{ "condition": "Long COVID – Post-Acute Sequelae of COVID-19", "key": "long-covid", "last_updated": "2026-07-07T07:53:30.036520Z", "count": 75, "source": "PubMed (NCBI)", "studies": [ { "pmid": "42409655", "title": "Post-acute sequelae of COVID in children: Pulmonary assessment using impulse oscillometry and the effect of vaccination.", "pub_date": "2026-07-07", "journal": "Pediatrics and neonatology", "authors": "Chen, Chieh-Ho, Chen, Pei-Chi, Liu, Xiao-Ling, Wei, Chi-Hung et al.", "abstract": "Post-acute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID syndrome (LCS), is characterized by persistent symptoms following SARS-CoV-2 infection and poses significant health challenges, particularly impacting pulmonary function in children. This study aims to evaluate the effect of COVID-19 vaccination on pulmonary function in children with PASC using standardized spirometry and impulse oscillometry (IOS). This prospective, observational study was conducted from July to September 2022, at the tertiary medical center of a children's hospital in Taiwan. Pediatric patients aged 6 to 18 years diagnosed with PASC were enrolled. Demographic data, vaccination status, and blood test results were collected. Pulmonary function was assessed using spirometry and IOS, measuring parameters such as respiratory resistance (R5, R20) and reactance (X5). Statistical analyses explored the association between IOS results and clinical symptoms, as well as vaccination status. Among 209 children, 78.7% were vaccinated. IOS detected abnormalities in 74.6%, with 12.0% diagnosed with obstructive lung disease (OLD) and 62.9% with small airway disease (SAD). Fatigue (56.0%) and dyspnea (52.0%) were most common in OLD, while chest pain (45.0%) and cough (41.7%) prevailed in SAD. Vaccinated children showed significantly lower respiratory resistance (R5, R20, p < 0.01) and improved reactance (X5, p < 0.001). Vaccination did not significantly reduce respiratory-related symptoms but it was associated with lower risks of decreased appetite (OR = 0.399) and sleep disturbance (OR = 0.345). COVID-19 vaccination may have a protective effect on pulmonary function in children with PASC, highlighting its mitigation of long-term respiratory complications. Further studies are needed to explore underlying mechanisms.", "url": "https://pubmed.ncbi.nlm.nih.gov/42409655/" }, { "pmid": "42409265", "title": "Macrophage-specific targeting of histone demethylases with small-molecule inhibitors suppresses inflammatory response in vivo.", "pub_date": "2026-07-07", "journal": "The Journal of biological chemistry", "authors": "Natarajan, Niranjana, Ahmed, Thaybah, Govindaswamy, Balaji, Manickam, Devika S et al.", "abstract": "Macrophages are versatile immune cells, with the ability to respond to varied intrinsic and extrinsic cues, and transition between inflammatory and pro-reparative phenotypes. A complex network of epigenetic processes, such as DNA methylation, and histone methylation and acetylation, plays key roles in modulating macrophage polarization and inflammatory gene expression. Transcriptional analysis in patients with respiratory failure, long COVID-19, and influenza revealed an augmented expression of chromatin-modifiers including histone demethylases, broadly defined as lysine demethylases (KDMs), in lung macrophages. Therefore, macrophage-specific pharmacological perturbation of these enzymes in vivo holds therapeutic promise in abating inflammation. To investigate the role of KDMs in inflammation, we screened a panel of small-molecule inhibitors of chromatin modifiers for their efficacy in inducing anti-inflammatory macrophage polarization in vitro. We demonstrate that pretreatment with the broad spectrum KDM inhibitor n-octyl-IOX1 and KDM5-specific inhibitor PB-IT resulted in a significant decrease of lipopolysaccharide (LPS)-induced expression of the inflammatory genes Il1b, Il6, Tnfa, and iNos in bone marrow-derived macrophages (BMDM). Subsequent RNA sequencing and CUT&RUN analyses revealed that LPS activation led to distinct transcriptomic and epigenomic alterations including expression of master transcription factors (TFs) BLIMP-1 and GFI1 whereas n-octyl-IOX1 and PB-IT treatments rewired these regulatory networks, thereby impeding inflammatory gene expression and response. To further probe the merit of KDM inhibition in perturbing macrophage-mediated inflammation in vivo, we delivered n-octyl-IOX1 selectively to macrophages in mice using cell-specific, targeted lipidoid nanoparticles. n-octyl-IOX1 encapsulated nanoparticles significantly diminished LPS-mediated peritoneal macrophage expansion and inflammatory gene expression in this cell population, underscoring the importance of macrophage-specific targeting of KDMs with small-molecule inhibitors in inflammatory disease.", "url": "https://pubmed.ncbi.nlm.nih.gov/42409265/" }, { "pmid": "42409185", "title": "Temelimab versus placebo in patients with post-COVID condition.", "pub_date": "2026-07-07", "journal": "Brain, behavior, and immunity", "authors": "Nehme, Mayssam, Hund-Georgiadis, Margret, Corral Beamonte, Esther Del, Bridevaux, Pierre-Olivier et al.", "abstract": "More than 400 million individuals are estimated to have been affected by post-COVID condition or long COVID. This condition can lead to significantly decreased quality of life and increased individual and societal costs. Temelimab, a monoclonal IgG4 backbone antibody targeting HERV-W ENV, may be a potential treatment for post-COVID. In this randomized, double-blind trial, which consisted of a 24-week treatment period, we enrolled adults who had fatigue and persistent symptoms due to post-COVID and were positive for HERV-W-ENV. Participants were randomized (1:1) to receive 54 mg/kg Temelimab or placebo IV once monthly. The primary endpoint was the decline in fatigue (defined as a 3-point decrease on the PROMIS Fatigue SF 7a scale) from baseline to Week 24. Secondary endpoints included changes in cognition, anxiety, depression, functional impairment, quality of life, safety and tolerability of Temelimab. A total of 203 individuals participated in this study, 72% women, mean age 46 (standard deviation, SD 10) years. The mean initial PROMIS Fatigue SF 7a score was 26.8 (SD 3.4) in the Temelimab group and 27.1 (SD 3.8) in the placebo group. At 24 weeks, there was no difference between Temelimab (3.2 points decrease in the PROMIS score) and placebo (3.8 points decrease). Secondary outcomes also did not show differences between the Temelimab and placebo groups. In adults with persistent symptoms due to post-COVID condition, the use of Temelimab did not show improvement in fatigue compared to placebo (Funded by GeNeuro SA; ClinicalTrials.gov number NCT05497089). National authorities for clinical trials on medicinal products and ethical approval was obtained in all participating countries in Europe. Trial registration numbers ClinicalTrials.gov number (NCT05497089), EudraCT (2022-000618-32). Protocol version v5.0, date 23 February 2024; CCER Geneva IRB: 2022-00658.", "url": "https://pubmed.ncbi.nlm.nih.gov/42409185/" }, { "pmid": "42407187", "title": "Jianpi Huayu decoction alleviates hepatic fibrosis involving coordinated modulation of PPARα-mediated lipid metabolic reprogramming and the ROCK pathway.", "pub_date": "2026-07-06", "journal": "Phytomedicine : international journal of phytotherapy and phytopharmacology", "authors": "Luo, Rui, Lai, Yongheng, Zhang, Sijia, Yao, Ruiwei et al.", "abstract": "Hepatic fibrosis is a critical stage in the progression from chronic liver injury to hepatocellular carcinoma (HCC), yet effective therapeutic options remain limited. Jianpi Huayu Decoction (JPHY) has been used clinically in patients with HCC accompanied by hepatic fibrosis, but its anti-fibrotic mechanisms remain unclear. This study evaluated the anti-fibrotic effects of JPHY and explored potential links between metabolic regulation and tissue mechanics. A carbon tetrachloride (CCl₄)-induced mouse model of hepatic fibrosis and TGF-β-activated hepatic stellate cells were used to assess the anti-fibrotic effects of JPHY. Interventions included JPHY, the PPARα agonist fenofibrate, and their combination. Multi-scale analyses were performed, including transcriptomic profiling, atomic force microscopy for local tissue stiffness measurement, molecular and cellular assays, and molecular docking and dynamics simulations. Clinical relevance was evaluated using human liver tissues. An orthotopic HCC model established in a fibrotic background was used to evaluate the association between JPHY treatment and tumor progression. JPHY attenuated CCl JPHY alleviates hepatic fibrosis through coordinated modulation of PPARα-mediated metabolic remodeling and ROCK-dependent mechanical signaling, thereby reducing liver stiffness and extracellular matrix accumulation, with potential implications for mitigating fibrosis-associated HCC progression.", "url": "https://pubmed.ncbi.nlm.nih.gov/42407187/" }, { "pmid": "42406565", "title": "Evaluation of nirmatrelvir/ritonavir treatment for COVID-19 on health-related outcomes: a global economic value systematic literature review.", "pub_date": "2026-07-06", "journal": "Journal of medical economics", "authors": "Mugwagwa, Tendai, Marcano Belisario, José, Hartley, Louise, Phan, Nguyen Thi Nhan et al.", "abstract": "Nirmatrelvir/ritonavir (NMV/r) A systematic search of Embase, PubMed, Cochrane, and EconLit and of conference and health technology assessment agency websites was performed to identify economic analyses published between January 2022 and October 2025. Of the 33 included economic evaluations, most were cost-utility analyses ( Most studies were conducted in high-income countries, were based on different COVID-19 variants, and were limited in data on the long COVID population. In addition to monetary benefits, NMV/r provides short-term and long-term health-related benefits to patients with mild to moderate COVID-19. This study provides further support for NMV/r as a cost-effective treatment option.", "url": "https://pubmed.ncbi.nlm.nih.gov/42406565/" }, { "pmid": "42406399", "title": "Postacute COVID-19 Symptoms and Health Care Utilization and Spending Among Traditional Medicare Beneficiaries.", "pub_date": "2026-07-06", "journal": "JAMA network open", "authors": "Ghosh, Kaushik, Zuckerman, Rachael, Feyman, Yevgeniy, Orav, E John et al.", "abstract": "Postacute sequelae of SARS-CoV-2 infection include fatigue, respiratory symptoms, and cognitive dysfunction. However, the extent to which these symptoms contribute to increased health care utilization and spending among Medicare beneficiaries remains unclear. To quantify differences in postacute symptoms and health care utilization and spending between traditional Medicare beneficiaries with COVID-19 and matched control beneficiaries without COVID-19. This cohort study used traditional Medicare claims from February 2020 through November 2022. Beneficiaries with a documented COVID-19 diagnosis were matched 1:5 to beneficiaries without COVID-19 based on demographic and clinical characteristics. Four variant-defined cohorts (original strain and Alpha, Delta, and Omicron variants) were analyzed. Follow-up extended through 40 weeks after diagnosis. Data were analyzed from February 2020 to November 2022. Diagnosis of 21 postacute COVID-19 symptoms, all-cause health care utilization, and Medicare spending were compared between those with COVID-19 and matched control beneficiaries using logistic and linear regression models adjusted for demographic and clinical covariates. The cohort study included 937 077 Medicare beneficiaries with COVID-19 and 4 808 573 matched control beneficiaries without COVID-19 (3 109 789 females [54.1%]), with most beneficiaries (4 880 497 [84.9%]) aged 65 years or older. During the acute phase of infection (diagnosis week), beneficiaries with COVID-19 were 41.71 (95% CI, 41.62-41.91) percentage points more likely to receive at least 1 postacute symptom diagnosis than control beneficiaries. This difference declined to 5.22 (95% CI, 5.11-5.32) percentage points during weeks 1 to 12 and to 1.94 (95% CI, 1.81-2.05) percentage points during weeks 13 to 40. Medicare spending was $7933.13 higher (95% CI, $7904.12-$7962.14) in the acute phase, decreasing to $232.31 (95% CI, $230.11-$234.14) per week in weeks 1 to 12 and to $28.21 (95% CI, $27.11-$30.13) per week in weeks 13 to 40. Differences in health care utilization followed a similar pattern, decreasing to 0.05 (95% CI, 0.05-0.06) visits per week in weeks 1 to 12 and to 0.03 (95% CI, 0.02-0.03) visits per week in weeks 13 to 40. In this cohort study of traditional Medicare beneficiaries across major COVID-19 variants, postacute symptom diagnoses and health care utilization and spending were substantially higher in the acute phase of COVID-19 but diminished over time, approaching levels observed in matched control beneficiaries without COVID-19 by 3 months after infection. These findings suggest limited long-term excess health care utilization or spending attributable to COVID-19 infection among older adults.", "url": "https://pubmed.ncbi.nlm.nih.gov/42406399/" }, { "pmid": "42404887", "title": "Mechanisms and impact of long COVID: pathophysiology, neuropsychiatric effects and vaccination.", "pub_date": "2026-07-06", "journal": "Frontiers in immunology", "authors": "Ponnachan, Pretty, Dhawlarker, Anam, Yasmin, Hadida, Shah, Akash et al.", "abstract": "Long COVID or post-acute sequelae of COVID-19 is defined as an after-effect of acute COVID-19 infection. Its broad clinical symptoms include brain fog, shortness of breath, fatigue, joint, chest, or muscle pain, dysautonomia and neuropsychiatric symptoms such as anxiety, depression and post-traumatic stress disorder. It is estimated that 1 in every 5 COVID-19 survivors exhibit symptoms within the Long COVID bracket. An array of risk factors such as smoking habit, age, obesity, female sex, and prior hospitalization may increase the probability of a person developing Long COVID. While the underlying mechanisms of Long COVID remain elusive, we examine the various possible pathophysiologies involved in Long COVID. We take up impactful neuropsychiatric issues as another spectrum of Long COVID symptoms and the likely effect of various forms of COVID-19 vaccines. In this review, the focus will be on the main mechanisms associated with the development of long COVID, which include latent Epstein-Barr virus reactivation, molecular mimicry, virus persistence, autoantibodies, and mitochondrial dysfunction. Understanding these mechanisms shed light on the continued persistence of COVID-19 related symptoms long after the resolution of acute infection. For instance, the reactivation of Epstein-Barr virus in the immunocompromised context seen post-acute SARS-CoV-2 infection could lead to the symptoms commonly observed in Long COVID such as fatigue and brain fog. The Epstein-Barr virus could possibly disrupt mitochondrial function, explaining the fatigue commonly observed in Long COVID patients. Other factors such as continued presence of viral particles in specific areas such as the gut may result in continued inflammation, leading to manifestations such as fatigue, cognitive impairment and gastrointestinal dysfunction. Additionally, heightened and persistent presence of autoantibodies post-acute infection results in persistent symptoms and could potentially trigger the onset of autoimmune disorders. We also aim to revisit the diverse and prolonged effects of the COVID-19 pandemic that continue to affect the well-being and quality of human life.", "url": "https://pubmed.ncbi.nlm.nih.gov/42404887/" }, { "pmid": "42403377", "title": "Post-COVID paediatric dysautonomia: never the heart, always the brain-myth or maxim?", "pub_date": "2026-07-06", "journal": "Cardiology in the young", "authors": "Das, Bibhuti, Moodley, Manikum", "abstract": "Paediatric dysautonomia has become increasingly recognised in children and adolescents, particularly in the post-COVID era. Affected patients commonly present with dizziness, palpitations, exercise intolerance, fatigue, and syncope, although reported prevalence varies widely because of evolving definitions and heterogeneous referral patterns. Contemporary evidence suggests that post-COVID dysautonomia arises from complex interactions among central autonomic network dysfunction, neurovascular dysregulation, impaired venous return, endothelial injury, hypovolemia, and altered cerebral perfusion, with tachycardia often representing a compensatory physiological response rather than a primary cardiac abnormality. Clinical phenotypes include postural orthostatic tachycardia syndrome, neurocardiogenic syncope, orthostatic hypotension, inappropriate sinus tachycardia, and undifferentiated orthostatic intolerance, frequently accompanied by fatigue, cognitive dysfunction, gastrointestinal symptoms, sleep disturbances, and post-exertional symptom exacerbation. Paediatric dysautonomia is best conceptualised as a distributed brain-heart-vascular network disorder that requires mechanistic understanding, standardised orthostatic assessment, and careful exclusion of structural heart disease and arrhythmia. The rapid expansion of specialised dysautonomia programmes and direct-to-consumer diagnostic pathways has also contributed to broader, and occasionally premature, application of autonomic diagnoses. Management should follow a stepwise, mechanism-guided approach emphasising patient education, trigger avoidance, hydration and salt optimisation, lower-body compression, individualised exercise rehabilitation, pacing strategies when post-exertional symptom exacerbation is present, school accommodations, and phenotype-directed pharmacotherapy for persistent functional impairment. Although post-COVID dysautonomia shares features with established paediatric autonomic disorders, important gaps remain in disease definitions, mechanistic understanding, and evidence-based treatment, underscoring the need for multidisciplinary care, standardised diagnostic frameworks, and prospective paediatric research.", "url": "https://pubmed.ncbi.nlm.nih.gov/42403377/" }, { "pmid": "42403350", "title": "Regional Disparities in Functional and Socioeconomic Impacts of Long COVID in Brazil: A Cross-Sectional Observational Study.", "pub_date": "2026-07-06", "journal": "Physiotherapy research international : the journal for researchers and clinicians in physical therapy", "authors": "Dos Santos, Ana Cleides Pereira, Goulart, Cássia da Luz, Neves, Victor Ribeiro, Milani, Mauricio et al.", "abstract": "In low- and middle-income countries such as Brazil, regional