@article {pmid40855465,
year = {2025},
author = {Sowanou, A and Morillon, GF and Guillon, M and Poder, TG and Laberge, M},
title = {General practitioners' experience about synchronous teleconsultation in primary care: a mixed-method systematic review.},
journal = {BMC primary care},
volume = {26},
number = {1},
pages = {264},
pmid = {40855465},
issn = {2731-4553},
support = {202209PJT-487640-HPM-CFBA-207592/CAPMC/CIHR/Canada ; },
mesh = {Humans ; *Remote Consultation/statistics & numerical data ; *General Practitioners/psychology ; *Attitude of Health Personnel ; *Primary Health Care ; *COVID-19/epidemiology ; SARS-CoV-2 ; },
abstract = {BACKGROUND: General practitioners (GPs) extensively used synchronous teleconsultation (STC) during the COVID-19 pandemic. Although this utilization decreased after the state of sanitary emergency was lifted, it remains higher than pre-pandemic levels. METHODS: The aim is to summarize the scientific evidence on the factors influencing GPs’ decision to conduct STC instead of face-to-face consultation. We conducted a systematic review and reported our results following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. We searched four electronic databases: MEDLINE, Cumulative Index of Nursing Literature and allied health, Web of Science and the Cochrane Central Register of Controlled Trials and conducted the last search on March 23, 2023. Two independent reviewers selected English/French articles reporting on GPs’ use, attitude, satisfaction, and experience with STC. We assessed the studies’ quality using the Mixed Methods Appraisal Tool, and a narrative approach was performed to synthesize findings. RESULTS: The screening of 9,288 references resulted in the inclusion of 34 studies, for a total of 5,563 participants. Results show that GPs’ decision to use STC is influenced by six categories of factors: (1) consultation, such as consultation purpose (e.g., follow-up care, administrative requests); (2) information and communication technology, such as quality of equipment and bandwidth (internet connection and the effectiveness of the hardware and software); (3) GP, such as convenience (the flexibility offered by the STC); (4) patient, such as access barriers (ex., physical, geographical, financial); (5) GP-patient relationship, such as ease of diagnosis; and (6) the institution, such as organizational and peer support. Lack of a reliable internet connection, need for physical exams, and limited visual cues were the main barriers to using STC. CONCLUSIONS: GPs’ utilization of STC depends on the interplay of six categories of factors, the most important being the purpose of consultation. Equity in access and a fair payment model are key elements to consider in designing health policies aimed at supporting adoption and appropriate use of STC. REVIEW’S PROTOCOL REGISTRATION: PROSPERO CRD42024505744},
}

Humans
*Remote Consultation/statistics & numerical data
*General Practitioners/psychology
*Attitude of Health Personnel
*Primary Health Care
*COVID-19/epidemiology
SARS-CoV-2

@article {pmid40859279,
year = {2025},
author = {Althobaiti, E and Almutairi, A and Muawwadh, R and Aljehani, A and Alqarni, F and Alilyyani, B},
title = {Experiences, challenges, opportunities of nursing interns in Saudi Arabia: a systematic review and synthesis of qualitative studies.},
journal = {BMC medical education},
volume = {25},
number = {1},
pages = {1201},
pmid = {40859279},
issn = {1472-6920},
mesh = {Saudi Arabia ; Humans ; Qualitative Research ; *Students, Nursing/psychology ; *Internship and Residency ; },
abstract = {BACKGROUND: Internship is considered as a main requirement for nursing students in Saudi Arabia in order to acquire the degree in bachelor of nursing. Also, it is mandatory for them to be registered and qualified nurses in healthcare settings in Saudi Arabia. Thus, there is a need to understand their experiences during the internship to enhance their experiences and maximize the benefits of internship. OBJECTIVE: The aim of this review was to understand and synthesize qualitative research systematically on the experiences of nursing interns during their internship in Saudi Arabia. METHODS: This review used a qualitative systematic review methodology with thematic synthesis. Nine databases (ProQuest Dissertations & Theses, ERIC, Scopus, PsycINFO, PubMed, Web of Science, ABI/INFORM, CINAHIL, Saudi Digital Library (SDL)) were searched from 1 January 1967 to 1 December 2023, and 56 abstracts were screened. Two screening stages were applied to review studies. Only qualitative studies, conducted in Saudi Arabia, explained the experiences of nursing students during their internship, published in English were included. RESULTS: Thirteen studies were included in this review. Four themes were identified based on the nursing interns’ experience during their internship in Saudi Arabia which are challenges and growth opportunities in a nursing internship, the critical role of preceptorship in nursing internship, challenges and barriers faced by male nursing interns, and the impact of the COVID-19 pandemic on nursing interns. CONCLUSIONS: This review identifies the importance of understanding of nursing interns’ experiences and highlights the keys elements that are necessary to improve the internship experience. The usefulness of internships in the nursing profession can be greatly increased by addressing the interns’ concerns which in turns could enhance the outcomes related to interns, patients, and healthcare settings. This study recommends that preceptorship programs should be enhanced by including formal training for preceptors and structured support for interns. However, some limitations were found for this review, including geographical scope, heterogeneity of studies, potential publication bias.},
}

Saudi Arabia
Humans
Qualitative Research
*Students, Nursing/psychology
*Internship and Residency

@article {pmid41073921,
year = {2025},
author = {Takamatsu, N and Kuga, H},
title = {Applicability and adaptation of cognitive behavior therapy for long COVID neuropsychiatric symptoms: a review with insights from ME/CFS.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {1275},
pmid = {41073921},
issn = {1471-2334},
support = {JP23K02953//Japan Society for the Promotion of Science/ ; },
mesh = {Humans ; *Cognitive Behavioral Therapy/methods ; *Fatigue Syndrome, Chronic/therapy/psychology ; *COVID-19/psychology/complications/therapy ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Long COVID presents a spectrum of persistent symptoms that substantially overlap with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), including debilitating fatigue, post-exertional malaise, cognitive dysfunction, and neuropsychiatric manifestations. Despite growing evidence of shared pathophysiological mechanisms, neither condition has established diagnostic biomarkers or disease-modifying treatments. Cognitive behavior therapy (CBT), when appropriately implemented, may serve as one component of comprehensive care. This review examines the neuropsychiatric manifestations, management principles, and implementation considerations for CBT in long COVID, drawing insights from ME/CFS experience. MAIN BODY: Our analyses revealed substantial overlap between patients with long COVID and ME/CFS including immune dysregulation, neuroinflammation, and metabolic dysfunction while identifying distinct features in disease trajectories. Evidence suggests ME/CFS may represent a severe phenotype in a subset of patients with long COVID. Management principles applicable to both conditions include patient validation, comprehensive needs assessment, individualized energy management, symptom-specific interventions, and comorbidity management. Current clinical trials demonstrate methodological evolution in CBT implementation, from traditional protocols to digital platforms. Moderate-certainty evidence indicates CBT may reduce fatigue and improve cognitive function in long COVID. However, substantial heterogeneity exists in both intervention characteristics and condition definitions. Implementation success requires provider competency, terminological precision, and individualized approaches that respect energy limitations. Careful monitoring for post-exertional symptom exacerbation is essential. We emphasize that these approaches do not imply these conditions are primarily psychological. CONCLUSION: Our review synthesizes current evidence on CBT in long COVID management, considering lessons from ME/CFS. Substantial challenges remain in standardizing terminology, strengthening trial methodology, and determining optimal implementation strategies. Future research should incorporate objective outcome measures alongside subjective reports, while clinical practice should consider how cognitive-behavioral approaches might contribute to comprehensive care plans tailored to individual patient needs. This approach recognizes that addressing both physical and psychological dimensions of these conditions may enhance treatment outcomes, while acknowledging the individualized nature of patient responses to different therapeutic elements.},
}

Humans
*Cognitive Behavioral Therapy/methods
*Fatigue Syndrome, Chronic/therapy/psychology
*COVID-19/psychology/complications/therapy
Post-Acute COVID-19 Syndrome
SARS-CoV-2

@article {pmid41121113,
year = {2025},
author = {Zamani, H and Parvaresh, F and Isfahani, MN},
title = {Optimizing patient flow logistics: strategic challenges, tactical solutions, and future directions.},
journal = {BMC health services research},
volume = {25},
number = {1},
pages = {1382},
pmid = {41121113},
issn = {1472-6963},
mesh = {Humans ; *Resource Allocation/organization & administration ; Operations Research ; Efficiency, Organizational ; COVID-19/epidemiology ; Decision Making ; },
abstract = {This study explores patient flow logistics (PFL) from strategic and tactical viewpoints, introducing a decision-making framework to systematically categorize key challenges. Through a systematic literature review, the research analyzes articles published between 2010 and 2023 in 17 top-tier journals within Operations Research (OR) and Management Science (MS), using SCOPUS and healthcare-specific keywords (e.g., “Capacity Planning,” “Resource Allocation,” “Pandemic,” “Hospital,” “Patient”) to retrieve relevant studies. After applying publication year, journal quality, and optimization technique filters—including mathematical programming and stochastic optimization—66 articles were selected for analysis. Findings reveal an increasing reliance on stochastic models, greater adoption of metaheuristic over heuristic algorithms, and stronger integration of real-world data in decision-making frameworks. Nevertheless, gaps persist, particularly in maximization-based methods addressing service rates and equity in epidemic resource allocation. The proposed classification framework offers actionable insights for academics, policymakers, and healthcare professionals by distinguishing pandemic and non-pandemic logistics. Future research should explore cross-sector hospital cooperation, integrated patient management strategies, and the incorporation of disease spread models in predictive resource planning.},
}

Humans
*Resource Allocation/organization & administration
Operations Research
Efficiency, Organizational
COVID-19/epidemiology
Decision Making

@article {pmid41162919,
year = {2025},
author = {Chimukuche, RS and Zuma, T and Wambua, GN and Manyaapelo, T and Edwards, A and Chimbindi, N and Orievulu, K and Gumede, D and Myburgh, N and Cloete, A and Seeley, J and Ngwenya, N},
title = {Challenges and opportunities in achieving sustainable development goal 3 in KwaZulu-Natal: reflections from a research institute, South Africa.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {3651},
pmid = {41162919},
issn = {1471-2458},
support = {/WT_/Wellcome Trust/United Kingdom ; },
mesh = {Humans ; South Africa ; *Sustainable Development ; Female ; Qualitative Research ; Health Services Accessibility ; Climate Change ; Rural Population ; Male ; HIV Infections/prevention & control ; },
abstract = {BACKGROUND: South Africa is committed to achieving Sustainable Development Goal 3 (SDG 3), which aims to ensure health and well-being for all. However, in rural provinces like KwaZulu-Natal, structural inequalities, socio-cultural challenges, and environmental stressors hinder progress. This study synthesises findings from qualitative research conducted at the Africa Health Research Institute (AHRI) to explore the challenges and opportunities in meeting SDG 3 targets. METHODS: An integrative literature review was conducted, analysing studies from 2015 to 2024 that focused on SDG 3related topics, including HIV/AIDS, tuberculosis, maternal and child health, sexual and reproductive health, and the impact of climate change. A framework analysis approach was applied to identify common themes, opportunities and challenges to achieving SDG 3 in rural KwaZulu-Natal. RESULTS AND DISCUSSION: Key challenges to achieving SDG 3 include limited access to healthcare, socio-cultural norms that influence health-seeking behaviours, climate-related stressors, and gender disparities. Studies highlighted poor maternal immunisation uptake due to traditional beliefs, stigma-related challenges in HIV prevention, and climate-induced economic hardships affecting treatment adherence. Gendered challenges were prominent, with men’s healthcare engagement being hindered by masculinity norms and adolescent girls facing restricted access to sexual health services. The COVID-19 pandemic further disrupted access to healthcare, particularly for older adults. Despite these challenges, opportunities exist for progress. Community-driven interventions such as DREAMS and MTV-Shuga improved adolescent engagement with sexual health education. Male-focused interventions like Stepping Stones and Creating Futures increased men’s involvement in HIV care. Additionally, integration of climate adaptation strategies into health systems could mitigate environmental health risks. CONCLUSION: This study provides critical insights for policymakers to enhance the progress towards achieving SDG 3. To do so policymakers should focus on addressing systemic healthcare challenges, integrating gender-responsive interventions, and strengthening community-based health initiatives. Climate-resilient healthcare infrastructure and policies are crucial to ensuring sustained progress. Future efforts should focus on expanding youth-friendly services, enhancing male engagement in healthcare, and leveraging local partnerships to improve health outcomes in rural communities.},
}

Humans
South Africa
*Sustainable Development
Female
Qualitative Research
Health Services Accessibility
Climate Change
Rural Population
Male
HIV Infections/prevention & control

@article {pmid41316031,
year = {2025},
author = {Effiong, FB and Elebesunu, EE and Ogunniyi, TJ and Olawuyi, DA and Ekpor, E and Ahiadorme, M and Bassey, AE and Hassan, IA and Effiong, EB and Ogundijo, OA and Kayode, AT and Uzairue, LI},
title = {Mpox surveillance in endemic regions: a scoping review of trends, challenges, and recommendations.},
journal = {BMC infectious diseases},
volume = {25},
number = {1},
pages = {1828},
pmid = {41316031},
issn = {1471-2334},
mesh = {Humans ; Africa/epidemiology ; *Endemic Diseases ; Public Health ; *Yellow Fever/epidemiology ; Population Surveillance/methods ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Mpox continues to pose a significant public health threat in endemic regions of Africa, particularly with the emergence of new viral clades and continuous human-to-human transmission. This scoping review assesses existing Mpox surveillance systems in endemic parts of Africa, highlighting key trends, challenges, and opportunities for improvement. METHODS: A scoping review was conducted following the PRISMA-ScR guidelines. Five electronic databases (PubMed, Scopus, Embase, Web of Science, and Cochrane Library) were searched in September 2025. Studies conducted in the WHO African Region that described, evaluated, or implemented Mpox laboratory surveillance systems were included. Eligible articles underwent screening and data extraction using the Covidence software. Data extracted from the reviewed studies were charted according to surveillance structures, diagnostic methods, reporting strategies, and implementation challenges. RESULTS: 24 studies were included for review, predominantly from Central and West Africa, particularly the Democratic Republic of Congo (DRC), Nigeria, Cameroon, and the Central African Republic (CAR). Surveillance systems varied in scope and design, ranging from passive and active national frameworks to cross-border monitoring. Diagnostic approaches commonly relied on polymerase chain reaction (PCR) testing, though limitations in laboratory infrastructure and delayed specimen transport hindered timely case confirmation. Key challenges identified include deficits in diagnostic capacity, misclassification of disease based on symptoms, and limited follow-up investigations. Structural barriers such as poor infrastructure, healthcare worker shortages, and conflict-related disruptions further weakened Mpox surveillance. Stigma and lack of community awareness contributed to underreporting. Additionally, the circulation of multiple Mpox viral clades and frequent cross-border transmission complicated outbreak detection and containment. CONCLUSION: While Mpox surveillance capacity has improved modestly, major structural and systemic challenges persist. Strengthening Mpox surveillance in endemic regions requires a multi-level strategy to ensure timely detection and containment of future outbreaks. CLINICAL TRIAL NUMBER: Not applicable},
}

Humans
Africa/epidemiology
*Endemic Diseases
Public Health
*Yellow Fever/epidemiology
Population Surveillance/methods
SARS-CoV-2

@article {pmid41408170,
year = {2025},
author = {Bissett, M and Aggar, C and Hockings, M and Prassos, T and Baker, JR},
title = {An integrative review of loneliness and quality of life in older adults who lived alone during COVID-19: considerations for supporting reconnection.},
journal = {BMC geriatrics},
volume = {26},
number = {1},
pages = {77},
pmid = {41408170},
issn = {1471-2318},
mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Loneliness/psychology ; *Quality of Life/psychology ; Aged ; *Independent Living/psychology ; *Social Isolation/psychology ; SARS-CoV-2 ; Aged, 80 and over ; Pandemics ; },
abstract = {BACKGROUND: Loneliness and decreased quality of life are associated with decreased life expectancy and are regarded as serious health concerns. Understanding the impact of the pandemic on older adults living alone is essential for informing strategies to decrease loneliness and improve quality of life following the COVID-19 pandemic and in future crises. This integrative review aimed to synthesise the qualitative and quantitative evidence on the factors of the pandemic that influenced loneliness and quality of life of older adults living alone, and examine associated interventions to support this population. METHODS: An integrative review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases (CINAHL Plus, MEDLINE with Full Text, APA PSYCArticles, Psychology & Behavioral Sciences Collection, Academic Search Premier and Proquest Coronavirus Research Database) were searched in February 2024 for peer-reviewed studies on community-dwelling older adults (60+) living alone during COVID-19. Screening and selection were completed in Covidence. The review included 53 articles (39 quantitative, 11 qualitative, and three mixed-methods) published between 2020 and 2023. Study quality was appraised using the Mixed Methods Appraisal Tool. Data were extracted into Excel and synthesised narratively across quantitative, qualitative, and mixed-methods studies to identify factors influencing loneliness, quality of life, and related interventions. RESULTS: Most studies were based on cross-sectional data and represented a broad international experience. Most studies reported increased loneliness and worsened quality of life during the pandemic. Loneliness was associated with isolation, intolerance of uncertainty and anxiety, however being accustomed to isolation, unity through adherence to pandemic measures, and socialising with neighbours were protective factors. Worsened quality of life was associated with poor sleep patterns, stigmatisation from being labelled as an ‘at risk’ population and feeling imprisoned at home. Protective factors included an appreciation for activities and connections, fostering creativity, engaging in hobbies and learning new skills. Lastly, interventions utilised technology via phone calls and socially assisted robots and were shown to help older adults. CONCLUSIONS: Additional meaningful, engaging and accessible strategies are needed to support older adults who live alone during crises. This integrative review offers insight into global experiences of loneliness and quality of life among older adults living alone during the COVID-19 pandemic, with suggestions for effective intervention strategies.},
}

Humans
*COVID-19/psychology/epidemiology
*Loneliness/psychology
*Quality of Life/psychology
Aged
*Independent Living/psychology
*Social Isolation/psychology
SARS-CoV-2
Aged, 80 and over
Pandemics

@article {pmid41422184,
year = {2026},
author = {Pilia, E and Belletti, A and Finco, G and Landoni, G},
title = {Full-dose heparin anticoagulation as prevention for COVID-19 disease progression in non-critically ill patients: An up-to-date brief meta-analysis.},
journal = {Journal of thrombosis and thrombolysis},
volume = {59},
number = {4},
pages = {1031-1035},
pmid = {41422184},
issn = {1573-742X},
mesh = {Humans ; *Heparin/administration & dosage/adverse effects ; *Anticoagulants/administration & dosage/adverse effects ; *COVID-19/blood/diagnosis ; Disease Progression ; Respiration, Artificial ; *COVID-19 Drug Treatment ; Randomized Controlled Trials as Topic ; SARS-CoV-2 ; },
abstract = {This systematic review and meta-analysis aims to investigate the effect of heparin full-dose anticoagulation on preventing COVID-19 disease progression in non-critically ill COVID-19 adult patients in accordance with the Cochrane methodology and the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed/Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and Clinicaltrials.gov (from inception to September 2025). Multicenter randomized controlled trials (mRCTs) comparing full-dose heparin anticoagulation with no full-dose anticoagulation (including prophylactic or intermediate-dose anticoagulation with heparin). The primary outcome was the need for invasive mechanical ventilation. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the number CRD42022348993. We included 6 mRCTs in the analysis, randomizing a total of 5777 COVID-19 patients. The rate of need for invasive mechanical ventilation was lower in patients treated with full-dose heparin at 7.9% (226/2842) compared with 9.5% (279/2935) in those receiving prophylactic or intermediate-dose ([RR] = 0.81; 95% [CI] = 0.68–0.96; P = 0.01). The absolute risk (AR) of requiring invasive mechanical ventilation was 77 per 1.000 in patients treated with full-dose heparin, compared with 95 per 1.000 in patients treated with prophylactic or intermediate-dose heparin. According to our updated data analysis of high-quality mRCTs, full-dose anticoagulation with heparin can be considered an important strategy to prevent disease progression and the need for invasive organ support in hospitalized non-critically ill COVID-19 patients.},
}

Humans
*Heparin/administration & dosage/adverse effects
*Anticoagulants/administration & dosage/adverse effects
*COVID-19/blood/diagnosis
Disease Progression
Respiration, Artificial
*COVID-19 Drug Treatment
Randomized Controlled Trials as Topic
SARS-CoV-2

@article {pmid41504815,
year = {2026},
author = {Doyle, P and McHugh, S and O'Neill, D},
title = {Nursing home research in Ireland before and after the pandemic.},
journal = {Irish journal of medical science},
volume = {195},
number = {2},
pages = {1159-1162},
pmid = {41504815},
issn = {1863-4362},
mesh = {*Nursing Homes ; Ireland/epidemiology ; Humans ; *COVID-19/epidemiology ; Pandemics ; Bibliometrics ; Nursing Home Residents ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Nursing home residents in Ireland experienced a disproportionate burden of illness and death during the COVID-19 pandemic, highlighting longstanding systemic deficiencies in governance, staffing, and research engagement. Prior to the pandemic, this vulnerable population, characterised by high levels of multimorbidity and disability, received limited research attention. A subgroup from the National Clinical Programme for Older People recommended the development of a research agenda in nursing homes, including resident involvement. This study aimed to characterise the extent and nature of Irish nursing home research from 1966 to 2024. METHODS: A bibliometric review was conducted using PubMed to identify publications related to Irish nursing homes from January 1966 to March 2020 (pre-pandemic) and April 2020 to July 2024 (post-pandemic). Data extracted included publication type, number of authors, institutional affiliations, countries of origin, disciplines involved, and acknowledgement of nursing home staff or residents. Descriptive analysis was performed using Excel and SPSS. RESULTS: A total of 144 publications were identified. Most papers (n = 106; 73.6%) were published pre-pandemic, while 38 (26.4%) appeared in the shorter post-pandemic period, showing a substantial increase in publication rate (1.9 to 9.5/year). Original research comprised 81.3% of papers Interdisciplinary authorship was common (53%), yet only 12.5% of papers listed a nursing home as an author affiliation, primarily from public or voluntary sectors. Less than 40% of papers acknowledged staff or resident contributions. While COVID-19-focused publications increased markedly post-2020, broader topics in nursing home care remained underrepresented. CONCLUSION: Irish nursing home research remains limited, especially in the private sector. A national strategy is needed to expand stakeholder involvement and research breadth. Better use of the interRAI system, the national assessment tool since 2011, could substantially strengthen quality improvement and research capacity. Long-term investment will be essential to guide evidence-based policy and care.},
}

*Nursing Homes
Ireland/epidemiology
Humans
*COVID-19/epidemiology
Pandemics
Bibliometrics
Nursing Home Residents
SARS-CoV-2

@article {pmid42347188,
year = {2026},
author = {Bambara, S and Isingizwe, MC and Adegboyega, TT and Mutesa, L},
title = {A Systematic Review of Gastrointestinal and Respiratory Pathogen Detection in Wastewater in Africa, with Focus on Rwanda: Implications for Early Warning and Public Health Surveillance.},
journal = {Pathogens (Basel, Switzerland)},
volume = {15},
number = {6},
pages = {},
doi = {10.3390/pathogens15060574},
pmid = {42347188},
issn = {2076-0817},
mesh = {Humans ; Rwanda/epidemiology ; *Wastewater/virology/microbiology ; *Respiratory Tract Infections/epidemiology/virology/microbiology ; *Public Health Surveillance ; Public Health ; Wastewater-Based Epidemiological Monitoring ; },
abstract = {In Africa, the disease burden of diarrheal and respiratory diseases is amplified by limited surveillance capacity, diagnostic limitations, and socioeconomic inequalities. In rapidly urbanizing settings such as Kigali (Rwanda), integrating wastewater-based epidemiology (WBE) into existing surveillance systems offers a promising strategy for generating real-time epidemiological intelligence, identifying community-level hotspots, and addressing gaps in traditional reporting systems. Gastrointestinal and respiratory infections remain major causes of morbidity and mortality globally, particularly in low- and middle-income countries (LMICs), where traditional clinical surveillance systems frequently underreport the true disease burden. This systematic review synthesizes current evidence on the detection of gastrointestinal and respiratory pathogens in wastewater and evaluates the utility of WBE for early warning and public health action. A narrative review approach was used to identify peer-reviewed literature, global health reports, and surveillance studies focusing on the wastewater detection of gastrointestinal and respiratory pathogens. Databases including PubMed, Scopus, and Google Scholar were searched for studies published between 2000 and 2026. The search yielded 1247 records, of which 312 duplicates were removed. After title/abstract screening, 228 full-text articles were retrieved and assessed for eligibility. After a detailed evaluation, 108 studies were excluded for the following reasons: absence of pathogen-specific wastewater data (n = 46), a focus on environmental monitoring without public health relevance (n = 25), insufficient methodological description (n = 21), or other eligibility limitations such as a lack of primary data (n = 16). WBE provides a non-invasive, cost-effective approach for monitoring symptomatic and asymptomatic infections. Challenges involve variability in sampling, environmental factors affecting viral decay, and differences in laboratory workflows. WBE is a powerful complement to traditional infectious disease surveillance, offering early warning capabilities, population-level coverage, and real-time insights into pathogen circulation. Integrating WBE into surveillance programs, especially in LMICs such as Rwanda, can significantly strengthen epidemic preparedness, guide resource allocation, and improve outbreak response. Sustained investment in laboratory capacity, standardized protocols, and multisector collaboration is essential to fully leverage WBE for public health protection.},
}

Humans
Rwanda/epidemiology
*Wastewater/virology/microbiology
*Respiratory Tract Infections/epidemiology/virology/microbiology
*Public Health Surveillance
Public Health
Wastewater-Based Epidemiological Monitoring

@article {pmid42347608,
year = {2026},
author = {Jang, HY and Ko, Y and Han, SY},
title = {Understanding Healthcare Workers' COVID-19 Vaccination Decision-Making as a Dynamic Process: A Qualitative Meta-Synthesis.},
journal = {Vaccines},
volume = {14},
number = {6},
pages = {},
doi = {10.3390/vaccines14060487},
pmid = {42347608},
issn = {2076-393X},
support = {HY- 202200000003466//Hanyang University/ ; },
abstract = {Background/Objectives: Healthcare workers play a critical role in vaccination programs, yet vaccine hesitancy has been widely reported even among this group during the Coronavirus disease 2019 (COVID-19) pandemic. Previous studies have primarily focused on identifying factors associated with vaccine acceptance, offering limited insight into the processes underlying decision-making. This study aimed to synthesize qualitative studies on healthcare workers' COVID-19 vaccination experiences to develop a comprehensive understanding of their decision-making processes. Methods: A qualitative meta-synthesis was conducted using the thematic synthesis approach proposed by Thomas and Harden. Electronic databases including PubMed, Embase, and CINAHL were searched for qualitative studies published up to February 2026. Thirteen studies were included following PRISMA guidelines. Data were analyzed through line-by-line coding, followed by the development of descriptive and analytical themes. Results: Four analytical themes were identified: (1) vaccination as a dynamic risk-benefit negotiation process, (2) trust as a central mechanism shaping information interpretation, (3) socially embedded and relationally negotiated decision-making, and (4) moral identity as a driver of vaccination behavior. Healthcare workers' vaccination decision-making was not a static choice but an evolving process shaped by continuous appraisal of risks and benefits, filtered through trust in information and institutions, influenced by social interactions, and guided by professional identity and ethical responsibility. Conclusions: Healthcare workers' vaccination decision-making is a multidimensional process embedded in cognitive, social, and ethical contexts. Interventions should move beyond individual-level approaches and instead focus on building trust, leveraging social networks, and reinforcing professional identity with implications for future public health crises.},
}

@article {pmid42347619,
year = {2026},
author = {Kong, F and Wu, N and Liang, S and Yan, Y},
title = {Next-Generation Vaccine Design for Porcine Enteric Coronaviruses: Aligning Antigenic Breadth, Mucosal Immunity, and Translational Evaluation.},
journal = {Vaccines},
volume = {14},
number = {6},
pages = {},
doi = {10.3390/vaccines14060498},
pmid = {42347619},
issn = {2076-393X},
support = {LH2022C070//Heilongjiang Provincial Natural Science Foundation of China/ ; },
abstract = {Porcine enteric coronaviruses (PECs), including porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine deltacoronavirus (PDCoV), and swine acute diarrhea syndrome coronavirus (SADS-CoV), remain major causes of neonatal diarrhea, dehydration, mortality, and economic loss in swine production. Despite substantial progress in vaccine development, durable field protection is still inconsistent. In this narrative review, this narrative review synthesizes current knowledge on PEC vaccine design from three connected perspectives: antigenic breadth, mucosal immunity, and translational evaluation. The economic and virological context of PEC vaccine development is first summarized, including the recurrent production burden of PECs, coronavirus genome organization, structural proteins, and the central role of the spike protein in receptor engagement, membrane fusion, and neutralizing antibody induction. Key issues are then discussed, including how spike diversity, conformational stability, epitope accessibility, glycan shielding, and antigen matching influence protective breadth; why intestinal secretory IgA, mucosal immune-cell trafficking, local memory responses, and lactogenic immunity should be prioritized as biologically relevant endpoints; and how delivery route, adjuvant selection, and platform design shape response quality. Current evidence on recombinant protein, viral-vectored, nanoparticle, virus-like particle, probiotic, plant-derived, and mRNA-based approaches is compared with attention to both promise and current evidentiary and translational limitations. The available literature suggests that future progress in PEC vaccinology is likely to depend less on platform novelty alone than on integrated vaccine designs that align antigen selection, mucosal delivery, maternal-neonatal protection, heterologous challenge, manufacturability, and field applicability.},
}

@article {pmid42347657,
year = {2026},
author = {Frączek, B and Pieniawska-Śmiech, K and Babicki, M and Balcer, B and Dolata, N and Pokorna-Kałwak, D and Kłoda, K},
title = {Maternal Vaccine Acceptance and Attitudes Before and After the COVID-19 Pandemic: A Narrative Literature Review.},
journal = {Vaccines},
volume = {14},
number = {6},
pages = {},
doi = {10.3390/vaccines14060536},
pmid = {42347657},
issn = {2076-393X},
abstract = {OBJECTIVES: This study aims to assess the acceptance of vaccinations among pregnant women, particularly against influenza, pertussis, COVID-19, and RSV, and to identify factors influencing their willingness to get vaccinated. It also seeks to evaluate the impact of the COVID-19 pandemic on maternal attitudes and behaviors regarding vaccination.

