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Bibliography on: covid-19

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ESP: PubMed Auto Bibliography 14 Jul 2026 at 07:41 Created: 

covid-19

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

NOTE: To obtain the entire bibliography (all 62014 citations) in bibtek format (a format that can be easily loaded into many different reference-manager software programs, click HERE.

Created with PubMed® Query: ( SARS-CoV-2 OR COVID-19 OR (wuhan AND coronavirus) AND review[SB] )NOT 40982904[pmid] NOT 40982965[pmid] NOT 35908569[pmid] NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)

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RevDate: 2026-07-11
CmpDate: 2026-07-11

Slama Schwok A (2026)

[Post-COVID neurological sequelae, proposed mechanisms and therapeutic approaches].

Medecine sciences : M/S, 42(3):280-289.

Approximately 5 % of patients suffer from the sequelae of the COVID-19 pandemics, representing a considerable number of individuals, often young or middle-aged working adults (18-50 years). Among them, women are disproportionately affected. The most common neurological symptoms include persistent cognitive impairment, known as "brain fog", chronic fatigue syndrome, inflammation of the nervous system (motor or autonomous), anxiety and depression, all of which significantly reduce patients' quality of life. There is therefore an urgent societal need to identify appropriate treatments based on a clear understanding of the underlying pathological mechanisms. This review describes the state of the art in Long neuro-COVID, with an emphasis on neuroinflammation, alteration of neurotransmission, and immune, endothelial and microvascular dysfunctions.

RevDate: 2026-07-11
CmpDate: 2026-07-11

Cracowski JL, Molimard M, Richard V, et al (2026)

[Assessing the risk-benefit balance of medicines: Some lessons from Covid-19].

Medecine sciences : M/S, 42(3):295-305.

The efficacy of medications is evaluated by clinical trials. However, such trials are not designed to assess adverse effects, particularly when those are rare. A robust pharmacovigilance system is therefore required to assess risks, supplemented as requested by pharmacoepidemiology studies. The benefits of medications are expressed in either relative or absolute terms and they vary depending on the baseline risk of the disease (its severity, potential complications, progression, and its incidence for the population-level benefits). This is not the case for adverse effects, which are influenced by the drug characteristics and the population receiving the treatment. In this context, can we truly balance the benefits and risks of medications? The experience of Covid-19 illustrates the complexity of this concept. It clearly highlights the need for a comprehensive approach, integrating analysis of clinical trials, pharmacovigilance monitoring, pharmacoepidemiology studies, and the detection of potential drug interactions. Finally, it is essential to inform and educate the general public about medications. This empowers individuals to accurately understand the complex concept of benefit-risk balance, prevents misleading over simplifications, and helps effectively counter misinformation.

RevDate: 2026-07-11
CmpDate: 2026-07-11

Kortz TB, Hidalgo JL, Akech SO, et al (2026)

10 Steps to Improve Sepsis Care in Low-Resource Settings.

Critical care medicine, 54(4):939-949.

OBJECTIVES: To develop a practical consensus-based framework for 10 steps to improve sepsis care in low-resource settings (LRSs), aligned with the sepsis chain of survival and informed by global expertise.

DATA SOURCES: We reviewed peer-reviewed literature on sepsis epidemiology, prevention, recognition, and management in LRS; international guidelines, including the Surviving Sepsis Campaign; and prior "10-step" consensus frameworks for resuscitation and emergency care.

STUDY SELECTION: A Task Force representing adult and pediatric sepsis care, emergency care, critical care, infectious diseases, public health, and implementation science identified key domains from the above data sources.

DATA EXTRACTION: With guidance from methodologists and implementation science experts, we utilized an iterative, consensus-based process-literature review, Delphi survey, Utstein-style conference, stakeholder input, and public comment-to first define and then refine steps and implementation strategies.

DATA SYNTHESIS: The process resulted in 10 nonsequential, actionable steps covering governance and commodities, provider and caregiver education, community and facility prevention, early recognition and rapid response, timely guideline-based interventions, structured post-sepsis care, data systems, quality improvement, a culture of excellence and respect, and holistic well-being of patients, caregivers, and providers. Each step includes a rationale and potential implementation strategies adaptable to local resources and needs. Collectively, the ten steps emphasize integration across the continuum of care, equitable access to essential interventions, and the role of emerging technologies to prevent, recognize, monitor, and follow-up sepsis.