inequalities in healthcare access and socioeconomic conditions may exacerbate the functional and occupational consequences of Long COVID. This study explored between-center differences in functional and socioeconomic outcomes among individuals with Long COVID from three Brazilian centers in Brazil, while examining how these findings may have been influenced by acute disease severity, symptom burden, and contextual factors. This was a cross-sectional study conducted with individuals diagnosed with Long COVID from three Brazilian regions (Federal District, Goiás, and Sergipe). Functional limitations were assessed through the 6-Minute Step Test (6MST) and muscle strength via Handgrip Strength (HGS). Additionally, cardiorespiratory responses and work productivity impairments were evaluated. A total of 142 participants were included: 47 from the Federal District, 59 from Goiás, and 36 from Sergipe. Most participants were classified as non-critical (n = 129), while 13 were classified as critical, all from the Federal District. Significant differences in 6MST performance were observed across regions (p < 0.005). Critical patients exhibited lower SpO Long COVID was associated with heterogeneous functional and socioeconomic impairments across the evaluated centers; however, these findings should be interpreted cautiously, as regional comparisons were substantially confounded by the unequal distribution of acute disease severity.", "url": "https://pubmed.ncbi.nlm.nih.gov/42403350/" }, { "pmid": "42402260", "title": "Time to Recovery from Long COVID: A Longitudinal Analysis of Symptom Duration and Risk Factors Using Accelerated Failure Time Models.", "pub_date": "2026-07-06", "journal": "International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases", "authors": "Jo, Youngji, Hu, Zeyu, Joo, Hyejin, Jung, Jaehun et al.", "abstract": "Long COVID comprises heterogeneous symptoms that may persist for months to years after acute SARS-CoV-2 infection. While prevalence is well described, less is known about symptom duration and determinants of recovery. We conducted a multicenter longitudinal cohort study across 12 institutions in Korea (December 2022-March 2025), enrolling adults with confirmed infection and uninfected controls. Participants were followed for up to 22 months with repeated assessments of symptoms, vaccination, and comorbidities. Eight common symptoms were analyzed. Time to resolution was estimated using Kaplan-Meier methods and log-normal accelerated failure time models, adjusting for demographic and clinical factors. Results are reported as time ratios (TRs). Among 757 infected participants and 558 controls, respiratory and physical symptoms resolved similarly between groups, whereas systemic and neurological symptoms persisted longer in infected individuals. At one year, 20-25% reported fatigue and 15-20% sleep disturbance versus ∼10% and ∼5% in controls. Infection was associated with ∼50% longer duration of fatigue and sleep disturbance. Individuals aged 40-59 recovered more slowly; other factors showed minimal associations. Persistent long COVID burden is driven by systemic neuro-related symptoms, highlighting the need for targeted, symptom-specific management strategies.", "url": "https://pubmed.ncbi.nlm.nih.gov/42402260/" }, { "pmid": "42402207", "title": "Association Between Air Pollution and Post Acute Sequelae of SARS-CoV-2 (PASC).", "pub_date": "2026-07-05", "journal": "American journal of respiratory and critical care medicine", "authors": "Jerrett, Michael, Nau, Claudia L, Young, Deborah R, Butler, Rebecca K et al.", "abstract": "No abstract available.", "url": "https://pubmed.ncbi.nlm.nih.gov/42402207/" }, { "pmid": "42402140", "title": "[Long-COVID syndrome and lung-specific abnormalities following COVID-19].", "pub_date": "2026-07-05", "journal": "Orvosi hetilap", "authors": "Fésü, Dorottya, Horváth, Gábor, Müller, Veronika", "abstract": "Following the acute phase of a SARS-CoV-2 infection, post-COVID - or long-COVID - syndrome may develop. This condition is characterized by unpleasant, persistent or new-onset symptoms following the acute phase of the infection. It might lead to an impaired health-related quality of life of affected patients and may involve multiple organ systems. It often poses diagnostic and therapeutic challenges for the healthcare system, and its exact course and outcomes are not yet fully understood. A multidisciplinary approach is required for diagnosis, including imaging studies (e.g., chest CT), tests to assess functional status (e.g., 6-minute walk test, pulmonary function tests, cardiopulmonary exercise testing) and the evaluation of parameters reported by patients subjectively (e.g., symptom burden, health-related quality of life). As part of long-COVID, lung parenchymal changes or abnormalities resulting from the viral infection can be detected on imaging studies in some cases, referred as post-COVID pulmonary fibrosis. Currently, therapeutic options are limited and largely based on symptomatic or organ-specific approaches. However, antiviral treatments used in the acute phase, such as remdesivir or nirmatrelvir/ritonavir, may be potentially beneficial regarding the development of late complications. Prevention, particularly COVID-19 vaccination, plays a key role, as it has been shown to reduce the risk of severe acute disease and the later probability of long-COVID syndrome. Further long-term patient follow-up is necessary to better understand the pathomechanisms underlying long-term effects of the virus, such as long-COVID and post-COVID pulmonary fibrosis. This article aims to present an up-to-date, comprehensive review of long-COVID syndrome and post-COVID pulmonary fibrosis. Orv Hetil. 2026; 167(27): 1051-1058. Az akut COVID–19 lezajlását követően post-COVID-, avagy long-COVID-szindróma léphet fel, mely a fertőzés akut időszaka után is fennálló kellemetlen perzisztáló vagy új keletű tünetekkel jellemezhető, az érintett betegek életminőségét ronthatja, és egynél több szervrendszert is érinthet. Az állapot sokszor diagnosztikus és főként terápiás kihívást jelenthet az ellátórendszernek, pontos lefolyása és kimenetelei egyelőre nem ismertek teljes mértékben. A diagnosztikus megközelítés multidiszciplináris szemléletet igényel, amelyben kiemelt szerepet kapnak a képalkotó vizsgálatok (például mellkasi CT), a funkcionális állapotot felmérő vizsgálatok (6 perces járásteszt, légzésfunkció, cardiopulmonalis terheléses teszt), valamint a betegek által szubjektíven jelzett paraméterek (tüneti profil, életminőség) felmérése is. A long-COVID-állapot részeként bizonyos esetekben a vírusinfekció következményeként a tüdőparenchyma kiterjedt károsodása detektálható képalkotó felvételeken, melyet a szakirodalom post-COVID-tüdőfibrosisként említ. A terápiás lehetőségek jelenleg korlátozottak, és nagyrészt tüneti, illetve szervspecifikus megközelítésen alapulnak, ugyanakkor az akut fázisban alkalmazott antivirális kezelések, mint a remdesivir vagy a nirmatrelvir/ritonavir, potenciálisan befolyásolhatják a késői szövődmények kialakulását. A megelőzés kulcsszerepet játszik, különös tekintettel a vakcinációra, amely bizonyítottan csökkenti a súlyos betegség és feltehetően a long-COVID kialakulásának kockázatát is. A long-COVID-szindróma és a post-COVID-tüdőfibrosis patomechanizmusának pontosabb megértéséhez további hosszú távú betegkövetés lehet szükséges. A jelen közlemény célja a long-COVID-szindróma és a post-COVID-tüdőfibrosis bemutatása egy naprakész, átfogó összefoglaló formájában. Orv Hetil. 2026; 167(27): 1051–158.", "url": "https://pubmed.ncbi.nlm.nih.gov/42402140/" }, { "pmid": "42402067", "title": "Long COVID: Lived Experiences, Diagnosis, Treatment and Care.", "pub_date": "2026-07-05", "journal": "Health expectations : an international journal of public participation in health care and health policy", "authors": "Mullard, Jordan", "abstract": "No abstract available.", "url": "https://pubmed.ncbi.nlm.nih.gov/42402067/" }, { "pmid": "42401313", "title": "Chronic stress primes TLR3-mediated systemic inflammation to produce persistent post-viral fatigue syndrome-like symptoms in mice.", "pub_date": "2026-07-05", "journal": "Neuroscience", "authors": "Lkhagvasuren, Battuvshin, Suematsu, Takafumi, Xiangyu, Liu, Hata, Tomokazu et al.", "abstract": "This study examined the long-term effects of polyinosinic:polycytidylic acid (poly I:C), a synthetic double-stranded RNA and Toll-like receptor 3 (TLR3) agonist, on behavioral and immune outcomes in chronically stressed mice. Male C57BL/6J mice were exposed to 21 days of wet bedding stress followed by a poly I:C injection. Post viral fatigue syndrome (PVFS)-like symptoms were evaluated over 7 days post-injection using grip strength testing, the forced swim test, von Frey filament testing, the Morris water maze, the open field test, and the social interaction test. Body temperature and locomotor activity were continuously monitored via intraperitoneally implanted dataloggers. Serum concentrations of interleukin-6 (IL-6), IL-10, and C-X-C motif chemokine ligand 10 (CXCL10) were quantified. In separate cohorts, minocycline (a microglial activation inhibitor) or RU486 (a glucocorticoid receptor antagonist) was administered prior to poly I:C injection. Following IP injection of poly I:C, body temperatures in both stressed and unstressed mice were significantly elevated, indicating a polyphasic febrile response. At 7 days post-injection, stressed mice treated with poly I:C exhibited persistent fatigue, mechanical allodynia, depressive-like behavior, impaired spatial memory, increased anxiety-like behavior, and reduced social interaction. Serum levels of IL-6 and CXCL10 remained elevated and correlated with behavioral outcomes. Pretreatment with minocycline partially attenuated both the behavioral and immune responses, whereas RU486 pretreatment did not. These findings demonstrate that TLR3-mediated systemic inflammation induced by poly I:C produces persistent, multi-domain PVFS-like symptoms in chronically stressed mice. The attenuation by minocycline implicates neuroinflammation as a possible mechanism.", "url": "https://pubmed.ncbi.nlm.nih.gov/42401313/" }, { "pmid": "42400138", "title": "Coronary artery dilatation in neonates: A novel case series.", "pub_date": "2026-07-04", "journal": "Journal of neonatal-perinatal medicine", "authors": "Bhat, Irfan Bashir, Rahul, Aswathy, Kn, Harikrishnan, Charulatha, Binsi et al.", "abstract": "BackgroundCoronary artery dilatation (CAD) in neonates is an uncommon but clinically important finding on echocardiography. Reported associations include multisystem inflammatory syndrome in the newborn (MIS-N) following COVID-19 infection, congenital cardiac malformations, and perinatal inflammatory states. In the post-COVID era, CAD has been reported more frequently.MethodsThis retrospective, record-based case series conducted at a Government Medical College in South India describes the clinical profile of neonates with CAD who were admitted between January 2023 and December 2024.ResultsA total of 24 neonates with CAD were identified during the study period. They were admitted in NICU for different conditions like respiratory distress syndrome, congenital pneumonia, sepsis, or perinatal asphyxia. The mean (SD) gestational age was 35.5 (2.2) weeks, and the mean birth weight was 2557 (646) g. Respiratory distress was the most common presenting feature (95.8%) followed by shock (75%). CAD was detected incidentally during echocardiography which was performed to evaluate persistent pulmonary hypertension of the newborn (PPHN), assess ventricular dysfunction during shock, and exclude congenital heart disease, particularly in those with an unexpected clinical course. One-third of the neonates (", "url": "https://pubmed.ncbi.nlm.nih.gov/42400138/" }, { "pmid": "42399853", "title": "Perceptions, acceptability and experiences of yoga to support long-COVID: a survey of people living with long-COVID.", "pub_date": "2026-07-04", "journal": "BMC complementary medicine and therapies", "authors": "Cheshire, Anna, Cartwright, Tina", "abstract": "The impact of long-COVID can be substantial for individuals, health systems and the economy, nevertheless, treatment and support options are limited. Yoga offers a potential solution to reduce the burden of long-COVID, demonstrating positive impacts on the biological mechanisms implicated in long-COVID, key long-COVID symptoms and associated mental health challenges. Yoga interventions can also be designed for people with limited physical ability, and online delivery can increase accessibility. To understand the perceptions and experiences of yoga among people with long-COVID (PWLC), and assess its potential benefits. An online survey of PWLC, comprised closed and open response questions on: long-COVID symptoms, support needs, perceptions of a yoga intervention and its components and yoga use. Participants (n = 171) were recruited via Prolific. Inclusion criteria were long-COVID (formal diagnosis or self-reported) and living in the UK. Inductive thematic analysis was used for open ended responses. Analysis identified unmet needs among PWLC that align with the potential benefits of a yoga intervention, particularly in supporting symptom management, self-management and associated psychological symptoms. Additionally, a yoga intervention could provide acknowledgment and support to PWLC who feel despondent about their condition and abandoned by health professionals. Participants reported a high level of interest in a yoga intervention, perceiving it could be of benefit. Barriers to yoga practise included anxiety regarding the group setting, fitting sessions into schedules, lack of energy and concerns about suitability for long-COVID. Those already practising yoga with long-COVID reported that yoga helped to manage symptoms and associated psychological challenges, as well as increasing flexibility and providing a safer alternative to exercise. Many PWLC have positive perceptions of yoga and there is a good level of interest in a yoga intervention among this population. These findings suggest that yoga is a suitable intervention for study in future research as well as delivery in the community by qualified yoga instructors with a knowledge of long-COVID - provided that any intervention is appropriately tailored to fit the ability and address the concerns of PWLC. It should be offered in the context of health professional validation of symptoms.", "url": "https://pubmed.ncbi.nlm.nih.gov/42399853/" }, { "pmid": "42399828", "title": "Understanding heterogeneity in paediatric long COVID research: an overview of reviews and recommendations for future pandemics.", "pub_date": "2026-07-04", "journal": "BMC pediatrics", "authors": "Appel, Simone, Coughtrey, Anna E, Kyrdalen, Anika, Takeda, Andrea et al.", "abstract": "Studies of Long COVID or Post-COVID-19 condition in children and young people have varied considerably in their reported prevalences. We aimed to examine the methodological heterogeneity underlying this variability and explore whether methodological characteristics were correlated with reported Long COVID outcome prevalence, in order to inform recommendations to improve reporting in future pandemic-related epidemiological research. We conducted an overview of reviews with a narrative synthesis, identifying systematic reviews and meta-analyses and extracting their included primary studies. We identified reviews of Long COVID in children & young people in PubMed and Embase using a systematic search strategy. We extracted key methodological details including study design, sample size, sample and control group characteristics, data collection and reporting methods, as well as time-point(s) of surveying and frequency of follow-up. We explored correlations between these factors and prevalence of Long COVID via Spearman's rank correlation coefficients or the Kruskal-Wallis test. 69 studies, from identified reviews, met the inclusion criteria with outcome symptom prevalence varying between 0 and 90% at > 3-months post-COVID-19 infection. Only 19% of studies used an established Long COVID definition to guide analyses. There was substantial heterogeneity in the design and outcome reporting of Long COVID studies. We did not find Long COVID prevalence varied by examined methodological factors (p ≥ 0.08 for all correlations). While substantial methodological heterogeneity was observed across studies of paediatric Long COVID, no statistically significant correlations were identified between examined methodological factors and reported prevalence. Such variability limits comparability across studies and highlights the need for more standardised definitions, outcome measures, and reporting approaches in future pandemic-related epidemiological research: we discuss reporting guidelines and recommendations for future paediatric epidemiological research during a pandemic.", "url": "https://pubmed.ncbi.nlm.nih.gov/42399828/" }, { "pmid": "42399727", "title": "Association between light exposure patterns and multidimensional health outcomes in individuals with myalgic encephalomyelitis/chronic fatigue syndrome: findings from an observational cross-sectional cohort study.", "pub_date": "2026-07-04", "journal": "Journal of translational medicine", "authors": "Cambras, Trinitat, Domingo, Joan Carles, Sanmartín-Sentañes, Ramon, Alegre-Martín, José et al.", "abstract": "Light is a major environmental factor regulating circadian rhythms, sleep- wake cycles, and mood-related behaviors. Patients with Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) often experience circadian disruption and poor sleep quality, which severely compromise their quality of life; however, the relationship between light exposure and illness severity remains largely unknown. An observational cross-sectional cohort secondary study used collected data from 100 ME/CFS patients and 56 healthy controls to explore the impact of spontaneous light exposure on multidimensional health status and circulating biochemical parameters. Demographic and clinical features were assessed using validated patient-reported outcome measures. Light intensity, wrist temperature, and physical activity were continuously monitored at home over one week using wrist-worn actigraphy. Light intensity during predefined intervals and rhythmic variables of light cycle were calculated. Principal component analysis (PCA) was applied to reduce dimensionality of light variables. Multivariable analysis was performed adjusting for age, sex, body mass index, and physical activity. Following PCA of the light patterns, two components emerged