahmad M, et al (2026)

Low-dose corticosteroids in severe pulmonary infection: a meta-analysis of randomised controlled trials.

BMJ open respiratory research, 13(1):.

PURPOSE: Pulmonary infections are one of the leading causes of intensive care unit (ICU) admission and contribute to high mortality rates. This paper aimed to determine the effect of low-dose corticosteroids on outcomes in patients with severe pulmonary infections, including coronavirus disease of 2019, community-acquired pneumonia (CAP), pneumocystis pneumonia, sepsis, septic shock, and acute respiratory distress syndrome.

METHODS: We systematically reviewed randomised controlled trials (RCTs) comparing low-dose corticosteroids (≤400 mg hydrocortisone-equivalent daily) to placebo or standard care in adults with severe pulmonary infections. The primary outcome was short-term mortality (≤90 days). Secondary outcomes included 28-day mortality, 30-day mortality, number of patients with at least one serious adverse event, length of hospital stay and ICU stay.

RESULTS: We analysed twelve RCTs including 4622 patients and 1203 events. The pooled OR showed a short-term mortality benefit: 0.83 (95% CI 0.70 to 0.98; p=0.029; I²=2.0%; number needed to treat: 37.84; Grading of Recommendations Assessment, Development and Evaluation (GRADE): low certainty). There was a reduction in length of ICU stay in patients with CAP, with a pooled mean difference of -0.78 days (95% CI -1.46 to -0.10, p=0.025). The use of corticosteroids did not significantly affect the length of hospital stay or severe adverse events. A significant difference remained in longer courses of steroids, whereas shorter courses had no significant difference (≤7 days vs >7 days; OR: 0.69; 95% CI 0.53 to 0.89; p=0.039 vs OR: 0.96; 95% CI 0.813 to 1.14; p=0.67; subgroup differences: p=0.03). Subgroup analyses in patients with CAP showed a significant benefit in short-term mortality (OR: 0.72, 95% CI 0.54 to 0.98; p=0.034; number needed to treat: 28.10).

CONCLUSION: We found that low-dose corticosteroids significantly reduce 90-day mortality in severe CAP, although evidence for their benefit in other severe pulmonary infections and at shorter follow-up intervals remains inconclusive.

PROSPERO REGISTRATION NUMBER: CRD42024627881.

RevDate: 2026-10-20
CmpDate: 2026-09-15

Ghosh AK, Overgaard JD, Abubeker I, et al (2026)

Consultative General Internal Medicine for Complex Care: The Model, Outcomes, and Lessons Learned.

The Permanente journal, 30(3):153-159.

As the landscape of modern medicine evolves, new health care delivery models are needed to meet the growing complexity of medical care. Primary care clinicians are increasingly managing patients with multiple chronic conditions, a challenge that will intensify as the population ages. Complex medical care involves multiple factors that contribute to difficulties in providing optimal quality of care for patients facing these types of medical problems. To address this need, models of consultative general internal medicine have emerged at various tertiary care institutions across the United States to synthesize prior evaluations, recommend appropriate testing and specialty consultations, and integrate findings into a cohesive care plan for implementation by patients' local care teams. Variability in expertise, patient volume, and structure exists across institutions, but the expansion of multidisciplinary care capabilities during the COVID-19 pandemic has created new opportunities for destination-type practices. This narrative review explores how consultative medicine will be crucial to providing integrative, patient-centric care by enhancing diagnostic accuracy, coordinating multidisciplinary input, and communicating actionable care plans to patients.

RevDate: 2026-08-13
CmpDate: 2026-07-10

Kassymbek S, Abduldayeva A, N Safonov (2026)

Global prevalence of post-COVID-19 condition (Long COVID): a systematic review and meta-analysis of observational studies.

Frontiers in public health, 14:1839646.

BACKGROUND: Long COVID is an umbrella term for persistent, relapsing, or newly developed health problems after SARS-CoV-2 infection, whereas post-COVID-19 condition (PCC) refers more specifically to the World Health Organization clinical case definition. Reported prevalence varies substantially because of differences in terminology, operational definitions, study populations, follow-up duration, hospitalization status, and symptom ascertainment. This systematic review and meta-analysis synthesized global observational evidence on Long COVID/PCC prevalence and examined major sources of variability.

METHODS: A systematic review and meta-analysis was conducted according to PRISMA 2020 principles. PubMed/MEDLINE, Scopus, Web of Science, and the WHO COVID-19 Global Literature Database were searched for studies published from 1 January 2020 to 23 February 2026. Observational studies were eligible if they included individuals with confirmed or probable SARS-CoV-2 infection, reported Long COVID/PCC or persistent post-COVID symptoms at least 4 weeks after acute infection, and provided numerator and denominator data. Terminology and operational case definitions were extracted separately. Prevalence estimates were pooled using a random-effects model with logit transformation and back-transformation. Heterogeneity was assessed using Cochran's Q, I[2], tau[2], and prediction intervals. Subgroup and sensitivity analyses were performed.

RESULTS: Twenty-two studies contributing 27 prevalence estimates and more than 200,000 participants were included. The primary estimate-level pooled prevalence was 30.8% (95% CI 26.8-35.0). Heterogeneity was extreme: Q = 8031.9, df = 26, p < 0.001; I[2] = 99.7%; tau[2] = 0.252 on the logit scale. The prediction interval was 14.0-54.8%. Pooled prevalence was higher among hospitalized cohorts (37.9%, 95% CI 29.5-47.1) than among non-hospitalized, community-based, or mixed cohorts (26.2%, 95% CI 22.0-30.9). WHO-defined PCC yielded lower prevalence (22.8%, 95% CI 14.3-34.4) than broader symptom-based definitions (39.7%, 95% CI 30.5-49.5). Cohort-level sensitivity analysis yielded a similar prevalence of 31.0% (95% CI 26.8-35.4).

CONCLUSION: Long COVID/PCC represents a substantial post-acute public health burden. However, because heterogeneity was extreme, the pooled prevalence should be interpreted as a descriptive summary of heterogeneous observational evidence rather than as a single precise global rate. Standardized definitions, harmonized surveillance, transparent reporting, rehabilitation pathways, and multidisciplinary care models are needed.

RevDate: 2026-09-22
CmpDate: 2026-07-11

Hasenpusch C, Kuper P, Skiba EM, et al (2026)

Interventions to Enhance COVID-19 Pandemic Health Literacy in Health Professionals: Systematic Review.

JMIR medical education, 12:e70400.

BACKGROUND: The COVID-19 pandemic has placed a significant burden on health professionals (HPs). They face higher infection risks due to the nature of their work environment and patient care responsibilities. Their ability to access and apply reliable COVID-19 information affects their own preventive behavior and that of those around them. In this context, health literacy (HL) has become increasingly important. Despite extensive research, information to foster COVID-19-related HL in HPs remains limited.

OBJECTIVE: This systematic review aimed to identify, appraise, and synthesize intervention studies on the effectiveness of COVID-19-related HL interventions in HPs.

METHODS: Five electronic databases (eg, PubMed (MEDLINE), Embase), six clinical trials registries (eg, ISRCTN registry), one preprint server (MEDRXIV), published conference proceedings, and five gray literature databases (eg, opengrey.eu, ProQuest) were searched in May 2022 and updated in August 2025. Reference lists of included studies were screened manually. Two reviewers independently screened titles, abstracts, and full-texts according to eligibility criteria and extracted data; disagreements were resolved by discussion or consultation with a third reviewer. We included randomized controlled trials (RCTs), nonrandomized studies of interventions, and uncontrolled before-and-after studies evaluating the effectiveness of any COVID-19-related HL intervention. Primary outcomes include COVID-19-related HL, its four facets (access, understand, appraise, and apply COVID-19 information), and indicators (eg, COVID-19-related knowledge), assessed at postintervention and follow-up. When studies were sufficiently similar, random-effects meta-analyses were performed; otherwise, a narrative synthesis was provided. Risk of bias was assessed using validated tools based on study design, and the overall certainty of the evidence was evaluated by the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.

RESULTS: We included 15 RCTs (2034 participants), 4 nonrandomized studies of interventions (291 participants), 74 uncontrolled before-and-after studies (327,298 participants), 5 ongoing studies, and 1 study with awaiting classification. Interventions targeted a broad range of health occupational groups. Intervention type, delivery mode, methods, settings, and comparator varied widely. No outcome measure explicitly referred to an HL model. Most studies aimed to enhance COVID-19-related knowledge and skills, and had a high risk of bias. COVID-19-related interventions may increase knowledge of vaccines (standardized mean difference 1.00; 95% CI 0.33 to 1.67, I2=24%), and the infection prevention control skills, such as donning and doffing of personal protective equipment (standardized mean difference 1.95; 95% CI 1.82 to 3.09, I2=46%), but the evidence remains very uncertain.

CONCLUSIONS: COVID-19-related HL interventions may promote HP's short-term competencies in infection control. However, the evidence remains uncertain, primarily due to the low quality of studies, characterized by a high risk of bias. Interventions specifically designed to enhance the full COVID-19 HL operationalized by its four facets are lacking. High-quality RCTs with sufficient statistical power, grounded in HL theoretical principles, are needed to achieve precise understanding.

RevDate: 2026-09-23
CmpDate: 2026-08-11

Hensley AA, Jiles KA, Edwards S, et al (2026)

Characteristics of successful and unsuccessful strategies to increase vaccine intention and improve vaccine uptake for U.S. adult populations in the Affordable Care Act era (2010-2025): a systematic review and meta-regression.

Vaccine, 88:128910.

BACKGROUND: Vaccine-preventable diseases continue to burden U.S. population health. Despite the Affordable Care Act (ACA) eliminating cost-sharing for recommended vaccines in 2010, adult vaccination rates persistently fall below Healthy People 2030 targets, signaling that access alone is insufficient.

OBJECTIVES: To synthesize peer-reviewed literature (2010-2025) on interventions designed to increase vaccine intention or uptake among U.S. adults; characterize strategies, populations, settings, and study quality; and identify predictors of vaccine uptake rate.

METHODS: Following PRISMA 2020 guidelines, a multi-database search was conducted across PubMed, Web of Science, Ovid/MEDLINE, and EBSCOhost, with a final updated search in December 2025. Dual independent reviewers screened studies in two stages. Quality was assessed using the EPHPP tool and certainty evaluated using GRADE. Strategies were categorized per the WHO Behavioral and Social Drivers of Vaccination (BeSD) Model. A meta-regression was conducted on 79 studies, with narrative synthesis across all 92 included studies.

RESULTS: Of 11,219 records, 92 studies were included. Study designs were predominantly RCTs; Influenza and COVID-19 vaccines were most commonly studied. In the meta-regression (adjusted R[2] = 0.229), prioritizing a specific population (b=0.121, p=.027), using service quality improvement strategies (b=0.226, p=.040), and recruiting through community-based partner organizations (b=0.585, p=.005) or healthcare organizations (b=0.230, p=.040) were associated with significantly higher vaccine uptake rates. Onsite vaccination was associated with lower uptake rates (b=-0.185, p=.033), an effect confirmed as specific to the COVID-19 pandemic emergency-response context rather than a generalizable effect of the strategy in sensitivity analysis. Narrative synthesis identified message framing and educational campaigns as the most frequently deployed strategies, with multi-component designs and community partnerships showing the most favorable outcomes.

CONCLUSIONS: Effective adult vaccination strategies were multifactorial. Service quality improvement, priority population focus, and community-based recruitment were the strongest predictors of higher uptake. Findings support the WHO BeSD model's Practical Issues domain: reducing friction outperformed persuasion alone. GRADE certainty remained LOW to MODERATE, emphasizing the need for higher-quality, equity-focused research.

REGISTRATION: This systematic review was registered at Open Science Framework: 10.17605/OSF.IO/SM7YD.

RevDate: 2026-08-13
CmpDate: 2026-07-11

Jöud AS, Thorén H, Spreco A, et al (2026)

Computational forecasting using Swedish data in the vaccination phase of the COVID-19 pandemic: a systematic literature review deliberating modelling relevance for public health and healthcare.

BMC health services research, 26(1):.

BACKGROUND: The benefits of computational forecasting in the later phase of the COVID-19 pandemic when vaccines and clinical pharmaceutical interventions were available have seldom been assessed. We aimed to evaluate computational forecasting research applied to Swedish populations in the vaccination phase of the pandemic.