METHODS: The analysis involved a review of existing literature and studies to evaluate the level of vaccine acceptance among pregnant women before and after the COVID-19 pandemic. Factors contributing to vaccine hesitancy, including misinformation, lack of knowledge, and the influence of healthcare professionals, were examined.

RESULTS: The findings indicated that, despite scientific evidence supporting the safety and efficacy of vaccines during pregnancy, public concerns remain about their impact on the developing fetus. The outbreak of the COVID-19 pandemic has increased awareness of the risk of infectious diseases, but at the same time, its impact on vaccination rates among pregnant women is ambiguous and geographically diverse. Misinformation and decreased access to healthcare during the pandemic negatively affected vaccine uptake. Trustworthy information provided by healthcare professionals emerged as a key factor in promoting vaccine acceptance.

CONCLUSIONS: To improve vaccination rates among pregnant women, it is essential to provide clear, evidence-based information through healthcare professionals, particularly those directly caring for pregnant women. Educational campaigns should address concerns calmly and without judgment, emphasizing the safety and benefits of vaccinations. Enhanced access to healthcare and vaccinations, along with strategic information dissemination, can significantly improve vaccine acceptance during pregnancy. Lessons learned from past pandemics should be incorporated into the development of healthcare strategies aimed at implementing recommended vaccinations for pregnant women in the future.},
}

@article {pmid42347672,
year = {2026},
author = {Aljadeeah, S and Payedimarri, AB and Dochez, C and Kielmann, K and Wirtz, VJ and Hargreaves, S and Ravinetto, R},
title = {Access to Vaccines Among Asylum Seekers, Refugees, and Undocumented Migrants Across the Migratory Cycle in the European Union, European Economic Area, Switzerland and the United Kingdom: A Scoping Review.},
journal = {Vaccines},
volume = {14},
number = {6},
pages = {},
doi = {10.3390/vaccines14060551},
pmid = {42347672},
issn = {2076-393X},
abstract = {Introduction: Inequities in access to medicines persist for asylum seekers, refugees, and undocumented migrants in Europe. For vaccines, access gaps not only exist for these groups in childhood routine immunization, but also for life-course and catch-up vaccinations. As part of a broader project examining access to medicines and vaccines for migrants across all stages of the migration cycle, this scoping review synthesizes evidence on the determinants of access to vaccines. Methods: We conducted a scoping review across PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews, Scopus, and grey literature sources, covering the period 2000-2024. Sources were eligible if they addressed access to vaccines among migrants. We examined access to vaccines along the life course, and across phases of the migratory cycle, including departure, transit, reception and settlement, and return or deportation. Results: A total of 47 research studies and grey literature reports were included. Most studies focused on migrants in reception and settlement (destination) settings, with only twelve sources addressing other phases of the migratory cycle. Across European countries, migrants were frequently reported to have lower uptake of routine vaccines (e.g., measles-mumps-rubella (MMR), polio, diphtheria-tetanus-pertussis (DTP), and human papillomavirus (HPV)) and COVID-19 vaccines than host populations. The most frequently reported barriers were related to migrants' legal status, administrative requirements, and lack of documentation, alongside poor affordability of vaccination, limited awareness of their rights, and mistrust in the health system. Conclusions: Health systems need to adopt innovative approaches to expand vaccine access for migrant populations. Further, protecting confidentiality is essential for building trust and reducing ethical and legal risks. Flexible and coordinated vaccination strategies are required to address migrants' mobility across the different migration stages and settings. Our findings appeal for sustained improvements in access to vaccines among migrants in Europe, contingent on strong policy commitments to equity, data protection, and the adoption of life-course and catch-up vaccination strategies.},
}

@article {pmid42348970,
year = {2026},
author = {Zhang, W and Yuan, W and Yuan, C and Cheng, Y and Zhang, D and Cao, X and Ding, C},
title = {Shared and context-specific mechanisms of T cell exhaustion in chronic viral infections and cancer: Transcriptional, metabolic, epigenetic, and therapeutic perspectives.},
journal = {Cytokine & growth factor reviews},
volume = {90},
number = {},
pages = {88-106},
doi = {10.1016/j.cytogfr.2026.06.004},
pmid = {42348970},
issn = {1879-0305},
abstract = {T cells are crucial for defending against viral infection and cancer by eliminating infected or transformed cells and establishing immune memory. However, persistent antigenic stimulation in chronic infections or tumors drives T cells into a dysfunctional state known as exhaustion. This state is characterized by reduced proliferation and effector functions, upregulation of inhibitory receptors like PD-1, LAG-3, and CTLA-4, and alterations in transcriptional, epigenetic, and metabolic programs. T cell exhaustion is driven by both intrinsic factors, including changes in transcription factor networks and metabolic dysfunction, and extrinsic factors, such as continuous antigen exposure and an immunosuppressive microenvironment. Key molecules like PD-1, TOX, and TCF-1 are central to this process, though the complex interactions between intrinsic and extrinsic signals in chronic viral infections and cancers remain poorly understood. This review summarized T cell exhaustion in chronic viral infections, such as HIV, HBV, and SARS-CoV-2, as well as in tumors, emphasizing shared mechanisms and context-specific differences. We focused on the roles of transcriptional networks, metabolic changes, immune checkpoints, and exhaustion-related signaling. Additionally, we discussed emerging therapeutic strategies, such as immune checkpoint inhibitors, CAR-T cell therapies, cytokine supplementation, and metabolic interventions, based on recent high-impact studies. By integrating insights from both chronic infection and cancer, this review aims to identify common principles of T cell exhaustion and propose strategies to improve clinical outcomes in chronic viral diseases and cancer immunotherapy.},
}

@article {pmid42349034,
year = {2026},
author = {Abdel-Moneim, AS and Al-Balushi, MS and Al-Jabri, AA},
title = {Post-COVID-19 immune dysregulation and autoimmune sequelae.},
journal = {Virology},
volume = {623},
number = {},
pages = {111017},
doi = {10.1016/j.virol.2026.111017},
pmid = {42349034},
issn = {1096-0341},
abstract = {SARS-CoV-2 infection induces profound immune dysregulation, including hyperinflammation, lymphopenia, and innate/adaptive immune imbalance. In some individuals, these responses persist beyond viral clearance, creating conditions that may disrupt immunological self-tolerance and precipitate autoimmune phenomena. We critically review mechanistic and clinical evidence linking SARS-CoV-2 infection to autoimmunity. Viral entry via ACE2/TMPRSS2, endothelial injury, and renin-angiotensin system dysregulation generates a pro-inflammatory milieu. Immune pathways, including molecular mimicry, bystander activation, epitope spreading, and persistent antigenic stimulation, can trigger the activation of autoreactive lymphocytes. Emerging evidence further implicates SARS-CoV-2-associated oral-gut microbiome dysbiosis and alterations in tryptophan and arginine metabolic checkpoints as contributors to chronic inflammatory signaling and impaired tolerance maintenance. We propose a mechanistic cascade from viral infection to dysbiosis to metabolic perturbation to loss of tolerance to autoantibody generation. Clinical manifestations encompass neurological, hematological, endocrine, and systemic autoimmune syndromes, with evidence of autoantibody emergence and post-COVID-19 immune sequelae. SARS-CoV-2 acts as an amplifier of autoimmune reaction in genetically susceptible hosts. Understanding these mechanisms is critical for identifying at-risk individuals and informing preventive and therapeutic strategies for post-COVID-19 autoimmune sequelae.},
}

@article {pmid42349528,
year = {2026},
author = {Elgendi, MM and Stewart, SH and Sherry, S and Deacon, SH},
title = {Did COVID-19 change the trajectory of children's internalising symptoms? A meta-analysis of longitudinal studies and moderating factors.},
journal = {Journal of affective disorders},
volume = {},
number = {},
pages = {122168},
doi = {10.1016/j.jad.2026.122168},
pmid = {42349528},
issn = {1573-2517},
abstract = {The COVID-19 pandemic disrupted children's and adolescents' daily lives worldwide, raising concerns about changes in internalising symptoms. Prior reviews have documented elevated depression and anxiety symptoms during the pandemic, but cross-sectional designs have limited conclusions about within-person change and its moderators. To address this gap, we conducted a meta-analysis of longitudinal studies assessing internalising symptoms before and during the COVID-19 pandemic. Eighty peer-reviewed studies (187 effect sizes) contributed data from youth aged 5-17 years across 20 countries. Standardized mean change (SMC) effect sizes were synthesised using random-effects models with robust variance estimation. Guided by Bronfenbrenner's ecological systems theory, we examined moderators spanning individual, family/school, contextual, and temporal domains. Overall, internalising symptoms increased modestly from pre- to peri-pandemic assessments (SMC = 0.32, 95% CI [0.11, 0.53]; multilevel SMC = 0.34, 95% CI [0.15, 0.53]). Effects varied widely across studies (I[2] = 97.9%), indicating highly heterogeneous symptom trajectories, and suggesting that pooled estimates should be interpreted cautiously. Larger increases were observed in studies including parent-report measures and in contexts of full school closures and highly stringent government responses. Age, gender/sex, region, COVID prevalence, and assessment timing were not significant moderators. Although there were larger increases for composite scores across broad internalising and depressive symptoms than for anxiety or stress, there were no statistically robust between-domain differences. Together, these results indicate that internalising symptoms increased modestly during the COVID-19 pandemic, but that youth experiences were highly context-dependent, underscoring the importance of considering ecological conditions-such as school closures and policy responses-when evaluating pandemic-related mental health change.},
}

@article {pmid42350210,
year = {2026},
author = {Marchesi, F and Girmenia, C and Trecarichi, EM and Piciocchi, A and Busca, A and Candoni, A and Cattaneo, C and Delia, M and Del Principe, MI and Fianchi, L and Gentile, G and Fracchiolla, NS and Tumbarello, M and Vignetti, M and Venditti, A and Pagano, L},
title = {Antibacterial, antifungal and antiviral prophylaxis and vaccination strategies in adult patients with acute myeloid and promyelocytic leukemia: An expert panel consensus from the GIMEMA group.},
journal = {Blood reviews},
volume = {},
number = {},
pages = {101412},
doi = {10.1016/j.blre.2026.101412},
pmid = {42350210},
issn = {1532-1681},
abstract = {Infections are a leading cause of morbidity, mortality, and treatment delays in AML and APL. While international guidelines emphasize intensive chemotherapy, they often overlook less intensive regimens, rely on outdated data, and ignore rising MDR infections. A GIMEMA survey across Italian centers revealed significant heterogeneity in antimicrobial prophylaxis, and vaccination practices. An expert panel reviewed 2012-2025 English literature with focus on infections via Delphi/nominal group methods, achieving ≥70% consensus. Prophylaxis with fluoroquinolones showed low agreement (28%) for intensive chemotherapy and venetoclax-based regimens due to no survival benefit, MDR pressure and microbiota disruption; not recommended for low-intensity/palliative care. Posaconazole is advised for intensive chemotherapy with or without FLT3 inhibitors, venetoclax-based regimens, HMA with or without ivosidenib (first 4 cycles), but not APL/palliative care. Antiviral prophylaxis is recommended for APL receiving arsenic trioxide; limited evidence elsewhere. The panel supports universal pneumococcal, influenza, SARS-CoV-2 and herpes zoster vaccination. Overall, these consensus statements aim to harmonize practice and highlight key areas requiring specifically designed prospective studies.},
}

@article {pmid42350880,
year = {2026},
author = {Filippatos, F and Kakleas, K and Michos, A},
title = {Immunopathogenesis and Cytokine Pathways in Reactive Infectious Mucocutaneous Eruption (RIME) in Pediatric Population: Infectious Triggers and Molecular Insights.},
journal = {Clinical reviews in allergy & immunology},
volume = {69},
number = {1},
pages = {},
pmid = {42350880},
issn = {1559-0267},
mesh = {Humans ; *Cytokines/metabolism/immunology ; Child ; *Mucositis/immunology/diagnosis ; Immunity, Innate ; Signal Transduction ; Innate Immunity Recognition ; },
abstract = {Reactive infectious mucocutaneous eruption (RIME) is increasingly recognized as a pediatric syndrome in which severe mucositis follows a recent infection and cutaneous involvement is usually limited. Although Mycoplasma pneumoniae remains the prototype trigger, influenza, SARS-CoV-2, adenovirus, respiratory syncytial virus, and other respiratory pathogens can produce a similar clinical phenotype. This narrative review summarizes pediatric RIME/MIRM literature and selected adult or comparator-disease evidence when direct pediatric data are unavailable, explicitly distinguishing direct RIME evidence from extrapolated mechanisms. This review synthesizes current evidence on the immunopathogenesis of RIME in children, with emphasis on how pathogen-specific factors intersect with innate and adaptive immune pathways to drive mucosal injury. We discuss the central roles of epithelial sensing, inflammasome activation, cytokine amplification, neutrophil recruitment, and T-cell polarization, and we relate these mechanisms to the severe oral, ocular, and anogenital disease that often defines pediatric presentations. We also integrate emerging proteomic data showing recurring molecular programs, including acute-phase and complement activation, neutrophil-associated epithelial injury, and interferon-inducible antiviral responses. In addition, we review the possible contribution of genetic susceptibility, especially variation in innate immune sensors and cytokine signaling pathways, to disease severity and recurrence. Finally, we address the main diagnostic challenges, histopathologic and imaging findings, differential diagnosis from Stevens-Johnson syndrome, erythema multiforme, and Kawasaki disease, and the implications of these insights for risk stratification and treatment. Taken together, current evidence supports RIME as a pathogen-triggered, mucosa-predominant inflammatory syndrome in which exaggerated host responses, rather than pathogen presence alone, shape the clinical phenotype.},
}

Humans
*Cytokines/metabolism/immunology
Child
*Mucositis/immunology/diagnosis
Immunity, Innate
Signal Transduction
Innate Immunity Recognition

@article {pmid42351066,
year = {2026},
author = {Tolera, ST and Zerihun, E and Hunduma, G and Letta, S},
title = {Application of health belief model (HBM) in health sciences and medical researches: systematic review on African and Asian countries.},
journal = {BMC public health},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12889-026-28281-5},
pmid = {42351066},
issn = {1471-2458},
abstract = {BACKGROUND: The Health Belief Model (HBM) is a widely used psychological framework for explaining and predicting individual's health related attitudes, belief, and behaviors. Although the model has been applied across various fields of health and medical sciences, the extent of its global use, particularly across African and Asian countries has not been well documented.

OBJECTIVE: This systematic review aimed to assess the application of HBM in health sciences and medical research conducted between 2010 and 2025 in Africa and Asian countries.

METHODS: The review followed the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted using keywords "Health Belief Model" combined with Boolean operators (AND, OR) across major databases, including PubMed, CINAHL, Web of Science, Scopus, Cochrane Library and PsycINFO. Eligible studies included peer-reviewed research articles applying the HBM within African and Asian contexts.

RESULT: From a total of 1,421 identified records, 77 studies met the inclusion criteria. Of these, 61% (n = 47) were conducted in Africa countries and 39% (n = 30) in Asian countries. Most studies (64.94%) employed cross-sectional quantitative design, while 12% used mixed-methods approaches. Random controlled trial account for 9.11% of studies, quasi-experimental design for 7%, and qualitative approaches (including focus groups and in-depth interviews) for 6%. Overall, 85.71% of the studies applied all core components of HBM. Fifteen studies examined COVID-19 vaccine acceptance, nine focused on HIV/AIDS testing, counseling and prevention, and eleven studies explored non-communicable diseases prevention. Additionally, six studies assessed women's adherence to breast cancer screening, and four studies examined cervical cancer screening behaviours using HBM.

CONCLUSION: A current systematic review demonstrates that the HBM remain a valuable framework for understanding and influencing health behaviors across diverse settings. Its application in Africa and Asian research highlights its usefulness in guiding targeted interventions that address perceived susceptibility, severity, benefits, barriers, and cues to action, ultimately contributing to improved health outcomes.},
}

@article {pmid42351227,
year = {2026},
author = {Kumar, N and Khandavalli, N and Avedissian, SN and Chand, HS and Acharya, A and Byrareddy, SN},
title = {Translational insights into Long-COVID: evaluation of preclinical animal models along the lung-brain-immune axis with focus on Golden Syrian Hamsters.},
journal = {Journal of neuroinflammation},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12974-026-03928-7},
pmid = {42351227},
issn = {1742-2094},
support = {DA052845, DA059874, DA061678/NH/NIH HHS/United States ; },
abstract = {Long-COVID, also referred to as post-acute sequelae of COVID-19 (PASC), is a heterogeneous disorder encompassing more than 200 reported symptoms that commonly affect the respiratory and nervous systems. Emerging clinical evidence indicates that unresolved lung inflammation, vascular injury, and immune dysregulation drive sustained neuroinflammation and impaired neurocognitive function in Long-COVID patients. Given the ethical and logistical constraints of human studies, biologically relevant animal models are essential for understanding the mechanisms and for evaluating therapeutic strategies against Long-COVID. In this review, we synthesize current evidence from preclinical animal models of Long-COVID, with a particular emphasis on the Golden Syrian Hamsters. Golden Syrian Hamsters are naturally susceptible to SARS-CoV-2 infection without the need for genetic modification and recapitulate key features of human disease, including robust viral replication, pulmonary pathology, and inflammatory response during acute infection. Importantly, accumulating evidence demonstrates that Golden Syrian Hamsters develop persistent post-acute abnormalities along the lung-brain-immune axis, including impaired alveolar repair, fibrotic lung remodeling, neuroinflammation, viral or antigen persistence, and behavioral alterations that parallel core features of Long-COVID. We compare the strengths and limitations of Golden Syrian Hamsters with other commonly used pre-clinical animal models including mice, and non-human primates, highlighting differences in translational relevance, feasibility, and ability to model chronic lung-brain-immune axis dysfunction. While there are limitations, particularly regarding limited availability of immunological reagents and validated cognitive and behavioral assays, the Golden Syrian Hamsters offers a balanced and accessible platform for mechanistic studies of PASC. Overall, this review positions Golden Syrian Hamster as a robust translational model for investigating lung-brain-immune axis pathology in Long-COVID and for advancing the development of targeted therapeutic interventions.},
}

@article {pmid42351549,
year = {2026},
author = {Shati, A and Abdulmutaali, A and Alsaeed, N},
title = {Respiratory Disease Detection: A Systematic Review of AI-Based Approaches, from Audio and Visual Unimodal Methods to Multimodal Integration.},
journal = {Diagnostics (Basel, Switzerland)},
volume = {16},
number = {12},
pages = {},
doi = {10.3390/diagnostics16121890},
pmid = {42351549},
issn = {2075-4418},
support = {RA.KKU/2/46/1446H//The Deanship of Research and Graduate Studies at King Khalid University/ ; },
abstract = {Background: Respiratory diseases (RDs), including asthma, COVID-19, chronic obstructive pulmonary disease (COPD), and pneumonia, remain a major global health challenge, contributing substantially to global morbidity and mortality. Conventional diagnosis relies heavily on clinicians' expertise to interpret respiratory sounds and radiographic images, a process that can be subjective, time-consuming, and prone to inter-observer variability. Recent advances in artificial intelligence (AI) and machine learning (ML) have enabled automated diagnostic approaches that can improve the efficiency, consistency, and scalability of respiratory disease detection. However, existing research remains fragmented across different data modalities. Methods: This review systematically analyzes recent studies on AI-based respiratory disease detection using both visual modalities (e.g., chest X-rays, computed tomography (CT) scans, and ultrasound) and audio modalities (e.g., cough and breath sounds). To provide a comprehensive perspective, the reviewed literature is organized using a unified taxonomy that categorizes existing approaches into three main groups: audio-based, visual-based, and audio-visual-based methods. In addition, two conceptual frameworks are proposed to illustrate representative pipelines for audio-based and visual-based respiratory disease classification. Results: The analysis reveals that most existing studies focus on single-modality approaches, while multimodal integration remains relatively underexplored. Only a limited number of studies combine audio and visual data within unified frameworks, primarily due to the scarcity of synchronized multimodal datasets collected from the same patients. The proposed taxonomy and conceptual frameworks provide a structured basis for comparing existing methods, identifying methodological trends, and highlighting key research gaps in multimodal respiratory disease detection. Conclusions: Future research should prioritize the development of multimodal datasets, robust evaluation protocols, and interpretable and lightweight AI models suitable for real-world clinical deployment. Advancing multimodal integration has the potential to significantly enhance the accuracy, reliability, and clinical applicability of AI-driven respiratory disease diagnosis systems.},
}

@article {pmid42351791,
year = {2026},
author = {Zdrobe, Z and Tornyi, I and Sárközi, AT and Horváth, I},
title = {The Complement System and Its Role in Eosinophilic Inflammation in Respiratory Diseases.},
journal = {Biomedicines},
volume = {14},
number = {6},
pages = {},
doi = {10.3390/biomedicines14061363},
pmid = {42351791},
issn = {2227-9059},
abstract = {The complement system is a key link between innate and adaptive immunity, contributing to pathogen elimination, immune regulation, and tissue homeostasis. Its activation is not only crucial in infections, such as COVID-19, but also plays a major role in the pathomechanism of several non-infectious respiratory diseases, such as asthma, COPD, sarcoidosis and lung cancer. Complement components can modulate the quality of the adaptive immune responses, including through the regulation of T2 immunity and eosinophilic inflammation, thereby linking natural defense to complex immune processes. In recent years, it has become increasingly clear that dysregulated complement activity contributes to inflammation, thrombosis and tissue damage in a wide range of respiratory diseases. The study of the various components of this cascade system may therefore be promising from both a diagnostic and therapeutic point of view. Some of its components may serve as biomarkers for distinguishing between different phenotypes of certain lung diseases, while their targeted inhibition or modulation may open the way towards new treatment options. A better understanding of the complement system's integrative and regulatory role not only allows for a deeper insight into immunological interactions but may also bring us closer to phenotype-oriented, immunology-based pulmonology, which may have real clinical benefits in the future.},
}

@article {pmid42352300,
year = {2026},
author = {Beyoğlu, D and Idle, JR},
title = {The Gut-Lung Microbiome Crosstalk and Pulmonary Disease.},
journal = {Biomolecules},
volume = {16},
number = {6},
pages = {},
doi = {10.3390/biom16060833},
pmid = {42352300},
issn = {2218-273X},
mesh = {Humans ; *Lung/microbiology/metabolism ; *Gastrointestinal Microbiome ; *Lung Diseases/microbiology/metabolism ; Animals ; COVID-19/microbiology ; *Microbiota ; Dysbiosis ; },
abstract = {Both the gut and the lungs possess a microbiome, a community of commensal bacteria, archaea, fungi, and viruses that perform important housekeeping functions in those organs. The colonic microbiome primarily ferments indigestible dietary fibers into essential short-chain fatty acids, synthesizes essential vitamins, regulates the mucosal immune system, and forms a protective barrier against pathogenic colonization. The lung microbiome maintains respiratory health primarily by regulating mucosal immunity, providing a physical barrier against invading pathogens, and producing beneficial metabolites. Several colonic microbiota metabolites, including the short-chain fatty acids acetate, propionate, and butyrate, together with the tryptophan metabolites indole-3-acetate and indole-3-propionate, secondary bile acids, and the polyamines spermidine and putrescine, are transported to the lungs via the gut-lung axis. These colonic microbiota biomolecules suppress lung inflammation, strengthen immune homeostasis, and reduce the severity of respiratory diseases. In contrast, lung microorganisms and their metabolites can travel to the gut via the gut-lung axis, influencing intestinal immune responses and potentially leading to an imbalance of gut microorganisms or dysbiosis. This means that respiratory diseases may lead to digestive issues, intestinal inflammation and chronic diseases. Here, we have reviewed this crosstalk and its impact on the principal pulmonary diseases: asthma, chronic obstructive pulmonary disease, cystic fibrosis, bronchogenic carcinoma, COVID-19, interstitial lung diseases, pneumonia, and tuberculosis. It is concluded that the gut microbiome plays a significant part in lung health and disease. Diet, tobacco smoking and electronic cigarette vaping all impact both the gut and lung microbiomes.},
}

Humans
*Lung/microbiology/metabolism
*Gastrointestinal Microbiome
*Lung Diseases/microbiology/metabolism
Animals
COVID-19/microbiology
*Microbiota
Dysbiosis