across groups with high consistency: PC1 (explaining 61.7% of the total variance) reflected higher daytime light and rhythm stability, and PC2 (explaining 16.1%) represented nocturnal/early-morning light and rhythm instability. In ME/CFS patients, light variables were more extensively associated with clinical outcomes measures (FIS-40, PSQI and SF-36) than in healthy controls (all p < 0.05). Furthermore, PC2 was associated with higher levels of VCAM-1 and triglycerides, and lower serotonin concentrations (all p < 0.05). Four distinct light patterns were identified based on PCA scores: nocturnal light, healthy, adverse, and low diurnal light. ME/CFS patients exhibiting the healthy light pattern showed significantly lower fatigue, fewer sleep complaints, reduced autonomic dysfunction, and higher quality of life compared to those with the adverse light pattern (all p < 0.05). No significant differences were observed among healthy controls. Light exposure patterns show distinct associations with symptom variability in ME/CFS compared to healthy controls. More stable daytime light appears to relate to better symptom profiles, whereas irregular exposure and nocturnal light are linked to poorer health outcomes. Although causality cannot be inferred, these findings highlight light exposure as a potentially modifiable, non-invasive target for behavioral interventions aimed at improving the quality of life in ME/CFS, representing a promising emerging for future translational research.", "url": "https://pubmed.ncbi.nlm.nih.gov/42399727/" }, { "pmid": "42398146", "title": "Symptom, functional, and medication overlap between long COVID and fibromyalgia.", "pub_date": "2026-07-03", "journal": "Clinics (Sao Paulo, Brazil)", "authors": "Hackshaw, Kevin V, Osuna-Diaz, Michelle M, Sebastian, Katherine R, Nuguri, Shreya Madhav et al.", "abstract": "Long COVID (LC/PASC) and Fibromyalgia (FM) share prominent pain, fatigue, and cognitive symptoms and are often difficult to distinguish clinically. The authors compared LC/PASC and FM using harmonized questionnaires assessing symptoms, function, and medication burden to quantify phenotype overlap and inform biomarker development. The authors analyzed a harmonized dataset including LC/PASC participants and FM-only comparators. Measures included age, sex, BMI, FIQR/SIQR-equivalent, BDI, CSI, MPQ, VAS pain, medication burden derived from free-text entries, and descriptive SF-36 domains. The sample included 54 LC/PASC and 889 FM-only visits. LC/PASC participants were older and less often female. Across symptom and function measures, partial overlap was observed, with domain-specific differences. Medication burden was common; FM showed greater centrally acting medication use. SF-36 domains showed broad similarity with domain-specific differences. In this preliminary, hypothesis-generating comparison, LC/PASC and FM demonstrate partial and domain-specific overlap across questionnaire measures, while differences in medication exposure may influence symptom reporting and limit direct clinical comparisons. These findings support the need for prospective studies integrating objective biomarkers with standardized clinical phenotyping.", "url": "https://pubmed.ncbi.nlm.nih.gov/42398146/" }, { "pmid": "42396494", "title": "Spatial Immune Model of Alveolar Lung Infection (SIMALI) Identifies Structural Determinants of Lung Inflammation.", "pub_date": "2026-07-03", "journal": "Research square", "authors": "Tasnim, Humayra, Forrest, Stephanie, Hofmeyr, Steven, Friedman, Alan et al.", "abstract": "Inflammation and lung damage in response to respiratory viral infection is a major cause of morbidity and mortality. How specialized lung alveolar structures contribute to variation in inflammatory lung damage observed in patients is a gap in current knowledge. Filling this gap is important for understanding how respiratory infections can lead to persistent and chronic sequelae after acute viral infection, including post-acute sequelae of COVID-19, or \"long COVID\". Few computational models have incorporated the spatial complexity of alveolar sacs, key sites where infection and inflammation damage lung function. We propose a novel computational model, SIMALI, which represents a sample of the lung's alveolar space as a structured 3D lattice of alveoli composed of air and epithelial cells surrounded by structural lung tissue through which virus and inflammation diffuse. SIMALI extends a previous agent-based model by adding key structural components of the lung, including physiological percentages of infectable cells and differential diffusion of virus through air and lung tissue. SIMALI's simulation predictions are validated against the spatial-temporal growth of lung lesions from Computed Tomography (CT) scans of patients with SARS-CoV-2 infection. By combining parameters validated in a prior study with alveolar structure, the model accurately predicts the typical growth of lung inflammation observed in patient CT scans. SIMALI demonstrates how the spatial architecture of alveolar sacs and the distribution of infectable cell types in the lung constrain the spread of virus and inflammation. Furthermore, SIMALI simulations show how the initial deposition of foci of viral infection distributed across alveolar sacs is an important mechanistic cause of variation in lung damage due to inflammation. The spatial SIMALI model demonstrates a key role for the structure of the alveolar space in driving inflammatory responses. Lung alveolar structure, combined with variation in immune response and the amount and location of initial viral deposition in the lung, all contribute to the highly variable damage to lung recapitulating variation observed across patients with SARS-CoV-2 infection.", "url": "https://pubmed.ncbi.nlm.nih.gov/42396494/" }, { "pmid": "42396417", "title": "Post-COVID neuropsychiatric symptoms in India: Prevalence, risk factors, and persistence.", "pub_date": "2026-07-03", "journal": "Indian journal of psychiatry", "authors": "Laha, Poulami, Gowda, Guru S, Moirangthem, Sydney, Veenakumari, H B et al.", "abstract": "The global research has actively investigated the post-COVID neuropsychiatric symptoms (PCNS). There is a paucity of studies from India that explore long-term PCNS. This study aims to estimate prevalence, types of PCNS, associated factors (sociodemographic factors, life events, COVID-19-related variables, and vaccination status) and persistence of PCNS after two years. A cross-sectional study was conducted from October 2022 to October 2023 in a tertiary care hospital. A total of 2,281 randomly selected individuals with reverse transcription polymerase chain reaction-positive for COVID-19 were screened for PCNS. Among 927 participants consented to and completed the telephonic screening for PCNS. Structured clinical interviews for DSM-5-Research Version and World Health Organization-Post-COVID Case Report Form were applied. Descriptive statistics and binary logistic regression analysis were used for data analysis. Median age of individuals was 34 years, and 51.3% being female. Only 21.6% had lifetime PCNS, and 7.3% had persistent PCNS at two years of COVID-19. The common lifetime PCNS were persistent fatigue (15.6%), reduced smell (5.9%), reduced taste (4.8%), anxiety (4.3%), insomnia (3.6%), depressed mood (2.6%), cognitive symptoms (2.6%), and persistent muscle pain (2.6%). The logistic regression analysis revealed a positive association of lifetime PCNS with female gender, preexisting medical comorbidities, symptomatic COVID-19, oxygen supplementation, repeated infections, and life events. Full or partially vaccinated against COVID-19 appeared to be protective against PCNS. About one in five individuals developed lifetime PCNS following COVID. Among them, one in three had persistent PCNS after two years of COVID. Female gender, life events, severity of COVID-19, repeated infection, and Vaccine-naïve status were associated with the development of PCNS.", "url": "https://pubmed.ncbi.nlm.nih.gov/42396417/" }, { "pmid": "42396378", "title": "Perception of body donation among the Phase-1 medical students, a questionnaire-based study.", "pub_date": "2026-07-03", "journal": "F1000Research", "authors": "Murlimanju, B V, Shenoy, M Praveen, Ullal, Sheetal D, Vadgaonkar, Rajanigandha", "abstract": "This study aimed to examine the knowledge, attitude, and perception of body donation among Phase-1 medical students at our institution. The objectives were to assist teachers in providing insight into the perception of this among students. This was a cross-sectional, institution-based, time-bound study comprising 29 validated questions regarding comprehensive aspects of body donation. There were 396 medical students in Phase-1 from admissions for two consecutive years. Most students (94.4%) were aware of the source of cadavers in the dissection hall, which were either donated or unclaimed bodies from the hospital. However, 38.9% of them were unaware of the guidelines for body donation, and 79% were ignorant of the documents required to pledge. However, 84.3% were aware that it was mandatory to sign a pledge form. The time frame to procure the dead body to the department of anatomy of the institution was not known to 79% of the participants, and 93.2% of the participants opined that corpses from other neighboring states could be accepted. Opinions regarding the acceptance of donated bodies afflicted with long COVID were supported by 218 (55.1%), not supported by 47 (11.9%), and neutral by 131 (33.1%) participants in this study. Specific knowledge gaps were encountered, including the timeframe, logistics, and legal issues in procuring the body. Since medical students play an important role in this societal motivation, it is suggested that a scientific session be planned in the curriculum of Phase-1 regarding the protocol of body donation. Apart from providing insights, this study also accomplishes the United Nations' sustainable development goal-4 in offering quality medical education. This study, apart from providing insights, also accomplishes the United Nation's sustainable development goal-4 in offering quality medical education.", "url": "https://pubmed.ncbi.nlm.nih.gov/42396378/" }, { "pmid": "42395315", "title": "Long COVID and health-related quality of life: a systematic review of immune, inflammatory, and metabolic markers.", "pub_date": "2026-07-03", "journal": "Frontiers in public health", "authors": "Turebekova, Dinara, Kosherova, Bakhyt, Dauletkaliyeva, Zhaniya, Shayakhmetova, Yelena et al.", "abstract": "Long COVID is known to be associated with prolonged multiple organ symptoms and decreased health-related quality of life (HRQoL), but the pathogenesis and relationship between immune, inflammatory, and metabolic biomarkers and HRQoL remains poorly understood. This systematic review aims to synthesize the evidence on the health-related quality of life of patients with Long COVID and to summarize the reported associations between health-related outcomes and biomarkers. We conducted a systematic search in PubMed, Web of Science, and Scopus in search of studies that evaluated immune, inflammatory, or metabolic biomarkers and HRQoL in patients with Long COVID. This review included case-control and cohort studies with a control group. The Rayyan tool was used to select studies, and full-text articles were evaluated for compliance with the criteria. Information was obtained on biomarkers, analytical methods, tools for assessing the HRQoL, and the relationship between HRQoL and biomarkers. Due to the high heterogeneity of the methods, the results were summarized in a descriptive form. Ten studies were included, involving 1,078 patients with Long COVID and 768 healthy controls. Most studies that used various methods to assess HRQoL consistently reported long-term deterioration after COVID, with the greatest deterioration observed in the areas of physical functioning, vitality, fatigue, daily activities, pain, discomfort, and respiratory distress. The most frequently measured markers were related to inflammation and endothelial/coagulation pathways, including CRP, hsCRP, IL-6, TNF- Our results indicate that Long COVID is consistently associated with a long-term decline in HRQoL, especially in the physical and functional areas. The available data indicate the presence of a strong signal regarding inflammatory processes and endothelial coagulation, while autoimmune, metabolic, and genetic data indicate phenotype-specific heterogeneity. Unique identifier: CRD420251239371, URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251239371.", "url": "https://pubmed.ncbi.nlm.nih.gov/42395315/" }, { "pmid": "42395031", "title": "Molecular, cellular and network mapping of brain structural deviations in patients with Post-COVID19 syndrome.", "pub_date": "2026-07-03", "journal": "Brain, behavior, & immunity - health", "authors": "Martins, Daniel, Cai, Ziyuan, Mariani, Nicole, Borsini, Alessandra et al.", "abstract": "Post-COVID-19 syndrome encompasses persistent cognitive, neurological, and psychiatric symptoms following SARS-CoV-2 infection, profoundly affecting global quality of life. Clarifying the neurobiological basis of these symptoms is vital for effective therapeutic interventions. This study utilized normative modelling of brain structure (\"CentileBrain\") to quantify subject-level deviations in cortical thickness, surface area, and subcortical volumes among 20 patients experiencing persistent fatigue following mild COVID-19, compared to 20 matched healthy controls. Group-level analyses on deviation scores revealed subtle yet distinct regional alterations in cortical thickness, specifically decreased thickness within orbitofrontal cortices and increased thickness in occipital/sensory cortices. Although at the individual regional level, the proportion of patients exhibiting infranormal or supranormal thickness values was relatively low (<35%) and comparable to controls, deviations frequently clustered within structurally connected circuits, affecting up to 50% more of patients. Spatial analysis of regional cortical thickness alterations correlated significantly with the constitutive expression patterns of TMPRSS2, an essential protein facilitating SARS-CoV-2 cellular entry. Canonical correlation analyses further identified specific cell-type distributions and neuroreceptor densities predictive of regional thickness changes, highlighting neurons and molecular targets associated with serotoninergic, cannabinoid, cholinergic, and glutamatergic signalling pathways. Network-diffusion modelling constrained by a canonical structural connectome significantly outperformed null models based on permuted connectomes and Euclidean distance metrics, identifying posterior-parietal regions as probable initiation points (\"seeds\") for network-wide structural changes. Seed likelihood correlated positively with TMPRSS2 expression levels, suggesting that these posterior-parietal regions may be particularly susceptible to SARS-CoV-2 infection. This highlights a plausible mechanism where structural alterations could propagate through connected neural networks, although direct evidence of such propagation requires further investigation. These findings provide novel insights into potential mechanisms underlying neural circuit disruptions in post-COVID-19 fatigue and suggest avenues for therapeutic neuromodulation.", "url": "https://pubmed.ncbi.nlm.nih.gov/42395031/" }, { "pmid": "42394349", "title": "Post-COVID-19 Autonomic Dysfunction in an Adolescent: Ogilvie Syndrome With Acute Urinary Retention.", "pub_date": "2026-07-03", "journal": "Journal of paediatrics and child health", "authors": "Musielak, Anna, Stachecka-Zyk, Alicja, Frankowicz, Magdalena, Noskiewcz, Jakub et al.", "abstract": "No abstract available.", "url": "https://pubmed.ncbi.nlm.nih.gov/42394349/" }, { "pmid": "42394340", "title": "FGFR Inhibitor AZD4547 Disrupts Inflammatory CAF Crosstalk With Cancer Cells and Macrophages and Attenuates Metastasis in Pancreatic Cancer.", "pub_date": "2026-07-03", "journal": "FASEB journal : official publication of the Federation of American Societies for Experimental Biology", "authors": "Mostafa, Ahmed M R H, Hemdan, Ahmed G, Assayag, Franck, Prakash, Jai", "abstract": "Cancer-associated fibroblasts (CAFs) are key cell types within the tumor microenvironment (TME), responsible for their pro-tumorigenic effects and metastasis. Specifically, inflammatory CAFs (iCAFs), a CAF subtype, are known to induce tumor cell progression, migration, and immunosuppression. Fibroblast growth factor receptors (FGFRs) play a crucial role in cell differentiation, migration, and proliferation. In this study, we investigated the effect of FGFR kinase inhibitor AZD4547 (AZD), a clinical-stage drug, on iCAF differentiation and iCAF-mediated effects on the tumor-stroma interaction in vitro and in vivo. Treatment with AZD inhibited the differentiation of human pancreatic stellate cells into iCAFs using IL-1α, as shown with reduced IL-6 expression. FGFR1, 2, 3, and 4 were upregulated in iCAFs, which were inhibited by AZD. Treatment with AZD also attenuated the iCAF-mediated paracrine effect on the PDAC cell-induced migration and epithelial-mesenchymal transition of tumor cells, as well as polarization of macrophages towards the M1 phenotype in vitro. Furthermore, AZD significantly reduced the growth of tumor cells and fibroblasts in co-cultured 3D heterospheroids in vitro. In vivo, treatment with AZD attenuated the tumor growth in the syngeneic subcutaneous KPC murine tumor model. Interestingly, flow cytometry and immunofluorescent staining analyses on isolated tumors revealed that AZD-treated tumors had a reduced iCAF population and M2-type macrophages. Furthermore, we found that AZD treatment reduced the liver metastasis, as shown with the reduction of ki-67 and p53 tumor markers in the AZD-treated group compared to the vehicle group. Altogether, this study demonstrates that FGFRs are overexpressed on iCAFs and their inhibition using AZD diminishes iCAF-mediated paracrine signaling with tumor cells and macrophages, thereby attenuating tumor growth and metastasis.", "url": "https://pubmed.ncbi.nlm.nih.gov/42394340/" }, { "pmid": "42394201", "title": "PNPLA3 I148M Variant Activates Hepatic Stellate Cells via AMIGO2 Upregulation Using iPSC-Derived Model.", "pub_date": "2026-07-03", "journal": "Liver international : official journal of the International Association for the Study of the Liver", "authors": "Toshida, Katsuya, Takeishi, Kazuki, Itoh, Shinji, Kurihara, Takeshi et al.", "abstract": "A variant in the patatin-like