METHODS: A systematic search was performed on March 8, 2024 in the electronic databases PubMed, Scopus, Cochrane library, Embase, Love platform and Epistemikos. An updated version of the Risk of bias Opinion Tool (ROBOT) was used to assess the quality of evidence reported in the papers identified in the search. The articles fulfilling the quality criteria were assessed for suitability for meta-analysis. Data were extracted from the selected articles for synthesis of characteristics, and a thematic analysis was used for a qualitative synthesis of the contents.

RESULTS: Of 2034 unique publications identified in the database search, 6 articles satisfied the selection and quality criteria. Variability in the reporting of forecasting performance results was found to make a quantitative meta-analysis of forecast performance infeasible. The data synthesis showed that statistical modeling using Bayesian calibration was the most common methodological approach. No external model validation was reported, but 5/6 articles included internal model corroboration data. The primary theme resulting from the qualitative synthesis of article content was design or refinement of computational models with demonstration of model use in health service practice as a secondary theme. None of the articles referred to health service policymaking as the primary research context.

CONCLUSION: Computational forecasting research using Swedish population data from the vaccination phase of the COVID-19 pandemic was deployed in a model design context. While methodological knowledge was developed, most of the research was not initiated to solve the public health and healthcare problems at hand. Our results indicate that the alignment between computational forecasting research and policymaking needs in the vaccination phase of pandemics can be enhanced.

RevDate: 2026-10-07
CmpDate: 2026-10-04

Chandak A, Chandak P, Patil A, et al (2026)

Digital health literacy among university students: a systematic review of global trends, determinants, measurement, and the literacy-to-intervention gap.

BMC public health, 26(1):.

INTRODUCTION: University students interact with the complexities of public health knowledge in digital environments. Digital health literacy (DHL), in this regard, is crucial as an upstream skill for ensuring safe, inclusive, and knowledgeable health care engagement among university students where mis-information, algorithm amplification, and AI-based content exist.

OBJECTIVE: This systematic review synthesizes global evidence on DHL among university students. It examines measurement approaches, socio-demographic determinants, online health information-seeking behaviours, mental health and well-being correlates, and the gap between literacy assessment and tested university-based interventions.

METHODS: This systematic review followed PRISMA 2020 guidance. Searches were conducted in PubMed, Scopus, and Web of Science for peer-reviewed studies indexed up to March 31, 2024; backward and forward citation tracking was updated to January 2025 to capture directly related empirical papers. Two reviewers independently performed screening, data extraction, and quality appraisal using design-appropriate tools: JBI for analytical cross-sectional studies, CASP for qualitative evidence, and AMSTAR 2-informed criteria for review-derived or pilot evidence. Because of heterogeneity in design, instruments, and outcomes, findings were synthesized narratively and thematically.

RESULTS: Twenty-one studies met the eligibility criteria. Most were cross-sectional studies conducted during or after the COVID-19 pandemic. Five themes were identified: DHL as a competence for appraising online health information; socioeconomic, gender, health-status, and contextual determinants of DHL; associations with mental health, well-being, fear, and sense of coherence; measurement heterogeneity and psychometric maturation; and a persistent literacy-to-intervention gap.

CONCLUSION: DHL is a relevant competency for Health Promoting Universities, but the current evidence base remains dominated by descriptive self-report and cross-sectional designs. Future research should prioritize longitudinal studies, objective task-based competence assessment, and theory-driven intervention trials embedded within campus health systems, library infrastructures, and digital mental health pathways. The future research must focus on conducting longitudinal research, assessing task-based competency objectively, and testing theory-based interventions that operate through campus health systems, library infrastructure, and pathways for digital mental health.

RevDate: 2026-10-08
CmpDate: 2026-10-06

Sasso EM, Eaton-Fitch N, Thapaliya K, et al (2026)

Neurological impairment in long COVID: implications for neurodegenerative disease.

Journal of translational medicine, 24(1):.

BACKGROUND: It has been six years since the COVID-19 pandemic and, despite substantial advances in management, the disease sequelae known as long COVID continues to represent a significant medical and societal burden. Long COVID is characterised by persistent neurological and neurocognitive symptoms, including brain fog, memory deficits, attention impairments, and fatigue, lasting for months after acute SARS-CoV-2 infection.

MAIN BODY: In this review, we collated emerging neurological findings related to long COVID, discussing neurodegenerative processes associated with long COVID, potential clinical implications and research limitations. Neurological and neurocognitive manifestations arise through multiple mechanisms, including direct SARS-CoV-2 invasion of the central nervous system and peripheral lymphocyte infiltration. Additionally, neurovascular damage potentially contributes to neurodegeneration through neuronal injury, impaired neurogenesis, microvascular abnormality and sustained neuroinflammation.

CONCLUSION: Understanding the mechanisms underlying neurological and neurocognitive symptoms is essential for developing long-term monitoring strategies and targeted interventions to mitigate neurocognitive decline in individuals with long COVID.

RevDate: 2026-10-13
CmpDate: 2026-10-08

Zhou Z, Luo B, Zhang X, et al (2026)

Incidence, mortality and risk factors of invasive pulmonary aspergillosis in critically ill patients during the COVID-19 era: a global systematic review and meta-analysis.

Annals of clinical microbiology and antimicrobials, 25(1):.

BACKGROUND: Invasive pulmonary aspergillosis (IPA) represents a growing threat to critically ill patients, with mortality rates exceeding 50%. The burden of IPA has been exacerbated during the COVID-19 era due to prolonged ICU stays and widespread use of immunosuppressive therapies. This systematic review and meta-analysis aimed to synthesize global evidence on the incidence, mortality, and risk factors of IPA in ICU patients.

METHODS: Observational studies reporting IPA incidence, mortality, or risk factors in ICU settings from their inception between November 1, 2019 to October 11, 2024 for eligible studies were retrieved from PubMed, Embase, Web of Science, and Cochrane Library. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Meta-analyses were performed using R software to calculate pooled estimates with 95% confidence intervals (CI). Multiple subgroup analysis was conducted.

RESULTS: Fifty-six studies involving 15,385 ICU patients (2,381 IPA cases) were included. The pooled incidence of IPA was 11.9% (95% CI: 9.7-14.6%). Subgroup analyses revealed higher incidence in mechanically ventilated patients (15.0%, 95% CI: 11.7-19.0%). Factors associated with an increased risk of IPA included male sex (OR = 1.29), smoking history (OR = 1.52), chronic lung diseases (OR = 1.30), chronic kidney disease (OR = 1.70), chronic liver disease (OR = 1.79), heart disease (OR = 1.20), malignant tumor (OR = 1.75), hematological malignancy (OR = 2.65), glucocorticoids use before ICU (OR = 2.13), immunosuppression (OR = 2.26), EORTC host factors (OR = 2.13), vasopressor use (OR = 3.28), mechanical ventilation (OR = 3.69), and renal replacement therapy (OR = 2.31). The overall mortality rate was 59.6% (95% CI: 55.0-64.0%), escalating to 61.9% in mechanically ventilated patients. Mortality-associated factors included age ≥ 65 years (OR = 2.85), ICU-administered glucocorticoids (OR = 1.95) and mechanical ventilation (OR = 1.93).

CONCLUSIONS: During the COVID-19 era, IPA remains a life-threatening complication in critically ill patients, particularly those with COVID-19, and is associated with immunosuppression, organ dysfunction, and invasive therapies. Our findings, predominantly reflecting CAPA epidemiology, generate the hypothesis that early screening in high-risk populations and tailored antifungal strategies warrant prospective evaluation to determine whether they improve outcomes.

TRIAL REGISTRATION: Ethical approval and patient consent were not required for this meta-analysis, as it was based on previously published studies. The protocol for this meta-analysis was registered on PROSPERO: International prospective register of systematic reviews (CRD42025631579).

RevDate: 2026-09-22
CmpDate: 2026-07-11

Magsi IA, Advani A, Alokozay E, et al (2026)

Trends and disparities in HIV before and after COVID-19 from 1999 to 2023.

Annals of medicine and surgery (2012), 88(7):4306-4313.

Despite advances in human immunodeficiency virus (HIV) treatment, disparities in HIV-related mortality persist across demographic groups in the United States. The COVID-19 pandemic disrupted healthcare systems and may have influenced established mortality trends. This study evaluates HIV-related mortality in the U.S. from 1999 to 2023, with emphasis on changes following the onset of COVID-19. Data were obtained from the CDC WONDER database, identifying HIV-related deaths (ICD-10: B20-B24) among adults aged 25 to 85+. Age-adjusted mortality rates (AAMR) per 100 000 were calculated. Trends were analyzed using Joinpoint regression to estimate annual percent changes (APCs) and average annual percent changes (AAPCs). From 1999 to 2023, there were 271 932 HIV-related deaths in the U.S. The overall AAMR declined by an AAPC of -4.34%, with a slower post-COVID decline of -4.19% (P < 0.05) from 2020 to 2023. Gender-stratified analysis showed greater post-COVID declines in women (APC: - .58%) than in men (APC: -3.90%). Older adults (85+) experienced a post-COVID increase in mortality (APC: +12.37%). Urban centers showed an APC increase (+2.33%), while rural areas continued to decline. Racial disparities narrowed modestly. Black and Hispanic populations saw sharper post-COVID declines (APCs: -6.21% and -6.26%, respectively) compared to White populations (-1.33%). The Southern U.S. remained the highest-burdened region across both timeframes. Observed mortality trends were temporally associated with demographic characteristics and urbanization patterns during the COVID-19 period. While HIV mortality continues to decline, the COVID-19 pandemic has disrupted progress, especially among elderly and urban populations. Persistent disparities demand targeted, equitable public health interventions.

RevDate: 2026-09-22
CmpDate: 2026-07-11

Abera EG, Himbaro SA, Megersa SW, et al (2026)

Emerging trends in post-COVID immune dysregulation: a narrative review.

Annals of medicine and surgery (2012), 88(7):4362-4370.

BACKGROUND: Long coronavirus disease (COVID), or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is a multi-system condition associated with persistent immune dysregulation, autoimmunity, and vascular perturbations. Understanding these immunological mechanisms is essential for guiding clinical management and therapeutic strategies.

METHODS: We conducted a narrative review of peer-reviewed human studies published between January 2020 and August 2025, using PubMed/Medline, Scopus, and Web of Science, supplemented by manual searches. Studies reporting immunological assessments in long COVID patients, recovered individuals, or healthy controls were included. Findings were extracted and synthesized thematically across six domains: humoral and cellular immunity, autoimmune signatures, proteomic/metabolic and vascular dysregulation, viral persistence, complement/coagulation/thromboinflammation, and pediatric long COVID.

RESULTS: Long COVID is characterized by persistent low-grade inflammation, T- and B-cell dysregulation, and prolonged adaptive immune activation. Humoral responses remain elevated, while T-cell exhaustion and loss of coordination between immune compartments are common. Autoimmune phenomena, including latent and polyautoimmunity targeting cytokines, thyroid antigens, and interferons, are frequently observed. Proteomic, metabolic, and vascular perturbations, complement activation, and thromboinflammatory processes contribute to ongoing symptoms. Viral persistence and early immune biomarkers predict long COVID development. These immune alterations correlate with fatigue, cognitive impairment, respiratory dysfunction, and reduced quality of life in both adults and children.

CONCLUSION: SARS-CoV-2 infection leaves a lasting immunological footprint marked by chronic inflammation, adaptive immune dysregulation, autoimmunity, and vascular perturbations. Integrating longitudinal immune assessments, biomarker profiling, and early predictive markers is critical for identifying high-risk individuals and informing interventions to reduce long COVID morbidity.

RevDate: 2026-08-13
CmpDate: 2026-07-11

Chen B, Tao X, Y Wang (2026)

Emerging Strategies for Antitumor Immunotherapy and Antiviral Defense Through the cGAS-STING Pathway.

International journal of nanomedicine, 21:593033.

The cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway is a central regulator of innate immunity and plays a critical role in inducing pro-inflammatory cytokines and type I interferons (IFN-I). This pathway has emerged as a promising target for cancer immunotherapy and antiviral treatments. Despite its promise, the clinical translation of STING agonists is hindered by several challenges, including structural instability, high production costs, and inefficient delivery systems. These barriers underscore the urgent need for further research and innovation to optimize STING-based therapies. This review provides a comprehensive overview of the cGAS-STING pathway, focusing on its activation mechanisms and recent advances aimed at enhancing its therapeutic efficacy. Alternative activators of STING, including metal ions, exogenous DNA, and endogenous DNA, are discussed for their potential to stimulate this pathway. Furthermore, synergistic therapeutic strategies combining cGAS-STING activation with reactive oxygen species (ROS)-based treatments, such as photodynamic therapy, radiotherapy, sonodynamic therapy, and chemodynamic therapy, are highlighted. Finally, recent progress in harnessing STING activation for antiviral defense against emerging pathogens, such as SARS-CoV-2 and influenza viruses, is summarized to provide insights into the future development of cGAS-STING-targeted immunotherapies.