CONCLUSIONS: The 10 steps provide a consensus-driven roadmap for health leaders, clinicians, and policymakers to improve sepsis care, strengthen the sepsis chain of survival, reduce preventable morbidity and mortality, and address global inequities in sepsis outcomes.

RevDate: 2026-07-11
CmpDate: 2026-07-11

Myatra SN, Boyer KM, Hidalgo JL, et al (2026)

Gaps and Strategies for Management of Sepsis in Low-Resource Settings: Expert Consensus Statements Using a Delphi Method.

Critical care medicine, 54(5):1209-1224.

OBJECTIVES: Almost 80% of sepsis cases occur in low-resource settings (LRS), where limited resources impede the effective implementation of international guidelines for sepsis management. In addition, existing sepsis guidelines have not fully addressed specific issues relevant to LRS. Therefore, an international panel of 20 multiprofessional sepsis experts was convened to generate consensus on the gaps in and strategies for sepsis care in LRS. The recently developed "sepsis chain of survival" was used as a framework.

DATA SOURCES: MEDLINE, Embase.

STUDY SELECTION: Studies selected included human studies (clinical trials, cohort, case-control, and case series) reporting clinical outcomes in patients with sepsis from LRS between January 1, 2000, and July 4, 2024. Search terms included "developing countries," "LMIC," "resource-poor settings," and regional terms such as Africa, Southeast Asia, and Latin America. The Delphi process involved iterative, anonymous voting by the expert panel to achieve consensus to draft clinical practice statements.

DATA EXTRACTION: A detailed literature review was conducted using the "sepsis chain of survival" as a basis, with an emphasis on sepsis prevention, detection, therapy, post-sepsis care, education, and future research priorities. A total of 8865 studies were identified and screened, with 155 included in the review.

DATA SYNTHESIS: Based on literature review, the Delphi process achieved a stable consensus for 58 of 62 (94%) of the proposed clinical practice statements after eight survey rounds. These statements offer guidance on measures to improve the prevention, early recognition and time-sensitive, comprehensive management of sepsis in LRS through the continuum of care from first response to post-sepsis care and follow-up.

CONCLUSIONS: There remains a significant lack of high-quality evidence to support improvements in sepsis care for patients in LRS. Pending new data, the clinical practice statements identified here complement the existing international guidelines for sepsis management by serving as a basis for immediate care and future research in LRS.

RevDate: 2026-07-11
CmpDate: 2026-07-11

Hidalgo JL, Akech SO, Acharya SP, et al (2026)

The Frame of Survival for Sepsis: A Practical Systems Framework for Time-Sensitive Critical Illness in Low-Resource Settings.

Critical care medicine, 54(5):1202-1208.

OBJECTIVES: Sepsis is a time-sensitive cause of preventable death worldwide, with disproportionate mortality in low-resource settings (LRS). Many recommendations in international sepsis guidance presume resources unavailable in many facilities and communities. We sought to develop a practical framework that helps health systems embed feasible sepsis actions within broader emergency and essential critical care systems, while highlighting where evidence is limited and where local learning systems are needed.

DATA SOURCES: A targeted scoping review of peer-reviewed and grey literature on sepsis epidemiology, emergency care systems, essential emergency and critical care, implementation strategies, and quality improvement (QI) in LRS; and key guideline and policy documents relevant to sepsis and emergency care.

STUDY SELECTION: We prioritized publications and guidance relevant to LRS, including observational studies, pragmatic implementation reports, consensus statements, and policies addressing emergency care organization, workforce, supply chains, diagnostics, and QI.

DATA EXTRACTION: Task force members abstracted actionable strategies, implementation barriers/enablers, and feasibility considerations across the care continuum (community, transport/prehospital, facility-based acute care, and referral). We also identified domains where guideline certainty is low or indirect for LRS.

DATA SYNTHESIS: A Society of Critical Care Medicine-convened multidisciplinary task force iteratively developed the "Sepsis Frame of Survival" using a structured process that included 1) scoping evidence review, 2) a Delphi-style prioritization of candidate framework elements by importance and feasibility, and 3) a structured consensus meeting ("Utstein-style" conference format) to finalize the model and its priority actions. We produced a concise implementation roadmap and a feasible measurement set aligned with resource constraints.

