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Bibliography on: covid-19

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ESP: PubMed Auto Bibliography 23 Oct 2025 at 01:42 Created: 

covid-19

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS coronavirus 2, or SARS-CoV-2), a virus closely related to the SARS virus. The disease was discovered and named during the 2019-20 coronavirus outbreak. Those affected may develop a fever, dry cough, fatigue, and shortness of breath. A sore throat, runny nose or sneezing is less common. While the majority of cases result in mild symptoms, some can progress to pneumonia and multi-organ failure. The infection is spread from one person to others via respiratory droplets produced from the airways, often during coughing or sneezing. Time from exposure to onset of symptoms is generally between 2 and 14 days, with an average of 5 days. The standard method of diagnosis is by reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab or sputum sample, with results within a few hours to 2 days. Antibody assays can also be used, using a blood serum sample, with results within a few days. The infection can also be diagnosed from a combination of symptoms, risk factors and a chest CT scan showing features of pneumonia. Correct handwashing technique, maintaining distance from people who are coughing and not touching one's face with unwashed hands are measures recommended to prevent the disease. It is also recommended to cover one's nose and mouth with a tissue or a bent elbow when coughing. Those who suspect they carry the virus are recommended to wear a surgical face mask and seek medical advice by calling a doctor rather than visiting a clinic in person. Masks are also recommended for those who are taking care of someone with a suspected infection but not for the general public. There is no vaccine or specific antiviral treatment, with management involving treatment of symptoms, supportive care and experimental measures. The case fatality rate is estimated at between 1% and 3%. The World Health Organization (WHO) has declared the 2019-20 coronavirus outbreak a Public Health Emergency of International Concern (PHEIC). As of 29 February 2020, China, Hong Kong, Iran, Italy, Japan, Singapore, South Korea and the United States are areas having evidence of community transmission of the disease.

NOTE: To obtain the entire bibliography (all 57700 citations) in bibtek format (a format that can be easily loaded into many different reference-manager software programs, click HERE.

Created with PubMed® Query: ( SARS-CoV-2 OR COVID-19 OR (wuhan AND coronavirus) AND review[SB] )NOT 40982904[pmid] NOT 40982965[pmid] NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)

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RevDate: 2025-10-22
CmpDate: 2025-10-22

Forgham H, Chang Y, Wang Y, et al (2025)

The evolution of nanomedicine: The rise of next-generation nanomaterials in cancer nanomedicine.

Science advances, 11(43):eadx1576.

The nanomedicine field continues to gain momentum, with several groundbreaking clinical trials underway. However, despite the promise of advanced antifouling nanoparticles incorporating poly(ethylene glycol)-a key component in the development of COVID-19 vaccines-the clinical translation of nanomedicine remains limited. This is primarily due to the relatively low delivery efficacy, with passive targeting relying on the enhanced permeability and retention effect, and active targeting leading to only modest improvements in target tissue accumulation. Improving the targeting, biocompatibility, and functionality of nanoparticles has the potential to create more effective, personalized, and minimally invasive therapies. This review aims to highlight the rise of a previously unidentified order of immune-minded nanomaterials and explores how mechanobiological principles and biomechanical nanotools are revolutionizing our understanding of nano-bio interactions in relation to disease. By considering mechanical properties such as stiffness, surface topology, and behavior under physiological flow conditions, researchers can better engineer nanoparticles for improved therapeutic outcomes.

RevDate: 2025-10-22

Moore TJ, Socal MP, G Anderson (2025)

Developing New Drugs for the COVID-19 Emergency: Anatomy of the U.S. Response.

Pharmacotherapy [Epub ahead of print].

CONTEXT: To meet the need for effective treatments during the COVID-19 Public Health Emergency, the U.S. government sought to accelerate the discovery and development of new antiviral treatments-a process that normally took 4-12 years. The government changed many features of the established system, selecting the investigational drugs, sponsoring or conducting the clinical testing, and purchasing and managing the distribution of the successful products.

METHODS: We focused on novel therapeutic agents for COVID-19 that were funded, clinically tested, and/or received Emergency Use Authorization during the Public Health Emergency from January 2020 to May 2023. The primary sources were the public records of the National Institutes of Health, the U.S. Food and Drug Administration, and the Biomedical Advanced Research and Development Authority. Excluded were vaccines, devices, diagnostic tests, and new indications for approved drugs.

RESULTS: In less than 24 months, the emergency program developed, tested, approved, and distributed eight new therapeutic products, including six monoclonal antibodies and two new oral antivirals. In addition, 11 other investigational agents were funded or tested under the emergency program but did not receive Emergency Use Authorization. More than 30 million courses of treatment were distributed at a cost of $29 billion or $881 per patient. By the end of the emergency, viral mutations and rapidly growing population immunity rendered the new products ineffective in almost all patients.

CONCLUSIONS: The emergency program was dramatically effective in finding and testing new drug treatments using a variety of clinically relevant endpoints and serving varied patient populations. Planning for future pandemics should include a global network of clinical testing centers that were key to a rapid response. Research is needed to discover more durable antiviral treatments, especially in settings where mutation and population immunity are subject to rapid change.

RevDate: 2025-10-22

Hortsch M, Girão-Carmona VCC, Leite ACRM, et al (2025)

A global overview of anatomical science education and its present and future role in biomedical curricula.

Anatomical sciences education [Epub ahead of print].

The four main anatomical sciences, gross anatomy, histology, neuroanatomy, and embryology, are fundamental subjects for most health professionals and biomedical students. Usually taught as part of preclinical basic science training, the anatomical sciences provide a structural understanding of human or animal bodies at both macroscopic and microscopic levels. This overview characterizes how the anatomical sciences are currently taught around the globe, highlighting similarities, differences, and recent curricular transformations that were partially in response to the COVID-19 pandemic. Globally, educators of the anatomical sciences navigate similar pressures, including expectations of curricular integration and reduced time for anatomical teaching. Student-centered teaching approaches and e-learning technologies have been adopted across many regions, transforming how educators engage their learners. However, not all educators are provided with technological resources to facilitate such educational advancements, particularly in regions where economic inequality and poor infrastructure hinder access to the internet. Though ethical standards guiding the procurement of human bodies have evolved over time, the sources of human bodies that academic institutions use for anatomy education vary widely. Specific regional issues complicate many aspects of anatomical science education, challenging educators to adopt novel teaching approaches. Despite some differences, every global region appears to be moving in a similar direction. However, where academic institutions fall on that trajectory differs for specific regions/countries. How these educational and technological changes influence anatomy education should be carefully considered for the strengths and weaknesses they provide and the opportunities and threats they bring.

RevDate: 2025-10-21

Song Y, Zhang S, Wang R, et al (2025)

Ginseng as Promising Natural Medicine against Infectious Diseases: Therapeutic Targets and Potential Mechanisms.

Journal of ethnopharmacology pii:S0378-8741(25)01456-4 [Epub ahead of print].

C.A. Meyer (ginseng) has been esteemed for centuries in traditional Chinese, Korean, and indigenous medicine as a vital tonic and therapeutic agent for enhancing resilience and treating infectious diseases. Historically, used for respiratory or skin infections, gastrointestinal disorders, etc. These applications align with modern evidence supporting its broad-spectrum anti-infective activity. Ginsenosides, the principal bioactive constituents, have been shown to exert targeted effects against diverse infectious pathogens. This review integrates ethnomedical insights with contemporary pharmacology, highlighting ginseng's translational potential in combating antimicrobial resistance and emerging infectious diseases.

AIM OF THE STUDY: This review aims to elucidate the therapeutic targets and molecular mechanisms of ginsenosides' anti-infective activities and critically evaluates their translational potential in addressing emerging infectious diseases and antimicrobial resistance.

MATERIALS AND METHODS: A comprehensive literature search was conducted across PubMed, Web of Science, ScienceDirect, SpringerLink, Elsevier, and the Chinese National Knowledge Infrastructure (CNKI) using keywords such as "ginsenosides", "anti-infective", "antiviral", "antibacterial", and "immunomodulation". Relevant studies published in English and Chinese were systematically screened, extracted, and analyzed to elucidate the mechanisms and clinical potential of ginsenosides in combating infectious diseases.

RESULTS: Ginsenosides exhibit anti-infective effects through three major mechanisms: (i) direct inhibition of viral entry and replication; (ii) immunomodulatory activity via activation of macrophages, T cells, and dendritic cells; and (iii) suppression of pro-inflammatory pathways, particularly NF-κB and MAPK signaling. They also demonstrate synergistic effects with conventional therapies against key pathogens such as influenza virus and SARS-CoV-2. Additional benefits include modulation of the gut microbiota and enhancement of host immune responses, underscoring their multifaceted therapeutic profile.

CONCLUSION: Ginsenosides represent promising natural anti-infective agents with broad-spectrum activity. This review highlights their mechanistic basis and clinical potential, supporting their development as novel therapeutics in the fight against infectious diseases, including the urgent threat of antimicrobial resistance.

RevDate: 2025-10-21

Oba S, Hosoya T, Iwai H, et al (2025)

Long COVID: mechanisms of disease, multisystem sequelae, and prospects for treatment.

Immunological medicine [Epub ahead of print].

Long COVID has emerged as a significant global health issue, affecting individuals across a wide spectrum of initial disease severity. While its definition and prevalence vary across studies, persistent symptoms such as fatigue, cognitive dysfunction, respiratory difficulties, and cardiovascular complications have been widely reported. Multiple pathophysiological mechanisms have been proposed, including incomplete viral clearance, reactivation of latent viruses, immune dysregulation, autoimmunity, endothelial dysfunction, microbiome alterations, and mitochondrial impairment. These interconnected processes are thought to contribute to chronic inflammation and multi-organ disease. To date, there are no established therapies for Long COVID, and management primarily focuses on symptomatic relief and rehabilitation. Vaccination has been shown to reduce the incidence of Long COVID, and emerging strategies, including antiviral agents, immune-modulating therapies, microbiome restoration, and mitochondria-targeted interventions, are under investigation. This review summarizes the current understanding of the epidemiology, pathophysiology, organ-specific manifestations, and potential therapeutic approaches for Long COVID, aiming to provide insights into future research directions and clinical management strategies.

RevDate: 2025-10-21

Sanchez ZM, Y Valente J, da Silva Dos Santos MH, et al (2025)

Substance Use During the COVID-19 Pandemic in the Americas: A Scoping Review.

Substance use & addiction journal [Epub ahead of print].

BACKGROUND: During the COVID-19 pandemic, substance use in the Americas was influenced by various factors, including social isolation, increased stress, and disruption of healthcare services. While the impacts varied across populations, the health crisis exacerbated challenges related to substance use, particularly in more vulnerable groups. This article aims to describe the pandemic's impact on substance use and substance use disorders in the Americas region.

METHODS: We conducted a scoping review across 4 databases (Pubmed, Scielo, Lilacs, and Google Scholar) using a search paradigm based on the combination of several keywords related to substance use during the COVID-19 pandemic in the Americas.

RESULTS: Most studies were conducted at the beginning of the pandemic and carried out in the United States and Canada. A higher proportion of the general population decreased or showed no changes in cannabis consumption. On the other hand, for those who reported pre-pandemic substance use, consumption has increased as a strategy to cope with COVID-related stress, exacerbating preexisting problems. Patients with substance use disorders reduced their visits to treatment services and in-person medication visits declined significantly. In an attempt to reverse the distancing of patients from the services, there was an increase in take-home medication and telehealth services. Rates for opioid-related deaths and other substance overdose-related deaths increased during the pandemic, especially among racial/ethnic minorities.

CONCLUSION: The study concludes that the pandemic-intensified substance use among vulnerable populations, particularly individuals with pre-existing mental health conditions or a history of substance use disorders, while having a low impact on the general population. This divergence has contributed to widening health disparities.

RevDate: 2025-10-21
CmpDate: 2025-10-21

Ebrahim MA, Makundi SE, Mushi NN, et al (2025)

Multisystem inflammatory syndrome in children associated with COVID-19: a case report and literature review.

The Pan African medical journal, 51:96.

Given the rarity of multisystem inflammatory syndrome related to COVID-19 (MIS-C). This case report highlights the high index of suspicion to diagnose MIS-C in a child who presented with symptoms suggestive of acute gastroenteritis. While admitted in the hospital, she deteriorated with worsening of symptoms, clinical decline, deranged laboratory markers, and significant radiological findings, even though on antibiotics. She had acute myocarditis with myocardial dysfunction on echocardiography and raised cardiac enzymes. Intravenous human immunoglobulin (IVIG) was given, but there was additional need for inotrope (norepinephrine) and methylprednisolone albeit the preliminary echocardiogram was normal. Early recognition of MIS-C with rapid escalation of care post IVIG administration is needed to prevent morbidity and mortality.

RevDate: 2025-10-21
CmpDate: 2025-10-21

Wright A, McGrowder D, S Bryan (2025)

Nitric Oxide in the Treatment of COVID-19: Nasal Sprays, Inhalants and Nanoparticles.

Biochemistry research international, 2025:8846903.

Although the World Health Organization has declared that the coronavirus disease (COVID-19) is not a public health emergency of international concern anymore, it has negatively impacted the world, and effective treatment for this pandemic remains a major priority. Vaccine effectiveness has been a matter of concern given the evolution of variants and subvariants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Thus, continued protection against SARS-CoV-2 and its variants is still necessary and could work alone or in parallel with vaccinations to treat COVID-19 in the future. Further, findings from in vitro and in vivo studies have noted the effectiveness of high dosages of nitric oxide (NO) as an antimicrobial agent against respiratory pathogens such as bacteria, viruses and fungi. NO has been previously utilized in the management of SARS-CoV and has shown a similar antiviral effect with SARS-CoV-2 in vivo and in vitro. Effective therapy with NO can be used to target several stages of COVID-19 infection to prevent transmission and progression of the disease. The unique properties of NO allow this simple, gaseous molecule to be administered in various forms. NO can be used as an inhalant, in the form of NO donor drugs such as S-nitrosothiols and more recently as NO-releasing nanoparticles (NO-nps). This review summarizes the bioavailability of NO in COVID-19 patients and highlights in vivo and in vitro studies as well as clinical trials with NO administered as a nasal spray, inhalant, or via nanodelivery for therapeutic applications for COVID-19 and other respiratory infections in the future.

RevDate: 2025-10-21
CmpDate: 2025-10-21

Mutee AF, Shareef A, Jyothi SR, et al (2025)

Exploring Potential Mechanisms for Epilepsy After mRNA COVID-19 Vaccination: An Extremely Rare Side-Effect.

Scandinavian journal of immunology, 102(4):e70059.

The rapid rollout of mRNA-based COVID-19 vaccines, including Pfizer-BioNTech's BNT162b2 and Moderna's mRNA-1273, has been instrumental in curbing the pandemic, demonstrating high efficacy and safety in the general population. However, concerns regarding neurological adverse effects, particularly in individuals with epilepsy (PWE), warrant scrutiny. Clinical data from case reports, multicenter studies, and meta-analyses (encompassing over 3000 PWE) indicate that most tolerate vaccination well, with seizure worsening in approximately 5% of cases, often transient and lower than post-COVID-19 infection rates. Rare severe events, such as status epilepticus, highlight vulnerabilities, though background seizure incidence remains comparable or lower than natural rates. This review examines potential neuroimmune mechanisms linking mRNA vaccination to seizure exacerbation, emphasising immune activation, neuroinflammation, and epileptogenesis. mRNA vaccines utilise lipid nanoparticles (LNPs) to deliver spike protein-encoding mRNA, eliciting robust immune responses. Potential triggers for seizures include cytokine storms (e.g., IL-1β, TNF-α, IL-6), blood-brain barrier (BBB) disruption, molecular mimicry with neuronal antigens, and autoantibody production, which may heighten neuronal hyperexcitability in susceptible individuals. Neurological side effects, including Bell's palsy, transverse myelitis, and herpes zoster reactivation, are more prevalent in mRNA platforms, potentially tied to LNP-induced inflammation or cross-reactive immunity. While evidence supports vaccination benefits outweighing risks for PWE, gaps persist in understanding individual predispositions. Future research should prioritise longitudinal studies, EEG monitoring, and AI-driven approaches for personalised risk assessment, mRNA optimisation, and pharmacovigilance. Integrating multi-omics and computational modelling could enhance vaccine safety, ensuring equitable protection for vulnerable populations.

RevDate: 2025-10-20

Bratzler DW (2025)

COVID-19 in Retrospect: Public Health Lessons from a Global Crisis.

The American journal of the medical sciences pii:S0002-9629(25)01248-0 [Epub ahead of print].

The COVID-19 pandemic, emerging in late 2019, rapidly evolved into a global health crisis of unprecedented scale. Initially marked by widespread transmission and severe illness, the pandemic overwhelmed healthcare systems, disrupted economies, and exposed deep-rooted inequalities. Over 775 million cases and an estimated 18-33 million global deaths were recorded by 2024. The crisis illuminated critical vulnerabilities in pandemic preparedness, healthcare infrastructure, and public health communication. Key lessons included the need for resilient supply chains, robust data systems, equitable healthcare access, and sustained investment in public health. Misinformation significantly hindered response efforts, underscoring the importance of aligned scientific and public messaging. The pandemic also triggered debates over civil liberties and public health authority. While rapid vaccine development was a major achievement, the overall response highlighted systemic gaps. These insights offer a roadmap for improving future pandemic responses and safeguarding global health security.

RevDate: 2025-10-21
CmpDate: 2025-10-21

Ni K, KS Korfmacher (2025)

A Scoping Review on the Ethics of Wastewater Surveillance for COVID-19.

Journal of public health management and practice : JPHMP, 31(6):E387-E395.

CONTEXT: Wastewater surveillance (WWS) emerged as a tool to monitor public health during the COVID-19 pandemic. Wastewater surveillance is generally undertaken voluntarily by public health and wastewater treatment agencies. Therefore, public trust and support is essential to its sustainability. Development and implementation of ethically informed practices may contribute to public support for expansion of WWS to other public health applications.

OBJECTIVE: We conducted a scoping review of existing publications on the ethics of WWS for COVID-19. We characterized these publications and identified research gaps.

DESIGN: This scoping review was based on searches through Scopus and PubMed for the period January 2020 to December 2023 focusing on four concepts: wastewater, surveillance, ethics, and COVID-19. We included studies published in journals, reports, and books and identified 31 publications. Publications were coded thematically as well as by approach, region, discipline, and publication type.

RESULTS: The majority of publications focused on the need to develop ethical guidelines that promote long-term public support for WWS. A number of publications proposed ethical guidelines and also emphasized that these considerations are context-specific and dynamic, requiring an ongoing system for input as new situations, endpoints, and technologies evolve. Themes included protection of privacy, potential to stigmatize communities with high COVID-19 signals, the importance of effective communication, equitable application of WWS, community engagement, and high standards for data quality. There were few empirical studies of diverse populations' preferences for WWS. Ethical considerations may vary across communities and countries and as new applications of wastewater surveillance emerge.

CONCLUSIONS: We provide an overview of the emerging principles for ethical practice of WWS and identify gaps in knowledge. These findings may guide future research and consideration of ethics as decisionmakers consider new monitoring endpoints (eg, pharmaceuticals, illegal drugs, infectious diseases, and indicators of population health).

RevDate: 2025-10-20
CmpDate: 2025-10-20

Gualotuña-Suntaxi J, Pérez-Muñoz D, Zambrano-Villacres R, et al (2025)

Available evidence on integrating COVID-19 into sentinel surveillance systems: A scoping review.

Medwave, 25(9):e3026.

INTRODUCTION: The COVID-19 pandemic exposed the weaknesses of epidemiological surveillance systems and highlighted the need to integrate new respiratory viruses into sentinel surveillance systems. However, current evidence on their effectiveness remains limited.