RevDate: 2026-08-13
CmpDate: 2026-07-11

Joshi A, Ogbemudia H, Cruess C, et al (2026)

Point-of-care smell testing for evaluation of olfactory function: a narrative review of clinical utility.

Frontiers in allergy, 7:1882615.

IMPORTANCE: Olfactory dysfunction (OD) is increasingly recognized as a clinically relevant biomarker for a wide range of health conditions, including neurodegenerative diseases, respiratory infections such as COVID-19, psychiatric disorders, and age-related sensory decline. Despite its diagnostic value, olfactory testing remains underutilized in routine clinical care due to challenges related to test accessibility, cultural adaptability, cost and practical implementation.

OBSERVATIONS: This narrative review provides a clinically focused synthesis of olfactory tests suitable for point-of-care (POC), focusing on their diagnostic accuracy, administration methods, user-friendliness, and applicability across diverse clinical populations. Commonly used tests such as the University of Pennsylvania Smell Identification Test (UPSIT®) and Sniffin' Sticks® are discussed alongside emerging rapid screening tools, pediatric assessments, and culturally adapted tests. Attention is given to distinguishing screening tools from comprehensive diagnostic batteries and to the role of point-of-care (POC) testing in primary care, neurology, and otorhinolaryngology settings. Practical considerations including assessment time, workflow feasibility, and clinical decision pathways are also examined. This review emphasizes the translation of available psychophysical tests into a practical POC framework for real-world clinical use.

CONCLUSIONS AND RELEVANCE: Available olfactory tests vary substantially in diagnostic accuracy, feasibility, and clinical applicability, highlighting the importance of selecting tests based on clinical indication and practice setting. Brief POC tests are best positioned as screening tools, while comprehensive batteries remain necessary when diagnostic precision is required. The main contribution of this review is a clinically oriented framework that distinguishes screening from diagnostic testing and aligns test selection with adult and pediatric clinical scenarios, workflow constraints, and referral needs. A tiered clinical approach using rapid screening followed by targeted comprehensive testing may represent the most practical, cost and time effective strategy for integrating olfactory assessment into routine care. Broader implementation of clinically feasible olfactory testing may improve early disease detection, support clinical decision making, and enhance patient care across conditions associated with OD.

RevDate: 2026-08-15

Gazda J, Koky T, Robinska A, et al (2026)

Epidemiology of Alcohol-Associated Hepatitis: A Systematic Review of Population-Based Studies.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association pii:S1542-3565(26)00515-X [Epub ahead of print].

BACKGROUND & AIMS: Alcohol-associated hepatitis is an acute and severe manifestation of alcohol-related liver injury that can occur at any stage of fibrosis. Despite its high mortality, reliable epidemiologic data on alcohol-associated hepatitis remain limited. We conducted a systematic review to synthesize available population-based estimates of alcohol-associated hepatitis annual incidence and point prevalence from 2000 to 2025.

METHODS: A comprehensive literature search of MEDLINE (PubMed), Scopus, and the Cochrane Library was performed. Eligible studies reporting population-based rates of alcohol-associated hepatitis were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

RESULTS: Eleven population-based studies from 7 countries were included. Reported annual incidence rates of alcohol-associated hepatitis ranged from 1.02 per 100,000 inhabitants in Iceland to 98.5 per 100,000 inhabitants in the United States, with a median incidence rate of 6.8 cases per 100,000 inhabitants (interquartile range, 4.2-19). Among the 9 studies reporting at least 2 estimates over time, 7 demonstrated an increasing incidence rate, whereas 2 reported a decrease. A prepandemic sensitivity analysis excluding studies affected by the COVID-19 pandemic showed a similar pattern, with incidence rates increasing in 5 of the 7 studies. Two studies reported a surge in incidence during the COVID-19 pandemic, whereas 1 of them extended follow-up beyond the pandemic period and observed a gradual return toward prepandemic levels. No studies reported prevalence data.

CONCLUSIONS: The global burden of alcohol-associated hepatitis remains poorly characterized. Existing population-based estimates are highly heterogeneous, reflecting differences in case definitions as well as probable true epidemiologic variation across countries, and collectively suggest an increasing trend over the past 25 years. These findings underscore the urgent need for prospective studies employing standardized and harmonized methodologies to more accurately define the burden of this condition.

RevDate: 2026-08-13
CmpDate: 2026-07-12

Hernandez J, Delgado S, McCarthy M, et al (2026)

The Impact of COVID-19 Infection and Vaccination on Neuromyelitis Optica Spectrum Disorder and Myelin Oligodendrocyte Glycoprotein Antibody Disease: A Narrative Review.

Journal of central nervous system disease, 18:11795735261467600.

Despite the estimated 776 million coronavirus disease 2019 (COVID-19) cases globally, little is known about its impact on immune-mediated neurological disorders such as neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody disorder (MOGAD). Scattered case reports, and reviews address this association, but none have collectively examined the impact of COVID-19 infection or vaccination on established and new-onset NMOSD and MOGAD. Reviewing all published reports of COVID-19 infection and vaccination in NMOSD and MOGAD from December 2019 to October 2024, this report examined the effects of infection and vaccination on patients with established disease and the occurrence of new-onset NMOSD and MOGAD. Outcomes associated with COVID-19 infection in NMOSD and MOGAD patients revealed similar hospitalization rates but a notable difference in deaths in NMOSD patients treated with rituximab. Following COVID-19 infection, twice as many patients developed new-onset MOGAD compared to NMOSD, with a similar larger number of patients who developed MOGAD than NMOSD post-COVID-19 vaccination. While the heavy female predominance in NMOSD is well-established, a greater ratio of male to female patients developed MOGAD post-infection and post-vaccination. Clinicians should closely monitor NMOSD patients with COVID-19 infection, particularly those receiving B-cell depleting therapies, among whom mortality was more frequently reported. The rise in NMOSD and MOGAD following COVID-19 infection and vaccination cases warrants further investigation of the underlying immunological mechanisms. Molecular mimicry and a bystander immune-mediated injury likely play a greater role in central nervous system damage than does direct viral injury.

RevDate: 2026-08-13
CmpDate: 2026-07-13

Torres-Pasillas HA, Luna-García H, Celaya-Padilla JM, et al (2026)

Metabolomic datasets in COVID-19 research: a systematic literature review of availability, characteristics, and methodologies.

PeerJ, 14:e21313.

The COVID-19 pandemic has accelerated the integration of metabolomics and Machine Learning in biomedical research, resulting in the creation of numerous datasets with high potential for reuse. However, information regarding their accessibility, quality, and usability remains scattered and inconsistent. This systematic review aims to identify and evaluate publicly available human metabolomic datasets related to COVID-19, providing detailed information on their main characteristics and how to access them, with the goal to inform their potential for reuse in future research. Following PRISMA guidelines and the Kitchenham methodology, we conducted a comprehensive search of the scientific literature and specialized metabolomics repositories, identifying 110 unique datasets. Each dataset was assessed based on 15 variables related to data availability, accessibility, collection methodologies, sample sizes, and the extent of participant metadata provided. These datasets offer significant value for secondary analyses and ML applications, contributing to insights into disease mechanisms, early diagnosis, and patient stratification. By offering a structured overview of dataset characteristics, this review aims to support researchers in identifying suitable resources, encourages data reuse, and promotes best practices for data sharing and standardization in the context of COVID-19 and metabolomics. Nonetheless, our findings reveal critical limitations, including the underuse of dedicated repositories, frequent unavailability of raw data, lack of standardization in processed data, and insufficient metadata-particularly regarding participant demographics and clinical information. Inconsistencies in data formats and reporting standards further hinder dataset findability, interoperability, and reuse. To enhance the value and impact of future metabolomic research, we recommend adopting standardized reporting guidelines, improving metadata completeness, ensuring the availability of raw data, and promoting the use of interoperable repositories to facilitate reproducibility, integration, and broader application of shared datasets.

RevDate: 2026-09-10
CmpDate: 2026-07-13

Kim JH (2026)

Use of corticosteroids in sepsis and infectious diseases: a narrative review.

The Korean journal of internal medicine, 41(4):585-596.

Critically ill patients with septic shock exhibit dysregulated host inflammatory responses. Critical illness-related corticosteroid insufficiency (CIRCI) has been recognized as a potential contributor to poor outcomes in critically ill patients. CIRCI is characterized by dysregulation of the hypothalamic-pituitary-adrenal axis, which results in a state of systemic inflammation through altered cortisol metabolism and tissue resistance to corticosteroids, all of which may lead to systemic inflammation. Based on these pathophysiological mechanisms, the beneficial anti-inflammatory effects of corticosteroids have been proposed and evaluated in several clinical trials. However, evidence of the beneficial effects of corticosteroids has been evolving for years. While some studies have demonstrated beneficial outcomes, such as accelerated shock reversal, reduced duration of mechanical ventilation, and reduced mortality, other studies have failed to demonstrate significant mortality benefits. Such disparity in studies suggests the heterogeneity of critical illnesses and the difficulty in identifying optimal indications for corticosteroids. Recent studies demonstrated the beneficial role of corticosteroids in patients with severe COVID-19 and community-acquired pneumonia. Given the evolving body of evidence, this review discusses the utility of corticosteroids in critically ill patients, including those with sepsis, septic shock, COVID-19, and severe community-acquired pneumonia.

RevDate: 2026-08-13
CmpDate: 2026-07-13

Kong J, Hong S, Oh J, et al (2026)

Autoimmune diseases in the era of COVID-19: emerging mechanisms, clinical implications, vaccine considerations, and future directions.

The Korean journal of internal medicine, 41(4):597-619.

The coronavirus disease 2019 (COVID-19) pandemic has highlighted a complex, bidirectional relationship between SARSCoV-2 infection and autoimmune diseases. This review examines how SARS-CoV-2 infection influences the incidence, progression, and outcomes of five major autoimmune conditions: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, and Guillain-Barré syndrome. Patients with autoimmune diseases are at increased risk of severe COVID-19 due to intrinsic immune dysregulation and the use of immunosuppressive therapies, both of which impair antiviral host defenses. Conversely, COVID-19 has been implicated in the initiation and exacerbation of autoimmune responses through mechanisms such as molecular mimicry and bystander activation. Concerns have also arisen regarding the safety and efficacy of COVID-19 vaccines in immunocompromised populations. Although vaccines are generally tolerated in these individuals, certain immunosuppressive therapies may attenuate humoral and cellular immune responses. Strategies such as adjusting immunosuppressive regimens and optimizing the timing of vaccination have been proposed to improve vaccine efficacy. Disease-specific considerations are essential to balance infection risk with adequate control of autoimmune activity. Overall, this review underscores the importance of individualized treatment strategies, close clinical monitoring, and interdisciplinary care in managing patients with autoimmune diseases during the COVID-19 pandemic. A deeper understanding of these interactions will be critical for improving patient outcomes and preparing for future pandemics involving immune-mediated diseases.

RevDate: 2026-07-30
CmpDate: 2026-07-29

Warkentin TE, A Greinacher (2026)

Platelet-Activating Anti-Platelet Factor 4 Disorders.

The New England journal of medicine, 395(5):478-491.

Platelet-activating antibodies against platelet factor 4 (PF4) cause highly prothrombotic disorders with reduced platelet counts. In heparin-induced thrombocytopenia (HIT), these antibodies bind PF4-heparin complexes, causing heparin-dependent platelet activation. Less common autoimmune and spontaneous HIT variants that are triggered by heparin and nonpharmacologic polyanions, respectively, have atypical clinical features and antibodies with additional heparin-independent platelet-activating properties. Vaccine-induced immune thrombocytopenia and thrombosis (VITT) antibodies directly target PF4. Initially, VITT was linked to adenoviral vector-based coronavirus disease 2019 vaccines, but in rare cases, an immune thrombocytopenia and thrombosis disorder that is clinically nearly identical to VITT can be caused by infection resulting from natural exposure to viruses, especially adenovirus. In persons with the IGLV3-21*02/*03 gene, anti-adenovirus protein VII antibody specificity shifts to PF4 by way of a specific somatic hypermutation (K31E) that creates VITT antibodies. In VITT-like monoclonal gammopathy of thrombotic significance, monoclonal anti-PF4 antibodies cause chronic prothrombotic conditions. Accurate diagnosis relies on distinct assays for HIT and VITT antibodies. Beyond anticoagulation, inhibition of FcγIIa receptor-mediated platelet activation may be needed for anti-PF4 disorders with heparin-independent reactivity (e.g., high-dose immune globulin in acute disease manifestations and Bruton's tyrosine kinase inhibitors in chronic manifestations).