@article {pmid42353563,
year = {2026},
author = {Liu, J and Mao, N and Cui, Y and Bao, Y and Tang, C},
title = {Research Progress on Coronary Artery Injury and Myocardial Ischemia in Multisystem Inflammatory Syndrome in Children.},
journal = {Current issues in molecular biology},
volume = {48},
number = {6},
pages = {},
doi = {10.3390/cimb48060558},
pmid = {42353563},
issn = {1467-3045},
abstract = {Multisystem inflammatory syndrome in children (MIS-C) is a severe systemic inflammatory complication triggered by prior SARS-CoV-2 infection. It predominantly affects the cardiovascular system, and coronary artery injury, myocardial dysfunction, and myocardial ischemia are closely associated with disease severity and clinical outcomes. This article reviews the immunopathological characteristics and clinical manifestations of MIS-C-related coronary artery lesions, including coronary artery dilation and aneurysm formation, as well as the key pathophysiological mechanisms leading to myocardial ischemia. Based on recent clinical and translational research, we summarize current approaches to diagnosis, risk stratification, acute medical management, and long-term follow-up strategies. By synthesizing updated evidence, this review aims to provide theoretical support and practical clinical guidance for the early identification, timely intervention, and optimized management of affected children, ultimately improving their long-term cardiovascular prognosis.},
}

@article {pmid42353688,
year = {2026},
author = {Wahnou, H and El Kebbaj, R and Demoré, B and Limami, Y and Duval, RE},
title = {Current State of the Fight Against Antimicrobial Resistance: What Are the Different Strategies for Tomorrow?.},
journal = {Antibiotics (Basel, Switzerland)},
volume = {15},
number = {6},
pages = {},
doi = {10.3390/antibiotics15060564},
pmid = {42353688},
issn = {2079-6382},
abstract = {Antimicrobial resistance (AMR) is a leading global cause of death, with recent World Health Organization (WHO) data revealing that one in six laboratory-confirmed bacterial infections shows resistance to at least one antibiotic treatment. This review comprehensively analyzes the AMR landscape in 2026, detailing its evolution, mechanisms, and the innovative strategies being deployed to combat it. Driven by Darwinian selection and accelerated by factors like antibiotic overuse during the Coronavirus Disease 2019 (COVID-19) pandemic (predominantly in hospitalized patients with suspected bacterial co-infection), AMR is propelled by a diverse molecular arsenal in bacteria. Key mechanisms include enzymatic drug inactivation (e.g., the diversifying β-lactamase superfamily), target site modification (e.g., mcr genes conferring colistin resistance), efflux pumps, and biofilm formation. The rapid global spread of these traits is facilitated by a dynamic "mobilome", a network of plasmids and transposons that shuttle resistance genes between species. This crisis has sparked a major scientific mobilization. Advances include the discovery of novel antibiotic scaffolds like lariocidin and the regulatory approval of critical new antibiotic/inhibitor combinations such as sulbactam/durlobactam and aztreonam/avibactam, which target highly resistant Gram-negative bacteria. Moreover, the first-in-class antibiotic gepotidacin offers a new option for urinary tract infections. Beyond traditional drugs, the pipeline is diversifying to include phage therapy, antivirulence strategies, and artificial intelligence-guided drug discovery. This diversification is critical as it helps preserve the effectiveness of existing Medically Important Antimicrobials (MIAs), those deemed essential for human medicine, by providing alternative or adjunctive treatment options. However, scientific innovation alone is insufficient. This review argues that lasting success requires parallel progress in global policy and infrastructure. Strategic priorities beyond 2026 must include finalizing and funding updated global action plans, strengthening real-time surveillance and diagnostic capacity, especially in low-resource settings, and implementing new economic models to de-risk antibiotic development. Embedding effective antimicrobial stewardship within universal health coverage and pandemic preparedness plans is crucial. Ultimately, defeating AMR demands an unprecedented, coordinated global effort that outpaces the relentless adaptability of bacterial pathogens.},
}

@article {pmid42354127,
year = {2026},
author = {Piva, M and Martelossi-Cebinelli, G and Mendes-Pierotti, S and Chinen, WH and Cardines, PHF and Martinez, RM and Georgetti, SR and Baracat, MM and Vicentini, FTMC and Verri, WA and Casagrande, R},
title = {Flavonoids as Nutraceuticals to Treat Inflammatory Diseases: Focusing on Quercetin, Kaempferol, Luteolin, Apigenin, Epicatechin and Their Effects on Hepatic, Nervous, and Pulmonary Systems.},
journal = {Foods (Basel, Switzerland)},
volume = {15},
number = {12},
pages = {},
doi = {10.3390/foods15122159},
pmid = {42354127},
issn = {2304-8158},
support = {Grant call #067/2024//Fundação Araucária/ ; #309633/2021-4, #405027/2021-4, #307852/2019-9; #481049/2012-6; #427946/2018-2 and # 405848/2025-0//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; finance code 001//Coordenação de Aperfeicoamento de Pessoal de Nível Superior/ ; n/a//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; dotação orçamentária #4560.19.571.06.6153; eprotocolo 21.234.745-0//Secretaria de Estado da Ciência, Tecnologia, e Ensino Superior (SETI)/ ; },
abstract = {The immune response is essential in the protection of our body against pathogens; however, the inflammatory response caused by the immune system can become a disease itself. In fact, anti-inflammatory and immune-suppressive drugs are applied to limit the immune response to treat inflammatory diseases. Flavonoids are plant-derived polyphenols extensively investigated for their anti-inflammatory and antioxidant properties in inflammatory diseases. Studies applying isolated compounds as well as using supplements as nutraceuticals based on flavonoids have been conducted. Our review systematically analyzed the top five studied flavonoids between 2020 and 2025: quercetin (1742 articles), kaempferol (642), luteolin (589), apigenin (419), and epicatechin (354), highlighting their major therapeutic applications in diseases affecting the liver (12%), nervous system (11%), and lungs (10%). Mechanistically, these compounds act as multi-target agents mainly by inhibiting NF-κB and inducing Nrf2-dependent antioxidant programs. Application of advanced delivery systems, which increase oral bioavailability by up to 20-fold, overcomes pharmacokinetic bottlenecks. Clinical highlights demonstrated promising therapeutic effects, including reduced intrahepatic lipid accumulation in non-alcoholic fatty liver disease patients following quercetin supplementation (11.5% to 9.6%) and accelerated SARS-CoV-2 clearance after quercetin phytosome administration. The translation of flavonoids into standardized clinical therapies remains limited by the lack of large-scale, well-controlled clinical trials.},
}

@article {pmid42354220,
year = {2026},
author = {Messova, AM and Ganiyeva, I and Abdrakhmanova, ST and Tuleubayeva, A and Sanbayev, M and Makibayeva, MG and Tamadon, A},
title = {Autoimmune Thyroid Diseases After COVID-19 Infection: A Systematic Review of Clinical Manifestation and Outcomes.},
journal = {International journal of environmental research and public health},
volume = {23},
number = {6},
pages = {},
doi = {10.3390/ijerph23060689},
pmid = {42354220},
issn = {1660-4601},
mesh = {Humans ; *COVID-19/complications ; *Graves Disease/etiology ; *Hashimoto Disease/etiology ; SARS-CoV-2 ; *Thyroiditis, Autoimmune/etiology ; },
abstract = {Background: Increasing evidence suggests that COVID-19 can induce or exacerbate autoimmune disorders, including immune-mediated thyroid dysfunction. The most common autoimmune thyroid diseases are Graves' disease and Hashimoto's thyroiditis; the mechanisms by which viral infections like SARS-CoV-2 trigger these diseases are not fully understood. Objectives: This study aims to systematically review published clinical evidence on the presentation, laboratory characteristics, and outcomes of autoimmune thyroid diseases after COVID-19 infection. Methods: The review followed the PRISMA 2020 framework. Scopus, Web of Science, and PubMed were searched for English-language studies between January 2020 and December 2025 using the terms COVID-19, SARS-CoV-2, autoimmune thyroiditis, Graves' disease, Hashimoto's thyroiditis, and autoimmune thyroid disease. Results: In total, 46 studies (five cohort studies and 41 case reports/series) involving 3856 patients were analyzed. The findings indicate that a significant increase in TPOAb prevalence occurs post-COVID-19 infection (15.7% vs. 7.7% in controls). New-onset Graves' disease (GD) post-COVID-19 presented with higher fT3/fT4 ratios and more aggressive thyrotoxicosis compared to non-viral cases. Rare but severe manifestations included thyrotoxic periodic paralysis, Hashimoto's encephalopathy, and dilated cardiomyopathy. Conclusions: SARS-CoV-2 may act as a trigger for autoimmune thyroid diseases, particularly in moderate-to-severe infections; however, the strength of this association warrants further investigation with controlled prospective data. Standard therapy remains effective, but thyroid function monitoring is advisable during post-COVID-19 recovery. An interdisciplinary approach is essential for early diagnosis and management of systemic complications.},
}

Humans
*COVID-19/complications
*Graves Disease/etiology
*Hashimoto Disease/etiology
SARS-CoV-2
*Thyroiditis, Autoimmune/etiology

@article {pmid42354473,
year = {2026},
author = {De Micco, F and Di Palma, G and Ferorelli, D and Giacomobono, F and Lima Arrais Ribeiro, I and Nóbrega, JBMD and Scendoni, R},
title = {Patient Safety Implications of Opportunistic Pathogens and Healthcare-Associated Infections in COVID-19 Patients: A Narrative Review.},
journal = {Healthcare (Basel, Switzerland)},
volume = {14},
number = {12},
pages = {},
doi = {10.3390/healthcare14121614},
pmid = {42354473},
issn = {2227-9032},
abstract = {The COVID-19 pandemic has highlighted the increased vulnerability of hospitalized patients to healthcare-associated infections (HAIs), which significantly impact patient safety and clinical outcomes. This narrative review summarizes the main opportunistic pathogens associated with HAIs in COVID-19 patients, with particular focus on multidrug-resistant organisms such as Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, and Candida spp. The review also examines key aspects of antimicrobial resistance, prevention and control strategies, and medico-legal implications. The evidence supports the need for a multifaceted approach based on antibiotic stewardship, infection prevention guidelines, and multidisciplinary clinical risk management.},
}

@article {pmid42354881,
year = {2026},
author = {Precup, CV and Mateescu, DM and Enache, A and Buhas, CL and Muresan, CO},
title = {SARS-CoV-2 Persistence and Cardiovascular Sequelae in the Post-COVID Era: A Public Health Microbiology Perspective on Sudden Cardiac Death and Pulmonary Thromboembolism.},
journal = {Microorganisms},
volume = {14},
number = {6},
pages = {},
doi = {10.3390/microorganisms14061256},
pmid = {42354881},
issn = {2076-2607},
support = {Victor Babeș University of Medicine and Pharmacy Timișoara//Victor Babeș University of Medicine and Pharmacy Timișoara/ ; },
abstract = {Post-acute sequelae of SARS-CoV-2 infection (PASC) extend well beyond the acute respiratory phase, with accumulating virological evidence that SARS-CoV-2 RNA, viral antigens, and proteolytic fragments may persist in cardiovascular and other extrapulmonary tissues, although the extent to which such detection represents replication-competent reservoirs versus residual viral material with uncertain pathological relevance remains under active investigation. Sudden cardiac death (SCD) and fatal pulmonary thromboembolism (PTE) have emerged as forensically and epidemiologically significant outcomes in individuals with prior infection, situated at the intersection of microbiology, public health, and forensic medicine. To synthesize current evidence on the virological mechanisms by which SARS-CoV-2 may contribute to post-acute sudden cardiac death (SCD) and pulmonary thromboembolism (PTE), the population-level epidemiology of these outcomes, and their implications for public health surveillance and forensic practice, we conducted a narrative review of PubMed (MEDLINE), Scopus, and Web of Science Core Collection. The search covered publications from January 2020 to December 2025 and focused on SARS-CoV-2 cellular tropism and tissue persistence, immune-mediated and thromboinflammatory mechanisms, excess cardiovascular and thromboembolic mortality, and autopsy-based pathological findings. After de-duplication of 1837 initially identified records (412 duplicates removed) and screening of 1425 unique records, 78 studies were retained for final synthesis based on virological, epidemiological, and forensic relevance. SARS-CoV-2 enters cardiomyocytes, pericytes, and vascular endothelial cells through ACE2-dependent mechanisms, with cathepsin L compensating for the limited cardiac expression of TMPRSS2. Viral RNA and antigen have been detected in cardiovascular and other extrapulmonary tissues months after symptom onset in selected autopsy series, although persistent detection of viral components does not necessarily indicate ongoing productive infection or direct tissue injury. Endothelial dysfunction, neutrophil extracellular trap (NET) formation, complement activation, and persistent thromboinflammation have been proposed as plausible mechanistic substrates for arrhythmogenic remodelling and thromboembolic events, although definitive causal pathways remain incompletely understood. Population-based studies document persistent excess cardiovascular mortality across multiple jurisdictions, with hazard ratios for pulmonary embolism remaining elevated months after acute infection, particularly in unvaccinated individuals. Autopsy series identify mixed pathological patterns including focal lymphocytic infiltrates, microvascular thrombosis, contraction-band necrosis, and cardiomyocyte vacuolation, although fulminant lymphocytic myocarditis fulfilling Dallas criteria remains uncommon. A microbiology-informed framework uniting tissue-based viral detection, standardized cardiac and pulmonary sampling protocols, and prospective post-mortem registries is needed to better characterize the potential contribution of SARS-CoV-2 to post-acute cardiovascular mortality and to support cause-of-death certification, public health surveillance, and medicolegal practice in the post-pandemic era. Many of the proposed mechanisms remain under active investigation, and definitive causal relationships between viral persistence and adverse cardiovascular outcomes have not yet been conclusively established.},
}

@article {pmid42354940,
year = {2026},
author = {Mpakosi, A and Cholevas, V and Lianou, A and Tziraki, F and Vogiatzis, I and Cholevas, S and Tzouvelekis, I and Mironidou-Tzouveleki, M and Tsante, KA and Tsakri, D and Petrakis, V and Ioannou, P and Bonovas, S and Sokou, R and Tsantes, AG},
title = {Targeting Zoonotic Spillover Drivers for Global Pandemic Prevention: A Narrative Review.},
journal = {Microorganisms},
volume = {14},
number = {6},
pages = {},
doi = {10.3390/microorganisms14061316},
pmid = {42354940},
issn = {2076-2607},
abstract = {Zoonoses account for the majority of recognized mammalian viral spillover events, primarily originating from bats, rodents, and primates. Human activities have significantly accelerated these transmissions. This narrative review synthesizes the evolutionary, ecological, pathogen-related, and anthropogenic drivers of viral zoonotic spillover to identify critical leverage points for pandemic prevention. A narrative literature review was conducted. The analysis focused on factors enabling animal pathogens to transform into human pathogens, examining host species, pathogen traits, human-animal interactions, and environmental impacts. Pathogen transformation depends on host traits, contact frequency, and viral characteristics. Anthropogenic drivers-including livestock expansion, the bushmeat trade, wet markets, and the exotic pet industry-significantly elevate spillover risks. Effective pandemic prevention requires targeted interventions at the wildlife-livestock-human interfaces. A holistic, multidisciplinary collaboration between national governments and international organizations is essential to mitigate future risks.},
}

@article {pmid42355811,
year = {2026},
author = {Khawandi, J and Choaib, A and Azzam, M and Oudit, GY and Patel, K and Nazzal, J and Khader, AA and Kawtharany, H and Al Zabibi, MA and Ahmad, J and Kivan, H and Al Hussein, S and Rehman, AU and Piché, A and Vasquez Camargo, A and McNaughton, C and Lam, GY and Kamrul, R and Afzal, S and Schunemann, HJ and Wiercioch, W and Nieuwlaat, R and Brignardello-Petersen, R and Falcone, EL and Mustafa, RA},
title = {Echocardiogram Testing in Patients with Post-COVID-19 Condition: A Systematic Review and Meta-Analysis.},
journal = {Journal of clinical medicine},
volume = {15},
number = {12},
pages = {},
doi = {10.3390/jcm15124643},
pmid = {42355811},
issn = {2077-0383},
support = {2223-HQ-000415//Public Health Agency of Canada/ ; },
abstract = {Background: Post-COVID-19 condition (PCC) is a complication following acute COVID-19 infection, which may lead to long-term cardiac abnormalities. This review aimed to assess the prevalence of structural/functional deviations in echocardiography in individuals with PCC compared to patients without PCC. Methods: We searched three databases. Two reviewers independently screened articles using LASER Al and extracted relevant data using a piloted Excel sheet. We performed meta-analysis using OpenMeta and RevManWeb and a subgroup analysis based on patients' settings during acute COVID-19. We assessed the risk of bias using the Hoy et al. tool and the certainty using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: We included 16 studies that reported on differences in echocardiographic findings in patients with or without PCC. Individuals with PCC were more likely to have structural/functional deviations in echocardiographic readings of unclear clinical significance, particularly those who were hospitalized during acute COVID-19. The overall certainty of the evidence was very low due to the high risk of bias, indirectness, and imprecision. Conclusions: This review provides insight into the use of echocardiograms and the frequency of test deviations in individuals with PCC. Despite existing evidence, there is a need for future studies to assess the diagnostic test accuracy of echocardiograms in PCC.},
}

@article {pmid42356418,
year = {2026},
author = {Posta, E and Gyarmati, E and Majoros, L and Fekete, I and Varkonyi, I and Zold, E and Barta, Z},
title = {Across Kingdoms: The Bacteriome, Mycobiome, and Virome in Autoimmune Diseases: Mechanistic Insights, Therapeutic Perspectives, and the Emerging Role of COVID-19.},
journal = {Nutrients},
volume = {18},
number = {12},
pages = {},
doi = {10.3390/nu18122032},
pmid = {42356418},
issn = {2072-6643},
mesh = {Humans ; *COVID-19/immunology ; *Autoimmune Diseases/microbiology/immunology/virology/therapy ; SARS-CoV-2 ; *Virome ; Dysbiosis/immunology ; *Gastrointestinal Microbiome/immunology ; },
abstract = {Autoimmune and immune-mediated inflammatory diseases (IMIDs) develop when genetically and environmentally susceptible hosts lose stable immune tolerance. The gut ecosystem is increasingly recognized as a biologically active interface in this process. Its bacterial, fungal, and viral components may shape mucosal and systemic immunity through antigenic stimulation, barrier regulation, and metabolite-dependent signaling, although the strength of evidence is uneven: bacteriome data are currently the most mature, whereas mycobiome, virome, and phageome findings remain more disease-specific and emerging. Dysbiosis may influence autoimmunity through overlapping routes, including epithelial barrier failure, altered short-chain fatty acid, bile acid, and tryptophan metabolism, molecular mimicry, and cross-kingdom microbial interactions. Nutrition is central to this network because dietary substrates determine microbial growth, metabolic output, epithelial integrity, and immune-cell differentiation. In this narrative review, we integrate evidence on disease-associated bacteriome, mycobiome, and virome patterns in systemic autoimmune diseases, with emphasis on rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, spondyloarthritis, vasculitides, and idiopathic inflammatory myopathies. COVID-19 is considered not as a proven causal driver of autoimmunity, but as an example of an environmental and infectious insult capable of perturbing microbiome-barrier-immune communication. Finally, we discuss diet-based and microbiome-targeted approaches, including probiotics, prebiotics, synbiotics, and postbiotics, as adjunctive strategies that may help restore microbial resilience and immune balance. A better understanding of the diet-microbiome-host immunity axis may support more personalized preventive and therapeutic concepts in autoimmune disease.},
}

Humans
*COVID-19/immunology
*Autoimmune Diseases/microbiology/immunology/virology/therapy
SARS-CoV-2
*Virome
Dysbiosis/immunology
*Gastrointestinal Microbiome/immunology

@article {pmid42356487,
year = {2026},
author = {Chiririwa, H},
title = {Selected Cannabinoids, Cannabimimetic Agents and Artemisia Combinations as Theoretical Adjunct Strategies Against COVID-19.},
journal = {Pharmaceuticals (Basel, Switzerland)},
volume = {19},
number = {6},
pages = {},
doi = {10.3390/ph19060869},
pmid = {42356487},
issn = {1424-8247},
abstract = {COVID-19 has spurred much interest in complementary and alternative agents for therapeutic purposes having antiviral and immunomodulatory effects. In these, natural products and bioactive compounds from plants have been at the center of attention due to their easy access, relatively low risk and long history of use in traditional medicine. This paper reviews in detail and critically assesses the scientific data that presently proposes the use of certain cannabinoids, cannabimimetic compounds and Artemisia species in the treatment and prevention of COVID-19. It gives an account of medicinal approaches to cannabinoids like cannabidiol (CBD), Δ9-tetrahydrocannabinol (THC) alongside other minor cannabinoids and synthetic and naturally-occurring cannabimimetics. The paper reports the potential of Artemisia annua and other species as treatments, especially focusing on their antiviral, anti-regulatory, anti-inflammatory and immunomodulating properties. It highlights the molecular interactions with SARS-CoV-2 targets as well as cytokine regulation and modulation of oxidative stress pathways, with special emphasis on these areas. The paper raises multiple issues like preclinical and clinical studies, safety aspects, regulatory hurdles and drawbacks related to the use of these natural compounds. After analyzing all the available data, the article entertains the idea of a cannabinoid-Artemisia combination as a supportive or adjunct therapy in COVID-19 treatment. It also points out that the clinical trials are insufficient concerning the establishment of effectiveness, determination of the appropriate dosage and assurance of the long-term safety of the treatment.},
}

@article {pmid42357296,
year = {2026},
author = {Dos Santos, RPN and Betancourt Roldan, DC and Guven, M and Leite, LC and Furlan, FJM and da Silva, GRM and de Oliveira, VAP and Capriglione, CDS and da Silva, JP and Pinto, JC and Eş, I and Balbino, TA},
title = {Microfluidic-Driven Assembly of RNA Nanocomplexes: Design, Process Control and Translational Perspectives in Oncology.},
journal = {Pharmaceutics},
volume = {18},
number = {6},
pages = {},
doi = {10.3390/pharmaceutics18060679},
pmid = {42357296},
issn = {1999-4923},
support = {124C536//Scientific and Technological Research Council of Turkey/ ; YTB//Presidency for Turks Abroad and Related Communities/ ; },
abstract = {RNA-based therapeutics are becoming increasingly important in oncology, particularly following the rapid development of mRNA technologies during the COVID-19 pandemic, but their success strongly depends on how efficiently they can be delivered to target cells. Microfluidic technologies have redefined the design and manufacturing of RNA-based nanocomplexes, as they enable precise control over physicochemical features that are critical for clinical translation in oncology. This review examines recent developments in microfluidic-assisted synthesis of RNA nanocarriers, with a focus on cancer applications. Through a detailed analysis of material systems, device architectures, and formulation strategies, we explore how laminar flow environments enable reproducible encapsulation, tunable particle size, and improved payload stability. We examine the microfluidic assembly of lipid nanoparticles and polymeric carriers for RNA delivery, highlighting strategies to enhance durability, bioavailability, and cellular uptake. Advancements in process optimization, including flow parameter refinement and inline monitoring, are discussed alongside the influence of device geometries on mixing dynamics and nucleation. Beyond formulation, we explore the integration of microfluidics with tumor-on-chip platforms to evaluate transport, penetration, and therapeutic response in physiologically relevant cancer models. By connecting technological innovation with preclinical application, this work outlines the trajectory toward next-generation, personalized RNA nanomedicines enabled by microfluidic precision.},
}

@article {pmid42357309,
year = {2026},
author = {Porta, EOJ and AlKharboush, DF and Jackson, L and Pang, F and Darin, A and Louka, J and Quamruzzaman, M and Shi, X and Wells, G and Kozielski, F},
title = {Targeting SARS-CoV-2 Non-Structural Proteins: A Blueprint for Next-Generation Small-Molecule Coronavirus Antivirals.},
journal = {Pharmaceutics},
volume = {18},
number = {6},
pages = {},
doi = {10.3390/pharmaceutics18060693},
pmid = {42357309},
issn = {1999-4923},
support = {MR/X013995/1/MRC_/Medical Research Council/United Kingdom ; },
abstract = {The SARS-CoV-2 non-structural proteome remains the most clinically validated and strategically important landscape for direct-acting small-molecule antiviral drug discovery. The success of inhibitors targeting the main protease (M[pro], Nsp5) and RNA-dependent RNA polymerase (RdRp, Nsp12) has firmly established viral replication enzymes as tractable, druggable, and therapeutically relevant targets, while setting clear benchmarks for translational antiviral development. Building on this foundation, a second wave of non-structural protein (Nsp) targets has emerged with increasing translational promise, including the papain-like protease (PL[pro]), the bifunctional Nsp14 proofreading and capping machinery, Nsp16 2'-O-methyltransferase, Nsp13 helicase, and Nsp15 endoribonuclease. In parallel, additional components such as Nsp1 and the Mac1 domain of Nsp3 continue to expand the antiviral design space, although they remain at earlier stages of chemical validation. In this review, we comprehensively assess SARS-CoV-2 non-structural proteins through a medicinal chemistry and translational lens, with an emphasis on structural tractability, mechanism of action, quality of chemical matter, cellular and in vivo antiviral evidence, evolutionary conservation, resistance liabilities, and developability. Particular attention is given to the features that distinguish tool compounds from genuinely actionable leads and to the opportunities for rational combination regimens that extend beyond first-generation protease- and polymerase-centred therapy. Collectively, the non-structural proteome offers the strongest foundation for next-generation and potentially broader-spectrum coronavirus antivirals with improved resilience to viral evolution.},
}

@article {pmid42357322,
year = {2026},
author = {Porta, EOJ and AlKharboush, DF and Jackson, L and Pang, F and Darin, A and Louka, J and Shi, X and Wells, G and Kozielski, F},
title = {Targeting SARS-CoV-2 Structural and Accessory Proteins: Emerging Opportunities for Small-Molecule Coronavirus Antivirals.},
journal = {Pharmaceutics},
volume = {18},
number = {6},
pages = {},
doi = {10.3390/pharmaceutics18060706},
pmid = {42357322},
issn = {1999-4923},
support = {MR/X013995/1/MRC_/Medical Research Council/United Kingdom ; },
abstract = {Although antiviral development against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been dominated by replication-directed strategies, structural and accessory proteins offer a complementary and increasingly important opportunity for small-molecule intervention. These proteins control key processes outside the core replication machinery, including viral entry, membrane remodelling, virion assembly, egress, and host immune modulation, thereby expanding the mechanistic scope of antiviral design. However, many of these targets are membrane-associated, oligomeric, conformationally dynamic, or function through protein-protein interactions, creating distinct challenges in target validation, assay design, and chemical optimisation. In this review, we comprehensively and critically evaluate the structural and accessory proteomes of SARS-CoV-2, with a strict focus on small-molecule tractability and translational relevance. We highlight the most credible direct-acting opportunities, focusing on the membrane (M), envelope (E), and nucleocapsid (N) structural proteins, together with the accessory protein open reading frame 3a (ORF3a), for which emerging chemical matter strengthens confidence in druggability. In contrast, Spike (S) and several host-interface accessory proteins, including ORF6, ORF8, ORF9b, and ORF10, are best viewed as more selective or earlier-stage opportunities that require stronger on-target chemical validation. Emphasis is placed on structural accessibility, mechanism-based assay systems, evidence quality, cellular and in vivo activity, and developability constraints relevant to exposure at the infection site. Rather than replacing replication-directed antivirals, these non-canonical targets are best considered adjunctive or complementary components of future combination strategies designed to broaden antiviral coverage, enhance robustness, and improve pandemic preparedness.},
}