phospholipase domain-containing protein 3 (PNPLA3) was reported to be related to metabolic-associated fatty liver disease. However, the mechanism by which this variant leads to liver fibrosis has not been unveiled yet. Using induced pluripotent stem cell (iPSC)-derived hepatic stellate cells (iHSC) containing a single nucleotide polymorphism (SNP) within PNPLA3, this study sought to clarify the mechanism through which this PNPLA3 SNP induces liver fibrosis. Two types of iPSC (PNPLA3rs73840989(C):Wild, PNPLA3rs73840989(G):Variant) were differentiated into iHSC. iHSC were activated by TGF-β1. TGF-β1 stimulation resulted in significantly higher secretion of the liver fibrosis markers αSMA and COL1A1 in Variant-iHSCs than in Wild-iHSCs. Variant-iHSC secreted significantly more PDGF and TGF-β and had significantly higher cell proliferative and migration ability. RNA sequencing showed that gene expression related to collagen-containing extracellular matrix and collagen metabolic processes was elevated in Variant-iHSC. We focused on AMIGO2 expression because Variant-iHSC expressed significantly more AMIGO2 than Wild-iHSC. AMIGO2 knockdown using siRNA in Variant-iHSC significantly reduced migration and proliferation ability. Additionally, significant changes were observed in Vimentin and E-cadherin, along with decreases in EMT activity and protein expression of αSMA and COL1A1. Staining for AMIGO2 in cirrhotic and normal liver samples showed that AMIGO2 protein expression was observed in PNPLA3-variant samples. PNPLA3 SNP-induced liver fibrosis involves EMT of HSC via AMIGO2 expression. A common genetic variant in the PNPLA3 gene is known to increase the risk of fatty liver disease and liver fibrosis, but the underlying mechanism has remained unclear. Using induced pluripotent stem cell‐derived hepatic stellate cells, we found that the PNPLA3 variant promotes fibrosis by increasing AMIGO2 expression and enhancing cell activation, migration, and proliferation. These findings suggest that AMIGO2 may be a potential therapeutic target for preventing liver fibrosis progression.", "url": "https://pubmed.ncbi.nlm.nih.gov/42394201/" }, { "pmid": "42394025", "title": "Challenges in Preprocessing Routine Laboratory Data for Machine Learning.", "pub_date": "2026-07-03", "journal": "Studies in health technology and informatics", "authors": "Wendt, Katharina, Marschollek, Michael, Illig, Thomas, Wolff, Dominik et al.", "abstract": "Post-Covid syndrome remains a major clinical challenge due to the lack of specific biomarkers and reliance on exclusion criteria. Routine laboratory data offers potential for identifying biological signatures, but their use in machine learning is hampered by data quality issues. This study investigates the impact of preprocessing on classification performance using 52 laboratory parameters from the German NAPKON cohort (n = 1,292: 1,130 Covid recovered, 162 post-Covid patients), measured at four time points. Data preprocessing included unit harmonization, handling of missing values and statistical assessment of inter-laboratory variability. Non-parametric tests (Kruskal-Wallis, Wilcoxon) revealed significant differences in laboratory values across units (p < 0.05), even after harmonization. The best classification performance was achieved at 70% allowed missingness per sample and feature. Our findings underscore that handling missing values and data harmonization are particularly crucial and have a major impact on model performance. But even after preprocessing, residual variability persists due to biological and technical factors.", "url": "https://pubmed.ncbi.nlm.nih.gov/42394025/" }, { "pmid": "42393618", "title": "Self-management of long COVID symptoms with over-the-counter medicines and other non-prescribed therapies: a cross-sectional survey.", "pub_date": "2026-07-03", "journal": "BMC public health", "authors": "Guan, Naijie, Turner, Grace, Hotham, Richard, Lange, Daniel et al.", "abstract": "The high prevalence of long COVID globally necessitates investigation into its self-management, especially given the absence of definitive and effective treatments and uneven access to healthcare services. This study surveyed the use of over-the-counter (OTC) medicines, supplements, remedies, and other non-prescription therapies for managing long COVID symptoms in the UK. It aimed to identify the range of treatments used for self-management, explore the sources of these treatments, factors influencing treatment choices, and associated out-of-pocket expenses. A cross-sectional electronic survey was provided to individuals experiencing long COVID. It included questions on the use of OTC medications, supplements, and other therapies, where they were sourced, decision-making influences, and financial costs. Descriptive statistics and thematic analysis were applied to analyse the data. Among the 193 surveyed participants, significant use of vitamins, minerals, and herbal treatments (88.8%), and analgesics (73.6%) was reported, with 42% exceeding recommended dosages. Some participants sought relief through alternative therapies such as physiotherapy and acupuncture, often incurring significant personal expenses. Choices about self-management were influenced by medical professionals, family, friends, and online sources, including support groups and social media. People with long COVID may access a wide range of OTC medicines, dietary supplements, herbal remedies, and non-pharmacological therapies to self-manage symptoms. Healthcare providers should be aware of the use of non-prescribed therapies among long COVID sufferers and consider these in their treatment plans. Public health policies should focus on providing accurate information and guidance for patients self-managing long COVID symptoms.", "url": "https://pubmed.ncbi.nlm.nih.gov/42393618/" }, { "pmid": "42392788", "title": "[Status analysis of clinical outcome for treatment of long COVID with traditional Chinese and western medicines].", "pub_date": "2026-07-03", "journal": "Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica", "authors": "Yan, Xing, Tang, Xiang, Zhang, Ya-Zi, Liu, Yao-Yuan et al.", "abstract": "This study sorted out the clinical outcome of traditional Chinese and western medicines in the treatment of long COVID to lay the foundation for the construction of a core indicator set. Search was made on some databases and platforms from their inception to December 2024, which included eight databases of CNKI, Wanfang, SinoMed, VIP, PubMed, Cochrane Library, EMbase, and Web of Science and three clinical research protocol registration platforms, namely the Chinese Clinical Trial Registry(ChiCTR), the International Traditional Medicine Clinical Trial Registry(ITMCTR), and the American Clinical Trial Registry(ClinicalTrials.gov). Two researchers independently extracted the basic information, outcomes, measurement time points, and measurement tools of literature in parallel according to the inclusion and exclusion standards. If there are any differences, a third researcher would make discussions and decisions. A total of 152 studies, including 50 literature studies and 102 protocol studies, were ultimately included. A total of 338 outcomes indicators were reported, with a reporting frequency of 1 633 times. Outcome indicators can be classified into 10 indicator domains based on attributes, including symptoms and signs(694 times, 42.50%), TCM diseases(61 times, 3.74%), security incidents(93 times, 5.70%), etiological detection(23 times, 1.41%), long-term prognosis(72 times, 4.41%), economic indicators(14 times, 0.86%), physical and chemical testing(472 times, 28.90%), quality of life(173 times, 10.59%), major events(16 times, 0.97%), and other indicators(15 times, 0.92%). There were problems in the outcomes indicators of treating long COVID with both traditional Chinese and western medicines, such as significant differences in symptom descriptions, lack of standardization in indicator selection, diverse choices of measurement tools, diverse selection of measurement time, lack of practicality in clinical practice, and non-prominent TCM indicators. These issues led to scattered evidence and the absence of a unified core indicator set to guide clinical research. Further efforts are needed to develop COS of integrated traditional Chinese and western medicine treatments for long COVID, and to enhance the quality of clinical research on long COVID.", "url": "https://pubmed.ncbi.nlm.nih.gov/42392788/" }, { "pmid": "42392250", "title": "Erianin ameliorates liver fibrosis through the PRDX3/NLRX1 axis.", "pub_date": "2026-07-03", "journal": "European journal of pharmacology", "authors": "Zhu, Mengqi, Yang, Xi, Xie, Jingmin, Shi, Xiaojing et al.", "abstract": "Liver fibrosis constitutes a central pathological hallmark of advanced chronic liver diseases. However, effective therapeutic targets and pharmacological interventions remain insufficiently defined. Mitochondrial oxidative stress plays a pivotal role in the pathogenesis of hepatic stellate cells (HSCs) activation during liver fibrosis. While erianin, a natural bibenzyl compound extracted from the stems of Dendrobium chrysotoxum Lindl., exerts antioxidant effects in various diseases, its protective effect against liver fibrosis remains elusive. Thus, this study aimed to evaluate the therapeutic potential of erianin against liver fibrosis and to explore the underlying molecular mechanisms. The results revealed that erianin markedly attenuated CCl", "url": "https://pubmed.ncbi.nlm.nih.gov/42392250/" }, { "pmid": "42391984", "title": "Exploring surgical patients' health literacy following the use of a patient safety checklist - A qualitative study.", "pub_date": "2026-07-03", "journal": "Patient education and counseling", "authors": "Austarheim, Ann Kristin Sandsbakk, Wæhle, Hilde Valen, Harris, Kristin, Haugen, Arvid Steinar", "abstract": "Low health literacy is common among surgical patients, with few interventions addressing this problem. A patient safety checklist (PASC) was developed to involve elective surgical patients in optimising health and safety before and after surgery. This study explores how PASC influences patients' health literacy. An explorative qualitative research design was utilised, including focus groups, dyadic, and individual interviews. The study is part of a multicentred, stepped wedge cluster randomized trial investigating various effects of PASC. A strategic sample of elective surgical patients (n = 20) who had utilised PASC were recruited from eight surgical wards from three hospitals in Norway. The interviews were analysed using content analysis at a thematic level. Two themes were identified. The first theme facilitating active self-management encompassed how PASC supported patients in understanding and managing their health by providing clear instructions and promoting awareness of critical information. It also helped patients organise health-related details and take proactive steps in their surgical care. The second theme impacting patients' communication and interactions demonstrated that PASC enhanced active dialogue with healthcare providers and encouraged patients to seek relevant information. Additionally, PASC supported patients in comparing and evaluating information to improve their understanding. Non-adherence to PASC was associated with several identified challenges and barriers. Findings suggest that PASC promote patients' health literacy and engagement by helping them manage complex health information throughout the surgical pathway. PASC has the potential to enhance patients' health literacy by providing clear and consistent information, as well as by strengthening organizational health literacy. Standardising health information through PASC may increase patients' awareness on safety issues and potentially contribute to the reduction of patient harm. The active involvement of healthcare professionals and their responsiveness to patients using PASC are essential to support these improvements. This study is associated with the trial entitled: \"Development and Implementation of Patient Safety Checklists Before, During and After In-hospital-Surgery\" a Stepped Wedge Cluster Randomized Controlled Trial. Registration date in the ClinicalTrials.gov, 20 March 2017, ID: NCT03105713.", "url": "https://pubmed.ncbi.nlm.nih.gov/42391984/" }, { "pmid": "42391726", "title": "Therapeutic plasma exchange and immunomodulatory strategies in post-infectious syndromes: A review of immune dysregulation in PTLDS, long COVID, ME/CFS, and PANS/PANDAS.", "pub_date": "2026-07-03", "journal": "Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis", "authors": "Kaplan, Gary", "abstract": "Post-infectious syndromes including post-treatment Lyme disease syndrome (PTLDS), long COVID, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and pediatric acute-onset neuropsychiatric syndrome (PANS)/pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) share overlapping clinical phenotypes characterized by fatigue, cognitive dysfunction, sleep disturbance, and neuropsychiatric symptoms. Increasing evidence suggests that immune dysregulation-including persistent inflammation, autoantibody production, and cellular immune dysfunction-may underlie these conditions. This narrative review synthesizes peer-reviewed literature describing immune abnormalities across these syndromes and evaluates the rationale for immunomodulatory therapies, including intravenous immunoglobulin (IVIG), rituximab, and therapeutic plasma exchange (TPE). Evidence supporting immune-targeted treatment strategies is strongest in subsets of patients with identifiable immunologic abnormalities. Notably, the phase III RituxME trial in ME/CFS and a phase II trial of TPE in post-COVID condition both failed to demonstrate efficacy in unselected populations, reinforcing the importance of biomarker-guided patient stratification. TPE functions by removing circulating immune complexes, autoantibodies, and inflammatory mediators, and observational data suggest benefit in patients with demonstrable autoantibody burden. Further controlled studies incorporating immunologic phenotyping and early intervention are needed to define the therapeutic role of immune-directed interventions across these conditions.", "url": "https://pubmed.ncbi.nlm.nih.gov/42391726/" }, { "pmid": "42390720", "title": "Distinctive Endoscopic Ultrasound Features of Pancreatic Adenosquamous Carcinoma: A Propensity Score-Matched Analysis.", "pub_date": "2026-07-02", "journal": "Digestive diseases and sciences", "authors": "Ke, Chen, Yini, Dang, Qiang, Zheng, Ming, He et al.", "abstract": "Pancreatic adenosquamous carcinoma (PASC) is a rare and aggressive malignancy with poorer prognosis than pancreatic ductal adenocarcinoma (PDAC). This study aimed to identify distinctive endoscopic ultrasound (EUS) features for pre-operative differentiation between PASC and PDAC. Forty-six PASC patients and 683 PDAC patients were retrospectively enrolled. Propensity score matching (1:2) balanced age, sex, and tumor size. EUS characteristics were compared, and independent predictors were identified by multivariate logistic regression. PASC tumors were significantly larger than PDAC tumors at baseline (p < 0.001). After matching, multivariate analysis identified five independent predictors of PASC: higher serum albumin (OR = 1.256), hyperechoic foci (OR = 7.733), non-infiltrative growth pattern (INF C: OR = 0.163), and absence of pancreatic duct dilation (positive: OR = 0.021; unknown: 0.008) (all p < 0.05). The model demonstrated good discrimination with an AUC of 0.931 (95% CI 0.888-0.974). PASC more frequently exhibited hyperechoic foci (69.6% vs. 34.8%) and expansive growth, while PDAC typically showed infiltrative growth and duct dilation. PASC demonstrates distinctive EUS features including hyperechoic foci, expansive growth pattern, and less frequent ductal obstruction compared with PDAC, which may facilitate pre-operative differentiation from PDAC.", "url": "https://pubmed.ncbi.nlm.nih.gov/42390720/" }, { "pmid": "42389520", "title": "Autoantibody-mediated pain in long COVID: evidence from multiple lines.", "pub_date": "2026-07-02", "journal": "Frontiers in immunology", "authors": "Nicaise, Charles, Bulpa, Pierre, Jamoulle, Marc", "abstract": "No abstract available.", "url": "https://pubmed.ncbi.nlm.nih.gov/42389520/" }, { "pmid": "42389466", "title": "Engineering", "pub_date": "2026-07-02", "journal": "Frontiers in bioengineering and biotechnology", "authors": "Štravs, Petra, Fierobe, Henri-Pierre, Perret, Stéphanie, Berlec, Aleš", "abstract": "Lactic acid bacteria are commonly used to convert carbohydrates into valuable products like lactic acid, but they currently rely on carbon sources from food crops, raising sustainability and cost concerns. Lignocellulosic waste is a more sustainable alternative, yet these bacteria cannot naturally break down cellulose to grow on it. Efficient cellulose degradation requires synergetic action of multiple cellulolytic enzymes, each operating through distinct mechanisms. To design genetic constructs for co-expression of gene pairs encoding different heterologous cellulases (Cel5I, Cel5H or Cel9A) from separate expression cassettes in The A1 strain that co-produced cellulase pair Cel5H-Cel9A achieved the highest activity on PASC and one of the highest activities measured on microcrystalline cellulose. Additionally, the A1 strain showed the highest degradation of PASC during the 16 days of anaerobic cultivation and one of the highest lactic acid production levels. In this study, co-expression of gene pairs that encode different heterologous cellulases from separate promoters in", "url": "https://pubmed.ncbi.nlm.nih.gov/42389466/" }, { "pmid": "42385306", "title": "Psychological and medical outcomes of post-COVID-19 patients: A longitudinal study.", "pub_date": "2026-07-01", "journal": "Journal of psychosomatic research", "authors": "Benfante, Agata, Di Tella, Marialaura, Chiappero, Chiara, Nocera, Claudia et al.", "abstract": "The coronavirus disease (COVID-19) pandemic affected different populations from a physical and psychological point of view. Psychological characteristics can have an impact on adjustment to illness conditions and increase the risk of persistence of physical symptoms and psychopathology. This prospective study examined possible changes in psychological and medical symptoms in people with post-COVID-19 condition by looking at which investigated variables could significantly predict anxiety and depressive symptoms at a long-term follow-up. A baseline assessment (T0: 3-6 months after hospital discharge