RevDate: 2026-08-13
CmpDate: 2026-07-13

Capodici A, Filippeschi A, Noci F, et al (2026)

Mapping global inequities in telemedicine implementation: An umbrella review of barriers and facilitators.

PloS one, 21(7):e0351885.

Telemedicine expanded rapidly during the COVID-19 pandemic, yet its diffusion has remained uneven across health systems. Whether implementation challenges differ systematically across economic contexts, and what implications these differences hold for global digital health equity, has not been comprehensively characterized. This study presents an umbrella review (PROSPERO CRD42024615998) of systematic reviews and meta-analyses indexed in PubMed and Scopus through December 2025 that reported barriers and/or facilitators to telemedicine implementation. Methodological quality was appraised using R-AMSTAR. Reported items were extracted verbatim, embedded with the Universal Sentence Encoder, and grouped into thematic clusters using HDBSCAN density-based clustering, with parameters optimized by SLSQP for cluster cohesion (median intra-cluster similarity ≥ 0.5). Analyses were stratified by World Bank country income group to characterize context-specific implementation profiles, identify evidence gaps, and detect orphaned barriers, defined as challenges lacking any corresponding documented facilitator. A total of 161 systematic reviews were included, yielding 1,333 barriers and 504 facilitators (corresponding to a barrier-to-facilitator ratio of 2.6:1). Across all settings, the most frequently reported barriers were high costs (n = 106), technical issues (n = 94), and training and knowledge (n = 91). Thematic profiles differed markedly by income group: high-income countries reported predominantly second-generation challenges centered on workflow integration, interoperability, and user experience, whereas lower-middle-income countries reported foundational barriers centered on infrastructures and costs. Evidence produced from low-income countries was entirely absent. Several high-frequency barriers lacked corresponding facilitator clusters, indicating challenges for which the published literature provides no documented solutions. The global telemedicine evidence base is itself inequitably distributed and risks reinforcing the disparities it is intended to reduce. High-income settings require implementation research focused on human and organizational factors, whereas lower-income settings require foundational research and investment in basic infrastructures before workflow-level optimization becomes meaningful. Without context-specific, equity-oriented strategies, telemedicine risks widening rather than narrowing the global digital health divide.

RevDate: 2026-10-19
CmpDate: 2026-10-07

da Costa ECR, Santana RF, Rembold SM, et al (2026)

Nursing Diagnosis "Maladaptive Coping with Infodemic": A Concept Analysis.

International journal of nursing knowledge, 37(3):466-479.

ObjectivesTo analyze the concept of infodemic in health as a theoretical basis for proposing the nursing diagnosis "Maladaptive Coping with the Infodemic".MethodsA conceptual analysis guided by the Walker and Avant method was conducted, following the steps of identifying the uses of the concept, attributes, antecedents, consequences, empirical referents, and model and contrary cases. To construct the definitions, an integrative literature review was carried out in June 2024.ResultsThirty-three studies addressing the concept of infodemic in individual health were identified. The core elements of the concept include information overload, disinformation, misinformation, fake news. The antecedents include the pandemic, low educational level, low income, and low health literacy with depression identified as an associated condition. The consequences include incorrect health actions (e.g., refusal to vaccinate), risk-prone behaviors (e.g., lack of protective measures), anxiety, stress, fear, social isolation, and insomnia, substance abuse.ConclusionsThe proposed nursing diagnosis, "Maladaptive Coping with the Infodemic," provides a theoretical framework to support nurses in identifying behaviors and psychological impacts associated with misinformation and to guide targeted nursing interventions.

RevDate: 2026-07-21
CmpDate: 2026-07-21

Alaka M, Tuaillon E, B Desnues (2026)

Intravenous immunoglobulin therapy in viral infections: Lessons learned from COVID-19.

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 201:119762.

OBJECTIVES: Intravenous immunoglobulin (IVIg) exerts both antiviral and immunomodulatory effects, but its role in viral infections remains incompletely defined. This review aims to provide an integrated overview of IVIg mechanisms of action and to evaluate its clinical relevance in viral diseases, with particular emphasis on coronavirus disease 2019 (COVID-19).

METHODS: A structured narrative literature review was conducted using PubMed (MEDLINE) and complemented by manual screening of the reference lists of relevant publications. The search included studies available through early 2026 addressing the mechanisms of action of IVIg and its clinical application in viral infections. Records were screened by title, abstract, and full-text evaluation according to predefined eligibility criteria, and the evidence was synthesized qualitatively.

RESULTS: IVIg acts through multiple mechanisms, including fragment antigen binding (Fab)-mediated neutralization, fragment crystallizable (Fc) receptor modulation, complement inhibition, cytokine regulation, and neonatal Fc receptor (FcRn)-mediated immunoglobulin G clearance. In immunodeficient patients, IVIg provides passive antiviral immunity and improves viral control. In contrast, in severe viral infections such as COVID-19, disease severity is largely driven by immune dysregulation. In this context, IVIg may exert benefit primarily through immunomodulatory effects rather than direct antiviral activity. Clinical studies in COVID-19 have shown heterogeneous results, influenced by treatment timing, patient selection, dosing strategies, and concomitant therapies.

CONCLUSIONS: IVIg should be considered a context-dependent immunomodulatory therapy rather than a universal antiviral strategy. Its clinical efficacy likely depends on alignment between its mechanisms and disease-specific immunopathology, highlighting the need for biomarker-guided and stage-specific therapeutic approaches.

RevDate: 2026-10-15
CmpDate: 2026-10-13

Kazer SW, Walsh JML, Juttukonda LJ, et al (2026)

Nasal immunity in respiratory viral infection, transmission, and protection.

Immunity, 59(10):2623-2642.

The nasal mucosa plays key roles in protecting against airborne pathogens as the major barrier to the airway. Catalyzed by the COVID-19 pandemic, recent studies focusing on nasal immunity have begun to elucidate how epithelial and immune cells work in concert to fight viral infection, reduce spread to the lower airways, and limit onward transmission. Technologies such as single-cell RNA sequencing and air-liquid interface models are enabling high-resolution views of the cell states and responses that dictate infection resolution and memory formation. Here, we review our current understanding of the cells of the nasal mucosa at homeostasis and their responses during and following viral infection in mice and humans. We discuss emerging correlates of protection before and after exposure, noting the differences between infection and intramuscular vaccination. Finally, we examine novel intranasal vaccination strategies and propose approaches to program tissue-scale memory into the nose to prevent disease and viral spread.

RevDate: 2026-08-15
CmpDate: 2026-08-13

Lee DH, H Kakeya (2026)

Reassessing Early COVID-19 Strategies in East Asia: Insights From Japan and Korea.

Journal of preventive medicine and public health = Yebang Uihakhoe chi, 59(4):343-351.

East Asian countries had remarkably low coronavirus disease 2019 (COVID-19) mortality in 2020, a pattern widely cited as evidence of effective public health interventions. However, Japan and Korea-often classified as having followed similar early intervention strategies-adopted substantially different approaches. These differences are largely obscured by commonly used stringency indices and policy score analyses. While neither country implemented a lockdown, Korea pursued an aggressive, government-mandated strategy based on extensive testing, isolation, quarantine, and compulsory data collection. In contrast, Japan relied on a voluntary model with limited mass testing, a policy that drew strong criticism during the early phase of the pandemic. Because asymptomatic COVID-19 infection was highly prevalent, these divergent testing policies were particularly important in shaping patterns of community transmission. Using excess mortality as a comprehensive outcome metric, Japan's outcomes were as favorable as Korea's through the pre-Omicron period, despite Japan's limited testing. In 2020, excess mortality was negligible in both countries (-1.7% in Japan vs. +0.3 to +2.1% in Korea). In 2021, excess mortality increased modestly (+2.2% vs. +4.0 to +5.6%). However, in 2022, despite approximately 80% vaccination coverage in both countries, excess mortality reached +7.6% in Japan and about +20% in Korea-three times the Japanese level despite Korea's much higher booster rate. These patterns of excess mortality in 2 countries with contrasting testing strategies challenge the view that East Asia's early success stemmed primarily from stringent virus suppression measures. They highlight the need to consider alternative explanations, including the possibility that pre-existing immunity differed substantially across geographical regions.

RevDate: 2026-08-13
CmpDate: 2026-07-14

Balcha WF, Kassahun EA, Nega AT, et al (2026)

Labor Pain Management Practices and Associated Factors Among Licensed Obstetric Care Providers in Ethiopia: A Systematic Review and Meta-Analysis.

Health science reports, 9(7):e72770.

BACKGROUND AND AIMS: Labor pain is a multidimensional experience influenced by emotional, cognitive, and cultural factors. It can be managed using pharmacological, non-pharmacological, or combined approaches. Licensed obstetric care providers (OCPs) are ethically obligated to ensure maternal comfort while safeguarding fetal safety. Evidence on labor pain management practices (LPMP) in Ethiopia remains inconsistent, as prior studies often included students or had unclear inclusion criteria. This systematic review and meta-analysis estimated the pooled prevalence of LPMP among licensed OCPs, identified associated factors, and examined trends before and during the COVID-19 pandemic.

METHODS: We searched major databases and repositories for studies published between January 1, 2018 and October 3, 2025. Risk of bias was assessed using the Joanna Briggs Institute checklist and modified Newcastle-Ottawa Scale, with inter-rater reliability analyses. Meta-analysis was conducted in STATA 17 using random or fixed-effects models. Heterogeneity was assessed using Cochran's Q test and quantified with I[2] statistic. Certainty of evidence rated using GRADE.

RESULTS: Twenty studies involving 7,202 participants were included. LPMP prevalence varied substantially across studies and settings. The pooled prevalence of overall LPMP was 46.9% (95% CI: 42.7-51.1; I[2] = 92.4%). Non-pharmacological practice was 42.8% (95% CI: 36.6-49.1), whereas pharmacological practice was 21.1% (95% CI: 12.5-29.7), decreasing to 15.2% after adjustment for publication bias. Pharmacological practice was modestly higher during COVID-19 (23.7% vs. 18.0%). Factors positively associated with LPMP included provider knowledge, attitudes, training, drug/protocol availability, supportive environments, higher education, longer experience, positive perceptions, being a midwife, and female sex. Certainty of evidence ranged from low to moderate.

CONCLUSION: LPMP prevalence varied considerably across studies and settings. While the pooled estimate suggests that fewer than half of Ethiopian OCPs practiced LPMP, substantial unexplained heterogeneity warrants cautious interpretation. Non-pharmacological methods were more commonly used than pharmacological approaches, highlighting opportunities to strengthen provider training, institutional support, and resource availability.

RevDate: 2026-08-13
CmpDate: 2026-07-14

Jha S, Chaliha LB, Pandey K, et al (2026)

Reimagining tuberculosis elimination in India: diagnostics, drug resistance, and digital health strategies.

Frontiers in epidemiology, 6:1868261.

Tuberculosis (TB) remains a major global public health challenge and one of the leading infectious causes of mortality worldwide, with India contributing approximately 26% of the global TB burden. Despite substantial progress under the National Tuberculosis Elimination Programme (NTEP), India's efforts to achieve the ambitious 2025 TB elimination target continue to face major challenges due to the COVID-19 pandemic, multidrug-resistant tuberculosis (MDR-TB), healthcare disparities, and limitations in surveillance and reporting systems. This review provides a comprehensive overview of the epidemiology of TB in India and critically evaluates the impact of COVID-19, drug resistance, healthcare accessibility, and emerging diagnostic technologies on TB control efforts. A structured literature search was conducted using PubMed, Scopus, and Google Scholar, along with reports from the World Health Organization and the Government of India. The reviewed evidence indicates that the COVID-19 pandemic significantly disrupted TB diagnosis, treatment, surveillance, and healthcare accessibility, leading to declines in case notification and the possible accumulation of undiagnosed TB cases. In addition, the increasing burden of MDR/RR-TB, fragmented private healthcare systems, underreporting, and unequal access to diagnostics and treatment continue to hinder progress toward TB elimination. Although advancements including molecular diagnostics, digital surveillance platforms such as Nikshay, AI-assisted screening, and patient-support programmes have strengthened TB control strategies, important challenges related to implementation, infrastructure, scalability, and antimicrobial stewardship remain unresolved. This review highlights the need for integrated and patient-centred TB control strategies that combine rapid diagnostics, strengthened surveillance, public-private healthcare integration, health systems strengthening, and interventions addressing broader socioeconomic determinants such as poverty, malnutrition, and healthcare inequity. Coordinated multisectoral approaches will be essential for accelerating TB elimination efforts in India in the post-COVID era.

