RevDate: 2026-04-02
CmpDate: 2026-04-02

Pathak H, Baliga SP, Shibu A, et al (2026)

Electroconvulsive therapy research in India: A scoping review.

Indian journal of psychiatry, 68(3):218-254.

BACKGROUND: Electroconvulsive therapy (ECT), since its introduction, remains one of psychiatry's most effective treatments. India has contributed substantially to research across its clinical, technical, ethical, and sociocultural dimensions. Despite this extensive body of work, the evidence has remained scattered and heterogeneous, without a single comprehensive synthesis.

AIM: The present review sought to systematically summarize the scope of ECT research conducted in India.

METHODS: Following PRISMA-ScR guidelines, a systematic search of major databases and Indian psychiatric journals was undertaken, and eligible studies were narratively synthesized.

RESULTS: A total of 270 articles were included. The findings demonstrate effectiveness of ECT in schizophrenia, depression, mania, and catatonia. Research on ECT parameters has refined understanding of stimulus dosing, seizure thresholds, pulse widths, and electrode placements, contributing to safer and more individualized treatment delivery. Literature on adverse effects indicates that most cognitive and noncognitive effects are transient and can be systematically monitored using structured tools. Anesthesia-related studies highlight agents that optimize seizure quality and cardiovascular stability, with propofol, etomidate, and ketamine offering distinct advantages. Adjuvants such as dexmedetomidine and esmolol effectively moderate sympathetic responses. Knowledge-attitude-practice studies reveal persistent knowledge gaps and media-driven stigma, although educational interventions improve perceptions. Legal and ethical discussions predominantly address challenges following the Mental Healthcare Act 2017. Additional literature addresses neurobiology, biomarkers, device development, service delivery trends, including COVID-19-related disruptions.

CONCLUSION: Overall, Indian ECT research is broad and methodologically diverse, yet important gaps remain, particularly regarding long-term outcomes, cost-effectiveness, qualitative perspectives, and ultrabrief pulse ECT. Addressing these gaps, enhancing awareness, and strengthening service capacity remain paramount.

RevDate: 2026-04-02
CmpDate: 2026-04-02

Khuna L, Sriarmad R, Pang MYC, et al (2026)

Effects of exercise programs on cardiopulmonary function and signs and symptoms in patients with post-COVID-19 condition: a systematic review and meta-analysis.

Frontiers in medicine, 13:1772741.

BACKGROUND: Exercise is increasingly recognized as an effective adjuvant therapy for individuals with post-COVID-19 condition. However, exercise interventions vary widely in intensity, frequency, setting, and duration. To date, no systematic review and meta-analysis has evaluated programs lasting at least 6 weeks in this population. This study aimed to assess the effects of exercise on cardiopulmonary function and clinical symptoms in patients with post-COVID-19 condition.

METHODS: We systematically searched for studies involving patients with post-COVID-19 condition in the Embase, MEDLINE/PubMed, and Scopus databases. The databases were searched using keywords including COVID-19 OR coronavirus OR SARS-CoV-2, AND exercise OR physical exercise OR rehabilitation program, AND pulmonary function OR lung function OR signs and symptoms, AND randomiz* contro* trial OR clinical trial OR RCT on July 2024. The risk of bias of individual trials and the certainty of the body of evidence were evaluated using the Physiotherapy Evidence Database scale and the Grading of Recommendations, Assessment, Development, and Evaluation approach, respectively. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was used to describe the study selection process. The mean (± standard deviation) for continuous data and the frequency (n) and percentage (%) for dichotomous data were estimated, and the effects across trials were combined using a meta-analysis with random-effects models.

RESULTS: We included 10 randomized controlled trials comprising 602 participants. The age of participants ranged from 18 to 70 years. The average exercise duration across the 10 studies was 8.6 weeks (ranging from 6 to 16 weeks). Most exercise programs included aerobic exercise, resistance exercise, breathing exercise, thoracic mobility exercise, chest expansion exercise, and respiratory muscle training. The exercise programs included home-based or telehealth-based programs, center-based programs, and combined center- and home-based programs. Compared with control groups (e.g., usual care, exercise advice, or no structured exercise), exercise interventions significantly improved exercise capacity (6-min walk distance), pulmonary function (forced vital capacity and forced expiratory volume in 1 s), dyspnea (the modified Medical Research Council scale), physical pain, and health-related quality of life domains. The overall certainty of evidence for all outcome measures ranged from moderate to high.

CONCLUSION: Exercise programs of at least 6 weeks are associated with improved cardiopulmonary function, reduced dyspnea and pain, and enhanced physical and health-related outcomes in patients with post-COVID-19 condition.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024538786.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Pullamsetti SS, Vanderpool RR, de Man F, et al (2026)

Advanced Molecular, Metabolic, and Imaging Approaches to Characterizing Right Ventricular Failure: A Scientific Statement From the American Heart Association.

Circulation, 153(19):e1304-e1322.

Right ventricular (RV) dysfunction is a key predictor of outcomes in pulmonary hypertension (PH), substantially contributing to illness and death. As PH progresses, increased pulmonary vascular resistance places chronic pressure overload on the right ventricle. Initially, the right ventricle adapts through hypertrophic remodeling, thickening the heart wall to maintain cardiac output. Over time, this adaptive phase shifts to maladaptive remodeling, marked by RV dilation, fibrosis, stiffness, and decoupling from the pulmonary artery, known as RV-pulmonary arterial uncoupling. This uncoupling reflects the inability of the right ventricle to sustain contractility against elevated afterload, ultimately leading to right heart failure, the primary cause of death in late-stage PH. Awareness of RV dysfunction has grown, extending beyond PH and pulmonary arterial hypertension to systemic conditions, such as heart failure with preserved ejection fraction, congenital heart disease, COVID-19, and complications of left ventricular assist device implantation. Research is increasingly focused on understanding the molecular and hemodynamic drivers of RV failure, including inflammation and altered cellular signaling. Innovations in imaging and biomarker discovery are improving the detection of maladaptive RV remodeling. Promising treatments, such as the activin signaling inhibitor sotatercept, may reduce pulmonary vascular resistance and support RV recovery. Further work is needed to enhance RV function and prevent failure. This review summarizes current knowledge on RV dysfunction in PH, emphasizing its mechanisms, clinical relevance, and therapeutic potential. Recognizing the right ventricle as a central therapeutic target may lead to more personalized, effective interventions and improved patient outcomes in PH and related conditions.

RevDate: 2026-04-02

Zhou W, H Fan (2026)

Towards sustainable age-inclusive workplaces: A systematic review on how technological tools support or hinder work participation for older workers (2014-2024).

Work (Reading, Mass.) [Epub ahead of print].

BackgroundThe rapid development of technological tools has significantly impacted the work participation of older workers. Technology opens new doors for older workers, though not everyone finds it easy to walk through them.ObjectiveThis review sought to investigate how technological tools influenced the participation of older workers in the workforce.MethodsWe searched four major databases (PubMed, Scopus, Web of Science, and Cochrane) using PRISMA guidelines to identify studies from the past decade (2014-2024).ResultsThirty-seven studies were included. Research on technology and older worker employment has grown substantially since 2020, with the COVID-19 pandemic likely driving this increased interest. Technological tools advance economic engagement and social inclusion for older workers, but they also generate participation barriers across personal and institutional dimensions.ConclusionsThe impact of technology on the employment of older workers depends largely on implementation strategies. Three strategies can help older workers prosper in digital workplaces: providing comprehensive training, designing user-friendly tools with older workers involved, and creating organizational support systems.

RevDate: 2026-06-21
CmpDate: 2026-04-02

Vidal M, Gallego C, Roncancio G, et al (2026)

Expert consensus: first multidisciplinary consensus on nuclear cardiology.

Archivos de cardiologia de Mexico, 96(Supl 2):1-17.

BACKGROUND: Nuclear cardiology integrates nuclear medicine and cardiology to improve the diagnosis, risk stratification, and management of cardiovascular diseases. The continuous development of these techniques and their increasing clinical use require standardized, evidence-based protocols to optimize their application. Therefore, developing consensus documents is essential to ensure appropriate use of imaging for patient benefit.

OBJECTIVE: To develop consensus recommendations for the use of nuclear imaging in cardiovascular infections, coronary artery disease, left ventricular dysfunction, amyloidosis, and sarcoidosis by addressing unresolved questions in clinical practice among general practitioners and specialists, promoting updated and safe application in prevalent national pathologies.

METHOD: A multidisciplinary panel of 19 experts in cardiology, nuclear medicine, and infectious diseases answered 18 clinical questions based on an initial literature review and applying the Nominal Group Technique in a nine-phase process.

RESULTS: The consensus generated 18 recommendations on specific indications for nuclear cardiology studies and key elements for report standardization, improving clinical interpretation, assessing the impact of pharmacological therapies and surgical procedures, and evaluating prognostic value and integration with other imaging techniques.

CONCLUSIONS: The consensus provides practical, evidence-based guidance to standardize and optimize nuclear cardiology use in common cardiovascular diseases, promoting rational, effective, and economically viable application of these advanced diagnostic techniques. It strengthens clinical decision-making, therapeutic planning, and interdisciplinary coordination in comprehensive cardiovascular patient management in Colombia.

RevDate: 2026-06-15
CmpDate: 2026-06-10

Torres-Flores A, Bautista-Sebastián E, Rivera-Hernández T, et al (2026)

COVID-19 in Latin America: Clinical and immunological insights, vaccine development, and lessons for pandemic preparedness.

Seminars in immunology, 82:102025.

The COVID-19 pandemic had a profound impact on Latin America, exposing structural inequalities, fragmented healthcare systems, and longstanding technological dependence. The region experienced a high burden of infection and excess mortality, influenced by socioeconomic vulnerability and a high prevalence of metabolic comorbidities. In response, countries expanded diagnostic capacity, strengthened genomic surveillance, and increased participation in clinical research and therapeutic evaluation. Coordinated regional collaboration facilitated the detection and tracking of emerging SARS-CoV-2 variants. Local innovation also advanced diagnostic platforms and vaccine development, leading to regionally produced vaccines such as Soberana, Abdala, ARVAC, and Patria. These initiatives generated valuable clinical and immunological data, including characterization of inflammatory biomarkers associated with severe disease and evidence of hybrid immunity in highly exposed populations. However, persistent inequities in healthcare access, research investment, and manufacturing capacity continue to constrain regional self-sufficiency. Although collaboration among academia, industry, and government reduced certain external dependencies, structural limitations in funding stability, regulatory harmonization, and large-scale production remain. The Latin American experience highlights both adaptive scientific capacity during crisis conditions and the challenges of consolidating emergency-driven advances into durable preparedness. Sustained investment and coordinated governance will likely determine whether short-term responsiveness translates into long-term regional strengthening.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Borromeo AS, Manaloto AM, RV Vicedo (2026)

Megatrends and equity gaps in global digital health: A bibliometric review (2010-2025).

Health policy (Amsterdam, Netherlands), 169:105621.

BACKGROUND: Digital health has become increasingly prominent in health systems and policy discourse, yet published evidence remains fragmented across technologies, regions, and equity dimensions.

OBJECTIVE: To descriptively map the evolution of global digital health research from 2010 to October 2025 and identify its intellectual foundations, thematic fronts, and equity gaps using bibliometric methods.

METHODS: A bibliometric review of Scopus-indexed English-language journal articles was conducted and analyzed in VOSviewer (v1.6.20). Co-citation mapping used association-strength normalization with a minimum citation threshold of 15 cited references, resolution 0.50, and minimum cluster size 5. Co-word analysis of author keywords used a minimum occurrence threshold of 462, resolution 1.03, and minimum cluster size 6. Descriptive indicators summarized annual output and citation impact.

RESULTS: The dataset comprised 8210 articles with 140,459 citations (mean=17.1). Output surged after 2020, with 82.9% of publications appearing from 2020 to 2025 and peaking in 2025 (n = 1705). Co-citation analysis revealed four clusters: systems-strengthening in LMICs, digital epidemiology and algorithmic equity, digital-health literacy and evidence-based eHealth, and virtual-care transformation during COVID-19. Co-word analysis identified four thematic fronts: adult care and health disparities, digital health systems and workforce access, youth health literacy and digital inclusion, and pandemic-era virtual care. Cross-cutting gaps included interoperability, sustainability, digital literacy, responsible AI governance, equity-by-design, and LMIC-led evaluation.

CONCLUSIONS: Global digital health research has expanded rapidly into an interdisciplinary field. This review maps major themes and gaps but does not establish causal evidence of policy impact. Findings highlight priorities for interoperability, responsible AI, digital inclusion, sustainability, and LMIC-led evaluation.

RevDate: 2026-04-02

Griner SB, Garza SR, Alkhatib SA, et al (2026)

Point-of-care testing for chlamydia and gonorrhoea: a narrative review of patient perspectives and implementation into non-traditional settings.

Sexually transmitted infections pii:sextrans-2025-056736 [Epub ahead of print].

OBJECTIVES: The demand for point-of-care testing (POCT) increased exponentially during the COVID-19 pandemic, providing a convenient and accessible method of virus detection outside of traditional laboratory settings. As high rates of sexually transmitted infections (STIs) remain a prominent public health concern, POCT for STI detection may offer an option that reduces key barriers to care such as stigma and limited clinic hours. The aim of this narrative review is to identify key facilitators, barriers and gaps related to the acceptability and implementation of STI POCT from patient perspectives in non-traditional settings.

METHODS: To conduct this narrative review, a comprehensive literature search was conducted using PubMed, Embase and Scopus to identify relevant studies published between 1 January 2015 and May 2025, focusing on patient perspectives and contextual determinants of POCT implementation for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). Search terms included free-text keywords (such as "point of care") and indexed terms (such as Point-of-Care Testing (MeSH)). Findings were contextualised based on patient perspective data and implementation into non-traditional settings.

RESULTS: 40 studies were included in the narrative review, reflecting geographical regions where POCT implementation has been prioritised. Study designs and implementation environments varied. POCT for CT/NG screening generally reported high diagnostic accuracy and reliability as well as increased uptake and high acceptability across settings. Availability, perceived convenience and increased autonomy significantly influenced POCT uptake and implementation among patients. Implementation facilitators included ease of device usage, minimal training and improved quality of care. Implementation barriers primarily focused on logistics, workflow and cost.

CONCLUSIONS: Community-engaged approaches to designing and implementing STI POC tests in non-traditional settings are necessary to better understand specific needs. High patient satisfaction, device acceptability and improved health outcomes place STI POCT as a promising avenue for strengthening public health efforts against the STI epidemic.

RevDate: 2026-06-03
CmpDate: 2026-06-03

Yi T, O'Hara DV, A Levin (2026)

Global kidney health: Are we failing the silent pandemic?.

Journal of internal medicine, 300(1):26-38.

Chronic kidney disease (CKD), although not infectious, has a sharply rising global incidence, alarming rates of death and disability, and the potential to disrupt health systems and economies. Thus, it demands the urgency and global attention of past pandemics. Over 850 million people are affected, disproportionately impacting people in low- and middle-income countries. Although CKD can be detected with simple and cost-effective testing, it is a silent condition, often remaining asymptomatic until it has progressed to advanced stages where effective treatment options are limited. Early detection relies on systematic population-level screening, especially among individuals with comorbidities. The global response to CKD has remained largely silent: There is limited evidence of prioritization within health agendas and inadequate infrastructure for screening, surveillance, and treatment. Coordinated global action is required to halt this silent "pandemic," especially given advances in care and policy: New effective disease modifying therapies may lead to remission of CKD for many individuals, and the 2025 World Health Organization's adoption of the Kidney Health Resolution at the 78th World Health Assembly prioritizes kidney health to reduce the burden of noncommunicable diseases through promoting early screening, strengthening disease prevention, and improving access to care. In this review, we examine the failure to address the escalating CKD "pandemic" and explore how the use of low-cost and cost-effective screening tools, such as simple urine dipstick testing, and applying lessons learned from the COVID-19 pandemic are critical to further reframing CKD as a public health emergency and prioritizing kidney health on the global agenda.

RevDate: 2026-04-02

Longet S, S Paul (2026)

Current status of intranasal and inhaled COVID-19 vaccines.

NPJ vaccines pii:10.1038/s41541-026-01432-w [Epub ahead of print].

The COVID-19 pandemic has accelerated the development of intranasal and inhaled COVID-19. vaccines. Four vector-based and one adjuvanted protein-based vaccines have been licenced. They have been shown to be safe. However, their ability to induce strong protective mucosal immunity in humans remains to be improved. Diversifying intranasal vaccine platforms, improving the delivery of vaccine components and determining mucosal correlates of protection could help in optimizing intranasal COVID-19 vaccine efficacy.

RevDate: 2026-06-10
CmpDate: 2026-06-04

Iuzabchuk DA, Andrianova AA, Yampolsky IV, et al (2026)

Beyond Antiviral Therapy: Untapped Potential of HIV & HCV Protease Inhibitors.

Medicinal research reviews, 46(4):1042-1050.

Development of de novo therapeutic agents is a complex, costly, and a high-risk process, whereas repurposing approved and investigational drugs for novel targets offers a more efficient and cost-effective strategy, likely yielding higher success rates. This approach demonstrated its effectiveness during SARS-CoV-2 pandemic, when existing drugs were repurposed to combat the virus. Originally pivotal in developing antiviral treatments against HIV and HCV, viral protease inhibitors represent a structurally privileged class of compounds capable of targeting difficult and non-classical protein sites. They have demonstrated promising biological activity against diverse alternative targets, including fungal pathogens, multidrug-resistant bacteria, and cancer, making them prime candidates for repurposing. This mini-review highlights the unique structural and physicochemical properties of approved HCV and HIV viral protease inhibitors that enable their repurposing for the development of new therapeutic agents.

RevDate: 2026-06-21
CmpDate: 2026-04-03

Yagi M, Tasaki R, J Komano (2026)

Meta-Analysis of COVID-19 Cluster Events Suggestive of Long-Distance Airborne Transmission/Inhalation.

MicrobiologyOpen, 15(2):e70232.

SARS-CoV-2 spreads through both contact and airborne routes, the latter encompassing airborne transmission/inhalation as well as the direct deposition of infectious respiratory particles. During the early phase of the COVID-19 pandemic, numerous cluster events were suspected to involve long-distance airborne transmission/inhalation. We conducted a comparative analysis of these cluster events to characterize outbreak settings and associated clinical parameters. Thirteen cluster events from 2020 attributed to the original SARS-CoV-2 strain were examined, including choral activities, indoor sports, and bus tours. Incubation periods and infection-hospitalization rates (IHRs) were compared across settings and against estimates from large-scale cohort studies that predominantly reflect transmission via direct deposition. Statistical analyses were performed using the Mann-Whitney U test, Student's t-test, and Fisher's exact test (p < 0.05). The mean incubation period in suspected long-distance airborne transmission/inhalation cases was 6.1 ± 3.9 days (median: 5 days; N = 176), with indoor sports and choral events showing significantly shorter incubation periods (p = 0.034). The average IHR was 6.7 ± 12.5%, with significantly higher rates in choral clusters (p = 0.013). Age-adjusted IHRs were lower in long-distance airborne transmission/inhalation-related clusters than those reported from contact-tracing datasets. This analysis provides an integrated evaluation of long-distance airborne transmission/inhalation settings and their associated clinical characteristics. Activities involving vigorous respiration may contribute to shorter incubation periods and higher disease severity, potentially reflecting increased viral inoculum at exposure.

RevDate: 2026-04-03
CmpDate: 2026-04-03

Nayak BB, Rajesh R, Teppan J, et al (2026)

Interleukin-23 in lung and airway diseases: from pathogenesis to precision-guided therapeutic targeting.

Frontiers in pharmacology, 17:1784434.

Interleukin-23 (IL-23) is a pleiotropic cytokine belonging to the IL-12 family and is predominantly produced by antigen-presenting cells. It plays a central role in shaping adaptive immunity by promoting the polarization, expansion, and maintenance of T helper 17 (Th17) cells, thereby driving the production of downstream effector cytokines such as IL-17A and IL-22. Under physiological conditions, IL-23 contributes to pulmonary immune homeostasis and host defense against bacterial and fungal pathogens. However, sustained or dysregulated IL-23 signaling promotes chronic inflammation and tissue damage. Beyond autoimmune diseases, where IL-23 is a well-established key mediator linked to disease severity and a validated therapeutic target, it has also emerged as a critical mediator in chronic lung diseases. Enhanced IL-23 signaling has been associated with increased disease severity, corticosteroid resistance, airway remodeling, and progressive tissue fibrosis, highlighting its contribution to both inflammatory and structural components of lung pathology. These findings suggest that IL-23 is not merely a bystander but an active driver of pathogenic processes in the respiratory system. In this review, we synthesize recent advances in understanding the role of IL-23 in chronic obstructive pulmonary disease, asthma, idiopathic pulmonary fibrosis, and coronavirus disease 2019. We further discuss the therapeutic potential of targeting IL-23 as a precision-guided strategy to modulate respiratory inflammation and remodeling, with particular emphasis on corticosteroid resistance, fibrotic endotypes, safety and pharmacologic tradeoffs, and the emerging role of IL-23-related biomarkers and molecular endotyping for precision-guided patient stratification and targeted intervention.