and virological recovery) and a second evaluation (T1: 9-16 months after virological recovery) were included. A total of 155 participants completed T0 evaluation by filling in questionnaires assessing resilience, difficulties in emotion regulation, fatigue, anxiety, depressive and post-traumatic stress symptoms (PTSS), while 84 participants also completed T1 evaluation. Participants reported lower scores in fatigue, depression and anxiety symptoms, and PTSS at T1 with respect to T0. PTSS and resilience evaluated at the baseline were found to be significant predictors of both anxiety and depressive symptoms measured at T1. PTSS and resilience at baseline affected people with post-COVID-19 condition in relation to anxiety and depression in the medium term after virological recovery. Despite the high percentage of dropouts, which may have introduced attrition bias, the results highlight the importance of monitoring the psychological state of people with post-COVID-19 condition during clinical follow-up to identify those at higher risk of developing chronic anxiety and depressive symptoms at an early stage.", "url": "https://pubmed.ncbi.nlm.nih.gov/42385306/" }, { "pmid": "42384984", "title": "Influence of inflammatory and reninangiotensin system gene polymorphisms ACE2 rs2285666, IL1A rs1800587, and TNF rs1800629 on COVID-19 severity and the persistence of symptoms in the post-COVID-19 phase: a cross-sectional study.", "pub_date": "2026-07-01", "journal": "Einstein (Sao Paulo, Brazil)", "authors": "Daudt-Lemos, Matheus, Oliveira, Evelyn Maciel de, Ramos-Silva, Alice, Rosário, Natalia Fonseca et al.", "abstract": "We evaluated the influence of single-nucleotide polymorphisms in cytokine, renin-angiotensin-aldosterone system, and uromodulin genes on COVID-19 severity and the persistence of symptoms in the post-COVID phase. Two cross-sectional cohort studies were conducted: a retrospective cohort (cohort 1) from early phase of the pandemic and a prospective cohort (cohort 2) including patients with symptoms in the post-COVID phase. Single-nucleotide polymorphism detection was performed using real-time and conventional polymerase chain reaction. Cohort 1 included 112 patients (mean age 57.4±17.5 years, 42% male). ACE rs4646994, ACE2 rs2285666, IL1A rs1800587, and TNF rs1800629 were associated with COVID-19 severity. However, when evaluating more specific outcomes such as intensive care unit admission and the need for invasive mechanical ventilation, associations were observed only for ACE2 and TNF. In women, the ACE2 rs2285666 GG genotype (p=0.003) and G allele (p=0.013) were associated with intensive care unit admission. In addition the A allele of TNF rs1800629 was associated with a higher risk of invasive mechanical ventilation (p<0.001). Cohort 2 included 107 patients (mean age 54.7±15.18 years 27.2% male). The TNF GA genotype was a risk factor for cough (p=0.03) and exertional fatigue (p=0.049). Lastly, IL1A rs1800587 was associated with the risk of persistent respiratory symptoms. Our results suggest that single-nucleotide polymorphisms in ACE2, IL1A, and TNF may be associated with an increased risk of severe COVID-19 and persistence of symptoms in affected patients.", "url": "https://pubmed.ncbi.nlm.nih.gov/42384984/" }, { "pmid": "42384384", "title": "Cognitive Rehabilitation and Functional Outcomes in Long COVID-Related Cognitive Impairment: A Randomized Clinical Trial.", "pub_date": "2026-07-01", "journal": "JAMA network open", "authors": "Vanova, Martina, Patel, Aysha Mohamed Rafik, Scott, Iona, Gilpin, Gina et al.", "abstract": "Cognitive impairment is common in long COVID and severely affects daily life, with no proven treatments to date. To evaluate the ability of cognitive rehabilitation (CR) to improve goal attainment, cognitive, and clinical outcomes in individuals with cognitive impairment as part of long COVID. This multicenter, single-blind, 2-arm, parallel-group randomized clinical trial was conducted at 3 sites in England between February 2023 and March 2024. Participants were adults aged 30 to 60 years with prior COVID-19 infection and objective cognitive impairment (≥1 SD below age norm in ≥2 cognitive domains). A sample size of 88 participants (44:44) was required to detect a conservative effect of 0.7 on the goal attainment score at 3 months. Participants were randomized (1:1) to CR or treatment as usual (TAU). CR consisted of 10 individual 1-hour sessions conducted once per week with a trained researcher, applying evidence-based strategies to 3 individually selected, personally meaningful functional goals. TAU was variable, with most participants having access to specialist memory clinics. The primary outcome consisted of participant-reported goal-attainment scores at 3 months after randomization measured by the Bangor Goal-Setting Interview. Analysis was conducted on an intention-to-treat basis using multilevel mixed-effects models with 2-sided 95% CIs and 5% significance. A total of 78 participants (24 male [30.8%] and 54 female [69.2%]; mean [SD] age, 47.3 [7.2] years) were randomized, including 38 individuals in CR and 40 individuals in TAU groups. At 3 months after randomization, goal attainment was significantly greater in the CR compared with the TAU group (adjusted mean difference, 2.88 [95% CI, 2.03-3.73]; P < .001; Cohen d = 1.57), with CR providing a large and clinically meaningful treatment effect. This was sustained at 6 months, with a lower effect size (adjusted mean difference, 1.72 [95% CI, 0.86-2.57]; P < .001; Cohen d = 0.91). In this study, individualized, goal-oriented CR led to significant and sustained improvements in goal attainment in people with long COVID-related cognitive impairment. These findings may guide and inform the provision of CR treatments and services for people living with long COVID. ClinicalTrials.gov Identifier: NCT05731570.", "url": "https://pubmed.ncbi.nlm.nih.gov/42384384/" }, { "pmid": "42383026", "title": "Exploring the mechanisms of acupuncture in improving cognitive function in post-COVID-19 myalgic encephalomyelitis/chronic fatigue syndrome: study protocol for a randomized controlled trial using multimodal MRI.", "pub_date": "2026-07-01", "journal": "Frontiers in neurology", "authors": "Luo, Tingting, Luo, Yang, Huang, Liang, Jin, Hongjiao et al.", "abstract": "Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a common sequela following COVID-19. Although cognitive dysfunction is one of the most debilitating symptoms in ME/CFS, effective therapies are limited. Acupuncture is an important complementary and alternative therapy for ME/CFS and has been shown to have positive effects on cognitive dysfunction in other diseases. However, the effect and mechanism of acupuncture in treating cognitive dysfunction in post-COVID-19 ME/CFS(PCME/CFS) remain unclear. In this study, we designed a randomized controlled trial to evaluate the efficacy of acupuncture treatment in improving cognitive function in PCME/CFS and to investigate the neural mechanisms of acupuncture using multimodal magnetic resonance imaging (MRI) techniques. A total of 129 patients and 30 healthy controls (HCs) will be enrolled. The 129 patients with PCME/CFS will be randomly assigned in a 1:1:1 ratio to a verum acupuncture (VA), sham acupuncture (SA), or a waitlist control group. Participants in the VA and SA groups will receive three sessions of treatment per week for 8 weeks, while patients in the waitlist control group will be treated after the 8-week waiting period. The primary outcome is the change in the Symbol Digit Modalities Test (SDMT) score from baseline to week 8. The secondary outcome measures include changes from baseline to endpoint (week 8) in cognitive performance as assessed by the Digit Span Test (DST), Trail Making Test (TMT), Rey Auditory Verbal Learning Test (RAVLT), Rey-Osterrieth complex figure test (RCFT), Stroop Color and Word Test (SCWT), phonemic fluency test, category fluency test, action fluency test, and 30-item Boston Naming Test (BNT-30). In addition, changes in hippocampal metabolites and resting-state functional connectivity(RSFC) will be examined using The results of this study will provide preliminary evidence regarding the efficacy of acupuncture therapy in improving cognitive function in PCME/CFS and will explore whether acupuncture improves cognitive function in this disease by modulating metabolism and RSFC in the hippocampus. www.clinicaltrials.gov, identifier: NCT07357688.", "url": "https://pubmed.ncbi.nlm.nih.gov/42383026/" }, { "pmid": "42382648", "title": "SARS-CoV-2 reinfection: a possible contributing factor to long COVID in children and adolescents.", "pub_date": "2026-07-01", "journal": "Frontiers in pediatrics", "authors": "Chipol-Ceja, Rosela Lucero, Morales-Romero, Jaime, Rivero-López, Carlos Alonso, Pérez-Callejas, María Del Sagario et al.", "abstract": "Following the end of the COVID-19 pandemic, attention shifted towards patients who developed sequelae, persistent symptoms, or relapsing or remitting symptoms of new conditions after a prior history of acute SARS-CoV-2 infection. The objective of the present study was to identify the prevalence, clinical characteristics, and potential associated factors of long COVID in children treated during the pandemic in a primary care unit. A cross-sectional analytical study was conducted from January to December 2022. Children under 18 years of age and their parents were included in the study if they had been treated at the Mexican Social Security Institute. Two distinct manifestations of long COVID were considered: (a) \"persistence\", defined as continuous symptoms beginning in the acute phase and lasting for more than 3 months; and (b) \"post-COVID conditions\", defined as new or recurrent symptoms lasting for more than 3 months, appearing after the acute episode, and not associated with any active disease or infectious condition. An exploratory binary logistic regression analysis was performed to identify associated factors, using an odds ratio (OR) as the measure of association. The study included 349 children and adolescents. The prevalence of long COVID was 11.8% ( For healthcare professionals, it is crucial to consider the possibility of long COVID, as this study indicated that approximately 12% of children and adolescents may be affected. Further research is necessary to better understand and manage long COVID in pediatric populations and to investigate the association between reinfections and their increased prevalence.", "url": "https://pubmed.ncbi.nlm.nih.gov/42382648/" }, { "pmid": "42381644", "title": "Voice Outcomes of Patients Intubated for Critical COVID Illness: A Multicenter Study.", "pub_date": "2026-07-01", "journal": "OTO open", "authors": "Caruana, Francesco F, Gelbard, Alexander, Francis, David, Pitman, Michael J et al.", "abstract": "Characterize the long-term vocal outcomes of patients who required ICU care for COVID-19 infection. Prospective cohort study. Multi-institutional North American Airway Collaborative Study. Patients with a COVID-19 diagnosis requiring ICU admission were identified via ICD-10 codes and recruited after discharge to complete patient-reported outcome measures (PROM) in voice (Voice Handicap Index: VHI-10), communication (Communicative Participation Item Bank: CPIB), and breathing (Clinical COPD Questionnaire: CCQ). Multivariate analysis investigated the association between clinical variables and PROMs. 308 patients enrolled; 271 were admitted with COVID to the ICU. 221 were intubated (81.5%); 50 patients admitted to the ICU did not require intubation (18.5%). Mean follow-up was 489 days after discharge (95% CI: 452-526). Mean intubation duration was 17 days (95% CI: 15-19). Median endotracheal tube (ETT) size was 7.5. Intubation was associated with higher VHI-10 score (15 vs 10; Survivors of COVID infection requiring ICU admission and intubation have persistent functional impairments in voicing and breathing more than 1 year after their hospitalization. While COVID survivorship and \"long COVID\" have centered on neuropsychiatric and metabolic outcomes, this study highlights the unappreciated negative impact of endotracheal intubation on voice and communication related to this illness and reinforces the relationship between duration of intubation and subjective dyspnea after surviving critical illness.", "url": "https://pubmed.ncbi.nlm.nih.gov/42381644/" }, { "pmid": "42380995", "title": "Prolonged return to work and hampered work ability: insights from a scoping review on the impact of long COVID on healthcare workers job performance.", "pub_date": "2026-07-01", "journal": "BMC health services research", "authors": "Delano, Pia, Serra-Suton, Vicky, Benavides, Fernando G, Utzet, Mireia", "abstract": "Healthcare workers (HCWs) may have a higher risk of developing long COVID due to greater exposure to COVID-19, with symptoms extending beyond the acute phase impacting their daily living activities and job performance. To systematically map the existing literature on the impact of long COVID on HCWs' job performance, focusing on their time to return to work and work ability. A scoping review following PRISMA-ScR guidance included peer-reviewed studies in English or Spanish (January 2020-December 2024). Four databases were searched. Experimental, epidemiological and qualitative studies were eligible. Two reviewers independently screened records. Methodological quality was appraised using the Mixed-Methods Appraisal tool (MMAT). Nineteen studies were included, mainly European and predominantly cross-sectional. Long COVID was most often defined as symptoms lasting ≥ 3 months. Among HCWs with prior infection or whole-staff samples, prevalence ranged from 10% to 74%, with multiple reports above 50%. Thirteen studies evaluated RTW, with 19-63% resumed work within six months, commonly with restrictions, while around one in five remained unable to work in some cohorts. Full-time employment decreased markedly (e.g., 57% pre-infection vs 31% at follow-up). Between 16% and 40% required workplace adjustments such as reduced hours, reassignment, or avoidance of night shifts. Sixteen studies reported diminished work ability compared with pre-infection or unaffected peers. Greater symptom burden, particularly cognitive impairment and fatigue, consistently predicted poorer outcomes. One study estimated a mean of 223 days to reach current work-ability levels. Older age, depression, comorbidity, and acute disease severity were recurrent associated factors while evidence for gender and job category was inconsistent. Long COVID delays RTW and reduces work ability in HCWs. Health services should plan long-term occupational follow-up, flexible reintegration pathways, and targeted accommodations while higher-quality longitudinal research refines risk and prognosis.", "url": "https://pubmed.ncbi.nlm.nih.gov/42380995/" }, { "pmid": "42380873", "title": "Multimorbidity patterns and phenotype transitions in patients with clinician-coded long COVID: a multicenter US electronic health record cohort study.", "pub_date": "2026-07-01", "journal": "BMC infectious diseases", "authors": "Wang, Xiaofeng F, Huang, Shuaiqi, Xu, Yaomin, Zou, Yan et al.", "abstract": "Long COVID is clinically heterogeneous, but longitudinal changes in documented chronic disease burden and transitions in multimorbidity phenotypes after infection are not well characterized in routine care. We considered 425,614 patients with clinician-coded long COVID (ICD-10-CM U09.9) and a definable COVID-19 index date between October 1, 2021 and September 16, 2024 using deidentified electronic health record data from Epic Cosmos, a multicenter US network. Pre-index and post-index windows were defined as days - 365 to - 1 and days 91 to 455 relative to infection, respectively; follow-up was available through December 15, 2025. Chronic condition groups derived from ICD-10-CM codes were compared across windows using adjusted generalized estimating equation models. K-modes clustering was used to identify multimorbidity phenotypes, and multinomial regression was used to estimate adjusted transition probabilities. Two pre-index phenotypes were identified: low burden (87.9%) and multimorbid (12.1%). Four post-index phenotypes emerged: low burden (63.3%), multimorbid/systemic (21.0%), respiratory-dominant (4.3%), and high-utilization/low-coded multimorbidity (11.3%). Higher baseline multimorbidity was associated with greater probability of transition to the multimorbid/systemic phenotype, whereas respiratory-dominant and high-utilization phenotypes arose from both baseline groups. Increases were concentrated in neurologic/autonomic, respiratory, hypercoagulable, endocrine/metabolic, sleep-related, and symptom-based domains. The high-utilization/low-coded phenotype was younger, predominantly female, and had greater emergency department and outpatient use. Fewer changes reached statistical significance in children than in adults. Among patients with clinician-coded long COVID, chronic disease burden increased after infection and diversified into interpretable post-index phenotypes with distinct utilization profiles, supporting phenotype-informed follow-up and health system planning.", "url": "https://pubmed.ncbi.nlm.nih.gov/42380873/" }, { "pmid": "42380577", "title": "SARS-CoV-2 inhibitory, anti-inflammatory, antibacterial activity of black chokeberry (Aronia melanocarpa (Michx.) Elliott) branches' extracts and proanthocyanidins, and their synergistic interaction with antibiotics.", "pub_date": "2026-07-01", "journal": "Scientific reports", "authors": "Andersone, Anna, Ramata-Stunda, Anna, Nikolajeva, Vizma, Truhins, Marks et al.", "abstract": "Bacteria and viruses' potential collaboration has been reported to result in enhanced infection pathogenesis. New antimicrobial agents are necessary, but stronger synthetic antibiotics cause more severe side effects. The relevance of natural agents has increased in the post-COVID-19 period also due to COVID-induced cytokine storm, causing severe complications. This study aimed to evaluate Aronia melanocarpa branches for producing anti-SARS-CoV-2, anti-inflammatory, and antimicrobial preparations, and their synergistic activity with antibiotics. Biomass water and water-ethanol extracts were analyzed for total polyphenols, tannins, individual compounds (UHPLC-MS/MS), content of functional OH groups. Anti-SARS-CoV-2 activity was tested using SARS-CoV-2 (2019-nCoV) Inhibitor Screening ELISA Kit, anti-inflammatory activity - in peripheral blood mononuclear cells (PBMNC) under normal and inflammatory conditions; antimicrobial and synergistic efficacy with