RevDate: 2026-08-06
CmpDate: 2026-07-14

Li N, Yan Y, Li Y, et al (2026)

The effect of high-dose of vitamin C on mortality among aged patients with severe COVID-19: A systematic review and meta-analysis.

Clinical and investigative medicine. Medecine clinique et experimentale, 49(2):31-42.

BACKGROUND: Critically ill patients are frequently deficient in vitamin C. Given the significant mortality rates in the elderly population associated with COVID-19, we aimed to systematically review the literature and evaluate whether high-dose vitamin C can reduce COVID-19 mortality in this population.

METHODS: Multiple data sources (PubMed, Web of Science, ScienceDirect, and medRxiv) were searched using the keywords "COVID-19" AND "vitamin C" up to November 2024. Randomized controlled trials (RCTs) involving COVID-19 patients with relevant data were collected. We used a random or fixed effects meta-analysis to calculate the pooling effect.

RESULTS: Eight RCTs comprising 2,104 patients were ultimately included in the meta-analysis. The pooling effect (odds ratio [OR] 0.97[95% CI 0.80-1.18, P = 0.76) suggested no significant difference in mortality rates between patients treated with high-dose vitamin C and those who were not.

CONCLUSIONS: Vitamin C supplementation might reduce the risk of COVID-19 mortality in critically ill patients; however, this effect varied by study. Additional research is necessary to arrive at a definitive conclusion on this subject.

RevDate: 2026-10-09
CmpDate: 2026-09-23

Naidoo T, Morgenstern C, Doohan P, et al (2026)

A systematic review of Nipah virus disease epidemiological parameters, outbreaks, and mathematical models.

The Lancet. Infectious diseases, 26(10):e409-e422.

Our systematic review, based on PRISMA guidelines (PROSPERO CRD42023393345), characterised the epidemiology, outbreaks, and mathematical models of Nipah virus, an important public health threat in south and southeast Asia. We searched PubMed and Web of Science from database inception to March 14, 2025, and extracted 243 parameters, 89 risk factors, 39 models, and 23 distinct outbreaks from 119 papers. IgG seroprevalence estimates in the general population ranged from 0% to 12·5%. Nipah virus causes severe disease, with pooled case-fatality ratio estimates ranging widely from 9·1% (95% CI 0·2-41·3) in Singapore to 81·9% (95% CI 71·9-88·9) in Bangladesh. The infection timeline and clinical course of Nipah virus remain poorly characterised; we estimated a median incubation period of 8·77 days (165, 95% CI 7·53-10·02) from eight estimates in seven articles with sufficient information. Transmission parameter estimates were scarce, and all but one of five central estimates of the basic reproduction number were less than one. Nipah virus mathematical models (39) were rarely fitted to data (eight). All extracted information is accessible via our R package, epireview.

RevDate: 2026-08-25
CmpDate: 2026-08-25

Thapa N, Jin Y, JH Han (2026)

Innate immune surveillance and nucleic acid sensing: Gatekeepers of inflammatory cell death in respiratory infectious diseases.

Pharmacological research, 231:108340.

Respiratory infections caused by viral pathogens, including influenza A virus, respiratory syncytial virus, and SARS-CoV-2, as well as bacterial pathogens, remain major contributors to global morbidity and mortality. The outcomes of these infections are largely determined by how the host innate immune system detects pathogen-derived nucleic acids and regulates subsequent inflammatory responses. Pattern recognition receptors (PRRs) located in endosomal and cytosolic compartments, including toll-like receptors, RIG-I-like receptors, absent in melanoma 2, and Z-DNA-binding protein 1, as well as the cyclic GMP-AMP synthase-stimulator of interferon genes pathway, recognize viral and bacterial nucleic acids and initiate signaling cascades that promote cytokine production and antimicrobial defense. However, dysregulated PRR activation can trigger inflammatory programmed cell death, including apoptosis, pyroptosis, necroptosis, and PANoptosis. This review summarizes recent advances in understanding how nucleic acid sensing orchestrates inflammatory cell death during respiratory infections, with particular emphasis on pathogen- and cell type-specific mechanisms that shape disease outcomes. We further highlight the dual nature of these pathways, which are essential for pathogen clearance but can drive immunopathology when excessively activated. Defining how nucleic acid-sensing pathways shape inflammatory cell death in respiratory infections may guide host-directed therapies that enhance pathogen clearance while preserving lung function. Overall, the field remains constrained by the predominance of virus-focused and murine preclinical studies, whereas bacterial nucleic acid sensing during respiratory infections remains poorly defined. Future studies should integrate major bacterial infection models with human-relevant respiratory epithelial systems to better translate PRR-mediated immune mechanisms into host-directed therapeutic strategies.

RevDate: 2026-09-29
CmpDate: 2026-09-29

Murugan AK (2026)

Oral disease-associated proteins implicated in neuronal disorders: Emerging roles in diagnosis and treatment.

International journal of biological macromolecules, 377:153500.

Oral health plays a crucial role in maintaining cognitive functions, reflecting a complex interplay between the oral cavity and brain health. Emerging evidence indicates that various oral disease-associated protein molecules are implicated in the pathogenesis of diverse neuronal disorders, including neurodegenerative diseases. This review comprehensively summarizes oral disease-related protein molecules involved in several neuronal disorders, including Alzheimer's disease, Parkinson's disease, neurodegeneration, neuroinflammation, dementia, cognitive decline, and brain fog in two different contexts. Firstly, it describes protein molecules under the classical oral disease condition [Aβ42, total-Tau, phosphorylated-Tau, α-synuclein, DJ-1, lactoferrin, MMP-2/8/9, IL-6, IL-1β, TNF-α, CRP, S100A8, S100A9, S100B, RAGE, LCN2, cathepsin B/L, HSP70/90, NfL, CXCL2/8, C3/4, defensins (α and β), and lysozyme]. Secondly, it explains in COVID-19 context [ACE2, TMPRSS2, furin-1, NRP1, spike, T1R, and T2R]. The review explores oral proteins implicated in neuronal disorders, highlighting their roles in activating inflammatory pathways, contributing to memory impairment, and mediating taste dysfunction in the context of COVID-19. Furthermore, the review delineates the mechanisms underlying the oral-brain axis, highlighting the roles of systemic inflammation, microbial interactions, and blood-brain barrier dysfunction in mediating these effects. It also highlights the innovative diagnostic potential of oral disease-associated proteins as non-invasive biomarkers for early detection and monitoring of neuronal disorders in both classical and COVID-19 contexts. In addition, the emerging therapeutic significance of these proteins is discussed, emphasizing their potential as molecular targets for the prevention and treatment of neurological diseases. Understanding oral disease-associated protein molecules provides novel insights into early diagnosis and progression of neuronal disorders.

RevDate: 2026-07-14
CmpDate: 2026-07-15

Viknesh K, Vijayalakshmi P, Alex AM, et al (2026)

Energetic landscapes and fuzzy complexes: Computational targeting of viral intrinsically disordered proteins.

Advances in protein chemistry and structural biology, 153:351-407.

The increased recognition of intrinsically disordered proteins (IDPs) as critical mediators in viral infections has shifted attention toward fuzzy drug targets, challenging the conventional structure-based paradigms of drug discovery due to their inherent conformational flexibility. The binding of viral IDPs and IDRs to host factors occurs in dynamic, multivalent, and context-dependent interactions and constitute flexible complexes, which form the basis of pathogenicity and immune evasion. In this review, the disordered proteins of viruses are considered with a combination of molecular, computational, and translational insights to assess the next-generation antiviral targets. In this, we have discuss about the energetic landscapes that control the disorder, functional disorder order transitions and the fuzzy interfaces as centers of the networks of virus-host interactions. Special focus is kept on the new lines of computational and AI-directed technologies such as ensemble-based docking, machine-learning computational models of IDP ligand recognition, and multi-omics-driven target prioritization. The experimental approaches that are modified to characterize disordered systems, including NMR spectroscopy and hybrid structural biology, are also reviewed. The translational applicability of the targeting of viral fuzziness is highlighted by case studies of HIV-1, influenza, SARS-CoV-2, and emerging viral pathogens. We also provide directions about the future involving adaptive pharmacophores, customized antiviral approaches, and AI-driven ensemble targeting making disordered viral proteins a paradigm shift in antiviral drug discovery.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Hetta HF, Haseeb A, Bukhari SQ, et al (2026)

Emerging Multimodal Point-of-Care Diagnostic Strategies for Rapid Detection and Management of Respiratory Viruses: A State-of-the-Art Review.

Diagnostics (Basel, Switzerland), 16(13):.

The co-circulation of respiratory viruses, including SARS-CoV-2, influenza A/B, and respiratory syncytial virus (RSV), represents a significant global health challenge that requires rapid, accurate, and differential diagnosis to support infection control and appropriate clinical decision-making. This narrative review summarizes emerging multimodal point-of-care testing (POCT) strategies for the detection and management of these respiratory viruses. Relevant studies were identified through literature searches of major scientific databases, including PubMed, Scopus, and Web of Science, focusing on recent advances in molecular diagnostics, biosensors, microfluidics, and digital health technologies. To improve clinical interpretation and comparative assessment, current POCT platforms were organized into four operational tiers based on infrastructure dependence, degree of portability, and level of decentralization of testing. Tier 1 (Professional Clinical Systems) includes fully integrated automated molecular diagnostic platforms designed for use in hospital and emergency care settings. Tier 2 (Field-Deployable Systems) comprises portable molecular and isothermal amplification technologies designed for use in decentralized or resource-limited environments. Tier 3 (Hardware-Lite Assays) includes simplified diagnostic approaches that minimize instrument requirements and are suitable for near-patient or low-infrastructure settings. Tier 4 (Consumer-Digital Diagnostics) encompasses emerging smartphone- and IoT-integrated diagnostic platforms that support user-driven testing and digital health connectivity. This tier-based framework reflects a proposed stratification of POCT technologies along a decentralization continuum and aims to facilitate comparison and selection of diagnostic strategies across diverse healthcare settings.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Lim S, B Martina (2026)

Immune Mechanisms and Translational Study Design in Viral Vaccine Development.

International journal of molecular sciences, 27(13):.

Viral vaccine development requires both mechanistic understanding of protective immunity and translational study designs that connect preclinical data with human outcomes. Animal models remain important for early assessment of safety, immunogenicity and protective efficacy, but their predictive value depends on the question being asked, the pathophysiology of infection, the immune mechanisms expected to mediate protection, and the biomarkers chosen to bridge animal and human data. This review focuses on viral vaccines and examines innate and adaptive mechanisms of vaccine-induced protection, including B cell and antibody responses, Fc-mediated functions, Fc glycosylation, T cell memory and CD8+ cytotoxic responses. We discuss common reasons for clinical failure and show how preclinical endpoints can be classified as human-counterpart, surrogate or comparative/mechanistic readouts. Influenza and COVID-19 examples illustrate how different models can be combined across discovery, challenge, transmission and late-stage bridging studies. Emerging tools such as systems serology, omics, AI/ML and new approach methods can improve candidate prioritization, but their value depends on assay standardization, biological validation and cautious interpretation. A mechanism-driven model cascade, paired with human-relevant immunological readouts, can improve preclinical interpretation and reduce the risk of advancing candidates that are unlikely to succeed in clinical trials.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Russjan E, Zając D, K Kaczyńska (2026)

Therapeutic Potential of Glucagon-like Peptide-1 Receptor Agonists in Respiratory Disorders.

International journal of molecular sciences, 27(13):.