@article {pmid42357443,
year = {2026},
author = {Zhao, S and Lin, Z and Wang, M},
title = {Positive-Strand RNA Viral RdRps: From Structure Conservation and Activity Assay to Drug Development.},
journal = {Molecules (Basel, Switzerland)},
volume = {31},
number = {12},
pages = {},
doi = {10.3390/molecules31122044},
pmid = {42357443},
issn = {1420-3049},
mesh = {*RNA-Dependent RNA Polymerase/chemistry/antagonists & inhibitors/metabolism/genetics ; *Antiviral Agents/pharmacology/chemistry/therapeutic use ; Humans ; *Drug Development ; *Positive-Strand RNA Viruses/enzymology/drug effects/genetics ; RNA Replication/drug effects ; Virus Replication/drug effects ; SARS-CoV-2/enzymology/drug effects ; },
abstract = {Positive-strand RNA viruses represented by SARS-CoV-2 and DENV spread globally with high infectivity and frequent mutations, posing a severe threat to human health. However, specific and effective antiviral drugs remain limited. RNA-dependent RNA polymerase (RdRp) plays a critical role in the genome replication of RNA viruses and shows high structural conservation. No homologous protein exists in human cells, making RdRp an effective, safe, and broad-spectrum antiviral target. Therefore, establishing an RdRp activity assay for drug development based on its mechanism is of great significance. This paper summarizes the structural characteristics of RdRp and the methods for constructing RdRp activity assay, especially for cell-free activity assay. In addition, several reported RdRp inhibitors and their pharmaceutical progress are also reviewed, aiming to provide a reference for the development of novel antiviral drugs targeting RdRp.},
}

*RNA-Dependent RNA Polymerase/chemistry/antagonists & inhibitors/metabolism/genetics
*Antiviral Agents/pharmacology/chemistry/therapeutic use
Humans
*Drug Development
*Positive-Strand RNA Viruses/enzymology/drug effects/genetics
RNA Replication/drug effects
Virus Replication/drug effects
SARS-CoV-2/enzymology/drug effects

@article {pmid42357608,
year = {2026},
author = {Domingo, JL},
title = {Toxicants, Exposome, and Hantavirus Disease: A One Health Perspective.},
journal = {Viruses},
volume = {18},
number = {6},
pages = {},
doi = {10.3390/v18060597},
pmid = {42357608},
issn = {1999-4915},
mesh = {Humans ; *Hantavirus Infections/transmission/epidemiology/virology ; Orthohantavirus ; Animals ; Climate Change ; *One Health ; *Environmental Exposure/adverse effects ; *Exposome ; SARS-CoV-2 ; COVID-19 ; Zoonoses/virology ; },
abstract = {Although hantaviruses have traditionally been considered geographically restricted rodent-borne pathogens, globalization, climate change, ecosystem disruption, and environmental contamination may collectively favor novel transmission scenarios and altered epidemiological patterns. The experience gained during the SARS-CoV-2 pandemic showed the importance of environmental determinants, airborne exposure, and host susceptibility factors in emerging viral diseases. In this context, increasing but still indirect evidence suggests that environmental toxicants and the exposome may modulate susceptibility to hantavirus infection and influence disease severity. The proposed mechanisms include oxidative stress, endothelial dysfunction, pulmonary inflammation, and immune dysregulation, rather than direct causal effects of toxicants on infection itself. This article discusses current knowledge regarding interactions among toxic environmental exposures, climate change, and hantavirus disease, with special emphasis on Andes orthohantavirus (ANDV), the principal hantavirus known to exhibit person-to-person transmission. The article integrates recent evidence within the One Health framework and highlights future research priorities linking environmental toxicology, zoonotic disease ecology, and global environmental change.},
}

Humans
*Hantavirus Infections/transmission/epidemiology/virology
Orthohantavirus
Animals
Climate Change
*One Health
*Environmental Exposure/adverse effects
*Exposome
SARS-CoV-2
COVID-19
Zoonoses/virology

@article {pmid42357652,
year = {2026},
author = {Jia, T and Huang, Z and Xia, N and Yuan, Q},
title = {Broad Neutralizing Antibodies Against SARS-CoV-2: Current Progress and Engineering Strategies.},
journal = {Viruses},
volume = {18},
number = {6},
pages = {},
doi = {10.3390/v18060642},
pmid = {42357652},
issn = {1999-4915},
support = {824B2066//National Natural Science Foundation of China/ ; 92369110//National Natural Science Foundation of China/ ; 82272305//National Natural Science Foundation of China/ ; },
mesh = {*Antibodies, Neutralizing/immunology/therapeutic use ; Humans ; *SARS-CoV-2/immunology/genetics ; *Antibodies, Viral/immunology/therapeutic use ; *COVID-19/immunology/prevention & control ; Spike Glycoprotein, Coronavirus/immunology/genetics ; Animals ; Epitopes/immunology ; Single-Domain Antibodies/immunology ; Protein Engineering ; Mutation ; },
abstract = {The high-frequency mutation characteristics of SARS-CoV-2 have posed formidable challenges to the development of vaccines and therapeutic agents. Neutralizing antibodies, which serve as effective tools for prevention and control, have undergone continuous updates and iterations in response to viral mutations. This article provides a comprehensive review of researchers' efforts to achieve both high neutralizing potency and high mutation tolerance in SARS-CoV-2-targeting neutralizing antibodies. Building on the characteristics of conventional antibodies directed against distinct epitopes on the S protein, it further discusses the research on nanobodies, antibody cocktails, multi-specific antibodies, and other antibody formats and engineering approaches, including artificial intelligence-enabled optimization. Each antibody-based strategy targeting SARS-CoV-2 has its own distinctive advantages and potential applications, providing an integrated perspective to support the continued development of antiviral neutralizing antibodies.},
}

*Antibodies, Neutralizing/immunology/therapeutic use
Humans
*SARS-CoV-2/immunology/genetics
*Antibodies, Viral/immunology/therapeutic use
*COVID-19/immunology/prevention & control
Spike Glycoprotein, Coronavirus/immunology/genetics
Animals
Epitopes/immunology
Single-Domain Antibodies/immunology
Protein Engineering
Mutation

@article {pmid42359054,
year = {2026},
author = {Dinç, HÖ and Saribaş, S and Kocazeybek, B},
title = {The immunopathological spectrum of COVID-19: from cytokine storm to autoimmunity-a systematic review.},
journal = {Frontiers in medicine},
volume = {13},
number = {},
pages = {1864452},
pmid = {42359054},
issn = {2296-858X},
abstract = {INTRODUCTION: This systematic review aimed to provide a comprehensive evaluation of the immunopathological mechanisms associated with SARS-CoV-2 infection and COVID-19 vaccination based on current evidence. Particular emphasis was placed on cytokine storm, endothelial dysfunction, complement activation, and autoimmune processes in COVID-19 pathogenesis.

METHODS: The study was conducted as a systematic literature review in accordance with PRISMA guidelines. English-language research articles published between 2020 and 2026 were identified through a structured search of the Scopus database. A total of 1,331 records were screened, and 53 studies were included based on predefined inclusion and exclusion criteria. The findings were systematically categorized according to major immunopathological mechanisms.

RESULTS: The included studies indicate that endothelial dysfunction (24.5%) and cytokine dysregulation (18.9%) are the most frequently reported mechanisms in COVID-19 immunopathogenesis. Autoimmune responses (15.1%), complement activation (17%), and immune complex-mediated inflammation also play significant roles. Elevated levels of proinflammatory cytokines, lymphopenia, and markers of vascular injury were consistently associated with increased disease severity and mortality. In addition, persistent immunological alterations and autoantibody production were observed in a subset of patients during the post-COVID period.

CONCLUSION: COVID-19 pathogenesis is driven by complex and interconnected immunopathological mechanisms rather than viral effects alone. Hyperinflammation, endothelial dysfunction, complement activation, and autoimmune processes are key determinants of disease severity and clinical outcomes. These findings underscore the importance of targeted immunomodulatory strategies and provide a comprehensive framework for future research.},
}

@article {pmid42359168,
year = {2026},
author = {Mundt, B and Kant, R and Grzybek, M},
title = {Viral pathogens in urban rats: A one health systematic review of global surveillance evidence.},
journal = {One health (Amsterdam, Netherlands)},
volume = {23},
number = {},
pages = {101468},
pmid = {42359168},
issn = {2352-7714},
abstract = {BACKGROUND: Commensal rats (Rattus norvegicus and Rattus rattus) thrive in urban environments worldwide, where they live near humans and may act as reservoirs for viral pathogens of public health relevance. Although rats are increasingly recognised as sentinels of urban environmental health, the diversity and distribution of viral infections circulating in urban rat populations remain incompletely characterised within a One Health framework.

OBJECTIVES: This systematic review synthesises global evidence on viral pathogens detected in urban rats, focusing on rat hepatitis E virus/Rocahepevirus ratti and human-associated hepatitis E virus/Paslahepevirus balayani where distinguishable, Seoul virus (SEOV), SARS-CoV-2, and additional viral taxa identified through targeted surveillance or, in rare cases, metagenomic approaches.

METHODS: Following PRISMA 2020 guidelines, five electronic databases were searched for primary studies reporting viral detection in urban Rattus spp. Eligible studies underwent screening, structured data extraction and quality appraisal. Viral prevalence was summarised descriptively by pathogen and geographic region.

RESULTS: A total of 70 studies met the inclusion criteria, spanning Europe, Asia, North America, South America and the Caribbean. HEV and SEOV were the most frequently reported viruses, with prevalence varying widely between regions. HEV prevalence ranged from low levels in parts of Europe and Asia to high levels in North America. SEOV was detected across all regions, with particularly high prevalence in parts of Asia and the Americas. SARS-CoV-2 was not detected in European rats but was reported at low to moderate prevalence in the Americas. Numerous additional viral pathogens were identified.

CONCLUSIONS: Urban rats globally harbour diverse viral communities, including pathogens with zoonotic potential. Surveillance remains uneven and methodologically heterogeneous. Integrating rat biomonitoring into coordinated One Health surveillance systems is critical to strengthen early warning capacity and mitigate zoonotic risk.},
}

@article {pmid42361431,
year = {2026},
author = {Bourgon, C and Moseman, EA},
title = {On or within: spatial determinants of antigen handling in the nasal turbinates.},
journal = {Current opinion in immunology},
volume = {101},
number = {},
pages = {102808},
doi = {10.1016/j.coi.2026.102808},
pmid = {42361431},
issn = {1879-0372},
abstract = {The SARS-CoV-2 pandemic has renewed interest in mucosal vaccines, yet these approaches have long struggled to generate durable protection against airway pathogens. A key limitation is the incomplete understanding of how upper airway antigens are handled to shape immune response quality and durability. Antigens located within the airspace or on the mucosal surface can be directly sampled by mucosal-associated lymphoid tissues (MALTs), such as Nasal-associated lymphoid tissue (NALT) in mice, or tonsils in humans. Because MALTs lack afferent lymphatics, antigen entry occurs primarily across a specialized epithelium. In contrast, antigens that arise within the mucosa following barrier breach are captured by immune cells and lymphatics for delivery to draining lymph nodes. This framework suggests that 'on the mucosa' antigens preferentially engage MALTs, whereas 'within the mucosa' antigens are handled by lymph nodes. However, the rules governing antigen handling within the nasal cavity remain poorly defined, limiting rational mucosal vaccine design.},
}

@article {pmid42361718,
year = {2026},
author = {Sanga, NA and Oranzie, M and January, JL and Cox, M and Januarie, KC and Cupido, C and Tovide, OO and Pokpas, K and Douman, SF and Iwuoha, EI},
title = {Bioelectrochemical Sensing Dynamics of SARS-CoV-2 Biomarkers.},
journal = {Bioelectrochemistry (Amsterdam, Netherlands)},
volume = {172},
number = {},
pages = {109368},
doi = {10.1016/j.bioelechem.2026.109368},
pmid = {42361718},
issn = {1878-562X},
abstract = {The SARS-CoV-2 outbreak has underscored the urgent need for rapid, sensitive and accessible diagnostic technologies. This review provides a comprehensive overview of recent advances in nucleic acid- and antibody-based bioelectrochemical detection strategies for SARS-CoV-2, targeting the nucleocapsid (N) protein, spike (S) protein, the receptor binding domain (RBD) antigens and the viral RNA genome. Particular emphasis is placed on aptasensor, immunosensor and genosensor, highlighting biosensor design strategies and associated advantages and limitations. Key analytical parameters, such as sensitivity, detection limit, response time, transduction mechanisms and integrated nanomaterials are compared and discussed. Future perspectives on the innovative nucleic acid- and antibody-based point-of-care biosensors for SARS-CoV-2 are presented.},
}

@article {pmid42362025,
year = {2026},
author = {Liaw, PC and Zarychanski, R and Lawler, PR and Lother, SA and Mendelson, AA},
title = {The evolving role of heparin in sepsis: Therapeutic potential in the age of immunothrombosis.},
journal = {Journal of thrombosis and haemostasis : JTH},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jtha.2026.06.017},
pmid = {42362025},
issn = {1538-7836},
abstract = {Sepsis is a life-threatening syndrome caused by a dysregulated host response to infection and remains a leading cause of global morbidity and mortality. Despite decades of research, most biologically targeted therapies have failed to improve survival, highlighting the need for new treatment strategies that address the complex pathophysiology of sepsis. A defining feature of sepsis is immunothrombosis, characterized by widespread activation of inflammation and coagulation, endothelial injury, platelet activation, and neutrophil extracellular trap (NET) formation, resulting in both macrovascular thrombosis and microvascular occlusion. Heparin is commonly used as an anticoagulant and has re-emerged as a potential therapeutic agent for sepsis due to its pleiotropic properties that extend beyond anticoagulant effects. Heparin exhibits anti-inflammatory and antimicrobial activities, inhibits immune activation, neutralizes damage-associated molecular patterns (DAMPs), and modulates NET-mediated pathology. Clinical evidence for efficacy in sepsis remains limited, and no adequately powered randomized trials have confirmed a net survival benefit of therapeutic-dose heparin. This may reflect historical challenges with trial methodology and the heterogeneous nature of human sepsis. Data from COVID-19-associated sepsis suggest that severity may influence outcomes, with potential benefits in earlier disease stages and possible harm in advanced stages. Emerging interest in non-anticoagulant heparin derivatives and biomarker-guided patient selection may offer scientific opportunities to optimize therapeutic benefit while minimizing bleeding, but these approaches remain investigational. This review synthesizes current mechanistic, preclinical, and clinical evidence supporting heparin-based strategies in sepsis and emphasizes that therapeutic use beyond standard thromboprophylaxis should be evaluated in clinical trials before being applied in practice.},
}

@article {pmid41838245,
year = {2026},
author = {Manchikanti, L and Pampati, V and Kaye, AD and Abd-Elsayed, A and Shekoohi, S and Sanapati, MR and Soin, A and Hirsch, JA},
title = {An Updated Review of Utilization Patterns of Sacroiliac Joint Interventions in the Fee-for-service (ffs) Medicare Population from 2000 to 2022.},
journal = {Current pain and headache reports},
volume = {30},
number = {1},
pages = {},
pmid = {41838245},
issn = {1534-3081},
abstract = {PURPOSE OF THE REVIEW: This updated review evaluates utilization patterns of sacroiliac joint (SIJ) interventions, including SIJ injections, radiofrequency neurolysis, and SIJ fusion, using data from the Centers for Medicare and Medicaid Services (CMS) and Physician Supplier Procedure Summary (PSPS) database. RECENT FINDINGS: Between 2019 and 2022, Medicare data revealed a notable significant decline in SIJ intervention utilization, with a cumulative drop of 28.9% and an annual decrease of 10.7% per 100,000 beneficiaries. This represents a stark contrast to the minimal 0.4% annual decline observed from 2010 to 2019. The most significant reduction occurred from 2019 to 2020 (− 18.7%), coinciding with the onset of the COVID-19 pandemic. Utilization declined slightly from 2020 to 2021 (− 1.1%), then more sharply again from 2021 to 2022 (− 11.5%). These patterns mirror trends seen in similar studies on epidural and facet joint interventions, which often evaluate SIJ procedures in tandem. While the Medicare population increased by 63.3% from 2000 to 2022, SIJ injections rose by 281% overall during the same period, with an annual increase of 6.3%. However, post-COVID-19 (2019–2022), there was a 13.5% overall decrease in SIJ procedures, averaging a 4.7% annual decline. The largest drop occurred in 2020 (− 19.2%), followed by an 8.3% rebound in 2021, and a subsequent 1.2% decline in 2022. These findings highlight shifting trends in interventional pain management, particularly in response to public health and economic disruptions.},
}

@article {pmid41879902,
year = {2026},
author = {Ashique, S and Das, J and Bhui, U and Islam, A and Taj, T and Ansari, MY and Kalra, JM and Hussain, MS},
title = {Drug repurposing against viral infections (2020-2025): clinical trials, computational strategies, and therapeutic interventions.},
journal = {Inflammopharmacology},
volume = {34},
number = {4},
pages = {2193-2218},
pmid = {41879902},
issn = {1568-5608},
abstract = {Over the past five years, amid the escalating threat of viral outbreaks, drug repurposing has emerged as a pivotal strategy for rapidly deploying existing pharmacological agents against newly emerging infectious diseases. This review provides a comprehensive analysis of drug repurposing efforts targeting major viral infections between 2020 and 2025, with a particular focus on clinical trials and intervention strategies. The background and growing significance of drug repurposing are discussed in the context of the urgent global demand for accelerated antiviral development. Key viral infections, including SARS-CoV-2, monkey pox virus, H1N1 influenza, dengue virus, Zika virus, and hepatitis B and C, are examined in detail, with an emphasis on therapeutic interventions and clinical trial outcomes. Tabulated data summarize the efficacy, target mechanisms, and trial phases of key repurposed drugs. Additionally, the integration of emerging technologies, particularly artificial intelligence and machine learning, has enhanced the identification of novel drug-virus interactions, thereby increasing the precision of repurposing strategies. The paradigm shift toward host-targeted therapies further offers an alternative approach by disrupting host factors essential for viral replication. Despite significant progress, clinical challenges such as drug resistance, dosing optimization, and safety concerns persist. Overall, this review underscores the evolving role of repurposed drugs as a strategic asset in combating current and future viral pandemics through an integrated, evidence-based framework. Unlike many prior reviews that focus on single pathogens or early in silico candidate lists, we (i) benchmarked computational predictions against Phase II–IV clinical outcomes and real-world evidence, (ii) compared host-directed versus virus-directed repurposing strategies across multiple viral families, and (iii) integrated organ-specific toxicity constraints to explain translational attrition and guide future trial design.},
}

@article {pmid42342927,
year = {2026},
author = {Li, X and Kang, M and Jiao, XY and Merits, A and Veit, M and Rey, FA and Dai, H and Wang, XY and He, WT and Holmes, EC and Varjak, M and Mahalingam, S and Wang, D and Jiang, Z and Wang, S and Li, X and Peng, Z and He, N and Su, S},
title = {Addressing the zoonotic threat of merbecoviruses.},
journal = {Nature microbiology},
volume = {},
number = {},
pages = {},
pmid = {42342927},
issn = {2058-5276},
abstract = {Merbecovirus is a subgenus of betacoronaviruses and exhibits high genetic diversity with a capacity for cross-species transmission. However, beyond Middle East respiratory syndrome coronavirus (MERS-CoV), our knowledge of the ecology and pathogenic potential of these viruses remains limited. Merbecoviruses were once thought to rely exclusively on dipeptidyl peptidase 4 for cell entry, but recent discoveries have revealed that several members can also engage with angiotensin-converting enzyme 2 or aminopeptidase N, expanding their receptor repertoire and potential host range. Here we summarize recent advances in understanding of the receptor usage of merbecoviruses and examine how these insights inform pandemic preparedness and risk assessment. We discuss the development of targeted diagnostics, broad-spectrum antivirals and vaccines, including pan-coronavirus strategies. Together, these advances provide a foundation for predictive surveillance and rational countermeasure design, enabling earlier detection and more effective containment of future merbecovirus spillover events before they escalate into epidemics.},
}

@article {pmid42344053,
year = {2026},
author = {Nichols, E and Arhin-Wiredu, K and Bratton, S and Cercone, E and Longa Chanda, S and Cobos Muñoz, D and Ebonwu, J and Espinosa-Bode, A and Handzel, E and Kapombe, P and Martin, D and Moolenaar, R and Muhwava, W and Atuheire, EB},
title = {Integrating mortality surveillance as a routine component of national essential public health functions: a blueprint for action.},
journal = {BMJ public health},
volume = {4},
number = {2},
pages = {e003392},
pmid = {42344053},
issn = {2753-4294},
abstract = {The COVID-19 pandemic and other recent public health responses have highlighted significant challenges in global mortality data collection, with approximately 40% of deaths unregistered and fragmented reporting systems hampering public health responses. This paper supports the establishment of routine mortality surveillance as a core function of essential public health services, emphasising the need for integration with civil registration and vital statistics (CRVS) systems. By leveraging existing frameworks and proposing a Theory of Change (ToC), we outline critical linkages between CRVS and mortality surveillance that enhance data accuracy, timeliness and utility for public health decision-making. The paper provides examples across key enablers-policies, agreements and legislation; infrastructure; governance, funding and resources; and people and organisational culture-that facilitate these linkages. We also present examples from initiatives like the Africa CDC's Mortality Surveillance Programme to illustrate effective strategies in low- and middle-income countries (LMICs). The ToC serves as a blueprint for stakeholders to implement strategic interventions aimed at overcoming barriers to linking systems and data integration and utilisation. Ultimately, this paper underscores the importance of coordinated efforts among national public health agencies, civil registration authorities and other stakeholders to improve mortality data systems globally. By addressing these systemic challenges through enhanced collaboration and technological innovation, we can significantly advance public health outcomes and policy formulation in response to future health crises.},
}

@article {pmid42344113,
year = {2026},
author = {Mohamed, RA and Huitao, S and Si, M and Jinguan, Z and Mabrouk, MS},
title = {An End-to-End Modular Blueprint for Rapid mRNA Vaccine Development, Computational Design, Functional Validation, and Scalable Delivery Against Evolving Pathogens.},
journal = {In silico pharmacology},
volume = {14},
number = {2},
pages = {173},
pmid = {42344113},
issn = {2193-9616},
abstract = {The rapid emergence of new pathogens evolving viral variants. Underscores the need for agile vaccine platforms capable of outpacing infectious threats. Building on the success of mRNA vaccine technology during the COVID-19 pandemic. We integrated computational precision tool to help the young Scientifics map the vaccine design. It is not a validated lab protocol nor does it report experimental results. Instead, it offers a stepwise conceptual roadmap to guide future wet-lab research. We also outline in silico workflow encompassing antigen selection, consensus sequence generation. The first step in the workflow is to check the conserved antigenic domains and epitopes. Bioinformatic analysis supported antigen identifying and its targets using appropriate tools, followed by consensus sequence creation through multiple sequence alignment using specific platforms. mRNA constructs were optimized via codon adaptation, GC content balancing, and secondary structure analysis. Delivery strategies also were briefly assessed between the FDA approved systems. Lipid nanoparticle formulation, were incorporated into the design to theoretically enhance stability and cellular uptake. Robust protein expression both in vitro and in vivo assessments further suggested the immunogenic potential along with providing a computational basis for future preclinical evaluation. This study review provides a step-by-step protocol that clarifies and simplifies the design process for linear mRNA constructs. The framework translates complex design considerations into actionable, sequential guidelines, enabling researchers to rationally design vaccine candidates in silico. Certainly, we support accelerated design efforts against current threats, while also serving as a preparedness blueprint for future pandemics.},
}

@article {pmid42344246,
year = {2026},
author = {Birhman, N and Kharkwal, G and Roy, S and Shaikh, N and Velamuri, PS and Lata, H and Saxena, A and Satija, A and Singh, KJ and Madan, T and Kishore, J and Kanti, P and Anand, T},
title = {Occupational health and safety in the wake of COVID-19: insights from India's workforce.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1807940},
pmid = {42344246},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Occupational Health ; India/epidemiology ; Working Conditions ; *Health Personnel/psychology ; SARS-CoV-2 ; Occupational Exposure/prevention & control ; Frontline Workers ; Pandemics ; Workplace ; },
abstract = {INTRODUCTION: Occupational health and safety (OHS) practices witnessed profound changes worldwide during the COVID-19 pandemic. The pandemic exposed critical vulnerabilities in workplace preparedness, particularly among workers in high-exposure and essential service sectors.

METHODS: A systematic review was conducted following PRISMA guidelines using PubMed, Google Scholar, DOAJ, ResearchGate, and gray literature sources. Studies published between January 2020 and December 2024 focusing on occupational exposure, workplace transmission, OHS guidelines, and workforce health during COVID-19 were included.

RESULTS: Healthcare workers experienced the highest occupational risk due to sustained patient contact and aerosol-generating procedures, accompanied by significant psychological distress and burnout. Essential workers, manufacturing sectors, retail workers, educators, and informal sector workers also faced substantial occupational and socioeconomic challenges. Workplace interventions including engineering controls, administrative controls, PPE use, vaccination strategies, and digital surveillance tools reduced workplace transmission. Remote-enabled sectors demonstrated lower infection risk but increased mental health concerns.