antibiotics were tested against Staphylococcus aureus and methicillin-resistant S. aureus (MRSA). Oligomeric proanthocyanidins were dominant compounds in the extracts, with the highest concentration in autumn samples (35% per dry extract). The extracts and oligomeric proanthocyanidins were effective in inhibiting the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein and regulating inflammatory processes caused by viral and bacterial infections, including the reduction of IL-6 and regulation of IL-10 secretion. Proanthocyanidins and extracts exhibited significant anti-biofilm activities and showed synergistic activity with antibiotics.", "url": "https://pubmed.ncbi.nlm.nih.gov/42380577/" }, { "pmid": "42380347", "title": "Hybrid deep learning framework for cardiovascular risk prediction in post-COVID-19 patients.", "pub_date": "2026-07-01", "journal": "Scientific reports", "authors": "Diana Juliet, S, Banumathi, J, Anix Joel Singh, J", "abstract": "Cardiovascular complications associated with Post-COVID-19 Patients remain difficult to identify at early stages due to heterogeneous physiological manifestations and the limited integration of imaging and clinical indicators in conventional diagnostic frameworks. To address this challenge, this work proposes a multimodal deep learning framework for cardiovascular disease (CVD) risk prediction by integrating cardiac computed tomography (CT) imaging with structured clinical data. The proposed approach applies Adaptive Bilateral Filtering for image enhancement, Kernel Density Fuzzy C-Means (KDFCM) for myocardial segmentation, and Squeezing Extract Chirplet Transform (SSECT) for extracting multi-scale texture and frequency-based imaging features. Clinical variables are preprocessed through Z-score normalization, interquartile range (IQR)-based outlier removal, and Isolation Forest anomaly detection, followed by Adaptive Starfish Optimization (ASO) for feature selection. Imaging and clinical representations are integrated through feature-level fusion and classified using a Deep Image Recognition-based Generative Adversarial Network (DIR-GAN), where adversarial learning enhances discriminative feature representation and model robustness. Experimental evaluation demonstrates strong predictive performance, achieving 94.98% accuracy, 94.98% sensitivity, 93.38% specificity, 95.43% precision, and 94.74% F1-score. The findings indicate that the proposed framework provides reliable and clinically relevant cardiovascular risk stratification for patients recovering from COVID-19, while demonstrating robustness against heterogeneous multimodal data.", "url": "https://pubmed.ncbi.nlm.nih.gov/42380347/" }, { "pmid": "42379475", "title": "A [", "pub_date": "2026-07-01", "journal": "Biochemical pharmacology", "authors": "Tang, Chao, Song, Huanhuan, Zhu, Qian, Han, Pengzhe et al.", "abstract": "Metabolic dysfunction-associated steatohepatitis (MASH) is characterized by hepatocellular injury, inflammation, and progressive fibrosis, yet current non-invasive tests do not directly assess the cellular drivers of fibrogenesis. Platelet-derived growth factor receptor beta (PDGFRβ) is highly expressed on activated hepatic stellate cells (aHSC), a major effector cell population in MASH. A PDGFRβ-targeted peptide was synthesized and radiolabeled with gallium-68. We investigated whether PDGFRβ-targeted PET imaging could enable non-invasive molecular assessment of MASH severity. Dynamic PET/CT, ex vivo autoradiography, histopathology, immunostaining, western blotting, and qPCR were performed in graded MASH mouse models induced by choline-deficient, L-amino acid-defined, high-fat diet (CDAHFD) and methionine-choline-deficient (MCD) diet, with human MASH liver specimens for validation. Both CDAHFD and MCD models developed progressive steatohepatitis and fibrosis accompanied by increasing hepatic PDGFRβ expression. PDGFRβ colocalized with αSMA positive aHSC populations and the proportion of PDGFRβ/αSMA double positive cells increased markedly in diseased livers. PET imaging demonstrated progressively increased hepatic uptake of the", "url": "https://pubmed.ncbi.nlm.nih.gov/42379475/" }, { "pmid": "42377994", "title": "Silencing the Signal: The Metastasis Suppressor NDRG1 Disrupts Small Extracellular Vesicle-Mediated Crosstalk in Pancreatic Cancer.", "pub_date": "2026-06-30", "journal": "Journal of extracellular vesicles", "authors": "Chang, Jiawei, Alenizi, Shafi, Milioli, Heloisa Zaccaron, Lay, Winston et al.", "abstract": "Pancreatic cancer (PaC) remains one of the deadliest cancers, with 5-year survival rates of 13%. A major driver of its aggressiveness is the tumour microenvironment (TME), which fuels tumour growth, metastasis, and therapeutic resistance through dynamic, bi-directional communication between cancer cells, fibroblasts, and immune cells. Emerging evidence highlights extracellular vesicles (EVs) as key mediators of oncogenic cross-talk within the PaC TME. This study demonstrates for the first time that the overexpression of metastasis suppressor N-myc downstream regulated gene 1 (NDRG1) significantly influences the biogenesis, cargo packaging and release of EVs by cancer cells. This was mediated by a direct interaction between NDRG1 and ALIX, a key protein involved in EV biogenesis and packaging, with NDRG1 facilitating ALIX proteasomal degradation. Further, EVs released from NDRG1-overexpressing cells had significantly fewer CAF-activation proteins (i.e. TGF-β), leading to attenuated ERK1/2 and p38 activation in pancreatic stellate cells (PSCs), and reduced expression of key fibrotic markers (α-SMA, FAP, and collagen 1A). NDRG1 overexpression also reduced sEVs uptake by PaC cells and diverted these to the lysosome for degradation. These findings uncover a previously unrecognized mechanism by which NDRG1 overexpression disrupts the oncogenic two-way communication between PaC cells and the TME, positioning NDRG1 overexpression as a compelling therapeutic approach against this formidable malignancy.", "url": "https://pubmed.ncbi.nlm.nih.gov/42377994/" }, { "pmid": "42377750", "title": "Factors affecting exercise performance at the 6-min walk test in long-COVID: a multicenter study from Italy.", "pub_date": "2026-06-30", "journal": "Internal and emergency medicine", "authors": "Floridia, Marco, Weimer, Liliana Elena, Palange, Paolo, Ciardi, Maria Rosa et al.", "abstract": "The cofactors potentially affecting exercise performance after COVID-19 are still incompletely investigated. The contribution of several clinical and demographic variables to the exercise capacity measured with the 6-min walk test was assessed in multivariable analyses that used the absolute distance walked in 6 min (6MWD) and an impaired performance (6MWD < 60% of the predicted value) as study outcomes. The variables considered were age, sex, preexisting comorbidities, COVID-19 severity, pandemic phase, treatments administered in acute phase, SARS-CoV-2 vaccination, reinfection, time from acute infection, and presence of 30 persisting symptoms. The mean 6MWD recorded among 686 patients at a mean interval of 184 days from COVID-19 was 474 m, with 8.3% of them presenting values below 60% of the predicted value. 6MWD was affected by sex, comorbidities, COVID-19 severity, and some persisting symptoms. The estimated effect sizes were -29.9 m for severe/critical acute disease, between -26 and -87 m for six comorbidities (atrial fibrillation, renal failure, chronic liver disease, chronic pulmonary disease, ischemic heart disease, diabetes) and between -21 and -99 m for four persisting symptoms (nausea/vomiting, paresthesia, depressed mood, dyspnea). The 6MWD increased by 2.6 m per month elapsed from acute infection. A 6MWD < 60% was associated with female sex, more intensive respiratory support, four comorbidities (atrial fibrillation, renal failure, chronic pulmonary disease and ischemic heart disease), and two persisting symptoms (nausea/vomiting and palpitations/tachycardia). Exercise performance after COVID-19 is affected by multiple factors, with estimated effect sizes that are clinically relevant. The results also suggest some spontaneous improvement over time.", "url": "https://pubmed.ncbi.nlm.nih.gov/42377750/" }, { "pmid": "42376966", "title": "Young People Navigating the Looping Effects of Long Covid: Exhausting Agency and the 'Ongoing After' of Pandemic.", "pub_date": "2026-06-30", "journal": "Sociology of health & illness", "authors": "Rhodes, Tim, Cowan, Hannah, Clarke, Zaira, Fernes, Praveena et al.", "abstract": "Seeing beyond the COVID-19 pandemic as an extraordinary spectacle situated in the past, we draw on qualitative research with young people to trace experiences of Long Covid as 'looping effects' of entangling physical and social impacts which intersect with, and extend, those of pandemic. Navigating the capacity to do ordinary things becomes highly contingent, and exhausting work, in the face of Long Covid. The physical impacts of illness, including fatigue, are materialised in altering biographical and social relationships, and managing the 'social life' of Long Covid is a key concern. The lifetimes of Long Covid and pandemic also feed into one another. Configurations of the COVID-19 pandemic as a thing of the past, and social responses felt discounting of the Long Covid experience, enact ongoing illness as 'out of sync', and contribute as elements of exhausted agency and extended precarity. The social impacts of the pandemic looping with Long Covid become iterations without clear end; events ongoing in the living present. Understanding how Long Covid extends the 'ongoing after' of pandemic highlights the need for lasting social support for affected young people.", "url": "https://pubmed.ncbi.nlm.nih.gov/42376966/" }, { "pmid": "42376726", "title": "The Silent Crisis: Loneliness in Older Adults-A Critical Review of Impacts, Strategies and Path Forward.", "pub_date": "2026-06-30", "journal": "Scandinavian journal of caring sciences", "authors": "Abdul Rahman, Hanif, Zahari, Nurrabiatul Haziqah", "abstract": "Loneliness, distinct from social isolation, is a subjective sense of social disconnection exacerbating a public health crisis among older adults. Affecting ~33% of community-dwelling individuals aged 50-80 years post-COVID-19, it rivals smoking in mortality risk and drives cognitive, cardiovascular, and mental health declines. This review synthesises evidence to inform clinical strategies. A critical review of per-reviewed meta-analyses, RCTs, and prospective cohorts literature (2019-2025) was conducted for adults aged 50 years and above. Studies were selected using validated loneliness or social isolation measures, with quality appraised via AMSTAR-2, Cochrane RoB 2, and Newcastle-Ottawa Scale; 34 studies met eligibility criteria from an initial yield of 1,847 records. Prevalence of loneliness stands at 29% isolation by 2024, highest among those with poor health (53%-75%), unemployment (52%), solitary living, and ages 50-64. Loneliness elevates all-cause mortality (32%), dementia (50%-59%), cardiovascular events (29%-32%), depression (40%), and anxiety (35%). Mechanisms include increased inflammation (↑CRP, IL-6), HPA dysregulation, immune compromise, hippocampal atrophy, and behavioural lapses. Interventions like CBT/reminiscence therapy, multicomponent programs, animal therapy, exercise, and digital platforms have been shown to reduce loneliness, though primary care implementation lags due to screening/referral barriers. Tools such as the UCLA Loneliness Scale enable feasible assessment. Loneliness as a geriatric syndrome demands mandated screening, provider education, and reimbursement reforms. Coordinated healthcare-community efforts could avert substantial morbidity/mortality, addressing gaps in long-term outcomes and cost-effectiveness research.", "url": "https://pubmed.ncbi.nlm.nih.gov/42376726/" }, { "pmid": "42376321", "title": "Genetic association between LONG COVID and TMPRSS2 polymorphisms (rs12329760 and rs2070788) in Brazilian healthcare professionals.", "pub_date": "2026-06-30", "journal": "Frontiers in cellular and infection microbiology", "authors": "Telles, Alysson Fellipe Costa, Menezes Junior, Bearli Souza, Dos Santos, Cliomar Alves, Sena, Ludmila Oliveira Carvalho et al.", "abstract": "Long COVID syndrome has a multifactorial cause that is not fully understood and may be influenced by both external and intrinsic factors. In this context, a Genome-Wide Association Study (GWAS) was proposed to evaluate the association between Single Nucleotide Polymorphisms (SNPs) in TMPRSS2 (rs12329760 and rs2070788) and the occurrence of Long COVID in 363 Brazilian healthcare professionals, recruited using a non-probabilistic method. The study employed a self-report questionnaire to collect sociodemographic and clinical data from both the acute and chronic phases and also collected oral mucosa cells for genotypic analysis by qPCR using Taqman probes. The categorized information was analyzed using the PSPP software using Pearson's chi-square test in three genetic statistical models: additive, dominant, and recessive. Assessing long COVID in general, only clinical variables such as increased susceptibility, presence of symptoms, and severity influenced the occurrence of the syndrome. When specifying the main reported symptom, brain fog, females and young adults (18 to 29 years old) are the most vulnerable, and rs2070788 in the recessive model proved to be relevant. This association is more evident when evaluating only the symptomatic group in the post-COVID period, as the additive model also influences the groups. rs12329760 showed no relevant influence on the groups. Therefore, this study provides unprecedented evidence of the association between brain fog and rs2070788, requiring case-control studies to better clarify how this association occurs.", "url": "https://pubmed.ncbi.nlm.nih.gov/42376321/" }, { "pmid": "42376237", "title": "A randomised, placebo-controlled, triple-blind clinical trial to investigate the efficacy of", "pub_date": "2026-06-30", "journal": "Frontiers in human neuroscience", "authors": "Matias-Guiu, Jordi A, Arelin, Katrin, Serrano, Paula Jiménez, Wacker, Anna et al.", "abstract": "Cognitive impairment is frequent in post-COVID-19 syndrome (PCS). The understanding of the pathogenesis is still limited. Key factors such as neuroinflammation, neurovascular dysfunction, and disruption of cellular energy metabolism have been identified. There are no evidence-based treatments targeting the pathologic mechanisms of cognitive impairment associated with PCS available to date. Thus, treatment is directed towards symptom relief. EGb 761 In this prospective, multicentre, randomised, placebo-controlled, triple-blind trial, treatment effects and safety of EGb 761 The results of this trial will show for the first time whether EGb 761 https://euclinicaltrials.eu/ctis-public/view/2024-517199-39-00?lang=en, Identifier CTIS2024-517199-39-00.", "url": "https://pubmed.ncbi.nlm.nih.gov/42376237/" }, { "pmid": "42375366", "title": "Case Report: Metastatic right ventricular tumor and pulmonary embolism from cervical cancer post COVID-19 infection.", "pub_date": "2026-06-30", "journal": "Frontiers in immunology", "authors": "Yang, Yuemei, Zhu, Xiaohui, Hu, Danli", "abstract": "The intracavitary cardiac metastasis from squamous cell carcinoma of the uterine cervix combined with pulmonary embolism is extremely rare, with mean survival less than six months. We report a case of a 52-year-old female with stage IVB cervical squamous cell carcinoma (SCC) and cardiac metastasis presented with exertional dyspnea and chest pain concerning pulmonary embolism (PE) post COVID-19 infection. After empirical anticoagulation and anti-infective therapy, the intracardiac mass and pulmonary embolism persisted. Subsequent PET-CT and histopathological examination revealed advanced cervical squamous cell carcinoma with suspected tumor thrombus involving the right heart and pulmonary artery. Given extensive metastatic disease and high bleeding risk, the multidisciplinary team discussed individualized systemic therapy and suggested conservative management. The patient survived 14 months after diagnosis.", "url": "https://pubmed.ncbi.nlm.nih.gov/42375366/" }, { "pmid": "42375052", "title": "Post-hospitalized Health Conditions of Covid-19 patients: A Cross-sectional study in Bangladesh.", "pub_date": "2026-06-30", "journal": "Mymensingh medical journal : MMJ", "authors": "Sharif, M M, Jabed, M A, Mahanta, J, Bari, M S et al.", "abstract": "The objective of this research is to examine comorbidity status of hospitalized Covid-19 patients and its association with post-Covid-19 health complications. Data were collected from 1207 Covid-19 patients who were hospitalized at Dhaka Medical College Hospital (DMCH), Bangladesh from May 2020 to April 2021. Results show that patients with pre-existing diseases needed longer hospitalization and reported experiencing post-Covid-19 related health complications. Moreover, Covid-19 hospitalized patients suffered from different physical and mental health problems after being discharged from hospital including weakness, dyspnea and physical discomfort while also suffered mental health problems like anxiety, brain fog, dementia. The majority of them (>80.0%) followed the precautions recommended by health care personnel after hospitalization and thus only a few of them were re-infected by Covid-19.", "url": "https://pubmed.ncbi.nlm.nih.gov/42375052/" }, { "pmid": "42375012", "title": "Association of the Primary Aldosteronism Severity Classification with Lateralization and Treatment Outcomes.", "pub_date": "2026-06-30", "journal": "The Journal of clinical endocrinology and metabolism", "authors": "Lee, Ju Hee, Kim, Ha Young, Park, Min Jeong, Hong, A Ram et al.", "abstract": "The 2025 clinical guideline for primary aldosteronism (PA) recommends a diagnostic and therapeutic pathway stratified by lateralization risk. The PA severity classification (PASC) integrates biochemical and clinical features and is intended to inform graded recommendations for adrenal venous sampling (AVS). We examined whether PASC is associated with AVS-defined lateralization and treatment outcomes. A retrospective multicenter cohort study. Eight tertiary centers. A total of 833 patients with PA who underwent AVS. PASC severity was classified as mild, moderate, or severe. We evaluated associations between severity, AVS-defined lateralization, and outcomes using the Primary Aldosteronism Surgical Outcome (PASO) and Primary Aldosteronism Medical Treatment Outcome (PAMO) criteria. Among 833 