CONCLUSIONS: The Sepsis Frame of Survival is a pragmatic model to organize sepsis improvement as part of emergency and essential critical care strengthening. It emphasizes high-impact actions that can be implemented with limited resources (triage and early recognition, timely antimicrobials, oxygen and basic supportive care, cautious fluid resuscitation with reassessment, source control and referral, diagnostics/microbiology where feasible, and QI). The framework explicitly distinguishes near-term, feasible changes from longer-term system investments and highlights the need for locally generated evidence to guide quality indicators and resuscitation strategies in LRS.

RevDate: 2026-07-07
CmpDate: 2026-06-23

Madhugiri R, Slanina H, Saleem-Batcha R, et al (2026)

The Coronavirus Replication-Transcription Complex.

Annual review of biochemistry, 95(1):317-346.

Coronaviruses (family Coronaviridae, order Nidovirales) include major human and animal pathogens. They have exceptionally large RNA genomes and use complex strategies to replicate and express these genomes. Intensive research activities in recent years have significantly advanced our knowledge of the molecular mechanisms involved in coronavirus RNA synthesis. Here, we briefly review these mechanisms and focus in particular on the structures and functions of the core replication-transcription complex (RTC) and other enzyme functions that can be recruited to this complex to fulfil additional functions, for example, in the context of 5' capping of viral mRNAs or in the context of mechanisms that control the processivity, replication fidelity, and backtracking of RTCs. Some of these recent studies provided fundamentally new insight into specific roles of previously identified genetic markers of coronaviruses and other nidoviruses, including specific functions in an unconventional RNA capping mechanism and potential roles in proofreading and discontinuous negative-strand RNA synthesis.

RevDate: 2026-07-11
CmpDate: 2026-07-11

Cordeiro J, Macela C, Kleiner R, et al (2026)

Harnessing the power of microbiome, nanotechnology, and immunity against cancer.

Journal of controlled release : official journal of the Controlled Release Society, 394:114839.

The human microbiome has emerged as a key player in health and disease, including cancer, which remains one of the leading causes of mortality worldwide. Although advances in understanding the tumor immune microenvironment and the development of immunotherapies have transformed cancer treatment, clinical efficacy remains limited by suboptimal response rates and severe side effects. Recent integrative research in cancer biology, immune-oncology, and cancer microbiome research, enabled by omics technologies and advanced bioinformatics, has begun to reveal intricate links between the microbiome, cancer progression, and immune modulation. These findings underscore the microbiome's pivotal role in shaping both therapeutic efficacy and resistance mechanisms. Currently, nanotechnology, propelled into mainstream success through the development of COVID-19 mRNA vaccines, is offering new tools for precision oncology. Nanomaterials are now being explored not only for targeted drug delivery but also for monitoring and modulating the microbiome, with significant potential for biomarker discovery and personalized medicine. In this article, we explore the role of the microbiota in tumorigenesis and cancer therapy, with a particular focus on its crosstalk with the immune system. We highlight emerging microbiota-targeted therapeutic strategies and discuss how nanotechnology-based systems are being designed to modulate the microbiome-immune-cancer axis. Finally, we discuss future directions in leveraging the convergence of microbiome science, nanotechnology, and immunotherapy to advance cancer treatment.

RevDate: 2026-07-11
CmpDate: 2026-07-11

Khalid K, Abdullah ADI, Lim HX, et al (2026)

Pharmacological and non-pharmacological management of long COVID.

Virology journal, 23(1):.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a major global health burden in terms of acute infection and long-term consequences. Approximately 10% of infected experience autonomic dysfunction, cardiovascular complications, and neurological impairments. While immune dysregulation, persistent viral reservoirs, chronic inflammation, gut dysbiosis, and vascular dysfunction are implicated, the exact pathophysiological mechanisms of Long COVID remain unclear. Additionally, treatment options are limited and challenging to prescribe due to symptom heterogeneity. Non-pharmacological interventions such as increased salt intake, elimination diets for gastrointestinal symptoms, and cognitive pacing for fatigue may not be sufficient for severe symptoms. Moreover, pharmacological interventions such as β-blockers, calcium channel blockers, pyridostigmine, antihistamines, and low-dose naltrexone can improve tachycardia, fatigue, and brain fog but there are no standardized guidelines. In light of evidence supporting a strong association of Long COVID with gut dysbiosis, probiotics have emerged as a promising intervention. Clinical studies have shown that Bacillus coagulans, Bacillus subtilis, Lactobacillus acidophilus, and Bifidobacterium species can improve fatigue, gastrointestinal health, and overall physical and mental well-being in Long COVID patients. Large-scale randomized controlled trials are warranted to validate probiotic efficacy in Long COVID and reduce burden on individual health and healthcare institutions.