DISCUSSION: The COVID-19 pandemic transformed traditional OHS frameworks by integrating infectious disease preparedness, vaccination strategies, mental health support, and workplace surveillance into occupational safety systems. The findings emphasize the need for integrated, adaptive, and equitable OHS frameworks aligned with public health preparedness to strengthen workforce resilience against future pandemics.},
}

Humans
*COVID-19/epidemiology/prevention & control
*Occupational Health
India/epidemiology
Working Conditions
*Health Personnel/psychology
SARS-CoV-2
Occupational Exposure/prevention & control
Frontline Workers
Pandemics
Workplace

@article {pmid42344751,
year = {2026},
author = {Toboltoc, PC and Gagiu, I and Lukusa, AL and Vekony, A},
title = {Hemato-Oncology Care During and After the COVID-19 Pandemic: Changes in Treatment Pathways, Patient Flow, and Durable Organizational Adaptations.},
journal = {Cureus},
volume = {18},
number = {6},
pages = {e111331},
pmid = {42344751},
issn = {2168-8184},
abstract = {The COVID-19 pandemic disrupted cancer care at every level of the clinical pathway, but its effect on hemato-oncology was distinctive because patients with hematologic malignancies often require urgent diagnosis, frequent hospital visits, transfusion support, intensive therapy, transplantation, cellular therapy, and infection-sensitive follow-up. This narrative review examines the pandemic as a disruption of hemato-oncology care delivery rather than only as a source of excess infection-related morbidity. It synthesizes evidence on diagnostic access, patient flow, treatment prioritization, infection-control circuits, day-hospital organization, inpatient access, telemedicine and hybrid follow-up, supportive care, vaccination, antiviral pathways, and high-complexity care delivery. The review distinguishes between temporary crisis restrictions, harmful diagnostic and therapeutic delays, and durable organizational adaptations that may remain relevant after the acute pandemic period. Evidence from cancer-service disruption studies, hemato-oncology outcome registries, telemedicine cohorts, and European hematopoietic cell transplantation activity surveys indicates that hemato-oncology care pathways were reorganized and selectively redirected during the pandemic, while selected components recovered through structured triage, protected circuits, remote review of stable patients, and individualized timing of transplantation and cellular therapy. The post-pandemic priority is not to preserve restrictive crisis practice, but to retain the organizational discipline generated by the crisis: protected diagnostic capacity, risk-stratified access, selective hybrid care, rapid infectious-risk assessment pathways, disciplined day-hospital scheduling, and reserved in-person capacity for unstable, procedure-dependent, or curative-intent patients. These adaptations should be maintained only insofar as they improve access, safety, and continuity of care without normalizing delayed diagnosis or undertreatment of aggressive disease.},
}

@article {pmid42344914,
year = {2026},
author = {Batool, R},
title = {From Jenner to genomics: the unfolding future of vaccinology.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1860464},
pmid = {42344914},
issn = {1664-3224},
mesh = {Humans ; *Vaccinology/trends/methods ; Genomics ; *COVID-19/immunology/prevention & control ; Animals ; COVID-19 Vaccines/immunology ; *SARS-CoV-2/immunology ; Vaccine Development ; History, 20th Century ; Vaccines/immunology ; Vaccines, DNA/immunology ; History, 21st Century ; },
abstract = {The development of the smallpox vaccine two centuries ago laid the foundation for modern vaccinology. Smallpox, once a major killer in human history, was eradicated globally in 1980. This breakthrough encouraged the development of contemporary vaccine technologies, including inactivated, recombinant, viral vector, and mRNA platforms. Owing to developments in genetics, bioinformatics, and molecular biology, personalised vaccines have been made possible. Advances in the field of immunology facilitated an accelerated response to the COVID-19 pandemic. This perspective synthesises key developments and technological advances in the field of global immunisation. The author sheds light on emerging tools, transformative platforms, and long-term directions in vaccine science research.},
}

Humans
*Vaccinology/trends/methods
Genomics
*COVID-19/immunology/prevention & control
Animals
COVID-19 Vaccines/immunology
*SARS-CoV-2/immunology
Vaccine Development
History, 20th Century
Vaccines/immunology
Vaccines, DNA/immunology
History, 21st Century

@article {pmid42345054,
year = {2026},
author = {Calcaterra, G and Oreto, L and Perrone, M and Chessa, M and Bianco, F and Borrelli, N and Leonardi, B and Moscatelli, S and Ciliberti, P and Sabatino, J and Guccione, P and Martino, F and Thiene, G and Di Salvo, G and Bassareo, PP},
title = {[Kawasaki disease: the update of American Heart Association guidelines. What adult cardiologists need to know].},
journal = {Giornale italiano di cardiologia (2006)},
volume = {27},
number = {7},
pages = {479-488},
doi = {10.1714/4722.47387},
pmid = {42345054},
issn = {1972-6481},
mesh = {Adult ; Child ; Child, Preschool ; Humans ; American Heart Association ; Cardiologists ; Diagnosis, Differential ; Immunoglobulins, Intravenous/therapeutic use ; *Mucocutaneous Lymph Node Syndrome/diagnosis/therapy/complications/physiopathology ; Practice Guidelines as Topic ; United States ; },
abstract = {The recent document from the American Heart Association updates the guidelines on the diagnosis and management of Kawasaki disease (KD), a severe acute systemic inflammatory and febrile illness with mucocutaneous manifestations and lymph node involvement primarily affecting children under 5 years of age. Coronary artery involvement, with dilation and aneurysms in approximately 25% of patients, and cardiovascular system involvement make KD the most common systemic vasculitides and the leading cause of acquired heart disease in pre-school children living in developed countries. Classic KD is diagnosed based on established clinical and laboratory criteria, which exclude other similar conditions. The etiology and pathogenesis of KD remain unknown, with the disease affecting genetically susceptible children through an immune-mediated mechanism. The leading theory is that an unidentified trigger initiates a multi-organ inflammatory pathological cascade, sometimes resulting in incomplete or atypical forms in younger patients. For this reason, the American guidelines review KD diagnostic criteria, cardiac imaging techniques (echocardiography, coronary computed tomography, magnetic resonance imaging), specific therapies (intravenous immunoglobulin, aspirin, and additional treatments for resistant cases), management of myocardial infarctions, and the transition of care from pediatric to adult age. This review article also highlights future research areas, the role of inflammation, the development of differential diagnostic algorithms for multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection, and the use of new oral anticoagulants. Lastly, the most recent data on the long-term course of the disease and the regression of coronary aneurysms are revisited.},
}

Adult
Child
Child, Preschool
Humans
American Heart Association
Cardiologists
Diagnosis, Differential
Immunoglobulins, Intravenous/therapeutic use
*Mucocutaneous Lymph Node Syndrome/diagnosis/therapy/complications/physiopathology
Practice Guidelines as Topic
United States

@article {pmid42345733,
year = {2026},
author = {Ionescu, A and Mihăilescu, A and Dumache, R and Capcelea, A and Turceanu, AD and Albulescu, N and Săndesc, MA},
title = {Perioperative Anemia, Transfusion Practices, and Patient Blood Management: Lessons from the COVID-19 Pandemic.},
journal = {Hematology reports},
volume = {18},
number = {3},
pages = {},
pmid = {42345733},
issn = {2038-8322},
abstract = {The COVID-19 pandemic exposed vulnerabilities in global blood supply systems and accelerated the adoption of patient blood management (PBM) strategies aimed at optimizing transfusion practices in surgical care. Perioperative anemia is a key contributor to adverse outcomes and is frequently treated with allogeneic blood transfusion (ABT), which carries infectious and immunologic risks. Iron deficiency remains the most common and potentially correctable cause of perioperative anemia. This narrative review examines various approaches to perioperative anemia, strategies to minimize reliance on ABT, and alternatives within the PBM paradigm. Evidence supports the use of iron therapy, erythropoiesis-stimulating agents, antifibrinolytic strategies, and blood conservation techniques to reduce transfusion requirements and improve clinical outcomes. Lessons from the COVID-19 pandemic highlight PBM as a framework to enhance transfusion safety and sustainability. Broader implementation of PBM may improve patient outcomes, reduce unnecessary transfusions, and preserve scarce blood resources.},
}

@article {pmid42345852,
year = {2026},
author = {Ferrara, F and De Berardinis, F and Scognamiglio, M and Zovi, A},
title = {The Shifting Paradigm of Monoclonal Antibodies in COVID-19 Management: From Early Triumphs to Viral Resistance and Future Perspectives.},
journal = {Antibodies (Basel, Switzerland)},
volume = {15},
number = {3},
pages = {},
doi = {10.3390/antib15030048},
pmid = {42345852},
issn = {2073-4468},
abstract = {BACKGROUND: Monoclonal antibodies (mAbs) initially played a major role in outpatient COVID-19 management by providing rapid passive immunity and reducing progression to severe disease. However, continuous SARS-CoV-2 evolution progressively compromised the effectiveness of several anti-spike products. This narrative review summarizes the trajectory of COVID-19 mAbs across three phases: early clinical efficacy, loss of efficacy due to immune escape, and future directions.

METHODS: We conducted a narrative review focusing on mechanisms of action, pivotal clinical trials, and real-world effectiveness of neutralizing anti-spike mAbs and host-directed immunomodulatory mAbs. Emphasis was placed on the impact of variants-especially Omicron-on susceptibility and clinical use, as well as on emerging next-generation platforms.

RESULTS: First-generation neutralizing mAbs substantially reduced the hospitalization rates during the Alpha and Delta waves, while immunomodulatory mAbs became standard options for the hyperinflammatory phase in hospitalized patients. With the emergence of Omicron and its sub-lineages, extensive immune escape led to marked reductions in neutralization for many earlier anti-spike agents and consequent restrictions in use. Later-generation approaches targeting more conserved epitopes provided temporary solutions but were also challenged by ongoing antigenic drift. Host-directed immunomodulators retained clinical relevance because their mechanism is independent of viral spike mutations.

CONCLUSIONS: The clinical role of monoclonal antibodies in COVID-19 has been dynamic and increasingly constrained by viral evolution. Future strategies should prioritize broadly neutralizing antibodies targeting conserved epitopes, innovative delivery platforms, and integration with real-time surveillance to preserve clinical utility in the endemic phase and improve preparedness for future outbreaks.},
}

@article {pmid42345854,
year = {2026},
author = {Lim, XR and Teo, RXW and Par, RYX and Leung, BPL},
title = {Anti-Type I Interferon Autoantibodies in COVID-19 and Systemic Lupus Erythematosus: A Comparative Review.},
journal = {Antibodies (Basel, Switzerland)},
volume = {15},
number = {3},
pages = {},
doi = {10.3390/antib15030050},
pmid = {42345854},
issn = {2073-4468},
abstract = {Type I interferons (IFN-I), including IFN-α, IFN-β, and IFN-ω, are central to antiviral defence and immune regulation. Autoantibodies targeting IFN-I (anti-IFN-I AAbs) have emerged as key pathogenic factors in severe coronavirus disease 2019 (COVID-19) and are detectable in systemic lupus erythematosus (SLE), a prototypic IFN-driven autoimmune disease. Here we compare the prevalence and clinical impact of anti-IFN-I autoantibodies (Aabs) in COVID-19 and SLE based on a structured review of 53 studies from 2014 to 2025 and highlight the clinical associations and therapeutic opportunities presented by these autoantibodies. In COVID-19, neutralising anti-IFN-α and/or anti-IFN-ω AAbs were consistently associated with severe disease and impaired antiviral responses, particularly in older male populations. In SLE, anti-IFN-α AAbs were variably detected; neutralising antibodies were associated with reduced interferon gene signatures in some cohorts but inconsistent correlations with disease activity. Therapeutically, anti-IFN-I AAbs in COVID-19 may inform risk stratification and early antiviral strategies, whereas in SLE, IFN-α blockade, including IFN-α kinoid vaccination, demonstrates modulation of IFN signatures but variable clinical benefit. Notably, these findings reveal an immunological paradox: the same neutralising mechanism that impairs antiviral defence in COVID-19 may attenuate chronic IFN-driven inflammation in SLE. Taken together, anti-IFN-I AAbs exert context-dependent effects: pathogenic in acute viral infection yet potentially modulatory in chronic IFN-driven autoimmunity. Prospective longitudinal studies are required to further clarify their translational utility and long-term clinical impact.},
}

@article {pmid42346165,
year = {2026},
author = {Ntais, C and Chatziprodromidou, IP},
title = {COVID-19 and Interacting Public Health Threats in Europe During 2020-2025: A Narrative Review.},
journal = {Epidemiologia (Basel, Switzerland)},
volume = {7},
number = {3},
pages = {},
pmid = {42346165},
issn = {2673-3986},
abstract = {Between 2020 and 2025, Europe has faced multiple interacting public health threats shaped by and following the COVID-19 pandemic. Alongside COVID-19, the region experienced other infectious disease events, including monkeypox, measles resurgence, legionellosis and acute hepatitis of unknown origin in children. At the same time, non-communicable disease burdens, including obesity, type II diabetes mellitus, disruption of chronic disease care, mental health disorders and increased problematic digital use, intensified during and after the pandemic period. Antimicrobial resistance (AMR) remained a major cross-cutting threat because it undermines the effective treatment of infections and weakens emergency preparedness. This narrative review synthesizes peer-reviewed articles and selected reports from international organizations for the 2020-2025 period, using COVID-19 as the organizing context for examining interconnected infectious, chronic and system-level threats. Across these topics, recurring themes included vaccination gaps, fragmented surveillance, disruption of routine care, health system inequities, misinformation and insufficient preparedness for cross-border threats. The review supports integrated surveillance, continuity plans for essential services, stronger vaccination and risk-communication strategies and sustained AMR stewardship within a One Health framework. Coordinated action across public health, primary care, mental health and chronic disease policy is essential for future resilience.},
}

@article {pmid42346828,
year = {2026},
author = {Cacciatore, S and Abbatecola, G and Calvani, R and Veronese, N},
title = {Effectiveness and Safety of Ozone Therapy in Humans: An Umbrella Review of Systematic Reviews with Meta-Analyses of Randomized Clinical Trials.},
journal = {Medical sciences (Basel, Switzerland)},
volume = {14},
number = {2},
pages = {},
doi = {10.3390/medsci14020289},
pmid = {42346828},
issn = {2076-3271},
mesh = {Humans ; *Ozone/therapeutic use/adverse effects ; Randomized Controlled Trials as Topic ; COVID-19/therapy ; Systematic Reviews as Topic ; *Chronic Periodontitis/therapy/drug therapy ; Treatment Outcome ; Meta-Analysis as Topic ; Diabetic Foot/therapy ; SARS-CoV-2 ; },
abstract = {BACKGROUND/OBJECTIVES: Ozone therapy has been proposed across multiple clinical conditions based on hormetic, antioxidant, and immunomodulatory effects, but its efficacy and safety remain controversial. We conducted an umbrella review to appraise the effectiveness and safety of ozone therapy using evidence from meta-analyses of randomized controlled trials (RCTs).

METHODS: We searched MEDLINE, Web of Science, Embase, and the Cochrane Library from inception to 14 February 2025, with an updated search performed on 9 May 2026. Eligible studies were systematic reviews with meta-analyses comparing ozone therapy with non-active controls, including placebo, sham, saline, or standard care. Methodological quality was evaluated with AMSTAR-2 and certainty of evidence with GRADE.

RESULTS: Of 1243 records identified, seven meta-analyses representing four clinical indications (chronic periodontitis, COVID-19, diabetic foot ulcers, and impacted mandibular third-molar surgery) were included. In chronic periodontitis, evidence was mixed: one meta-analysis found no significant adjunctive benefit, whereas a more recent meta-analysis reported improvements in probing depth and gingival index, but not in bleeding on probing, plaque index, or clinical attachment level. For COVID-19, ozone therapy reduced PCR positivity at follow-up (RR 0.07; 95% CI 0.01-0.34), although this was considered a clinically non-important surrogate endpoint, and showed no significant benefit for hospital stay, intensive care unit admission, or mortality. For diabetic foot ulcers, ozone therapy was not superior to control treatment for ulcer healing (RR 1.69; 95% CI 0.90-3.17) or reduction in ulcer area. In third-molar surgery, ozone therapy did not reduce swelling or improve mouth opening, but was associated with improved short-term quality of life and reduced analgesic use. Safety outcomes were inconsistently reported, and available data did not allow firm conclusions regarding adverse events. The certainty of evidence was low or very low for all outcomes.

CONCLUSIONS: Despite mechanistic plausibility, current meta-analytic evidence from RCTs remains inconsistent, methodologically fragile, and largely based on low- or very low-certainty findings. Routine clinical use is not justified pending adequately powered, blinded RCTs with standardized dosing and delivery, patient-centered endpoints, and rigorous safety monitoring.},
}

Humans
*Ozone/therapeutic use/adverse effects
Randomized Controlled Trials as Topic
COVID-19/therapy
Systematic Reviews as Topic
*Chronic Periodontitis/therapy/drug therapy
Treatment Outcome
Meta-Analysis as Topic
Diabetic Foot/therapy
SARS-CoV-2

@article {pmid41944494,
year = {2026},
author = {Gao, T and Liu, J and Du, Y and Yang, J and Sheng, G and Zhou, L and Qiu, Y and Zhang, Q and Duan, M},
title = {Association Between Acute Gastrointestinal Injury and Mortality Risk in Critically Ill Patients: A Systematic Review and Meta-Analysis.},
journal = {Clinical and translational gastroenterology},
volume = {17},
number = {6},
pages = {e01028},
doi = {10.14309/ctg.0000000000001028},
pmid = {41944494},
issn = {2155-384X},
mesh = {Humans ; *Critical Illness/mortality ; Intensive Care Units/statistics & numerical data ; *Gastrointestinal Diseases/mortality/diagnosis ; Hospital Mortality ; Risk Factors ; Risk Assessment ; Severity of Illness Index ; },
abstract = {INTRODUCTION: To systematically evaluate the association between severe acute gastrointestinal injury (AGI)/gastrointestinal dysfunction score (GIDS) and mortality risk in adult intensive care unit (ICU) patients.

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

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

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

Humans
*Critical Illness/mortality
Intensive Care Units/statistics & numerical data
*Gastrointestinal Diseases/mortality/diagnosis
Hospital Mortality
Risk Factors
Risk Assessment
Severity of Illness Index

@article {pmid42154963,
year = {2026},
author = {Clarke, C and Esposito, D and Urdaneta, V and Mukherjee, P and Buttery, AK},
title = {Safety of COVID-19 mRNA-1273 booster doses in Asian populations: A literature review of post-marketing observational studies.},
journal = {Human vaccines & immunotherapeutics},
volume = {22},
number = {1},
pages = {2662118},
pmid = {42154963},
issn = {2164-554X},
mesh = {Humans ; *COVID-19/prevention & control ; *Immunization, Secondary/adverse effects/methods ; Product Surveillance, Postmarketing ; *COVID-19 Vaccines/adverse effects/administration & dosage ; Observational Studies as Topic ; *2019-nCoV Vaccine mRNA-1273/adverse effects/administration & dosage ; Asia/epidemiology ; SARS-CoV-2/immunology ; Asian People ; },
abstract = {Real-world data on the safety of COVID-19 booster doses in Asian populations are needed to inform national immunization programs. The safety profile of mRNA-1273 (Moderna, Inc.) was evaluated using post-marketing observational data. PubMed and EMBASE were searched on June 30, 2025, for studies meeting the following predefined criteria: observational design, adverse events (AEs), mRNA-1273 boosters (dose 3+), and population data from the South-East Asia and Western-Pacific regions. Data on study characteristics, and AE incidence and severity, were extracted. Of 886 records screened, 27 studies from eight countries (Japan, the Republic of Korea, Australia, Taiwan, Indonesia, Thailand, the Philippines, and Singapore) met the inclusion criteria. Across studies, mRNA-1273 boosters were well tolerated, with severe AEs occurring at low frequency. Based on the included observational studies, these findings support the favorable safety profile of mRNA-1273 boosters in Asian populations. Long-term safety monitoring is needed to guide public-health responses to evolving SARS-CoV-2 variants.},
}

Humans
*COVID-19/prevention & control
*Immunization, Secondary/adverse effects/methods
Product Surveillance, Postmarketing
*COVID-19 Vaccines/adverse effects/administration & dosage
Observational Studies as Topic
*2019-nCoV Vaccine mRNA-1273/adverse effects/administration & dosage
Asia/epidemiology
SARS-CoV-2/immunology
Asian People

@article {pmid42156022,
year = {2026},
author = {Murai, H},
title = {[Imported Infectious Diseases of the Nervous System].},
journal = {Brain and nerve = Shinkei kenkyu no shinpo},
volume = {78},
number = {5},
pages = {432-436},
doi = {10.11477/mf.188160960780050432},
pmid = {42156022},
issn = {1881-6096},
mesh = {Humans ; Animals ; Rabies/epidemiology/transmission ; Japan/epidemiology ; Dengue/epidemiology/transmission ; Dogs ; },
abstract = {Although sanitary conditions in Japan are generally favorable, pathogens may be introduced by patients who acquire the infections overseas. Dengue fever has a high global incidence, with nearly 200 cases occurring annually in Japan. Most of these infections are acquired in Southeast Asia. As dengue fever is transmitted by mosquitoes, preventive measures against insect bites are important. The incidence of Japanese encephalitis has markedly decreased in Japan owing to widespread vaccination. This disease is mosquito-borne, and only approximately 1% of infected individuals develop symptoms. However, once symptoms appear, the mortality rate is 20-30%. A characteristic clinical feature of this condition is the presence of extrapyramidal symptoms. Rabies is a representative disease transmitted through dog bites. In Japan, its incidence has dramatically declined owing to canine vaccination and the control of stray dogs. Once rabies develops, the fulminant form accounts for 70-80% of cases. Measles is a representative disease that is transmitted between humans. It is highly contagious and requires careful monitoring. During the coronavirus disease-19 pandemic, the number of measles cases decreased. Recently, the trend has reversed, with many patients believed to have been infected in Vietnam.},
}

Humans
Animals
Rabies/epidemiology/transmission
Japan/epidemiology
Dengue/epidemiology/transmission
Dogs

@article {pmid42156048,
year = {2026},
author = {Shimohata, T},
title = {[COVID-19-Associated Encephalitis and Encephalopathy: Current Status].},
journal = {Brain and nerve = Shinkei kenkyu no shinpo},
volume = {78},
number = {5},
pages = {567-572},
doi = {10.11477/mf.188160960780050567},
pmid = {42156048},
issn = {1881-6096},
mesh = {Humans ; COVID-19/complications ; *Brain Diseases/therapy/etiology ; *Coronavirus Infections/complications/therapy/epidemiology ; Pandemics ; *Pneumonia, Viral/complications/therapy/epidemiology ; *Encephalitis, Viral/therapy ; SARS-CoV-2 ; *Betacoronavirus ; },
abstract = {In recent years, the incidence of COVID-19-associated encephalitis and encephalopathy has decreased due to viral mutations and the acquisition of population immunity. The underlying mechanisms are now thought to involve immune-mediated pathology and cerebral microvascular injury, rather than direct viral invasion. In adults, encephalitis and encephalopathy are independent predictors of disease severity and mortality. In children, acute necrotizing encephalopathy is associated with high mortality rates and long-term neurological sequelae. Regarding treatment, correction of reversible factors and timely immunotherapy are essential, and favorable responses to high-dose corticosteroids and interleukin-6 receptor blockade have been reported.},
}

Humans
COVID-19/complications
*Brain Diseases/therapy/etiology
*Coronavirus Infections/complications/therapy/epidemiology
Pandemics
*Pneumonia, Viral/complications/therapy/epidemiology
*Encephalitis, Viral/therapy
SARS-CoV-2
*Betacoronavirus

@article {pmid42160264,
year = {2026},
author = {Romoff, M and Chandekar, A and Beyer, R and Kim, MS and Baz, S and Mills, ES and Park, DY and Lee, YP and Bhatia, N and Hashmi, S and Wu, HH},
title = {Evaluating Virtual and Hybrid Mentorship in Orthopaedic Surgery: Perceived Benefits, Challenges, and Impacts in the Post-COVID Era.},
journal = {JBJS reviews},
volume = {14},
number = {5},
pages = {},
pmid = {42160264},
issn = {2329-9185},
mesh = {Humans ; COVID-19 ; *Mentors ; *Orthopedics/education ; Pandemics ; SARS-CoV-2 ; },
abstract = {» Virtual and hybrid mentorship models have transitioned from temporary coronavirus disease 2019 pandemic responses to durable, scalable components of the orthopaedic training curriculum. » Despite high trainee satisfaction, most orthopaedic virtual mentorship programs rely on short-term, self-reported metrics and lack the objective, longitudinal tracking of research productivity or career advancement seen in other specialties. » While virtual pipelines demonstrate the potential to broaden access for underrepresented groups, inconsistent collection of detailed demographic and socioeconomic data limits the assessment of their true impact on diversity. » Neurosurgery and plastic surgery provide instructive models for virtual collaboratives that successfully use standardized expectations and longitudinal outcome tracking to measure success. » To ensure these programs drive equitable change rather than just broader participation, future orthopaedic virtual mentorship programs should incorporate standardized outcome frameworks, mentor perspectives, and longitudinal, multi-institutional follow-up.},
}

Humans
COVID-19
*Mentors
*Orthopedics/education
Pandemics
SARS-CoV-2

@article {pmid42169206,
year = {2026},
author = {Ropeter, J and Overhageböck, N and Dreier, M and Meyerdierks, D and Imran, A and Heinsohn, T and Steinmann, M and Kuhlmann, A and Jahn, B and Lange, B and Klett-Tammen, CJ and Harries, M},
title = {Impact of the COVID-19 pandemic on diagnosis, and healthcare utilization, among patients with cancer (lung, breast, and pancreas) and cardiovascular diseases (HF, AF, hypertensive, and chronic ischemic heart disease) in Germany: two systematic reviews.},
journal = {Systematic reviews},
volume = {15},
number = {1},
pages = {},
pmid = {42169206},
issn = {2046-4053},
support = {031L0299H//Bundesministerium für Forschung, Technologie und Raumfahrt/ ; },
mesh = {Humans ; *COVID-19/epidemiology ; Germany/epidemiology ; *Cardiovascular Diseases/diagnosis/therapy/epidemiology ; *Patient Acceptance of Health Care/statistics & numerical data ; *Neoplasms/diagnosis/therapy/epidemiology ; Pandemics ; SARS-CoV-2 ; Female ; Hospitalization/statistics & numerical data ; },
abstract = {BACKGROUND: The COVID-19 pandemic and related non-pharmaceutical interventions (NPIs) (e.g., lockdowns and contact restrictions) disrupted routine healthcare delivery. In Germany, these measures affected diagnostic and treatment services for people with cancer and cardiovascular diseases, potentially delaying diagnosis and adversely influencing outcomes. We assessed whether and to what extent diagnosis, health utilization and health outcome among patients with selected cancer and cardiovascular conditions changed in Germany during the pandemic.

METHODS: We conducted two systematic reviews of studies from Germany on selected cancers (breast, lung and pancreatic) and cardiovascular conditions (atrial fibrillation/flutter, heart failure, hypertensive and chronic ischemic heart disease). Protocols were registered in PROSPERO and the reviews were reported in accordance with PRISMA. We searched PubMed, Web of Science, Cochrane Library, Scopus, and Embase and screened grey literature. Outcomes included changes in new diagnoses, healthcare utilization, treatment, and disease-specific mortality during the pandemic (2020-2023) compared with the pre-pandemic period (2018-2019). Two reviewers independently screened records, extracted data, and assessed risk of bias using an adapted ROBINS-E tool. Owing to heterogeneity, we synthesized findings narratively.

RESULTS: We screened 1991 records for cancer and 4,981 records for cardiovascular diseases, and included 9 cancer studies and 10 cardiovascular studies. For cancer, several studies reported a relative reduction in new breast and lung cancer diagnoses of up to 25% during lockdown periods; hospital admissions decreased by up to 9%. For cardiovascular conditions, hospital admissions for atrial fibrillation/flutter and heart failure decreased by up to 20%, particularly during pandemic peaks. Evidence on treatment delays, changes in treatment, and mortality was limited, and outcomes for other included diagnoses were often not reported.