patients, 52 (6.1%), 563 (67.6%) and 218 (26.2%) had mild, moderate, and severe PA, respectively. Higher severity was associated with a stepwise increase in AVS-defined lateralizing PA (19.2%, 48.0%, and 76.1%, respectively; p < 0.001). In unilateral PA treated surgically, PASO clinical outcomes differed by severity (p = 0.002), with complete clinical success in 40.2% (moderate) and 31.3% (severe), and a marked increase in partial clinical success in severe disease (55.1%). PASO biochemical outcomes were similar across severity groups (p = 0.389). In bilateral PA treated medically, PAMO clinical outcomes varied by severity (p = 0.005), with complete clinical response decreasing from mild to severe disease (36.8%, 27.0%, and 8.8%), whereas biochemical outcomes were comparable (p = 0.993). PASC-defined severity correlated with AVS-defined lateralization. Greater severity was associated with lower rates of complete clinical success/response despite preserved biochemical outcomes, supporting a severity-informed framework to complement AVS in PA management.", "url": "https://pubmed.ncbi.nlm.nih.gov/42375012/" }, { "pmid": "42372895", "title": "Characterization of a lytic polysaccharide monooxygenase important for utilization of chitin in Chitinibacter mangrovi FCG-7.", "pub_date": "2026-06-30", "journal": "International journal of biological macromolecules", "authors": "Huang, Liju, Fang, Hongliang, Yang, Dengfeng, Yang, Liyan et al.", "abstract": "Lytic polysaccharide monooxygenases (LPMOs) are crucial for recalcitrant biomass degradation. We characterized CmLPMO10, an AA10 LPMO from Chitinibacter mangrovi FCG-7, and demonstrated its essential role in α-chitin utilization through transcriptomics and gene deletion. Biochemically, CmLPMO10 is a robust enzyme with optimal activity at 50 °C and pH 7.0, featuring unique regioselectivity: C1-specific oxidative activity on chitin and C1/C4 activity on cellulose. CmLPMO10 showed the strongest synergistic degradation of α-chitin with its homologous chitinase CmChi18B (degree of synergy: 1.96). Furthermore, CmLPMO10 also exhibited synergistic enhancement of cellulosic substrate hydrolysis when combined with the commercial cellulase preparation Celluclast® 1.5 L, achieving degree of synergy values of 1.31 for Avicel, 1.24 for PASC, and 1.55 for sugarcane bagasse-derived cellulose. Structural analysis revealed CmLPMO10 pretreats α-chitin not by forming pores but by inducing surface roughening, loosening, and selective crystallinity reduction to enhance substrate accessibility. The collaboration is finely tuned, with optimal enzyme ratios differing between chitinase partners (1:5 for CmChi18B; 1:25 for SmChiC), and exhibits nonlinear kinetics reflecting synergy-competition balance. Our work elucidates the function and mechanism of CmLPMO10 and its potential as a key biocatalyst for efficient α-chitin biomass valorization.", "url": "https://pubmed.ncbi.nlm.nih.gov/42372895/" }, { "pmid": "42371512", "title": "Mapping the occupational therapy process in response to COVID-19 and long COVID: A scoping review.", "pub_date": "2026-06-29", "journal": "The British journal of occupational therapy", "authors": "Cezar da Cruz, Daniel, Haertl, Kristine, Tomlin, George S, Yu, Chih-Huang et al.", "abstract": "COVID-19 and long COVID have had an impact worldwide on people's participation in occupations. Occupational therapists play a role in supporting individuals' recovery and participation in daily life. This present study undertook a scoping review of research on COVID-19 and long COVID to map the occupational therapy process with this population, including evaluation, intervention and outcomes. Three online databases were searched to identify research papers published between 2020 and 2023 from all countries, published in English, Portuguese, or Spanish. From 455 texts, 25 studies were selected for this review. Studies were conducted across varied healthcare settings, mainly inpatient hospitals. Participants ranged from children to older adults, with adults being the most represented group. Standardised assessments included occupational history, activities, body functions, cognition and emotional regulation. Interventions were educational, compensatory, restorative or acquisitional, with outcomes focused on daily living activities, performance skills and client factors. Our review underscores the need for more comprehensive documentation of occupational therapy effectiveness, particularly in unpredictable circumstances such as COVID.", "url": "https://pubmed.ncbi.nlm.nih.gov/42371512/" }, { "pmid": "42371502", "title": "The Time Course of Serum Iron and Serum Ferritin Concentrations Post-COVID-19 and Influenza Vaccinations.", "pub_date": "2026-06-29", "journal": "Case reports in infectious diseases", "authors": "Lodemann, Peter, Tsuprykov, Oleg, Lawaczeck, Rüdiger", "abstract": "Temporal responses of serum iron and ferritin in COVID-19 infection and vaccination remain insufficiently characterized. This case report presents their timeline after SARS-CoV-2 and influenza vaccinations and may serve as a model for future studies. The approach can be extended to cohort studies or investigations of other acute-phase reactants. A vaccination protocol with a defined timeline can provide a template for COVID-19 and long COVID studies. Blood samples were collected from vaccination through 6 weeks postvaccination, focusing on iron metabolism. Prevaccination values served as baseline controls. SARS-CoV-2 mRNA vaccination was administered together with routine seasonal influenza vaccination. Previous influenza vaccinations in this patient were not associated with systemic symptoms such as dizziness or fever; in contrast, the present case exhibited clear reactions, suggesting that the observed alterations in serum iron and ferritin are attributable to the SARS-CoV-2 vaccine. The vaccination induced an abrupt decrease in serum iron and a concomitant increase in ferritin. While ferritin returned to baseline within 6 weeks, iron levels steadily increased to approximately 1.8-fold above baseline values but remaining within the reference interval. The observed decrease in serum iron reflects an iron-withholding response, a well-established host defense mechanism during infections that limits pathogen proliferation. The increase in ferritin requires further interpretation. A hypothesis is presented, but further data are needed to support this mechanism. In future cohort studies, the protocol should include individual prevaccination values so that an additional control group is not necessary. Immune reactions to vaccines can trigger transient changes in serum iron and ferritin that resemble the acute-phase response observed during infections. This case may serve as a template for studying the kinetics of immune responses, where", "url": "https://pubmed.ncbi.nlm.nih.gov/42371502/" }, { "pmid": "42371051", "title": "Post-COVID: a specific neuropsychological profile in performance deficits.", "pub_date": "2026-06-29", "journal": "Journal of neural transmission (Vienna, Austria : 1996)", "authors": "Müller, Britta, Balz, Ulrike, Bartels, Katharina, Eggers, Farina et al.", "abstract": "SARS-CoV-2 is frequently associated with cognitive impairment. When symptoms persist for more than four weeks after acute infection, a Long-COVID condition is diagnosed. When persisting more than 12 weeks, Post-COVID ist diagnosed. Cognitive complaints commonly include impairments in attention, memory, and executive functions. However, precise data on the specific pattern and extent of these deficits remain limited. Results: Conclusions: The findings indicate that attentional impairments are more prevalent than memory deficits in this Post-COVID cohort. Furthermore, distinct cognitive profiles can be identified using cluster analysis, ranging from globally impaired to cognitively preserved subgroups. These results may be relevant for clinical characterization and rehabilitation planning in Post-COVID conditions. We examined 88 patients (mean age 50.9 years, 80.7% female) diagnosed with COVID symptoms according to the WHO-criteria. Neuropsychological assessment was performed using a standardized test battery covering attentional performance, working memory, and executive functions. A cluster analysis was conducted to identify subgroups based on cognitive performance profiles. Overall, 55.7% of patients showed below-average attentional performance, whereas memory deficits were less frequent (33.0%). Impairments in executive functions were similarly distributed across the sample. Cluster analysis yielded a three-cluster solution. Cluster 1 (34.1%) was characterized by pronounced impairments across all cognitive domains. Cluster 2 (20.0%) showed generally below-average cognitive performance; however, verbal fluency was preserved at or above average in all participants. In Cluster 3 (17.6%) more than 50% of patients in performed within average to above-average ranges across all cognitive domains. The findings indicate that attentional impairments are more prevalent than memory deficits in this Post-COVID cohort. Furthermore, distinct cognitive profiles can be identified using cluster analysis, ranging from globally impaired to cognitively preserved subgroups. These results may be relevant for clinical characterization and rehabilitation planning in Post-COVID conditions.", "url": "https://pubmed.ncbi.nlm.nih.gov/42371051/" }, { "pmid": "42370768", "title": "Idiopathic anaphylaxis and histamine dysregulation: Revisiting pathophysiologic assumptions.", "pub_date": "2026-06-29", "journal": "The Nurse practitioner", "authors": "Applewhite, Tneecia L", "abstract": "Idiopathic anaphylaxis (IA) is a diagnosis of exclusion, and the etiology remains elusive. Research on immunoglobulin E (IgE)-mediated anaphylaxis has identified histamine as the immune system mediator, but dietary histamine's potential role in IA is often overlooked. For some individuals, excessive histamine may cause IA and mimic signs and symptoms of IgE-mediated anaphylaxis.1 This review provides an overview of IA and the potential role of histamine in symptom manifestation. It aims to enhance awareness and provide nurse practitioners with insights into the complexities of managing IA, emphasizing the importance of considering dietary factors in patient care and treatment strategies.", "url": "https://pubmed.ncbi.nlm.nih.gov/42370768/" }, { "pmid": "42369154", "title": "Longitudinal trajectories of hematological indices and serum metalloproteinases-2 and 9 over 1 year after moderate and severe COVID-19.", "pub_date": "2026-06-29", "journal": "Frontiers in medicine", "authors": "Salomão, Rebecca, Pasquarelli-do-Nascimento, Gabriel, Ananias, Mayara, Assis, Victoria et al.", "abstract": "The long-term clinical burden of Coronavirus disease (COVID-19) remains substantial, yet one-year cohort evidence linking blood-based biomarkers to persistent sequelae is limited. We conducted a longitudinal study in adults aged 18-80 years who were classified as moderate or severe COVID-19 or non-COVID-19 controls. Blood was collected at four time points through 360 days after infection or hospital discharge. Cytokines were quantified by flow cytometry. MMP-2 and MMP-9 levels and activity were assessed by gelatin zymography. Hematological parameters were measured in an accredited clinical laboratory. Longitudinal effects were evaluated using generalized estimating equations. Compared with moderate cases and controls, participants who experienced severe acute disease showed persistent immune dysregulation and systemic inflammation at approximately 1 year, with higher concentrations of inflammatory mediators and cytokines and sustained elevations in MMP-2 and MMP-9. Complete blood count-derived indices were also altered over time in severe cases, including the aggregate index of systemic inflammation, the C-reactive protein to lymphocyte ratio, the neutrophil to platelet ratio, and the systemic inflammation response index, together with red cell distribution width, while renal function tests, hepatic enzymes, and muscle injury markers were largely stable across groups. These findings delineate a persistent inflammatory and matrix-remodeling signature up to 1 year after severe COVID-19, based on longitudinal biomarker profiles rather than symptom-defined long COVID-19 outcomes. This biomarker panel may help to inform future studies of post-acute risk stratification and targeted interventions, but prospective prognostic validation and clinical endpoint data are still required. https://clinicaltrials.gov/study/NCT04961255?term=NCT04961255&rank=1, NCT04961255.", "url": "https://pubmed.ncbi.nlm.nih.gov/42369154/" }, { "pmid": "42368852", "title": "Associated thromboembolic events to the post COVID syndrome: a systematic review and meta-analysis.", "pub_date": "2026-06-29", "journal": "Frontiers in cardiovascular medicine", "authors": "Endara-Mina, Jesús, Escudero, Cristopher-Josue, Intriago, Cesar, Coloma-Ramirez, Lisseth et al.", "abstract": "The COVID-19 pandemic has imposed a substantial worldwide health burden; a fraction of people develops post-COVID syndrome, in which symptoms persist long after the initial phase of infection. Although these individuals may be more susceptible to developing thromboembolic events, the extent and significance of this link remain uncertain. This systematic review and meta-analysis sought to explore the prevalence of thromboembolic events in people with post-COVID syndrome, therefore addressing knowledge gaps and providing critical information for therapeutic management. Following PRISMA principles, a thorough search across numerous databases-including Medline, Web of Science, Scopus, Dimensions, the Virtual Health Library, the British Library, and Google Scholars-was performed. Analytical cross-sectional, case-control, and cohort studies on individuals with post-COVID syndrome were considered eligible research. Meta-analysis was performed using Review Manager 5.4.1, with a random-effects model providing hazard ratios (HR) and 95% confidence intervals (CI) for specific thromboembolic events. The initial database search yielded 1,617 publications, 1,021 of which passed title and abstract screening after duplicates were removed. Following a full-text analysis of 83 publications, 20 met the inclusion criteria, with 5 included in the quantitative synthesis and 15 in the qualitative synthesis. Emphasizing ramifications for clinical therapy, particularly among vascular surgeons, this thorough review and meta-analysis exposes a significant thromboembolic risk among patients with post-COVID syndrome. The outcomes highlight the need for early detection, proactive monitoring, and tailored preventive treatments, including anticoagulant drugs. https://www.crd.york.ac.uk/PROSPERO/view/CRD42023441556, PROSPERO CRD42023441556.", "url": "https://pubmed.ncbi.nlm.nih.gov/42368852/" }, { "pmid": "42368558", "title": "Microthrombi targeted nano-micelle synchronizing endothelial gap opening and matrix decompression for augmenting drug perfusion within pancreatic cancer.", "pub_date": "2026-06-29", "journal": "Acta pharmaceutica Sinica. B", "authors": "Yang, Mengnan, Tong, Yuqing, Yin, Shaoping, Zhang, Hengchuan et al.", "abstract": "Local inhibition of the \"patching\" function of tumor-associated platelets against neutrophil infiltration-caused vascular breaches has been used as an \"enhanced permeability and retention (EPR) amplification\" strategy. Nevertheless, the vascular leakage-resulted elevation of interstitial fluid pressure (IFP) could impact tumoral perfusion and convection of nanodrugs. Especially for hypoperfused and desmoplastic pancreatic ductal adenocarcinoma (PDAC), solely relying on vascular destruction would predictably diminish tumoral drug perfusion. According to multi-thrombosis formation in PDAC, a microthrombi and matrix co-targeted dasatinib (DAS) nano-micelle (CPHD/DAS) synchronizing endothelial gap opening and matrix decompression was constructed for sustained augmentation of drug perfusion within PDAC. CPHD/DAS was composed of CREKA peptide-modified hyaluronic acid-deoxycholate conjugates co-assembled with DAS.", "url": "https://pubmed.ncbi.nlm.nih.gov/42368558/" }, { "pmid": "42367705", "title": "Impact of COVID-19 Infection and Vaccination on Abdominal-based Microvascular Breast Reconstruction Outcomes.", "pub_date": "2026-06-29", "journal": "Plastic and reconstructive surgery. Global open", "authors": "Tobias, Finn, Fazzalari, Amanda, Malapati, Sri Harshini, Hyland, Colby et al.", "abstract": "SARS-CoV-2 (COVID-19) infection increases thrombotic risk; however, its impact on microsurgical breast reconstruction outcomes remains unclear. This study examines postoperative complications in patients following abdominal-based microvascular breast reconstruction relative to (1) timing relative to the COVID-19 pandemic, (2) history of COVID-19 infection, and (3) time since COVID-19 vaccination/booster. A retrospective review of patients who underwent abdominal-based microvascular breast reconstruction was conducted. Patients were categorized into pre-COVID-19 (January 23, 2017-January 19, 2020, n = 236) and post-COVID-19 (January 20, 2020-October 17, 2022, n = 233) groups. The post-COVID-19 group was further stratified by COVID-19 infection history and vaccination/booster status, within 40 days before surgery. Sociodemographic, clinical, and postoperative complication data were analyzed. The sample included 469 patients with a median age of 50 years and mean body mass index of 28.6 kg/m Postoperative complication rates were similar between pre- and post-COVID-19 cohorts. COVID-19 infection or recent vaccination within 40 days before surgery was not associated with increased risk of major complications, including thrombotic events, in abdominal-based microvascular breast reconstruction.", "url": "https://pubmed.ncbi.nlm.nih.gov/42367705/" }, { "pmid": "42367505", "title": "Progressive Supranuclear Palsy Unmasked After Post-COVID-19 Functional Decline in an Elderly Patient: A Diagnostic Challenge.", "pub_date": "2026-06-29", "journal": "Cureus", "authors": "Fulco, Enrico", "abstract": "Progressive supranuclear palsy (PSP) is a rare neurodegenerative tauopathy characterized by early postural instability, vertical supranuclear gaze palsy, axial rigidity, and poor response to levodopa therapy. Diagnosis remains challenging, particularly in the early stages, because of overlap with other Parkinsonian syndromes. We report the case of an 83-year-old woman who developed progressive gait instability, severe functional decline, dysphagia, and marked