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

Luo S, Zheng Z, Karimi L, et al (2026)

Between silence and solutions: a global guideline review of long COVID care and services in Australia.

BMC health services research, 26(1):.

BACKGROUND: As the acute response to the COVID-19 pandemic shifts to long-term management, the lasting effects of infection are becoming increasingly evident. Long COVID continues to challenge healthcare systems, with many healthcare professionals reporting uncertainty about assessment and referral pathways. This updated review examines recent international guidelines alongside Australian services to identify gaps between guidelines and practice. METHODS: Between April and October 2025, we searched for guidelines on Long COVID published in English and assessed their quality by applying the AGREE II appraisal tool. We also conducted a grey literature search to profile active Australian services providing Long COVID care. RESULTS: Three new or updated guidelines were published in the United States, Canada, and New South Wales, Australia. Together with the World Health Organisation, United Kingdom and New Zealand guidelines identified in the previous review, all emphasise integrated, primary care-led approaches. Notably, Australian service delivery remains fragmented, with a growing number of primary health practitioner-led private services operating largely under a fee-for-service model, leading to variations in access and affordability. Many hospital-based outpatient clinics have been absorbed into existing chronic-disease services. The most fundamental challenge is statistical invisibility: without an activated diagnostic code, services cannot reliably identify or follow people living with Long COVID. This invisibility limits both surveillance and service planning. DISCUSSION AND CONCLUSIONS: Australia is currently developing national clinical best-practice guidelines for ME/CFS, which may also benefit Long COVID; however, Australia remains behind comparable nations such as Canada, the United Kingdom, and the United States in developing and implementing the integrated, multidisciplinary care models recommended internationally. This has significant implications, namely that the rapid transition from hospital-based Long COVID clinics to primary care-led services has resulted in fragmented and uncoordinated care. Strengthening Australia’s response will require national leadership and investment in workforce training, sustainable funding for care coordination, improved public and professional awareness, the establishment of primary care-led multidisciplinary pathways, and the activation of a dedicated diagnostic code. Also importantly, shifting to a patient-centred approach and patient-practitioner collaborative model of care is essential to prepare the health system for managing Long COVID and future complex, multi-system conditions.

RevDate: 2026-03-21

Mori Y, Silwal S, Wan Mohd Yunus WMA, et al (2026)

Long-Term Trends in Screen Time Use Among Children and Adolescents: A Systematic Review Including Pre- and Post-COVID Periods.

Clinical child psychology and psychiatry [Epub ahead of print].

The rapid rise in internet access and smartphone use has significantly changed how children and adolescents engage in screen-based activities. To date, no systematic review has examined long-term trends in screen time use among children and adolescents that cover periods before and after the onset of the COVID-19 pandemic. This systematic review examined repeated cross-sectional studies to determine whether screen time use among children and adolescents changed over time. This systematic review was registered with PROSPERO (ID: CRD42021243869). The Web of Science, PubMed, Embase, and PsycINFO databases were searched to identify peer-reviewed studies that had been published in English, included data from at least two time points, and focused on children and adolescents between 0 and 19 years of age. The search was conducted without any restrictions on publication year. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs. A narrative synthesis was conducted following the Synthesis Without Meta-analysis guidelines. This review identified 60 studies covering the period 1991-2022. The findings indicate that traditional TV watching declined while the use of computers and video games grew. Screen time increased significantly over the years, especially after the COVID-19 pandemic started. The studies reviewed varied in how they defined and measured screen time. The review underscores the importance of continued research and evidence-based policies to guide responsible technology use in the lives of young people.

RevDate: 2026-07-11
CmpDate: 2026-07-11

Barzoki MG, Farahmand M, Mahmodi MJ, et al (2026)

The Impact of SARS-CoV-2 on Male Infertility: A Systematic Review and Meta-Analysis of Cohort Studies.

Reviews in medical virology, 36(2):e70128.