RevDate: 2026-04-03

Seguin M, Cavagnoud R, Gianella C, et al (2025)

Stressors, mental health and coping amongst forcibly displaced youth since the advent of COVID-19: A systematic review.

Developmental child welfare, 7(4):251-269.

Mental health is a key issue for forcibly displaced youth. The evidence base on the mental health of youth forcibly displaced since the start of the pandemic is undefined, as well as sources of stressors and coping approaches. This systematic review aims to identify literature on the mental health of forcibly displaced youth in low- and middle-income settings, with focus on displacement since the advent of the COVID-19 pandemic. Objectives are to examine (1) sources of stress, (2) prevalence and covariates of common mental disorders (CMDs) and (3) coping approaches. Six databases were searched in February 2023. Search terms focused on CMDs, stress and forcibly displaced populations. Articles based on data collected after the onset of the COVID-19 pandemic focused on forcibly displaced persons aged 10-29 were included. Quantitative observation and intervention studies reporting CMD prevalences and related concepts were included, as were qualitative studies about stressors and/or coping approaches. Prevalences of CMDs and covariates were tabulated. Inductive thematic coding was conducted on qualitative data on stressors and coping. Interpretation of coping data was guided by a taxonomy including problem solving, support seeking, distraction/avoidance and positive cognitive restructuring. Twenty-one articles were included. Economic issues were the most prominent source of stress and led to subsequent stressors. Depression and anxiety symptom prevalence ranged from 6.2% to 77.4% and 17.2%-32.8% respectively. Problem-solving and support seeking were the most common coping approaches. Supporting the mental health and coping approaches of this marginalised group is critical to recovery in the post-COVID era.

RevDate: 2026-04-03
CmpDate: 2026-04-03

Giannopoulou I, Efstathiou V, Stefanou MI, et al (2026)

Disrupted beginnings: Neurodevelopmental outcomes of COVID-19 lockdowns in early childhood (Review).

Experimental and therapeutic medicine, 31(5):137.

Early childhood development depends on stable routines, social interaction and responsive caregiving. The 2019 coronavirus disease pandemic disrupted these supports through lockdowns, reduced early-education access and elevated caregiver stress. The present review synthesized empirical studies (2020-2025) of children aged 0-5 years and found consistent evidence of modest increases in emotional and behavioral difficulties, particularly where caregiver stress or socioeconomic adversity was elevated. Cognitive, language and executive-function (EF) outcomes were found to be more heterogeneous and appeared most affected in the contexts of reduced stimulation or limited access to early learning, with EF processes showing particular sensitivity to stress-related and environmental disruptions. Biological findings (cortisol, DNA methylation and infant brain measures) showed a number of converging signals, particularly in higher-risk contexts, but remained preliminary given modest sample sizes, methodological heterogeneity and limited replication. Overall, this suggested that pandemic-related disruptions disproportionately affected children in vulnerable family contexts. Therefore, the present study suggested targeted caregiver mental-health support, preservation of early-education access during emergencies and longitudinal follow-up of high-risk cohorts.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Lotti V, Lagni A, Diani E, et al (2026)

When viruses meet cystic fibrosis: Insights into host-pathogen dynamics.

Microbiological research, 308:128508.

Cystic fibrosis (CF), an autosomal-recessive genetic disorder, is caused by mutations in the CFTR gene, which encodes for a membrane anion channel expressed on multiple organs, with major impact on the airways. The impaired ion transport leads to thickened mucus secretions, which in turn can cause pancreatic insufficiency, sinusitis, infertility and, particularly, chronic pulmonary infections. While bacterial colonization of the airways has been extensively studied, increasing evidence highlights the significant, yet underappreciated, role of respiratory viruses in exacerbating lung disease in people with CF (pwCF). This review provides a comprehensive overview of the pathogenesis, epidemiology, and clinical impact of key respiratory viruses, including respiratory syncytial virus (RSV), human rhinovirus (HRV), influenza viruses, parainfluenza viruses, coronaviruses, and emerging pathogens such as human bocavirus, as well as relevant non-respiratory viruses, such as Cytomegalovirus (CMV), Epstein-Barr virus (EBV) and hepatitis viruses. Viral infections in pwCF are associated, particularly in pediatric patients, with increased respiratory symptoms, higher hospitalization rate and long-term decline in lung function. Despite a similar incidence of viral infections to non-CF individuals, pwCF often exhibit more severe clinical outcomes, except for SARS-CoV-2 infection, which shows an incidence and severity unexpectedly attenuated in this cohort. Moreover, while CFTR modulators have dramatically improved clinical outcomes in pwCF, their effects on antiviral immunity remain poorly understood and are an area of active investigation. Elucidating virus-host interactions and the impact of CFTR restoration in this context is essential for optimizing preventive and therapeutic strategies against viral infections in CF.

RevDate: 2026-05-01

Camici M, Piano Mortari E, Del Duca G, et al (2026)

Intravenous immunoglobulin treatment for long COVID: a case report of clinical and immunological findings.

The Lancet. Infectious diseases pii:S1473-3099(26)00063-0 [Epub ahead of print].

A previously healthy 39-year-old man developed highly symptomatic post-COVID-19 condition (also known as long COVID) marked by cognitive dysfunction, disabling fatigue, and autonomic symptoms unresponsive to multiple multidisciplinary interventions. Given the presence of markedly elevated serum autoantibodies against G protein-coupled receptors, high-dose intravenous immunoglobulin therapy was initiated at 400 mg/kg per day for 5 consecutive days. After 4 weeks, a maintenance dose of 500 mg/kg was administered for 1 day, followed by two further maintenance cycles consisting of 500 mg/kg per day for 3 consecutive days, each given at 4-week intervals. In parallel, the patient underwent a cognitive stimulation intervention. Neurological symptoms were assessed with the Fatigue Assessment Scale and the WHO Disability Assessment Schedule 2.0, and the immunological profile was longitudinally analysed during intravenous immunoglobulin treatment. Fatigue scores normalised, neurocognitive performance returned to normal value, and quality of life improved after the first infusion and fully recovered within 1 year. Immunological profiling revealed the presence of an inverted CD4 to CD8 T-cell ratio that persisted during the whole follow-up. We also identified a CD8[+] T cell-monocyte complex and spontaneous IFNγ release. Intravenous immunoglobulin therapy was associated with a significant reduction of these complexes, spontaneous IFNγ and TNF production, markers of endothelial inflammation, and circulating autoantibody titres. This patient provides exploratory evidence that high-dose intravenous immunoglobulin was associated with sustained clinical recovery from long COVID over 1 year of follow-up, accompanied by immunological changes consistent with modulation of post-viral immune dysregulation, including a reduction in pathogenic T cell-monocyte synapses. Although causal inference cannot be established from a single patient, these findings suggest that this cellular interaction can contribute to long COVID and that immunomodulation could represent a rational therapeutic approach to be evaluated in selected patients.

RevDate: 2026-06-21
CmpDate: 2026-05-07

Sithole MN, Khan MR, Mohammed HA, et al (2026)

A systematic review on vaccine developmental approaches: Evaluating efficacy, and addressing challenges of infectious diseases in the post-COVID-19 era.

Virus research, 367:199720.

Vaccination prevents millions of fatalities annually and works as one of the most effective and cost-efficient public health interventions. This systematic review critically evaluates vaccine development strategies in the post-COVID-19 era, focusing on platform technologies, delivery systems, and the regulatory and societal challenges that shape vaccine efficacy and accessibility. The COVID-19 pandemic redefined expectations for vaccine science, compressing traditional development timelines, and accelerating the adoption of novel platforms, such as mRNA and viral vectors. While these innovations significantly reduced global morbidity and mortality, they also exposed persistent barriers, including unequal distribution and widespread vaccine hesitancy fuelled by misinformation. This review evaluates the biochemical foundations of vaccine design, including antigen selection, adjuvant use, and delivery optimisation, alongside the emerging formulation strategies and vaccine-platforms integration. The review emphasises the need for continuous alignment between scientific progress and equitable access. By integrating historical context, technical advancement, and social determinants, this review highlights the imperatives for future vaccine strategies to be not only scientifically robust, but also globally inclusive and implementation ready. By positioning recent advancements within the historical timeline of vaccine science, this review argues that the post-COVID-19 era represents an acceleration of progress where speed, adaptability and global equity are essential for safeguarding the populations against current and emerging threats from the pandemics and localized infectious challenges in medical emergencies.

RevDate: 2026-06-21
CmpDate: 2026-05-14

Zhao Y, He X, Hu Y, et al (2026)

Impact of the COVID-19 pandemic on the incidence of Clostridioides difficile infection based on hospital surveillance data: a systematic review and meta-analysis.

Antimicrobial resistance and infection control, 15(1):.

BACKGROUND: Clostridioides difficile infection (CDI) remains a substantial burden on healthcare systems worldwide. The COVID-19 pandemic has had profound and multifaceted effects on healthcare delivery and infection control practices, potentially influencing the epidemiology of CDI.

OBJECTIVE: To assess whether the coronavirus disease 2019 (COVID-19) pandemic has influenced the incidence of CDI and to explore potential contributing factors.

METHODS: This systematic review and meta-analysis was conducted in accordance with the PRISMA guidelines. Seven databases were searched for relevant literature published from December 2019 to October 2025. Study quality was assessed via the Newcastle‒Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) critical appraisal tools. Random- or fixed-effects models were selected according to heterogeneity. Publication bias was evaluated via funnel plots and Egger's test, and sensitivity analyses were conducted. The primary outcome was the incidence rate of CDI, expressed as cases per 10,000 patient-days. Incidence rate ratios (IRR) were calculated to compare the incidence of CDI between the prepandemic and pandemic periods.

RESULTS: Sixteen studies were included. The pooled CDI incidence rate was 4.42 (95% CI: 3.37-5.46) per 10,000 patient-days in the prepandemic period and 3.80 (95% CI: 2.63-4.96) per 10,000 patient-days during the pandemic. The pooled incidence rate ratio was 0.80 (95% CI: 0.67-0.97), indicating a significant reduction in the incidence of CDI. This decline was associated with changes in medical practices (e.g., the suspension of nonurgent and high-risk procedures), antimicrobial stewardship practices, and strengthened infection control measures (e.g., enhanced hand hygiene and environmental disinfection) during the pandemic.

CONCLUSION: Compared with the prepandemic period, the incidence of CDI decreased significantly during the COVID-19 pandemic. This finding suggests that strengthened infection prevention measures, improved antimicrobial stewardship, and adaptations in healthcare delivery may have contributed to reduced CDI transmission. Reinforcing these evidence-based foundational strategies may help mitigate ‌the risk of CDI and other healthcare-associated infections during future public health emergencies.

RevDate: 2026-07-06
CmpDate: 2026-04-04

Medina YF, Rodríguez Grande EI, Galindo JL, et al (2026)

Non-pharmacological rehabilitation strategies for pulmonary and physical recovery in ICU survivors after COVID-19: A systematic review.

Chronic respiratory disease, 23:14799731261439941.

BackgroundSurvivors of severe COVID-19 requiring intensive care frequently experience persistent pulmonary and functional impairment consistent with post-critical illness sequelae. The effectiveness of non-pharmacological rehabilitation in this severity-specific subgroup remains uncertain.MethodsA systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Epistemonikos, LILACS, and Google Scholar were searched for randomized and observational studies evaluating non-pharmacological rehabilitation in adult ICU survivors of COVID-19. Risk of bias was assessed using RoB 2 and ROBINS-I tools. Given substantial clinical and methodological heterogeneity, quantitative meta-analysis was not performed; a structured narrative synthesis was undertaken.ResultsFourteen studies met inclusion criteria. Five incorporated comparator groups, while nine employed uncontrolled pre-post designs. Interventions ranged from early ICU mobilization to inpatient and outpatient pulmonary rehabilitation. Controlled studies reported variable between-group benefits in dyspnea and functional outcomes, whereas observational studies consistently described within-group improvement over time. However, most studies were at moderate to serious risk of bias, and heterogeneity in intervention timing, dosage, and outcome assessment limited comparability.ConclusionsNon-pharmacological rehabilitation in ICU survivors of COVID-19 is associated with improvement over time; however, the certainty of causal effectiveness remains low. ICU survivors constitute a distinct recovery population within the broader post-COVID spectrum. Adequately powered, multicenter randomized trials with standardized protocols and harmonized outcomes are required to establish long-term effectiveness.

RevDate: 2026-07-02
CmpDate: 2026-06-21

Sharma S, HK Manikyam (2026)

Emergence of SARS-CoV-2 omicron subvariant NB.1.8.1 in India: Genomic evolution, transmission patterns, and public health implications.

The Indian journal of medical research, 163(1):104-110.

Background and objectives The NB.1.8.1 Omicron subvariant has demonstrated notable epidemiological relevance in India, though without evidence of a marked increase in severity compared to prior Omicron waves. Understanding its genomic trajectory and policy implications is critical. Methods This was a retrospective convergent mixed-methods study integrating genomic sequencing (GISAID, INSACOG), epidemiological counts (ICMR, WHO, CDC), and policy/advisory analysis (MoHFW, WHO-SEARO). Data were analysed across January-May 2025 using prevalence tracking, hospitalisation comparisons, and thematic policy review. Results Genomic analyses showed NB.1.8.1 carrying lineage-defining spike mutations (A435S, V445H, T478I) linked to transmissibility and immune escape. While prevalence rose in China, India reported <5% share. Hospitalisation burdens remained lower in India than in China. India's policy response showed increasing alignment between genomic surveillance outputs and subsequent public health advisories, with targeted booster promotion and enhanced surveillance in high-incidence States. Interpretation and conclusions NB.1.8.1 illustrates the dynamic evolutionary trajectory of SARS-CoV-2. India's adaptive genomic surveillance and flexible public health frameworks contributed to mitigating clinical severity, though surveillance gaps and rural under-reporting remain concerns. Sustained genomic tracking, booster equity, and real-time advisory mechanisms are needed to strengthen preparedness.

RevDate: 2026-07-02
CmpDate: 2026-04-04

Shakeel A, Sircar K, DB Popli (2026)

Xerostomia after COVID-19 recovery: A preliminary investigation.

The Indian journal of medical research, 163(1):122-125.

Background and objectives Xerostomia, or dry mouth, was frequently reported during COVID-19 infection, but its persistence after recovery remains underexplored. This study aimed to assess the prevalence and duration of xerostomia following recovery from COVID-19 infection. Methods This observational study included 50 participants who had recovered from COVID-19. They were surveyed using a xerostomia assessment questionnaire and underwent the modified Schirmer test (MST) to measure their salivary flow rate. Results Overall, n=31(62%) of participants reported one or more xerostomia-related symptoms after recovery. "Feeling of dry mouth" (n=22, 44%) was the most common, followed by nocturnal water intake (n=18, 36%), difficulty swallowing dry food (n=7, 14%), and reliance on liquids during swallowing (n=6, 12%). Hyposalivation (MST <15 mm at 3 min) was observed in 10% (n=5) of participants, all of whom were infected during the second wave (Delta variant). A significant association was noted between self-reported dry mouth and MST findings (P=0.029). Symptoms persisted up to 15 months post-recovery. Interpretation and conclusions Xerostomia may persist after COVID-19 recovery, with potential implications for oral health. Early recognition and management are warranted.

RevDate: 2026-06-21
CmpDate: 2026-04-04

Gillini L, Sevilla-Hernández C, M Cavaleri (2026)

COVID-19 and its short- and long-term effects on the operations of the EMA: fostering innovation in the EU during and beyond time of crisis.

European journal of public health, 36(2):.

The European Medicines Agency (EMA) played a crucial role in responding to the COVID-19 pandemic by implementing various innovations that facilitated the development and approval of vaccines and treatments. This article analyses some of those innovations on the agency's operations through literature on innovation in the public sector using a literature review, publications on EU policy along with internal knowledge by the authors. The agency's innovative approaches such as the establishment of the COVID-19 Emergency Task Force and the effective use of real-world evidence enabled the agency to provide rapid advice to developers and ensure the provision of scientific feedback to the authorities and the public during crisis. The changes implemented led to new legislation allowing long-term effects within the agency. The EMA has emerged from the COVID-19 pandemic strengthened by innovative approaches leading to new legislation enabling an expanded mandate of the agency. To sustain innovation at the EMA, the agency might have to consider a structured and comprehensive approach to innovation, including the importance of fostering an innovation culture within the organization.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Hernández-Pizarro HM, A Prades-Colomé (2026)

The Spanish long-term care system reaches majority of age: A narrative review of evidence and lessons obtained.

Health policy (Amsterdam, Netherlands), 169:105620.

BACKGROUND: Spain has one of the highest life expectancies at 65-years-old among OECD countries, yet only half of these years are expected to be in good health. Thus, many older people require support for carrying out activities of daily living. In response, the Spanish government established the Spanish long-term care (LTC) system in 2007.

OBJECTIVE: To review the published evidence from the analysis of the first 18 years of existence of the system.

METHODS: This study adopts a narrative literature review approach, drawing from academic and policy-oriented research on the Spanish LTC system.

RESULTS: The LTC system has improved the wellbeing of its beneficiaries -particularly in terms of health- and has reduced healthcare costs by lowering hospital admissions and primary care visits. However, it suffers from chronic underfunding and design flaws. Financial sustainability remains a challenge, especially due to low central Spanish government contributions and regional disparities. Nonetheless, the LTC system has yielded significant economic returns through job creation and increased female labour participation. LTC benefits have also influenced family decisions: reducing savings, increasing the supply of informal caregivers and delaying early retirement. The COVID-19 pandemic exposed structural vulnerabilities, particularly in residential care. Moreover, while the navigation across the LTC system ensures horizontal equity, inequity is documented in the form of providing the benefits.

CONCLUSIONS: After almost two decades of the Spanish LTC system, evidence calls for adequate and stable financing mechanisms to achieve sustainability. It should also expand towards service-based care, integrate with healthcare, and systematically measure quality-of-life outcomes.

RevDate: 2026-06-21
CmpDate: 2026-05-11

Rajesh Krishnan A, Famiyeh IM, Ahmad A, et al (2026)

Macular and retinal manifestations following COVID-19 vaccinations: a 2025 update systematic review and meta-analysis.

Eye (London, England), 40(7):950-958.

An increasing number of reports have linked COVID-19 vaccination to ocular complications, including retinal vascular occlusions, inflammatory disorders, and neuro-ophthalmic events. However, the spectrum and temporal associations of these ocular complications are not adequately understood. This study aims to characterise the types of retinal and macular complications, evaluate latency patterns, and assess the associations with COVID-19 vaccination from 2020 to 2025. We conducted a systematic review and meta-analysis according to the PRISMA 2020 guidelines. Studies reporting retinal or macular complications post-COVID-19 vaccination were searched via Ovid MEDLINE, Embase, and the Cochrane Library. Extracted data included study demographics, outcome, latency, and vaccine subtype. The risk of bias was assessed, and a random-effects meta-analysis was performed to estimate the pooled relative risk of ocular complications following vaccination. A total of 173 studies were included, with the most frequently reported outcome being retinal vascular occlusions (n = 107). The distribution of ocular complications was significantly different between COVID-19 vaccine and infection exposure (p = 0.014). Most complications occurred within the first month of exposure, particularly among mRNA vaccines, which had a significantly different adverse event rate across vaccine platforms (p = 0.0084). A meta-analysis resulted in a pooled relative risk of 2.40 (95% CI: 0.33-17.73) for retinal vein occlusion following vaccination; however, due to the uncertainty around the estimate, the association remains inconclusive. These findings support considering COVID-19 vaccination as a potential differential cause for patients with retinal vascular occlusions, highlighting the need for continued vaccine safety and surveillance.

RevDate: 2026-06-21
CmpDate: 2026-04-15

Alanazi YA, Albilasi B, Almaa Z, et al (2026)

Paternal vaccine hesitancy and its impact on childhood immunization coverage in Saudi Arabia: A systematic review.

Journal of infection and public health, 19(5):103210.