DISCUSSION: The available evidence indicates substantial reductions in hospital admissions and new diagnoses among patients with cancer and cardiovascular disease in Germany during the pandemic, suggesting major disruptions to care delivery. However, heterogeneity and gaps in the evidence base limit a comprehensive assessment of downstream outcomes. More comprehensive, linked data and further research are needed to quantify the full pandemic's impact and to strengthen health-system resilience for future crises.},
}

Humans
*COVID-19/epidemiology
Germany/epidemiology
*Cardiovascular Diseases/diagnosis/therapy/epidemiology
*Patient Acceptance of Health Care/statistics & numerical data
*Neoplasms/diagnosis/therapy/epidemiology
Pandemics
SARS-CoV-2
Female
Hospitalization/statistics & numerical data

@article {pmid42170790,
year = {2026},
author = {Carretero Rey, M},
title = {[Epidemiological surveillance of Andes virus: have we really learned anything after COVID-19?].},
journal = {Revista espanola de salud publica},
volume = {100},
number = {},
pages = {},
pmid = {42170790},
issn = {2173-9110},
mesh = {Humans ; Animals ; COVID-19 ; Zoonoses/epidemiology ; *Hantavirus Infections/epidemiology/transmission/prevention & control ; *Pandemics ; SARS-CoV-2 ; *Epidemiological Monitoring ; *Orthohantavirus ; *Coronavirus Infections/epidemiology ; *Pneumonia, Viral/epidemiology ; *Betacoronavirus ; Disease Outbreaks ; *Communicable Diseases, Emerging/epidemiology ; Spain/epidemiology ; Viral Zoonoses/epidemiology ; },
abstract = {Recent Andes virus outbreaks have reignited international debate regarding Public Health preparedness for hantaviruses with documented interpersonal transmission capacity. Unlike other orthohantaviruses, Andes virus has demonstrated person-to-person transmission in specific epidemiological settings, including household and nosocomial environments. The recent emergence of cases linked to multinational outbreaks has prompted renewed assessments and recommendations from international public health organizations. This manuscript presents an epidemiological reflection on current surveillance challenges associated with emerging hantaviruses following the experience gained during the COVID-19 pandemic. It also reviews aspects related to zoonotic surveillance, molecular monitoring, early detection, and integrated One Health approaches applied to preparedness against future emerging threats. Available evidence highlights the need to strengthen multidisciplinary surveillance systems capable of integrating human, environmental, and zoonotic information in order to improve responses to complex epidemiological scenarios associated with emerging hantaviruses.},
}

Humans
Animals
COVID-19
Zoonoses/epidemiology
*Hantavirus Infections/epidemiology/transmission/prevention & control
*Pandemics
SARS-CoV-2
*Epidemiological Monitoring
*Orthohantavirus
*Coronavirus Infections/epidemiology
*Pneumonia, Viral/epidemiology
*Betacoronavirus
Disease Outbreaks
*Communicable Diseases, Emerging/epidemiology
Spain/epidemiology
Viral Zoonoses/epidemiology

@article {pmid42172294,
year = {2026},
author = {Swartwood, NA and Singh, N and Mortazavi, SA and Can, MH and Cui, H and Ryuk, DK and MacPherson, P and Horton, KC and Menzies, NA},
title = {Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993-2025: A systematic review and meta-analysis.},
journal = {PLoS medicine},
volume = {23},
number = {5},
pages = {e1005114},
pmid = {42172294},
issn = {1549-1676},
mesh = {Humans ; Prevalence ; Male ; Female ; *Developing Countries/economics ; Sex Factors ; *Tuberculosis/epidemiology ; Risk Factors ; },
abstract = {BACKGROUND: Global and national initiatives to combat tuberculosis (TB) have expanded over recent years. Despite this, the TB burden remains high in some population groups, with men recognized as having elevated TB risks. Summary measures of sex differences in TB prevalence were last estimated in 2016. Since then, many additional prevalence surveys have been conducted, including in the highest TB burden countries. We conducted a systematic review of sex-stratified TB prevalence survey data published over 1993-2025, to provide updated estimates of male-to-female (M:F) TB prevalence ratios and determine whether sex-related disparities in TB burden have closed over time.

METHODS AND FINDINGS: We identified surveys reporting community-representative, sex-stratified estimates of pulmonary TB prevalence in low- and middle-income countries (LMICs), including surveys from an earlier review (covering January 1993-March 2016) and a new systematic review (covering 1st December 2015-13th October 2025). This review was prospectively registered with PROSPERO (CRD42024503853) and included searches of PubMed, Embase, Global Health, the Cochrane Library, Africa Index Medicus, LILACS, and SciELO. We extracted data on bacteriologically confirmed and smear-positive TB prevalence among adults (aged ≥ 15 years), stratified by sex. Risk of bias was evaluated using eight criteria specific to prevalence surveys. We fit multi-level Bayesian regression models with study- and country-level random effects to estimate the M:F ratio of TB prevalence (male prevalence divided by female prevalence), overall and for key subgroups. In meta-regression analyses, we estimated how prevalence ratios varied over time and according to known TB risk factors and TB case definitions. We identified 10,124 publications and extracted data from 100 eligible studies representing 102 unique prevalence surveys and 4,658,310 participants (45.6% male) in 33 LMICs. TB prevalence was higher in men than women in 90/102 of the included surveys, with a pooled M:F prevalence ratio of 2.02 (95% credible interval (CrI): 1.71, 2.34) for bacteriologically confirmed TB and 2.38 (95% CrI: 1.91, 2.90) for smear-positive TB. Time trend analyses showed a 2.0% (95% CrI: -0.2, 4.5%) average annual change in the M:F ratio of bacteriologically confirmed TB over the study period. The M:F prevalence ratio was estimated to be higher for countries with greater excess HIV prevalence among men, and countries with greater gender equity (as measured by the United Nation's Gender Development Index). The estimated M:F prevalence ratio was also higher for surveys that did not restrict testing to individuals reporting TB symptoms. Study limitations include heterogeneity in survey methods and definitions, as well as limited data from the Americas, Eastern Mediterranean, and Europe WHO world regions and post-COVID-19 period.

CONCLUSIONS: Men in LMICs consistently experience TB at a higher prevalence than women. Time trend estimates are uncertain, but consistent with widening sex differences in TB prevalence over the last three decades, despite efforts to address the risk factors underlying this excess TB burden.},
}

Humans
Prevalence
Male
Female
*Developing Countries/economics
Sex Factors
*Tuberculosis/epidemiology
Risk Factors

@article {pmid42173631,
year = {2026},
author = {Vaidya, H and Kumar, M},
title = {AI in multi-omics analysis in viral diseases.},
journal = {Progress in molecular biology and translational science},
volume = {222},
number = {},
pages = {229-240},
doi = {10.1016/bs.pmbts.2026.02.005},
pmid = {42173631},
issn = {1878-0814},
mesh = {*Multiomics ; Humans ; *Artificial Intelligence ; *Virus Diseases/genetics/metabolism/virology ; Machine Learning ; Genomics ; Metabolomics ; Proteomics ; },
abstract = {Viral diseases are a serious threat to human health worldwide, and are known to cause long-term health complications as well as epidemics and pandemics. Yet it is difficult to understand how they spread, persist, and damage the body, which requires advanced methods. Multi-omics datasets, including genomics, transcriptomics, epigenomics, proteomics and metabolomics provide a complete view of virus-host interactions. However, the integration and interpretation of these high dimensional datasets remain a major challenge. To overcome this, artificial Intelligence (AI), including machine learning (ML) and network-based approaches, has proven to be a powerful tool to analyze, integrate, and interpret multi-omics data. This chapter discusses examples from studies on SARS-CoV-2, HIV, influenza, EBV and others, where AI has been applied to multi-omics research. These studies show how AI-assisted multi-omics approaches are helping in the advancement of viral disease research by providing better understanding of virus induced cellular changes, identifying biomarkers, designing targeted therapies etc. Therefore, integrating multi-omics with AI enables improved diagnosis, treatment, and prevention of viral diseases. We have also discussed challenges faced in combining multi-omics with AI and highlighted future directions that would help in enhancing AI assisted multi-omics research.},
}

*Multiomics
Humans
*Artificial Intelligence
*Virus Diseases/genetics/metabolism/virology
Machine Learning
Genomics
Metabolomics
Proteomics

@article {pmid42173633,
year = {2026},
author = {Agrawal, P},
title = {AI in multi-omics analysis of COVID-19 patient data.},
journal = {Progress in molecular biology and translational science},
volume = {222},
number = {},
pages = {261-293},
doi = {10.1016/bs.pmbts.2026.01.017},
pmid = {42173633},
issn = {1878-0814},
mesh = {Humans ; *Multiomics ; *COVID-19/genetics/virology/metabolism ; *Artificial Intelligence ; *SARS-CoV-2 ; Genomics ; Proteomics ; Pandemics ; Metabolomics ; Machine Learning ; Data Analytics ; },
abstract = {The COVID-19 pandemic has led to an unprecedented increase in the volume of biological data generation, demonstrating the importance of developing an integrative and intelligent analytical framework. In the last few years, advancements in the artificial intelligence (AI) approaches have completely transformed the biological research landscape. Researchers have integrated the AI approaches with the multi-omics data generated from the COVID-19 patients to have a systems-level understanding of underlying disease mechanisms, predicting new variants and their spread rate, disease severity, immune response, and therapeutic opportunities. In this chapter, we have explored the utility of AI on multi-omics data. We started with an introduction to different kinds of omics data, such as genomics, epigenomics, transcriptomics, proteomics, and metabolomics. Next, we elaborated on what AI is and discussed its types, which include conventional machine learning methods (supervised and unsupervised), deep learning methods (autoencoders and convolutional neural networks), and network-based methods (graph neural networks, network propagation, and knowledge graphs). Next, we discussed different types of integration methods (early, intermediate, and late) used for integrating AI and multi-omics data. Moving ahead, we mentioned several applications of AI, such as biomarker discovery, host-pathogen interaction, drug repurposing, and predicting long COVID. Lastly, we mentioned several important projects and consortia and discussed several important case studies highlighting the usefulness of integrating AI with multi-omics data for personalized medicine.},
}

Humans
*Multiomics
*COVID-19/genetics/virology/metabolism
*Artificial Intelligence
*SARS-CoV-2
Genomics
Proteomics
Pandemics
Metabolomics
Machine Learning
Data Analytics

@article {pmid42184107,
year = {2026},
author = {Khoo, LY and Dhillon, SK},
title = {Comparative review of artificial intelligence for transcriptomic biomarker discovery in coronavirus disease 2019 (COVID-19).},
journal = {Briefings in bioinformatics},
volume = {27},
number = {3},
pages = {},
pmid = {42184107},
issn = {1477-4054},
support = {//Ministry of Higher Education, Malaysia/ ; FP019-2022//Fundamental Research Grant Scheme/ ; },
mesh = {*Artificial Intelligence ; *COVID-19/genetics/virology/metabolism ; Humans ; *SARS-CoV-2/genetics ; Biomarkers/metabolism ; *Transcriptome ; Gene Expression Profiling ; },
abstract = {The Coronavirus Disease 2019 (COVID-19) pandemic has highlighted the significance of reliable molecular biomarkers in clinical use. Despite the popularity of traditional statistical approaches, the high dimensionality of transcriptomic data presents challenges for these conventional methods. While artificial intelligence (AI) algorithms have emerged as highly advantageous for handling these complex datasets, there is a lack of evaluation of these approaches in COVID-19 transcriptomic studies. This review aims to provide an evaluation of these studies employed for transcriptomic biomarker discovery in COVID-19 using AI, assessing their study designs, methodologies, and outcomes. Based on a comprehensive search for literature across five databases including Web of Science Core Collection, Scopus, PubMed/MEDLINE, IEEE Xplore Digital Library, and LitCovid from December 2019 to March 2025, this review selected 63 studies for a narrative synthesis of four key sections: (i) The Landscape of AI-Driven COVID-19 Transcriptomics, (ii) Limitations of Studies, (iii) A Proposed AI-Driven Transcriptomics Framework, and (iv) Clinical Translation Challenges, Opportunities, and Future Directions. Our analysis revealed limitations in data quality, sample size, and heterogeneity, as well as methodologies regarding validation and interpretability. Thus, we proposed an evidence-informed workflow that addresses these current limitations in study design, while acknowledging real-world constraints. We further discuss the emerging potential of agentic AI systems as a promising solution to current limitations. By bridging methodological gaps with translation considerations, this review can enhance pandemic response strategies for future emerging infectious diseases. Key Points Applications observed in reviewed studies mainly included applications in diagnosis and severity stratification of COVID-19 patients. The limitations of current studies included small sample sizes, the reliance on public datasets lacking detailed metadata, batch effects and data heterogeneity reducing model robustness, the lack of external validation, risks of data leakage and circular validation leading to inflated performance metrics, and challenges in model interpretability. An evidence-informed AI-driven framework is proposed, acknowledging real-world constraints including small pandemic cohort sizes, domain shift from viral evolution, and resource-limited settings, with emerging agentic AI systems offering potential solutions.},
}

*Artificial Intelligence
*COVID-19/genetics/virology/metabolism
Humans
*SARS-CoV-2/genetics
Biomarkers/metabolism
*Transcriptome
Gene Expression Profiling

@article {pmid42185895,
year = {2026},
author = {Petakh, P and Ravlo, E and Pan, Q and Bruzzone, R and Oksenych, V and Vähä-Koskela, M and Kamyshnyi, O and Kainov, DE},
title = {Standardizing antiviral response metrics for mono- and combination therapies in acute, chronic and latent viral infections.},
journal = {Virology journal},
volume = {23},
number = {1},
pages = {},
pmid = {42185895},
issn = {1743-422X},
mesh = {*Antiviral Agents/therapeutic use/pharmacology ; Humans ; Drug Therapy, Combination ; *Virus Diseases/drug therapy ; Drug Resistance, Viral ; SARS-CoV-2/drug effects ; COVID-19 ; Pandemics ; Microbial Sensitivity Tests/standards ; *Coronavirus Infections/drug therapy/virology ; Animals ; *COVID-19 Drug Treatment ; Betacoronavirus/drug effects ; },
abstract = {The COVID-19 pandemic showed that heterogeneous antiviral assay designs, endpoints and reporting practices can obscure which candidate drugs and combinations are genuinely promising. As antiviral discovery expands from acute infections to chronic and latent viral diseases, the field needs a compact, reproducible and biologically interpretable set of response metrics. In this Personal View, we argue that EC50 and the selectivity index should be retained for pharmacological interpretation but systematically complemented by drug sensitivity scores (DSS), which integrate potency and efficacy across the tested concentration range, and by ΔDSS, calculated as DSS_antiviral minus DSS_toxicity from matched efficacy and viability curves. We propose standardized modules for resistance passaging, sequencing and host-side-effect profiling so that monotherapies are assessed not only for antiviral potency but also for durability and host-cell perturbation. For combinations, we discuss Bliss, ZIP, HSA and Loewe models as complementary tools for identifying additive or synergistic regimens while accounting for toxicity, resistance suppression and drug-drug interactions. Finally, we outline how harmonized metrics can support organoid, animal and clinical prioritization, improve machine-learning datasets and guide pandemic response, including rapid monotherapy testing for some DNA viruses and early combination testing for RNA and reverse-transcribing viruses.},
}

*Antiviral Agents/therapeutic use/pharmacology
Humans
Drug Therapy, Combination
*Virus Diseases/drug therapy
Drug Resistance, Viral
SARS-CoV-2/drug effects
COVID-19
Pandemics
Microbial Sensitivity Tests/standards
*Coronavirus Infections/drug therapy/virology
Animals
*COVID-19 Drug Treatment
Betacoronavirus/drug effects

@article {pmid42189856,
year = {2026},
author = {Malieuze Nanfah, MD and Binam Nkot, VM and Yop Kite, MM and Beack Bayengue, SS and Tchamba, GB and Tandja, AG and Koloko, BL and Ngo Malabo, ET and Ekwe Priso, JGLF and Embolo Enyegue, EL and Koanga Mogtomo, ML and Kojom Foko, LP},
title = {Burden and clinical impact of 'neglected' transfusion-transmitted infections in Cameroon: A systematic review and meta-analysis.},
journal = {PLoS neglected tropical diseases},
volume = {20},
number = {5},
pages = {e0014378},
pmid = {42189856},
issn = {1935-2735},
mesh = {Humans ; Cameroon/epidemiology ; *Transfusion Reaction/epidemiology ; Blood Donors ; *Blood-Borne Infections/epidemiology ; Prevalence ; Blood Donation ; Blood Banks ; Blood Safety ; },
abstract = {BACKGROUND: Blood supply is a public health challenge in African countries. In Cameroon, blood selection guidelines focus on four viral and bacterial pathogens (HIV, hepatitis B and C viruses, Treponema pallidum) associated with transfusion-transmitted infections (TTIs). Other pathogens, often endemic (e.g., Plasmodium spp.), are not routinely screened in blood banks and are not included in blood safety guidelines or surveillance, despite their potential for transfusion transmission.

MATERIALS AND METHODS: Here, we conducted a systematic review and meta-analysis of prevalence, determinants, and clinical impact of 'neglected' pathogens, defined as pathogens not included in national blood safety guidelines (e.g., filaria, dengue virus, Toxoplasma gondii), in blood banks. Additionally, we identified the most urgent challenges and proposed actionable solutions to guide blood safety guidelines in the country.

RESULTS: A total of 18 studies, covering ~12,500 donations, were included, with the bulk coming from donors living in three regions (Littoral, Northwest, Centre). Plasmodium parasite (68.4%) was the major studied pathogen, even though an evident publication bias was found (p = 0.004). The other pathogens included dengue virus (5.3%), T. gondii (5.3%), and HTLV-1 (5.3%). The filarial parasite Loa loa was consistently accidentally found. Even though there is no evidence of SARS-CoV-2-associated TTIs till now, the pooled proportion of this virus was 17.7%. The pooled proportions of infection in blood donors were 16.6% for Plasmodium spp. and 0.5% for Loa loa. There is a paucity of clinical impact studies on these 'neglected' TTIs, and the available literature suggests impaired levels of immunoglobulin E and albumin. We identified urgent challenges, including awareness among healthcare providers and policymakers, diagnostic and logistical constraints, and low microbial density infections, associated with neglected pathogen-related blood safety.

CONCLUSION: We opine that providing more epidemiological evidence is crucial to address the above-mentioned challenges for guiding and guaranteeing blood safety in Cameroon.},
}

Humans
Cameroon/epidemiology
*Transfusion Reaction/epidemiology
Blood Donors
*Blood-Borne Infections/epidemiology
Prevalence
Blood Donation
Blood Banks
Blood Safety

@article {pmid42213322,
year = {2026},
author = {Ahmad, T and Alhammadi, BA and Almaazmi, SY and Arafa, S and Blatch, GL and Dutta, T and Gestwicki, JE and Keyzers, RA and Meskiri, A and Sharafeldin, A and Shonhai, A and Singh, H},
title = {Malaria Public Health Status: Global Context and Update on Gulf Cooperation Council Countries.},
journal = {Advances in experimental medicine and biology},
volume = {1507},
number = {},
pages = {35-53},
pmid = {42213322},
issn = {0065-2598},
mesh = {Humans ; Antimalarials/therapeutic use ; *Malaria/epidemiology/prevention & control/drug therapy/transmission ; Animals ; *Public Health ; Middle East/epidemiology ; Drug Resistance ; Plasmodium falciparum/drug effects/pathogenicity ; Malaria Vaccines/therapeutic use ; Global Health ; },
abstract = {From 2000 to 2019, the global malaria death toll fell from 864,000 to 576,000 deaths; however, progress on reducing this toll has since slowed, with the COVID-19 pandemic contributing to an increase in the mortality rate since 2020. The emergence of widespread resistance in the major malaria parasite (Plasmodium falciparum) to first-line treatment drugs has highlighted the need for new antimalarials and smarter drug delivery strategies. Nevertheless, recent successes of the first malaria vaccines (RTS,S/AS01 and R21/MM) have renewed the promise of widely applicable vaccines in the future. Since 2015, the Eastern Mediterranean Region has experienced an overall increase in malaria cases and deaths. In the Arabian Peninsula, while most of the Gulf Cooperation Council (GCC) countries have been declared free of indigenous malaria (Bahrain, Kuwait, Qatar, and the United Arab Emirates), malaria is still endemic in two GCC countries (Saudi Arabia and Oman) and their neighbors (Yemen). Furthermore, a number of factors threaten malaria control in this region, especially antimalarial drug resistance, the emergence of highly invasive mosquito species, increasing average temperatures, and imported malaria. In this review, we assess the current worldwide status of malaria before providing a critical evaluation of the malaria situation in the GCC countries.},
}

Humans
Antimalarials/therapeutic use
*Malaria/epidemiology/prevention & control/drug therapy/transmission
Animals
*Public Health
Middle East/epidemiology
Drug Resistance
Plasmodium falciparum/drug effects/pathogenicity
Malaria Vaccines/therapeutic use
Global Health

@article {pmid42215147,
year = {2026},
author = {Petropoulou, D and Karampela, I and Christodoulatos, GS and Kounatidis, D and Vallianou, NG and Dalamaga, M},
title = {Hormonal, metabolic and metabolomic biomarkers in long COVID.},
journal = {Advances in clinical chemistry},
volume = {133},
number = {},
pages = {217-283},
doi = {10.1016/bs.acc.2026.01.002},
pmid = {42215147},
issn = {2162-9471},
mesh = {Humans ; Biomarkers/metabolism/blood ; Post-Acute COVID-19 Syndrome ; *COVID-19/metabolism/complications ; *Hormones/metabolism ; Metabolomics ; SARS-CoV-2 ; },
abstract = {Long COVID (LC), a complex syndrome affecting approximately 6-12 % of individuals post infection, is characterized by persistent, fluctuating, or progressive symptoms lasting at least three months. Its pathogenic mechanisms involve viral persistence, chronic inflammation, immune dysregulation, endothelial dysfunction, and endocrine/metabolic abnormalities. Currently, no specific diagnostic tests exist for LC, highlighting the need for reliable biomarkers. This review synthesizes current evidence on hormonal, metabolic, and metabolite biomarkers in LC. While vitamin D deficiency is prevalent in LC, being associated with neurocognitive symptoms, delayed recovery and poor physical performance, particularly in older adults, its lack of specificity reduces diagnostic utility. Insulin resistance markers consistently correlate with fatigue, mood disturbances, and myalgia, suggesting a distinct metabolic LC phenotype. Lower cortisol frequently correlates with fatigue, sensory disturbances, and neurocognitive symptoms. Alterations in cortisol/adrenocorticotropic hormone, growth hormone, prolactin, and gonadotropins suggest a potential hypothalamic-pituitary axis involvement; however, these abnormalities are often transient, dynamic or nonsignificant. While some patients may exhibit low free triiodothyronine associated with fatigue, no significant incidence of thyroid dysfunction and autoimmunity was associated with LC. Despite the absence of a distinct and consistent metabolomic signature, LC is characterized by the activation of the kynurenine pathway, including increased kynurenine and quinolinic acid, being associated with fatigue, neurocognitive and depressive symptoms. Emerging metabolites of mitochondrial dysfunction and lipid metabolism alterations require further validation. Despite promising findings, evidence remains scattered, hindered by small sample sizes and methodological limitations. Future research should prioritize standardization of biomarker assessment, validation in diverse populations, and exploration of targeted therapeutic interventions.},
}

Humans
Biomarkers/metabolism/blood
Post-Acute COVID-19 Syndrome
*COVID-19/metabolism/complications
*Hormones/metabolism
Metabolomics
SARS-CoV-2

@article {pmid42216347,
year = {2026},
author = {Faseeh, A and Rida, M and Karim, NE and Zafar, A and Shah, A and Perveen, A},
title = {Prevalence and long-term outcomes of brain fog and cognitive impairment in individuals with long COVID: A systematic review.},
journal = {Medicine},
volume = {105},
number = {22},
pages = {e49022},
pmid = {42216347},
issn = {1536-5964},
mesh = {Humans ; *Cognitive Dysfunction/epidemiology/etiology ; Prevalence ; *COVID-19/complications/epidemiology ; Post-Acute COVID-19 Syndrome ; Female ; Male ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Long COVID is increasingly recognized as a complex multisystem condition, with brain fog and cognitive impairment emerging as some of its manifestations. Despite growing literature, the pooled prevalence, subgroup differences, and underlying mechanisms remain incompletely understood.

METHODS: We systematically reviewed 47 studies (2000-2025) encompassing over 25,000 patients to evaluate the prevalence of brain fog and cognitive impairment among long COVID populations. Data were extracted on study design, patient demographics, follow-up duration, and subgroup variables including gender, hospitalization, vaccination, and geographic region. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS v9.0) and JBI checklists. Quantitative synthesis was performed with subgroup and temporal analyses, presented in forest plots and summary figures.

RESULTS: The pooled prevalence of brain fog was 30% (95% CI: 28-32), while cognitive impairment was 25% (95% CI: 23-27). Female patients consistently showed higher rates compared to males (34% vs 23% for brain fog; 29% vs 21% for cognitive impairment). Community-managed patients demonstrated higher prevalence compared to hospitalized cohorts, and unvaccinated individuals had a greater burden than vaccinated ones. Temporal analyses indicated that prevalence increased with longer follow-up, suggesting symptom persistence or late manifestation. Pathophysiological explanations include neuroinflammation, microvascular injury, immune dysregulation, and psychosocial stressors.

CONCLUSION: Brain fog and cognitive impairment are common, persistent, and clinically significant features of long COVID. Gender differences, vaccination status, and follow-up duration influence prevalence. Future studies should focus on mechanisms, preventive strategies, and targeted interventions to mitigate long-term cognitive sequelae.},
}

Humans
*Cognitive Dysfunction/epidemiology/etiology
Prevalence
*COVID-19/complications/epidemiology
Post-Acute COVID-19 Syndrome
Female
Male
SARS-CoV-2

@article {pmid42339932,
year = {2026},
author = {Theodoro, EL and Prediger, KM and Damacena, MA and Silva, CVD and Cano, RDN and Uehara, SCDSA},
title = {Oral manifestations associated with long COVID: a scoping review.},
journal = {Revista brasileira de enfermagem},
volume = {79},
number = {},
pages = {e20250198},
doi = {10.1590/0034-7167-2025-0198},
pmid = {42339932},
issn = {1984-0446},
mesh = {Humans ; Post-Acute COVID-19 Syndrome ; *COVID-19/complications ; *Mouth Diseases/etiology/epidemiology ; Quality of Life ; SARS-CoV-2 ; Female ; },
abstract = {OBJECTIVES: to map scientific evidence on oral manifestations originating during long COVID.

METHODS: this is a scoping review based on the method described by JBI. Primary articles published in Portuguese, English, and Spanish between March 2020 and December 2024 were included from the PubMed, Web of Science, Virtual Health Library, Scopus, Excerpta Medica dataBASE, and Scientific Electronic Library Online databases, and a descriptive analysis was performed.

RESULTS: of the 15 studies analyzed, the most frequent oral manifestations of long COVID were taste alterations, xerostomia, difficulty chewing, gingival bleeding, periodontitis, and changes in the teeth.

CONCLUSIONS: an association between long COVID and various oral manifestations was evidenced, impacting the quality of life of patients. Factors such as age, comorbidities, and social inequalities influence the persistence of these manifestations, with a higher prevalence in women. Multiprofessional collaboration and clearer guidelines are essential to improve dental care.},
}

Humans
Post-Acute COVID-19 Syndrome
*COVID-19/complications
*Mouth Diseases/etiology/epidemiology
Quality of Life
SARS-CoV-2
Female

@article {pmid42340118,
year = {2026},
author = {Poder, TG and Camara, MA and Bouchard, PA and Lellouche, F},
title = {Pricing Policy for Medical Oxygen and Potential Savings.},
journal = {Journal of evaluation in clinical practice},
volume = {32},
number = {4},
pages = {e70510},
doi = {10.1111/jep.70510},
pmid = {42340118},
issn = {1365-2753},
mesh = {Humans ; Quebec ; *Oxygen Inhalation Therapy/economics ; *Cost Savings ; *Oxygen/economics/therapeutic use ; *COVID-19/epidemiology ; *Costs and Cost Analysis ; },
abstract = {BACKGROUND: Medical oxygen is essential in modern medicine.