Several conclusions have emerged regarding the impact of COVID-19 on the male reproductive system. This systematic review and meta-analysis aimed to provide a comprehensive update on the relationship between COVID-19 and male reproductive health. We investigated the effects of SARS-CoV-2 on various semen parameters, including semen volume, sperm concentration, sperm total count, total motility, progressive motility, morphology, and DNA fragmentation index (DFI). A literature review was conducted on all studies evaluating the impact of SARS-CoV-2 infection on male infertility from the beginning of 2019 through December 2023. Main electronic databases such as PubMed, Scopus, Cochrane Library, and Web of Science were used. The research question was based on the PECO framework, focusing on (Population) exposed to SARS-CoV-2 (Exposure), compared to uninfected men (Comparator), with conventional sperm parameters as the measured Outcome. The studies were divided into two groups for analysis: between-group comparisons, which compared sperm parameters of men recovered from COVID-19 to uninfected controls, and within-subject comparisons, which assessed sperm parameters in the same individuals before and after infection. Standardized mean differences (SMD) were calculated as effect sizes with 95% confidence intervals (CI) for each outcome. The DerSimonian-Laird method estimated between-study variance (τ[2]), while the Jackson method calculated confidence intervals for τ[2] and τ. Publication bias was assessed using funnel plots and Egger's test. This meta-analysis included two types of cohort studies: single-arm studies and those with a control group. In the single-arm studies, a statistically significant decrease in semen volume (p = 0.0023) was observed. Additionally, in the cohort studies with controls, there were statistically significant reductions in sperm concentration (p < 0.0001), total count (p = 0.0001), total motility (p = 0.0009), progressive sperm motility (0.0391), and DFI (0.04). This is the most up-to-date systematic review and meta-analysis incorporating cohort study data. The findings provide compelling evidence that SARS-CoV-2 infection adversely affects male reproductive health, particularly in terms of semen quality. The analysis reveals significant reductions in key semen parameters, including sperm count, concentration, total motility, and progressive motility. Adult maleand DFI.

RevDate: 2026-07-11
CmpDate: 2026-07-11

Rauf M, Naveed A, MU Asghar (2026)

Post-acute sequelae of COVID-19: A disorder of impaired innate immune resolution - A narrative review.

Clinical immunology (Orlando, Fla.), 285:110701.

Post-acute sequelae of COVID-19 (PASC) affect millions of people worldwide and are increasingly recognized as a disorder of failed innate immune resolution rather than a persistent viral infection. Emerging evidence shows that residual SARS-CoV-2 antigens, host-derived alarmins, reactivated latent viruses, and mucosal microbiome-derived products from oral-nasopharyngeal and gut reservoirs sustain the chronic activation of pattern-recognition receptors, inflammasomes, and complement pathways. In parallel, deficits in specialized pro-resolving mediators, impaired efferocytosis, and persistent tissue injury prevent physiological termination of inflammation. These unresolved cues drive long-lasting epigenetic and metabolic reprogramming of hematopoietic stem cells and myeloid lineages, creating maladaptive trained immunity states characterized by hyper-responsiveness or exhaustion of these cells. Thromboinflammatory processes, including aberrant NETosis and sustained interface signalingling, further reinforce self-perpetuating inflammatory circuits. Together, these pathways give rise to reproducible molecular endotypes, including thromboinflammatory, interferon-driven, and neuroinflammatory phenotypes, which explain clinical heterogeneity. Framing PASC as a disorder of impaired immune resolution within a mucosal microbial viral context provides a unifying mechanistic scaffold for biomarker identification and host-directed therapies. This review proposes that restoring active resolution programs, rebalancing metabolic-epigenetic networks, and dismantling pathogenic innate feedback loops are promising strategies for reversing the chronic immune imprint of PASC.

RevDate: 2026-06-04

Prichett LM, Young AS, Wu EG, et al (2026)

Uneven Recovery: Intersectional Disparities in Youth Mental Health After COVID-19.

Academic pediatrics, 26(4):103299.

RevDate: 2026-07-07
CmpDate: 2026-06-27

Liu HQ, Liu Y, Gu KN, et al (2026)

Meta-analysis of factors influencing depression in the elderly before and after the COVID-19 pandemic in 2023.

BMC geriatrics, 26(1):.