Vaccine hesitancy remains a challenge to achieving optimal childhood immunization coverage. This systematic review examined parental vaccine hesitancy in Saudi Arabia, with emphasis on paternal determinants and their association with vaccination uptake. Following PRISMA 2020 guidelines, databases were searched between January 2000 and January 2025. Hesitancy toward routine childhood vaccines was generally low (3%-20%), whereas hesitancy toward newer or non-mandatory vaccines, including COVID-19, influenza, and HPV, exceeded 50% in some settings. Studies reporting father-specific data indicated higher hesitancy among fathers, particularly regarding safety, novelty, and possible long-term effects. Common determinants included safety concerns, misinformation, social media influence, and low confidence in vaccine effectiveness. Hesitancy was associated with delayed schedules, incomplete immunization, and reduced uptake of optional vaccines. Vaccine hesitancy in Saudi Arabia appears vaccine-specific and influenced by sociocultural factors, with paternal attitudes playing a measurable role in immunization decision-making.

RevDate: 2026-06-21
CmpDate: 2026-04-19

Zheng C, Zhu J, Lu Z, et al (2026)

High-flow nasal oxygen versus conventional oxygen therapy in patients with hypoxemic COVID-19 pneumonia: A randomized controlled trials based meta-analysis.

Respiratory medicine, 256:108806.

BACKGROUND: Although the COVID-19 pandemic has ended, severe cases of COVID-19 pneumonia (pneumonia caused by SARS-CoV-2) are still common in clinical practice. These patients frequently suffer from hypoxemia, for which conventional oxygen therapy (COT) may be insufficient. High-flow nasal oxygen (HFNO) provides enhanced oxygen delivery, but its overall clinical benefits remain uncertain. Our meta-analysis assesses HFNO's effectiveness and safety compared to COT for treating COVID-19-related hypoxemia by combining data from RCTs.

METHODS: We thoroughly explored six databases to identify suitable RCTs that examined HFNO versus COT in COVID-19 hypoxemic patients. Mortality and intubation were the main outcomes, while secondary outcomes included hospitalization indicators and blood gas monitoring indicators following oxygen therapy.

RESULTS: Eight RCTs involving 2528 patients were included. HFNO therapy demonstrated significantly lower rates of total intubation (Risk ratio: 0.86 [0.78, 0.95], P = 0.003), as well as intubation at 7, 14, and 28 days compared with COT. Additionally, the HFNO group showed a shorter time to oxygen therapy de-escalation (MD: 3.53 [-4.50, -2.55] days, P < 0.00001). After oxygenation therapy, the HFNO group exhibited a lower respiratory rate (MD: 2.77 [-3.67, -1.88] breaths/min, P < 0.00001), PaCO2 (MD: 1.00 [-1.67, -0.33] mmHg, P = 0.003), and a higher SpO2/FiO2 ratio (MD: 47.00 [34.77, 59.23], P < 0.00001). Similar baseline characteristics and mortality rates were found between the two groups.

CONCLUSIONS: HFNO treatment demonstrated advantages over COT, with comparable mortality rates, reduced intubation requirements, and improved post-therapy monitoring metrics in patients with COVID-19-induced hypoxemia.

RevDate: 2026-06-21
CmpDate: 2026-05-12

García-Cesar M, Cueto-Robledo G, Roldan-Valadez E, et al (2026)

Management of pulmonary arterial hypertension with intermediate-high-risk pulmonary embolism during pregnancy: Diagnostic challenges, catheter-directed thrombolysis, and intravenous treprostinil - A narrative review with an institutional case snapshot.

Current problems in cardiology, 51(8):103337.

BACKGROUND: Maternal mortality from pregnancy-related pulmonary arterial hypertension (PAH) is estimated at 7-12%. The superimposition of pulmonary embolism (PE) and COVID-19 further compromises right-ventricular (RV) function. Pregnancy-compatible PAH pharmacotherapy and catheter-directed techniques show promise; however, their intersection remains undocumented.

METHODS: We performed a narrative review of imaging diagnosis, risk stratification, catheter-directed reperfusion, PAH-targeted pharmacotherapy, and multidisciplinary peripartum management of PAH complicated by acute PE during pregnancy. MEDLINE/PubMed, Embase, Scopus, and the Cochrane Library were searched up to March 2026. We also describe an institutional case from the Hospital General de México Dr. Eduardo Liceaga (Mexico City, Mexico).

RESULTS: Evidence supports echocardiography for initial assessment, CT pulmonary angiography for embolic/vascular evaluation, right-heart catheterization for hemodynamic determination, and catheter-directed thrombolysis for intermediate-high-risk PE when systemic thrombolysis is contraindicated. The institutional case describes a 17-year-old primigravida (24.6 weeks' gestation) with undiagnosed idiopathic PAH (mean pulmonary artery pressure 64 mmHg; pulmonary vascular resistance (PVR) 13.8 Wood units), intermediate-high-risk PE (thrombotic burden 37.5%), and COVID-19 pneumonia. Catheter-directed thrombolysis combined with sildenafil and intravenous treprostinil achieved substantial hemodynamic improvement (cardiac index 2.8 to 4.2 L/min/m²; PVR 13.8 to 6.7 Wood units). Elective cesarean at 37 weeks resulted in satisfactory maternal and neonatal outcomes.

CONCLUSIONS: Early, multidisciplinary approaches integrating invasive hemodynamics, catheter-directed thrombolysis, and pregnancy-compatible PAH therapy can decompress RV function and allow safe pregnancy continuation. Prospective international registries and pregnancy-specific PERT pathways are urgently needed.

RevDate: 2026-04-06
CmpDate: 2026-04-06

Kisielinski K, Steigleder-Schweiger C, Wagner S, et al (2026)

Risks and benefits of face masks in children.

Frontiers in pediatrics, 14:1679586.

INTRODUCTION: Children, a significant and vulnerable portion of the global population, are particularly susceptible to environmental factors.

METHODS: We conducted a systematic search and scoping review of 3,144 articles, including 107 publications from medical literature, to assess mask use in children during the 2020-2023 pandemic. We examined expected viral protection vs. scientific evidence and side effects, synthesizing findings with SWiM and GRADE frameworks for evidence certainty and the Cochrane adverse effects approach.

RESULTS: Masking children lacks ecological validity, with high-quality studies showing little real-world effectiveness against viruses. On the other hand, side effects can clearly be identified. Masks contain hazardous materials (carcinogens, heavy metals, organic compounds, and microplastic), impacting childreńs health by altering inhaled air (including elevated carbon dioxide) and causing many physical symptoms and bio-psychosocial issues (MIES, mask-induced exhaustion syndrome), akin to sick building syndrome. Toxicological assessments highlight risks to biology of the young. Evidence certainty is high for non-effectiveness, moderate for risks and side effects, and low to very low for viral protection or benefits in children.

CONCLUSIONS: With a negligible COVID-19 mortality rate in children (0.0003%) and no evidence of child-to-child or school-based transmission, masks offered little benefit during the pandemic. The documented adverse effects-respiratory impairment, toxicity, and health risks-outweigh any justification for their mandatory use. An individual risk-benefit analysis is essential (individual medical advice), but this review suggests avoiding this intervention in children because of its numerous downsides and the lack of proven efficacy. It is the responsibility of political leaders to address our findings.

RevDate: 2026-04-06
CmpDate: 2026-04-06

Sleman S, Abid OI, Abdullah BJ, et al (2026)

Safety and efficacy of major antiviral and immune therapies in pregnancy for maternal viral infections: evidence synthesis of maternal and neonatal outcomes.

Frontiers in medicine, 13:1762439.

Antiviral safety and efficacy in pregnancy. Summarizing the key findings visually in a single high-impact figure. This will integrate pathogens, antivirals, maternal and neonatal outcomes, and evidence certainty.Flowchart titled "Graphical Abstract: Antiviral Safety & Efficacy in Pregnancy" summarizes evidence for antiviral treatments by infection. Green boxes (oseltamivir, acyclovir/valacyclovir, TDF/lamivudine, ART) indicate decreased maternal disease and no increase in congenital anomalies or preterm birth for influenza, HSV/VZV, HBV, and HIV. Yellow boxes for COVID-19 (paxlovid/remdesivir) show decreased maternal hospitalization with no proven risk to the fetus. Red boxes (tecovirimat for mpox, favipiravir for hemorrhagic fevers) highlight insufficient data or increased maternal risk with potential increase in congenital anomalies or preterm birth. Arrows indicate treatment progression and outcomes.

RevDate: 2026-04-06
CmpDate: 2026-04-06

Zhang X, Liu X, Zhou Q, et al (2026)

Extracellular vesicle-based delivery systems for nucleic acid therapeutics.

Molecular therapy. Nucleic acids, 37(2):102870.

Nucleic acid-based therapeutics, which involve the manipulation of genetic materials to treat or prevent diseases, have gained considerable attention, leading to the approval of medicines such as COVID-19 vaccines, patisiran (Onpattro), and nusinersen (Spinraza). However, their clinical application is hindered by challenges such as nuclease degradation, poor biodistribution, limited cellular uptake, and inefficient endosomal escape. Extracellular vesicles (EVs), which are natural nanoscale drug delivery systems derived from various eukaryotic and prokaryotic cells, offer a safe, efficient, specifically targeted, and non-pathogenic method for nucleic acid delivery. In this review, we summarize the classical methods and the latest research advances in EV preparation and nucleic acid loading. Additionally, we review the primary administration routes for nucleic acid-loaded EVs, such as intravenous, local, oral, intranasal, and inhalation delivery. By addressing these aspects, this review aims to guide the optimal design and clinical application of nucleic acid-loaded EVs.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Jefferson V, Endlich-Frazier A, M Letko (2026)

Exploring coronavirus cell entry with functional viromics.

Journal of virology, 100(5):e0172825.

Over the past 2 decades, viral discovery has uncovered thousands of novel coronaviruses in wildlife, including viruses with high similarity to known human pathogens. As human coronaviruses emerge from cross-species transmission events involving wildlife and humans, their frequent discovery in wildlife suggests these viruses will continue to impact global health. Unfortunately, while viruses are discovered often, laboratory limitations have stymied research on experimentally assessing their zoonotic potential. Thus, new laboratory approaches and research mindsets are needed to functionally characterize the ever-growing virome. Here, we discuss several platforms we have developed and the resulting advancements made toward functionally annotating the virome, which we refer to collectively as "functional viromics." We also explore how these approaches may be adapted to assess other viral phenotypes and how laboratory-derived data sets on viral functions will improve next-generation models of zoonotic risk.

RevDate: 2026-06-21
CmpDate: 2026-05-20

Trigg KL, Zhang A, AW Wu (2026)

Operational strategies among infectious disease clinical trial sites during pandemics: a scoping review.

Trials, 27(1):.

PURPOSE: The aim of this study is to examine documented strategies, challenges, and lessons related to clinical trial site operations during pandemics.

METHODS: This review focused on seven major pandemics: COVID-19, HIV/AIDS, Ebola, SARS, MERS, H1N1, and Zika. Searches were conducted using PubMed and Embase between September 2024 and February 2025, yielding 7572 unique records. After dual screening, 47 articles met inclusion criteria, with an additional 8 identified through citation searching, for a total of 55. Non-English articles were translated using Google Translate. Data were extracted and thematically analyzed through iterative familiarization, keyword identification, coding, and consensus discussion.

RESULTS: Of the 55 included articles, most originated from the European Region (61%) and the Americas (52%), with additional representation from Africa (19%), the Western Pacific (8%), Eastern Mediterranean (5%), and Southeast Asia (5%). Percentages exceed 100% because several studies reported across multiple regions. Study designs were predominantly descriptive (60%) with fewer randomized controlled trials (22%), observational (18%), and cohort studies (2%). COVID-19 accounted for the majority of articles (58%), followed by HIV/AIDS (20%), Ebola (13%), H1N1 (2%), and Zika (4%); no eligible studies addressed SARS or MERS. Operational themes included policy (73%), resources (55%), networks (53%), infrastructure (47%), technology (45%), study design (31%), and communication (22%). Publications peaked during pandemic years, reflecting intensified research activity. Reported challenges included protocol-practice misalignment, fragmented infrastructure, regulatory bottlenecks, and under-resourced sites. Reported practices included early site engagement in protocol development, streamlined ethics and contracting processes, investment in digital and decentralized infrastructure, and cross-trained staff. Gaps included limited use of adaptive trial designs and insufficient cross-national collaboration.

CONCLUSIONS: Clinical trial sites implemented systemic operational changes to sustain research during pandemics. Key lessons include the need to strengthen infrastructure, workforce capacity, and institutional adaptability, and the need to address persistent global inequities. Institutionalizing early site engagement, adaptive designs, and equitable collaboration will be essential to enable timely and resilient clinical research responses in future pandemics.

RevDate: 2026-07-03
CmpDate: 2026-06-28

Ankomah M, Abekah-Nkrumah G, Okai GA, et al (2026)

An account of health systems resilience to emergencies in Africa: a scoping review.

Globalization and health, 22(1):.

BACKGROUND: Healthcare systems across Africa continue to face a wide range of shocks. Using Ebola and COVID-19 as case studies, this study examines the various resilience strategies implemented in different countries and synthesises them in a way that can serve as a practical guide to make health systems in Africa more resilient for future emergencies. METHODOLOGY: The study is a scoping review that synthesises evidence from peer-reviewed journal articles and grey literature, structured around a conceptual framework developed by the authors. We focused on various aspects of health system resilience during the Ebola outbreaks and the COVID-19 pandemic in Africa. KEY FINDINGS: This review identifies six key elements vital to health system resilience in Africa: strong leadership and governance, equitable social protection, digital health innovation, trusted community engagement, a sustainable and flexible workforce, and adaptable infrastructure. However, several gaps must be addressed to strengthen resilience against future health emergencies. While political commitment and coordination mechanisms improved integration and awareness, poor decentralisation, weak accountability, and fragmented governance undermined effectiveness. Social protection initiatives and digital tools enabled rapid responses but persistent inequities in access and data gaps hindered their reach. Telemedicine and workforce expansion showed adaptability but lacked sustainability. Community trust and local innovations supported resilience, yet their potential was curtailed by top-down strategies and insufficient institutional support. CONCLUSION: This review emphasises the need for equitable, inclusive, and coherent strategies to strengthen resilient health systems in Africa. It calls for a shift from reactive, fragmented approaches to a long-term system-wide transformation grounded in inclusive governance, equitable social protection, robust digital health systems, a sustainable workforce, integrated and trusted community engagement, and adaptive physical infrastructure. Importantly, the review affirms that addressing deep-seated political, structural, and social inequities is crucial to ensuring resilience does not become an empty concept. The framework developed from this review provides a roadmap for policymakers to embed resilience as a core, institutional principle of long-term health system transformation, rather than a temporary emergency measure.

RevDate: 2026-06-21
CmpDate: 2026-04-07

Zhu W, Qian J, Peng M, et al (2026)

Post-COVID-19 Area Postrema Syndrome With SARS-CoV-2 in CSF: A Dual-Case Report and Review of the Literature.

Immunity, inflammation and disease, 14(4):e70421.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune astrocytopathy characterized by inflammatory demyelinating lesions in the central nervous system. Area postrema syndrome (APS), marked by intractable nausea, vomiting, and hiccups, is a recognized but less common initial manifestation. Post-infectious autoimmunity triggered by SARS-CoV-2 has been increasingly associated with NMOSD pathogenesis; however, the clinical significance of direct viral neuroinvasion and its relationship to divergent patient outcomes remains poorly understood.

METHODS: We report two female patients who developed isolated APS shortly after COVID-19 infection. Both patients underwent comprehensive neurological evaluation, including brain and spinal magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis with metagenomic next-generation sequencing (mNGS), and serological testing for aquaporin-4 immunoglobulin G (AQP4-IgG), myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG), and glial fibrillary acidic protein immunoglobulin G (GFAP-IgG) using cell-based assays. Clinical outcomes were compared in the context of antibody serostatus and treatment strategies. A review of the relevant literature on post-COVID NMOSD was also performed.

RESULTS: Both patients presented with intractable vomiting and hiccups following SARS-CoV-2 infection, and MRI demonstrated isolated T2/FLAIR hyperintense lesions in the dorsal medulla consistent with area postrema involvement. SARS-CoV-2 RNA sequences were detected in the CSF of both patients via mNGS, suggesting direct viral neuroinvasion or blood-brain barrier compromise. Despite similar initial presentations, their outcomes diverged dramatically. Patient 1 was AQP4-IgG negative, responded well to immunotherapy with intravenous immunoglobulin and corticosteroids followed by mycophenolate mofetil maintenance, and remained relapse-free at 12-month follow-up with significant lesion regression on MRI. Patient 2 was AQP4-IgG positive in both serum and CSF, and despite acute treatment, experienced a fatal relapse 6 months later with longitudinally extensive transverse myelitis while on low-dose prednisone monotherapy.

CONCLUSIONS: Isolated APS may represent an important yet under-recognized manifestation of post-COVID-19 autoimmune neuroinflammation. Detection of SARS-CoV-2 in CSF supports a role for direct viral neuroinvasion as a localized inflammatory stimulus. AQP4-IgG serostatus serves as a critical prognostic determinant: seronegativity is associated with a benign, monophasic course, whereas seropositivity mandates prompt initiation of potent immunosuppressive therapy to prevent devastating relapses. Clinicians should maintain a high index of suspicion for NMOSD in patients with unexplained persistent vomiting following COVID-19, and perform urgent neuroimaging and antibody testing for early risk stratification.

RevDate: 2026-06-21
CmpDate: 2026-04-07

Al-Momani H, Alsheikh A, Balawi HA, et al (2026)

An Emerging Global Threat After The COVID-19 Pandemic: Monkeypox Similarities and Differences.

Polish journal of microbiology, 75(1):20-32.

During the post COVID-19 pandemic, monkeypox (mpox) has returned and become a significant concern for health. The epicenter of clade I mpox is within the Democratic Republic of Congo (DRC) where two subclade consists of Ia and Ib are now in circulation and maintain their transmission from human to human. As of late 2024, worldwide mpox cases had surpassed 100,000 across 127 nations, with the World Health Organization reporting over 260 fatalities. CDC recently reported that the spread of clade I is no longer limited to Africa, highlighting its growing potential to become a pandemic. The World Health Organization (WHO) declared the disease an international public health emergency on August 14, 2024. This undoubtedly raises the question of whether global outbreaks of mpox represent the onset of another full-blown pandemic. Although Monkeypox can lead to other public health issues (especially in areas where it is not usually endemic), it is unlikely to become a pandemic on the same scale as COVID-19. Moreover, it is more containable due to vaccine availability, its transmission dynamics, and lessons learned from COVID-19. Nonetheless, it is still important to remain vigilant to prevent outbreaks from spreading, particularly in vulnerable populations and regions with limited healthcare resources.

RevDate: 2026-06-25
CmpDate: 2026-06-24

Gao T, Liu J, Du Y, et al (2026)

Association Between Acute Gastrointestinal Injury and Mortality Risk in Critically Ill Patients: A Systematic Review and Meta-Analysis.

Clinical and translational gastroenterology, 17(6):e01028 pii:01720094-990000000-00570.

INTRODUCTION: To systematically evaluate the association between severe acute gastrointestinal injury (AGI)/gastrointestinal dysfunction score (GIDS) and mortality risk in adult intensive care unit (ICU) patients.

METHODS: We conducted a systematic review and meta-analysis. We searched the MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials databases for articles published between January 2016 and January 2025. Observational cohort studies reporting mortality outcomes in ICU patients with AGI (grades III-IV vs 0-II) or GIDS (scores 2-4 vs 0-1) were included. Studies focusing on specific subpopulations such as patients after cardiac surgery or with COVID-19 were excluded to maintain population homogeneity. The primary outcome was short-term all-cause mortality. Random-effects meta-analysis using inverse-variance weighting was performed using odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Eight studies involving 2,786 critically ill patients were included. The pooled analysis demonstrated that severe GI dysfunction (AGI III-IV or GIDS 2-4) was significantly associated with increased mortality risk (OR 2.78, 95% CI 2.19-3.52, I 2 = 42.5%). Subgroup analyses by outcome type (28-day/ICU mortality: OR 2.70, 95% CI 2.04-3.58; in-hospital mortality: OR 4.27, 95% CI 1.63-11.18) and scoring system (AGI: OR 2.75, 95% CI 2.07-3.67; GIDS: OR 3.18, 95% CI 1.43-7.07) showed consistent results. The addition of a large-scale prospective Chinese study (n = 1,102) and a multicenter European cohort (n = 540) strengthened the findings and broadened generalizability.