weight loss following a mild SARS-CoV-2 infection. Extensive investigations initially excluded metabolic, infectious, neoplastic, and structural causes. Neurological examination revealed axial and limb bradykinesia, hypomimia, hypophonia, apraxia, severe postural instability, and vertical gaze limitation. Oculomotor assessment also documented square wave jerks and eyelid opening apraxia. Levodopa therapy was ineffective. Brain MRI demonstrated marked midbrain atrophy with relative preservation of pontine volume, producing the characteristic hummingbird sign and Mickey Mouse sign. DAT-SPECT showed bilateral putaminal dopaminergic deficit, supporting a degenerative Parkinsonian syndrome. A diagnosis of probable PSP was established according to Movement Disorder Society criteria, clinical presentation, absence of levodopa responsiveness, and supportive imaging findings. This case highlights the diagnostic complexity of PSP when nonspecific systemic manifestations precede neurological deterioration and emphasizes the value of integrating clinical assessment with structural and functional neuroimaging.", "url": "https://pubmed.ncbi.nlm.nih.gov/42367505/" }, { "pmid": "42367370", "title": "\"That's not my silo\": Navigating fragmented long COVID care in the mid-Atlantic United States.", "pub_date": "2026-06-29", "journal": "SSM. Qualitative research in health", "authors": "Tan, Heang-Lee, Rosser, Erica, Hernandez, Angélica Lopez, Fei, Y Christine et al.", "abstract": "Long COVID is a chronic illness affecting multiple organ systems, which can be at odds with a highly specialized and siloed U.S. healthcare system. Patients frequently see multiple specialists for diverse symptoms, creating substantial coordination challenges. We conducted a qualitative study using semi-structured interviews with 69 U.S. Mid-Atlantic adults diagnosed with or suspected of having Long COVID, recruited through a Long COVID clinic, MyChart patient-portal outreach, and snowball sampling. Interviews were conducted via Zoom, phone, or in person, audio-recorded, transcribed, and analyzed using the Framework Approach. Participants described significant difficulty navigating a fragmented healthcare system characterized by siloed care, communication breakdowns, long wait times, and unclear provider responsibilities, as well as difficulties obtaining a diagnosis. When coordination failed, patients were often forced to organize and direct their own healthcare, a task that was cognitively and physically taxing, particularly for those experiencing brain fog and fatigue, and, for some, ultimately led to delaying or forgoing care. Strengthening care coordination for Long COVID could reduce patient burden and improve access to care. Needed strategies include standardized diagnostic definitions, enhanced primary care roles, interoperable referral pathways, and institutional case conferencing to clarify provider responsibilities. Patient navigators, expanded telehealth options, and community-based support, especially culturally tailored services for disproportionately affected groups, may further reduce fragmentation, scheduling strain, and inequities. Addressing these systemic barriers is essential to creating a more efficient, patient-centered care experience in which patients are no longer responsible for coordinating their own complex care.", "url": "https://pubmed.ncbi.nlm.nih.gov/42367370/" }, { "pmid": "42366452", "title": "Dissociation Between Peripheral Muscle Strength and Exercise Capacity in Symptomatic Post-COVID-19 Individuals: Implications for Musculoskeletal Rehabilitation.", "pub_date": "2026-06-29", "journal": "Musculoskeletal care", "authors": "Silva, Kaique Fernando Macedo da, Sczepanski, Felipe, Júnior, Vagner Pires de Campos, Brunnquell, Claudia", "abstract": "Infection with SARS-CoV-2 may result in persistent functional impairment after the acute phase of the disease. Emerging evidence suggests that the presence and intensity of COVID-19-related symptoms may be associated with deficits in muscle strength and physical performance during the post-infection period. Our objective was to compare physical performance after the acute phase of COVID-19 between symptomatic and asymptomatic individuals, focusing on exercise capacity and peripheral muscle strength. This cross-sectional, prospective study included 76 adults aged 18-77 years, registered in the Brazilian Unified Health System. Participants were classified as symptomatic or asymptomatic based on clinical records. Physical activity level was assessed using the International Physical Activity Questionnaire (IPAQ). Physical performance was evaluated through handgrip strength and exercise capacity measured by the Incremental Shuttle Walking Test (ISWT). Multivariate analysis of covariance (MANOVA) and univariate analyses (ANCOVA) were performed, adjusted for age, sex, and physical activity level. The presence of COVID-19-related symptoms was independently associated with lower handgrip strength (p = 0.0099) after adjustment for covariates. No significant differences were observed in exercise capacity between the symptomatic and asymptomatic groups (p = 0.497). Effect size analysis demonstrated a moderate association between symptom presence and peripheral muscle strength, whereas the association with exercise capacity was small. Symptomatic individuals after COVID-19 exhibited reduced peripheral muscle strength despite no significant differences in exercise capacity between the groups. These findings underscore the relevance of handgrip strength assessment as a simple and sensitive tool for identifying residual functional impairment in post-COVID-19 follow-up.", "url": "https://pubmed.ncbi.nlm.nih.gov/42366452/" }, { "pmid": "42364998", "title": "Systemic atopy and upper-airway disease define susceptibility to incident asthma after COVID-19 in Korea.", "pub_date": "2026-06-28", "journal": "Nature communications", "authors": "Choi, You-Jung, Kim, Young-Chan, Bea, Sungho, Shin, Ju-Young et al.", "abstract": "Incident asthma is an important respiratory sequela after COVID-19, but it is unclear which allergic phenotypes amplify risk. Using a linked nationwide Korean database of 3,987,182 individuals with confirmed severe acute respiratory syndrome coronavirus 2 infection, we compare claims-based incident asthma in those with pre-existing systemic atopy and/or upper-airway disease (allergic rhinitis, chronic rhinosinusitis, atopic dermatitis or food allergy) versus those without after 1:1 propensity score matching. During follow-up to 31 December 2022, participants with pre-existing disease have higher asthma incidence than matched controls (3.55 vs 2.13 per 1,000 person-years), with a hazard ratio of 1.66 (95% confidence interval 1.58-1.75). Asthma risk is elevated for each condition and increases with greater disease burden. These findings show that pre-existing allergic and upper-airway phenotypes stratify post-COVID incident asthma risk on a national scale, supporting targeted surveillance in high-risk subgroups.", "url": "https://pubmed.ncbi.nlm.nih.gov/42364998/" }, { "pmid": "42364466", "title": "Artificial intelligence-enhanced nurse navigation for monitoring and care of long COVID.", "pub_date": "2026-06-28", "journal": "International journal of medical informatics", "authors": "Bandeira Barboza, Ana Paula, Monteiro, Renata Luciria, Muschi, Alessandra Luna, Dos Santos Silva, Alexandra Rodrigues et al.", "abstract": "Long COVID is a multisystem condition with challenging diagnosis. Nurse-navigation, a patient-centered intervention, can enhance education and care access. Analyzing patient-nurse text message exchanges using natural language processing (NLP) enables automated extraction of clinical information, potentially supporting early identification of long COVID. We aimed to evaluate a digital nurse navigation platform integrating a predictive model for long COVID identification as a triage-assisting tool and to assess user acceptance. This observational study included patients and healthcare professionals diagnosed with COVID-19 from January to July 2024. Participants received nurse-navigation support for 16 weeks with monthly interactions via a WhatsApp-integrated platform. Structured sociodemographic and clinical data were combined with text-message insights using NLP techniques such as term frequency-inverse document frequency (TF-IDF), and analyzed using language models (Gemini 1.5 Pro, BERTimbau) and probabilistic linkage. The dataset was split into 70% training and 30% testing, and eight machine learning models were evaluated. Performance metrics included accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUROC). User satisfaction was assessed with the Net Promoter Score (NPS). Among 177 participants, 141 (78%) were female, with an overall mean age of 51 years. A total of 7,016 messages were processed. Long COVID was identified in 60 participants (33%), most frequently reporting memory loss, dyspnea, cognitive fatigue, and hair loss. Participants received structured education, and 20 were referred for further evaluation. The XGBoost-minor model achieved the highest classification performance with an accuracy of 72%, sensitivity of 38%, specificity of 88%, PPV of 63%, NPV of 74%, and AUROC 0.59. Predictive factors included age, COVID-19 episodes, vaccination, comorbidities, and respiratory symptoms. The NPS was 92, indicating strong endorsement. An AI-enhanced triage process within nurse navigation represents a promising and scalable strategy to support the identification and monitoring of patients at risk for long COVID.", "url": "https://pubmed.ncbi.nlm.nih.gov/42364466/" }, { "pmid": "42363551", "title": "Genetic evidence that advanced COVID-19 accelerates longitudinal brain atrophy: A Mendelian randomization study.", "pub_date": "2026-06-27", "journal": "Medicine", "authors": "Wen, Jie, Chen, Yuyao, Zhang, Jingwei, Tan, Zeming et al.", "abstract": "Coronavirus disease 2019 (COVID-19) was reported to persist long-term in the brain and leave several long-term neurologic sequelae. However, the causal relationship between COVID-19 and brain aging is still unknown. The genome-wide association study (GWAS) data on COVID-19 phenotypes (susceptibility, hospitalization, and severity), involving a total of 5,779,391 participants, were collected from the COVID-19 Host Genetics Initiative. In addition, GWAS data on longitudinal changes in 15 brain structures, assessed via magnetic resonance imaging across the lifespan, were sourced from the ENIGMA Consortium and involved 15,640 participants. Two-sample Mendelian randomization was conducted to infer the causal relationship between COVID-19 and longitudinal brain changes. Multi-trait GWAS meta-analysis, colocalization, and fine-mapping analyses were performed to identify shared genetic etiologies. H3K27me3 ChIP-seq was used to evaluate the regulatory effect of colocalized loci. Two-step Mendelian randomization was applied to explore potential mediating mechanisms across multi-omics layers, including proteomics, metabolomics, and immunomics. Our results showed that COVID-19 hospitalization (β = -262.405, P = .041) and severity (β = -177.676, P = .049) were genetically associated with atrophied volume of total brain during longitudinal change. This suggests that individuals with advanced COVID-19 may be more susceptible to accelerated global brain aging. Caudate was genetically affected by all COVID-19 phenotypes. Seven variants were shared between advanced COVID-19 and global brain aging. rs117169628 was colocalized between advanced COVID-19 and global brain aging, and exerted an inhibitory effect on CDH15 expression, further strengthening the causality. Six metabolites, 1 protein, and 1 immune trait were identified as potential mediators. Our study indicates that advanced COVID-19 might be genetically associated with accelerated brain aging. Brain health should be paid more attention in long COVID-19.", "url": "https://pubmed.ncbi.nlm.nih.gov/42363551/" }, { "pmid": "42363216", "title": "Bronchovascular texture pattern on quantitative CT reveals airway and vascular remodeling in post-COVID-19 Lungs.", "pub_date": "2026-06-27", "journal": "Respiratory research", "authors": "Zhang, Xuan, Rajaraman, Prathish K, Comellas, Alejandro P, Hoffman, Eric A et al.", "abstract": "The long-term consequences of COVID-19 remain poorly understood. To assess CT image-based biomarkers and clinical symptoms in COVID-19 survivors approximately 3-4 years after infection. Eighty post-COVID-19 participants (81% infected with the pre-Alpha strain) underwent pulmonary function tests (PFTs) and inspiratory/expiratory CT at approximately 5 months (Visit 1, V1) and 3-4 years (Visit 2, V2) after infection. At V2, participants completed the St. George's Respiratory Questionnaire (SGRQ), Leicester Cough Questionnaire (LCQ), Fatigue Severity Scale (FSS), modified Medical Research Council Dyspnea Scale (mMRC), and a study-specific symptom and medical history questionnaire. Seventy-eight healthy individuals served as controls. Image-based biomarkers included airway diameter, airway wall thickness, functional small airway disease percentage (fSAD%), ground-glass opacity percentage (GGO%), and bronchovascular percentage (Bronchovascular%). Post-COVID-19 participants exhibited normal predicted PFT values, but consistently lower DLCO compared with healthy controls at both visits. At V2, they also reported significantly worse SGRQ scores than the general population, indicating reduced quality of life. Although the elevated fSAD% and GGO% observed at V1 largely resolved by V2, several biomarkers of airway and vascular remodeling persisted, including increased Bronchovascular%, airway narrowing and wall thickening, and a compositional shift from large to small airways and a shift from small to large vessels. Persistent symptoms-such as fatigue, brain fog, cough, and hypertension-were associated with these structural abnormalities. Airway and vascular structural abnormalities persisted in COVID-19 survivors 3-4 years after infection and were associated with ongoing symptoms and reduced quality of life.", "url": "https://pubmed.ncbi.nlm.nih.gov/42363216/" }, { "pmid": "42363213", "title": "A qualitative study of the impact of the COVID-19 pandemic on healthcare access and service delivery for people living with chronic obstructive pulmonary disease and asthma.", "pub_date": "2026-06-27", "journal": "Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology", "authors": "Brehon, Katelyn, Choi, Mirsol, Hung, Pam, Miciak, Maxi et al.", "abstract": "Incidence of chronic obstructive pulmonary disease and asthma diagnosis were lower during and after the Coronavirus disease 2019 pandemic in Alberta, Canada. However, it is unknown whether incidences were actually lower or if the pandemic created circumstances where patients did not seek care. As such, the objective of the current study was to explore the impact of COVID-19 on patient and clinician experiences of healthcare access and delivery. The study was conducted between October 2023 and July 2024. We used interpretive description, a qualitative approach with the end-goal of informing clinical decisions. Analysis was informed by Braun and Clarke's six phases of reflexive thematic analysis. We completed thirteen interviews. Two key themes were generated: (1) The pandemic impacted care-seeking behaviours; and (2) A time and place for virtual and in-person care. Clinicians discussed how access to entry points to the health system were impacted by the pandemic and highlighted how strategies to manage health and stressors impacted symptoms and subsequent care-seeking behaviours. Participants highlighted the positives of virtual and in-person care with the consensus that both are valuable. Future use of virtual care modalities should include a visual element at minimum and prioritize the therapeutic relationship.", "url": "https://pubmed.ncbi.nlm.nih.gov/42363213/" }, { "pmid": "42362970", "title": "SARS-CoV-2 and diabetes: a post-pandemic reappraisal.", "pub_date": "2026-06-27", "journal": "Diabetologia", "authors": "Said, Noora, Jones, Ian, Anderson-Baucum, Emily K, Evans-Molina, Carmella", "abstract": "The COVID-19 pandemic was a dynamic and often confusing period for clinical and biomedical research. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread globally, knowledge accumulated rapidly through publications that were frequently based on preliminary or sometimes conflicting evidence, yet these papers played a critical role in shaping evolving medical, research and societal responses. Early in the pandemic, diabetes emerged as one of the strongest predictors of severe COVID-19 outcomes and mortality, placing it at the centre of early risk-stratification and therapeutic frameworks and prompting urgent efforts to understand the biological basis of these associations. As the pandemic progressed, reports of new-onset diabetes following COVID-19 infection raised the possibility of a bidirectional relationship between SARS-CoV-2 infection and diabetes. In this review, we provide a post-pandemic reappraisal of the clinical and experimental literature examining the intersection of COVID-19 and diabetes. We summarise proposed pathophysiological mechanisms, including the effects of SARS-CoV-2 infection in the pancreas and on peripheral insulin-sensitive tissues. We review key meta-analyses assessing the association between COVID-19 and incident type 1 and type 2 diabetes and highlight strengths and weaknesses of the epidemiologic studies underpinning these findings. We highlight the highest-quality evidence from prospective cohorts, as well as relevant clinical trials and registry-based studies that emerged from this collective experience. We discuss emerging relationships between long COVID and diabetes and the effect of vaccination on diabetes risk following SARS-CoV-2 infection. Finally, we identify critical knowledge gaps and outline priorities for ongoing and future studies needed to resolve remaining uncertainties.", "url": "https://pubmed.ncbi.nlm.nih.gov/42362970/" }, { "pmid": "42362344", "title": "The efficacy of conventional chest physiotherapy in managing acute hypoxaemic respiratory failure.", "pub_date": "2026-06-27", "journal": "BMJ case reports", "authors": "Deshmukh, Mayura, Vishwakarma, Janvi Chandrasen, Chitale, Neha, Palekar, Tushar", "abstract": "A man in his 60s presented with acute hypoxaemic respiratory failure secondary to post-COVID-19 fibrotic pneumonia, requiring 3 L/min oxygen therapy (peripheral oxygen saturation (SpO", "url": "https://pubmed.ncbi.nlm.nih.gov/42362344/" } ] }