OBJECTIVE: This study aimed to explore and summarize the changes in depressive symptoms and their influencing factors among the elderly before and after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, so as to provide evidence-based references for the prevention and management of depression in the elderly. METHOD: By searching published in PubMed, EBSCOhost, Springer Link, Web of Science, Taylor and Francis databases, the literature on depression in older adults was collected using the 15-item Geriatric Depression Scale (GDS-15), Depression Scale (CDS-11) questionnaire and diagnostic interview (CDI-SF) as a tool. Among them, in the included literature, before January 2023 was identified as the pre-outbreak of the COVID-19 pandemic, and due to the differences in the time of full liberalization of countries, the beginning of 2023 to now was identified as the late outbreak of the COVID-19 pandemic, and Stata17 was used for meta-analysis. RESULTS: Thirteen pre-COVID-19 pandemic and seven post-COVID-19 pandemic literatures were included. A total of seven influencing factors were included. Before the COVID-19 pandemic: Before the COVID-19 pandemic, trends in potential risks for depression among older adults included: being female (OR = 1.464, 95% CI: 1.164~1.840,p < 0.001), being divorced or widowed (OR = 2.126, 95% CI: 1.170~3.862, P = 0.013), and having a chronic disease (OR = 1.174, 95% CI: 1.023~1.347, P = 0.022), age ≥ 70 years (OR = 1.336,95%CI: 0.850~2.102, P = 0.210), loneliness (OR = 2.450,95%CI: 2.445~2.455, P = < 0.001) and the junior middle school and the following qualifications (OR=1.145, 95% CI:0.873~1.501, p=0.327) were trends in potential risks for depression in older adults. Living alone (OR = 0.939, 95%CI: 0.417~2.116, P = 0.88), high school education or above (OR = 0.904,95%CI: 0.640~1.276, P = 0.564) were the lower risks. After the outbreak: being female (OR = 1.156, 95% CI: 0.675 ~ 1.980, P = 0.596), the junior middle school and the following qualifications (OR = 1.05, 95% CI: 0.964 ~ 1.143, P = 0.264), having a chronic disease (OR = 1.269, 95% CI: 1.003 ~ 1.605, P = 0.047), age ≥ 70 years (OR = 1.472, 95% CI: 0.861 ~ 2.517, P = 0.158), there is loneliness (OR = 2.913, 95% CI: 2.372 ~ 3.578, p < 0.001), live alone (OR = 1.627, 95% CI: 0.798 ~ 3.318, P = 0.180), high school education or above (OR = 1.053,95%CI:0.757 ~ 1.465, P = 0.757) were trends in potential risks for depression in older adults, divorce or widowed (OR = 0.482,95%CI:0.041 ~ 5.704, P = 0.563) were lower risks. CONCLUSIONS: The study found that the association patterns between depression in the elderly and five factors (divorced or widowed status, aged ≥ 70 years, loneliness, living alone, and high school education or above) exhibited distinct characteristics before and after the pandemic. Among these, loneliness and chronic diseases were consistently significant risk factors for depression in the elderly, and the strength of the association between loneliness and depression was further enhanced in the post-pandemic period. Notably, the significant association between female gender and depression observed in the pre-pandemic period no longer existed in the post-pandemic period. This change is speculated to be related to adjustments in the coverage of social support after the pandemic, which requires further verification in subsequent studies. Based on the above association characteristics, targeted intervention measures can be adopted in the post-pandemic period, such as striving to alleviate loneliness in the elderly, strengthening health monitoring for key groups including the elderly living alone and those aged ≥ 70 years, and promoting the organic integration of chronic disease management and psychological assessment, so as to effectively reduce the risk of depression in the elderly.

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

Tao S, Zhou Z, Li X, et al (2026)

Recent Advances of Non-Nucleoside Polymerase Inhibitors With Broad-Spectrum Antiviral Activities.

Medicinal research reviews, 46(4):945-965.

A tremendous and painful price has been paid in the fight against pandemic viruses in the global health field. Emerging and re-emerging viruses serve as primary drivers of severe pandemics, such as influenza virus (IV), respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Viral polymerases are highly conserved among viruses of the same genus. Inhibitors targeting polymerases often exhibit broad-spectrum antiviral activity against these same genus viruses, playing a crucial role in antiviral therapies. Non-nucleoside polymerase inhibitors demonstrate their superiority in terms of safety and anti-mutation ability out of nucleoside/nucleotide polymerase inhibitors. This review presents an overview of non-nucleoside polymerase inhibitors along with their relative antiviral activities and mechanisms of action, providing a reference for the development of novel antiviral drugs with broad-spectrum activities.