AIMS: This study analyzes the pricing policies and costs of medical oxygen in Quebec, provides elements of international comparison, and explores the potential savings through the optimization of oxygen therapy practices.

MATERIALS AND METHODS: It combines a narrative literature review, an analysis of administrative and financial documents, as well as administrative data obtained from representatives of the healthcare sector in Quebec.

RESULTS: The literature review highlights the challenges of producing, storing, and distributing medical oxygen, which have been accentuated by the COVID-19 pandemic. A very large disparity in pricing policies is also noted among healthcare systems, especially when cylinders are predominantly used. In Quebec, costs vary according to production methods, logistics, and contractual clauses. Optimizing oxygen therapy practices would allow significant savings, particularly by reducing oxygen consumption through various strategies.

DISCUSSION: The study shows the complexity of managing medical oxygen costs, amplified by limited competition and rigid contractual clauses. International comparison highlights the importance of infrastructure, while optimizing oxygen therapy practices offers significant savings potential. To reduce costs, it is recommended to improve distribution management, adopt more flexible contractual clauses, and strengthen competition.

CONCLUSION: To optimize medical oxygen use, actions to undertake from managers and clinicians are highlighted.},
}

Humans
Quebec
*Oxygen Inhalation Therapy/economics
*Cost Savings
*Oxygen/economics/therapeutic use
*COVID-19/epidemiology
*Costs and Cost Analysis

@article {pmid42340456,
year = {2026},
author = {Tahmtan, A and Nissapatorn, V and Saravanabhavan, SS and Taherkhani, S and Aghcheli, B},
title = {Viral Infections and Neurodegenerative Diseases: Reinterpreting the Crosstalk Through a Dual-Role Lens.},
journal = {Current microbiology},
volume = {83},
number = {8},
pages = {},
pmid = {42340456},
issn = {1432-0991},
mesh = {Humans ; *Neurodegenerative Diseases/virology/therapy ; Genetic Vectors/genetics ; *Virus Diseases/complications/virology/therapy ; Genetic Therapy/methods ; Animals ; Gene Therapy Agents ; },
abstract = {Neurodegenerative diseases (NDDs) are multifactorial disorders with increasing evidence implicating viral infections in their pathogenesis. However, current reviews often catalog virus-disease associations without integrating this evidence into a unified conceptual model that also accounts for the therapeutic potential of viral platforms. This review investigates recent literature to propose a "dual-role" model for viruses in NDDs. We analyze how diverse viruses (e.g., HSV-1, HIV, EBV, and SARS-CoV-2) converge on shared pathogenic pathways, including protein misfolding, chronic neuroinflammation, and mitochondrial dysfunction, across different NDDs. Paradoxically, engineered viral vectors derived from neurotropic viruses are being investigated as tools for targeted gene therapy. To address these therapeutic applications of viruses, this review also provides an in-depth report of the various viral vector technologies developed. The approaches involved in designing rationally engineered viral vectors based on various adeno-associated virus serotypes through rational design, directed evolution and machine learning strategies, as well as the lentiviral and herpes simplex virus-based platform are described. Different strategies that have been used to incorporate large and/or small payloads such as gene replacement, RNA interference, microRNA cassettes, CRISPR-based gene editing (base editing, prime editing, CRISPRa and CRISPRi) and the double AAV systems to deliver larger transgene cassette have also been reviewed. This review further includes various routes of administration including intrathecal, intracerebroventricular and convection-enhanced delivery with the use of Focused Ultrasound. The constraints imposed by the Blood-Brain Barrier are discussed, especially the approach using receptor-mediated transcytosis for crossing. The review also critically evaluates obstacles toward clinical translation of viral vectors due to various factors including immunogenicity, the presence of pre-existing neutralising antibodies and dose-dependent toxicity, illustrated by the fatal outcome of ASPIRO and DMD trials. Finally, this review concludes with other promising non-viral approaches such as lipid nanoparticle and extracellular vesicles. Future research needs include long-term studies to investigate causality and extensive safety optimization of viral vectors.},
}

Humans
*Neurodegenerative Diseases/virology/therapy
Genetic Vectors/genetics
*Virus Diseases/complications/virology/therapy
Genetic Therapy/methods
Animals
Gene Therapy Agents

@article {pmid42340792,
year = {2026},
author = {Elgazzar, YA and Abdelrazek, M and Ghozzy, OAM and Mashhour, K and Elhady, MA and Amro, OAEA and Mokhtar, HM and Abdellatif, KAK and Mohamed, MM and Alsharif, MB and Mawkili, H and Hendi, AM and Dhayihi, TM and Adawy, Z and Ali, RF},
title = {CT-Assessed Sarcopenia Combined with Laboratory Inflammatory Markers for Outcome Prediction in Critically Ill, Pulmonary, and Geriatric Patients: A Systematic Review and Meta-Analysis.},
journal = {La Clinica terapeutica},
volume = {177},
number = {4},
pages = {903-915},
doi = {10.7417/CT.2026.2085},
pmid = {42340792},
issn = {1972-6007},
mesh = {Humans ; *Sarcopenia/diagnostic imaging/blood/mortality ; *Tomography, X-Ray Computed ; *Critical Illness ; Biomarkers/blood ; Prognosis ; Aged ; C-Reactive Protein/analysis ; *Lung Diseases/blood/complications/mortality ; Length of Stay ; Respiration, Artificial/statistics & numerical data ; Predictive Value of Tests ; *Inflammation/blood ; },
abstract = {BACKGROUND: Sarcopenia, assessed via computed tomography (CT), is an emerging prognostic tool in critically ill, pulmonary, and geriatric patients. Laboratory inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) are routinely obtained in these populations. Whether CT-assessed sarcopenia combined with laboratory markers offers superior prognostic accuracy over either measure alone remains unclear.

OBJECTIVES: To systematically evaluate the prognostic value of CT-assessed sarcopenia, alone or combined with laboratory inflammatory/nutritional markers, for predicting mortality, mechanical ventilation duration, and ICU length of stay in critically ill, pulmonary, and geriatric patients.

METHODS: MEDLINE/PubMed, Scopus, Embase, and Cochrane Library were searched from inception to December 2024. Observational studies (prospective or retrospective cohorts, case-control) that reported CT-based sarcopenia assessment alongside at least one laboratory inflammatory marker and at least one clinical outcome were included. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale (NOS). Random-effects meta-analysis was performed; heterogeneity was assessed using the I² statistic.

RESULTS: Twenty-five studies encompassing 12,347 patients were identified. The pooled odds ratio for mortality in sarcopenic versus non-sarcopenic patients was 2.28 (95% CI: 1.83-2.83; I² = 22.1%) across critically ill ICU cohorts. In COVID-19 pulmonary populations, pooled OR for in-hospital mortality with low skeletal muscle mass was 5.84 (95% CI: 1.07-31.83). CT-derived muscle measurements correlated inversely with CRP (r = -0.315), fibrinogen (r = -0.392), D-dimers (r = -0.363), and WBC count (r = -0.287). Combined CT-sarcopenia and inflammatory marker models outperformed conventional scoring systems (APACHE II, SOFA, CURB-65, PSI).

CONCLUSIONS: CT-assessed sarcopenia, when integrated with laboratory inflammatory markers, provides a robust, mechanistically grounded, and clinically accessible multimodal prognostic framework across critically ill, pulmonary, and geriatric populations.},
}

Humans
*Sarcopenia/diagnostic imaging/blood/mortality
*Tomography, X-Ray Computed
*Critical Illness
Biomarkers/blood
Prognosis
Aged
C-Reactive Protein/analysis
*Lung Diseases/blood/complications/mortality
Length of Stay
Respiration, Artificial/statistics & numerical data
Predictive Value of Tests
*Inflammation/blood

@article {pmid42342266,
year = {2026},
author = {Xu, J and Kathiresan, T and Siddiqui, A and Mazzone, SB and Vogel, A},
title = {Cough biomarkers for diagnosis and monitoring of respiratory disease: a systematic review.},
journal = {European respiratory review : an official journal of the European Respiratory Society},
volume = {35},
number = {180},
pages = {},
doi = {10.1183/16000617.0288-2025},
pmid = {42342266},
issn = {1600-0617},
mesh = {Humans ; *Cough/diagnosis/physiopathology/etiology ; Biomarkers ; Predictive Value of Tests ; *Respiratory Tract Diseases/diagnosis/physiopathology ; *Acoustics ; Prognosis ; },
abstract = {Cough is a common and physiologically informative component of respiratory morbidity, but its potential for diagnosing and monitoring disease is not thoroughly investigated. This systematic review synthesised the literature on algorithmic and statistical models analysing cough acoustics for diagnosing or monitoring respiratory conditions. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, five databases (PubMed, Embase, Scopus, Web of Science and CENTRAL) were systematically searched for studies published from January 2010 to June 2025. Eligible studies performed quantitative acoustic feature analysis of human coughs using statistical, machine learning or deep learning models and reported diagnostic or prognostic performance. 89 studies from 34 countries were assessed, covering cough detection (n=31), disease classification (n=55) and disease severity prediction (n=3), reflecting potential applications in disease monitoring. Deep learning approaches, especially convolutional and recurrent networks, were predominant (n=56) and tended to achieve the higher accuracies, although machine learning ensemble methods and logistic regression also demonstrated strong performance, particularly with well-engineered features. Across different diseases, sensitivities and specificities were often reported to be ≥90%, notably for tuberculosis, asthma and COVID-19. However, methodological weaknesses were common, with only 11.2% of studies introducing external validation, 71.1-87.6% demonstrating high risk of bias (according to PROBAST-AI) and most based on small, homogeneous or crowdsourced cohorts with limited generalisability. These limitations contribute to inflated internal performance and uncertainty about real-world applicability. Cough acoustic biomarkers hold promise as an adjunctive tool for screening and longitudinal monitoring in low-resource environments. Nevertheless, widespread implementation will require large, multicentre validation, standardised calibration, bias control and incorporation into privacy-preserving workflows.},
}

Humans
*Cough/diagnosis/physiopathology/etiology
Biomarkers
Predictive Value of Tests
*Respiratory Tract Diseases/diagnosis/physiopathology
*Acoustics
Prognosis

@article {pmid42342297,
year = {2026},
author = {Yasam, SK and Vignesh, N and Rajagopal, S},
title = {Advances in ferroptosis research and applications.},
journal = {International review of cell and molecular biology},
volume = {405},
number = {},
pages = {149-186},
doi = {10.1016/bs.ircmb.2025.12.004},
pmid = {42342297},
issn = {1937-6448},
mesh = {*Ferroptosis/drug effects/physiology ; Humans ; Animals ; COVID-19/metabolism/pathology/virology ; Iron/metabolism ; Lipid Peroxidation ; SARS-CoV-2 ; Neoplasms/pathology/metabolism ; Neurodegenerative Diseases/pathology/metabolism ; Pulmonary Fibrosis/pathology/metabolism ; Renal Insufficiency, Chronic/metabolism/pathology ; },
abstract = {Ferroptosis is an iron-dependent form of regulated cell death driven by lipid peroxidation and redox imbalance. It has emerged as a pivotal mechanism implicated in various diseases, including cancer, chronic kidney diseases (CKD), neurodegenerative disorders, pulmonary fibrosis, chronic wounds, and viral infections such as COVID-19. This chapter presents a comprehensive overview of the molecular underpinnings of ferroptosis, emphasizing its key regulators-iron metabolism, lipid peroxidation pathways, and antioxidant defenses such as GPX4 and system Xc[-]. We explore recent advances highlighting the therapeutic potential of ferroptosis modulation across multiple pathological contexts. In cancer, ferroptosis inducers have shown efficacy in overcoming drug resistance and enhancing immunotherapy. In contrast, inhibition of ferroptosis offers protective effects in neurodegenerative diseases, ischemia-reperfusion injury, and chronic inflammatory conditions. Applications in nanomedicine have further enabled targeted delivery of ferroptosis modulators, expanding their clinical relevance. The chapter also discusses emerging roles of ferroptosis in wound healing, CKD and pulmonary fibrosis, with particular attention to COVID-19-related lung injury. Finally, we evaluate current therapeutic strategies, safety considerations, and potential clinical applications, along with future directions including biomarker development and personalized medicine. Our aim is to provide a unified perspective on ferroptosis as a disease-modifying mechanism and to highlight its growing importance as a therapeutic target across diverse clinical disciplines.},
}

*Ferroptosis/drug effects/physiology
Humans
Animals
COVID-19/metabolism/pathology/virology
Iron/metabolism
Lipid Peroxidation
SARS-CoV-2
Neoplasms/pathology/metabolism
Neurodegenerative Diseases/pathology/metabolism
Pulmonary Fibrosis/pathology/metabolism
Renal Insufficiency, Chronic/metabolism/pathology

@article {pmid42342836,
year = {2026},
author = {Schuele, L and Nzoyikorera, N and Udahemuka, JC and Cassidy, H and Murhula Masirika, L and Nieuwenhuijse, DF and Nduwimana, C and Molenkamp, R and Nyandwi, J and Boter, M and Minega Ndoli, J and Zaeck, LM and Musabyimana, JP and de Vries, RD and Mbiribindi, JB and Siangoli, FB and Otani, S and Aarestrup, FM and Koopmans, M and Ndishimye, P and Oude Munnink, BB},
title = {Capacity building for genomic surveillance of mpox and other emerging diseases in resource-limited settings within the African Great Lakes region.},
journal = {Communications medicine},
volume = {6},
number = {1},
pages = {},
pmid = {42342836},
issn = {2730-664X},
abstract = {Genomic surveillance has become an indispensable tool for the identification of pathogens and tracking of transmission chains. Building upon the global sequencing and surveillance infrastructure developed and expanded during the COVID-19 pandemic, these capacities are now being adapted to track other pathogens in low- and middle-income countries which remain disproportionately affected by infectious diseases. This is evident in the recent and unprecedented spread of mpox virus in regions experiencing multiple concurrent infectious disease outbreaks, highlighting the need for broad, adaptable diagnostic detection and sequencing capacity. In this Perspective, we describe the applications, insights, and challenges encountered during ongoing capacity building efforts for the characterization of the mpox outbreak and other emerging pathogens in the African Great Lakes Region.},
}

@article {pmid42342874,
year = {2026},
author = {Locci, M and Pardi, N},
title = {Immunological mechanisms of mRNA vaccines for infectious diseases.},
journal = {Nature},
volume = {654},
number = {8120},
pages = {892-901},
pmid = {42342874},
issn = {1476-4687},
mesh = {Humans ; Animals ; *COVID-19 Vaccines/immunology ; *Communicable Diseases/immunology ; COVID-19/prevention & control/immunology ; *RNA, Messenger/immunology/chemistry/genetics ; Adaptive Immunity ; Immunity, Innate ; *mRNA Vaccines/immunology ; Nanoparticles/chemistry ; Vaccines, Synthetic/immunology/chemistry ; SARS-CoV-2/immunology ; Adjuvants, Immunologic ; Immunogenicity, Vaccine ; Liposomes ; },
abstract = {Nucleoside-modified mRNA-lipid-nanoparticle (mRNA-LNP) vaccines confer a high level of protection against severe COVID-19 and, since their first authorization for human use in 2020, have saved millions of lives. The efficacy of this vaccine platform relies on the induction of powerful and coordinated innate and adaptive immune responses. A deep understanding of the mechanisms of action by which mRNA-LNP vaccines drive protective immunity is crucial for advancing the development of next-generation mRNA vaccines with improved immunogenicity and tolerability. A flurry of recent studies has shed light on aspects of this vaccine modality's modus operandi. Nonetheless, key gaps in knowledge remain, including understanding how LNPs are sensed by the immune system and exert their adjuvant activity, identifying the specific signals and cellular pathways critical for eliciting protective immune responses and determining whether it is feasible to uncouple vaccine immunogenicity and reactogenicity. Here we review the known and unknown features of the immunological mechanisms of mRNA-LNP vaccines for infectious diseases. Furthermore, we discuss how the components of this vaccine platform can be modified to fine-tune immune responses against challenging pathogens for which effective vaccines do not exist or need improvement.},
}

Humans
Animals
*COVID-19 Vaccines/immunology
*Communicable Diseases/immunology
COVID-19/prevention & control/immunology
*RNA, Messenger/immunology/chemistry/genetics
Adaptive Immunity
Immunity, Innate
*mRNA Vaccines/immunology
Nanoparticles/chemistry
Vaccines, Synthetic/immunology/chemistry
SARS-CoV-2/immunology
Adjuvants, Immunologic
Immunogenicity, Vaccine
Liposomes

@article {pmid41756780,
year = {2026},
author = {Ferriero, AM and Di Lella, R and Farroni, C and Aiello, A and Giarratano, A and Todaro, M and Bocci, MG and Nicastri, E and Goletti, D},
title = {Host-pathogen interaction in community-acquired pneumonia: a focus on the immune response.},
journal = {Frontiers in cellular and infection microbiology},
volume = {16},
number = {},
pages = {1731074},
pmid = {41756780},
issn = {2235-2988},
mesh = {Humans ; *Community-Acquired Pneumonia/immunology/microbiology/epidemiology/diagnosis/virology ; Adaptive Immunity ; *Host-Pathogen Interactions/immunology ; Immunity, Innate ; *Pneumonia, Viral/immunology/epidemiology ; *Pneumonia, Bacterial/immunology/microbiology ; Streptococcus pneumoniae/pathogenicity/immunology ; SARS-CoV-2 ; *Community-Acquired Infections/immunology ; },
abstract = {Community-acquired pneumonia (CAP) remains one of the leading causes of morbidity and mortality worldwide, affecting individuals of all ages. Various pathogens can cause this condition, and growing antibiotic resistance makes treatment more difficult while raising the risk of severe outcomes. Despite substantial advances in diagnostics, antimicrobial therapy, and supportive care, CAP continues to represent a significant clinical and public health challenge. In this review, we provide a comprehensive overview of CAP, summarizing key aspects of its epidemiology, pathogen frequency, and recent progress in diagnostic tools and biomarkers. We also describe the innate and adaptive immune responses involved in CAP, with a particular focus on pneumonia caused by Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, respiratory syncytial virus, severe acute respiratory syndrome coronavirus 2, and Influenza A and B viruses. A deeper understanding of CAP immunopathogenesis may support the development of improved diagnostic and therapeutic approaches for pneumonia management.},
}

Humans
*Community-Acquired Pneumonia/immunology/microbiology/epidemiology/diagnosis/virology
Adaptive Immunity
*Host-Pathogen Interactions/immunology
Immunity, Innate
*Pneumonia, Viral/immunology/epidemiology
*Pneumonia, Bacterial/immunology/microbiology
Streptococcus pneumoniae/pathogenicity/immunology
SARS-CoV-2
*Community-Acquired Infections/immunology

@article {pmid41757222,
year = {2026},
author = {Ravinetto, R and Bottieau, E and Fusco, D and Marrone, R and Van Den Broucke, S and Tarrafeta-Sayas, MB and Rinaldi, L and Losada-Galván, I and Calleri, G and Albonico, M},
title = {Inequitable access to medicines for neglected tropical diseases in Europe: health system vulnerabilities and a call for coordinated action.},
journal = {The Lancet regional health. Europe},
volume = {63},
number = {},
pages = {101616},
pmid = {41757222},
issn = {2666-7762},
abstract = {The COVID-19 pandemic has exposed the vulnerability of the European medicine supply systems, but the lack of access to medicines for diseases of poverty, including neglected tropical diseases (NTDs), is unfrequently brought to the attention of the European policy makers. As a result, clinicians in Europe are forced to "bricolage solutions" to treat NTDs: ad hoc donations from companies, product-specific donations via the World Health Organization (WHO) or WHO collaborating centres, case-by-case importation -sometimes from poorly regulated countries-, and possibly the recourse to compounding pharmacies. Noteworthy, NTDs are unlikely to decrease in the next years in Europe, due to increasing global mobility, and climate change expanding the parasites' habitat. This serious but neglected problem was discussed at the 2025 European Congress in Tropical Medicine and International Health (ECTMIH) in Hamburg, Germany. This viewpoint analyses the availability, affordability and accessibility challenges in some countries in Europe, and their consequences at patient and health system level. It also proposes a set of interconnected recommendations and policy measures to make quality-assured medicines for NTDs sustainably available and affordable across Europe. Restoring access to these essential and sometimes life-saving medicines is critical for restoring the right to health for all in Europe, while protecting continental public health.},
}

@article {pmid41758633,
year = {2026},
author = {Marefat, M and Tran, D and Watson, RM and Abdulghani, H and Fortino, M},
title = {A practical model for integrated temporomandibular disorder assessment in the routine oral examination.},
journal = {General dentistry},
volume = {74},
number = {2},
pages = {57-61},
pmid = {41758633},
issn = {0363-6771},
mesh = {Humans ; *Temporomandibular Joint Disorders/diagnosis ; Facial Pain/diagnosis/etiology ; Physical Examination ; },
abstract = {The COVID-19 era has seen an increase in orofacial pain related to temporomandibular disorders (TMDs). The increased relevance and awareness of these conditions, including the enactment of accreditation standards dictating the inclusion of TMD education in dental school curricula, highlights the need for a simplified TMD screening and evaluation model. A literature review was conducted to establish whether a widely accepted, comprehensive, and clinically practical approach to screening and evaluation for TMDs during routine oral examination was available. Previous studies and available medical and dental history forms were reviewed. While medical and dental history forms currently available to practitioners contain TMD-related questions, they are presented in a nonsequential, sporadic manner that may not lead to intuitive diagnosis from the dental practitioner. This article introduces a proposed model and questionnaire for incorporating TMD examinations into routine examinations. The inclusion of a more practical TMD screening and evaluation model in routine examination is intended to facilitate the dentist's identification and assessment of TMD signs and symptoms, leading to a more targeted approach in diagnosis and referral. This proposed model has not yet been validated clinically; the next steps include further development, implementation within a clinical setting, and evaluation of its effectiveness.},
}

Humans
*Temporomandibular Joint Disorders/diagnosis
Facial Pain/diagnosis/etiology
Physical Examination

@article {pmid41758637,
year = {2026},
author = {Kozdrowicki, M and Szczepaniak, P and Kyslyi, V and Carnevale, L and Carnevale, D and Lembo, G and Guzik, TJ and Mikołajczyk, TP},
title = {The impact of inflammation, neuromodulation, and gut microbiota on developing cardiac fibrosis and hypertension.},
journal = {Cardiovascular research},
volume = {122},
number = {6},
pages = {681-706},
pmid = {41758637},
issn = {1755-3245},
support = {ERA-CVD/NEMO/7/2019//Polish National Centre for Research and Development/ ; ERA-CVD/Gut-brain/8/2021//Polish National Centre for Research and Development/ ; ERA-CVD/JTC2020/25/ImmuneHyper/Cog/2022//Polish National Centre for Research and Development/ ; //Ministry of Health/ ; },
mesh = {Humans ; *Hypertension/physiopathology/metabolism/immunology/microbiology/therapy ; Animals ; Fibrosis ; *Myocardium/pathology/metabolism/immunology ; *Gastrointestinal Microbiome ; *Inflammation Mediators/metabolism ; Signal Transduction ; *Blood Pressure ; *Inflammation/physiopathology/metabolism ; *Heart Failure/physiopathology/pathology/metabolism ; Epigenesis, Genetic ; },
abstract = {Cardiovascular diseases (CVD) are the leading cause of premature mortality worldwide. Due to pressure overload and cardiac fibrosis, CVD often begin with hypertension and gradually progress to heart failure. Cardiac fibrosis reduces the number of functional cardiomyocytes and the force of contraction while increasing oxygen demand. It has been noted that myofibroblasts, which produce excessive amounts of extracellular matrix in the failing heart, express specific proteins such as periostin, tenascin C, thrombospondin, and osteopontin. Their activation involves immune cells that have a well-documented effect on the pathogenesis of hypertension. Moreover, dysregulation of the autonomic nervous system and sympathetic hyperactivity heightens peripheral inflammation and fosters fibrosis. In this review, we outline and summarize the most significant and recent findings concerning the molecular pathways of immune activation, neuromodulation, epigenetic modifications, and the impact of gut microbiota on myofibroblast activation and fibrosis in the heart, as well as potential therapeutic options (e.g. experimental anti-inflammatory treatments, epigenetic modulators, and vagus nerve stimulation). We will also highlight how current heart failure treatments, including renin-angiotensin-aldosterone system (RAA) inhibitors, β-adrenergic receptor (β-AR) antagonists, sodium-glucose co-transporter 2 (SGLT2) inhibitors, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean diet, affect these processes at a molecular level. A comprehensive understanding of the neuroimmune mechanisms involved in the pathogenesis of heart failure and hypertension is particularly crucial in light of the increased risk of CVD following the COVID-19 pandemic, which resulted from the 'cytokine storm' during SARS-CoV-2 infection.},
}

Humans
*Hypertension/physiopathology/metabolism/immunology/microbiology/therapy
Animals
Fibrosis
*Myocardium/pathology/metabolism/immunology
*Gastrointestinal Microbiome
*Inflammation Mediators/metabolism
Signal Transduction
*Blood Pressure
*Inflammation/physiopathology/metabolism
*Heart Failure/physiopathology/pathology/metabolism
Epigenesis, Genetic

@article {pmid41758742,
year = {2026},
author = {Al-Talhi, AA and AlRajhi, B and Almalki, AHS and Alqazenli, M and AlGhamdi, MA and Munhish, FA and Sumaily, I},
title = {Effectiveness of Intranasal Insulin for the Treatment of Olfactory Dysfunction: A Systematic Review.},
journal = {ORL; journal for oto-rhino-laryngology and its related specialties},
volume = {},
number = {},
pages = {1-11},
doi = {10.1159/000550990},
pmid = {41758742},
issn = {1423-0275},
abstract = {INTRODUCTION: The aim of the study was to assess the effectiveness and safety of intranasal insulin (INI) for the treatment of olfactory dysfunction (OD) in patients with anosmia and/or hyposmia compared to placebo or no treatment.

METHODS: We searched four databases: Medline, Scopus, Directory of Open Access Journals (DOAJ), and Springer Nature. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42023456891). The protocol design was in accordance with the PRISMA. Participants with hyposmia or anosmia aged ≥18 years were included. Patients with an altered sense of smell due to anatomical malformations, trauma, neurodegenerative diseases, surgery, or intranasal lesions were excluded from the study.

RESULTS: Five studies with 131 participants were included. There were 131 participants, of whom 63 were men and 68 were women. The participants' ages ranged from 16 to 56 years. Almost all studies used a dose of 40 IU, except one that used different doses for different participants. Glycemic assessment was performed in three studies, which showed a very slight decrease in glucose, except in one study in which the drop in glucose reached 10.4 mg/dL. All studies agreed that olfactory function improved after INI administration.

CONCLUSION: This systematic review concluded that INI can be an effective treatment option for patients with OD. However, further well-designed clinical trials are required to establish robust clinical recommendations.},
}

@article {pmid41759027,
year = {2026},
author = {Hussein, R and Shafiai, N and Fakrurrozi, A and Sabbagh, J},
title = {The impact of COVID-19 on dental practice and care: Adapting to unprecedented times.},
journal = {Wiadomosci lekarskie (Warsaw, Poland : 1960)},
volume = {79},
number = {1},
pages = {223-231},
doi = {10.36740/WLek/216768},
pmid = {41759027},
issn = {0043-5147},
mesh = {Humans ; *COVID-19 ; Pandemics ; *Dental Care ; SARS-CoV-2 ; Dentist-Patient Relations ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; Telemedicine ; },
abstract = {OBJECTIVE: Aim: This review aims to shed light on the ways dental practices and patient care strategies have evolved in response to the pandemic. It also investigates how patients' perspectives and dentist-patient dynamics have shifted, highlighting lessons for the future of dental healthcare systems.