AIM: This project conducts a scoping review to describe the available evidence on the integration of COVID-19 into sentinel surveillance systems.

METHODS: The included studies addressed sentinel surveillance in the context of the pandemic following the World Health Organization declaration. A systematic search was performed in databases including MEDLINE, LILACS, EPISTEMONIKOS, and DIMENSIONS, selecting observational studies and systematic reviews. Data collection and analysis were organized into categories such as clinical characteristics, timely detection, geographic representativeness, co-infection, and adaptability with genomic surveillance. Seventeen studies reporting on COVID-19 integration impact and one preliminary WHO report were identified.

RESULTS: Results identified the most prevalent symptoms in the general population: fever (73%), cough (51.8%), loss of taste or smell (45.1%), hypoxemia (33%), and sputum production (23.9%). A high correlation was obtained between SARI cases or hospitalizations due to respiratory infection and the incidence of COVID-19 (ρ = 0.78 and ρ = 0.82 respectively).

CONCLUSIONS: Integrating COVID-19 into the sentinel surveillance system could improve detection, response, and follow-up capacity. Additionally, implementing standardized case definitions promotes more efficient use of laboratory resources, thereby enhancing the sustainability of the surveillance system.

RevDate: 2025-10-20
CmpDate: 2025-10-20

Boraschi D, Carsetti R, Chen L, et al (2025)

Advocating mucosal immunization: A global need in a viewpoint from China.

Innovation (Cambridge (Mass.)), 6(10):100951.

Human mucosal immunization is expected to afford protection against infection and reduce transmission by generating anti-infective immunity at the mucosal entry site of viruses and bacteria. Nasal or oral administration has the advantage of being needle free and self-administered, thereby improving compliance and coverage of large populations. In China, the experience of COVID-19 has promoted substantial efforts in the development of nasal vaccinations in the general health protection strategy. The hurdles we are facing in the development of mucosal vaccines, however, come from the still limited knowledge of the mechanisms controlling mucosal immunity in different anatomical locations and in response to different pathogens/vaccines. Identifying and filling the knowledge gaps in order to develop effective and safe mucosal immunization strategies requires global collaboration, not only at the scientific level but, most importantly, by engaging public and private health organizations, governments, and regulatory authorities. We have highlighted here some of the crucial issues in mucosal immunization and provided suggestions for the way forward toward a global preparedness effort to prevent infectious diseases and ensure vaccine equity.

RevDate: 2025-10-20
CmpDate: 2025-10-20

Ding W, Zhang Y, Wang MZ, et al (2025)

Post-pandemic mental health: Understanding the global psychological burden and charting future research priorities.

World journal of psychiatry, 15(10):109502.

The coronavirus disease 2019 pandemic has left an indelible mark on global mental health, with widespread psychological consequences that persist beyond the acute phase of the virus. This review synthesizes current evidence on the post-pandemic mental health burden across diverse populations, highlighting elevated rates of depression, anxiety, posttraumatic stress, and substance use disorders linked to prolonged social isolation, economic instability, and grief. We examine disparities in psychological outcomes among vulnerable groups (e.g., healthcare workers, survivors, marginalized communities) and identify key challenges in addressing these issues, including fragmented healthcare systems, stigma, and the limited scalability of interventions. Emerging evidence on resilience factors (e.g., social support and adaptive coping) is also discussed. Finally, we propose critical priorities for future research, including longitudinal studies on the chronic mental health effects, the development of culturally tailored interventions, and the integration of digital mental health solutions. This review distinctively addresses enduring post-pandemic mental health challenges, integrating neurobiological insights, equity-focused interventions, and critical perspectives on digital solutions, gaps underrepresented in prior syntheses. By charting a roadmap for multidisciplinary collaboration, this review aims to inform policymakers and researchers in mitigating the long-term psychological aftermath of the pandemic.

RevDate: 2025-10-20
CmpDate: 2025-10-20

Xin R, Garigliany MM, J Li (2025)

KAP1 in antiviral immunity: dual roles in viral silencing and immune regulation.

Frontiers in cellular and infection microbiology, 15:1618103.

Krüppel-associated box (KRAB)-associated protein 1 (KAP1), also known as TRIM28 due to its tripartite motif (TRIM) domain, is a member of the transcription intermediary factor 1 (TIF1) family. Since its discovery in 1996, KAP1 has been widely studied as a scaffold protein involved in histone methylation, heterochromatin formation, and genome maintenance. Its function and stability are dynamically regulated by post-translational modifications (PTMs), including phosphorylation, SUMOylation, and acetylation. In addition, KAP1 serves as a signal transducer via its SUMO/ubiquitin E3 ligase activity. This review summarizes current advances in understanding the roles of KAP1 in regulating retroviruses (RVs), herpesviruses, and emerging respiratory viruses such as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and influenza A virus (IAV), with a particular focus on the interplay between its structural domains and physiological functions. Recent findings on human immunodeficiency virus (HIV) are highlighted to address ongoing mechanistic controversies, particularly those involving KAP1-mediated latency control. We further examine novel insights into KAP1's involvement in other viruses, including hepatitis B virus (HBV), porcine reproductive and respiratory syndrome virus (PRRSV), and African swine fever virus (ASFV). as well as its emerging regulatory roles in host innate immune responses through PTM-mediated modulation of antiviral signaling pathways. Although KAP1 exerts both antiviral and proviral effects, the underlying mechanisms remain incompletely defined, especially in systems where conflicting observations exist for the same pathogen. These discrepancies-reflecting both methodological variation and KAP1's inherent regulatory complexity-underscore the need for deeper mechanistic insight. Future studies utilizing precise genetic tools and in vivo models will be critical for elucidating the context-specific roles of KAP1 in viral gene regulation and advancing its translational potential.

RevDate: 2025-10-20
CmpDate: 2025-10-20

Cavada BS, Osterne VJS, Oliveira MV, et al (2025)

Bridging Viral Glycobiology and Lectin Biotechnology for Antiviral and Diagnostic Strategies.

ACS bio & med chem Au, 5(5):792-814.

Lectins, proteins that reversibly bind specific glycan motifs, offer dual utility as molecular probes or inhibitors of virus-host interactions. This review explores the molecular interactions between lectins and viral envelope glycoproteins, emphasizing their applications as antiviral agents and diagnostic tools. Enveloped viruses, such as HIV, Influenza, Herpesviruses, and Coronaviruses, exhibit dense glycosylation on their surface proteins, forming a glycan shield rich in high-mannose and complex glycans crucial for viral processes and immune evasion. Lectins exploit these glycan shields by selectively targeting conserved glycosylation sites on key viral proteins like gp120 (HIV), hemagglutinin (Influenza), spike (SARS-CoV-2), and glycoprotein D (HSV), thereby interfering with viral entry. Potent inhibitory activity across diverse virus families has been demonstrated for natural lectins such as griffithsin (GRFT), cyanovirin (CV-N), and banana lectin (BanLec), with novel fungal and algal lectins continually expanding the list. Concurrently, lectin-based biosensors utilizing electrochemical, plasmonic, and microfluidic platforms, often enhanced by nanomaterials or aptamers, enable sensitive and specific detection of glycosylated viral targets. Despite challenges including potential immunogenicity and production scalability, ongoing bioengineering efforts aim to refine lectin specificity, reduce toxicity, and enhance overall functionality. These collective advances showcase the role of lectins as versatile molecular tools for the detection, inhibition, and mechanistic study of viral pathogens.

RevDate: 2025-10-20
CmpDate: 2025-10-20

Mohammed M, Konda M, L Ganti (2025)

Deficiency and Development: A Bibliometric Analysis of the Effects of Iron Deficiency on Human Development.

Cureus, 17(9):e92544.

Iron is an important micronutrient for biological and neurocognitive function. Iron deficiency is significantly undertreated; yet, for many vulnerable populations, such as women and children, iron deficiency is prevalent and leads to serious developmental consequences. As global trends continue to rise, it is crucial to research trends in this area. Publications were extracted from the Web of Science (WoS) Core Collection database, specifically containing the keywords "iron deficiency" and "development." A total of 6,850 articles were acquired from the search. A bibliometric analysis was then conducted on VOSViewer 1.6.2 to assess data concerning the publication year, country, journal, and keyword frequency. The quantity of published articles on iron deficiency and development has an overall increasing trend, dominated by the United States, China, and India. The top five publishing journals included Nutrients, Journal of Nutrition, and American Journal of Clinical Nutrition, with the Journal of Nutrition having the highest link strength. The frequently co-occurring keywords included iron, anemia, and iron-deficiency. Although COVID-19 had some disruption on publication due to priority on the pandemic-related research, the overall global trend. The occurrence of nutrition journals suggests an emphasis on the nutritional aspects of managing iron deficiency. The recurring keywords highlight the data focus primarily on early pediatric care, plant science, and medical research.

RevDate: 2025-10-20
CmpDate: 2025-10-20

Sato T, Kakuda K, Sekiguchi E, et al (2025)

Psychological Safety and Burnout in Nurses: A Scoping Review.

Cureus, 17(9):e92411.

Burnout among nurses has become a global problem, with prevalence rates exceeding 40% in high-intensity clinical settings. Psychological safety represents a shared belief about team interpersonal risk-taking safety. These constructs have emerged as potential protective factors in recent research. However, studies that simultaneously examine both constructs remain limited, thereby hindering the development of evidence-based interventions aimed at promoting psychological safety and preventing burnout.Therefore, we conducted a scoping review to evaluate and synthesize existing literature that investigates the direct relationship between psychological safety and burnout among nurses, with emphasis on the conceptualization, measurement, and contextual association of these constructs within the nursing profession. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology and complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive literature search was conducted across Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Excerpta Medica Database, International Clinical Trials Registry Platform, and ClinicalTrials.gov. The search was conducted using terms related to psychological safety, burnout, and nurses. Studies were deemed eligible if they involved nurses employed in hospital-based settings and simultaneously examined the concepts of psychological safety and burnout. All published studies that examined psychological safety and burnout among nurses were included, with data extracted on study design, setting, country of origin, publication year, definitions used, measurement instruments, reported scores, and associated factors. Of 1,021 initially identified studies, six met the inclusion criteria, comprising 4,984 nurses across the United States, China, Pakistan, Japan, and South Korea, published between 2021 and 2025. Study designs included four cross-sectional studies, one longitudinal study, and one non-randomized controlled trial, conducted across diverse healthcare settings, including coronavirus disease 2019 wards, emergency departments, and psychiatric units. Three studies reported a consistent inverse relationship between psychological safety and burnout. Psychological safety was consistently defined in accordance with Edmondson's framework, while burnout was assessed based on Maslach's three-dimensional conceptualization. Leadership style, particularly servant leadership, emerged as a key factor potentially influencing both constructs. Workplace conditions, including patient acuity, exposure to workplace violence, and team dynamics, were identified as significant contextual factors.This review provides evidence of a consistent inverse relationship between psychological safety and burnout among nurses, with Edmondson's and Maslach's frameworks offering appropriate conceptual foundations for future research. These findings suggest that promoting psychological safety serves as a protective organizational strategy in high-intensity clinical settings. They also underscore the need for comprehensive, multi-level interventions focused on leadership development, structured communication protocols, and robust organizational support systems to enhance psychological safety and mitigate the risk of burnout.

RevDate: 2025-10-19
CmpDate: 2025-10-19

Thomas C, RM Pearse (2025)

Socioeconomic deprivation and health inequity: independently associated with postoperative outcomes, and does this matter?.

British journal of anaesthesia, 135(5):1141-1143.

Health inequities are unjust disparities in health between groups of people, typically described in terms of sex, race and ethnicity, or socioeconomic position. The COVID-19 pandemic highlighted significant ongoing health inequities across the United Kingdom and worldwide. We believe that socioeconomic deprivation is the single most important driver of health inequity. For patients having surgical treatments, it is clear that socioeconomic deprivation is an important risk factor for poor patient outcomes. However, there is overlap with other important risk factors such as smoking and obesity. We discuss recent work that describes the associations between socioeconomic deprivation and short-term patient outcomes after surgery. We explore the difficulties in identifying risk factors for poor patient outcomes that can be modified by perioperative teams, and why it is important not to confuse modifiable risks with the underlying drivers of health inequity.

RevDate: 2025-10-20
CmpDate: 2025-10-20

Abdul-Azees PA, Marinkovic M, Singh BB, et al (2025)

The Impact of Aging Oral Health on Long COVID-19.

Journal of dental research, 104(12):1294-1303.

At least 10% of individuals infected with SARS-CoV-2 develop a variety of multisystem symptoms lasting more than 12 wk known as postacute sequelae of COVID-19 (PASC) or "long COVID." While the precise pathogenesis of PASC remains unclear, immune dysregulation is widely recognized as a key factor. Moreover, PASC disproportionately affects older individuals who are prone to age-related immune system decline, which further exacerbates the risk and severity of PASC. The oral cavity, a primary site for initial SARS-CoV-2 infection, may contribute to the development and persistence of PASC. Emerging evidence suggests that changes in age-related oral health, such as periodontitis, salivary gland (SG) dysfunction, and gustatory and olfactory impairments, may create an environment conducive to forming an oral reservoir of intact virus or viral antigens, which may contribute to the chronicity of PASC. Alternatively, the pathogenesis of PASC may increase the risk of a wide range of oral health issues, such as dental diseases, dry mouth, and sensory dysfunction (e.g., taste and smell) that are frequently reported by patients with PASC. This review highlights how aging facilitates oral SARS-CoV-2 infection, co-infection with other viruses may drive PASC in aging patients, aging and PASC dysregulate the oral microbiome, SARS-CoV-2 infection promotes molecular mechanisms involved in oral tissue aging, aging oral health affects susceptibility to developing PASC, and inflammation associated with PASC exacerbates dysregulation of metabolic/enzymatic pathways of aging oral mucosa and diseases of the periodontal apparatus, SGs, and taste. It underscores the urgent need to comprehensively address the interplay between aging oral health and PASC, which will help mitigate long-term complications and improve overall health outcomes for affected individuals.

RevDate: 2025-10-20
CmpDate: 2025-10-20

Pascual-Mato M, Gárate Viñas G, Muñoz San Martín M, et al (2025)

Calcitonin gene-related peptide (CGRP) in the pathophysiology of gastrointestinal disorders - A key mediator in the gut-brain axis.

Revista espanola de enfermedades digestivas, 117(10):572-578.

The concept "gut-brain axis" means a bidirectional communication between the central nervous system and the gastrointestinal (GI) tract. This axis is key in keeping the physiological homeostasis of the GI tract and its dysfunction has been implicated in a number of neuropsychiatric and gut conditions. A number of neurotransmitters are known to be involved in the performance of gut-brain axis. Our objective has been to review and critically analyze the contribution of the calcitonin gene-related peptide (CGRP) in the physiology and pathophysiology of the gut-brain axis, with emphasis in the fresh, basic, and clinical evidence supporting an outstanding role of this neuropeptide. CGRP is considered the pivotal molecule and the first biomarker of migraine, a debilitating disease combining digestive and neurological symptoms. A number of recent experimental and clinical data support a relevant protective role for CGRP, and in particular for beta-CGRP, the isoform located in the enteric nervous system, in the gut-brain axis proper functioning and in the pathophysiology of several gut diseases, including conditions such as diverticular disease, acute infectious diarrhea or inflammatory bowel disease. As examples of its adaptable behavior, circulating beta-CGRP levels are increased in patients with acute diarrhea in COVID-19 infection or reduced already in the early phases of inflammatory bowel disease. In addition, beta-CGRP antagonism could explain the constipation seen with the new CGRP antagonists used in the preventive treatment of frequent migraine. These evidences indicate a relevant role of CGRP in gut-brain axis functioning and call for analyzing a potential role of CGRP in other common diseases of the GI tract, comorbid with brain conditions, such as irritable bowel syndrome or chronic constipation.

RevDate: 2025-10-19

Borrow R, Caugant DA, Clark SA, et al (2025)

Current global trends in meningococcal disease control, risk groups and vaccination: Consensus of the Global Meningococcal Initiative.

The Journal of infection pii:S0163-4453(25)00235-X [Epub ahead of print].

This review outlines recent trends on invasive meningococcal disease (IMD) discussed at the latest meeting of the Global Meningococcal Initiative (GMI). There has been a re-emergence of the Hajj strain sublineage (serogroup W; ST-11 clonal complex), with travel to the Kingdom of Saudi Arabia being a critical factor in transmission. The epidemiology of IMD has also changed following the COVID-19 pandemic, with annual IMD cases increasing in many countries. For example, the highest number of IMD cases since 2014 was reported in the USA in 2023-2024. Atypical presentations of IMD have been prominent irrespective of the pandemic. For instance, an increase in cases of meningococcal epiglottitis has been reported in France in 2022-2023 (serogroups W and Y). When considering vaccination, the GMI has identified a need for broader meningococcal serogroup B (MenB) immunisation owing to the potential impact of the vaccines on reducing IMD incidence caused by other serogroups than MenB. There is also a case for using MenB vaccination to protect against Neisseria gonorrhoeae infection based on initial evidence, albeit further studies will need to be conducted.

RevDate: 2025-10-19

Li W, Chen X, Liu C, et al (2025)

Vitamin D deficiency and respiratory health: A narrative review bridging gaps in public health through innovative strategies and sustainable solutions.

Journal of infection and public health, 19(1):103013 pii:S1876-0341(25)00362-4 [Epub ahead of print].

Vitamin D deficiency is a global public health issue, highly prevalent in middle-income and Eastern Mediterranean countries. It is associated with increased risks of respiratory infections like COVID-19 and influenza, alongside osteoporosis and cardiovascular disease. Functioning as an immunomodulator, vitamin D enhances macrophage activity, suppresses inflammatory cytokines, and induces antimicrobial peptides. Observational studies link deficiency to a higher risk of infection, although clinical trial results are mixed. Risk factors include dark skin, older age, urban living, and reduced sun exposure. This narrative review synthesized findings from peer-reviewed literature (2000-2025) in databases such as PubMed, Scopus, and Web of Science. It focuses on addressing respiratory infections associated with vitamin D deficiency through multifaceted public health strategies. These include policy-led food fortification, biofortification, public awareness campaigns, and technological innovations to increase dietary vitamin D intake and reduce the global burden of deficiency and respiratory infection.

RevDate: 2025-10-18

Akbar N, Phadke S, Mehelay S, et al (2025)

Considerations of race and ethnicity within rehabilitation studies for post COVID-19 condition: A scoping review.

PM & R : the journal of injury, function, and rehabilitation [Epub ahead of print].

Post COVID-19 condition (PCC) or long COVID disproportionately affects racial and ethnic minority communities. There are a growing number of rehabilitation studies for PCC, however, it has yet to be determined whether existing studies take race and ethnicity into account in their study designs and whether existing rehabilitative approaches are equally effective across diverse racial and ethnic groups. The objective of this study was to describe the extent to which rehabilitation studies of PCC consider race and ethnicity in defining eligibility criteria, planning recruitment strategies, designing intervention delivery and adherence promoting approaches, selecting outcome measures, and reporting results. Of the 4845 studies screened, 23 met eligibility criteria and were included in this review. The most common reason for exclusion was a lack of mention of race or ethnicity anywhere within the article. Among the 23 studies included, 13 studies provided data on the race and/or ethnicity characteristics of their sample, with 88% of participants across all of these studies being White. Less than 25% of studies described the incorporation of race and/or ethnicity in their recruitment strategies (n = 3, 13%) or data analysis (n = 5, 22%). Greater racial and ethnic diversity is needed within rehabilitation studies for PCC as there is currently a significant underrepresentation of racial and ethnic minorities in existing studies. Overall, more PCC rehabilitation studies need to incorporate race and ethnicity into their study designs as it is not well understood whether existing rehabilitation strategies are equally effective across different racial and ethnic groups.