Glucagon-like peptide-1 (GLP-1) is an incretin hormone secreted in response to food intake that acts biologically by binding to GLP-1 receptors. The primary function of GLP-1 is to stimulate insulin secretion and inhibit glucagon secretion, which helps limit after-meal spikes in blood glucose. GLP-1 reduces intestinal contractility, slows down gastrointestinal motility and emptying, and also acts directly on the hypothalamus, thereby regulating appetite and food intake. Due to its metabolic effects, GLP-1 forms the basis of medications currently used to treat type 2 diabetes (T2DM) and obesity. However, it has also been observed that the use of GLP-1 agonists in the treatment of obesity or diabetes has a beneficial effect on comorbid respiratory conditions. This narrative review analyzes the scientific literature and describes the most recent information on the impact of GLP-1 receptor agonist (GLP-1 RA) therapies on the most common respiratory disorders-both the beneficial and undesirable effects. We discuss evidence that acute lung injury, COVID-19, pulmonary fibrosis, asthma, chronic obstructive pulmonary disease (COPD), and obstructive sleep apnea can benefit from therapies with various GLP-1 RAs. They can complement existing lung-targeted treatments, but as research progresses, they are likely to play an ever more important role in the treatment of respiratory diseases.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Angamarca-Iguago J, Parise-Vasco JM, Reytor-González C, et al (2026)

Temporal Dynamics of Innate Immune Activation and Viral Interference During Sequential Co-Infection with Influenza A Virus and SARS-CoV-2: Molecular Mechanisms, Clinical Evidence, and Therapeutic Implications.

International journal of molecular sciences, 27(13):.

The concurrent circulation of influenza A virus (IAV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has unveiled complex host-pathogen interactions governed by temporal dynamics of innate immune activation. This narrative review synthesizes evidence from human air-liquid interface (ALI) epithelial models, animal studies (hamster, ferret), clinical cohorts, and randomized controlled trials (2015-2026) to delineate the molecular mechanisms underlying viral interference between these two major respiratory pathogens. Prior IAV infection induces a robust type I/III interferon (IFN) response and broad interferon-stimulated gene (ISG) upregulation that restricts subsequent SARS-CoV-2 replication within a critical 24-72 h temporal window. Conversely, SARS-CoV-2 employs a multi-layered immune evasion strategy that blunts IFN induction, providing minimal heterologous protection. Simultaneous co-infection tends to exacerbate disease severity. Host genetic determinants, including OAS1 and TLR7 variants, modulate interference capacity. Therapeutically, early pegylated IFN-λ shows clinical benefit, while experimental evidence from in vitro and animal models suggests oseltamivir may paradoxically reduce IAV-induced interference. These findings underscore the need for multi-pathogen diagnostics, temporally informed clinical decision-making, and IFN-based therapeutic strategies during co-circulation periods.

RevDate: 2026-08-25
CmpDate: 2026-07-15

Basu S, Adhikary D, Ghosh K, et al (2026)

Machine Learning and Deep Learning Frameworks for Human-Virus Protein-Protein Interaction Prediction: Emerging Architectures, Methods, Benchmarks, and Challenges.

International journal of molecular sciences, 27(13):.

The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged as one of the most significant global health crises in recent history. Coronaviruses are a diverse group of RNA viruses classified into alpha, beta, gamma, and delta genera, with SARS-CoV-2 belonging to the beta-coronavirus family. The virus exhibits high transmissibility and causes a wide spectrum of clinical manifestations ranging from mild respiratory symptoms to severe complications such as acute respiratory distress syndrome, multi-organ failure, and death, particularly among elderly and immunocompromised individuals. Structurally, SARS-CoV-2 possesses a large single-stranded RNA genome encoding major structural proteins, including spike (S), envelope (E), membrane (M), and nucleocapsid (N) proteins, which play critical roles in host-cell recognition and viral infection. Understanding the molecular mechanisms of virus-host interactions, especially protein-protein interactions (PPIs), is essential for uncovering viral pathogenesis and identifying potential therapeutic targets. Traditional experimental techniques for PPI detection, such as yeast two-hybrid and affinity purification methods, are often expensive, labor-intensive, and prone to inaccuracies. Consequently, computational approaches based on machine learning (ML) and deep learning (DL) have gained significant attention for efficient and scalable PPI prediction. These methods use diverse biological information, including protein sequences, structural features, genomic data, Gene Ontology annotations, and interaction networks, to model complex biological relationships. This survey reviews computational approaches to PPI prediction, highlighting ML- and DL-based techniques, methodological advances, performance evaluation practices, and limitations that affect benchmark comparability. It also discusses biological databases and data sources commonly used in PPI studies and explicitly considers how models trained in coronavirus-centered settings may generalize to other viral families with different mechanisms of host interaction.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Latzer Y, D Stein (2026)

The Impact of Recent Collective Trauma in Israel on Eating Disorders and Disordered Eating: An Overview and Clinical Perspective.

Healthcare (Basel, Switzerland), 14(13):.

Background: Periods of collective crises are associated with substantial deterioration in mental health. Whereas trauma-related psychopathology has received considerable clinical and policy attention during such periods, eating disorders (EDs) and disordered eating (DE) remain comparatively under-recognized. EDs and DE are well recognized in the Israeli context; however, accumulating evidence indicates a significant increase in their prevalence during periods of collective crisis. Objective: We sought to synthesize empirical findings and clinical observations in Israel about the impact of the COVID-19 pandemic and the October 2023 War on the emergence and exacerbation of DE and EDs, and to examine the implications for clinical practice and mental health policy. Methods: We conducted a narrative review integrating epidemiological data, findings from Israeli healthcare organizations, scientific studies, and clinical insights from specialized ED services. Results: Across both crises, Israel experienced a marked increase in the full spectrum of eating-related disturbances, ranging from emotional eating and subclinical DE to severe full-blown EDs. Adolescents and young adults were particularly affected, but increased ED-related disturbance was also observed among adults and individuals with pre-existing EDs. These findings coincide with a prolonged duration period before receiving treatment and with limited service capacity. In response, the mental health system attempted to implement rapid adaptations, including expanded telemedicine, short-term targeted interventions, and new ambulatory and day treatment programs. Conclusions: Our findings indicate that DE and EDs constitute a significant and escalating mental health burden during periods of collective crises that is comparable to other trauma-related conditions. Just as comprehensive short- and long-term intervention frameworks have been developed for trauma-related conditions, similar models are urgently required for EDs.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Rada M, Petculescu IM, Pah AM, et al (2026)

Valvular Heart Disease and Heart Failure in the Post-COVID-19 Era: A Narrative Review of Mechanisms, Diagnosis, Differential Assessment, and Clinical Outcomes.

Journal of clinical medicine, 15(13):.

Background/Objectives: Cardiovascular involvement is among the most consequential sequelae of SARS-CoV-2 infection. Myocardial injury, arrhythmia, and thromboembolic disease have been characterized in depth, yet the relationship between COVID-19 and valvular heart disease (VHD), and its interplay with heart failure (HF), has received comparatively limited synthesis. This narrative review consolidates current evidence on the mechanisms, diagnosis, differential assessment, and clinical outcomes linking acute and post-acute COVID-19 to valvular dysfunction and to incident or worsening heart failure, with emphasis on practical implications for cardiologists and internists. Methods: We searched PubMed, Scopus, and Web of Science (January 2020-January 2026) for studies on valvular dysfunction, heart failure, myocardial injury, and endothelial pathology in SARS-CoV-2 infection, and synthesized findings narratively. Results: Convergent pathways-endothelial injury, systemic hyperinflammation, micro- and macrovascular thrombosis, and pressure-volume overload-contribute to functional and, less frequently, structural valvular changes. Available evidence suggests that clinically relevant post-COVID valvular abnormalities are more often secondary/functional (mitral and tricuspid regurgitation) than primary structural lesions, although dedicated prospective valvular studies remain scarce. Pre-existing severe VHD markedly worsens acute COVID-19 prognosis. Elevated NT-proBNP, troponin, and interleukin-6 consistently predict decompensation and mortality, and a substantial minority of survivors show persistent fibrotic pulmonary changes and restrictive ventilatory defects on follow-up (pulmonary rather than cardiac findings). Conclusions: Post-COVID valvular dysfunction appears, on currently available but largely indirect evidence, predominantly functional and inflammation-related, and may overlap with HFpEF phenotypes in selected patients when objective diagnostic criteria are fulfilled. Biomarker-guided, multimodality follow-up is reasonable in high-risk survivors, and prospective longitudinal studies with standardized valvular endpoints remain a priority. Dedicated longitudinal evidence on valvular outcomes specifically remains very limited.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Kasiak P, G Procyk (2026)

COACH Study: COVID-19 Influence on Cardiorespiratory Fitness in Athletes-A Systematic Review and Meta-Analysis.

Journal of clinical medicine, 15(13):.

Objectives: We aimed to systematically review and meta-analyze the impact of COVID-19 infection on cardiorespiratory fitness (CRF): (1) within-athlete (the same participants before and after infection), and (2) between-athlete (infected vs. healthy reference participants). Methods: In this systematic review (PROSPERO Registry: CRD42024540430) we included observational studies enrolling recreational or competitive athletes ≥18 years old with laboratory confirmation of SARS-CoV-2 infection. The primary outcome was change in relative maximal oxygen uptake (VO2max). Secondary outcomes included changes in absolute VO2max, maximal ventilation (VEmax), and maximal heart rate (HRmax). We searched Embase, PubMed, Medline, Scopus, and Web of Science up to August 9th, 2025. Risk of bias was assessed with the JBI critical appraisal tool. Meta-analyses were performed with a random-effects model. Results: Twelve studies enrolling a total of 1595 participants met the eligibility criteria. COVID-19 infection was associated with lower relative VO2max (MD = -1.83 mL·kg[-1]·min[-1]; 95%CI [-3.16, -0.49]; p = 0.007; I[2] = 54%) and absolute VO2max (MD = -0.15 L·min[-1]; 95%CI [-0.29, -0.01]; p = 0.03; I[2] = 0%). COVID-19 infection was associated with lower VEmax (MD = -7.99 L·min[-1]; 95%CI [-12.94, -3.04]; p = 0.002; I[2] = 0%) but not with HRmax (MD = -0.34 bpm; 95%CI [-1.54, 0.86]; p = 0.58; I[2] = 0%). High heterogeneity of included studies was addressed with subgroup analyses. The risk of bias in most studies was high. The certainty of evidence was very low for each outcome. Conclusions: COVID-19 infection in athletes was associated with reduced VO2max and VEmax. The relationships were highly dependent on the quality of the studies. CRF and athlete profile should be considered when making shared decisions regarding safe return to sport after infection.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Olarewaju A, Adebowale A, Odutola P, et al (2026)

Use of Natriuretic Peptides in Critically Ill Patients: A Narrative Review.

Journal of clinical medicine, 15(13):.

Background: Natriuretic peptides, including B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), are established biomarkers of myocardial stress and circulatory overload. Although originally validated for diagnosis and exclusion of heart failure, their diagnostic and prognostic applications have expanded significantly in the context of critical illness. However, interpretation in critically ill patients is complicated by confounding factors such as systemic inflammation and renal dysfunction. Objective: This review synthesizes current evidence on the diagnostic, monitoring, and prognostic applications of natriuretic peptides in critically ill adults. It further outlines practical considerations, confounding variables, and emerging complementary biomarkers pertinent to clinical decision-making. Methods: A structured search of PubMed, Embase, and the Cochrane Library (January 2000 to October 2025) identified studies evaluating BNP, NT-proBNP, and atrial natriuretic peptide (ANP) in intensive care unit (ICU) patients. Eligible studies and review articles assessed diagnostic utility, volume status, hemodynamic monitoring, and prognostic performance. Narrative synthesis was employed using information obtained from eligible studies. Results: Twenty-four studies met the inclusion criteria. BNP and NT-proBNP facilitate differentiation between cardiogenic and noncardiogenic respiratory failure, identification of mixed shock states, and assessment of volume status when used in association with other modalities such as echocardiography and ultrasonography. Elevated natriuretic peptide concentrations consistently predict mortality, acute kidney injury, prolonged mechanical ventilation, and adverse outcomes in several disease states, including sepsis, acute respiratory distress syndrome [ARDS], postoperative cardiac dysfunction, and COVID-19-related critical illness. However, interpretation remains limited by confounders, including renal impairment, age, systemic inflammation, brain injury, mechanical ventilation, and right-ventricular strain/dysfunction. Conclusions: Natriuretic peptides serve as valuable adjuncts for diagnostic assessment, hemodynamic monitoring, and risk stratification in the ICU. When interpreted with attention to biological kinetics and clinical context, these biomarkers enhance multimodal monitoring and support individualized management. Future research should refine ICU-specific cutoffs and assess natriuretic peptide-guided therapeutic strategies in prospective multicenter trials.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Neogi SB, Saroha E, Mishra SS, et al (2026)

Telemedicine: An exploration of global impact and Indian perspectives on healthcare delivery, effectiveness, and challenges.