DISCUSSION: Severe AGI is strongly associated with increased mortality in critically ill patients. Early recognition and assessment of GI dysfunction using standardized grading systems may facilitate risk stratification and guide clinical management.

RevDate: 2026-06-11
CmpDate: 2026-06-11

Shammout M, Abdullah J, Shammout A, et al (2026)

Altered sensation of the inferior alveolar nerve in sagittal spilt osteotomies: a review of cases at a major UK centre over 10 years.

The British journal of oral & maxillofacial surgery, 64(5):350-357.

Inferior alveolar nerve (IAN) injuries are common complications of orthognathic surgery, with incidences reported from 0% to 85% due to inconsistent definitions, assessment methods and follow-up protocols. These limitations hinder comparisons, emphasising the need for standardised evaluation. This 10-year retrospective cohort study investigates IAN injury rates following mandibular osteotomies, focusing on medium-long term outcomes and risk factors. A retrospective cohort study was conducted at a tertiary orthognathic centre (2014-2024) on sagittal split osteotomies, performed either as stand-alone or as part of bimaxillary surgeries. Altered sensation was assessed via patient-reported outcomes during clinical follow ups (0-60+ months). While a final review was typically conducted at 6 months, extended follow ups addressed nerve symptoms, revision surgeries, or COVID-19 disruptions. Chi squared tests, Fisher's exact test and odds ratios evaluated associations with demographics, split quality, and nerve injuries. The primary outcome was altered sensation at ≥6 months. Of 221 procedures, 75.6% (n = 167) had follow ups ≥6 months, with 44.3% (n = 74/167) reporting altered sensation, primarily in the lower lip. Rates were 49% (n = 49/100) at 6-12 months, 50% (n = 13/26) at 13-18 months, and 29.2% (12/41) beyond 18 months. Females (OR = 1.07) and the 41-50 age group (50%, n = 2/4) showed slightly increased sensory changes, although they were not statistically significant. Unsatisfactory splits had higher altered sensation rates (60%, n = 6/10) compared with satisfactory splits (43.9%, n = 65/148) although these were not statistically significant (p = 0.15). Among documented nerve injuries, 100% (n = 7) resulted in sensory changes at ≥6 months. Altered sensation affected 44.3% (74/167); non-standardised follow up limits interpretation and supports standardised neurosensory reporting.

RevDate: 2026-06-27
CmpDate: 2026-06-27

Sahu D, Van Nynatten LR, Tweddell D, et al (2026)

Computational proteomics to enhance personalized treatment of COVID-19 and Long COVID.

Clinical proteomics, 23(1):.

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to significant global health burden, including both acute infections and persistent post-acute sequelae, also known as Long COVID (LC) in survivors. While clinical management has reduced case-fatality rates, a substantial proportion of patients develop LC, a heterogeneous syndrome with long-term symptoms. This complex continuum requires therapeutic strategies for both the acute and chronic phases. Plasma proteomics has emerged as a powerful tool in precision medicine, offering insights into systemic molecular changes and disease trajectories. Using targeted and untargeted proteomic analyses, researchers can identify disease-relevant pathways, perform cellular deconvolution to assess tissue-specific contributions, and pinpoint therapeutic targets for both acute infection and persistent symptoms. Combined with bioinformatics and machine learning, these proteomic insights support biomarker discovery and drug repurposing strategies.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Myer A, Calfee MW, Monge M, et al (2026)

Exploring Surrogate Selection for Virucidal Aerosol Testing: A Qualitative Analysis.

Environmental science & technology, 60(15):11202-11217.

The COVID-19 pandemic heightened interest in the development and testing of virucidal chemistries and technologies for use in indoor environments. Direct testing of pathogens often requires a high-level biosafety containment, which can restrict performance evaluations to smaller scales that may have limited translatability to the complexities of real-world indoor environments. Therefore, using viral surrogates that are safer to work with than target pathogens offers many potential benefits, including aerosol testing in more realistic conditions. This scoping review analyzes surrogate selection and use across aerosol, surface, and suspension-based tests and identifies bridges in surrogate selection considerations. A qualitative analysis of 133 studies was conducted to highlight trends, knowledge gaps, and future directions toward standardized surrogate selection frameworks. This review finds that Enterobacteria phage MS2 (MS2) and other bacteriophages are commonly used due to their practicality and safety. There are limited examples of concurrent pathogen and surrogate testing to assess suitability, which is highly context-dependent on the test conditions. Beyond virucide testing, the surrogate selection considerations discussed herein are informative for research on the persistence, transmission, transport, behavior, and nonchemical management of airborne viruses.

RevDate: 2026-06-21
CmpDate: 2026-04-08

Alrashidi Y, Sriram S, Beek MA, et al (2026)

Work-related musculoskeletal disorders among gig-based food delivery workers: a systematic review and meta-analysis.

Frontiers in public health, 14:1788523.

BACKGROUND: The digital economy has spurred gig work, especially in food delivery, which grew during COVID-19. However, gig workers face occupational hazards like traffic accidents, poor ergonomics, and unsafe conditions, leading to work-related musculoskeletal disorders (WMSDs). Studies show high rates of back and neck pain among delivery riders due to physical strain, repetitive motions, and long hours. WMSDs reduce productivity and increase healthcare costs. This review examines WMSD prevalence, risk factors, and related issues like accidents and violence among food delivery workers.

METHODS: We searched for relevant articles up to June 2025 from PubMed, Scopus, and Web of Science. Two independent reviewers extracted data from the selected studies, including baseline information, outcomes, and prevalence of WMSDs. All data analyses were performed using R version 4.3.3.

RESULTS: After removing 1,013 duplicate records, we retained 1,279 for screening. Following a thorough review, we identified 23 eligible entries for inclusion in our study. As per our analysis, delivery workers face high injury prevalence: lower back (43%), shoulder (39%), neck (30%), upper back (24%), and RTA (25%). Risk factors include gig economy systemic vulnerabilities, prolonged static postures, vibration exposure, open-door vehicles, and dangerous traffic practices. Different forms of violence (physical, verbal, and psychological) affected delivery workers, while exploitation and discrimination were particularly evident among minorities.

CONCLUSION: This review demonstrated a high burden of WMSDs among delivery workers, who face serious hazards like injuries, accidents, and violence due to precarious gig economy conditions, time pressures, and poor safety measures. This study provides the first quantitative pooled estimates of WMSD prevalence among food delivery workers, along with an additional narrative synthesis of traffic accidents and workplace violence.

RevDate: 2026-04-08
CmpDate: 2026-04-08

Mangahas AM, Chang M, IA Husain (2026)

The Effect of COVID-19 on Voice Quality: A Systematic Review.

World journal of otorhinolaryngology - head and neck surgery, 12(2):218-227.

OBJECTIVES: To determine the effect of COVID-19 on voice by evaluating acoustic, aerodynamic, auditory-perceptual, and patient-reported measurements for COVID-19 patients compared to controls.

DATA SOURCES: A systematic review was conducted using PubMed and Embase.

REVIEW METHODS: Studies were reviewed for acoustic, aerodynamic, auditory-perceptual, and patient-reported outcomes.

RESULTS: Seven studies met criteria. There were 790 patients diagnosed with COVID-19 and 484 controls. Acoustic measurements revealed that COVID-19 patients had an increased harmonic-to-noise ratio (HNR) (27.14 vs. 41.37 dB), and increased fundamental frequency (177.66 vs. 172.81 Hz), jitter (0.73 vs. 0.31), and shimmer (4.43 vs. 3.42). Auditory-perceptual measurements indicated that COVID-19 patients had an increased Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) score (11.46 vs. 2.15). COVID-19 patients also had an increased Voice Handicap Index (VHI-10) score (4.89 vs. 1.59). Finally, COVID-19 patients had a statistically significant decrease in maximum phonation time compared to controls (9.94 s vs. 16.32 s, p = 0.01).

CONCLUSIONS: Although maximum phonation time was the only statistically significant measurement, other measurements were worse for COVID-19 patients. The current research suggests negative effects of COVID-19 on the voice; however, this is the first systematic review to summarize its effects with measurable outcomes. More studies with vocal measurements taken at different time points following infection are needed to understand the full long-term effect of COVID-19 on the voice. Additionally, studies evaluating voice quality for mild cases of COVID-19 with comparison to healthy controls are needed to understand its prevalence and effect as the severity of COVID-19 decreases.

RevDate: 2026-06-21
CmpDate: 2026-04-28

Kleinert S (2026)

[Cardiovascular risk in inflammatory rheumatic diseases : Evidence-based strategies for risk reduction in rheumatologic practice].

Zeitschrift fur Rheumatologie, 85(4):307-316.

Patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) have a persistently increased cardiovascular (CV) risk and higher mortality, independently of traditional CV risk factors. Effective control of inflammation reduces CV events, whereas glucocorticoids increase the risk in a dose- and duration-dependent manner, even at ≤ 5 mg prednisolone/day. Disease-modifying antirheumatic drugs especially tumor necrosis factor (TNF) inhibitors, are largely protective through the reduction of systemic inflammation. For patients receiving Janus kinase (JAK) inhibitors or long-term glucocorticoid therapy, a structured CV risk assessment and guideline-based management of modifiable risk factors (including lipid optimization/statin therapy) are essential. Primary prevention should be based on the cardiovascular prevention guidelines of the European Society of Cardiology (ESC). Vaccinations (influenza, COVID-19, pneumococcus, respiratory syncytial virus, zoster) represent an effective pillar of CV prevention in populations at cardiovascular risk; however, evidence in patients with inflammatory rheumatic diseases is still lacking. The main challenge for CV prevention remains implementation: digital clinical reminders/decision support systems and multicomponent strategies can improve the implementation of recommendations.

RevDate: 2026-06-21
CmpDate: 2026-04-08

Ananth S, Alimani GS, Boccabella C, et al (2026)

Prevalence of respiratory viruses in stable and acute asthma: a systematic review and meta-analysis.

European respiratory review : an official journal of the European Respiratory Society, 35(180):.

BACKGROUND: Respiratory viruses, frequently detected in asthma, are associated with worse outcomes. This meta-analysis systematically quantifies the prevalence of respiratory viruses in stable and acute asthma, across children and adults, and explores factors associated with increased viral burden through meta-regression.

METHODS: This prospectively registered meta-analysis (PROSPERO-CRD42023375108) included studies employing molecular techniques to assess respiratory virus prevalence in asthma. Three databases were searched in August 2024. Risk of bias and certainty of evidence were assessed. We performed random-effects meta-analysis of proportions.

RESULTS: We included 111 eligible studies. Moderate-certainty evidence indicated a pooled prevalence of any respiratory virus of 33.9% (95% confidence interval 24.8-43.7%) in children and 23.0% (12.9-35.0%) in adults with stable asthma. In acute asthma, prevalence increased to 58.8% (52.5-65.0%) in children and 49.9% (41.2-58.5%) in adults (moderate certainty). Rhinovirus was the most frequently identified virus, especially in acute asthma (45.0% in children versus 21.2% in adults). Respiratory syncytial virus and bocavirus were more common in younger children, while coronavirus and influenza were more frequently detected in adults; respiratory syncytial virus peaked in older adults too. A higher prevalence of influenza virus B and adenovirus in children, and of influenza virus A and parainfluenza 2 in adults with severe versus non-severe acute asthma suggests a potential association with more severe acute attacks.

CONCLUSION: Respiratory viruses are common in both stable and acute asthma. This suggests that the diagnostic value of a positive viral test during acute episodes may be limited and could benefit from complementary biomarkers to improve interpretation.

RevDate: 2026-07-02
CmpDate: 2026-07-02

Scheid PL, Padi D, Schvach H, et al (2026)

Application of Telemedicine for Mission Support-Importance of a Cost-Benefit Analysis.

Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 32(7):682-691.

BACKGROUND: Digital health is more relevant now than ever before, and interventions have a clear potential to improve the quality of care while reducing health care costs. Telemedicine has emerged as a transformative approach to health care delivery, particularly accelerated by the COVID-19 pandemic. In mission environments, telemedicine increasingly supports the management of acute injuries, chronic conditions, predeployment screening, and follow-up assessments, often using low-bandwidth store-and-forward modalities.

METHOD: By reviewing existing literature and considering several different (heterogeneous) programs for "telemedicine for mission support," the key performance indicators are explored to evaluate telemedicine in missions, following its implementation. Both acute and chronic care use cases, as well as operational, clinical, and technical determinants of feasibility, were considered.

RESULTS: This article presents the clinical, operational, and economic benefits of "telemedicine in missions" and the metrics for a comprehensive cost-effectiveness analysis or cost-benefit analysis, considering its economic and clinical impacts.

CONCLUSIONS: Telemedicine in missions shows considerable differences from other telemedicine applications depending on the actors and the resulting circumstances. Considering the heterogeneity of the metrics provided, even within the field of "telemedicine in missions," the analyses have to be conducted in accordance with the encountered conditions. Nevertheless, a set of metrics can be applied to nearly all use cases across the different applications and actors. A mission-adaptable minimum data set is proposed to support standardized evaluation across diverse operational contexts.

RevDate: 2026-06-15

King R, Ford T, Coleman Z, et al (2026)

Racial Disparities in Long COVID: Why Black Americans are Likely Underrepresented in Long COVID Estimates.

Journal of racial and ethnic health disparities [Epub ahead of print].

In this conceptual paper, we posit that Black Americans are likely underrepresented in current Long COVID data estimates and explore potential reasons for this underrepresentation, with the purpose of beginning a critical dialogue within the Long COVID research community on this topic. Throughout the COVID-19 pandemic, Black individuals were 10% more likely to acquire SARS-CoV-2 and twice as likely to be hospitalized with COVID-19 than White individuals, increasing their risk for Long COVID. Nevertheless, studies based on national surveys and electronic health records often report lower Long COVID prevalence estimates for Black vs. White populations. Factors contributing to this discrepancy may include lack of Long COVID awareness, limited generalizability of existing studies, barriers to diagnosis, and medical racism and mistrust. Addressing these issues requires a comprehensive approach that includes creating targeted Long COVID awareness campaigns, updating the mode and breadth of data collection activities, reducing diagnostic barriers, and ultimately tackling the systemic racism that underlies these health inequities. Accurate representation in data is essential for understanding the full impact of Long COVID and developing interventions that are equitable and effective.

RevDate: 2026-06-27
CmpDate: 2026-06-21

Zhang Y, Yu X, Li P, et al (2026)

Targeting immunosenescence in lung diseases: mechanistic insights and clinical interventions.

BMC medicine, 24(1):.

Immunosenescence, the age-related decline in immune function, plays a crucial role in the pathogenesis and progression of lung diseases, including chronic obstructive pulmonary disease, lung cancer, pulmonary fibrosis, asthma, and respiratory tract infections. This comprehensive review examines the hallmarks of immunosenescence, and illustrates the association between immunosenescence and the pathogenesis of lung diseases. In addition, we discuss current and emerging therapeutic strategies that have been evaluated in human clinical trials for targeting immunosenescence in lung diseases. Specifically, this review provides in-depth insights into the therapeutic strategies, including senolytics and senomorphics, immunotherapy, stem cell therapy, thymic rejuvenation, probiotics, and lifestyle. We also highlight the potential of personalized approaches integrating multi-omics data and artificial intelligence to guide biomarker-driven interventions, enabling truly personalized therapeutic strategies. Finally, this review underscores the imperative for rigorously designed clinical trials to develop and validate interventions that specifically target immunosenescence, with the ultimate goal of improving clinical outcomes for the aged population with lung diseases.

RevDate: 2026-06-27
CmpDate: 2026-06-27

Selby A, Sutton A, Bamford E, et al (2026)

Factors and mitigating strategies impacting receipt of healthcare by the Deaf community: an umbrella review.

BMC health services research, 26(1):.

BACKGROUND: Despite over 70 million Deaf people using sign languages worldwide, their ability to access and receive health services remains disproportionately limited. The Deaf community commonly encounter reduced access to preventive care compared to the hearing population. This umbrella review aims to collate and appraise systematic reviews examining factors and mitigating strategies influencing Deaf people’s receipt of healthcare. METHODS: The protocol was registered in PROSPERO (CRD42024563083). Eligible systematic reviews investigated factors affecting healthcare receipt among the Deaf communities in any Organisation for Economic Co-operation and Development (OECD) country. Databases searched included MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL, PsycINFO, Science Citation Index, Social Sciences Citation Index, and PROSPERO. Screening, data extraction, and quality appraisal (AMSTAR 2) were undertaken independently by reviewers, with disagreements resolved by consensus. Data were synthesised narratively using a purpose-specific conceptual framework, categorising factors as individual or environmental. RESULTS: From 3,749 records, 32 systematic reviews were included. Most reviews (78%) were rated critically low in quality. Individual-level barriers were dominated by reduced health literacy (reported in 26 reviews), including inadequate access to sign language health information, limited family awareness, and poorer knowledge of medicines and preventive practices. Socioeconomic status, rural residence, minority ethnic background and limited family support were also linked to reduced healthcare access. Environmental factors included communication barriers, low Deaf awareness among healthcare professionals and shortages of qualified interpreters, all of which fostered Deaf people’s mistrust and disengagement with healthcare. Inadequate recording of communication needs, inaccessible complaints processes and COVID-19 policies further exacerbated inequalities. Strategies identified included sign language–adapted health education, interpreter provision, telehealth services, and specialist Deaf health clinics with interpreters, however few reviews offered evidence for effectiveness. CONCLUSIONS: Deaf people experience persistent, multifactorial barriers to equitable healthcare, driven by low health literacy, social disadvantage, poor communication support and systemic failings. Current evidence is largely of low methodological quality, underscoring the need for robust, co-produced research with Deaf communities. Priority areas include redesigning healthcare processes for accessible communication, expanding interpreter provision, and embedding Deaf awareness training into professional education to achieve systemic change.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Pineschi M, Rossi S, Butini S, et al (2026)

Beyond the Shadow of Indole: Medicinal Chemistry of Indolizines and Isoindolinones in the Fight Against Infectious Diseases.

Archiv der Pharmazie, 359(4):e70233.

Infectious diseases remain a major global health challenge, accounting for millions of deaths annually and placing an increasing burden on healthcare systems worldwide. The rapid emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacterial strains, together with recurrent outbreaks of viral infections such as SARS-CoV-2, Ebola, Zika, Monkeypox, and influenza, underscores the urgent need for novel therapeutic agents with diverse mechanisms of action. In this context, indolizines, isoindoles, and isoindolinones represent promising scaffolds in anti-infective drug discovery due to their unique structural features, versatile reactivity, and ability to engage multiple biological targets. This review provides an updated overview of the medicinal chemistry of indolizine and isoindoles, with particular emphasis on compounds demonstrating activities against infectious pathogens. Representative examples are highlighted to illustrate structure-activity relationships (SARs), scaffold-based optimization strategies, and emerging mechanistic insights. Relevant synthetic methodologies are discussed only in the context of biologically active compounds to provide a framework for rational design. Collectively, this review underscores the therapeutic potential of indolizine- and isoindole-derived scaffolds as versatile frameworks for anti-infective drug development and highlights opportunities for further chemical and biological exploration.

RevDate: 2026-04-09
CmpDate: 2026-04-09

Usman AB, Comlan MBL, Victory KR, et al (2026)

Strengthening Global Health Security in West Africa: Insights from Joint External Evaluations and After-Action Reviews.

Dialogues in health, 8:100294.

PURPOSE: West Africa faces recurring public health outbreaks, including Ebola, COVID-19, and Mpox, underscoring the need for strong Global Health Security (GHS) core capacities. This study uses Joint External Evaluation (JEE) scores and After-Action Review (AAR) findings to assess public health emergency preparedness across 15 West African countries and identify gaps between theoretical assessments and operational response capacity.

METHODS: A mixed-methods approach compared JEE scores (2016-2023) with thematic analysis of AAR findings from major outbreaks. Consistency between JEE-predicted capacities and AAR-reported challenges was assessed using a three-level rating system (High/Moderate/Low) and the Kappa statistic.

RESULTS: In 68 of 105 technical area comparisons (65%) of cases, JEE scores accurately predicted weaknesses in laboratory systems and workforce development. However, in 37 comparisons (35%) of cases, JEE scores overestimated preparedness, particularly in risk communication(all15 countries,100%), real-time surveillance(13 of 15 countries, 87%), and cross-border coordination, where countries with high scores faced operational failures during outbreaks. AARs revealed logistical bottlenecks, supply chain disruptions, and coordination failures not captured by JEEs. Alignment with SDG 3.d (health security), SDG 10 (inequalities), SDG 17 (partnerships), and SDG 9 (infrastructure) underscores broader development implications.