RevDate: 2025-10-19
CmpDate: 2025-10-19

Ortega-Paz L, Talasaz AH, Sadeghipour P, et al (2025)

Safety and effectiveness of statins in hospitalized patients with COVID-19: Systematic review and collaborative meta-analysis of randomized controlled trials.

Thrombosis research, 255:109484.

AIMS: Statins may impact COVID-19 outcomes through lipid-mediated and lipid-independent pathways. However, the clinical impact of statin therapy among hospitalized patients with COVID-19 remains unclear due to the limited power of existing randomized controlled trials (RCTs).

METHODS: A systematic search of PubMed, Embase, and clinicaltrials.gov was conducted through July 17th, 2024. RCTs were included if they compared statin therapy to control (placebo or standard care) in hospitalized COVID-19 patients and enrolled at least 250 randomized participants. Studies with co-treatment were considered in sensitivity analyses. The primary effectiveness outcome was 30-day all-cause death. The main safety outcomes were myopathy and rise in liver enzymes.

RESULTS: Three RCTs were included in the main analysis (3882 statin-naive patients, 33.7 % female, average follow-up duration 37 days). Compared with control, statin therapy was associated with reduced all-cause death (20.9 % vs. 23.8 %; odds ratio [OR]: 0.82, 95 % confidence interval [CI] 0.70-0.96; P = 0.01), with a small but significant increase in myopathy (0.6 % vs. 0 %; risk difference: 0.00, 95 % CI -0.00; 0.01), and no significant difference in liver enzyme abnormalities (1.0 % vs. 1.4 %; OR 1.00, 95 % CI: 0.25-3.99). A sensitivity analysis including two additional RCTs that included randomized co-treatments yielded similar findings. There were no significant interactions for effectiveness by disease severity (critically vs. non-critically ill, P = 0.38) or sex (males vs. females, P = 0.83).

CONCLUSION: Among hospitalized patients with COVID-19, statin therapy was associated with a significant reduction in 30-day all-cause death compared with control and exhibited an excellent safety profile.

STUDY REGISTRATION: This study is registered in PROSPERO (CRD42023478764).

RevDate: 2025-10-19
CmpDate: 2025-10-19

Filipczak N, Yalamarty SSK, Li X, et al (2025)

Neutrophil extracellular traps: Formation, pathological roles, and nanoparticle-based therapeutic targeting strategies.

Journal of controlled release : official journal of the Controlled Release Society, 387:114220.

Neutrophil extracellular traps (NETs) are large, web-like DNA structures released by neutrophils, coated with histones and antimicrobial proteins. They serve as a crucial defense mechanism for neutrophils against microbial invasion, playing a significant role in eliminating microorganisms such as bacteria, fungi, and viruses. While NETs are primarily recognized for their role in microbial defense, growing evidence indicates that excessive NET formation, triggered by physical and chemical stimuli, pathogens, or pathological factors, can worsen inflammation and cause organ damage. Understanding NETs' presence in various tissues and body fluids is crucial for elucidating their contribution to disease etiopathogenesis. By designing nanoparticles that can either prevent NET formation or facilitate their degradation, researchers aim to mitigate the harmful effects of excessive NETs. These nanotechnological interventions can be tailored to specifically target the molecular components of NETs, enhancing treatment precision and efficacy. Furthermore, nanoparticles can deliver therapeutic agents directly to inflammation sites, reducing systemic side effects and improving patient outcomes. This review summarizes the role of NETs in various pathologies, focusing on strategies to inhibit NETosis, including mechanisms of pathogen evasion, and the use of nanodelivery systems to enhance the efficiency of NETs inhibition or removal.

RevDate: 2025-10-18
CmpDate: 2025-10-18

Demongeot J, Hillen T, Ruan S, et al (2025)

The work of Pierre Magal on differential equations, functional analysis and mathematical biology.

Journal of mathematical biology, 91(5):59.

Pierre Magal (1967-2024) was a leading researcher at the interface of differential equations, functional analysis, and mathematical biology. He made substantial contributions to both theoretical and applied aspects of these subjects. He published a dozen monographs, proceedings, and special issues and more than 125 journal articles. In this article we provide an introduction to Pierre's contributions in some topics, including discrete population dynamics, integrated semigroup theory and abstract Cauchy problems with nondense domain, traveling waves in biological systems, uniform persistence and global attractors, cell-to-cell P-glycoprotein transfer in breast cancers, transfer problems in population dynamics and economics, and modeling of various epidemic problems, in particular his recent and extensive work on modeling COVID-19.

RevDate: 2025-10-18

Lv Y, Zhu L, Li FH, et al (2025)

Nonadherence to anti-VEGF intravitreal injections in patients with diabetic macular edema : The names of the authors.

Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Epub ahead of print].

Diabetic macular edema (DME) is a principal cause of impaired vision in individuals with diabetes. The effectiveness of treatment using intravitreal injection (IVI) of anti-vascular endothelial growth factor (anti-VEGF) has been established in clinical trials, and it has become the treatment of choice for the majority of DME patients. However, real-world treatment outcomes for patients with DME have consistently lagged behind those reported in clinical trials. Nonadherence to IVI treatment and loss to follow-up (LTFU) limit the results of clinical treatment for patients with DME in real-world conditions.Herein, we report results from different real-world studies and analyse high levels of nonadherence to anti-VEGF treatment in patients with DME. IVI adherence may involve a variety of patient-related, condition-related, therapy-related, and COVID-19-related factors. Notably, although the overall adherence rate to IVI declined during the COVID-19 pandemic, targeted interventions addressing treatment barriers significantly improved DME patient adherence. In this review, we highlight changes in IVI practices that were implemented to reduce nonadherence in patients with DME during the pandemic, along with other emerging strategies, including assessments of the risk of visual impairment and prioritisation of treatment; distinguishing among types of appointments; modifications of anti-VEGF injection protocols; diversification of medical services, telemedicine, and artificial intelligence (AI); and improvements in patient education.Our analysis identified multifaceted factors associated with nonadherence to IVI among DME patients and proposed corresponding intervention strategies. Future investigations should focus on developing clinically feasible adherence assessment tools and standardised metrics to facilitate individualised therapeutic decision-making. We advocate for the systematic integration of adherence monitoring into standardized clinical workflows as a fundamental component of IVI management protocols. This evidence-based paradigm holds significant promise in addressing the growing practical challenges in contemporary DME management.

RevDate: 2025-10-17
CmpDate: 2025-10-18

Zhou T, Zhang S, Liu S, et al (2025)

Digital technology integration in home-based exercise: a systematic review of research evolution, applications, and impact mechanisms.

BMC public health, 25(1):3528.

The integration of digital technologies in home-based exercise (HBE) has emerged as a critical public health intervention, particularly following the COVID-19 pandemic. However, comprehensive understanding of how digital technologies influence HBE research evolution and practice remains limited. This systematic review aims to: (1) map the knowledge evolution of digital technology-supported HBE research, (2) analyze innovative applications and value propositions of digital technologies in HBE, (3) identify key determinants of HBE participation in the digital era, and (4) predict future development trends. Following PRISMA guidelines, we conducted a comprehensive search of the Web of Science database from 2000 to 2024, yielding 311 articles for bibliometric analysis using CiteSpace and VOSviewer. Results indicated that digital technology-supported HBE research has grown exponentially, peaking in 2022. We identified seven core research themes, including intelligent exercise training, AI-driven fall prevention, wearable device interventions, virtual reality rehabilitation, mobile health applications, cancer patient tracking systems, and remote diagnostics. These themes highlight innovative approaches to personalized training, remote monitoring, and immersive rehabilitation experiences, demonstrating significant value in enhancing exercise adherence and health outcomes. Key determinants of HBE participation were identified at personal (social support, professional guidance, self-efficacy) and technological (digital literacy, accessibility, user interface design, data privacy) levels. Digital technologies demonstrate substantial potential for enhancing HBE accessibility, improving adherence, and reducing public health burden. Future research should prioritize addressing digital equity and developing evidence-based implementation frameworks to ensure sustainable and inclusive digital health interventions.

RevDate: 2025-10-17

Iskuzhina L, Turaev Z, Rozhin A, et al (2025)

Artificial intelligence in biology and medicine.

Die Naturwissenschaften, 112(6):80.

This article explores the role of artificial intelligence (AI) in medicine and biology. Special attention is given to areas of biology such as genomics, proteomics, biotechnology, cell, and synthetic biology. In the field of medicine, the emphasis is on diagnosis, vaccine development, and treatment of various diseases, including COVID-19. The future of AI is explored, including explainable AI and biologically inspired models, as well as the synergy of AI with other advanced technologies, such as robotics and nanotechnology. The limitations and challenges facing AI are also analysed, including ethical and legal aspects, data quality issues, and the need for standardisation. The article emphasises that the potential of AI can both improve the quality of life and accelerate scientific discovery, and increase the occurrence of risks associated with its introduction into the scientific process. It concludes by emphasising the need for responsible use of AI to preserve scientific diversity and innovation.

RevDate: 2025-10-17

Ma W, Hu ZB, Zhu N, et al (2025)

An overview of needle-free injection technology in human vaccines.

International journal of pharmaceutics pii:S0378-5173(25)01124-X [Epub ahead of print].

With the outbreak of the COVID-19 pandemic, the harmful effects of infectious diseases have gained widespread attention among the public. Vaccination is one of the most effective means of preventing infectious diseases, and the willingness to receive vaccinations is a key factor influencing the success of vaccination programs. Infants and young children, with relatively low immune levels, are a primary target group for preventive vaccinations. However, they often exhibit strong anxiety, resistance, and crying when facing traditional needle-based injections, which highlights the clinical significance of developing needle-free vaccination methods. In recent years, needle-free injection technology has been widely applied to the administration of various medications, but its application in human vaccines remains limited, with only a few commercially available products. This paper provides a review of needle-free injection technology, covering its classification and development history, research progress in vaccine applications, the advantages of needle-free human vaccines, the current status and prospects of market applications, as well as the technical challenges and considerations involved in developing needle-free human vaccines. The review aims to explore the prospects of developing needle-free vaccine formulations for human use.

RevDate: 2025-10-17

Sousa VC, Freitas FC, Gouveia E Silva EC, et al (2025)

Functional impact for indication and access to physical therapy after hospital discharge due to COVID-19.

Clinics (Sao Paulo, Brazil), 80:100807 pii:S1807-5932(25)00225-X [Epub ahead of print].

INTRODUCTION: After hospitalization for COVID-19, patients may present impairment in functionality and require physical therapy after hospital discharge for functional recovery.

OBJECTIVE: To understand the association between Covid-19 functional impacts and physical therapy indication and access 30 days and 1 year after hospital discharge of severely and critically ill patients.

METHODS: Cross-sectional study with two assessments: 30 days and one year after hospital discharge, in individuals ≥ 18 years of age, admitted to a referral hospital in São Paulo between June 2020 and July 2021. A convenience sample of 345 patients was used. The Poisson test was used to estimate the prevalence ratio for the association between Covid-19 functional impacts and physical therapy indication and access, with ≤ 0.05 considered significant.

RESULTS: Of the 185 patients included, 67 % (n: 104) were indicated for physical therapy and the majority (53 %; n:79) could not access it 30 days after hospital discharge. Post-Covid-19 functional limitations were associated with physical therapy indication (PR: 1.69; 95 %CI 1.1-2.5) and impairment in basic activities of daily living (BADLs) with access 30 days (PR: 1.81; 95 %CI 1.2 -2.6) and 1 year after discharge (PR: 1.70; 95 %CI 1.2-2.3). Physical therapy indication was significant, with a 4.07 and 2.06 likelihood of access 30 days and 1 year after discharge.

CONCLUSION: Despite the lack of functional criteria at discharge, patients with poor functional performance perceived the need for physical therapy indication and referral. Indication was essential for access to physiotherapy within the healthcare network.

RevDate: 2025-10-17
CmpDate: 2025-10-17

Luo S, Lai LY, Zhu R, et al (2025)

Prevalence and duration of common symptoms in people with long COVID: a systematic review and meta-analysis.

Journal of global health, 15:04282.

BACKGROUND: During the COVID-19 pandemic, an increasing number of patients have reported persistent symptoms after recovery, a phenomenon known as long COVID. These symptoms may persist for weeks or months, affecting the patient's daily life and health. To systematically understand the long-term impact of long COVID, this study conducted a systematic review and meta-analysis. This study aims to determine the long-term effects of long COVID by identifying, evaluating and summarising the incidence and duration of persistent symptoms after the acute phase of COVID-19.

METHOD: We searched PubMed, Embase, and medRxiv up to August 2021 for articles and preprints presenting original research on the symptoms of long COVID. Following title/abstract and full-text screening, based on the PICOS framework, we excluded articles that did not clearly report on diagnoses, reported on symptoms lasting less than four weeks, lacked epidemiological data, or did not provide complete data. We assessed the bias of included studies using the Newcastle-Ottawa Scale. For effects reported in more than two studies, we performed meta-analysis of prevalence, and also counted the duration of each symptom.

RESULTS: We included 19 observational studies in the meta-analysis, through which we determined the incidence and duration of five common long COVID symptoms, including cognitive/memory/attention disorders (36%, unreported duration), fatigue (34%, 5.5 months), mental health problems (including anxiety and depression, 31%, 3.5-3.8 months), and dyspnoea (24%, 6.52 months) and chest pain (23%, 2 months).

CONCLUSIONS: The symptoms of long COVID usually persist after the acute phase of COVID-19. The clustering of long COVID symptoms provides a direction for studying the aetiology, diagnosis, and management of post-COVID conditions. Our findings provide important baseline data for the prevention and treatment of long COVID.

RevDate: 2025-10-17
CmpDate: 2025-10-17

Raza MW, Uddin F, Rahman O, et al (2025)

Driving the Consumer Adoption of Halal Cosmetics: A Systematic Review Using PRISMA and TCCM Framework.

Journal of cosmetic dermatology, 24(10):e70479.

BACKGROUND: The COVID-19 epidemic has fuelled increasing anxiety regarding the environment and religiosity. Moreover, the worldwide halal cosmetics industry is expected to experience significant growth in the years ahead. Still, the reasons that drove people all across to choose halal cosmetics are unclear.

OBJECTIVES: The study aims to find factors influencing halal cosmetics purchases. Based on the findings, the review proposes a conceptual framework and new directions for future research in the context of halal cosmetics.

METHOD: The PRISMA & TCCM framework systematically evaluates 51 empirical articles on consumers' behaviors regarding the purchase of halal cosmetics from Scopus between 2014 and 2024 for the review.

RESULTS: The review suggests forthcoming investigations to utilize Consumer Culture theory, Social Practice theory, and the UTAUT model. By highlighting patterns in halal cosmetics literature, the paper helps to guide future research in underexplored domains such as artificial intelligence and e-commerce.

PRACTICAL IMPLICATIONS: The review contributes to the existing corpus of knowledge regarding the theoretical perspective of contemporary halal marketing through its proposed conceptual framework. In particular, scholars, academicians, and practitioners may delve into the reliable body of literature on halal cosmetics.

ORIGINALITY/VALUE: This study examines consumer behavior regarding the consumption of halal cosmetics. It pinpoints research gaps and offers future avenues using the TCCM framework. In addition, it provides the conceptual framework for measuring the behavior of halal cosmetics.

RevDate: 2025-10-17

Kris LP, Dixon DL, Bihari S, et al (2025)

Revisiting the monocrotaline-treated rat as a model of inflammatory lung disease: COVID-19 and future pandemic threats?.

Animal models and experimental medicine [Epub ahead of print].

The COVID-19 pandemic posed a challenge for clinical management of a new lung disease that was characterized by inflammation, endothelial cell dysfunction, and thrombosis, which occur after the replication phase of infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There are many laboratory models of active SARS-CoV-2 infection in mice, reflecting an acute lung injury in an otherwise healthy animal, but there is a lack of accurate animal models of the postviral inflammatory phase of the COVID-19 lung reflecting severe disease. The monocrotaline (MCT)-treated rat is a widely used laboratory model of pulmonary hypertension (PH). Not often discussed, however, are the observed changes in inflammation, edema, fibrosis, and microthrombosis in the lung prior to PH. At the cellular level, there is loss of pneumocytes and endotheliopathy, and at the molecular level the MCT rat lung is characterized by a pro-inflammatory cytokine profile, namely elevated interleukin 6, transforming growth factor β and tumor necrosis factor, M1 macrophage phenotype, and dysregulation of the angiotensin converting enzyme (ACE)/ACE2 balance. The systems-level pathophysiology of the MCT-treated rat includes progressive cardiopulmonary dysfunction. The MCT-treated rat clearly differs from the COVID-19 lung in terms of the triggers for pathology, but there are many parallels apparent in both the MCT-treated rat and the COVID-19 lung. The MCT-treated rat lung as a model of the COVID-19 lung may provide an in-depth understanding of the factors that drive the lung to more severe pathology, treatments that benefit lung recovery, or the factors that prove a useful research platform for future emerging respiratory threats of similar pathology.

RevDate: 2025-10-17
CmpDate: 2025-10-17

Wang J, Tao R, Jiang Y, et al (2025)

Risk factors for postherpetic neuralgia: a meta-analysis based on demographic, clinical features, and treatment characteristics.

Frontiers in immunology, 16:1667364.

BACKGROUND: This study aims to comprehensively analyze the independent risk factors of postherpetic neuralgia (PHN) through a systematic evaluation, including demographic characteristics, clinical manifestations, treatment regimens, comorbidities, and virological factors, in order to provide evidence-based support for the early identification of high-risk patients and the optimization of preventive strategies in clinical practice.

METHOD: A systematic search of PubMed, Embase, and the Cochrane Library was conducted to identify studies reporting risk factors for PHN. After screening the literature according to predefined inclusion and exclusion criteria, effect size indicators such as odds ratios (OR) and 95% confidence intervals (95% CI) for each risk factor were extracted. Meta-analyses were performed using RevMan 5.4 and Stata 15.0 software, with a random-effects model applied to pool effect sizes. Publication bias was assessed using Egger's test, and sensitivity analysis was conducted by sequentially removing individual studies to verify the robustness of the result.

RESULTS: Age (≥60 years), severe rash manifestations, prodromal pain symptoms, smoking history, alcohol abuse, immunosuppressive status, and comorbidities including diabetes mellitus, chronic obstructive pulmonary disease (COPD), hypertension, malignant tumors, or chronic kidney disease, along with high viral load, have been identified as independent risk factors for the development of PHN(p<0.05). In contrast, gender differences and socioeconomic status were not significantly associated with PHN incidence, with insufficient evidence observed (I²>50%, p>0.05).

CONCLUSION: This meta-analysis confirms that older age (≥60 years), severe rash, prodromal pain, immunosuppressive therapy, and smoking are significant risk factors for PHN. Furthermore, it identifies alcohol abuse, T2DM, COPD, hypertension, cancer, high pain scores (as measured by VAS or NRS), and high HZ viral load as additional risk factors. COVID-19 may represent a potential risk factor that must be further investigated. The association between socioeconomic status and PHN remains inconclusive, while antibody levels against varicella-zoster virus (VZV) may serve as a protective factor.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42025629699.

RevDate: 2025-10-17
CmpDate: 2025-10-17

Moghadam SHP, Sarkoohi A, Navidi Z, et al (2025)

Comparing the Effectiveness and Safety of Remdesivir and Molnupiravir in COVID-19: A Systematic Review and Meta-Analysis.

Immunity, inflammation and disease, 13(10):e70289.