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

Valero-Gaspar T, Garriga C, Unim B, et al (2026)

Indirect impact of COVID-19 pandemic on health and wellbeing: a narrative review.

Annali dell'Istituto superiore di sanita, 62(1):53-66.

INTRODUCTION: The COVID-19 pandemic had a profound impact on global health, notably affecting patients with non-COVID-19 conditions, who faced substantial disruptions in their treatment and care. The aim of this narrative review was to identify the main indicators used in literature to evaluate the indirect impact of COVID-19 on health and wellbeing.

METHOD: A literature search was conducted using PubMed from January 2021 to November 2022. The indicators were categorized into five main groups: burden of disease (BoD), life expectancy (LE), health-related quality of life (HRQoL), cost of illness and mental health status and were retrieved from 20 scientific articles.

RESULTS: Disability-adjusted life years (DALYs) revealed substantial health losses; a decrease in LE was observed, with inequalities across population subgroups; HRQoL showed impairments in physical functioning, daily activities and emotional well-being; productivity losses were economically relevant and varied by context and elevated symptoms of anxiety and depression were reported.

DISCUSSION: The compiled indicators may contribute to the development of sustainable pandemic mitigation policies.

RevDate: 2026-03-23
CmpDate: 2026-03-23

Li H, Wang T, Xiang T, et al (2026)

Secondary fungal infections in severe acute viral diseases: clinical features and underlying immune mechanisms.

Frontiers in microbiology, 17:1780547.

Secondary fungal infections are increasingly recognized as critical factors in the prognosis of severe acute viral infections, including influenza, SARS-CoV-2, Severe Fever with Thrombocytopenia Syndrome virus, and Dengue. This review outlines the clinical features of fungal complications, proposing a "virus-driven immune reprogramming" framework. It highlights how viral infections disrupt immune barriers, impair the Th17-IL-17 antifungal axis, attenuate platelet immune function, and involve unique pathogen interactions, creating a host immune microenvironment that is more susceptible to fungal invasion. Understanding these immune-injury mechanisms underscores the clinical importance of earlier surveillance of secondary fungal disease and informs the development of mechanism-guided therapeutic approaches to improve patient outcomes.

RevDate: 2026-03-23
CmpDate: 2026-03-23

Bartley G, Waugh S, V Gopalan (2026)

Evaluating Study Techniques for Australian Medical Students During Clinical Placement: A Scoping Review.

Cureus, 18(2):e103802.

Transitioning from pre-clinical to clinical phases of medical education represents a unique challenge as students learn most content through self-directed learning (SDL), rather than the more prescriptive pre-clinical curriculum. There is a range of SDL study techniques employed by medical students on placement. The COVID-19 pandemic accelerated the adoption of digital resources, prompting a need to reassess the study techniques that best support clinical-year medical students. However, there is a lack of research on which study techniques Australian clinical-year medical students find most effective. The objective of this study is to evaluate the evidence on student-perceived utility of common study techniques for SDL whilst on clinical placement in Australia. A qualitative scoping review of literature on PubMed and Medline Ovid was performed in 2024. Study inclusion criteria for articles were published articles, English language, publication within 20 years, and focus on clinical-year medical students. Exclusion criteria were review articles, investigations focusing on a specific educational intervention, and studies including only pre-clinical students. Studies were qualitatively appraised and synthesised by tabulation in Microsoft Excel (Microsoft Corp., Redmond, WA, US). Risk of bias analysis was not performed. Nine studies from Australia, the USA, the UK, Thailand, Saudi Arabia, and Malaysia were analysed. This included seven cross-sectional, one mixed-methods, and one qualitative analysis. Sample size ranged from 12 to 350 students. Only two studies were conducted after the COVID-19 pandemic. Overall, the results of the included studies demonstrate a consistent trend towards third-party online tools, including question banks, mobile applications, and revision courses for SDL. The strength of evidence on students' perceived efficacy of study techniques in the post-pandemic era presented is limited due to the small number of included studies and the lack of formal study appraisal. There is also poor generalisability of pre-pandemic and international studies to the contemporary Australian context. As there is a lack of a standardised tool to evaluate study technique utility, comparison between studies is difficult. Ongoing research is required to develop evidence-based guidelines that can assist students in commencing SDL whilst on clinical placement.