CONCLUSION: While JEE is valuable for baseline assessment, it incompletely predicts real-world outbreak response performance. Integrating AAR findings into national planning and refining JEE indicators to include operational metrics will enhance health security evaluations. Regionally coordinated action through WAHO is essential for addressing gaps and building resilient systems aligned with sustainable development goals.

RevDate: 2026-04-09
CmpDate: 2026-04-09

Kim B, S Choi (2026)

Comparing pre- and post-COVID-19 chronic allergy prevalence in children using National Health and Nutrition Examination Survey in 2019 and 2021.

Allergologie select, 10:36-48.

OBJECTIVE: To investigate changes in demographic characteristics, parental smoking habits, and the prevalence of asthma, atopic dermatitis, and rhinitis among children in South Korea before and after the COVID-19 pandemic.

MATERIALS AND METHODS: A retrospective analysis of national health survey data from 2019 and 2021 was conducted, including children aged 3 - 18 years. Factors such as gender, age, location, housing type, family size, income, body mass index, subjective health status, influenza vaccination, family structure, and parental smoking habits were analyzed.

RESULTS: No significant differences were found in most demographic characteristics and parental features between 2019 and 2021, except for influenza vaccination rates and mothers' age at first childbirth. The influenza vaccination rate increased from 69.3% in 2019 to 77.8% in 2021, and the average maternal age at first birth increased from 28.46 years to 29.22 years. Asthma diagnoses showed no significant differences between the 2 years after adjusting for general and parent-related characteristics. For atopic dermatitis, significant differences in gender distribution were observed in 2021. Rhinitis diagnoses showed significant differences in age, area, and breastfeeding status between the two years.

CONCLUSION: The COVID-19 pandemic may have influenced certain demographic characteristics, such as influenza vaccination rates and mothers' age at first childbirth, but the prevalence of asthma, atopic dermatitis, and rhinitis among children remained largely unchanged between 2019 and 2021. This study underscores the importance of monitoring the impact of social changes on children's health, particularly during significant events like the COVID-19 pandemic. Further research is required to understand the long-term effects of these changes on child health.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Valencia S, Jaimes C, Victoria T, et al (2026)

Strategies for radiology faculty recruitment and retention in a competitive market: implications for pediatric radiology.

Pediatric radiology, 56(5):1068-1077.

This narrative review examines strategies and recommendations to address the current radiologist shortage in the USA, with a particular emphasis on workforce retention and preservation through operational efficiency, organizational leadership, cultural transformation, and technology integration. National workforce data, expert commentaries, and strategic frameworks from academic radiology and healthcare leadership literature were reviewed to contextualize current challenges and proposed solutions. The radiology workforce faces escalating pressure driven by rapidly increasing imaging volumes, limited growth in the number of practicing radiologists, and rising attrition rates. Between 2008 and 2018, radiologist workloads nearly doubled while workforce expansion was much smaller, exacerbating workload imbalance, burnout, and professional dissatisfaction. The COVID-19 pandemic exacerbated workforce challenges by causing an exodus of workers and making on-site work more challenging. Although short-term mitigation strategies exist, sustainable long-term solutions require coordinated cultural and structural changes that prioritize strategic hiring, transparent career advancement pathways, protected academic and professional development time, and optimized workflow efficiency supported by technology. In conclusion, effective management of the radiology workforce shortage necessitates integrated operational and cultural approaches, with departments implementing comprehensive and tailored interventions to expand workforce capacity, enhance professional fulfillment, and maintain high-quality patient care.

RevDate: 2026-06-21
CmpDate: 2026-04-09

Gentilini P, Lindsay JC, Konishi N, et al (2026)

Exploring the potential link between mRNA COVID-19 vaccinations and cancer: A case report with a review of haematopoietic malignancies with insights into pathogenic mechanisms.

Oncotarget, 17(1):34-49.

Copyright: &copy; 2026 Gentilini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This article investigates the potential association between modified mRNA (modRNA) COVID-19 vaccinations and the development of haematopoietic cancers. We present a case involving a healthy, young, athletic woman who developed acute lymphoblastic leukaemia (ALL) and lymphoblastic lymphoma (LBL) following her second dose of the Pfizer/BioNTech COVID-19 vaccine (Comirnaty®). This case is part of an expanding body of literature documenting similar occurrences after modRNA vaccinations, which we critically examine. Emerging evidence suggests that the biodistribution and persistence of modRNA, facilitated by lipid nanoparticles, can affect various tissues and organs, including the bone marrow and other blood-forming organs. Notably, modRNA vaccines exhibit a particular affinity for the bone marrow, potentially influencing the immune system at multiple levels and triggering both autoimmune disorders and neoplastic processes. In this article, we assess the risk of developing haematopoietic cancers post-modRNA vaccination based on current scientific literature and explore the reported potential genetic and molecular mechanisms involved in disease pathogenesis. By integrating clinical observations and current research, we aim to provide valuable insights into the potential carcinogenic outcomes associated with modRNA vaccination.

RevDate: 2026-04-09

Wu D, Dasgupta A, Hora JS, et al (2026)

SARS-CoV-2 targets mitochondria, exacerbating COVID-19 pneumonia.

The Journal of physiology [Epub ahead of print].

Mitochondrial damage is a conserved feature of coronavirus infection, occurring with human (SARS-CoV-2, HCoV-OC43) and murine (MHV-1) coronaviruses. Coronaviruses damage mitochondria in airway epithelial cells (AEC), pulmonary artery smooth muscle cells (PASMC), pulmonary artery endothelial cells, immune cells and cardiomyocytes by causing rapid transcriptomic changes in nuclear-encoded genes regulating mitochondria and by viral proteins interacting with host mitochondrial proteins. Coronavirus infection causes mitochondrial depolarization, mitochondrial transition pore (MTP) opening, inhibition of the electron transport chain (ETC) and ATP synthetic apparatus, increased mitochondrial fission, apoptosis, and impaired mitochondrial oxygen sensing. Within hours of infection, SARS-CoV-2 induces transcriptional reprogramming of genes relevant to the mitochondrial matrix in AECs, downregulating mRNA encoding ETC complex I components and the ATP synthesis complex. These bioenergetic consequences of SARS-CoV-2 mitochondriopathy may contribute to long COVID. Infection also upregulates dynamin-related protein 1 (DRP1), activating mitochondrial fission while promoting apoptosis by activating apoptosis inducing factor (AIF) and caspase 7. Even without infection, transfection with specific coronaviral proteins opens the MTP and depolarizes the mitochondria, or activates DRP1 and AIF, promoting AEC damage or apoptosis, thereby contributing to diffuse alveolar damage. In human PASMCs, coronaviral M and Nsp9 proteins suppress hypoxic pulmonary vasoconstriction (HPV), a homeostatic mechanism in PASMCs that uses a mitochondrial oxygen sensor to redistribute blood flow to well-ventilated lung regions during pneumonia. Impairment of HPV, seen as intrapulmonary shunting, contributes to the profound hypoxaemia in COVID-19 pneumonia. Coronavirus-induced mitochondriopathy may have therapeutic relevance as blocking AIF-induced apoptosis or enhancing HPV appears beneficial in a MHV-1 model of COVID-19 pneumonia.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Temiz A, K Tascilar (2026)

Why we need to maintain a critical view on big data and artificial intelligence predictions.

Current opinion in immunology, 100:102776.

Artificial intelligence (AI) and machine learning are widely promoted as transformative tools for medical practice, yet their impact in daily rheumatology remains limited. This review examines the gap between expectations and reality using historical parallels, conceptual considerations, and recent methodological evidence. Experiences with antioxidant supplementation, vitamin D, the microbiome, and the Human Genome Project illustrate a recurring pattern: early studies report large effects that diminish or disappear in larger, higher-quality studies. Meta-epidemiological work and the 'cursed auction' analogy explain why early and small studies systematically overestimate effects. Conceptually, individualized clinical risk remains a group-based construct, constrained by the reference class problem and irreducible uncertainty. Methodologically, many AI models in rheumatology suffer from small and heterogeneous datasets, overfitting, inadequate handling of missing data, poor calibration, and limited external or prospective validation. The failure of COVID-19 prediction models and the neutral trial of the Ada diagnostic assistant in rheumatology illustrate how strong retrospective performance often collapses in real-world use. In contrast, AI performs well in high signal-to-noise domains with abundant, structured data. Overall, AI can generate valuable insights and support narrowly defined tasks, but it cannot yet overcome the fundamental limits of noisy clinical data and group-based risk. Progress in rheumatology will require realistic expectations, large representative datasets, transparent methods, rigorous validation, and a focus on robust, interpretable tools that improve decisions for populations and well-defined patient subgroups rather than precise individual prediction.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Ngwoke I, Ahmed MM, Gideon JA, et al (2026)

Molecular characteristics, epidemiological trends, and public health implications of human metapneumovirus (hMPV): a review.

Virology, 619:110897.

Human Metapneumovirus (hMPV) is an emerging respiratory pathogen associated with significant morbidity, particularly among young children, older adults, and immunocompromised individuals. Although clinically relevant, it remains underrecognized relative to influenza and respiratory syncytial virus (RSV). Recent regional outbreaks, including the January 2025 surge in northern China, highlight hMPV's capacity to cause significant above-seasonal transmission events, particularly in settings with immunity debt following prolonged non-pharmaceutical interventions. This review synthesizes current knowledge on hMPV epidemiology, genetic diversity, transmission dynamics, pathogenesis, host immune interactions, diagnostic approaches, and therapeutic and vaccine development efforts. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and ScienceDirect with no publication date restriction, using MeSH and free-text terms including "hMPV," "epidemiology," "immune response," "diagnosis," "treatment," and "pandemic preparedness." Relevant reference lists were hand-searched to identify additional studies. Eligible articles included molecular, clinical, observational, and epidemiological studies; case reports and commentaries were excluded unless they provided unique outbreak insights. Findings emphasize that hMPV represents a growing public health concern due to limited awareness, diagnostic overlap with other viral pathogens, and the absence of targeted therapeutics or licensed vaccines. Strengthened surveillance, improved diagnostic capacity, and accelerated research into immunopathogenesis and vaccine platforms are urgently needed. Integrating hMPV into regional outbreak preparedness frameworks rather than pandemic-level frameworks applicable to influenza or SARS-CoV-2 while fostering collaborative research and proportionate public health communication, is essential to mitigate its future impact.

RevDate: 2026-04-09

Vincent E (2026)

Resolving 'Collective Amnesia': uncovering disease outbreaks past to shape pandemic futures.

Medical humanities pii:medhum-2025-013473 [Epub ahead of print].

At the International Pandemic Sciences Conference in 2024, scholars of science and the medical humanities were united in asking one guiding question: how can we learn from disease outbreaks of the past to prepare for future pandemics? This article will explore how interdisciplinary public conference forums are productive spheres of knowledge exchange which enable proponents of science and literature to detect and trace past issues of public health which persist into present-day pandemics. The article considers the claim of bioethicists Maxwell J Smith and Ross Upshur that there is 'collective amnesia' when pandemics arise, to foreground the importance of uncovering and evaluating the visual, literary and media histories of pandemics past. Analysis of literary-historical research presented as part of the interdisciplinary 'Media and Epidemics' project, which analysed the visual and literary cultures of historic epidemics of influenza, demonstrates how historic literature and media collides with present-day public health discourse. Examining past epidemics reveals shared issues raised by COVID-19 media reportage concerning the historic role of storytelling, stigmatisation and fears of contagion. While COVID-19 haunts our recent past, there remains '[a]n urgency to understanding how narratives are constructed and understood between communities and their impact on structural factors, such as health policy' which can be enriched through 'a framework of public health humanities'. In conclusion, the proposed antidote to a global 'amnesia' centres on privileging memory, learning actionable lessons and telling stories of disease within collaborative medical humanities forums which unite literature and science.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Hadidchi R, Pahuja S, Mehrotra-Varma S, et al (2026)

COVID-19 and cardiovascular outcomes in patients with pre-existing hypertension.

Journal of human hypertension, 40(6):446-455.

Patients with hypertension have worse acute COVID-19 outcomes, but the long-term effects of SARS-CoV-2 infection is unclear. We conducted a retrospective cohort study of adults with hypertension and no prior cardiovascular events in the Montefiore Health System, comparing those with and without COVID-19 over up to 4.5 years post-infection. Outcomes included first-time myocardial infarction (MI), heart failure (HF), stroke, all-cause mortality, and major adverse cardiovascular events (MACE). Multivariate regression and inverse-probability weighting adjusted for demographics, comorbidities, socioeconomic status, and COVID-19 vaccination. Adjusted hazard ratios (HRs) with 95% confidence intervals were calculated. Sub-analyses examined hypertension stage and acute COVID-19 blood biomarkers in relation to outcomes. Among 75,180 hypertensive patients, hospitalized COVID-19 was associated with increased risk of first-time MI (adjusted HR = 1.40 [1.21-1.63]), HF (1.59 [1.45-1.75]), stroke (1.35 [1.17-1.57]), all-cause mortality (2.51 [2.17-2.90]), and MACE (1.65 [1.54-1.77]) compared to COVID-negative individuals. Non-hospitalized COVID-19 patients had elevated risks of HF (1.17 [1.06-1.30]) and MACE (1.14 [1.05-1.23]). Hospitalized COVID-19 was associated with an increase in MACE risk by 75% in those with normal blood pressure, and by 126% and 148% in those with elevated blood pressure and stage 1 hypertension, respectively. Abnormal C-reactive protein, creatinine, lactate dehydrogenase, D-dimer, hemoglobin, and neutrophil-to-lymphocyte ratio predicted higher MACE risk. COVID-19, irrespective of disease severity, puts hypertensive patients at greater risks of worse cardiovascular outcomes, especially those with more advanced hypertension. These findings underscore the importance of long-term cardiovascular monitoring in this vulnerable population.

RevDate: 2026-06-22
CmpDate: 2026-05-05

Morton LC, Forshey BM, Klinkhammer KE, et al (2026)

Local genomic epidemiology investigations of SARS-CoV-2 during the early pandemic response: A global systematic review.

Epidemiology and infection, 154:e56.

Genomic epidemiology was essential for characterizing SARS-CoV-2 transmission during the early COVID-19 pandemic. This systematic review examined how whole-genome sequencing was used in local outbreak investigations published between March 2020 and March 2021. Searches of PubMed, Scopus, and Web of Science identified 32 studies from 18 countries that integrated genomic and epidemiological data for local outbreak investigations. Most studies were conducted in healthcare settings or in high-income countries. A limited number of studies were conducted in low- and middle-income countries, except for China and Vietnam. Illumina or Oxford Nanopore platforms and tiled-amplicon protocols were the most common sequencing methods. Phylogenetic trees were the most common genomic epidemiology analytical approach. Genomic data enabled confirmation of suspected transmission links, detection of multiple introductions, and identification of asymptomatic or presymptomatic transmission. Important enablers of early implementation included open-access genomics databases, standardized protocols (e.g. ARTIC), open-source tools (e.g. Nextstrain), and cross-sector partnerships and funding. Study quality and adherence to common observational study reporting guidelines varied widely. Familiarity with the STROME-ID guidelines for molecular epidemiology studies would have improved overall quality. These findings highlight the utility of genomic epidemiology in outbreak response and support its continued integration into public health surveillance systems.

RevDate: 2026-06-21
CmpDate: 2026-04-10

Crețu OE, Poalelungi CV, Neacșu AV, et al (2026)

Epigenetic alterations in preeclampsia: a systematic review of current mechanisms and biomarker potential.

Journal of medicine and life, 19(2):69-88.

Preeclampsia (PE) remains a major cause of maternal and fetal morbidity and mortality worldwide, with placental dysfunction and angiogenic imbalance playing central roles in disease pathogenesis. Emerging evidence highlights epigenetic regulation and angiogenic biomarkers, including placental growth factor (PlGF), as key contributors to disease heterogeneity and risk stratification. A systematic review of studies published between 2022 and 2025 was conducted in accordance with PRISMA 2020 guidelines to synthesize current evidence on epigenetic mechanisms and biomarker potential in PE. In addition, a supplementary exploratory analysis was performed using laboratory-derived PlGF data to assess analytical variability and biological associations. Non-parametric methods were applied, including Mann-Whitney U testing to compare PlGF distributions by analytical sample classification and Kendall's tau correlation to evaluate associations with gestational age and the sFlt-1/PlGF ratio. The systematic review identified consistent epigenetic alterations involving DNA methylation, histone modifications, and non-coding RNAs across maternal and placental tissues. Supplementary analysis demonstrated significantly higher and more variable PlGF concentrations in analytically classified measured samples compared with accepted samples (P = 0.03), suggesting an influence of analytical factors on biomarker distribution. PlGF levels showed a positive association with gestational age (τ = 0.32, P = 0.04) and an inverse association with the sFlt-1/PlGF ratio (τ = -0.41, P = 0.02). These findings support PlGF as a biologically relevant marker of gestational progression and angiogenic balance while underscoring the importance of rigorous analytical quality control. Integrating epigenetic insights with robust biomarker analysis may enhance personalized risk stratification in preeclampsia.

RevDate: 2026-06-21
CmpDate: 2026-04-10

Garcia-Zamora S, Pulido L, Sosa Liprandi MI, et al (2026)

Consensus document on the role of adult vaccination in the prevention of cardiovascular events. Joint Statement by the Argentine Federation of Cardiology (FAC), Argentine Society of Cardiology (SAC), and the Argentine Council of Cardiology Residents (CONAREC).

Medicina, 86(2):447-476.

Cardiovascular diseases remain the leading cause of death among adults, both in Argentina and worldwide. Numerous studies have established a consistent association between infections -particularly respiratory infections- and an increased risk of cardiovascular events, stroke, arrhythmias, and both cardiovascular and all-cause mortality. The underlying pathophysiological mechanisms include systemic inflammation, immune activation, endothelial dysfunction, prothrombotic states, sympathetic stimulation, and elevated myocardial oxygen demand. In respiratory infections, these effects are further exacerbated by hypoxemia and impaired gas exchange. Such alterations can trigger de novo cardiovascular events or exacerbate preexisting conditions, such as ischemic heart disease or heart failure. In this context, robust evidence supports the safety of vaccines against Influenza, Pneumococcus, Respiratory Syncytial Virus, COVID-19, and Herpes Zoster in adults, including those with established cardiovascular disease or risk factors. Moreover, these vaccines have demonstrated efficacy in reducing cardiovascular events by mitigating infection-related complications. Notably, influenza vaccination has proven safe even during the acute phase of myocardial infarction, when administered during hospitalization. Despite this strong evidence base, vaccination rates remain suboptimal among individuals with cardiovascular disease, both in Argentina and across Latin America. This consensus document reviews the current evidence linking infections and cardiovascular events, and highlights vaccines as a safe and cost-effective strategy for primary, secondary, and tertiary prevention. It also provides concrete recommendations to improve vaccine coverage and reduce residual cardiovascular risk in the region.

RevDate: 2026-06-21
CmpDate: 2026-04-10

Estenssoro E, Steinberg E, GA Plotnikow (2026)

[Acute respiratory distress syndrome: a clinical and conceptual journey towards a global, valid, and fair definition].

Medicina, 86(2):495-507.

Acute Respiratory Distress Syndrome (ARDS) is an acute, severe form of respiratory failure characterized by profound hypoxemia, reduced thoracopulmonary compliance, alveolar collapse leading to intrapulmonary shunt, and increased deadspace ventilation. It can originate from pulmonary or extrapulmonary causes, leading to heterogeneous pathophysiology. Clinical variability has driven the pursuit of more precise diagnostic definitions to standardize management and facilitate research. Since its first description in 1967, multiple definitions and classifications of ARDS were proposed, including the Murray Score, the American-European Consensus Conference (AECC), and the Berlin Definition. More recently, the Kigali Definition from Rwanda and the challenges posed by COVID-19 pandemic prompted further re-evaluation of the syndrome. This led to the publication of the New Global ARDS Definition in 2023, which introduced new diagnostic categories and broader diagnostic tools. The ongoing need for refinement, combined with the pathophysiological heterogeneity, motivated an exploration by expert clinician and researchers about the value of defining and subphenotyping ARDS for research, education, and clinical care. To ensure representativeness and validity, a Delphi process was conducted by a panel that included members across all world regions, representing high-intermediate and low-resource settings. This review will explore the evolution of ARDS definitions over time, and the advantages and limitations each has presented in clinical and research contexts.

RevDate: 2026-06-11
CmpDate: 2026-06-11

Redenti BJ, Zhong Y, Yu C, et al (2026)

Recent advances in LNP-mRNA vaccines.