BACKGROUND: Remdesivir and molnupiravir have been approved and are being used as viable treatment options for patients with coronavirus disease 2019 (COVID-19). This systematic review and meta-analysis sought to evaluate and compare the safety and effectiveness of these two antiviral drugs in the treatment of COVID-19.

METHODS: An extensive search was conducted across several databases, including Web of Science, PubMed, the Cochrane Library, and medRxiv, up to July 1, 2024. To evaluate the risk of bias, a standardized bias assessment tool was used. Data from the selected studies were analyzed using Comprehensive Meta-Analysis software.

RESULTS: The analysis included data from 10 studies, encompassing a total of 5766 patients. According to the meta-analysis, remdesivir and molnupiravir showed no statistically significant differences in mortality (odds ratio [OR] = 2.54, 95% confidence interval [CI]: 0.67, 9.57), hospitalizations (OR = 2.43, 95% CI: 0.81, 7.24), viral clearance rates (OR = 1.49, 95% CI: 0.64, 3.46), or average time to viral clearance (standardized mean difference = 0.02, 95% CI: -0.40, 0.46). However, the incidence of adverse events was lower in the remdesivir group (OR = 0.49, 95% CI: 0.26, 0.93). The certainty of evidence for these findings was evaluated and determined to be low or moderate.

CONCLUSION: The findings of this study suggest that remdesivir and molnupiravir have similar effectiveness in treating COVID-19 outpatients; however, molnupiravir is associated with a higher rate of adverse events. Additional studies are required to enable a more thorough evaluation of these treatments for COVID-19.

RevDate: 2025-10-17

Lokesh BVS, Sreedharan Nair R, Mohd Hashim NB, et al (2025)

Targeted respiratory viral infection therapy using mucoadhesive nanodrug-polymer conjugates: a comprehensive review.

Journal of biomaterials science. Polymer edition [Epub ahead of print].

The pulmonary route presents a highly effective approach for treating respiratory infections, enabling targeted drug delivery with rapid absorption and minimal systemic toxicity. Inhalation therapy, which bypasses first-pass metabolism, offers localized treatment for conditions such as COVID-19 and influenza, providing faster relief and reducing hospitalizations. Polymeric drug-conjugate nanoparticles, proven effective in lung cancer therapies, hold promise for viral infections by enhancing drug bioavailability and targeting precision while minimizing side effects. This review explores the potential of aerosol-based antiviral drug delivery systems, specifically focusing on the design, conjugation, and application of polymeric nanoparticles using natural and biodegradable polymers. We highlight the role of mucoadhesive properties and polymer-drug conjugation to improve drug retention through electrostatic interactions with respiratory mucin, critical for effective delivery. Challenges such as aerosolization efficiency, inhaler device design, particle size, and site-specific release are discussed, along with strategies to overcome these hurdles. The use of biodegradable, pH-responsive polymers for controlled release and targeted delivery is emphasized, considering the physiological differences between healthy and infected lungs. Future strategies for scalable, self-administered inhalable polymeric nanodrug conjugates are outlined, with the potential to reduce viral loads, limit transmission, and minimize systemic side effects in the treatment of respiratory viral infections.

RevDate: 2025-10-17
CmpDate: 2025-10-17

Ma J, S Zhang (2025)

Prevalence and risk factors of intimate partner violence among pregnant women: a systematic review and meta-analysis.

BMC pregnancy and childbirth, 25(1):1104.

BACKGROUND: Intimate partner violence (IPV) has adverse physical and psychological effects on pregnant women. With regard to the influencing factors of IPV among pregnant women, discrepancies still exist in clinical studies. By identifying these factors, more targeted and effective interventions can be developed for this population. Consequently, this review aims to examine the impact of IPV on pregnant women and provide an empirical basis for the development of preventive strategies in clinical practice.

METHOD: Bibliographic databases like PubMed, Embase, Web of Science, Science Direct, Cochrane Library, CBM, VIP, CNKI, and Wan Fang Data were employed in the investigation for retrieving articles. A thorough evaluation of all study designs was conducted to understand the impact of IPV on pregnant women, focusing on articles published before May 2025. In total, 36,214 pregnant women were included in the studies reviewed.

RESULTS: A total of 33,355 articles were retrieved, and 37 articles were systematically screened to evaluate the influencing factors of IPV among pregnant women. The meta-analysis revealed that the prevalence of IPV in pregnant women was 34%[95%CI (27%-41%)]. Sixteen significant influencing factors were identified: Age of pregnant women<25, Partner's smoking habit, Unemployed, Low level of education, Undesired pregnancy, Partner's Khat chewing habit, Partner's alcohol drinking habit, household income, Experience of violence before the current pregnancy, Parental exposure to IPV, Living alone, Rural dwellers, Income loss due to COVID-19, Household decisions made by husband alone, partner controlling behaviors, and partner has more than one wife.

CONCLUSION: IPV has detrimental effects on the physical and mental well-being of pregnant women. Consequently, prompt implementation of prevention and intervention strategies is essential to decrease the prevalence of IPV and enhance the quality of life for pregnant women. Numerous factors contribute to IPV during pregnancy. Healthcare providers should systematically identify these high-risk factors and offer targeted preventive guidance to effectively reduce its incidence at its root cause.

TRIAL REGISTRATION: CRD420251046017.

RevDate: 2025-10-16
CmpDate: 2025-10-17

Hui DSC, KKP Chan (2025)

Host Immunomodulatory Interventions in Severe Influenza.

The Journal of infectious diseases, 232(Supplement_3):S262-S272.

Currently, no immunomodulatory agents have been conclusively shown to benefit severe influenza. The World Health Organization conditionally advises against the use of systemic corticosteroids, macrolides, plasma therapy, mechanistic target of rapamycin inhibitors, and nonsteroidal anti-inflammatory drugs for such patients. High-dose systemic corticosteroids may increase mortality and morbidity in severe influenza; the potential of low-dose corticosteroids merits further study given survival benefits in patients with severe coronavirus disease 2019 (COVID-19). Passive immunotherapy using convalescent plasma or intravenous immunoglobulin (IVIG) from healthy donors has not proven effective, suggesting that future research should focus on hyperimmune plasma or IVIG from recent infections. An open-label randomized controlled trial (RCT) found that a triple combination of oseltamivir, clarithromycin, and naproxen improved outcomes in severe influenza. One RCT has indicated that sirolimus with corticosteroids can expedite liberation from mechanical ventilation and reduce viral load, warranting larger trials of sirolimus alone. In contrast, adding macrolides or nitazoxanide has not consistently improved clinical outcomes. Promising evidence exists for anti-C5a antibodies in COVID-19, while case reports hint that intravenous N-acetylcysteine may benefit severe influenza pneumonia. Observational data on statins remain conflicting. Further studies on COX-2 inhibitors in combination with antivirals and other immunomodulators are needed. Mycophenolic acid, pamidronate, and peroxisome proliferator-activated receptor gamma agonists are low priorities due to toxicity concerns. Research into human mesenchymal stromal cells and herbal medicine remains inconclusive. Overall, these findings support large-scale trials to validate promising results and address limitations in small studies. Treatment of severe influenza requires a multidisciplinary approach that integrates antiviral and immunomodulatory strategies. Clarifying these roles may enhance patient outcomes.

RevDate: 2025-10-16
CmpDate: 2025-10-17

Beigel JH, D Oldach (2025)

Polyclonal and Monoclonal Antibodies for the Treatment and Prevention of Influenza.

The Journal of infectious diseases, 232(Supplement_3):S347-S358.

While at least 8 monoclonal and 3 polyclonal antibody products have been tested in clinical trials for the treatment of influenza, no products have been licensed, and most have stopped clinical development. The COVID-19 pandemic demonstrated that these approaches, especially monoclonal antibodies, may have unique potential in certain stages of disease and populations, especially in preventing severe disease in a population without preexisting immunity or in those with a limited capacity to mount an effective humoral immune response. This review summarizes past and ongoing efforts in using monoclonal and polyclonal antibodies for the treatment and prevention of influenza, focusing on products that have entered clinical trials and drawing lessons from COVID-19 to direct future efforts on these strategies.

RevDate: 2025-10-16
CmpDate: 2025-10-17

Zambon M, Myles P, N Sugaya (2025)

Use of Influenza Antivirals in Pandemic Response.

The Journal of infectious diseases, 232(Supplement_3):S177-S190.

Pandemics of respiratory illness with devastating societal impact have been recognized since antiquity. This article reviews how, in the last 100 years, the response to influenza pandemics has gradually evolved from fragmented crisis response to vaccines and direct acting antivirals (DAAs).The first pandemic to make use of mass antiviral prophylaxis and treatment was in 2009. Introduction of DAAs for seasonal influenza management in 1999/2000 provided a foundation for use in the pandemic response. Lessons from the 2009 pandemic helped inform the response to the COVID-19 pandemic in 2020. DAAs, antibody therapies, and immune modulators may all have a role to play in minimizing the severity of disease from a pandemic virus strain. Rapid clinical studies evaluating potential therapeutic options will likely be necessary; an agile research infrastructure is a crucial element of a pandemic response capability. Preplanning different pandemic influenza scenarios and the likely treatment uncertainties will help maintain healthcare system preparedness.

RevDate: 2025-10-16
CmpDate: 2025-10-17

Damhorst GL, WA Lam (2025)

Point-of-care and Home Use Influenza Diagnostics for Advancing Therapeutic and Public Health Strategies.

The Journal of infectious diseases, 232(Supplement_3):S314-S326.

Point-of-care (POC) antigen-based diagnostics for influenza that have been granted waived status since the Clinical Laboratory Improvement Amendments of 1988 (CLIA-waived) have been available commercially in the United States for the last 25 years. Improved sensitivity, molecular, CLIA-waived tests have entered the market in the last 10 years. More recently, a new generation of assay technologies authorized for home use and available for over-the-counter sale has been introduced primarily though Emergency Use Authorization pathways during the SARS-CoV-2 pandemic. While evidence for the clinical impact of waived and home use diagnostic technologies is limited, their emerging availability and capabilities carry promise for impact on influenza management. In this review, we discuss the regulatory aspects, history, and capabilities of POC and home use influenza diagnostics. We draw on specific examples from the COVID-19 pandemic to propose ways in which these technologies can advance diagnostic and therapeutic strategies and highlight areas of need for ongoing investigation.

RevDate: 2025-10-16
CmpDate: 2025-10-17

Bright RA (2025)

Optimizing Antiviral Stockpiles for Pandemic Response: A Strategic Framework.

The Journal of infectious diseases, 232(Supplement_3):S309-S313.

Influenza antiviral stockpiling represents a critical component of pandemic preparedness, yet evolving challenges demand new approaches to this strategic imperative. The Strategic National Stockpile's target of maintaining antiviral courses for 25% of the United States population reflects both economic modeling and practical experience from recent pandemics, including the 2009 influenza A(H1N1) and coronavirus disease-19 pandemics. This perspective examines the evolution of antiviral stockpiling strategies, highlighting key lessons from these events as well as challenges in supply chain resilience, resistance management, and rapid deployment. The increasing diversity of available antivirals, from traditional neuraminidase inhibitors to a newer cap-dependent endonuclease inhibitor and emerging host-targeted therapeutics, offers opportunities for more robust stockpiling strategies. However, this diversity also introduces complexities in decision-making, storage, and deployment. Recent advances in artificial intelligence and manufacturing technologies present promising solutions for enhancing stockpile management, potentially enabling more responsive just-in-time production capabilities. The integration of rapid diagnostics, streamlined distribution systems, and novel therapeutic approaches could transform traditional stockpiling paradigms. This analysis provides a framework for optimizing antiviral stockpiles that balances immediate pandemic response capabilities with long-term strategic considerations, while addressing critical challenges in resistance management, pediatric formulations, and supply chain resilience.

RevDate: 2025-10-16
CmpDate: 2025-10-17

Waite AAC, Peto L, Gordon AC, et al (2025)

Platform Trials to Assess Therapeutics in Patients Hospitalized With Influenza.

The Journal of infectious diseases, 232(Supplement_3):S254-S261.

Evidence-based effective treatments for hospitalized patients with influenza have yet to be identified. Traditional randomized controlled trials have struggled to provide definitive guidance due in part to small sample sizes and logistical challenges. Adaptive platform trials, such as REMAP-CAP (Randomised Embedded Multifactorial Adaptive Platform for Community-Acquired Pneumonia) and RECOVERY (Randomised Evaluation of COVID-19 Therapy), offer a transformative approach to evaluating influenza therapeutics. REMAP-CAP and RECOVERY utilize flexible, efficient designs that enable the simultaneous assessment of multiple interventions, adaptation to emerging data, and large-scale recruitment. Both platforms are currently evaluating antiviral and immunomodulatory therapies for severe influenza, building on their success in identifying effective treatments for COVID-19. Establishing global platform trials for influenza will facilitate the generation of high-quality evidence to guide seasonal influenza treatment and enhance pandemic preparedness. A coordinated international effort to sustain platform trials beyond pandemic periods is essential for improving clinical outcomes, optimizing resource utilization, and ensuring readiness for future pandemics.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Ummer O, Sarangi A, Khanna A, et al (2025)

Lessons Learned From Over 20 Years of Telemedicine Services in India: Scoping Review of Telemedicine Services Initiated From 2000 to 2023.

Journal of medical Internet research, 27:e63984 pii:v27i1e63984.

BACKGROUND: India is home to some of the world's earliest and largest telemedicine services. Since the first telemedicine services emerged in the 1990s, the growing digitization of health care services has highlighted the potential for telemedicine services to increase access to timely and appropriate care seeking, corresponding to improved health outcomes and cost savings to the individual and health system. Despite this potential, little is known about the varied typologies of telemedicine services providing in India, their design and model characteristics, scale of implementation, and the available evidence on their impact.

OBJECTIVE: This scoping review aims to identify the characteristics of telemedicine services in India, including the type of telemedicine model, details on the timing of delivery, health services provided, and service delivery channel. Additional details are extracted on the scale of implementation, software used, and evidence gathered, including impact on care seeking, health outcomes, and cost.

METHODS: Telemedicine services in India were identified through searches of Google, the Google Play Store, 3 major scientific databases (Embase, PubMed, and Scopus), and a reference review of identified peer-reviewed articles. Included services were restricted to those implemented in India between January 1, 2010, and July 4, 2023, which included humans, and were published in the English language. Once identified, articles were imported to Covidence, and the process of abstract screening was initiated using 2 independent reviewers and a third person to resolve conflicts. Full-text articles were screened, and data were extracted into Microsoft Excel.

RESULTS: A total of 2368 articles were identified, 151 of which were included for the full-text review and data extraction. From the 151 studies, a total of 115 unique services were identified and further classified based on a scale-moderate to large (n=89) and small (n=26). Among moderate- to large-scale services (n=89), 75 used specialized software and 14 used nonspecialized software, such as WhatsApp. On average, 3 new telemedicine services were initiated annually from 2000 to 2019, and the growth of new services occurred predominantly in the private sector. Evidence was available for 43% (32/75) of the telemedicine services. While 21 services reported on some facet of the quality of care, no studies systematically assessed quality of care. Where structured surveys were reported, questions were often leading, used longer Likert scale response options, and asked respondents about broad constructs subject to varied interpretations (eg, quality of care or satisfaction). Additional details on model characteristics, reach, and impact are presented.

CONCLUSIONS: The widespread proliferation of telemedicine services in India has much potential to improve access to and continuity of timely and appropriate care seeking for health. However, improved evidence demonstrating the impact of telemedicine services on care seeking, quality of care, cost, and health outcomes is needed.

RevDate: 2025-10-17
CmpDate: 2025-10-17

Sulaiman KA, Alharthi AF, Alqahtani R, et al (2026)

Ethical, data security, and resource allocation considerations in AI integration for healthcare during Hajj: task force insights and future directions.

International journal of medical informatics, 205:106123.

BACKGROUND: Hajj represents one of the largest mass gatherings globally, attracting millions of pilgrims annually from various cultural and geographical backgrounds, all coming together to participate in its holy rituals. The unprecedented scale of this event necessitates advanced strategies to ensure safety, and efficiency in resource management. As the use of artificial intelligence (AI) technology becomes increasingly prevalent in managing large-scale gatherings, it raises vital ethical questions regarding privacy, data use, and the risk of mass surveillance. This paper explores the integration of AI during Hajj, with a specific focus on ethical considerations, data security measures, and strategies for allocating limited healthcare and logistical resources.

METHODS: A task force was formed consisting of experts, including healthcare providers, AI specialists, and representatives from the Saudi Society for Multidisciplinary Research Development and Education (SCAPE Society), the Saudi Critical Care Pharmacy Research Platform (SCAPE platform), the Saudi Society of Clinical Pharmacy (SSCP), policymakers, and frontline healthcare practitioners involved in Hajj. The task force initially agreed on the framework and voting system, and consensus was achieved through a voting system that required over 80% agreement.

RESULTS: The task force identified key focus areas: 1) AI Ethics: Bias, Fairness, Transparency and Explainability. 2) Ethical Deployment in Hajj Healthcare 3) Data Security Considerations: Key Challenges in Data Security, Advanced Security Measures, and Saudi Arabia's Cybersecurity Framework 4) Resource Allocation Considerations: AI for Dynamic Resource Management, Enhancing Healthcare Supply Chain, and Stakeholder Collaboration. The task force developed a comprehensive set of statements designed to provide direction for future initiatives.

CONCLUSION: Enhancing the integration of AI in healthcare during mass gatherings neccessitates a strong focus on ethical considerations and data security measures. Addressing ethical concerns is crucial to ensure that AI systems are used responsibly and transparently. Robust protocols for data protection must be implemented to safeguard patient information and maintain trust in healthcare systems.

RevDate: 2025-10-17
CmpDate: 2025-10-17

Katz C, Cohen N, Attrash-Najjar A, et al (2025)

The remote work of child protection professionals during COVID-19: A scoping review and thematic analysis.

Child abuse & neglect, 168(Pt 2):106759.

BACKGROUND: The COVID-19 pandemic created new challenges and barriers for the work of child protection professionals (CPPs) and intensified existing hardships for families and children, increasing the risk of child maltreatment. As new restrictions and precautions were implemented by governments worldwide to stop the virus from spreading, CPPs had to adapt to a new reality of working remotely. However, limited research has investigated how remote work impacted CPPs and child protection work and how CPPs handled this alternative work style.

OBJECTIVE: This review aims to address gaps in the research to reveal the creative and effective approaches CPPs developed to overcome the challenges presented by COVID-19, defined as the 'positive legacy' of CPPs, particularly in adapting to remote work challenges.

METHOD: This review was conducted using a scoping review, followed by two rounds of thematic analysis. The scoping review was conducted in six languages: Hebrew, Arabic, French, Portuguese, Spanish, and English.

RESULTS: The first round of thematic analysis found 18 articles relevant to this review. The second round extracted two main themes: 1) the challenges of remote work and 2) overcoming the challenges of no contact.

CONCLUSIONS: The findings of this review may be used to inform future strategies for child protection during a pandemic. They also provide an opportunity to rethink the relationship child protection work has with technology to systematically reform current and future protection policies and practices, including outside of a pandemic.

RevDate: 2025-10-17
CmpDate: 2025-10-17

Katz C, Attrash-Najjar A, Cohen N, et al (2025)

Child protective services and out-of-home Care for Children during COVID-19: A scoping review and thematic analysis.

Child abuse & neglect, 168(Pt 2):106540.

BACKGROUND: The COVID-19 pandemic challenged child protection and posed new risks for child maltreatment (CM). Moreover, governmental efforts worldwide prioritized mitigating the spread of the virus over ensuring the welfare and protection of families and children. This neglect caused hardship for many vulnerable children, including those in out-of-home care (OOHC), and challenged the functionality of child protective services (CPS). However, only limited research has investigated the impact of COVID-19 on OOHC and CPS and explored how CPS overcame the challenges of helping children in OOHC.