Journal of family medicine and primary care, 15(4):1473-1478.

Telemedicine represents a transformative approach to healthcare delivery, leveraging information and communication technologies to bridge geographical barriers between patients and healthcare providers. This paper explores telemedicine's historical development, global applications, and specific relevance in India, particularly focusing on the eSanjeevani program. Despite its potential, telemedicine faces challenges, such as the digital divide, regulatory frameworks, patient acceptance, and technical limitations. Addressing these challenges requires collaborative efforts among stakeholders to ensure equitable access, data security, and interoperability of telemedicine platforms. Telemedicine has demonstrated its efficacy in enhancing access to healthcare services, particularly in underserved regions, and has emerged as a vital tool during the COVID-19 pandemic. The eSanjeevani program in India serves as a prominent example of successful telemedicine implementation, facilitating millions of consultations and bridging the urban-rural healthcare divide. Looking ahead, telemedicine holds promise in revolutionizing healthcare delivery, fostering ecological responsibility, and advancing toward universal health coverage. Embracing telemedicine represents a significant step toward a healthier, greener, and more sustainable future for healthcare systems worldwide.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Rajeh DA, Amer KA, Alasmari R, et al (2026)

Diabetic ketoacidosis after COVID-19 infection in newly diagnosed patients with diabetes in the Middle East and African countries: A systematic review and meta-analysis.

Journal of family medicine and primary care, 15(4):1527-1539.

INTRODUCTION: The risk of diabetic ketoacidosis (DKA) is increased following the severe acute respiratory syndrome coronavirus 2 infection, "COVID-19," however, little evidence is available regarding the prevalence and outcomes of DKA in newly diagnosed patients with diabetes in the Middle East and African countries. Our objective was to conduct a systematic review of case reports detailing the prevalence and outcomes of DKA in COVID-19 infected in the above referenced countries.

METHODS AND SUBJECTS: Our search encompassed Medline (via PubMed), Embase (via OVID), Web of Science, Scopus, grey literature sources such as Open Access Theses and Dissertations (OATD), and the reference lists of the included studies.

RESULTS: The results of the current meta-analysis study showed that 17 studies met the search criteria and a total of 22 patients (15 patients with newly type 1 diabetes and seven patients with newly diagnosed type 2 diabetes). About 69.5% of the patients were of Arabian ethnicity. Body mass index (BMI) was reported only for seven patients, with a mean of 25.04 k g/m[2]. Two patients died in patients with newly diagnosed type 2 diabetes, giving a mortality rate of 14.3%, while all patients were in type 1 diabetes, who had DKA survived.

CONCLUSIONS: Covid 19 infection in patients with new diabetes from the Middle East and African countries was associated with increased risk of DKA with high mortality in patients with newly diagnosed type 2 diabetes.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Hsu PC, Tsai CC, Chu TY, et al (2026)

Jing-Si Herbal Tea as a multitargeted complementary therapy: Evidence from preclinical and clinical studies.

Tzu chi medical journal, 38(3):289-299.

Jing-Si Herbal Tea (JSHT) is a traditional multi-herbal preparation composed of flavonoids, polyphenols, triterpenoid saponins, glycyrrhizin, and other bioactive constituents that collectively contribute to a wide spectrum of biological activities. Emerging laboratory and clinical studies indicate that JSHT is associated with modulation of oxidative stress, inflammatory responses, and immune-related pathways, with reported antiviral and cytoprotective effects primarily observed in experimental models and exploratory clinical settings. This review synthesizes current evidence describing the diverse pharmacological actions of JSHT and its potential applications across oncologic, inflammatory, metabolic, and infectious disease contexts. Experimental findings suggest that JSHT may be associated with modulation of tumor progression-related processes, including epithelial-mesenchymal transition and aberrant nuclear factor kappa B activity, while being associated with intracellular oxidative stress-related activation of apoptosis- and ferroptosis-related pathways in cancer cell models. Its immunoregulatory capacity is reflected in the attenuation of pro-inflammatory cytokines and the promotion of anti-inflammatory macrophage phenotypes. In respiratory and infectious diseases such as coronavirus disease 2019 and chronic obstructive pulmonary disease, JSHT has been reported to attenuate hyperinflammatory responses and preserve cellular or organ function and has been associated with clinical improvement in selected observational studies, which should be interpreted cautiously. Early clinical data, including results from a randomized study in functional dyspepsia, suggest benefits for gastrointestinal symptoms and anxiety, accompanied by increases in serum butyrate that may indicate involvement of the gut-brain axis. Across available studies, JSHT has shown good tolerability with few reported adverse effects. Overall, the accumulating evidence suggests that JSHT may have potential relevance as a multitarget complementary approach, pending confirmation through well-controlled clinical studies. Nonetheless, more extensive, well-controlled clinical investigations are warranted to validate its efficacy and clarify its mechanistic pathways.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Wendt K, Schieck M, Gille C, et al (2026)

Biomarkers of post-acute infection syndrome: a systematic literature review.

Frontiers in immunology, 17:1741761.

BACKGROUND: Post-acute infection syndrome (PAIS) remained underrecognized before the COVID-19 pandemic, which further increased exposure by introducing a novel global cause. The global burden of post-acute COVID syndrome (PACS) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) alone is estimated at several tens of millions affected worldwide. Biomarker discovery is central to improving PAIS diagnosis and may provide therapeutic targets. This review summarizes current knowledge on biomarkers for PAIS, including PACS and ME/CFS.

METHODS: A systematic literature search was conducted in PubMed and Web of Science. Inclusion criteria were: (1) studies including PAIS patients; (2) reporting laboratory or omics biomarkers; and (3) investigating biomarkers or pathomechanisms of PAIS. Although Guillain-Barré syndrome (GBS) is not PAIS, we have included it as a separate mechanistic comparator due to its prevalence in search results and its clinical and immunological similarities to PAIS.

RESULTS: A total of 142 studies analyzing PAIS biomarkers were included. GBS was analyzed separately and later compared with the other results. Overall, the reviewed studies employed heterogeneous approaches. While similar types of data were frequently investigated, analytical methods varied and often focused only on a subset of molecules. The results indicate that amino acid, energy, and lipid metabolism, microbiome, mitochondrial stress, and miRNA networks are affected. All pathways are connected via NF-κB.

DISCUSSION: PAIS is a multisystem disorder rooted in persistent immune activation, metabolic reprogramming, and systemic inflammation, driven not by active viral infection, but by dysregulated host responses. The NF-κB pathway serves as a unifying hub, connecting molecular, cellular, and clinical phenotypes. Our framework enables a shift from symptom-based to mechanism-based classification, paving the way for biologically grounded interventions.

CONCLUSION: This review synthesizes a broad spectrum of biomarkers in PAIS, integrating findings across pathogens and molecular levels rather than restricting to individual conditions or symptom clusters. This study highlights the differences and commonalities among pathogens and diseases that lead to post-acute sequelae, fills a critical knowledge gap, and provides a foundation for future research and clinical practice. Future studies incorporating multi-omics approaches, longitudinal designs, and larger patient cohorts are needed to validate specific biomarkers and advance the understanding of PAIS.

RevDate: 2026-08-13
CmpDate: 2026-07-15

Sanz-Muñoz I, Farre-Avella M, Barroso-Santos PJ, et al (2026)

State-of-the-art of the high dose influenza vaccine in Spain.

Frontiers in immunology, 17:1843611.

High-dose (HD) influenza vaccines have demonstrated robust effectiveness in preventing severe influenza-related outcomes, including pneumonia, cardiorespiratory complications, and mortality, with evidence from randomized clinical trials, meta-analyses, and real-world studies consistently showing superiority over standard-dose (SD) vaccines and supporting international recommendations for adults aged ≥60 years. This is increasingly relevant in the context of global aging and immunosenescence, which weakens vaccine-induced immune responses and heightens biological frailty, functional decline, and the risk of severe complications in older adults, especially those with comorbidities. The objective of this work is to describe the introduction, uptake, and current use of HD influenza vaccines in Spain and to summarize the evidence supporting their broader adoption in adults ≥60 years of age. Methods include a narrative synthesis of clinical evidence and an analysis of vaccination strategies implemented across Spanish autonomous communities since the introduction of HD vaccines during the COVID-19 pandemic. Available evidence supports extending HD vaccine use as a population-based strategy to enhance protection and promote equitable access. The results show that the incorporation of HD influenza vaccines marked a significant shift in national vaccination strategies, with heterogeneous uptake across regions: while some prioritized institutionalized or dependent populations, others implemented mixed approaches that also included community-dwelling adults aged ≥60 years. In conclusion, a clear trend toward wider adoption is emerging, with an increasing number of autonomous communities incorporating HD vaccines into their programs and progressively lowering the recommended age threshold, in alignment with international guidance and the biological rationale for strengthened protection in older adults.

RevDate: 2026-08-25
CmpDate: 2026-08-13

Albini TA, Yeh S, Regillo CD, et al (2026)

Expert Opinion: Management of Intraocular Inflammation and Vasculitis After Intravitreal Pegcetacoplan for Geographic Atrophy.

Ophthalmic surgery, lasers & imaging retina, 57(8):492-498.

BACKGROUND AND OBJECTIVE: This expert opinion review is intended to provide guidelines for diagnosis and management of intraocular inflammation (IOI) and vasculitis following pegcetacoplan.

PATIENTS AND METHODS: A case series of all post-marketing reports classified by experts as definite or suspected vasculitis over an 18-month period was assessed.

RESULTS: A total of 306,000 pegcetacoplan intravitreal injections were given in the real world between March 1, 2023, and August 31, 2024. Twenty-four eyes from 22 patients (mean age 76 years, 59% female) with definite or suspected vasculitis were evaluated. Comorbidities included hypertension (55%), hypothyroidism (27%), and recent COVID-19 infection (14%). Twelve eyes were classified as vasculitis with occlusion, seven as vasculitis without occlusion, and five as suspected vasculitis. Median time from intravitreal injection to symptoms was 10 days and 88% (n = 21) occurred after the first injection. Symptoms included reduced vision (71%), eye pain (33%), and elevated intraocular pressure (50%). All patients received corticosteroids and 29% received antibiotics. At last follow-up, six eyes recovered visual acuity to within one line of baseline, seven lost between 2 to 5 lines, and 11 lost 6 lines or more.

CONCLUSION: While IOI and vasculitis are rare, patients can be educated to call a retina specialist promptly if symptoms or any vision loss develop, especially within the 2 weeks following the first injection. In addition to excluding an infectious etiology, individualized management with multiroute corticosteroids can be considered.

RevDate: 2026-08-14
CmpDate: 2026-08-14

Dietrich N, B Stubbert (2026)

Artificial intelligence for chest imaging in hantavirus pulmonary syndrome: A review of practical considerations for rare-disease imaging.

Clinical imaging, 138:110895.

Hantavirus pulmonary syndrome (HPS) is an uncommon zoonotic respiratory illness with a high case fatality rate. Recent travel-associated Andes orthohantavirus clusters have renewed interest in early radiographic recognition of the disease outside its usual geographic range. Artificial intelligence (AI) tools developed during the COVID-19 pandemic now inform several radiology workflows, but the application of AI to HPS chest imaging remains largely unexplored. This narrative review summarises the imaging features of HPS across modalities, considers lessons from AI applications in COVID-19 and viral pneumonia imaging, and discusses practical development considerations for HPS-aware imaging AI, including dataset development, label standardisation, realistic comparator inclusion, candidate modelling approaches, external validation, and clinical workflow integration. The review also considers challenges to HPS-aware imaging AI, including data scarcity, low pretest probability in non-endemic settings, overlapping imaging findings, and translational pitfalls from recent AI literature. As HPS is unlikely to support conventional disease-specific model development without coordinated data collection, future work will likely require multi-institutional datasets, prevalence-aware evaluation, and multimodal workflow integration that combines imaging with clinical, laboratory, and epidemiologic context.

RevDate: 2026-08-13
CmpDate: 2026-07-16

Vera E, Galanis P, Mangoulia P, et al (2026)

Factors affecting nurses' professional quality of life in Europe - A systematic review.

AIMS public health, 13(2):485-512.

BACKGROUND: Nursing care involves both cognitive and emotional aspects, significantly impacting nurses' professional quality of life (ProQOL). This systematic review investigated the factors affecting nurses' professional quality of life in Europe.

METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting framework and was registered in the International Prospective Register of Systematic Reviews (registration number: CRD420251133948). Searches were conducted in PubMed, Scopus, CINAHL, ScienceDirect, and EBSCOhost from inception to August 2025. Eligible peer-reviewed quantitative studies from European Union countries utilized the ProQOL instrument, reporting on all three dimensions: compassion satisfaction, burnout, and secondary traumatic stress. Two reviewers independently screened records, extracted data, and appraised methodological quality using the Joanna Briggs Institute critical appraisal tool.

RESULTS: A total of 3407 records were initially identified, and 35 studies were ultimately included, comprising 8580 nursing staff across diverse clinical settings, predominantly hospitals, with 13 studies conducted during the coronavirus disease period in 2019. Most studies reported moderate levels of compassion satisfaction and moderate levels of burnout and secondary traumatic stress. Higher compassion satisfaction was generally associated with greater age and professional experience, relevant education and training, work engagement, supportive work environments, better perceived control over workload, and stronger psychosocial resources, including resilience, psychological flexibility, self-compassion, mindfulness, and social support. Higher burnout and secondary traumatic stress related to indirect exposure were consistently linked to a high workload, overtime, rotating schedules, job stress, workplace violence, employment in high-intensity clinical areas, and adverse psychological states, including persistent stress, fear related to the coronavirus disease, and moral distress.

CONCLUSIONS: Professional quality of life among European nursing staff is influenced by a combination of demographic, occupational, and psychosocial factors. Multilevel strategies addressing organizational stressors while strengthening individual and team-based resources are warranted to improve compassion satisfaction and reduce burnout and secondary traumatic stress.

RevDate: 2026-08-13
CmpDate: 2026-07-16

Du D, Sun G, Yuan L, et al (2026)

Internet healthcare in Chinese public hospitals: Towards high-quality development (1986-present).

AIMS public health, 13(2):598-621.

BACKGROUND: Internet healthcare has become a key part of China's hospital-centered health system. Driven by "Internet Plus Healthcare", Healthy China 2030, and public-hospital high-quality development policies, it has evolved from remote consultation experiments into regulated online-offline care pathways. This review traces its development from the first documented remote medical practice in 1986 to the present, focusing on policy, institutional models, clinical evidence, governance challenges, and reform.

METHODS: We conducted a structured narrative review of English- and Chinese-language sources on internet healthcare in Chinese public hospitals. PubMed/MEDLINE, Web of Science Core Collection, China National Knowledge Infrastructure (CNKI), and official policy sources were searched. Eligible sources addressed internet hospitals, telemedicine, online follow-ups, remote monitoring, e-prescriptions, insurance payments, digital governance, clinical outcomes, patient safety, equity, or implementation barriers in mainland China.

RESULTS: Internet healthcare progressed through early telemedicine, institutional network expansion, internet-hospital development, and pandemic-driven normalization. The 2018 regulatory framework positioned internet hospitals as extensions of licensed physical medical institutions, thereby permitting online follow-ups for common and chronic diseases while preserving offline accountability. During COVID-19, online consultation, e-prescriptions, drug delivery, and insurance payments rapidly expanded. Evidence suggests benefits for chronic disease management, medication adherence, cardiovascular secondary prevention, and reduced travel burden. However, evidence remains limited for diagnostic accuracy, adverse events, emergency escalation, and long-term outcomes. Persistent barriers include quality variation, workload, cybersecurity, data fragmentation, artificial intelligence (AI) accountability, reimbursement design, regional inequity, and digital exclusion among older adults.

CONCLUSION: China's model may be understood as a hospital-centered extension of public-hospital functions rather than a stand-alone virtual-care system. Future development should prioritize outcome-based evaluations, safety governance, equitable access, data interoperability, and accountability for internet-based and AI-assisted care.

RevDate: 2026-09-26
CmpDate: 2026-07-16

Larrain D, CM Parker (2026)

Beyond Prison Walls: A Scoping Review of Incarceration's Public Health Impacts in Latin America.

Wellcome open research, 11:193.

BACKGROUND: Incarceration has vast and unequal impacts on public health beyond prison walls. Research from the United States documents these collateral consequences, including elevated mental illness and morbidity for the children and partners of incarcerated individuals, alongside community-level effects such as increased rates of teenage pregnancy and multidrug-resistant tuberculosis. In Latin America, however, these broader health impacts remain critically understudied. A significant barrier is the absence of data collection efforts or theoretical frameworks for mapping how Latin America's prisons affect the health of families and surrounding communities.

OBJECTIVE: This scoping review synthesises existing evidence on the collateral health consequences of incarceration in Latin America by conducting a comprehensive search in 2025 that included English, Spanish and Portuguese language peer-reviewed studies.

RESULTS: From 17 included documents, prisons emerge as epicentres for tuberculosis transmission to visiting families and surrounding communities. The evidence reveals significant mental and physical health burdens on families. Women with incarcerated partners experience depression and anxiety whilst managing economic strain and expanded caregiving responsibilities, often neglecting their own health. Children of incarcerated parents show marked emotional distress, and incarcerated mothers alongside their young children face severely inadequate healthcare access within detention spaces.

CONCLUSIONS: Despite collecting demographic data, most studies overlook how these burdens fall unequally across racialised populations. Future research must centre ethnoracial disparities and situated knowledge.

RevDate: 2026-07-16

Foláyan MO, Arobo A, Oyeyemi E, et al (2026)

Integrating Oral Health Into Pandemic Preparedness and Response: Missed Opportunities and Strategic Imperatives for Global Health System Resilience and Security.

Community dentistry and oral epidemiology [Epub ahead of print].

BACKGROUND: Despite evidence linking oral health to severe COVID-19 outcomes and its potential role in surveillance and service delivery, integration remained absent. This study enquired about: (1) representation of oral health in national COVID-19 taskforces and funding; (2) policy-level barriers to inclusion; (3) lessons from maintaining essential services; and (4) strategies for mobilizing oral health professionals in future emergencies.

METHODS: We conducted a scoping review guided by the PRISMA-ScR framework. Systematic searches were performed in PubMed/MEDLINE and Scopus (2000-2025) using tailored search strings combining key terms: oral health, pandemic preparedness, COVID-19, dentistry, health systems and related MeSH terms. Eligible evidence included peer-reviewed studies, reviews, policy documents and commentaries in English. Non-human studies were excluded. Data were charted using the WHO Health System Building Blocks framework.

RESULTS: After dual-reviewer screening, 2569-3860 records were screened, yielding 5-8 eligible studies per question (26 studies total). The evidence revealed a consistent narrative of systemic exclusion yet operational resilience. For representation, oral health professionals were almost universally absent from national COVID-19 task forces, with dedicated financial support entirely lacking. Regarding barriers, policy integration was hindered by the framing of oral care as non-essential, its omission from global health security architectures like the International Health Regulations, and limited professional advocacy. In contrast, lessons from service adaptation demonstrated that essential care was maintained through the rapid adoption of triage, teledentistry, robust infection control and effective communication. On workforce mobilization, while consensus existed on the potential for OHPs to expand into roles such as vaccination and surveillance, implementation was obstructed by a lack of pre-emergency training, formal deployment mechanisms and regulatory frameworks with minimal linkage to international instruments.

CONCLUSION: The review reflects systemic neglect of oral health, with the literature dominated by descriptions of clinical and operational adaptations rather than formal policy integration. We identify missed opportunities in leveraging OHPs for pandemic response and propose embedding oral health within One Health governance, financing, surveillance and emergency response structures to build more resilient health systems.

RevDate: 2026-08-20
CmpDate: 2026-08-18

Översti S, Lytras S, Kawakubo S, et al (2026)

From sites to structure to serology: a roadmap for structure-aware molecular evolution of antigenically evolving viruses.

Journal of virology, 100(8):e0168725.

The genomic deluge has pushed viral molecular evolution into a site-resolved era. For antigenically evolving viruses such as influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), dense genomic sampling now supports mutation-annotated phylogenies and per-site estimates of mutation and substitution processes. These data highlight strong effects of sequence context, genomic region, RNA structure, and protein-level constraints that are blurred by classic uniform substitution models. In parallel, accurate structure prediction and emerging structure-aware phylogenetic and machine-learning approaches provide practical ways to map mutations onto three-dimensional constraints, identify structurally plausible escape routes, and interpret evolutionary rate variation through solvent exposure, packing, stability, glycosylation, receptor-binding interfaces, and epitope geometry. Finally, antigenic cartography translates some forms of genetic change into an epidemiologically meaningful phenotype-antigenic distance-while predictive modeling increasingly enables sequence-to-antigenicity inference for variants that have not yet been tested experimentally. Here, we outline a practical framework linking sites, structure, and serology for viruses in which antigenic evolution is a major component of immune escape and lineage turnover; highlight why genetic and antigenic "clocks" can diverge; and discuss how integrating genomic surveillance data, phylogenetics, structural analysis, and predictive modeling could support more prospective variant assessment and improved vaccine and therapeutic design.

RevDate: 2026-09-11
CmpDate: 2026-09-11

Hashemi S, D Pati (2026)

Healthcare Design for Pandemic Resilience: A Systems Thinking Approach.

HERD, 19(4):256-276.

BackgroundThe COVID-19 pandemic created unprecedented operational challenges (such as surge-capacity demands and infection-control requirements) that disturbed the equilibrium of healthcare work systems worldwide. Physical environments can play a pivotal role in mitigating or exacerbating these challenges.PurposeThis article aims to strengthen healthcare-system resilience in future pandemics by synthesizing the findings of existing literature to identify environmental factors that supported or hindered healthcare work systems during the COVID-19 pandemic.MethodsWe conducted a systematic search of the CINAHL, MEDLINE, PubMed, and ScienceDirect databases and complemented this search with handsearching. We included studies if they addressed the COVID-19 pandemic, focused on physical healthcare environments, and were published in English in peer-reviewed journals. With a focus on environmental influences, we deductively coded the findings using components of the Systems Engineering Initiative for Patient Safety (SEIPS) model.ResultsForty-two studies met the inclusion criteria. The analysis revealed six major operational challenges: (1) surge capacity, (2) infection control, (3) increased risk of errors, (4) rethinking of care models, (5) financial losses, and (6) the pandemic's adverse psychological impacts on staff and patients. The article documents environmental factors that influenced either the overall healthcare work system or its individual components during the COVID-19 pandemic. We identified three overarching roles for these environmental factors: they served as barriers, solutions, or facilitators.ConclusionsUsing the SEIPS framework can enable well-orchestrated pandemic-response planning by guiding the creation of design strategies that will strengthen resilience, flexibility, and safety in future health crises.

RevDate: 2026-10-19
CmpDate: 2026-10-19

Farrag MA (2026)

The Role of Artificial Intelligence and Machine Learning in Predictive Virology: Forecasting, Tracking, and Combating Viral Threats.

Vector borne and zoonotic diseases (Larchmont, N.Y.), 26(12):733-755.

The escalating threat of viral pandemics, dramatically illustrated by the COVID-19 crisis, has exposed the critical shortcomings of conventional reactive virology in addressing rapidly evolving pathogens. This review introduces predictive virology (PV) as an artificial intelligence (AI)-driven discipline within broader epidemic intelligence and public health surveillance that uses advanced computational tools to forecast viral threats and accelerate countermeasure design. The current review systematically examines how AI-driven approaches (e.g., machine learning and deep learning) are reshaping virology by integrating vast genomic datasets, multimodal surveillance signals, and advanced computational models to anticipate viral emergence and evolution before widespread transmission occurs. Core pillars of PV discussed include zero-shot mutational fitness and antigenic escape prediction using large protein language models; multimodal early-warning systems that fuse wastewater monitoring, digital epidemiology, mobility data, and social media; neural differential equation-based transmission modeling; generative AI for de novo design of broad-spectrum antivirals and vaccines; and ecological risk assessment of zoonotic spillovers. In retrospective benchmarks against deep mutational scanning experiments and real-world epidemiological outcomes (SARS-CoV-2 variants, influenza, and other outbreaks), several AI-powered tools have demonstrated performance comparable to or exceeding traditional methods, although prospective validation at scale remains limited. Despite remarkable progress, significant challenges persist, including data bias, overfitting to historical patterns, lack of prospective validation, and limited generalizability across settings. In addition, there are concerns about mechanistic interpretability, equitable global data integration, and responsible deployment. This review also critically addresses the ethical, governance, and equity implications of deploying predictive capabilities at a global scale. By consolidating cutting-edge AI methodologies with virological insights and acknowledging current limitations, this work provides a comprehensive framework for transitioning virology from a reactive to a truly predictive discipline, ultimately strengthening global health security and pandemic preparedness.

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