Colloids and surfaces. B, Biointerfaces, 265:115675.

Messenger RNA (mRNA) vaccines have revolutionized immunotherapy by coupling modular mRNA engineering with advances in lipid nanoparticles (LNPs). LNPs, generally composed of ionizable lipid, phospholipid, cholesterol, and PEGylated lipid, have emerged as the leading vehicles for stabilizing mRNA and enhancing its cellular delivery. Concurrent innovations in mRNA chemistry and structure, such as nucleoside modification and untranslated region optimization, have improved translation efficiency, fidelity, and control of innate immune sensing. These synergistic advances underpinned the success of COVID-19 vaccines and have since propelled the rapid expansion of LNP-mRNA platforms across infectious and oncologic diseases. Preclinical and clinical studies now demonstrate potent and durable immune responses elicited by LNP-mRNA vaccines against diverse viral, bacterial, and cancer targets. Together, these findings illustrate how rational integration of biomaterial design with mRNA engineering defines the next generation of programmable immunotherapies. Continued refinement of both particle composition and mRNA architecture is poised to broaden the reach of mRNA nanomedicines across preventive and therapeutic domains.

RevDate: 2026-06-22
CmpDate: 2026-05-30

Chen M, MS Driscoll (2026)

Hypervitaminosis: The deleterious effects of vitamins on the skin.

Clinics in dermatology, 44(3):442-453.

Vitamin supplementation has recently shown a dramatic increase in usage, especially during the COVID-19 pandemic, as a potential aid in preventing, treating, and recovering from infection. In dermatology, vitamin supplements may be used to support the management of a myriad of conditions. A common misconception is that vitamins are safe to consume and that taking more will improve overall health; however, hypervitaminosis may lead to harmful effects. We provide an overview illustrating the use of vitamins A, D, E, niacin, and biotin in dermatology and the potential adverse effects of hypervitaminosis.

RevDate: 2026-06-21
CmpDate: 2026-04-10

Kurup C, Ford A, P Heidke (2026)

Digital Strategies Utilised to Encourage Undergraduate Nursing Students' Engagement in Online Units of Study Throughout the COVID-19 Pandemic: A Systematic Review.

Nursing open, 13(4):e70528.

AIM: This systematic review provides an overview of digital strategies utilised to encourage undergraduate nursing students' engagement in online units of study throughout the COVID-19 pandemic.

BACKGROUND: In nursing education, engagement was crucial in acquiring knowledge, skills, critical thinking and problem-solving abilities. The COVID-19 pandemic forced schools and universities worldwide to quickly adapt from face-to-face learning to online platforms. While online teaching and digital technologies in education were not new, the urgency to create effective online learning opportunities that meet curriculum needs and maintain student engagement was particularly challenging for teaching staff and students.

DESIGN: REVIEW METHODS: The databases used were Embase, CINAHL, EMCARE, ERIC and BASE. The review was limited to English and literature published between January 2020 and September 2022 to capture the studies published around the COVID-19 lockdown. Three researchers independently completed the study selection, quality assessment and data extraction. Any discrepancies were resolved in a consensus-building conversation.

RESULTS: Multiple strategies, such as simulations, gamification and telehealth role-playing, effectively enhanced nursing students' online engagement during COVID-19. Instructor expertise, student-centred approaches and reliable infrastructure emerged as pivotal.

CONCLUSION: The COVID-19 pandemic accelerated the shift to online nursing education, highlighting the need for innovative strategies to sustain student engagement. Identifying the most effective pedagogical approaches, such as virtual simulations, gamification and experiential learning, will support future online learning. Integrating emerging technologies and student-centred teaching methods will be crucial in preparing nursing students for clinical practice in a post-pandemic world.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Kariuki CK, Doijen J, Mann MK, et al (2026)

Beyond assembly: functions of the coronavirus M protein.

Virology journal, 23(1):.

Coronaviruses are enveloped RNA viruses from the family Coronaviridae, notable for their crown-like spike glycoproteins. Though historically regarded as inconsequential, recent outbreaks, most notably COVID-19 caused by SARS-CoV-2, highlight their significant impact on global health. SARS-CoV-2 possesses a 27-31 kb, complex genome encoding multiple structural and non-structural proteins. The membrane/matrix (M) glycoprotein is the most abundant structural component of the viral envelope and confers the minimal requirement for virion formation. Its highly conserved structure, featuring three transmembrane domains, facilitates interactions with other viral proteins that are essential for assembly, budding, and maintaining the integrity of the viral envelope. Beyond its canonical functions in virion assembly and egress, emerging evidence suggests the M protein influences early infection processes, modulates host immune responses, and may serve as a promising antiviral target. This mini review consolidates current knowledge on the structure, multifunctional roles, and therapeutic potential of the coronavirus M protein, emphasizing the necessity for further research into its diverse functions throughout the viral lifecycle.

RevDate: 2026-06-21
CmpDate: 2026-05-22

Senyel D, Boutros E, Frith M, et al (2026)

The (dis-)advantages of telehealth consultation for allied health services: a scoping review.

BMC health services research, 26(1):.

BACKGROUND: The COVID-19 pandemic resulted in an uptake of teleconsultations across the healthcare sector, including for allied health services. However, (dis-)advantages specific to allied health services are under-researched. The aim of this scoping review is the understand the (dis-)advantages patients and providers perceive when using teleconsultations for allied health services.

METHODS: This scoping review was conducted using the JBI methodology for scoping reviews and reported according to the PRISMA-ScR statement. The final search was conducted in January 2024, through the databases MEDLINE Complete, EMBASE, CINAHL, PsycINFO, AMED Allied and Complementary Medicine. Studies were eligible for inclusion if they reported qualitative findings on the (dis-)advantages of teleconsultations for allied health services from a patient's and/or provider's perspective. The screening process was conducted by two independent researchers, while the data extraction and inductive analysis were performed by the first author.

RESULTS: We identified 116 eligible articles. Eight categories were identified from a patient's perspective, including improved access to care, resource savings, convenience, comfort, reduced infection risk, effects on therapy, privacy, and patient-provider relationship. From the provider's perspective, additional categories included telehealth as a trigger for change and improvement, the patients in their own home, disruptions, interpreters, efficiency, changes to workday, and safety and risks.

CONCLUSION: While there are clear advantages, such as improved access to care, and disadvantages, such as the lack of hands-on treatment, the impact of telehealth often depends on the individual context of both the provider and the patient. Although some aspects are broadly relevant across all allied health professions, there are notable differences in the suitability of telehealth for specific services. Understanding the disadvantages and advantages of teleconsultations is key to informing policies and identifying suitable applications of telehealth.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Li M, Li Z, Zhao Z, et al (2026)

Oncovirus-Driven Endothelial Plasticity: Endothelial-to-Mesenchymal Transition as a Hijacked Pathway in Oncoviral Cardiovascular Pathogenesis.

Reviews in medical virology, 36(3):e70143.

Oncoviruses utilise various molecular strategies to modulate host cells and induce microenvironments that favour viral persistence, immune evasion, and disease progression. Endothelial-to-mesenchymal transition (EndMT) has recently emerged as a critical, yet underrecognized, pathway hijacked by oncoviral pathogens to modulate endothelial plasticity within the cardiovascular system. Accumulating evidence indicates that Oncogenic and non-oncogenic viruses, including Kaposi's sarcoma-associated herpesvirus (KSHV/HHV-8), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), human immunodeficiency virus (HIV), and other endothelial-tropic viruses, directly manipulate host signalling networks, such as TGF-β, Wnt/β-catenin, Notch, and NF-κB, to induce partial or complete EndMT. This virus-driven EndMT contributes to vascular remodelling, chronic inflammation, aberrant angiogenesis, and the development of oncoviral-associated cardiovascular pathology and vascular tumours. The present review integrates current virological and mechanistic insights into EndMT as a hijacked host process, highlighting its role at the virus-host interface and discussing emerging antiviral and pathway-targeted strategies aimed at limiting oncovirus-mediated endothelial dysfunction.

RevDate: 2026-06-22
CmpDate: 2026-06-22

Sirago G, Solarino B, Dell'Erba A, et al (2026)

Mapping 25 years of forensic and legal medicine research: a multi-database bibliometric and science-mapping analysis (2000-2025).

Journal of forensic and legal medicine, 120:103127.

BACKGROUND: Forensic and legal medicine spans forensic pathology, clinical forensic practice, toxicology, genetics, imaging, and emerging digital methods. Long-horizon mapping can support research prioritisation and editorial strategy.

METHODS: We conducted performance analysis and science-mapping of records published between 2000 and 2025. Primary analyses were performed on Web of Science Core Collection records (articles and reviews) using bibliometrix/biblioshiny. Outputs included annual production, leading sources and countries, citation indicators, collaboration metrics, keyword co-occurrence, Callon centrality-density thematic mapping, and trend-topic analysis. A conservative, prespecified keyword harmonisation was applied to a small set of orthographic variants (medico-legal, postmortem, machine learning, deep learning). Scopus-derived outputs were used as a robustness comparison for source and country landscapes.

RESULTS: The WoS corpus comprised 16,190 documents from 3052 sources with 49,746 distinct authors and 372,874 cited references. Annual growth was 7.68%, with 5.07 co-authors per document and 13.38% international co-authorship. Output was concentrated in a compact Bradford nucleus of specialist forensic journals, while a long tail of occasional publications appeared in adjacent clinical and multidisciplinary venues. Thematic mapping identified four macro-domains-identification, risk/epidemiology, autopsy/postmortem pathology, and clinical forensic practice-with recent growth in COVID-19-related work, postmortem interval research, and AI/ML terminology.

CONCLUSIONS: Forensic and legal medicine shows sustained growth with a stable conceptual backbone and accelerating innovation in digital and computational themes. These maps can inform research prioritisation, training needs, and editorial planning across specialist forensic outlets.

RevDate: 2026-06-22
CmpDate: 2026-05-14

Yadav P, Singh A, Kumari M, et al (2026)

Clinical evidence on BCG vaccination and COVID-19 infection: A systematic review.

Respiratory investigation, 64(3):101422.

The COVID-19 pandemic, starting in late 2019, led to the rapid development of SARS-CoV-2 vaccines, though early availability was limited, and variants like Delta and Omicron impacted their effectiveness. The Bacillus Calmette-Guérin (BCG) vaccine, used to prevent tuberculosis, has attracted interest for its potential non-specific protective effects against COVID-19. This review systematically evaluates the role of BCG vaccination in enhancing innate immune responses and its utility against COVID-19, focusing on mechanisms like trained immunity and cross-protection. It also discusses recent studies on BCG's impact on COVID-19 outcomes. Preliminary clinical trial findings suggest potential benefits of BCG vaccination against COVID-19, but the evidence remains inconclusive. Therefore, this review highlights the necessity of additional studies to determine whether BCG can prevent COVID-19 infection, mitigate severe outcomes and hospitalizations, and serve as a preventive tool for future viral pandemics.

RevDate: 2026-06-22
CmpDate: 2026-06-22

Gashema P, Iradukunda PG, Rudacogora JC, et al (2026)

Unlocking Africa's vaccine Independence: The critical role of technology transfer and intellectual property.

Vaccine, 81:128573.

The COVID-19 pandemic exposed Africa's profound dependency on external vaccine suppliers, with the continent producing less than 1% of global vaccines and hosting only 1.1% of clinical trials. Despite emerging initiatives, most African facilities remain limited to downstream fill-and-finish operations, while full vaccine antigen manufacturing capacity is largely absent. This perspective paper examines the critical role of Technology Transfer (TT) and Intellectual Property (IP) access in achieving Africa's vaccine independence. Effective TT must extend beyond documentation to include unspoken know-how, on-site mentorship, regulatory dossiers, and supply-chain integration. Simultaneously, pragmatic IP frameworks through voluntary licensing, patent pooling, and time-bound waivers are essential to enable lawful and sustainable local production. Drawing lessons from mature European and U.S. ecosystems, the paper highlights the need for regional manufacturing clusters, harmonized regulatory systems under the African Medicines Agency (AMA), and African pooled procurement mechanisms to ensure market viability. Persistent challenges such fragmented regulation, supply-chain fragility, limited skilled human capital, and uncertain financing continue to constrain progress and highlight the imperative for political commitment to be operationalized through sustained structural investments. Africa's vaccine sovereignty will depend on aligning TT with IP reform, regional cooperation, and predictable market assurance, transforming the continent from a dependent recipient into a resilient and globally competitive vaccine producer.

RevDate: 2026-06-22
CmpDate: 2026-04-12

Eshete MT, Shrestha P, Ang C, et al (2025)

Exploring Grassroots Indicators for Pandemic Prevention, Preparedness, and Response: A Systematic Narrative Review.

International journal of health policy and management, 14:8886.

BACKGROUND: The COVID-19 pandemic has revealed how conventional top-down, expert-driven indicators often fail to align with local community realities, marginalising their perspectives, concerns, knowledge, and narratives. However, the limitations of pandemic-related and global health security indicators are not unique but reflect recurring patterns across major social metrics. In response, an alternative paradigm advocates for grassroots-inclusive approaches to developing indicators. Our objective is to assess how and why grassroots-inclusive approaches complement top-down approaches to developing indicators, and to synthesise their theoretical and practical contributions to public health.

METHODS: We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. We systematically searched six databases (MEDLINE, Embase, CINAHL, Web of Science, Scopus, and PsycINFO), as well as Google Scholar, to identify relevant articles published from their inception to September 1, 2024. We included peer-reviewed articles, opinion pieces, and book chapters, narratively synthesising their findings.

RESULTS: This review included 43 studies from various disciplines. Across these studies, communities co-produced indicators through participatory workshops, interviews, and consensus exercises in areas such as environmental sustainability, disaster resilience, public health, well-being, and local development. The reported strengths included greater local relevance, community ownership, and accountability, alongside challenges in sustaining participation, integrating into top-down systems, and addressing data gaps. Notably, no study applied grassroots-inclusive indicators to health security or pandemic preparedness.

CONCLUSION: Despite retrieving and analysing articles from various disciplines, no study has specifically applied grassroots-inclusive indicators to health security or pandemic preparedness. However, the evidence clearly shows that it is both feasible and practical to integrate expert and non-expert perspectives when developing indicators.

RevDate: 2026-06-21
CmpDate: 2026-04-12

Hudon PA, Haren MT, Gartner JB, et al (2025)

Public Healthcare Procurement Strategies in Response to the COVID-19 Pandemic: A Scoping Review.

International journal of health policy and management, 14:8556.

BACKGROUND: The COVID-19 pandemic posed unprecedented public healthcare procurement challenges. The objective of this review was to identify and characterise the scope of the literature on public procurement strategies for healthcare supplies during the COVID-19 pandemic (2019-2023) in relation to the public procurement contexts, systems, and processes and methods (the public procurement ecosystem) worldwide.

METHODS: We performed a scoping review of governmental strategies for the procurement of medical equipment, personal protective equipment (PPE), or medications related to the COVID-19 pandemic. Extracted data were mapped to the fields of the public procurement ecosystem. We used inductive thematic analysis to derive within-field themes, and subsequently, cross-cutting themes through which we structured a narrative synthesis.

RESULTS: 1909 unique studies were identified through a systematic search, of which 89 met the inclusion criteria. One hundred and ten themes were derived from the extracted data within the 21 fields of the public procurement ecosystem, and from these, 10 cross-cutting themes were identified which served to structure the narrative synthesis. It was clear in this literature that the scale and impact of the COVID-19 pandemic required governments to act well outside of the public procurement processes and methods themselves, to procure and distribute the required supplies. Notwithstanding the significant attention to contextual and system-level responses, there were significant responses at the procurement process and methods level, including rapid and temporary expedited procurement processes and longer-term strategic procurement responses.

CONCLUSION: This scoping review of public procurement strategies during the COVID-19 pandemic has demonstrated a focus of the literature not only on the public procurement processes and methods themselves, but also on governmental actions to adapt both structures of public procurement systems and conditions within broader environmental contexts to facilitate procurement goals.

RevDate: 2026-06-22
CmpDate: 2026-06-22

Žigová K, Marčeková Z, Gautieri A, et al (2026)

Recombinant Taq DNA polymerase.

Journal of biotechnology, 415:152-169.

The sudden COVID-19 pandemic highlights the importance of diagnostic assays in health security readiness. One persistent difficulty is the rapid molecular detection of pathogenic microorganisms and viruses. Taq DNA polymerase remains an essential component for COVID-19 molecular detection. Taq DNA polymerase exhibits a high level of thermostability, which results from tighter hydrophobic packing, increased salt bridges, shortened loops, and proline substitutions that reduce flexibility, enabling activity above 90 °C. In addition, engineered variants address limitations by improving fidelity, processivity, and stability. The enzyme´s thermostability has significantly increased the efficiency, automation, and specificity of PCR. Hot-start modifications using antibodies, aptamers, or chemical inhibitors further reduce non-specific amplification, strengthening its role in sensitive diagnostics. Although Taq polymerase is available from several commercial sources, it is crucial and urgent to produce enzymes recombinantly for use in research and diagnostic procedures. To satisfy the demands of industry, it is necessary to maximize and optimize its production. We provide an overview of the recombinant Taq DNA polymerase´s characteristics, structural features, engineering advances, production background and strategies, and purification history in this paper. Together, these insights underscore its central role in diagnostics, research, and biotechnology, as well as its continued relevance as a model enzyme for protein engineering.

RevDate: 2026-06-22
CmpDate: 2026-06-22

Tang Y, Li D, Zhu Y, et al (2026)

Rational design of lipid and lipid-like structures for non-liver-targeted mRNA therapy.

Biomaterials science, 14(9):2237-2259.

The application of mRNA therapies has witnessed significant advancement since the outbreak of COVID-19. However, the widespread use of mRNA therapies has been restricted by the liver accumulation of traditional lipid structures used as delivery vectors. The efficacy of mRNA expression has been demonstrated to be highly related to vector structures and properties. To expand non-liver organs or cells as therapeutic targets for mRNA, lipid and other lipid-like molecules such as lipid analogs and lipid-like polymers with more favorable mRNA delivery efficiencies have been developed based on a deeper understanding of their structure-function correlations. This review primarily summarizes the structure commonalities leading to an excellent delivery performance and specific organ or cell targeting and illustrates the potential and future prospects of related materials in different biomedical applications of mRNA therapies.

RevDate: 2026-06-21
CmpDate: 2026-04-13

Jariah ROA, MS Hakim (2026)

Antiviral properties of phages: potential mechanisms of actions.

The new microbiologica, 49(1):1-10.

Bacteriophages (phages) have long been known to treat bacterial infections, although some early studies showed that phages also have potential antiviral mechanisms. This review provides a descriptive summary of ideas on how phages might have a significant role in inhibiting viral infections. Phages are known to directly modulate the host immunity that subsequently influences the immune responses against viral infections. It is also reasonable to explore the phage potential to directly inhibit viral infection in humans, including herpes simplex virus (HSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Lastly, phages have been utilized as a molecular tool in phage display. Phages have already been engineered to produce monoclonal antibodies against the spike (S) protein of SARS-CoV-2. Despite all these possibilities, further extensive and deeper explorations are highly required.

RevDate: 2026-04-13
CmpDate: 2026-04-13

Cao X, Tang J, Liu Y, et al (2026)

Evolutionary trajectory and co-infection dynamics of human influenza A(H1N1) virus (2000-2025): an integrated framework informed by expert-informed bibliometrics.

Frontiers in microbiology, 17:1793244.

INTRODUCTION: Influenza A (H1N1) remains an important seasonal respiratory pathogen, but evidence on its evolutionary dynamics, reported co-detections, and surveillance priorities remains fragmented.

METHODS: We conducted an evidence-mapping synthesis (2000-2025) integrating bibliometric analysis, expert-guided curation, and sequence/structure-informed interpretation. A total of 15,028 records were retrieved from PubMed, Web of Science, and Scopus, and 11,848 unique publications were retained after deduplication. GenBank-derived hemagglutinin (HA) sequences and Swiss-Model homology models were used to characterize mutational patterns and structural features. Literature-derived co-detection records were extracted from eligible publications and interpreted using a method-aware framework.

RESULTS: A post-2010 shift in the HA mutational landscape was observed, with recurrent substitutions at sites including S13, S146, S160, and S202. Structure-informed comparison of representative HA models identified a conformationally flexible segment spanning residues aa190-aa226, suggesting potential relevance to the receptor-binding microenvironment. Mapping of literature-derived co-detection records showed that RSV and SARS-CoV-2 were among the most frequently reported co-pathogens; however, these proportions reflected reporting composition across heterogeneous studies rather than population-level co-infection prevalence. In a China-focused module, G219A in Eurasian avian-like (EA) H1N1 strains was prioritized through protocol-constrained expert annotation requiring isolate-level evidence and was interpreted as a hypothesis-generating site of interest within the receptor-binding region rather than an algorithm-derived global bibliometric signal.