OBJECTIVE: This review aims to address this gap in the research to unveil the 'positive legacy' left by CPS in their work with children in OOHC during COVID-19.

METHOD: This review utilized three stages of analysis, including a scoping review followed by two rounds of thematic analysis. The scoping review was carried out in six languages: English, Hebrew, Arabic, French, Portuguese, and Spanish. The first round of thematic analysis found eight relevant articles for this review. The second round of thematic analysis found three themes related to this paper's aim in the context of COVID-19.

RESULTS: Three main themes were identified: 1) decision-making and OOHC, 2) difficulties in procedures related to OOHC placement, and 3) handling challenges of OOHC.

CONCLUSIONS: The discussion emphasizes the crucial role of preserving children's rights, hearing their voices and needs, and considering their safety and well-being when planning policies and practices to protect them. It also emphasizes society's responsibility to acknowledge contextual factors in child protection.

RevDate: 2025-10-17
CmpDate: 2025-10-17

Katz C, Glucklich T, Attrash-Najjar A, et al (2025)

The global impact of COVID-19 on child protection professionals: A scoping review and thematic analysis.

Child abuse & neglect, 168(Pt 2):106347.

BACKGROUND: The COVID-19 pandemic triggered new risks for child maltreatment (CM) and exacerbated existing challenges for families and children, elevating the importance of child protection professionals (CPPs) while also adding barriers to their work. During the pandemic, many CPPs experienced increased workloads, a disrupted work environment, and personal pandemic-related hardships. However, the scope of how COVID-19 impacted CPPs globally, as well as their adopted coping strategies, have not been well explored.

OBJECTIVE: This study addresses these gaps in the research by conducting an international scoping review to explore and analyze these topics.

METHOD: The scoping review was performed in six languages: English, Hebrew, Arabic, French, Spanish, and Portuguese, across 16 databases. Sixteen manuscripts were included in the final thematic analysis of this review.

RESULTS: Two main themes were identified: 1) the impact of COVID-19 on CPPs, and 2) the coping and adaptation strategies employed by CPPs during COVID-19. This review revealed and emphasized the importance of CPPs' resilience during COVID-19, underpinned by the theoretical framework of the social ecology of resilience.

CONCLUSIONS: This study highlights the responsibility of social ecologies and organizational structures to create readiness for a rapid response in times of crisis as well as valuable evidence to inform how CPPs, children, and families may be better supported in the event of a future crisis.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Modipane N, Mbambara S, Serite T, et al (2025)

Classification and regulatory interactions of key transcription factors in COVID-19.

Frontiers in cellular and infection microbiology, 15:1645333.

SARS-CoV-2, the virus responsible for COVID-19, interferes with the host's transcriptional control systems, triggering widespread disruption of immune regulation and metabolic stability. Key transcription factors (TFs), including AHR, NRF2, NF-κB, IRFs, HIF-1α, PARP, STAT3, ATF3, and PPARγ, play crucial roles in inflammation, oxidative stress defence, anti-viral responses, and immunometabolic adaptation. Their activity and interactions are modulated by post-translational modifications (PTMs) such as phosphorylation, SUMOylation, and ubiquitination, which shape COVID-19 progression. Specifically, SUMOylation of PPARγ suppresses NF-κB-driven inflammation, though impairment under severe disease amplifies macrophage activation and cytokine release. NRF2 degradation via KEAP1-CUL3-mediated ubiquitination is manipulated by the virus to deregulate oxidative stress responses, while SARS-CoV-2 also modulates NF-κB activity through ubiquitination of viral proteins (e.g., NSP6, ORF7a). Dynamic crosstalk between AHR and NRF2 further illustrates TF duality in detoxification and inflammation, with SUMOylation potentially influencing nuclear retention and transcriptional precision. This review classifies transcription factors into four functional categories: inflammatory regulators, antiviral response mediators, stress and pathogen response elements, and metabolic modulators. It further examines how PTM-driven crosstalk contributes to immune dysregulation. Targeting these transcriptional networks presents promising therapeutic strategies to mitigate hyperinflammation, rebalance immune responses, and enhance clinical outcomes in COVID-19.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Kuo WT, IH Lai (2025)

Medication, Nutrition, and Hygiene in COVID-19 Prevention and Treatment: A Comprehensive Narrative Review.

Global challenges (Hoboken, NJ), 9(10):e00223.

Despite advances in Coronavirus Disease 2019 (COVID-19) prevention and treatment, emerging variants and persistent challenges continue to affect global health. Studies are retrieved from PubMed using title-based searches for COVID-19, SARS-CoV-2, and related therapies from 2020 to 2025, focusing on randomized controlled trials, systematic reviews, and clinical guidelines. This review explores treatments, nutrients, and adjuvant therapies that support the immune system in fighting COVID-19. It highlights the role of antiviral medications such as remdesivir, nirmatrelvir/ritonavir, and molnupiravir in reducing mortality and hospitalizations. Additionally, adjunctive therapies like corticosteroids, interleukin-6 (IL-6) inhibitors, Janus kinase (JAK) inhibitors, and N-acetylcysteine (NAC) are discussed for their potential to modulate inflammation. Nutritional support, including omega-3 fatty acids, vitamins D, C, and A, zinc, selenium, and probiotics, enhances immune function. Preventive measures, such as hygiene practices, wearing masks, and physical distancing, reduce transmission. An integrated approach that combines antiviral treatments with adjunctive therapies, prevention, and nutrition is crucial for improving outcomes.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Shyam T, Atuaka C, Venigalla M, et al (2025)

Scars from the pandemic: understanding post-COVID-19 interstitial lung disease.

Breathe (Sheffield, England), 21(4):250037.

Five years after the COVID-19 pandemic, the world continues to record acute cases of COVID-19 infection and witness its residual effects. Lung injury persisting beyond the resolution of acute viral pneumonia has been a known entity since the severe acute respiratory syndrome outbreak in 2005. However, residual interstitial lung disease (ILD) secondary to COVID-19 infection has become a new entity of interest due to the widespread and global impact of COVID-19. Post-COVID-19 ILD (PC-ILD) has emerged as a unique entity with age, male sex, smoking and the severity of acute illness as risk factors. Using current evidence, we discuss possible mechanisms for disease occurrence and the genetic similarities between PC-ILD and idiopathic pulmonary fibrosis. Characteristic radiographic findings, pulmonary function abnormalities and potential therapies are also discussed. As the world moves away from the acute phase of the pandemic, obtaining information on the long-term consequences of this disease becomes even more crucial. Continued research in this field is vital to guide decisions and obtain better outcomes in treatment and follow-up.

RevDate: 2025-10-16

Arca KN, Bazarsky AB, Yuan DY, et al (2025)

Telemedicine is effective and safe for clinical management of patients with headache disorders: An American Headache Society position statement.

Headache [Epub ahead of print].

OBJECTIVES/BACKGROUND: This study was undertaken to review the published literature and provide a position statement from the American Headache Society regarding the safety, efficacy, and impact on access to care of telemedicine for the clinical management of patients with headache disorders. Access to specialized care in headache medicine is severely limited in the United States and worldwide. Telemedicine has been used as an approach to care delivery in headache medicine for more than a decade, with accelerated adoption during the COVID-19 pandemic. There is now uncertainty regarding the extent to which telemedicine will be accepted by health systems and reimbursed by payers moving forward. The purpose of this position statement is to summarize evidence and clinical experience supporting the utility of telemedicine in headache medicine.

METHODS: Evidence regarding the safety and efficacy of telemedicine, and patient and clinician satisfaction with the use of telemedicine for headache specialty care, was gathered from a variety of sources, including PubMed, Google Scholar, and ClinicalTrials.gov. The results and conclusions based upon these results were reviewed and discussed by the authors and the Board of Directors of the American Headache Society to confirm consistency with clinical experience and to achieve consensus.

RESULTS: Several randomized clinical trials and observational studies have been performed to compare telemedicine with in-person visits in the management of patients with headache disorders. These studies showed consistently that telemedicine is noninferior to in-person care based upon multiple outcome measures, including disability measures, patient satisfaction, and clinician satisfaction. In addition, these studies found that telemedicine rarely leads to a missed diagnosis of secondary headache or mismanagement of primary headache. Telemedicine has substantial advantages for patients, including improved access to care and reduced costs associated with obtaining care. Studies evaluating health care utilization indicate no significant differences between patients evaluated and treated virtually versus in person. Obvious limitations of telemedicine include the inability to perform an in-person physical exam or to perform injections. For a substantial number of patients, however, these limitations are outweighed by its advantages. The experience with telemedicine reported in the literature is consistent with the experience of the Board of Directors of the American Headache Society, who endorse its use for patients when feasible and appropriate.

CONCLUSION: Telemedicine has significantly advanced the care of patients with headache disorders. Its further development and deployment should be supported and reimbursed.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Mohib O, Bomans S, Jimenez Garcia B, et al (2025)

Clinical Benefits of Exogenous Ketosis in Adults with Disease: A Systematic Review.

Nutrients, 17(19): pii:nu17193125.

BACKGROUND/OBJECTIVES: Ketone bodies are increasingly studied for their potential therapeutic effects, particularly through exogenous ketosis, in a variety of diseases. This systematic review aimed to rigorously assess the clinical efficacy of exogenous ketosis in adults with medical conditions.

METHODS: Following PRISMA guidelines, we systematically searched MEDLINE and Scopus databases. Our inclusion criteria were defined according to the PICOS framework, focusing on studies involving exogenous ketosis in adult patients with specific diseases. The study is registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42023492846).

RESULTS: After a stringent selection process, fifty-one studies were analyzed. Twenty-two studies focused on neurological disorders, one on psychiatric disorders, twenty-two on metabolic disorders, five on cardiovascular disorders, and one on an inflammatory disorder. Exogenous ketosis demonstrated potential benefits across multiple conditions, including Alzheimer's disease, mild cognitive impairment, McArdle's disease, various forms of heart failure, cardiogenic shock, pulmonary hypertension, and COVID-19-related acute respiratory distress syndrome, although evidence is mostly limited to surrogate endpoints with insufficient hard outcome data. Subtherapeutic ketone concentrations induced by medium-chain triglycerides and limited follow-up periods often precluded firm conclusions regarding clinically meaningful outcomes.

CONCLUSIONS: Exogenous ketosis shows potential in neurological, metabolic, and cardiovascular disorders, while evidence in psychiatric and inflammatory conditions remains scarce and preliminary. Ketone esters appear preferable for effective and tolerable ketosis. Future research should focus on identifying responsive patient populations, optimizing treatment regimens, and conducting long-term clinical trials with hard endpoints to validate these findings.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Russell T, Formiconi E, Casey M, et al (2025)

Viral Metagenomic Next-Generation Sequencing for One Health Discovery and Surveillance of (Re)Emerging Viruses: A Deep Review.

International journal of molecular sciences, 26(19): pii:ijms26199831.

Viral metagenomic next-generation sequencing (vmNGS) has transformed our capacity for the untargeted detection and characterisation of (re)emerging zoonotic viruses, surpassing the limitations of traditional targeted diagnostics. In this review, we critically evaluate the current landscape of vmNGS, highlighting its integration within the One Health paradigm and its application to the surveillance and discovery of (re)emerging viruses at the human-animal-environment interface. We provide a detailed overview of vmNGS workflows including sample selection, nucleic acid extraction, host depletion, virus enrichment, sequencing platforms, and bioinformatic pipelines, all tailored to maximise sensitivity and specificity for diverse sample types. Through selected case studies, including SARS-CoV-2, mpox, Zika virus, and a novel henipavirus, we illustrate the impact of vmNGS in outbreak detection, genomic surveillance, molecular epidemiology, and the development of diagnostics and vaccines. The review further examines the relative strengths and limitations of vmNGS in both passive and active surveillance, addressing barriers such as cost, infrastructure requirements, and the need for interdisciplinary collaboration. By integrating molecular, ecological, and public health perspectives, vmNGS stands as a central tool for early warning, comprehensive monitoring, and informed intervention against (re)emerging viral threats, underscoring its critical role in global pandemic preparedness and zoonotic disease control.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Lagostena L, Minicozzi V, Meucci M, et al (2025)

The Two-Pore Channel 2 in Human Physiology and Diseases: Functional Characterisation and Pharmacology.

International journal of molecular sciences, 26(19): pii:ijms26199708.

Two-pore channel 2 (TPC2) is a member of the endolysosomal ion channel family, playing critical roles in intracellular calcium signaling and endomembrane dynamics. This review provides an in-depth analysis of TPC2, covering its structural and functional properties, physiological roles, and involvement in human diseases. We discuss current experimental approaches to studying TPC2, including heterologous expression in plant vacuoles and computational modeling strategies. Particular emphasis is placed on the structural determinants of ion permeation, with a focus on the selectivity filter and the central cavity's influence on channel kinetics. Furthermore, we explore emerging roles of TPC2 in viral infections, particularly SARS-CoV-2, and in cancer, including melanoma progression and neoangiogenesis. The inhibitory potential of natural compounds, such as naringenin, is also examined. By offering a comprehensive overview of current knowledge and methodologies, this review underscores the potential of TPC2 as a promising pharmacological target in both infectious and neoplastic diseases.

RevDate: 2025-10-16
CmpDate: 2025-10-16

McCarthy MW, Chong C, Riedemann NC, et al (2025)

A Targeted Blockade of Terminal C5a Is Critical to Management of Sepsis and Acute Respiratory Distress Syndrome: The Mechanism of Action of Vilobelimab.

International journal of molecular sciences, 26(19): pii:ijms26199628.

Vilobelimab, a first-in-class, human-mouse chimeric immunoglobulin G4 (IgG4) kappa monoclonal antibody, targets human complement component 5a (C5a) in plasma. Unlike upstream complement inhibitors, vilobelimab does not inhibit the generation of the membrane attack complex (C5b-9), necessary to mitigate certain infections. C5a is a strong anaphylatoxin and chemotactic agent that plays an essential role in both innate and adaptive immunity. Elevated levels of C5a have been associated with pathologic processes, including sepsis and inflammatory respiratory disorders such as acute respiratory distress syndrome (ARDS). Blocking C5a with vilobelimab has shown therapeutic promise. A randomized, multicenter placebo-controlled Phase III study of vilobelimab in patients with severe COVID-19 (PANAMO) found that patients treated with vilobelimab had a significantly lower risk of death by day 28 and 60. Based on this study, the United States Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for Gohibic[®] (vilobelimab) injection for the treatment of COVID-19 in hospitalized adults when initiated within 48 h of receiving invasive mechanical ventilation (IMV) or extracorporeal membrane oxygenation (ECMO). In January 2025, the European Commission (EC) granted marketing authorization for Gohibic[®] (vilobelimab) for the treatment of adult patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced ARDS who are receiving systemic corticosteroids as part of standard of care and receiving IMV with or without ECMO. Herein, we review the mechanism of action of vilobelimab in selectively inhibiting C5a-induced inflammation, outlining its bench-to-bedside development from the fundamental biology of the complement system and preclinical evidence through to the clinical data demonstrating its life-saving potential in the management of COVID-19-induced ARDS.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Bankov D, Kostadinova N, J Marinova (2025)

The Way of SARS-CoV-2 Pneumonia-An Early-Pandemic Review of the Key Manifestations and Severity.

Journal of clinical medicine, 14(19): pii:jcm14197096.

The disease COVID-19, which has befallen mankind in recent years, was a challenge that we had not faced for centuries. The first registered patient case was in China. This review is performed by the inspection of a large body of worldwide investigations conducted in the peak period of the disease's progress. The disease is spread by airborne droplets and develops mainly with fever, cough, sputum, and shortness of breath. Laboratory tests show leukopenia, lymphopenia, a decrease in the levels of sodium, potassium, and calcium, and an increase in the levels of CRP, LDH, and D-dimer. Radiological changes in most cases are bilateral and of the "ground glass" type in the lower parts of the lungs. The most severe complication of COVID-19 pneumonia is ARDS. The risk groups are people with chronic lung diseases, the elderly, and those who are overweight. This article analyzes and summarizes the main characteristics of SARS-CoV-2 pneumonia in order to better understand and apply better clinical management of this condition.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Wołowiec Ł, Osiak-Gwiazdowska J, Jaśniak A, et al (2025)

Colchicine in Contemporary Pharmacotherapy: Mechanistic Insights and Clinical Horizons.

Journal of clinical medicine, 14(19): pii:jcm14197078.

Colchicine, a natural alkaloid, has emerged as a promising anti-inflammatory therapy with applications in cardiovascular diseases, dermatological conditions, and COVID-19 management. Its mechanisms, including the modulation of neutrophil activity, the inhibition of the NLRP3 inflammasome, and the mitigation of cytokine storms, have expanded its therapeutic potential beyond traditional uses. This review synthesizes current evidence on colchicine's clinical applications and mechanisms of action. In cardiovascular medicine, colchicine has been shown to reduce risks of pericarditis, coronary artery disease and atrial fibrillation. In dermatology, most evidence derives from small-scale studies, case series, and retrospective analyses, suggesting potential benefits in conditions such as leukocytoclastic vasculitis, cutaneous amyloidosis, and pemphigus, although these findings require confirmation through randomized controlled trials (RCTs). Emerging studies also indicate a potential role for colchicine in improving outcomes in severe COVID-19. Overall, colchicine demonstrates broad therapeutic utility, warranting further research to clarify its effectiveness across diverse clinical settings.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Cotet IG, Mateescu DM, Ilie AC, et al (2025)

Systematic Review and Meta-Analysis of Myocarditis Prevalence and Diagnostics in COVID-19:Acute, Post-COVID, and MIS-C (2020-2025).

Journal of clinical medicine, 14(19): pii:jcm14197008.

Background: Myocarditis is a recognized complication of COVID-19, but prevalence estimates vary by disease phase and diagnostic method. Methods: We conducted a systematic review and meta-analysis of 54 studies including 32,500 patients, stratified by acute COVID-19, post-COVID, and MIS-C phases. Results: The pooled prevalence of myocarditis was 1.2% (95% CI: 0.8-1.6) in acute COVID-19, 7.4% (95% CI: 5.1-9.8) in post-COVID, and 39.8% (95% CI: 32.4-47.2) in MIS-C. CMR-based diagnosis yielded higher prevalence than clinical criteria (8.1% vs. 0.9%). Major cardiac outcomes included reduced LVEF in 22% and ventricular arrhythmias in 15% of cases. Heterogeneity across studies remained high (I[2] = 98%). Conclusions: Myocarditis prevalence in COVID-19 varies widely across phases and diagnostic methods. Findings suggest a need for cautious screening approaches, particularly in MIS-C and selected post-COVID or athlete populations, while emphasizing the importance of standardized reporting and long-term follow-up data.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Sandu A, Bratu D, Mihețiu A, et al (2025)

Spontaneous Retroperitoneal Hematoma in SARS-CoV-2 Patients: Diagnostic and Management Challenges-A Literature Review.

Journal of clinical medicine, 14(19): pii:jcm14196999.