PATIENTS AND METHODS: Materials and methods: The study is based on a comprehensive analysis of previously published research articles and clinical reports on how dental practitioners adapted their practices during the COVID-19 pandemic. It includes qualitative and quantitative data reflecting both professional and patient experiences. The pandemic led to the rapid adoption of new technologies, heightened hygiene protocols, and increased mental health burdens on both patients and practitioners. Tele-dentistry, limited in-person visits, and stricter sterilization practices became the norm. Patients expressed both fear and appreciation for enhanced safety, altering their expectations of dental care, resilience and adaptability in dental settings.

CONCLUSION: Conclusions The lessons learned from COVID-19 experience underline the importance of incorporating dentistry into broader public health strategies. Moving forward, there is a need to invest in innovative technologies, uphold rigorous hygiene standards, and provide mental workers and patients. These steps are essential to prepare for future health emergencies and ensure the sustainability of dental care delivery.},
}

Humans
*COVID-19
Pandemics
*Dental Care
SARS-CoV-2
Dentist-Patient Relations
*Pneumonia, Viral/epidemiology
*Coronavirus Infections/epidemiology
Telemedicine

@article {pmid41759616,
year = {2026},
author = {Girndt, M},
title = {Vaccinations to Prevent Infections in Adult Individuals With CKD and After Kidney Transplantation: A Review.},
journal = {American journal of kidney diseases : the official journal of the National Kidney Foundation},
volume = {87},
number = {6},
pages = {841-851},
doi = {10.1053/j.ajkd.2025.10.021},
pmid = {41759616},
issn = {1523-6838},
mesh = {Humans ; *Kidney Transplantation/adverse effects ; *Vaccination/methods ; *Renal Insufficiency, Chronic/immunology/surgery/complications/therapy ; Adult ; Influenza, Human/prevention & control ; Immunosuppressive Agents ; Influenza Vaccines ; Respiratory Syncytial Virus Infections/prevention & control ; },
abstract = {Patients with chronic kidney disease (CKD), especially those undergoing dialysis, are at high risk of infections that lead to hospitalizations, morbidity, and mortality. Influenza, pneumococcal pneumonia, and respiratory syncytial virus infections account for a significant proportion of typical infectious complications and are preventable by vaccination. The immune system is weakened in CKD, reducing vaccination efficacy. Additionally, some patients with CKD receive immunosuppressive medications. The reduced seroreactivity to various vaccines must be considered when selecting vaccines, vaccine doses, and schedules for patients with CKD. Vaccinations are generally safe in CKD and should be widely used in accordance with public health recommendations to reduce morbidity. Immunosuppression after kidney transplant further impairs vaccination responses. Nevertheless, vaccinations can still be effective and provide protection in a relevant number of patients. Patients who have received transplants should generally not receive live vaccines because of the risk of vaccine-induced complications. Vaccination is usually recommended 6 months after transplant, when immunosuppression is less intense than in the early months. This approach may conflict with seasonal vaccinations, which are often omitted. Data show that at least the influenza vaccination can be administered as early as 4 weeks after transplant without additional risk. In all patients with CKD or posttransplant status, omitting recommended vaccinations is a missed opportunity to prevent relevant infectious complications.},
}

Humans
*Kidney Transplantation/adverse effects
*Vaccination/methods
*Renal Insufficiency, Chronic/immunology/surgery/complications/therapy
Adult
Influenza, Human/prevention & control
Immunosuppressive Agents
Influenza Vaccines
Respiratory Syncytial Virus Infections/prevention & control

@article {pmid41760558,
year = {2026},
author = {Laudani, C and Bujak, K and Occhipinti, G and Rinaldi, R and Imbesi, A and Sanchez, JS and Galli, M and Abbate, A and Ortega-Paz, L and Capodanno, D and Angiolillo, DJ},
title = {Safety and Efficacy of Colchicine across the Spectrum of Coronary Artery Disease: A Systematic Review and Meta-Analysis of 20 Randomized Trials.},
journal = {Clinical pharmacology and therapeutics},
volume = {119},
number = {6},
pages = {1431-1439},
doi = {10.1002/cpt.70246},
pmid = {41760558},
issn = {1532-6535},
mesh = {Humans ; *Colchicine/adverse effects/therapeutic use ; Randomized Controlled Trials as Topic ; *Coronary Artery Disease/drug therapy/mortality/diagnosis ; Treatment Outcome ; },
abstract = {Recent evidence questioned the overall safety and efficacy of colchicine in patients with coronary artery disease (CAD), as novel evidence focusing on acute coronary syndromes (ACSs) gave neutral results, while trials focusing on chronic coronary syndrome supported colchicine administration to improve long-term outcomes. However, no study has ever explored whether there is a true therapeutic difference across the populations or these discrepancies are due to additional confounders. Against this background, we performed a systematic review and meta-analysis of randomized trials of colchicine in patients with CAD. The primary endpoints were trial-defined major adverse cardiovascular events (MACE) and serious adverse events (SAEs). Secondary endpoints included all-cause death, measures of ischemia (cardiovascular death, myocardial infarction [MI], any revascularization, stroke) and measures of safety (serious infections or sepsis and gastrointestinal adverse events). All analyses included an interaction term for the clinical presentation. Sensitivity analyses were performed to explore sources of heterogeneity. After literature search, 20 trials encompassing a total of 21,486 patients (65.4% ACS) were included. Colchicine significantly reduced MACE (incidence rate ratio [IRR]: 0.70; 95% CI 0.55-0.87) without increasing risk for SAEs. Colchicine also reduced MI (IRR 0.81; 95% CI 0.70-0.94) and any revascularization (IRR 0.71; 95% CI 0.51-0.99), while increasing the risk of gastrointestinal adverse events (IRR 1.68; 95% CI 1.23-2.28). No statistically significant interaction was noted for clinical presentation for any endpoint, but a significant interaction for the drug dosage administered and the relationship with the COVID-19 pandemic was noted. In conclusion, the use of colchicine in patients with CAD reduces MACE without significantly increasing SAEs compared to control, although increasing gastrointestinal adverse events, without interaction by clinical presentation.},
}

Humans
*Colchicine/adverse effects/therapeutic use
Randomized Controlled Trials as Topic
*Coronary Artery Disease/drug therapy/mortality/diagnosis
Treatment Outcome

@article {pmid41761197,
year = {2026},
author = {Yu, E and Wang, M and Berdugo, J and Towheed, S and Yang, J and Moosavi, I and Lalji-Mawji, S and Czapla, CS and Ostermeyer, BK and Olagunju, AT},
title = {Mental health issues and associated factors amongst healthcare workers in US forensic-correctional settings: a systematic review of literature since the COVID-19 pandemic.},
journal = {BMC health services research},
volume = {26},
number = {1},
pages = {},
pmid = {41761197},
issn = {1472-6963},
mesh = {Humans ; *COVID-19/epidemiology/psychology ; United States/epidemiology ; *Health Personnel/psychology ; *Mental Health ; Risk Factors ; *Mental Disorders/epidemiology ; SARS-CoV-2 ; Frontline Workers ; Working Conditions ; Pandemics ; *Prisons ; Female ; },
abstract = {BACKGROUND: Healthcare professionals provide essential services to populations in the criminal justice system, often at the expense of their own well-being. This review synthesized literature findings on mental health challenges faced by healthcare professionals working in the US forensic-correctional settings since the COVID-19 pandemic. We investigated the prevalence of mental health conditions, their risk-protective factors, the impacts of these mental health issues on workplace retention, and highlighted relevant recommendations.

METHODS: This study followed PRISMA guidelines. A comprehensive search of major databases (PubMed/MEDLINE, PsycINFO, Web of Science, CINAHL, and Embase) was conducted and supplemented with citation chaining to identify eligible reports spanning January 1st 2020 up to March 18th, 2025. Article screening, full-text review, and data extraction were completed by two independent investigators. Study quality was assessed using the NIH tool for quantitative studies and the Critical Appraisal Skills Program (CASP) framework for qualitative studies.

RESULTS: A total of 10,005 identified reports were screened, with seven fair-to-good eligible studies included in the final review. Both quantitative (n = 4) and qualitative (n = 3) studies were included, and spanned multiple states, with most studies (n = 3, 42.9%) conducted in California. Healthcare workers reported various mental health conditions such as depression (48%), anxiety (18.8-51.1%), sleep disorders (17.4%), burnout (47.2%) and PTSD (49.3%), albeit significant heterogeneity constrains comparative analysis. Qualitatively, workers experienced considerable isolation, personality shifts, and cognitive dissonance. Risk factors predictive of mental health conditions included increased workload (β = 0.18, p < 0.001), workplace conflict (β = 0.15, p < 0.001), female sex (β = 0.10, p = 0.04), younger age, chronic medical conditions (β = 0.09, p = 0.03), fears around COVID-19 (β = 0.14, p < 0.001), and a lack of pandemic safety training (p = 0.033). Protective factors included resilience, administrator and peer support, access to needed resources, and a sense of fulfilment and purpose from working with populations in forensic-correctional settings.

CONCLUSIONS: Systemic reforms including decreased mandatory overtime, staffing, workload distribution, organizational support, training, improved communication, access to adequate resources and psychosocial interventions may help promote wellness and optimize the ability of healthcare workers to provide care in forensic-correctional settings. However, the preliminary nature of the study findings suggests caution in their interpretations. Further high-quality research is needed to support evidence-informed decision-making and translation.},
}

Humans
*COVID-19/epidemiology/psychology
United States/epidemiology
*Health Personnel/psychology
*Mental Health
Risk Factors
*Mental Disorders/epidemiology
SARS-CoV-2
Frontline Workers
Working Conditions
Pandemics
*Prisons
Female

@article {pmid41761653,
year = {2026},
author = {Gavor, E and Choong, YK and Singh, S and Sivaraman, H and Yin, ES and Sivaraman, J},
title = {Structural Basis of MERS-CoV Receptor Interactions and Antibody Neutralisations.},
journal = {Reviews in medical virology},
volume = {36},
number = {2},
pages = {e70113},
pmid = {41761653},
issn = {1099-1654},
support = {//J.S. acknowledges partial support from Ministry of Education, Singapore grants R154-000-A72114, R-154-000-B03-112, and R-154-000-697-112./ ; },
mesh = {*Middle East Respiratory Syndrome Coronavirus/immunology/genetics/chemistry ; Humans ; *Antibodies, Neutralizing/immunology ; *Antibodies, Viral/immunology ; *Coronavirus Infections/virology/immunology/prevention & control ; Animals ; *Receptors, Virus/chemistry/metabolism/immunology ; *Spike Glycoprotein, Coronavirus/immunology/chemistry/genetics/metabolism ; },
abstract = {Increasing outbreaks of coronaviruses underscore the importance of antivirals and vaccines that can combat a wide range of coronaviruses. Neutralising antibodies (nAbs), along with vaccines and small-molecule drugs, are among the most promising treatments and prevention options against coronaviruses. Here, we focus on Middle East Respiratory Syndrome coronavirus (MERS-CoV) and discuss receptor usage and current progress in antibody research against MERS-CoV infections. First detected in Saudi Arabia and Jordan in 2012, MERS-CoV is a lethal zoonotic pathogen. MERS-CoV infections have been reported by 27 countries between April 2012 till now, with 953 deaths (∼35% mortality) (5 new infections and 4 fatalities reported as of 1 October 2024). WHO identified MERS-CoV as a high-threat pathogen due to its severity, high mortality rate, and potential for epidemic or pandemic spread with recent outbreaks and deaths raising more concerns amidst the COVID-19 pandemic. As of now, there is no antiviral drugs or vaccine against MERS-CoV available. Here we provide a perspective on receptor usage, the risk of MERS-CoV and other CoVs evolution on future pandemics, and the mechanisms of MERS-CoV-derived nAbs. We offer insight into how these antibodies cross-react and cross-neutralise by analysing available structures of spike glycoprotein-antibody complexes. This review provides an update and a basis for the development of antibodies and vaccines for MERS-CoV, and possibly for the designing of next-generation pan-coronavirus vaccines and antivirals.},
}

*Middle East Respiratory Syndrome Coronavirus/immunology/genetics/chemistry
Humans
*Antibodies, Neutralizing/immunology
*Antibodies, Viral/immunology
*Coronavirus Infections/virology/immunology/prevention & control
Animals
*Receptors, Virus/chemistry/metabolism/immunology
*Spike Glycoprotein, Coronavirus/immunology/chemistry/genetics/metabolism

@article {pmid41761906,
year = {2026},
author = {Morand-Grondin, D and Berthod, J and Sigouin, J and Beaulieu-Bonneau, S and Kairy, D},
title = {Paving the road for more ethical and equitable policies and practices in telerehabilitation in psychology and neuropsychology: A rapid review.},
journal = {Health informatics journal},
volume = {32},
number = {1},
pages = {14604582261431026},
doi = {10.1177/14604582261431026},
pmid = {41761906},
issn = {1741-2811},
mesh = {Humans ; *Neuropsychology/methods/ethics ; *Telerehabilitation/ethics ; COVID-19/epidemiology ; Telemedicine/ethics ; *Psychology ; SARS-CoV-2 ; Canada ; },
abstract = {BackgroundTelerehabilitation (TR) has been increasingly used to deliver psychological and neuropsychological care remotely, especially since the COVID-19 pandemic. As health services continue to shift toward telehealth, ensuring ethical and equitable TR delivery is essential to establish sustainable TR models.ObjectiveThe objective of this review is to synthesize existing evidence on the ethical and equity-related benefits and pitfalls associated with the use of TR in a psychological and neuropsychological context for individuals with physical disabilities.MethodsThis rapid review included reviews (2010-2020) and original studies (2020-2023) that focused on TR interventions for people with physical disabilities in the context of psychology and neuropsychology rehabilitation.ResultsA total of 16 reviews and 82 original articles were included. Key ethical concerns centered around privacy, confidentiality, caregiver burden, and clinician-patient relationship quality. Equity concerns centered around access disparities (e.g., geographic location, income), digital literacy, and demographic underrepresentation.ConclusionThis review is part of a pan-Canadian initiative aimed at informing policy development and clinical practice in TR. Findings highlight the need for clear guidelines and targeted interventions to ensure that TR in psychology and neuropsychology is both ethically sound and equitable.},
}

Humans
*Neuropsychology/methods/ethics
*Telerehabilitation/ethics
COVID-19/epidemiology
Telemedicine/ethics
*Psychology
SARS-CoV-2
Canada

@article {pmid41762078,
year = {2026},
author = {Wimalasundera, MO and Mohammad, ZMW and Choudhury, S and Mandour, Y},
title = {Understanding E-Consent in Anaesthesia: A Review of Clinical, Legal, and Ethical Dimensions.},
journal = {British journal of hospital medicine (London, England : 2005)},
volume = {87},
number = {2},
pages = {50953},
doi = {10.31083/BJHM50953},
pmid = {41762078},
issn = {1759-7390},
mesh = {Humans ; *Informed Consent/legislation & jurisprudence/ethics ; *COVID-19/epidemiology ; *Anesthesia ; *Anesthesiology/legislation & jurisprudence/ethics ; SARS-CoV-2 ; },
abstract = {The integration of electronic consent (e-consent) into anaesthetic practice has accelerated since the Coronavirus Disease 2019 (COVID-19) pandemic, offering new opportunities to enhance patient autonomy, documentation fidelity, and clinical efficiency. This review examines the clinical, legal, and ethical dimensions of e-consent, situating it within the statutory and common law frameworks, such as the Mental Capacity Act 2005 and the principles established in Montgomery v Lanarkshire Health Board. It further interrogates the challenges posed by digital exclusion, cybersecurity vulnerabilities, and the environmental implications of transitioning to digital platforms. The emerging role of artificial intelligence in tailoring and strengthening consent processes is explored, while highlighting the imperative to preserve ethical integrity and legal validity.},
}

Humans
*Informed Consent/legislation & jurisprudence/ethics
*COVID-19/epidemiology
*Anesthesia
*Anesthesiology/legislation & jurisprudence/ethics
SARS-CoV-2

@article {pmid41762443,
year = {2026},
author = {Balakrishnar, K and Long, BS and Lo, J and Fiorini, LA and Gohar, B and Nowrouzi-Kia, B},
title = {Assessing the antecedents behind after-hours work in teleworkers: a scoping review.},
journal = {Journal of public health (Oxford, England)},
volume = {48},
number = {2},
pages = {582-593},
pmid = {41762443},
issn = {1741-3850},
mesh = {Humans ; *Teleworking/statistics & numerical data ; *COVID-19/epidemiology ; Working Conditions ; Work Schedule Tolerance ; },
abstract = {BACKGROUND: Since the start of the COVID-19 pandemic, telework arrangements have become increasingly prevalent, driven by benefits such as greater autonomy, reduced work-related stress, decreased commuting time and cost, and enhanced flexibility. Despite these advantages, teleworkers are more likely to engage in after-hours work, creating additional strain that may impact health and organizational outcomes.

METHODS: A systematic search was conducted across seven online databases: Medline via OVID, Embase via OVID, APA PsycINFO via OVID, International Bibliography of Social Sciences via ProQuest, Sociological Abstracts via ProQuest, Business Source Premier via EBSCOhost, and CINAHL via EBSCOhost. Studies were included if they were empirical, peer-reviewed, published between 2010 and 2024, examined the antecedents of after-hours work, and focused on adults aged 18 to 65 engaged in telework. Descriptive thematic analysis was conducted to develop themes and sub-themes.

RESULTS: Findings: A total of 17 studies were included in the review: 13 cross-sectional studies, three qualitative studies, and one longitudinal study. Using the Person-Environment-Occupation framework, three overarching themes were identified: (i) misalignment between personal capacities and occupational demands; (ii) environmental constraints that undermine healthy role balance; and (iii) occupational role strain in the context of remote work.

CONCLUSIONS: These findings may help to inform the development of targeted interventions that reduce cases of after-hours work among teleworkers and promote their overall health and well-being. Future research should examine these antecedents in non-Western contexts and explore the interplay between the individual, environmental, and occupational factors shaping after-hours work behaviors.},
}

Humans
*Teleworking/statistics & numerical data
*COVID-19/epidemiology
Working Conditions
Work Schedule Tolerance

@article {pmid41762542,
year = {2026},
author = {Sagués, T and Ferrer, A and Delgado, JF and Julià, G and Rodríguez-González, R and Ruiz, À and Estrada, F and Soria, V and Palao, DJ and Labad, J and Montalvo, I},
title = {Clozapine use and COVID-19 risk: A systematic review, meta-analysis, and retrospective cohort evidence.},
journal = {Psychiatry research},
volume = {359},
number = {},
pages = {117040},
doi = {10.1016/j.psychres.2026.117040},
pmid = {41762542},
issn = {1872-7123},
mesh = {Humans ; *Clozapine/adverse effects/therapeutic use ; *Antipsychotic Agents/adverse effects/therapeutic use ; *COVID-19/epidemiology ; Retrospective Studies ; *Schizophrenia, Treatment-Resistant/drug therapy ; Severity of Illness Index ; },
abstract = {BACKGROUND: Clozapine's immune-modulating effects, including neutropenia and suppression of adaptive immunity, have raised concerns about its potential impact on SARS-CoV-2 infection risk and COVID-19 severity in individuals with treatment-resistant schizophrenia. Findings in the literature remain inconsistent.

METHODS: First, we conducted a longitudinal retrospective study in which we analysed 995 outpatients with severe mental disorders receiving antipsychotic treatment to assess the association between clozapine use and SARS-CoV-2 infection and disease severity. Secondly, we performed a systematic review of the literature and searched for studies published up to July 2025 examining the link between clozapine exposure and SARS-CoV-2 infection. Eight cohort studies plus our dataset were meta-analysed using a random-effects model.

RESULTS: In our cohort, clozapine users demonstrated a higher rate of SARS-CoV-2 infection (18% vs. 10%, p < 0.001) and increased COVID-19 severity compared to non-users. The meta-analysis comprised 155,945 participants, with individual study ORs ranging from 0.40 to 2.80. The pooled random-effects OR was 1.53 (95% CI: 1.02-2.30, p = 0.044), indicating a significant association between clozapine exposure and increased infection risk. However, high heterogeneity (I² = 91.2%) suggests variation in effects across studies.

CONCLUSIONS: Clozapine treatment is associated with an increased risk and severity of SARS-CoV-2 infection. Although meta-analytic results support this association, substantial heterogeneity in pooled estimates highlights the need for further research to clarify underlying clinical and methodological factors influencing risk.},
}

Humans
*Clozapine/adverse effects/therapeutic use
*Antipsychotic Agents/adverse effects/therapeutic use
*COVID-19/epidemiology
Retrospective Studies
*Schizophrenia, Treatment-Resistant/drug therapy
Severity of Illness Index

@article {pmid41763558,
year = {2026},
author = {Li, M and Sharma, K and Chon, JE and Yehia, NA and Retnakaran, R and Harris, SB and Hanley, AJ},
title = {The impact of COVID-19 illness on metabolic phenotypes underlying type 2 diabetes mellitus: a systematic review.},
journal = {Diabetes research and clinical practice},
volume = {235},
number = {},
pages = {113163},
doi = {10.1016/j.diabres.2026.113163},
pmid = {41763558},
issn = {1872-8227},
mesh = {Humans ; *Diabetes Mellitus, Type 2/metabolism/complications/epidemiology ; *COVID-19/metabolism/complications/epidemiology ; *Insulin Resistance/physiology ; *Insulin-Secreting Cells/metabolism ; SARS-CoV-2 ; Phenotype ; },
abstract = {We aimed to systematically review literature investigating the impact of COVID-19 on insulin resistance and beta-cell dysfunction in humans. Ovid MEDLINE and Embase were searched for studies published between December 2019 and May 2024. Observational studies examining adults with no history of type 2 diabetes comparing the development of insulin resistance and beta-cell dysfunction between COVID-19 exposed groups vs. controls were included. Risk of bias was assessed using adapted Newcastle-Ottawa and Joanna Briggs Institute scales. Among 6901 studies screened, 10 met the inclusion criteria. Across these studies, 37 individual measures of insulin resistance and beta-cell dysfunction were reported. Insulin resistance worsened significantly in 16 of 25 (64.0%) comparisons, whereas beta-cell dysfunction worsened significantly in 7 of 12 (58.3%) measures among COVID-19 patients when compared to controls. Five studies were considered low risk of bias. COVID-19 was associated with worsened insulin resistance and beta-cell dysfunction, suggesting infection may be a metabolic stressor that overwhelms gluco-regulatory mechanisms. Results, especially those for beta-cell function, should be interpreted cautiously given methodological limitations in the utilized measures. These findings highlight the pathophysiological aspects of type-2 diabetes impacted by COVID-19 infection and support the development of targeted monitoring and therapeutic strategies.},
}

Humans
*Diabetes Mellitus, Type 2/metabolism/complications/epidemiology
*COVID-19/metabolism/complications/epidemiology
*Insulin Resistance/physiology
*Insulin-Secreting Cells/metabolism
SARS-CoV-2
Phenotype

@article {pmid41764591,
year = {2026},
author = {Çivilidağ, A and Durmaz, Ş},
title = {The relationship of flexible working arrangements on work-family conflict, work-life balance and organizational commitment: a systematic review and meta-analysis.},
journal = {BMC psychology},
volume = {14},
number = {1},
pages = {},
pmid = {41764591},
issn = {2050-7283},
abstract = {BACKGROUND: Technological advances and the COVID–19 pandemic have fundamentally reshaped the global work landscape, establishing flexible work arrangements (FWAs)—such as schedule flexibility and remote work—as a permanent feature of contemporary employment. This shift necessitates a rigorous quantitative synthesis of how FWAs relate to critical employee and organizational outcomes. This study examines the associations between FWAs and work–life balance (WLB), work–family conflict (WFC), and organizational commitment (OC).

METHODS: A systematic review and meta–analysis was conducted across five electronic databases. Initially, 3,777 records were identified. Following the application of strict inclusion and quality criteria, 38 studies from 19 countries (N = 83,951) were selected for analysis. Data were synthesized using the Comprehensive Meta–Analysis (CMA 3.0) software, employing a random–effects model to calculate pooled effect sizes.

RESULTS: The findings revealed significant and relatively large positive correlations between FWAs and WLB (r = .39, p < .001) and between FWAs and OC (r = .29, p < .001). Conversely, while the correlation between FWAs and WFC was positive (r= .25), it was statistically non–significant (p > .05). Meta–regression identified between countries the level of economic development as a significant moderator (p < .001), with the positive relationship of flexibility being significantly more pronounced in developed countries compared to developing nations.

CONCLUSION: This meta–analysis provides robust evidence that FWAs are an effective strategic tool for enhancing WLB and substantially strengthening OC. However, their impact on reducing WFC remains less conclusive and is highly context–sensitive. Organizations are encouraged to formally adopt and support FWAs to improve employee well–being and foster loyalty, while remaining mindful of the macro–level institutional frameworks that shape flexibility outcomes.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40359-026-04216-y.},
}

@article {pmid41765322,
year = {2026},
author = {Yezli, S and Bonanni, P and Dinleyici, EC and Divyesh, T and Kumar, V and Leng, S and Coste, F and Taha, MK},
title = {Invasive meningococcal disease rebound in older adults post-COVID-19 pandemic: A targeted literature and surveillance review.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {166},
number = {},
pages = {108502},
doi = {10.1016/j.ijid.2026.108502},
pmid = {41765322},
issn = {1878-3511},
mesh = {Humans ; *COVID-19/epidemiology ; Aged ; *Meningococcal Infections/epidemiology/mortality ; Incidence ; Neisseria meningitidis/classification ; Aged, 80 and over ; SARS-CoV-2 ; Pandemics ; },
abstract = {OBJECTIVES: Invasive meningococcal disease (IMD), caused by Neisseria meningitidis, remains a significant public health concern due to its rapid progression, high case fatality rate (CFR), and evolving epidemiology. Recent trends suggest a demographic shift toward older adults. This review examined post-COVID-19 changes in IMD epidemiology among adults aged ≥65 years, including regional variations, serogroup distribution, and mortality.

METHODS: A targeted literature review was conducted using OVID (Embase, MEDLINE) following PICOS-T criteria, including full-text English-language studies published between January 2021 and June 2024, supplemented by surveillance reports.

RESULTS: Of 1639 records screened, four peer-reviewed publications and ten surveillance reports met inclusion criteria. During the COVID-19 pandemic, IMD incidence declined sharply across all age groups, including older adults. Post-pandemic data indicate a re-emergence of IMD among older populations, with incidence in several regions returning to or exceeding pre-pandemic levels by 2023. Across multiple locations, serogroup Y emerged as the dominant or increasingly prevalent serogroup among older adults. CFR varied by region and serogroup and consistently remained high in this age group.

CONCLUSION: These findings demonstrate the re-emergence of IMD among older adults and highlight the need for strengthened IMD surveillance and serogroup monitoring in this population, to guide prevention strategies and inform public health policy.},
}

Humans
*COVID-19/epidemiology
Aged
*Meningococcal Infections/epidemiology/mortality
Incidence
Neisseria meningitidis/classification
Aged, 80 and over
SARS-CoV-2
Pandemics