DISCUSSION: This study provides an integrated overview of H1N1 research evolution, HA mutational change, and reported co-detection patterns over the past 25 years. The findings support a tiered, method-aware multi-pathogen surveillance framework for preparedness, while underscoring that heterogeneous literature-derived co-detection data require standardized definitions, assay-aware interpretation, and local calibration before translation into clinical or public health decision-making.

RevDate: 2026-04-13
CmpDate: 2026-04-13

Wang K, Z Yang (2026)

Future prospects of antiviral research in traditional Chinese medicine.

Chinese herbal medicines, 18(2):226-230.

Traditional Chinese medicine (TCM) has a long history of treating viral diseases through holistic approaches and multi-component formulations. In response to emerging global viral threats like coronavirus disease-2019 (COVID-19), TCM has demonstrated significant potential in both antiviral and immune-modulatory roles. This review summarizes the current state of TCM antiviral research, highlighting advances in identifying active components and elucidating their mechanisms, which include direct viral inhibition and immune regulation. Technological innovations, including artificial intelligence (AI)-driven drug discovery and advanced extraction methods, are accelerating the development of TCM antiviral products. However, challenges remain in standardization, mechanistic validation, and international regulatory acceptance. Looking ahead, research should prioritize systems pharmacology, the development of multi-dimensional evaluation models, standardized clinical trials, and global health integration. By addressing these challenges, TCM can play a vital role in worldwide antiviral strategies and public health.

RevDate: 2026-04-15
CmpDate: 2026-04-13

Sergazy S, Gulyaev A, Z Shulgau (2026)

Oxidative Stress as a Mechanistic Link Between Severe Respiratory Viral Infection and Pulmonary Fibrosis.

Biology, 15(7):.

Post-viral pulmonary fibrosis represents a clinically significant and mechanistically complex consequence of severe respiratory infection. The COVID-19 pandemic has highlighted that a subset of survivors, particularly those with severe pneumonia or acute respiratory distress syndrome, develop persistent fibrosis-like lung abnormalities, including reticulation and traction bronchiectasis, often accompanied by impaired gas transfer. Although the clinical course is heterogeneous and many lesions regress over time, longitudinal studies indicate that structural and functional impairment may persist for years in susceptible individuals. Oxidative stress has emerged as a plausible convergent mechanism linking acute epithelial injury, dysregulated inflammatory resolution, and chronic fibrotic remodeling. Reactive oxygen and nitrogen species amplify inflammatory signaling, promote epithelial cell death and senescence, influence macrophage polarization, and activate canonical profibrotic pathways, notably the TGF-β axis. Redox imbalance is embedded within reinforcing circuits involving NOX4-dependent ROS amplification, mitochondrial dysfunction, endoplasmic reticulum stress, inflammasome activation, and senescence-associated secretory programs. Persistent immune activation and organelle stress may sustain redox dysregulation beyond viral clearance, thereby bridging acute lung injury to maladaptive remodeling. This review integrates epidemiological, clinical, and mechanistic evidence to position oxidative stress as a central mediator of post-viral lung fibrosis and discusses therapeutic and translational implications.

RevDate: 2026-06-22
CmpDate: 2026-06-22

Asaba CN, Gwanyama BN, Ayuk HS, et al (2026)

Neutrophil Extracellular Traps in Viral Infections: Regulation, Immune Consequences, and Pathogenic Outcomes.

Cells, 15(7):.

Neutrophils are among the early responders of the innate immune system and play a key role in host defense against viral infections. Beyond their classical antimicrobial functions, neutrophils can engage in a specialized defense mechanism by releasing web-like extracellular DNA known as neutrophil extracellular traps (NETs). These extracellular traps are a mesh-like network of chromatin DNA decorated with cellular components, including histones, proteases, and antimicrobial enzymes, that function to contain and limit the spread of pathogens. While NET formation contributes to antiviral immunity, accumulating evidence indicates that excessive or dysregulated NET formation can significantly contribute to immunopathology during viral infections. Thus, depending on the context and outcome, NET formation may be viewed as a double-edged sword. Therefore, understanding the regulatory mechanisms governing NET formation and its harmful effects is critical for developing therapeutic strategies that enhance antiviral defense while minimizing tissue damage. In this review, we provide a comprehensive overview of the molecular mechanisms that drive NET formation and clearance, with a particular focus on how viruses modulate these processes to influence disease outcome. We also discuss the pathways underlying NET formation and subsequent neutrophil cell death (NETosis), including canonical and non-canonical pathways, and highlight key signaling axes involving SYK, MAPKs, and NF-κB. Using SARS-CoV-2 and hepatitis B virus as representative models, we examine how different viral components trigger, exploit, or evade NET targeting and how persistent accumulation of NETs can contribute to hyperinflammation, progressive tissue injury, and post-viral syndromes. We further explore emerging evidence linking impaired NET clearance and neutrophil heterogeneity, particularly low-density neutrophils (LDNs), to chronic inflammation and post-viral sequelae such as long COVID and autoimmune hepatitis. Finally, we summarize current and emerging therapeutic strategies aimed at modulating NET formation or enhancing NET clearance. Altogether, this review underscores the dual nature of NETs in viral infections, highlighting their potential roles in antiviral defense and tissue injury, and provides a framework for the development of targeted interventions to limit virus-induced immunopathology.

RevDate: 2026-06-21
CmpDate: 2026-06-21

Wang Z, Chen B, Gao Y, et al (2026)

Redox-responsive nanoparticles for enhanced mRNA delivery: a comprehensive review.

Journal of materials chemistry. B, 14(15):4546-4570.

The clinical success of mRNA vaccines during the COVID-19 pandemic highlighted the therapeutic potential of mRNA while exposing persistent delivery barriers, including intrinsic instability, poor cellular uptake, and inefficient intracellular trafficking. Redox-responsive nanoparticles (NPs) provide a promising strategy to improve mRNA delivery by undergoing stimulus-triggered disassembly in the reductive cytosol, facilitating efficient mRNA release, endosomal escape, and enhanced translation. This review elucidates emerging structure-function relationships by systematically linking redox-labile chemistries (e.g., disulfide, diselenide, and polysulfide), carrier type, and NP architecture to key biological outcomes, including endosomal escape, redox responsiveness, transfection efficiency, and biodistribution. We further identify critical translational challenges-such as tumor redox heterogeneity, insufficient systematic preclinical evaluation, and manufacturing constraints-and propose actionable strategies, including multi-stimulus-responsive systems, microfluidic and process-analytical manufacturing, and formulation approaches to improve efficacy, reproducibility, and stability. Collectively, these insights provide a practical framework to guide the rational design and clinical translation of next-generation redox-responsive mRNA delivery platforms.

RevDate: 2026-06-22
CmpDate: 2026-04-13

Peddireddy S, VanWingerden N, Patel P, et al (2026)

Stellate Ganglion Block in the Treatment of Long COVID: A Systematic Review.

Current pain and headache reports, 30(1):.

OBJECTIVES: This review evaluates stellate ganglion block as a treatment for long COVID, seeking to evaluate the treatment's efficacy by various symptoms and the limitations of the current literature.

STUDY DESIGN: Systematic Review.

SETTING: Ambulatory or Outpatient Setting.

METHODS, SUBJECTS: A systematic review of the current literature regarding use of stellate ganglion block in patients with long COVID was conducted. 2 databases were searched on August 28th, 2025. Search terms were "long COVID" and "stellate ganglion block", yielding 45 results. Studies examining patient outcomes after stellate ganglion block were included. Case reports, case series, basic science studies and previous reviews were excluded. Seven studies met inclusion criteria.

RESULTS: Patients received a single stellate ganglion block in some studies and multiple stellate ganglion blocks in others. All studies reported symptomatic improvement without control groups. Response rates ranged from 55.8% to 100%. The most robust improvements (> 80% patients reporting relief) were seen in cough, dyspnea, headache, joint pain, pain interference/intensity, pins/needles, subjective relief.

CONCLUSION: Stellate ganglion block is a promising treatment that appears to generate substantive benefit for many of the symptoms seen in long COVID. However, the current literature has small, uncontrolled studies with heterogenous study designs and follow-up periods. Standardized research with larger sample sizes, control groups, and longer-term follow up is necessary to elucidate the degree of benefit. IRB approval and clinical trial registration not required.

RevDate: 2026-06-21
CmpDate: 2026-04-13

Hudnall SR, Jacobs BC, KB Fields (2026)

Functional Testing for Return to Activity with COVID-19.

Current sports medicine reports, 25(4):118-122.

Return-to-play decisions following COVID-19 infection remain challenging due to persistent variability in cardiopulmonary and functional recovery. This review examines four validated functional tests: the Timed Up and Go, 6-Minute Walk Test, Kasch Pulse Step Recovery Test, and 1-Minute Sit-to-Stand Test and their potential roles in assessing readiness for physical activity and sport after COVID-19 infection. These office-based assessments are simple, reproducible, and sensitive to impairments in cardiovascular, pulmonary, and musculoskeletal function. Evidence suggests that post-COVID-19 individuals may demonstrate significant deficits in performance across functional tests, supporting their integration into return-to-play evaluations. The 6-Minute Walk Test is recommended as the primary measure of functional capacity, with the 1-Minute Sit-to-Stand Test as a validated alternative. Incorporating functional testing into return-to-play protocols can enhance clinical decision-making, guide rehabilitation, and promote safe resumption of physical activity.

RevDate: 2026-06-22
CmpDate: 2026-05-21

Fam JY, N Männikkö (2026)

Can the Bergen Facebook Addiction Scale be adapted across contexts? Evidence from a COnsensus-based Standards for the selection of health Measurement INstruments systematic review.

Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 40(4):484-497.

OBJECTIVE: The Bergen Facebook Addiction Scale (BFAS) has served as a foundation for a series of adapted measures designed to assess social media-related behavioral addictions. Despite widespread application of these instruments, a systematic evaluation of their psychometric properties is lacking. This review aimed to evaluate the measurement properties of the BFAS and its adaptations using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology.

METHOD: A systematic search was conducted to identify psychometric studies of the BFAS and its adapted versions, including the BFAS-18, Bergen Social Media Addiction Scale (BSMAS), Bergen Mukbang Addiction Scale, Social Media Addiction during COVID-19 Pandemic scale, and Social Networks Addiction Scale-6 Symptoms. Eligible studies were assessed using the COSMIN Risk of Bias checklist, and the quality of evidence was graded according to the COSMIN-Grading of Recommendations Assessment, Development and Evaluation approach.

RESULTS: A total of 55 studies were included. The BFAS and BSMAS demonstrated strong evidence for structural validity, internal consistency, measurement invariance, and hypothesis testing, with high-quality evidence across multiple domains. The BFAS-18 and Bergen Mukbang Addiction Scale received more limited and inconsistent support, while the Social Media Addiction during COVID-19 Pandemic scale and Social Networks Addiction Scale-6 Symptoms remain underexplored with very low-quality evidence. Across all scales, evidence for content validity, reliability, measurement error, and responsiveness was sparse, highlighting important gaps.

CONCLUSIONS: The BFAS and BSMAS currently represent the most robust instruments for assessing Facebook and social media addiction, respectively. However, additional research is required to strengthen evidence for other adaptations, particularly in relation to content validity, measurement error, and responsiveness, as well as to evaluate linguistic and cultural invariance. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

RevDate: 2026-06-22
CmpDate: 2026-05-18

Albaloul H, Nemer A, Saini N, et al (2026)

Infectious Diseases: What You May Have Missed in 2025.

Annals of internal medicine, 179(5_Supplement):e2600983.

This article highlights clinical trials on infectious diseases published in 2025 that we believe are highly relevant to internal medicine physicians who are not infectious diseases specialists. Selected studies address prevention and treatment strategies across infectious diseases. We highlight 2 studies of sexually transmitted infections (STIs): one examining the effectiveness of treating male partners to reduce recurrence of bacterial vaginosis and another study of doxycycline as postexposure prophylaxis against bacterial STI. A strategy for using methanamine hippurate to prevent recurrent urinary tract infections (UTIs) in older women is included in our review. We review the updated evidence supporting the effectiveness of COVID-19, respiratory syncytial virus, and influenza vaccines for the 2025-2026 season, and a modified messenger RNA influenza vaccine, which showed superior efficacy with an acceptable safety profile. In HIV care, a study of dual antiretroviral maintenance therapy showed that dolutegravir and lamivudine was noninferior to triple therapy at 48 weeks. A meta-analysis supporting shorter antibiotic courses for pyelonephritis and complicated UTIs provides important information for antibiotic stewardship strategies. In serious infections, dalbavancin was noninferior to standard therapy for Staphylococcus aureus bacteremia, whereas cefiderocol expanded treatment options for gram-negative bloodstream infections without clear superiority, particularly in carbapenem-resistant pathogens. Finally, a study found that elevated C-reactive protein identifies patients most likely to benefit from adjunctive corticosteroids in community-acquired pneumonia.

RevDate: 2026-06-22
CmpDate: 2026-04-13

Watanabe H, Nagao R, Kawabata K, et al (2026)

[Olfactory Nerve: The Vulnerability Inherent in its Unique System and Neurological Diseases].

Brain and nerve = Shinkei kenkyu no shinpo, 78(4):303-311.

The olfactory nerve possesses unique anatomical features, including direct central nervous system (CNS) projection and continuous regeneration. Scientific advances have elucidated mechanisms such as combinatorial receptor coding and signal amplification. This review summarizes these foundations and examines olfactory dysfunction in COVID-19 and Parkinson's disease (PD). In COVID-19, evidence suggests that SARS-CoV-2 targets sustentacular cells rather than olfactory neurons, causing gene downregulation and parosmia attributed to incomplete peripheral filtering, while direct CNS invasion remains rare. In PD, olfactory loss is a prodromal feature. However, seed amplification assays reveal that alpha-synuclein aggregation in the nasal mucosa does not fully correlate with olfactory dysfunction, as reflected by differences between PD and Multiple System Atrophy. This, together with correlations with cardiac sympathetic denervation, challenges simple pathogen propagation hypotheses. We propose that PD-related hyposmia reflects a systemic vulnerability involving deficits in energy metabolism and neural network organization, rather than solely peripheral protein aggregation. Understanding these pathologies requires a multifaceted approach beyond anatomical lesions.

RevDate: 2026-06-12
CmpDate: 2026-06-10

Matthews R, Alam A, Bullmore E, et al (2026)

Understanding the long-term neurological effects of SARS-CoV-2 infection.

Nature reviews. Neurology, 22(6):351-365.

Post-COVID-19 condition (PCC), also known as long COVID, is a heterogeneous condition marked by persistent symptoms following acute SARS-CoV-2 infection. As approximately 6% of people who have experienced acute COVID-19 are estimated to develop PCC, the potential population is vast. Many of the key symptoms of PCC reflect involvement of the nervous system, ranging from cognitive impairment ('brain fog'), headaches and fatigue to anxiety and depression. This Review summarizes the spectrum of neurological and psychological symptoms that occur following acute SARS-CoV-2 infection, with a particular focus on the international consensus-based core outcome set for PCC. We also explore the proposed underlying mechanisms, including evidence for immune system dysregulation, microvascular dysfunction and volumetric changes on neuroimaging. In addition, we review ongoing and completed large-scale treatment trials. Growing evidence suggests a bidirectional interaction between symptoms traditionally considered neurobiological in origin, such as cognitive deficits and headache, and those within the purview of psychiatry, such as anxiety and depression. PCC represents an opportunity to better understand the long-term consequences of acute infection and improve management strategies and outcomes, not only for people with the condition but also for those with other post-viral syndromes that affect brain health.

RevDate: 2026-06-27
CmpDate: 2026-06-27

Alhumaid S, Alkhars O, Algrafi AS, et al (2026)

Vaccine effectiveness across the Omicron evolutionary spectrum (BA.2, BA.5, XBB, JN.1, KP.3): a systematic review of studies published 2022-2025.

BMC infectious diseases, 26(1):.

BACKGROUND: Since late 2021, the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has undergone rapid evolutionary diversification, giving rise to successive subvariants with increasing immune escape. In response, coronavirus disease 2019 (COVID-19) vaccination strategies transitioned from ancestral-strain vaccines to variant-adapted formulations. Real-world evidence on the effectiveness and durability of these updated vaccines across the full Omicron evolutionary spectrum remains fragmented. OBJECTIVES: To synthesise real-world evidence on the effectiveness of COVID-19 vaccines against SARS-CoV-2 infection and severe clinical outcomes across successive Omicron subvariants from 2022 to 2025, with particular emphasis on variant-adapted vaccine formulations and waning immunity over time. METHODS: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and registered in PROSPERO. MEDLINE (via PubMed), Embase, CINAHL, Scopus, and Web of Science Core Collection were systematically searched for peer-reviewed observational studies published between January 2022 and December 2025. Eligible studies assessed vaccine effectiveness during periods dominated by Omicron subvariants including BA.2, BA.5, XBB, BA.2.86/JN.1, and KP lineages. Findings were synthesised narratively due to substantial heterogeneity. RESULTS: Thirty observational studies from North America, Europe, and East Asia were included. Across Omicron subvariants, vaccine effectiveness against SARS-CoV-2 infection was generally modest and short-lived, with rapid waning within months after vaccination and estimates frequently approaching null during later subvariant periods. In contrast, updated and variant-adapted vaccines consistently provided meaningful protection against severe COVID-19 outcomes, including hospitalization and death. Protection was highest during BA.4/BA.5 and early XBB-dominant periods and declined with increasing time since vaccination, especially during JN.1- and KP-predominant periods and among the oldest age groups. Importantly, substantial protection against severe outcomes persisted within the first 1–3 months following vaccination, with effectiveness against hospitalization and death generally ≥ 50%, although effectiveness declined over time during later Omicron subvariant periods. CONCLUSION: Updated and variant-adapted COVID-19 vaccines continue to confer substantial protection against severe COVID-19 outcomes across successive Omicron subvariants, despite limited and rapidly waning effectiveness against SARS-CoV-2 infection. These findings support prioritisation of periodic booster vaccination for older adults and other high-risk populations, with vaccine performance primarily evaluated using protection against severe clinical outcomes. CLINICAL TRIAL NUMBER: Not applicable.

RevDate: 2026-06-28
CmpDate: 2026-06-28

Porter AV, Joseph-Williams N, Leighton C, et al (2026)

Barriers and facilitators to knowledge translation at the science-policy interface during the COVID-19 pandemic public health emergency: a rapid review and theoretical analysis to inform development of a logic model.

BMC public health, 26(1):.

BACKGROUND: The COVID-19 pandemic necessitated the rapid production, synthesis, and translation of best available evidence to inform public health policy and practice decisions. This presents a unique learning opportunity to understand the interventions and strategies used to promote evidence-informed decision-making at the science-policy interface during this public health emergency and to explore what hindered or facilitated these processes. OBJECTIVES: To describe the interventions at the science-policy interface used to support knowledge translation during the COVID-19 pandemic, explore the barriers and facilitators to such interventions, and apply findings to formal knowledge translation principles to inform the development of a logic model. METHODS: A systematic literature search of Medline via OVID, Scopus, and Web of Science was conducted. Studies were assessed for eligibility and critically appraised. A narrative synthesis was conducted. Knowledge translation models and frameworks were identified via Google Scholar and analysed for their applicability to a public health emergency context. RESULTS: We included 18 articles. The most common interventions at the science-policy interface were advisory committees, knowledge translation platforms and hubs, knowledge translation activities (knowledge brokering, priority-setting, workshops) and products (data visualisation and summaries). Barriers included: data availability and accessibility, time constraints, underrepresentation in advisory committees, political influence, and lack of transparency. Facilitators included: research coordination, interdisciplinary collaboration, transparency in research methods, and actionable and accessible evidence. We identified 11 knowledge translation models that contributed to the logic model. CONCLUSIONS: Our findings, developed from empirical findings and theoretical principles, offer valuable insights into how knowledge translation infrastructures and processes could be strengthened in preparation for future public health emergencies.

RevDate: 2026-06-27
CmpDate: 2026-06-27

Rák T, Ormai E, Pandur E, et al (2026)

Exploring the interplay between olfaction and vision: neuroplasticity, rehabilitation, and the therapeutic potential of herbal ingredients.

BMC complementary medicine and therapies, 26(1):.