Background: Spontaneous retroperitoneal hematomas constitute a rare clinical entity, yet their incidence has markedly increased during the SARS-CoV-2 pandemic. The pathophysiological substrate is incompletely elucidated, being influenced by anticoagulant therapy, vascular inflammatory alterations induced by SARS-CoV-2 infection, and comorbidities in critically ill patients that exacerbate hemorrhagic risk. Methods: We performed a comprehensive literature review of published case reports and case series on spontaneous retroperitoneal hematomas in COVID-19 patients, complemented by our institutional experience, in order to synthesize current diagnostic and therapeutic approaches. Results: Available evidence indicates that most cases occur in anticoagulated patients, with clinical manifestations often limited to nonspecific abdominal or lumbar pain. Diagnosis relies primarily on contrast-enhanced CT imaging. Reported therapeutic strategies include conservative management, endovascular embolization, and surgical intervention, with outcomes ranging from complete recovery to fatal progression, particularly in elderly and comorbid individuals. Conclusions: Spontaneous retroperitoneal hematomas in the setting of SARS-CoV-2 infection represent a diagnostic and therapeutic challenge associated with considerable morbidity and mortality. Early recognition, prompt imaging, and individualized multidisciplinary management are essential, while further research is needed to clarify incidence, risk factors, and preventive strategies.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Muchtaridi M, Lestyawan S, Fakhirah MA, et al (2025)

Therapeutic Potential of Erythrina Genus: Bioactive Phytoconstituents with Potent Antiviral and Antimicrobial Activities.

Plants (Basel, Switzerland), 14(19): pii:plants14193053.

Infectious diseases present a significant global health challenge, further exacerbated by the rising prevalence of antimicrobial resistance and the limited availability of effective antiviral and antimicrobial agents. The Erythrina genus has garnered scientific interest due to its diverse array of bioactive phytoconstituents, with potential therapeutic relevance. This review aims to synthesize and critically assess the existing literature on the antiviral, antibacterial, antifungal, and antiplasmodial properties of Erythrina species. A comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar databases. Relevant studies were identified through keyword searches combining pathogen-specific terms with "Erythrina". The extracted data were categorized based on the pathogen type and its associated bioactive compounds. Several Erythrina species exhibited substantial antiviral activity against prominent viral pathogens, such as HIV and SARS-CoV-2. Notably, strong antibacterial efficacy was observed against Staphylococcus aureus, including multidrug-resistant strains. Antifungal activity was most pronounced against Candida albicans, while potent antiplasmodial effects were reported against both drug-sensitive and drug-resistant strains of Plasmodium falciparum. These pharmacological effects were predominantly attributed to prenylated flavonoids, isoflavones, pterocarpans, and erythrina-type alkaloids. Further mechanistic studies and in vivo evaluations are essential to fully assess their clinical efficacy and support the development of plant-derived antimicrobial agents.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Lemarchand P, Pape M, J Schwarz (2025)

Understanding sex and gender disparities in COVID-19 mortality: a narrative review beyond biology.

Biology of sex differences, 16(1):76.

BACKGROUND: Men have consistently experienced higher COVID-19 mortality than women across most countries and time periods, prompting widespread investigation into potential biological causes. Early research focused on sex-related genetic, hormonal, and immunological mechanisms to explain these disparities.

MAIN BODY: This narrative review traces the evolution of scientific explanations for women/men mortality differences in COVID-19, from early biological hypotheses to more nuanced gendered and intersectional models. While some studies suggest sex-linked genetic variants, chromosomal mechanisms, or hormone-regulated expression of viral entry receptors might partially explain men's higher mortality, the overall evidence remains inconsistent and inconclusive. Increasingly, attention has shifted to social and structural factors, including occupational exposure, pre-existing health conditions, healthcare access, and behaviors, that can differently shape vulnerability to COVID-19 in women and men. Data disaggregated by gender and race further revealed significant heterogeneity in outcomes, underscoring the influence of intersecting axes of inequality. International comparisons suggested that gender inequality at the societal level was associated with wider women/men COVID-19 mortality gaps. Analyses that overlook the interaction between sex- and gender-related factors and their intersection with racial disparities and socioeconomic status risk obscuring the underlying drivers of COVID-19 disparities.

CONCLUSION: Sex-related biological factors may have influenced COVID-19 outcomes, but they do not adequately account for the observed differences in mortality between women and men. Approaching the study of health inequities through a gendered, intersectional framework is essential for accurately identifying and addressing underlying risk factors, and for better understanding how sex- and gender-related factors may interact, not only in COVID-19, but across a broad range of health conditions.

RevDate: 2025-10-16
CmpDate: 2025-10-16

D'Angelo S, Zaballa E, Ntani G, et al (2025)

The impact of changes to work circumstances enforced by COVID-19 on anxiety: a systematic review.

Systematic reviews, 14(1):195.

BACKGROUND: The COVID-19 pandemic enforced changes on employment circumstances for all workers but older workers experiencing job loss are less likely to return to work than younger individuals. Under normal circumstances, job loss is a well-recognised risk factor for poor mental health, while it is unclear whether working from home is beneficial or harmful to mental health. We systematically reviewed the literature to explore the association between enforced changes in employment (job loss, working from home or being furloughed) and anxiety in the adult population, with a particular focus on older workers.

METHODS: The protocol was registered in June 2021 in the International Prospective Register of Systematic Reviews database. We searched Medline, Embase, PsycInfo and CINAHL (January 2020-July 2023) databases for studies including older adults (some of the study sample were workers aged over 50 years). Results were presented by narrative review, complemented by a vote-counting technique and effect direction plots to summarise the relationship between exposures and anxiety.

RESULTS: Forty-eight studies from several countries met the inclusion criteria, including 39 cross-sectional and nine longitudinal studies. The prevalence of anxiety varied between studies due to different tools and cut-offs chosen, reaching as high as 63% in one study. The vote-counting method showed convincing evidence that job loss since lockdown negatively impacted anxiety overall and among people aged 50 and over. Inconsistent results were observed across studies investigating the effect of working from home or furlough on anxiety.

CONCLUSION: Disruption of employment during the pandemic and related lockdowns has increased anxiety levels in the adult population and among older workers. More research is needed to know how persistent these effects are and to identify strategies to support those most affected.

The protocol of the systematic review was registered in June 2021 in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42021260499), and it is provided as supporting information (Additional File 1).

RevDate: 2025-10-15
CmpDate: 2025-10-16

Arab Z, Shayanfar N, Mojaver MR, et al (2025)

Cardiopulmonary crosstalk in Long COVID: a systematic review of emerging evidence.

BMC cardiovascular disorders, 25(1):742.

BACKGROUND: Long COVID is a complex, multisystem syndrome with significant cardiopulmonary implications. Persistent inflammation, endothelial dysfunction, and microvascular injury contribute to prolonged symptoms such as dyspnea, chest pain, and exercise intolerance. Despite growing recognition of these complications, the underlying mechanisms of cardiopulmonary interactions remain poorly understood.

METHODS: A comprehensive literature search was conducted on PubMed, Scopus, Google Scholar, and Web of Science covering studies from 2019 to 2025. Keywords included "Long COVID", "cardiopulmonary interaction", "pulmonary fibrosis", "myocardial inflammation", and "endothelial dysfunction". A total of 102 articles were included, comprising 65 original research studies and 37 review articles.

RESULTS: Pulmonary sequelae, such as fibrotic remodeling, persistent hypoxia, and microthrombosis, impose significant strain on the cardiovascular system, exacerbating myocardial inflammation, arrhythmias, and endothelial dysfunction. Shared mechanisms, such as oxidative stress, immune dysregulation, and neurohumoral activation, create a vicious cycle of sustained cardiopulmonary impairment. The disruption of the renin-angiotensin-aldosterone system (RAAS) further contributes to systemic vascular dysregulation.

CONCLUSION: A deeper understanding of cardiopulmonary interactions in Long COVID is essential for developing effective management strategies. Targeting inflammatory pathways, restoring endothelial function, and addressing autonomic instability may provide therapeutic benefits. As the long-term impact of this syndrome continues to evolve, further research is needed to refine treatment approaches and mitigate its burden on global health.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Kim Y, I Kim (2025)

Medical certification in sickness benefit schemes (I): theoretical perspectives and return-to-work.

Annals of occupational and environmental medicine, 37:e23.

This study explores the theoretical foundations and practical applications of medical certification within the sickness benefit systems, particularly in the context of Korea's pilot program and its planned national rollout. While sickness benefit systems have long existed in many Organization for Economic Cooperation and Development (OECD) countries, Korea has only recently initiated pilot projects, largely prompted by the coronavirus disease 2019 pandemic. These systems aim to compensate for income loss due to illness or injury, and medical certification plays a central role in determining eligibility and work ability. This study defines medical certification as a two-stage process: clinical diagnosis and formal assessment of a worker's ability to return-to-work. The dual nature highlights the distinct objectives of the medical treatment and social security policies. Drawing on international practices, this study reviews the International Classification of Functioning, Disability, and Health (ICF) as a key global framework for assessing disability and work ability, although it acknowledges the limitations of its application to sickness benefits. The research emphasizes a shift in global trends toward return-to-work-oriented certification models, such as the UK's "fit note" system, which focuses on evaluating fitness-for-work rather than merely documenting illness. Sweden and Japan also offer models that integrate rehabilitation with flexible work accommodations. Three key issues were identified in Korea's system: the role of medical certification and concerns about moral hazard, the burden of proof and workload on physicians, and public perceptions of the program's purpose. We believe that medical certification should not only verify illness but also support early intervention and a healthy workforce. Ultimately, this study advocates for a balanced and efficient medical certification system tailored to Korea's healthcare context closely aligning with labor market policies to ensure long-term sustenance and integration of the sickness benefit program.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Petka-Nosal N, Bielska IA, Badora-Musiał K, et al (2025)

Skill mix changes in healthcare professions during the COVID-19 pandemic: a scoping review.

BMJ open, 15(10):e100024 pii:bmjopen-2025-100024.

OBJECTIVES: The objective of the scoping review was to systematise the existing knowledge about skill mix changes among the healthcare workforce during the COVID-19 pandemic.

DESIGN: Scoping review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review.

DATA SOURCES: Five databases including CINAHL Ultimate, Web of Science, Medline, Embase and Scopus were searched in August 2024.

ELIGIBILITY CRITERIA: The review encompassed original research studies published from January 2020 to August 2024, on the skill mix of healthcare workers during the COVID-19 pandemic. Quantitative and qualitative studies were included without geographical or linguistic restrictions.

DATA EXTRACTION AND SYNTHESIS: Data were independently extracted by two researchers, capturing details such as publication year, study title, country, target population, study purpose and methodology, sample size, analysed variables, results and recommendations.

RESULTS: A total of 13 563 records were identified in the databases of which 3962 remained for abstract review. 32 articles were included in the final analysis. 17 of the 32 papers were from Western and Southern Europe. The healthcare professions which were described in the studies were physicians, nurses, midwives, paramedics, pharmacists, physiotherapists, occupational therapists and medical assistants, of which the majority of the studies were conducted among nurses (n=16), pharmacists (n=11) and physicians (n=6). Most studies (n=9) concerned the adding of new tasks/roles and reallocating tasks in combination with teamwork (n=8). Research covered a range of topics, including psychological aspects of work, patient safety, work reorganisation, training and collaboration. Many studies focused on the challenges related to skill mix, such as the blurring of responsibilities and role ambiguity.

CONCLUSIONS: The research summarised in this review demonstrates the impact of implementing skill mix changes on healthcare workers during the COVID-19 pandemic, particularly in the area of mental health. The research highlights the importance of adaptation in response to pressures among healthcare professions and the entire system. Further research is needed to examine the long-term impact of skill mix on healthcare workers across regions and professions in crisis situations.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Tome R, Arima S, Akamine M, et al (2025)

Varicella-zoster Virus Reactivation with Severe Pneumonia Following Convalescence from Coronavirus Disease: A Case Report and Literature Review.

Internal medicine (Tokyo, Japan), 64(20):3051-3056.

An association between coronavirus disease 2019 (COVID-19) and concomitant varicella-zoster virus (VZV) reactivation has been proposed. We herein report a case of severe VZV pneumonia in a 73-year-old man who underwent corticosteroid tapering after recovering from COVID-19 and presented with fever, vesicular rashes, and hypoxemia. Chest computed tomography revealed ground-glass opacities (GGOs) and multiple granular shadows. Varicella-zoster virus was detected in the skin and bronchoalveolar lavage fluid. The patient was diagnosed with disseminated VZV reactivation and thereafter successfully recovered with acyclovir treatment. Physicians should consider the possibility of VZV reactivation when GGOs or patchy nodular shadows appear during the course of patients with COVID-19.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Joyner MJ, Carter RE, Wright RS, et al (2025)

The Safety Profile of COVID-19 Convalescent Plasma.

Current topics in microbiology and immunology, 443:79-88.

Despite concerns about potential side effects, based both on historical experience with plasma products and more recent concerns about contemporary use of plasma, COVID-19 convalescent plasma has been shown to be a very safe product. Research early in the COVID-19 pandemic documented-among the very large population of convalescent plasma recipients in the US Convalescent Plasma Study component of the FDA-authorized Expanded Access Program-that the overall risk profile was no different than that seen for fresh frozen plasma, a product used routinely in medical practice. The safety of CCP was further demonstrated using real-world evidence, pragmatic trials, and formal randomized trials. The rates of all serious adverse events were very low, an especially impressive finding in light of the fact that nearly all safety data came from the use of COVID-19 convalescent plasma in patients who were hospitalized, were older, and/or had significant co-morbid cardiopulmonary and metabolic disorders. The well-known complications of blood and plasma transfusions-transfusion-associated circulatory overload and transfusion-related acute lung injury-were found with no higher incidence than with standard use of blood and plasma, nor was there evidence for antibody-dependent enhancement or increased incidence of thromboembolic events. The comprehensive safety profile derived from studies enrolling hundreds of thousands of recipients of COVID-19 convalescent plasma across the world should allay safety fears about the rapid deployment of convalescent plasma in future pandemics.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Paneth N, Joyner MJ, A Casadevall (2025)

Using Passive Antibody Therapies in the Next Pandemic.

Current topics in microbiology and immunology, 443:259-273.

The twenty-first century has witnessed seven human viral pandemics. Approximately once every three to four years over the past quarter-century, the world has experienced a new viral epidemic that expanded well beyond its original national borders to become a pandemic. The probability that another pandemic caused by a previously unknown agent will occur in the near future is thus very high and public health agencies must prioritize mechanisms for detecting their first signals. At the onset of these recent pandemics, no specific therapeutic agent was available for any of the newly emergent pathogens. However, convalescent plasma therapy can be available as soon as there are survivors and is likely to be effective if used early and in sufficient strength. But for the three forms of passive antibody-convalescent plasma, monoclonal antibodies, and hyperimmune globulins-to be available and effective in a pandemic situation, careful strategic planning will be necessary. In the pre-pandemic period, we must reinforce the capacities of blood banks and plasma fractionating companies in the production and storage of their products; ensure that outpatient settings can provide intravenous products; educate providers in the proper use of plasma; and create a research infrastructure to examine the effectiveness of passive antibody products. Once a pandemic is underway, regulatory bodies should simplify the approval of research and emergency use protocols and develop treatment registries. Incentives for the rapid production of monoclonal antibodies and hyperimmune globulins will likely be required. A national resource to link providers with passive antibody products and national databases to monitor pandemic progress and pandemic treatment will permit the most effective allocation of pandemic-fighting resources. We cannot afford to wait until the next pandemic is upon us to respond. The time to strengthen clinical, research, and manufacturing infrastructure to permit us to be ready to confront the next new virulent pathogen is now.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Marks PW (2025)

The Importance of Antibody Titer Determination to the Effective Use of Convalescent Plasma.

Current topics in microbiology and immunology, 443:55-62.

Convalescent Plasma (CP) has been used prophylactically and therapeutically over the past century to address a variety of infectious threats. Two tenets of the use of CP were clear from prior experience in the setting of other infectious outbreaks: (1) best results are obtained when CP is given early in the course of the disease, and (2) plasma containing high-titer neutralizing capacity is necessary to achieve optimal results. The magnitude of the COVID-19 pandemic along with the initial lack of effective therapeutic alternatives, combined with the relative safety of the approach of administration of CP, led to the initiation of an expanded access program (EAP) that ultimately provided CP to tens of thousands of individuals. When the program was initiated, no high-throughput assay was available for the determination of antibody titers, so antibody positive units were administered without regard to titer. With foresight regarding the need to ultimately determine such titers, samples from the CP units administered were retained and titers were determined retrospectively. An automated live-virus neutralization assay was ultimately selected for this purpose based on an evaluation of its accuracy and precision. Ultimately, an analysis performed in 13,794 individuals from the EAP for which clinical outcomes were known following the administration of single units of COVID-19 CP between the period of April and August 2020 indicated that higher titer COVID-19 CP was associated with a modest reduction in absolute mortality. The benefit observed was confined to individuals who were not intubated, and there was a trend toward a greater reduction in mortality using the highest SARS-CoV-2 neutralizing antibody-containing CP units. This experience during the COVID-19 pandemic is instructive for the future. To facilitate the production of CP that is likely to be most effective, high-throughput assays to determine neutralizing antibody titers need to be developed and implemented early during an outbreak to facilitate the identification and early administration of high-titer units.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Paneth N, Walsh M, Kornatowski B, et al (2025)

A Brief History of Polyclonal Antibody Therapies Against Bacterial and Viral Diseases Before COVID-19.

Current topics in microbiology and immunology, 443:15-39.

The use of the serum or plasma of patients or animals who have recovered from an infectious disease, or had been immunized with a relevant antigen, to treat or prevent the same infection in others began in the late 1880s when French and German scientists uncovered, one step at a time, several of the elements of the immune system's response to infection. A key finding was that the damage caused by some bacteria depends upon their secreted toxins which can be neutralized by biologic agents. Antitoxins to diphtheria and tetanus began to be manufactured in large animals in France, Germany, and the US in the 1890s and were soon being used worldwide. The impact of diphtheria antitoxin on childhood mortality was profound. Shortly after the development of antitoxins, convalescent serum began to be used for its anti-bactericidal properties thus addressing serious infections caused by non-toxin-producing organisms. The effectiveness of antitoxins and antisera was demonstrated by examining mortality rates in hospitals before and after the introduction of antitoxins, by comparisons of treated and untreated patients, by comparing early and late treatment and dosage, by examining vital data mortality trends, and by several randomized and alternate assignment trials. Antitoxins continue to have a role in the rare cases of diphtheria and other conditions largely eradicated by immunization, but serum therapy nearly disappeared from the medical armamentarium with the development of antibiotics in the 1940s. Inasmuch as new human pathogens are now emerging with unprecedented regularity as seen in the recent COVID-19 pandemic, and because specific therapies are unlikely to be available for them, plasma-based antibody therapies are likely to again carve out a niche in infectious disease control.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Klassen SA, JW Senefeld (2025)

Evidence for the Efficacy of COVID-19 Convalescent Plasma.

Current topics in microbiology and immunology, 443:99-117.

During the global health emergency caused by the coronavirus disease 2019 (COVID-19), evidence relating to the efficacy of convalescent plasma therapy-evidence critically needed for both public policy and clinical practice-came from multiple levels of the epistemic hierarchy. The challenges of conducting clinical research during a pandemic, combined with the biological complexities of convalescent plasma treatment, required the use of observational data to fully assess the impact of convalescent plasma therapy on COVID symptomatology, hospitalization rates, and mortality rates. Observational studies showing the mortality benefits of convalescent plasma emerged early during the COVID-19 pandemic from multiple continents and were substantiated by real-time pragmatic meta-analyses. Although many randomized clinical trials (RCTs) were initiated at the onset of the pandemic and were designed to provide high-quality evidence, the relative inflexibility in the design of clinical trials meant that findings generally lagged behind other forms of emerging information and ultimately provided inconsistent results on the efficacy of COVID-19 convalescent plasma. In the pandemic framework, it is necessary to emphasize more flexible analytic strategies in clinical trials, including secondary, subgroup, and exploratory analyses. We conclude that in totality, observational studies and clinical trials taken together provide strong evidence of a mortality benefit conferred by COVID-19 convalescent plasma, while acknowledging that some randomized clinical trials examined suboptimal uses of convalescent plasma.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Nierich A, Bihariesingh R, R Bansie (2025)

HemoClear: A Practical and Cost-Effective Alternative to Conventional Convalescent Plasma Retrieval Methods.

Current topics in microbiology and immunology, 443:185-201.

Convalescent plasma has increasingly been used to treat various viral infections and confer post-exposure prophylactic protection during the last decade and has demonstrated favorable clinical outcomes in patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) during the recent COVID-19 pandemic. The pandemic has highlighted the need for cost-effective, accessible, and easy-to-use alternatives to conventional blood plasmapheresis techniques, allowing hospitals to become more self-sufficient in harvesting and transfusing donor plasma into recipients in a single setting. To this end, the use of a membrane-based bedside plasmapheresis device (HemoClear) was evaluated in an open-label, non-randomized prospective trial in Suriname in 2021, demonstrating its practicality and efficacy in a low-to middle-income country. This paper will review the use of this method and its potential to expedite the process of obtaining convalescent plasma, especially during pandemics and in resource-constrained settings.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Focosi D (2025)

Monoclonal Antibody Therapies Against SARS-CoV-2: Promises and Realities.

Current topics in microbiology and immunology, 443:131-147.

Monoclonal antibodies targeting the Spike protein of SARS-CoV-2 have been widely deployed in the ongoing COVID-19 pandemic. I review here the impact of those therapeutics in the early pandemic, ranging from structural classification to outcomes in clinical trials to in vitro and in vivo evidence of basal and treatment-emergent immune escape. Unfortunately, the Omicron variant of concern has completely reset all achievements so far in mAb therapy for COVID-19. Despite the intrinsic limitations of this strategy, future developments such as respiratory delivery of further engineered mAb cocktails could lead to improved outcomes.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Shoham S (2025)

Convalescent Plasma for Immunocompromised Patients.

Current topics in microbiology and immunology, 443:119-130.

COVID-19 convalescent plasma (CCP) is an important therapeutic option for immunocompromised patients with COVID-19. Such patients are at increased risk for serious complications of infection and may also develop a unique syndrome of persistent infection. This article reviews the rationale for CCP utilization in immunocompromised patients and the evidence for its value in immunosuppressed patients with both acute and persistent COVID-19. Both historical precedence and understanding of the mechanisms of action of antibody treatment support this use, as do several lines of evidence derived from case series, comparative studies, randomized trials, and systematic reviews of the literature. A summary of recommendations from multiple practice guidelines is also provided.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Yoon H, LA Pirofski (2025)

Generating the Evidence Base for Convalescent Plasma Use for a New Infectious Disease.

Current topics in microbiology and immunology, 443:205-217.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swept across the world in the waning months of 2019 and emerged as the cause of the coronavirus disease 19 (COVID-19) pandemic in early 2020. The use of convalescent plasma (CP) for prior respiratory pandemics provided a strong biological rationale for the rapid deployment of COVID-19 convalescent plasma (CCP) in early 2020 when no validated treatments or prior immunity existed. CCP is an antiviral agent, with its activity against SARS-CoV-2 stemming from specific antibodies elicited by the virus. Early efforts to investigate the efficacy of CCP in randomized clinical trials (RCTs) that targeted hospitalized patients with COVID-19 did not demonstrate the overall efficacy of CCP despite signals of benefit in certain subgroups, such as those treated earlier in disease. In contrast, studies adhering to the principles of antibody therapy in their study design, choice of patient population, and product qualification, i.e., those that administered high levels of specific antibody during the viral phase of disease in immunocompromised or very early in immunocompetent individuals, demonstrated benefits. In this chapter, we leverage the knowledge gained from clinical studies of CCP for COVID-19 to propose a framework for future studies of CP for a new infectious disease. This framework includes obtaining high-quality CP and designing clinical studies that adhere to the principles of antibody therapy to generate a robust evidence base for using CP.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Sullivan DJ (Jr) (2025)

Convalescent Plasma and Other Antibody Therapies for Infectious Diseases-Lessons Learned from COVID-19 and Future Prospects.

Current topics in microbiology and immunology, 443:219-242.

Antiviral passive antibody therapy includes convalescent plasma, hyperimmune globulin, and monoclonal antibodies. Passive antibodies have proven effective in reducing morbidity and mortality for SARS-CoV-2 and other infectious diseases when given early in the disease course with sufficiently high specific total and neutralizing antibody levels. Convalescent plasma can be delivered to patients before vaccination implementation or novel drug production. Carefully designed and executed randomized controlled trials near the pandemic outset are important for regulatory bodies, healthcare workers, guideline committees, the public, and the government. Unfortunately, many otherwise well-designed antibody-based clinical trials in COVID-19 were futile, either because they intervened too late in the disease or provided plasma with insufficient antibodies. The need for early treatment mandates outpatient clinical trials in parallel with inpatient trials. Early outpatient COVID-19 convalescent plasma transfusion with high antibody content within 9 days of symptom onset has proven effective in blunting disease progression and reducing hospitalization, thus reducing hospital overcrowding in a pandemic. Convalescent plasma offers the opportunity for hope by enabling community participation in outpatient curative therapy while monoclonal therapies, vaccines, and drugs are being developed. Maintaining the appropriate infrastructure for antibody infusion in both outpatient and inpatient facilities is critical for future pandemic readiness.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Kunze KL, PW Johnson (2025)

The Importance of Geographic Proximity of Convalescent Plasma Donors.

Current topics in microbiology and immunology, 443:89-98.

Donor-recipient proximity emerged as an important factor influencing the efficacy of COVID-19 convalescent plasma (CCP) treatment during the early stages of the COVID-19 pandemic. This relationship was uncovered while analyzing data collected in the collaborative Expanded Access Program (EAP) for CCP at Mayo Clinic, a project aimed to establish protocols for CCP use amid the uncertainty of the novel disease. Analysis of data from nearly 28,000 patients revealed a significant reduction in risk of 30-day mortality for those receiving near-sourced plasma when compared to those receiving distantly sourced plasma [pooled relative risk, 0.73 (95% CI 0.67-0.80)], prompting adjustments in treatment protocols at selected institutions, and highlighting the importance of proximity in optimizing CCP outcomes. Despite its significance, subsequent studies of CCP effectiveness in COVID-19 have often overlooked donor-recipient proximity. Our findings emphasize the importance of donor-recipient proximity in CCP treatment in the current pandemic, and we discuss potential methods for improving CCP efficacy in future pandemics. Our recommendations include prioritizing virus genotyping for vulnerable patients, establishing a robust testing infrastructure, and collecting additional donor data to enhance plasma selection. This chapter underscores the importance of comprehensive data collection and sharing to navigate the evolving landscape of newly emerging infectious diseases.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Joyner MJ (2025)

Convalescent Plasma and the US Expanded Access Program: A Personal Narrative.

Current topics in microbiology and immunology, 443:63-78.

Between early April 2020 and late August 2020, nearly 100,000 patients hospitalized with SARS-CoV2 infections were treated with COVID-19 convalescent plasma (CCP) in the US under the auspices of an FDA-authorized Expanded Access Program (EAP) housed at the Mayo Clinic. Clinicians wishing to provide CCP to their patients during that 5-month period early in the COVID pandemic had to register their patients and provide clinical information to the EAP program. This program was utilized by some 2,200 US hospitals located in every state ranging from academic medical centers to small rural hospitals and facilitated the treatment of an ethnically and socio-economically diverse cross section of patients. Within 6 weeks of program initiation, the first signals of safety were found in 5,000 recipients of CCP, supported by a later analysis of 20,000 recipients (Joyner et al. in J Clin Invest 130:4791-4797, 2020a; Joyner et al. in Mayo Clin Proc 95:1888-1897, 2020b). By mid-summer of 2020, strong evidence was produced showing that high-titer CCP given early in the course of hospitalization could lower mortality by as much as a third (Joyner et al. in N Engl J Med 384:1015-1027, 2021; Senefeld et al. in PLoS Med 18, 2021a). These data were used by the FDA in its August decision to grant Emergency Use Authorization for CCP use in hospitals. This chapter provides a personal narrative by the principal investigator of the EAP that describes the events leading up to the program, some of its key outcomes, and some lessons learned that may be applicable to the next pandemic. This vast effort was a complete team response to a crisis and included an exceptional level of collaboration both inside and outside of the Mayo Clinic. Writing just 4 years after the initiation of the EAP, this intense professional effort, comprising many moving parts, remains hard to completely understand or fully explain in this brief narrative. As Nelson Mandela said of the perception of time during his decades in prison, "the days seemed like years, and the years seemed like days."

RevDate: 2025-10-16
CmpDate: 2025-10-16

Lebovits C (2025)

The Role of the Patient Advocate During a Pandemic: The Case of Convalescent Plasma.

Current topics in microbiology and immunology, 443:167-172.

The onset of the COVID-19 pandemic confronted medicine with several difficulties, including a lack of specific therapeutic options, the absence of out-of-hospital testing facilities to diagnose the condition, and the sudden extraordinary need for intensive medical care that overwhelmed most hospitals. Early in the pandemic, many physicians recognized that using antibodies harvested from recovering patients was a treatment that had a proven track record for many diseases and that might be used to manage the disease at least as a stopgap until more specific medicines for COVID-19 were developed. But using convalescent plasma raised many additional complications, most especially the logistics that needed to be put in place to collect and distribute such plasma. Unlike drugs ordered from a pharmacy, plasma and other blood products are procured by a complex process that depends intensely on interaction with the public, the provider of all blood products that are directly provided to patients. Blood components such as convalescent plasma, intended to be used immediately without major processing, are entirely supplied by donations from the public. This form of treatment can therefore benefit from patient advocates, especially if they are experienced in solving problems of logistics and in the process of matching supply to demand that is more commonly encountered in the business world than in medicine. In this chapter, one patient advocate, Chaim Lebovits, describes the process of mobilizing the population, interacting with blood banks and hospitals, and successfully channeling thousands of units of plasma from volunteers recovering from COVID-19 to patients in hospitals. Starting in New York City in early 2020 and initially working with communities with which Mr. Lebovits was familiar, the efforts steadily spread across many parts of the US. The model described here, which uses patient advocates to serve as a link between patients, blood banks, and hospitals in the service of gathering and distributing high-titer convalescent plasma to patients is likely to be relevant to the next pandemic.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Franchini M, D Focosi (2025)

Monoclonal Antibodies and Hyperimmune Immunoglobulins in the Next Pandemic.

Current topics in microbiology and immunology, 443:243-257.

Pandemics are highly unpredictable events that are generally caused by novel viruses. There is a high likelihood that such novel pathogens belong to entirely novel viral families for which no targeted small-molecule antivirals exist. In addition, small-molecule antivirals often have pharmacokinetic properties that make them contraindicated for the frail patients who are often the most susceptible to a novel virus. Passive immunotherapies-available from the first convalescent patients-can then play a key role in controlling pandemics. Convalescent plasma is immediately available, but if manufacturers have fast platforms to generate marketable drugs, other forms of passive antibody treatment can be produced. In this chapter, we will review the technological platforms for generating monoclonal antibodies and hyperimmune immunoglobulins, the current experience on their use for treatment of COVID-19, and the pipeline for pandemic candidates.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Maor Y, O Zimhony (2025)

Hyperimmune Globulins in COVID-19.

Current topics in microbiology and immunology, 443:149-164.

The COVID-19 pandemic, resulting from the emergence of the novel coronavirus SARS-CoV-2, posed unprecedented challenges to global health systems as no proven therapy was available. Initially, COVID-19 convalescent plasma (CCP) from recovered COVID-19 patients showed promise as a therapeutic option. However, the efficacy of this approach was closely correlated with the neutralizing antibody titer in the administered plasma and thus effectiveness was not always guaranteed. In response, hyperimmune immunoglobulins (hIG) derived from CCP obtained by apheresis from recovered or vaccinated individuals emerged as a potential alternative. hIG were purified through stringent chromatographic processing from CCP units and displayed varying results in clinical trials, although it seems likely that they improved outcomes compared to placebo or CCP at day 28, particularly in unvaccinated patients. The variability in the effect of hIG likely stems from factors such as the timing of outcome assessment, the administered dose of hIG, the patients' immunological background, and the matching between the variant infecting patients and the neutralization ability of the immunoglobulin batch, which depended on the timing of the CCP collection. Despite logistical challenges and high production costs, hIG showcase advantages over CCP, offering versatility in administration routes and eliminating the need for blood matching, thus facilitating administration in the community, and allowing for variant-specific preparations. hIG appear to be of particular importance in the treatment of immunocompromised patients and patients with persistent COVID-19, although studies in these populations are lacking. Non-human alternatives, such as equine-derived hIG and recombinant hIG, may provide a solution to the logistical challenges of large-scale hIG preparation. Further study is needed to explore these avenues. Establishing the infrastructure for large-scale hIG production independent of plasma donations emerges as a strategic approach for future pandemics, justifying exploration and promotion by health authorities.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Casadevall A, N Paneth (2025)

The Logic and History of Passive Immunity and Antibody Therapies.

Current topics in microbiology and immunology, 443:41-52.

This volume takes a broad overview of antibody-based therapies prior to and during the COVID pandemic and examines their potential use in future pandemics. Passive antibody therapy was the first effective antimicrobial treatment and its development in the early twentieth century helped catalyze immunological and microbiological research. During the era of serum therapy (1890-1940) antibody-based therapies were developed against both viral and bacterial diseases. Effective treatment required an understanding of how to quantify antibodies, how to develop serotype-specific sera and recognition of the need to treat early in disease. Thus, although the era of serum therapy essentially ended with the development of small molecule antimicrobial therapy in the 1940s, antibody-based therapies led to important new scientific understanding, while remaining in use for some toxin and venom-caused diseases and in the prevention of outbreaks of viral hepatitis. A renewed interest in antibody-based therapies was seen in the widespread deployment of convalescent plasma and monoclonal antibodies during the COVID-19 pandemic. Convalescent plasma will likely be the first specific therapy during outbreaks with new pathogens for which there is no other therapy. For all forms of antibody-based therapies, effectiveness relies on the key principles of antibody therapy, namely, treatment early in disease with preparations containing sufficient antibody specific to the microbe in question.

RevDate: 2025-10-16
CmpDate: 2025-10-16

Bloch EM (2025)

Blood Banking Capacity in Low-and Middle-Income Countries: Covid-19 Convalescent Plasma in Context.

Current topics in microbiology and immunology, 443:173-184.

Blood transfusion capacity in low- and middle-income countries (LMICs), encompassing both the safety and adequacy of the blood supply, is limited. The challenges facing blood banks in LMICs include regulatory oversight, blood donor selection, collection procedures, laboratory testing, and post-transfusion surveillance. A high proportion of LMICs are unable to fully meet clinical demands for blood products, and many do not meet even the minimum threshold of collection (10 units per 1000 population). Suboptimal clinical transfusion practices, in large part due to a lack of training in transfusion medicine, contribute to blood wastage. During the COVID-19 pandemic, high- and LMICs alike experienced blood shortages, in large part due to quarantine and containment measures that impeded donor mobility. COVID-19 convalescent plasma (CCP) was particularly appealing for the treatment of patients with COVID-19 in LMICs, as it is a relatively inexpensive intervention and makes use of the existing blood collection infrastructure. Nonetheless, the challenges of using CCP in LMICs need to be contextualized among broad concerns surrounding blood safety and availability. Specifically, reliance on first time, family replacement and paid donors, coupled with deficient infectious disease testing and quality oversight, increase the risk of transfusion transmitted infections from CCP in LMICs. Furthermore, many LMICs are unable to meet general transfusion needs; therefore, CCP collection also risked exacerbation of pervasive blood shortages.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Nagra G, Ezeugwu VE, Bostick GP, et al (2025)

Return-to-work for people living with long COVID: A scoping review of interventions and recommendations.

PloS one, 20(10):e0321891 pii:PONE-D-25-11140.

INTRODUCTION: Long COVID is characterized by the presence of new onset or persistent symptoms 3 months after a suspected or confirmed history of SARS-CoV-2 infection. It is a complex and multi-faceted condition that affects people in different ways. Long COVID affects individuals' labour market participation. While some cannot work, others may return to work (RTW) in a limited capacity. Determining what rehabilitation or related strategies are safe and effective for facilitating RTW is necessary.

OBJECTIVES: To synthesize evidence on RTW interventions for people living with Long COVID and to identify 'promising' interventions for enhancing work ability and RTW.

METHODS: We followed Arksey & O'Malley's methodology and the PRISMA extension for scoping reviews. Five electronic bibliographic databases and grey literature were searched. The literature search included various study designs, such as randomized controlled trials (RCT), quasi-experimental designs, and observational studies as well as clinical practice guidelines (CPGs). Two reviewers conducted screening and data extraction, with disagreements resolved through consensus. Intervention studies were categorized as promising (statistically significant RTW outcomes or ≥ 50% RTW), somewhat promising (20% to < 50% RTW), not promising (non-statistically significant RTW outcomes or < 20% RTW), or uncertain (did not specify proportion of RTW).

RESULTS: Twelve CPGs and nineteen intervention studies were identified. Of the intervention studies, 5 were cohort studies, 3 quasi-experimental studies, 4 observational, 2 interventional, 3 RCTs, and 2 case reports. Promising interventions included multimodal and interdisciplinary work-focused rehabilitation, multidisciplinary inpatient and outpatient rehabilitation, psychoeducation, pacing, and breathing strategies, shifting focus from symptom monitoring to optimizing functional outcomes, enhanced external counterpulsation inflatable pressure to improve blood flow, and constraint-induced cognitive therapy.

CONCLUSION: Many uncertainties remain regarding which RTW interventions are effective or the optimal characteristics of these interventions.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Filippatos F, Matara DI, Michos A, et al (2025)

Immunological Mechanisms Underlying Allergy Predisposition After SARS-CoV-2 Infection in Children.

Cells, 14(19): pii:cells14191511.

As the pediatric COVID-19 landscape evolves, it is essential to evaluate whether SARS-CoV-2 infection predisposes children to allergic disorders. This narrative review synthesizes current epidemiological and immunological evidence linking pediatric COVID-19 with new-onset atopy. Epidemiological data remain heterogeneous: large Korean and multinational cohorts report increased risks of asthma and allergic rhinitis following COVID-19, whereas U.S. cohorts show neutral or protective associations, highlighting geographic and methodological variability. Mechanistic insights provide biological plausibility: epithelial injury and the release of alarmin cytokines (IL-33, IL-25, TSLP) promote Th2 polarization and ILC2 expansion, while epigenetic "scars" (e.g., LMAN2 methylation changes) and hematopoietic stem cell reprogramming may sustain long-term Th2 bias. Cytokine memory involving IL-7 and IL-15 contributes to altered T- and B-cell homeostasis, whereas disrupted regulatory T-cell function may reduce tolerance thresholds. Paradoxical trade-offs exist, such as ACE2 downregulation in allergic airways, which may lower viral entry but simultaneously amplify type-2 inflammation. Together, these processes suggest that SARS-CoV-2 infection could foster a pro-allergic milieu in susceptible children. Although current evidence is inconclusive, integrating epidemiological surveillance with mechanistic studies is crucial for predicting and alleviating post-COVID allergic outcomes. Longitudinal pediatric cohorts and interventions targeting epithelial alarmins or microbiome restoration may hold promise for prevention.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Alamri A, Alkhathami A, Alshabab SQA, et al (2025)

Prevalence of depression anxiety and stress among health professionals during COVID-19 pandemic A systematic review.

Journal of family medicine and primary care, 14(9):3646-3651.