Post-COVID-19, olfactory and visual training have demonstrated health benefits, particularly for individuals with visual impairments and neurodegenerative conditions such as Parkinson’s and glaucoma. Integrating olfactory training with essential oils and developing multisensory technologies could improve the quality of life for those with sensory deficits, underscoring the brain’s adaptability and the therapeutic potential of herbal ingredients. This short review commentary proposes that the neuroplastic interplay between the olfactory and visual pathways, including their demonstrated anatomical and functional convergence, may provide a conceptual foundation for integrating olfactory stimulation into future visual rehabilitation strategies.

RevDate: 2026-04-15
CmpDate: 2026-04-14

Noh W, Y Ko (2026)

Resilience-Enhancing Programs for Nurses in the Era of COVID-19: A Systematic Review and Meta-Analysis.

Healthcare (Basel, Switzerland), 14(7):.

Background/Objectives: In the post-pandemic era, growing concern about the mental health of healthcare professionals has led to the development of various resilience-enhancing programs. Although such programs are not new, having been implemented before the pandemic, it is important to investigate how post-pandemic programs differ from earlier ones. This review aimed to analyze resilience-enhancing programs for nurses and evaluate their effectiveness. Methods: This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was performed in the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and EMBASE. Six studies met the inclusion criteria. The meta-analysis was conducted using Stata version 16.0 (StataCorp LLC., College Station, TX, USA). Results: Six studies were included in the systematic review and meta-analysis. The characteristics of the included studies, such as country, study design, setting, population, outcome variables, and resilience-enhancing programs for nurses, were analyzed. The random-effects meta-analysis indicated a statistically significant positive effect on nurses' resilience (SMD = 0.58, 95% CI 0.10 to 1.07, Z = 2.35, p = 0.019). Conclusions: This study provides foundational evidence for understanding resilience-enhancing programs for nurses and highlights their potential value in post-pandemic healthcare settings.

RevDate: 2026-04-15
CmpDate: 2026-04-14

Mihai AM, Marc M, Lucaciu F, et al (2026)

Incident Heart Failure Risk Following COVID-19 Recovery: A Systematic Review and Meta-Analysis.

Journal of clinical medicine, 15(7):.

Background/Objectives: While acute cardiac injury during COVID-19 is well-documented, the long-term risk of new-onset heart failure (HF) in survivors remains a critical clinical concern. This study aims to quantify the risk of new-onset heart failure during a 25 months prognostic follow-up period following recovery from SARS-CoV-2. Methods: We conducted a systematic review and meta-analysis of nine high-quality studies (n > 400,000 survivors) in accordance with PRISMA 2020 guidelines. Databases including PubMed/MEDLINE and Scopus were searched through January 2026. A quantitative meta-analysis was performed on six studies using a random-effects model to pool adjusted hazard ratios (aHR). Results: The pooled analysis revealed a significant 35% increased risk of new-onset heart failure following COVID-19 recovery (aHR 1.35; 95% CI: 1.14-1.60; p = 0.001). Significant heterogeneity was observed (I[2] = 92.62%), reflecting diverse risk profiles among survivors. The risk was most pronounced in immunocompromised kidney transplant recipients (aHR 2.32) and younger adults under the age of 65 (aHR 1.53). Subclinical myocardial damage, characterized by reduced left ventricular longitudinal strain, was identified even in survivors who experienced mild initial infections. Conclusions: COVID-19 recovery serves as a significant independent risk factor for chronic heart failure, emphasizing that cardiovascular impact extends far beyond the acute phase. These findings necessitate the implementation of structured cardiovascular monitoring and biomarker screening for at least one year post-infection to address this emerging chronic disease burden.

RevDate: 2026-04-15
CmpDate: 2026-04-14

Mastrangelo H, Sacco MA, Gualtieri S, et al (2026)

Placental Vascular Malperfusion, Perinatal Death and Neonatal Brain Injury: A Mechanism-Based Narrative Review with Medico-Legal Implications.

Journal of clinical medicine, 15(7):.

Background/Objectives: Placental vascular malperfusion, on both the maternal (MVM) and fetal (FVM) side, is a key mechanism linking hypertensive disorders of pregnancy, fetal growth restriction (FGR), stillbirth, preterm neonatal death and neonatal encephalopathy. Nevertheless, clinical use and medico-legal interpretation of placental findings remain inconsistent. To summarize recent evidence on the relationship between placental vascular malperfusion, perinatal mortality and neonatal brain injury, integrating standardized placental pathology with Doppler and angiogenic biomarkers, and to outline the main medico-legal implications. Methods: A PubMed search using the string "((placenta OR placental pathology) AND (stillbirth OR fetal death) AND (maternal vascular malperfusion OR fetal vascular malperfusion))" yielded 118 records. After excluding reviews, meta-analyses, case reports (except one illustrative SARS-CoV-2 placentitis case), non-human studies and papers without original histopathology, 33 studies were included: observational cohorts and case-control studies with standardized placental assessment, autopsy series, biomarker/Doppler cohorts, mechanistic work, one randomized trial protocol and a small number of focused clinical commentaries. Results: Across these studies, MVM emerges as the dominant placental lesion in pre-eclampsia, FGR and a large proportion of stillbirths, especially in early-onset disease and in association with maternal hypertension. FVM is strongly linked to stillbirth and term neonatal encephalopathy, and specific combinations of MVM, FVM and inflammatory lesions correspond to distinct patterns of brain injury. Large population-based cohorts confirm that maternal hypertensive disorders and placental malperfusion are major upstream causes of intrauterine hypoxia and preterm neonatal death. Doppler velocimetry and angiogenic biomarkers (PlGF, sFlt-1 and their ratio) are strongly associated with an increased likelihood of underlying MVM and adverse neonatal outcomes, although their predictive performance remains probabilistic and context-dependent rather than diagnostic. Mechanistic studies suggest roles for placental genomic instability and altered decidual immunity in defective placentation. Conclusions: Maternal and fetal vascular malperfusion represent converging pathways to FGR, stillbirth, preterm neonatal death and neonatal encephalopathy. Routine, standardized placental examination, interpreted together with Doppler and biomarker data, substantially improves causal attribution and timing of injury, with direct consequences for counselling, prevention and medico-legal assessment.

RevDate: 2026-04-28
CmpDate: 2026-04-28

Ganji V, Kamble B, Mustafa F, et al (2026)

The Dual Burden: Long-Term Impact of COVID-19 on Tuberculosis Incidence - Presentation and Outcomes.

Maedica, 21(1):198-206.

INTRODUCTION: Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a major public health concern globally ranking as the second leading infectious disease and the 13th leading cause of death worldwide. The global healthcare systems have experienced unprecedented challenges in recent years due to COVID-19 pandemic causing widespread disruptions. Delaying TB diagnosis and treatment led to lower reported incidence but could increase mortality, hindering efforts to eradicate TB. Although a few studies have focused on COVID-19 and TB cases to date, most of them are case reports. Since it is unclear whether patients with COVID-TB co-infection have a worse prognosis or more likely to develop severe disease, we believed that doing this study was a necessity. The present systematic review investigates the long-term effects of COVID-19 on TB incidence, reporting follow-up and treatment outcomes.

OBJECTIVES: The present study aimed to explore the long-term impact of COVID-19 on TB incidence, presentation and outcome.

METHODS: We conducted our systematic review following PRISMA (Preferred reporting in systematic reviews and meta-analysis) guidelines. We performed a comprehensive literature search of EMBASE, PubMed, Scopus, The Lancet, Web of Science and Cochrane Central Register of Controlled Trials. The search items included "Corona virus disease 19", "impact of COVID-19", "SARS-CoV-2", "Tuberculosis", "TB and COVID-19 co-infection", "comorbidities", "prognosis", "incidence", "outcomes" and "risk factors" for articles published between the 1st of January 2020 and the 31st of June 2024. Searches were limited to English language only. We included articles with primary outcomes including studies which reported TB incidence or notification rates, clinical presentation, treatment interruption or outcomes of TB due to COVID-19 and TB-COVID-19 co-infection. Cohort studies, case-control studies, cross-sectional studies and surveillance or registry-based studies were included.

RESULTS: Information regarding COVID-19 and TB was collected from the databases, and out of 1973 articles, 41 articles were included. COVID-19 has had a negative impact on TB control programs leading to decrease in reporting of TB cases. As per the global tuberculosis report by WHO 2025, there has been approximately one-third reduction in incidence rates with TB case notifications declining by 21% of TB cases notification in 2020 compared to 2019. The reports indicated that the number of people diagnosed with TB was 7.5 million in 2022 above the baseline of 7.1 million in 2019 and 5.8 million in 2020.

CONCLUSION: COVID-19 has affected TB diagnosis and control, with a significant decline in TB case notifications leaving many undiagnosed cases, thereby reversing years of progress in TB control. The high-TB burden countries like India should tackle the havoc caused by the COVID-19 pandemic by addressing the needs of the poor and having a concrete agenda and perpetual TB strategy to reach the target by 2030.

RevDate: 2026-06-30
CmpDate: 2026-04-14

Abid S, H Jannath (2026)

Cardiac Effects in Post-COVID-19 Heart Failure: A Systematic Review of Longitudinal Imaging- and Biomarker-Based Structural and Functional Remodeling.

Annals of cardiac anaesthesia, 29(2):157-168.

COVID-19 has been linked to persistent cardiovascular sequelae, yet the trajectory of structural and functional cardiac changes beyond the acute phase remains unclear. This systematic review synthesizes longitudinal evidence on post-COVID cardiac remodeling assessed by imaging and biomarkers. Following PRISMA guidelines, we searched PubMed and Cochrane Library (January 2020-April 2025) for peer-reviewed studies enrolling adults (≥18 years) with polymerase chain reaction (PCR)/antigen-confirmed SARS-CoV-2 infection and reporting cardiac outcomes ≥ 12 weeks post-infection. Eligible outcomes included imaging-based abnormalities (cardiac magnetic resonance [CMR]: T1/T2 mapping, late gadolinium enhancement [LGE]; echocardiography: left ventricular ejection fraction [LVEF], LV/RV strain). Longitudinal trends of biomarkers (troponin, NT-proBNP, C-reactive protein [CRP]) were also studied. Risk of bias was assessed using joanna briggs institute (JBI) tools; synthesis followed synthesis without metaanalysis (SWiM) principles. Fifteen studies (n ≈ 166,000; 14 cohorts, 1 case report) were included. Across CMR cohorts, global systolic function was largely preserved, but tissue abnormalities were frequent early and improved over time: edema indices normalized by ~ 12 months, while LGE prevalence declined (e.g. 50%→19% in paired scans). However, residual non-ischemic scars and elevated T1/T2 persisted in symptomatic subgroups. Echocardiography showed normal LVEF, but subtle left ventricular global longitudinal strain (LV-GLS) impairment versus controls (e.g. -18.5% vs - 19.3%). Biomarker trends were heterogeneous: natriuretic peptide positivity persisted in patients with prior cardiovascular disease (CVD), while troponin and CRP generally normalized. Large population-based cohorts demonstrated sustained 12-month risk for heart failure, myocarditis, and major cardiovascular events, graded by acute severity. Most patients recover gross systolic function, yet subclinical myocardial changes and elevated population-level cardiovascular risk persist up to 1 year. These findings support risk-stratified follow-up, judicious use of advanced imaging, and preventive cardiology strategies.

RevDate: 2026-04-15
CmpDate: 2026-04-14

Rosińska M, Czarkowski MP, M Sadkowska-Todys (2026)

Infectious diseases in Poland in 2023.

Przeglad epidemiologiczny, 79(4):730-749.

OBJECTIVE. The aim of this study was to summarize the epidemiological situation of infectious diseases in Poland in 2023. The ongoing impact of the COVID-19 pandemic and the effects of the influx of refugees to Ukraine were taken into account. MATERIAL AND METHODS. We performed a narrative review of studies published in Epidemiological Chronicle, along with data from the national infectious disease registry, Epibaza, which collects data from epidemiological investigations conducted by the State Sanitary Inspectorate. Mortality data were obtained from reports of the Statistics Poland Office. RESULTS. In 2023, 381,244 cases of COVID-19 and 4,329 deaths due to this disease were recorded. The COVID-19 mortality rate in 2023 was several times lower than in 2022, although COVID-19 still accounted for more deaths than other infectious diseases. An "immunity gap" effect was observed following the COVID-19 pandemic, resulting in a significant increase in the incidence of pertussis (2.5 times compared to 2022), influenza and influenza-like illnesses, and intestinal infections (enteric salmonellosis +57.9%, campylobacteriosis +64.1%, yersiniosis +74.5%, norovirus +27.8%). A reduction in the incidence was observed for rotavirus infections, for which routine infant vaccinations were introduced in 2021. The increase in pneumococcal disease incidence occurred mainly in the adult and senior population. While the number of new HIV diagnoses among Polish nationals is increasing, the number of cases among migrants has declined, although they still account for 25% of all new diagnoses. The incidence of other sexually transmitted infections also continues to increase (compared to 2022, gonorrhoea +110.6%, syphilis +89.6%). CONCLUSIONS. For many diseases, incidence increased compared to previous years, for a variety of reasons, including the persistent "immunity gap" following the pandemic and the specific nature of the vaccination program. The impact of the influx of refugees from Ukraine was minor.

RevDate: 2026-06-27
CmpDate: 2026-06-27

Graessner H, Ripp S, Pereira AM, et al (2026)

European Reference Networks - a flagship activity of the EU in the field of rare and complex diseases: from 2017 to 2025.

Orphanet journal of rare diseases, 21(1):.

BACKGROUND: Although individual rare and complex diseases (RDs) affect small patient populations, together they impact an estimated 27–36 million people across the European Union. Addressing this major public health challenge has been a long-term priority for the European Union, leading to the establishment of the European Reference Networks (ERNs) in 2017. MAIN BODY: ERNs are cross-border networks connecting clinical expert centres to share knowledge, improve and harmonise diagnosis and care for patients with rare and complex diseases. Since their inception, 24 ERNs have united 1,606 expert centres across 375 hospitals in all EU Member States and Norway. Their activities span multidisciplinary clinical collaboration, patient-centred governance, education and training, and the development of clinical guidelines. Over 4900 extremely rare or difficult cases have been discussed among experts without requiring the patients to travel abroad when expertise was not available in their own countries. A key factor for this success is the cross-border IT platform - known as the Clinical Patient Management System 2.0 - provided by the European Commission for medical discussions, which enables experts to share patient data, including medical images and lab results, in a secure and protected environment that is fully compliant with all relevant security and data privacy requirements. ERNs have demonstrated resilience in crises such as the COVID-19 pandemic and the war in Ukraine, providing rapid, coordinated responses to sustain care for vulnerable patient groups. The first formal evaluation in 2023 confirmed that more than 95% of member centres met quality standards, underscoring the networks’ maturity and effectiveness. Moving into the next phase, the Joint Action JARDIN (2024–2027) aims to integrate ERNs into national healthcare systems to ensure sustainability and equitable access to high-quality RD care. CONCLUSIONS: ERNs exemplify European solidarity and innovation in healthcare, transforming how rare disease expertise is shared and applied across borders. Their continued integration into national systems will be pivotal to achieving a truly cohesive European Health Union that delivers improved outcomes for all patients with rare and complex diseases.

RevDate: 2026-06-22
CmpDate: 2026-06-22

Sepúlveda MD, Cardona Maya WD, Zapata-Builes W, et al (2026)

Decoding NK Cell Subset Dysregulation in SARS-CoV-2 Infection: Phenotypic, Functional, and Transcriptomic Insights Into COVID-19 Pathogenesis.

Scandinavian journal of immunology, 103(4):e70115.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection significantly affects innate immune responses, particularly those of natural killer (NK) cells, which play an important role in antiviral defence. This review combines phenotypic, functional, and transcriptomic findings to explain the disruption of NK cell subsets in COVID-19. Flow cytometry studies have shown generalised lymphopenia and a significant reduction in the CD56bright and CD56[dim]CD16[+] subsets. This change is linked to an increase in the CD56[dim]CD16[-] and CD56[-]CD16[+] populations, which correlate with disease severity. At the molecular level, there is an imbalance between activating and inhibitory receptors. This includes increases in NKG2A, PD-1, and LAG-3, along with decreases in NKp30, NKp46, and NKG2D. These findings are consistent with an exhausted phenotype and weakened cytotoxicity. Single-cell RNA sequencing (scRNA-seq) studies have identified an increase in proliferative, cytotoxic, and platelet-associated CD56[dim] NK subpopulations in severe cases and a reduction of CD56[bright] cells. Transcriptomic profiling showed that upregulation of interferon-stimulated genes (ISGs) and inflammatory pathways driven by STAT1/3, NF-κB activation, and transforming growth factor-beta (TGF-β) signalling suppresses NK effector functions. Collectively, these findings suggest a model in which progressive NK cell dysfunction may be associated with the immunopathogenesis of COVID-19. The integration of multi-omic and phenotypic approaches provides a comprehensive view of NK cell responses to SARS-CoV-2 and suggests potential biomarkers and therapeutic targets to restore NK cell antiviral activity.

RevDate: 2026-04-18
CmpDate: 2026-04-15

Bechini A, Salvati C, Del Riccio M, et al (2026)

Burden and Characteristics of Respiratory Syncytial Virus-Associated Bronchiolitis in Hospitalized Infants in Italy: A Systematic Review.

Immunity, inflammation and disease, 14(4):e70420.

BACKGROUND: Respiratory syncytial virus (RSV) is the main cause of bronchiolitis in infants. This systematic review aimed to evaluate the burden of RSV-associated bronchiolitis among hospitalized Italian infants between 2000 and 2023.

METHODS: A comprehensive literature search identified studies examining RSV-related hospitalizations for bronchiolitis in children aged 0-59 months. Eligible studies met the following criteria: conducted in Italy, focused on children, reported on RSV prevalence, co-infections, genotype distribution (RSV-A, RSV-B), and seasonal trends, and published in English or Italian. Data extraction focused on study design, infant characteristics (e.g., age, preterm birth), and RSV detection methods.

RESULTS: Twenty-four studies were included. Infants under 12 months were most affected. RSV was the primary pathogen identified, though co-infections with other respiratory viruses, such as human rhinovirus, were common. RSV infections typically peaked in late autumn and winter, but the COVID-19 pandemic altered these patterns. This review highlights the significant burden of RSV-associated bronchiolitis in Italian infants. While RSV remains the primary pathogen, co-infections and pandemic related factors have altered its epidemiological trends.

CONCLUSIONS: Nationwide RSV immunization programmes and improved diagnostics are crucial to ease the strain on pediatric intensive care units. Recent recommendations for widespread RSV long-acting monoclonal antibody use in infants offer promising solutions to address this challenge.

RevDate: 2026-06-22
CmpDate: 2026-04-15

Gou H, Zhai Y, Yu Q, et al (2026)

Epidemiological Changes in Mycoplasma pneumoniae Infections in Children and Adolescents Before and After COVID-19: A Systematic Review and Meta-Analysis.

Reviews in medical virology, 36(3):e70151.

Mycoplasma pneumoniae (M. pneumoniae) is a major cause of respiratory tract infections in children and adolescents, yet its epidemiological burden before, during, and after the COVID-19 pandemic remains unclear. This meta-analysis, which searched Web of Science, Embase, PubMed, and Cochrane Library for reports published up to December 25, 2025, aimed to evaluate trends in the prevalence of M. pneumoniae infections across these three periods to guide clinical practice and public health responses. A total of 70 studies were included, and methodological quality was assessed using the Joanna Briggs Institute criteria. The pooled prevalence of M. pneumoniae infections before, during, and after COVID-19 was calculated in R 4.5.0, with Freeman-Tukey double arcsine transformation for extreme proportions. The prevalence of M. pneumoniae infections before COVID-19, during COVID-19, and after COVID-19 was 21.72% (95% CI: 17.09, 26.73), 10.73% (95% CI: 7.57, 14.35), and 28.64% (95% CI: 22.74, 34.93), respectively. Age-stratified analysis revealed the highest prevalence consistently in children > 6 years (pre-pandemic: 46.35%; during-pandemic: 27.32%; post-pandemic: 41.36%) and the lowest in infants < 1 year (8.21%, 4.87%, and 7.81%, respectively). Seasonally, pre-pandemic prevalence peaked in summer (33.34%) and autumn (31.00%). During the pandemic, overall rates declined but remained highest in autumn (15.51%). Post-pandemic, prevalence rebounded broadly, peaking in autumn (37.97%). In conclusion, this study summarises M. pneumoniae trends in children and adolescents before and after COVID-19, indicating a delayed resurgence following the pandemic, and highlights the need for further research to explain these patterns and improve future pandemic preparedness.

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