The COVID-19 pandemic has posed unprecedented challenges to healthcare systems and the mental well-being of healthcare professionals (HCPs) globally. This systematic review synthesizes existing research on the prevalence of depression, anxiety, and stress among HCPs during the pandemic. We employed a systematic search strategy to identify relevant studies published between December 2019 and December 2023, ultimately including 30 studies that met our inclusion criteria. The findings reveal a significant increase in the prevalence of depression, anxiety, and stress among HCPs compared to pre-pandemic levels. Several risk factors were identified, including direct exposure to COVID-19 patients, female gender, the nursing profession, inadequate resources, and lack of support. This review highlights the detrimental impact of the pandemic on HCPs' mental health and emphasizes the need for urgent interventions and support systems to address this critical public health issue.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Hu S, Song D, Wan S, et al (2025)

Digital health: current applications, challenges, and future directions for enhancing healthcare quality and safety.

Frontiers in public health, 13:1646802.

Digital Health Technologies (DHTs) have become a cornerstone of modern healthcare, significantly improving quality and safety across clinical practice, public health, and medical research. Originating in the mid-to-late 20th century, DHTs have facilitated substantial progress in personalized medicine, predictive analytics, and remote patient monitoring through the implementation of artificial intelligence (AI), wearable devices, and telemedicine platforms. During the Coronavirus Disease 2019 (COVID-19) pandemic, these technologies proved indispensable for epidemic surveillance and precision containment, while also mitigating healthcare access disruptions. Nevertheless, critical challenges including the digital ethics and equity, technical and regulatory policy restrictions, privacy and data security concerns, and clinical workflow integration issues remain to be addressed. This narrative review explores the transformative role of DHTs throughout the disease management continuum-from prevention to prognosis-and evaluates their contributions to healthcare quality and safety. It also provides strategies for stakeholders to address existing barriers. By overcoming these challenges, DHTs can further elevate healthcare standards, fostering a safer and more efficient global healthcare system.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Hojecki CE, Tursi NJ, Livingston C, et al (2025)

Advances in molecular adjuvants for nucleic acid vaccines.

Frontiers in immunology, 16:1646800.

As nucleic acid vaccine technology continues to advance, modern adjuvants are being engineered to quantitatively and qualitatively shape immune responses. Since their development in the early 1990's, nucleic acid approaches have garnered significant attention, and numerous platform technologies have been developed both to improve delivery as well as immunogenicity. These advances were highlighted during the COVID-19 pandemic, with the approval of both mRNA-LNP and DNA vaccines for SARS-CoV-2. Early clinical trials with DNA antigens alone displayed suboptimal immunogenicity, supporting interest in adjuvant molecules. Molecular adjuvants, nucleic acid-encoded cytokines, chemokines, and enzymes, among others, are used to enhance and direct nucleic acid antigen-induced immunity in vivo. Additionally, mRNA-LNP vaccines, and more recently DNA-LNP vaccines, have demonstrated robust immunogenicity with intrinsic adjuvant activity based on the delivery mode. This review summarizes the molecular adjuvant landscape and highlights recent findings in the context of nucleic acid vaccines.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Pollmann NS, Dondorf F, Rauchfuß F, et al (2025)

Impact of recent COVID-19 infection on liver and kidney transplantation - a worldwide meta-analysis and systematic review.

Frontiers in immunology, 16:1626391.

INTRODUCTION: The shortage of suitable donor organs represents an ongoing global challenge for organ transplantation. During the COVID-19 pandemic, the number of transplantable organs was especially limited. To date, the impact of recent coronavirus-19 (COVID-19) infection on liver and kidney transplant recipients has not been systematically analyzed, which is essential for the development of future transplant management.

METHODS: We conducted a systematic review and meta-analysis to assess the clinical outcomes of recent COVID-19 infection in the donor (1) or the recipient (2). A total of 17 studies were considered for systematic review, seven of these were included for meta-analysis.

RESULTS: Transplantation of COVID-19 positive donors did not result in an impaired graft survival for liver or kidney transplantation up to 180-days of follow up. Additionally, a positive COVID-19 donor status was not associated with decreased overall survival in kidney transplant recipients within 180 days of transplantation. Nevertheless, an association was found with decreased overall survival in liver transplant recipients within the 180-day follow-up period.

DISCUSSION: However, the heterogeneity of studies investigating COVID-19 infection of the recipient did not allow a classification of the significance of COVID-19 positive recipients. Conclusively, a COVID-19 positive donor status should not be considered as an exclusive factor for declining a suitable liver or kidney for transplantation.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024562551.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Demaria F, Pontillo M, Bertoncini I, et al (2025)

Obsessive trajectories in children and adolescents exposed to adverse events (coronavirus disease 2019: global crisis teaches).

Frontiers in psychology, 16:1623629.

Adverse events (AEs), such as natural disasters, community violence and public health crises, impact global health and are associated with fear, anxiety and disorientation. AEs are related to both short-term and long-term mental health problems in children and adolescents. Particularly, research has shown a significantly higher prevalence of obsessive-compulsive disorder (OCD) in individuals with a history of trauma. This work aims to explore the obsessive-compulsive (OC) trajectories following an AE, considering the role played by individual vulnerability, anxiety and psychological consequences for children and adolescents. In this direction, Coronavirus Disease 2019 (COVID-19) pandemic has represented an ideal and unique AE of concomitant factors that can help to understand the obsessive trajectory. Our framework shows that intrusive flashbacks, following a traumatic experience, can turn into automatic intrusive thoughts that become persistent and emotionally intense, similar to obsessive reactions. Intrusive thoughts can evolve into obsessive patterns, leading to compulsive behaviors aimed at reducing discomfort. The nature of the traumatic event may influence the development of specific OC symptoms. Risk factors include individual vulnerability, such as developmental stage and emotional reactivity, which can exacerbate obsessive stress responses. Anxiety plays a key role, as increased stress can stimulate automatic intrusive thoughts and amplify OCD reactions, especially in younger individuals. Disruptions in daily life can further increase anxiety and maladaptive behaviors in children and adolescents, affecting psychological well-being. The psychological effects of AEs can continue well beyond the events themselves. It is necessary to monitor and support young people involved to prevent their development. Community and individual resources are essential to promote resilience following such events.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Nojomi M, Babaee E, Rampisheh Z, et al (2025)

AI-Powered Clinical Decision Support Systems in Disease Diagnosis, Treatment Planning, and Prognosis: A Systematic Review.

Medical journal of the Islamic Republic of Iran, 39:81.

BACKGROUND: Artificial intelligence (AI) is transforming healthcare with applications that can surpass human performance in prevention, detection, and treatment. This systematic review aimed to collect and assess the impact and success of AI technologies across various healthcare domains.

METHODS: A systematic search of major databases (including PubMed, Scopus, and ISI) was conducted for articles published up to 2023. Keywords related to AI-driven disease detection, classification, and prognosis were used. Non-English articles or those with inaccessible full texts were excluded. Data was extracted by two researchers, and the quality of selected articles was evaluated based on the strengths and limitations stated by the authors.

RESULTS: In total, 123 articles were included. AI contributions were categorized into three areas. For disease detection (n=75), Coronavirus disease 2019 (COVID-19) was the most frequent topic (n=18), followed by oncology. Chest X-rays were the most common input (n=15). In disease classification (n=23), oncology (especially breast cancer) was the most researched field (n=7), primarily using breast imaging. For prediction and prevention (n=25), oncology was again the most studied category, with clinical and laboratory parameters being the most utilized input (n=12).

CONCLUSION: AI-driven clinical decision support systems (CDSS) exhibit strong diagnostic and prognostic accuracy in imaging and laboratory settings. However, many models function as "black boxes," which limits interpretability and clinician trust. Data bias and challenges in integrating AI tools into practice also persist. The findings suggest that future work should focus on explainable AI and rigorous real-world validation to safely implement these tools in healthcare.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Albazee E, Alajmi SA, Alkandari AM, et al (2025)

Platelet-Rich Plasma for COVID-19-Related Olfactory Dysfunction: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Cureus, 17(10):e94386.

A notable rise in olfactory dysfunction (OD) prevalence has been observed since the COVID-19 pandemic. COVID-19-related OD is associated with several consequences, especially deteriorated quality of life. Hence, several treatment options have been investigated, with platelet-rich plasma (PRP) showing promising results. A systematic review and meta-analysis summarizing randomized controlled trial (RCT) evidence were retrieved from PubMed, Google Scholar, Scopus, and Web of Science up to June 2025. The risk of bias was assessed using the Cochrane Risk of Bias 2 assessment tool. Data were analyzed using Stata MP version 18 (StataCorp LLC, College Station, TX), pooling dichotomous outcomes as relative risks (RRs) and continuous outcomes as standardized mean differences (SMDs), each with 95% confidence intervals (CIs). Four RCTs, including 198 participants, were included in our meta-analysis. PRP significantly improved objective olfactory scores (SMD = 1.86, 95% CI (0.14, 3.57), p = 0.03) and subjective olfactory scores (SMD = 0.92, 95% CI (0.32, 1.51), p < 0.001). Additionally, PRP significantly increased the response rate (RR = 1.79, 95% CI (1.14, 2.81), p = 0.01). PRP was generally well-tolerated across the included trials, with no major adverse events reported. Two RCTs showed an overall low risk of bias, one trial showed some concerns, and another showed a high risk of bias. With uncertain evidence, PRP may improve both objective and subjective smell function and clinical outcomes in people with long COVID-related OD. PRP treatment was reported to be safe, with minor, temporary side effects primarily related to the procedure. Although initial results are promising, the small number of RCTs requires a cautious approach to interpretation.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Blitshteyn S, Funez-dePagnier G, Szombathy A, et al (2025)

Immunotherapies for postural orthostatic tachycardia syndrome, other common autonomic disorders, and Long COVID: current state and future direction.

Frontiers in cellular and infection microbiology, 15:1647203.

Postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope, and orthostatic hypotension are the most common autonomic disorders encountered in clinical practice. The autoimmune etiology and association of these conditions with systemic autoimmune and inflammatory disorders, autonomic neuropathy, and post-acute infectious syndromes, including Long COVID, suggest that immunotherapies should be considered as a therapeutic option, at least in a subset of patients. However, the treatment of common autonomic disorders has traditionally included pharmacologic and non-pharmacologic symptomatic therapies as the standard approach. Unfortunately, these symptomatic therapies have been of limited or insufficient efficacy to meaningfully improve functional status or result in recovery, especially in patients with severe symptoms. Case reports, case series, and clinical experience suggest that intravenous and subcutaneous immunoglobulin, as well as other immunologic therapies (such as plasmapheresis, corticosteroids, and rituximab), may be effective in some patients with severe POTS and other common autonomic disorders who are refractory to standard therapies. In this narrative review, we summarize the literature available on the topic of immunotherapies for POTS, other common autonomic disorders, and Long COVID. We also highlight the need for large, multicenter, placebo-controlled trials of immunoglobulin, plasmapheresis, intermittent corticosteroids, and other repurposed immunotherapies in patients with common autonomic disorders who have significant functional impairment.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Yang X, Lou Z, Wang X, et al (2025)

Resistance profile and influence factors of carbapenem-resistant Klebsiella pneumoniae (CRKP) causing infections in China: a systematic review and meta-analysis.

Annals of clinical microbiology and antimicrobials, 24(1):56.

The prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) infections has surged in China over the past decade, posing a significant public health concern. However, comprehensive data on CRKP antimicrobial resistance patterns and the impact of the COVID-19 pandemic on these patterns in China remain unclear. We conducted a systematic review of CRKP infections in China, utilizing data from PubMed spanning 2006 to July 2023. We focused on resistance rates of CRKP causing infections, examining variations across time, regions, and age groups, as well as factors contributing to antimicrobial resistance. Our analysis included 68 studies from 19 provinces in China, comprising 1,284 CRKP isolates obtained from 779 patients. The overall mortality rate for CRKP infections in China was 27% (95% CI: 0.14-0.41, I[2] = 73%, k = 47), with ST11 being the predominant sequence type (Pooled Rate: 80%, 95% CI: 0.67-0.90, I[2] = 86%, k = 31). Temporal and spatial analyses indicated increased resistance to ciprofloxacin (Random effects model: Qb = 9.88, df = 1, P < 0.010) and levofloxacin (Random effects model: Qb = 7.69, df = 1, P < 0.010) during the COVID-19 pandemic. Resistance to chloramphenicol (Random effects model: Qb = 4.97, df = 1, P = 0.030) and ceftazidime-avibactam (Random effects model: Qb = 8.58, df = 1, P < 0.010) was lower in southern regions, while tetracycline resistance (Random effects model: Qb = 9.69, df = 1, P < 0.010) was lower in the north. Higher resistance rates were observed in adults and the elderly. Age and geographic location were key factors associated with antimicrobial resistance. Fourteen out of thirty-five drugs showed a positive correlation with mortality rates, emphasizing their significant impact on CRKP infection mortality. This study underscores the need for targeted interventions to address regional and age-related variations in CRKP resistance and highlights the critical role of antimicrobial resistance in influencing mortality outcomes.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Ríos-Quituizaca P, Endara-Mina J, Ramos-Avasola S, et al (2025)

Ethnic inequalities and contraception in Latin America and the Caribbean: a scoping review.

International journal for equity in health, 24(1):272.

BACKGROUND: One of the Sustainable Development Goals (SDGs) is SDG 3.7. Ensuring universal access to sexual and reproductive health. The COVID-19 pandemic exacerbated pre-existing inequalities, disproportionately impacting ethnic groups in Latin America and the Caribbean (LAC). This review examines 23 years of evidence on contraceptive inequalities among these populations.

METHODS: A comprehensive literature review was conducted covering the period from 2000 to 2023 across seven databases. A combination of natural language and MESH/DECS terms was used, focusing on ethnicity and contraception in LAC countries. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR), 856 studies were identified. After title and abstract screening, 92 full texts were reviewed, and 33 studies were included that analyzed or compared contraceptive coverage based on ethnicity.

RESULTS: The countries with the highest output on this topic are Guatemala, Mexico, and Ecuador. More than half (22) relied on national representative surveys, with most focusing on women of reproductive age, while only five included adolescents. Eight studies analyzed Afro-descendant populations, and 27 studies included indigenous populations. Although some studies reported increases in contraceptive coverage over time, 85% identified lower usage rates or probabilities among ethnic minorities, with persistent gaps.

CONCLUSION: This review highlights contraceptive coverage gaps related to ethnicity in LAC, revealing enduring inequalities. As post-pandemic efforts aim to reduce disparities, countries with significant indigenous populations must prioritize evidence generation. Further research is needed in countries showing progress and among subgroups, such as adolescents or intra-country ethnic groups, to understand underlying causes and enhance contraceptive Access.

RevDate: 2025-10-15
CmpDate: 2025-10-15

Komura T, Watanabe M, K Shioda (2025)

Exploring the application of target trial emulation in vaccine evaluation: scoping review.

American journal of epidemiology, 194(10):3028-3040.

Target trial emulation (TTE) has gained popularity in evaluating treatments and health interventions. Its application to infectious disease outcomes requires careful consideration, as infectious disease transmission violates the assumption of no interference. Thus, we conducted a scoping review to understand how TTE approaches have been applied to vaccine evaluation. We searched literature published in PubMed, Embase, and Web of Science until May 2024, using keywords related to TTE, infectious diseases, and vaccines. Full-text articles meeting inclusion criteria were further assessed for eligibility. Our keyword-based search and citation search identified a total of 241 studies. Of these, 35 original research studies used TTE approaches to evaluate vaccines, predominantly published from 2022 to 2024. The majority (n = 32, 91%) evaluated the effect of COVID-19 vaccines, with 1 study each evaluating influenza, mpox, and rotavirus vaccines. Most studies did not define which of the 4 effects of vaccination they evaluated (direct, indirect, total, or overall effect), and none incorporated interference in vaccine evaluation. Our review highlights the increasing popularity of TTE in vaccine evaluation following the COVID-19 pandemic. Further discussions are needed to establish TTE approaches to estimating 4 effects of vaccination, using large, routinely collected data.

RevDate: 2025-10-14

Amelimojarad M, M Amelimojarad (2025)

The dual role of ACE2 in viral infections and neurodegeneration: mechanisms and therapeutic opportunities.

Journal of neurovirology [Epub ahead of print].

Angiotensin-converting enzyme 2 (ACE2), a key regulator of the renin-angiotensin system (RAS), maintains central nervous system (CNS) homeostasis by metabolizing neuroinflammatory peptides like angiotensin II (Ang II) and apelin-13, thereby exerting neuroprotective effects. Recent evidence underscores ACE2's paradoxical roles in neurodegeneration: its loss of function due to SARS-CoV-2 spike protein binding exacerbates neuroinflammation and cognitive decline, while its upregulation may mitigate AD pathology by reducing amyloid-β (Aβ) accumulation and tau hyperphosphorylation. The COVID-19 pandemic has further highlighted ACE2 axis dysregulation as a potential accelerator of AD progression, with studies reporting elevated biomarkers of neurodegeneration in post-COVID patients. Therefore, in this review, we highlight the emerging insights into ACE2's dual role in AD and other neurodegenerative diseases, emphasizing its interactions with microglial activation, blood-brain barrier integrity, and mitochondrial dysfunction. We also critically evaluate novel therapeutic strategies, including recombinant ACE2, ACE2-derived peptides, and gene therapy approaches designed to restore RAS balance without compromising viral defense mechanisms. By integrating mechanistic and clinical insights, this work highlights ACE2 as a promising target for neurodegenerative disease interventions.

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In the early 1990's, Robert Robbins was a faculty member at Johns Hopkins, where he directed the informatics core of GDB — the human gene-mapping database of the international human genome project. To share papers with colleagues around the world, he set up a small paper-sharing section on his personal web page. This small project evolved into The Electronic Scholarly Publishing Project.

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In 1995, Robbins became the VP/IT of the Fred Hutchinson Cancer Research Center in Seattle, WA. Soon after arriving in Seattle, Robbins secured funding, through the ELSI component of the US Human Genome Project, to create the original ESP.ORG web site, with the formal goal of providing free, world-wide access to the literature of classical genetics.

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In reading the early works of classical genetics, one is drawn, almost inexorably, into ever more complex models, until molecular explanations begin to seem both necessary and natural. At that point, the tools for understanding genome research are at hand. Assisting readers reach this point was the original goal of The Electronic Scholarly Publishing Project.

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Usage of the site grew rapidly and has remained high. Faculty began to use the site for their assigned readings. Other on-line publishers, ranging from The New York Times to Nature referenced ESP materials in their own publications. Nobel laureates (e.g., Joshua Lederberg) regularly used the site and even wrote to suggest changes and improvements.

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With the development of methods for adding typeset side notes to PDF files, the ESP project now plans to add annotated versions of some classical papers to its holdings. We also plan to add new reference and pedagogical material. We have already started providing regularly updated, comprehensive bibliographies to the ESP.ORG site.

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With the world now in the middle of a new and rapidly spreading pandemic, now is the time to read this book, originally published in 2012, that describes animal infections and the next human pandemic (that's actually the book's subtitle). You would be hard pressed to find a more relevant explanation of how this got started and why there will be more after this one. R. Robbins

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The ESP began as an effort to share a handful of key papers from the early days of classical genetics. Now the collection has grown to include hundreds of papers, in full-text format.

Digital Books

Along with papers on classical genetics, ESP offers a collection of full-text digital books, including many works by Darwin and even a collection of poetry — Chicago Poems by Carl Sandburg.

Timelines

ESP now offers a large collection of user-selected side-by-side timelines (e.g., all science vs. all other categories, or arts and culture vs. world history), designed to provide a comparative context for appreciating world events.

Biographies

Biographical information about many key scientists (e.g., Walter Sutton).

Selected Bibliographies

Bibliographies on several topics of potential interest to the ESP community are automatically maintained and generated on the ESP site.

ESP Picks from Around the Web (updated 28 JUL 2024 )