RevDate: 2026-03-23
CmpDate: 2026-03-23

Singh H, Tripathi G, Khan AA, et al (2026)

Autophagy, telomerase, and endothelial dysfunction in COVID-19-induced cardiac injury: an evidence-graded genetic and epigenetic synthesis.

Frontiers in cardiovascular medicine, 13:1769828.

BACKGROUND: Cardiac injury is a frequent and severe complication of COVID-19, yet the molecular mechanisms driving myocardial involvement remain incompletely understood. Dysregulated autophagy, telomerase/telomere biology, and endothelial dysfunction have emerged as biologically plausible and potentially interconnected contributors to COVID-19-associated cardiac injury.

METHODS: We conducted a narrative, evidence-graded review of literature retrieved from PubMed and EMBASE, with Google Scholar used selectively as a supplementary source to capture emerging or cross-disciplinary studies. Eligible studies included human investigations and relevant animal models reporting genetic, epigenetic, or molecular alterations in autophagy, telomerase, or endothelial pathways with cardiovascular relevance. Non-English publications, studies lacking primary data, and reports unrelated to cardiovascular or systemic disease mechanisms were excluded. Evidence was stratified as Level I (direct evidence in COVID-19-associated cardiac injury), Level II (COVID-19 systemic or vascular evidence with plausible cardiac relevance), and Level III (non-COVID cardiovascular or systemic disease; hypothesis-generating).

FINDINGS: Across viral, cardiovascular, and systemic contexts, key candidate genes, including ATG5, ATG7, Beclin-1, TERT, ICAM1, and eNOS -emerged as potential mediators of COVID-19-related cardiac injury. While endothelial activation is supported by relatively consistent clinical and molecular evidence, direct cardiac-tissue data linking autophagy and telomerase pathways to COVID-19-associated myocardial injury remain limited. These gaps highlight substantial uncertainty regarding causal mechanisms and inter-individual susceptibility.

CONCLUSION: Autophagy dysregulation, telomere attrition, and endothelial dysfunction represent convergent and biologically plausible mechanisms contributing to COVID-19-associated cardiac injury; however, current evidence remains largely indirect and derived from systemic or vascular compartments rather than cardiac tissue. Cardiac-specific, longitudinal genetic and epigenetic studies are required before these pathways can be considered for biomarker development or therapeutic targeting.

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

Frodsham C, Harvey SB, Collins D, et al (2026)

Prevalence of post-traumatic stress disorder in healthcare workers before and during COVID-19: a systematic review and meta-analysis.

Frontiers in public health, 14:1735552.

UNLABELLED: The COVID-19 pandemic exacerbated many known risk factors for post-traumatic stress disorder (PTSD) among healthcare workers. This systematic review and meta-analysis examines pooled prevalence estimates of probable PTSD among this cohort prior to COVID-19 compared to during COVID-19 and investigates time trends in prevalence. Systematic multi-database literature searches were conducted to identify studies published between January 2017 and July 2023. Included studies reported the prevalence of probable PTSD, measured by validated screening tools, in clinical healthcare workers. Two reviewers independently conducted study screening, data extraction, and quality assessment. Random-effects meta-analyses were performed to estimate pooled prevalence of probable PTSD among healthcare workers in each time period. Subgroup analyses were carried out for year, profession, quality of study, COVID-19 mortality rates, and income level within the country of study. Screening identified 21 papers comprising 11,838 healthcare workers published in the 3 years preceding the pandemic, and 129 papers reporting on 130,363 healthcare workers during the pandemic. The pooled prevalence estimate of probable PTSD prior to the pandemic was 15.5% (95% CI: 12.3-19.3%) and this significantly increased during the pandemic to 24.8% (95% CI: 22.0-27.8%), peaking early in the pandemic in 2020 before returning to pre-pandemic levels in 2022. During the pandemic, prevalence estimates were significantly higher among nurses and those in countries with high COVID-19 mortality rates, whilst no significant difference was observed between studies conducted in high-income versus low- and middle-income countries. Substantial heterogeneity was observed. The findings of this review suggest that prevalence of PTSD among healthcare workers significantly increased following the COVID-19 outbreak. By the third year of the pandemic, probable PTSD prevalence rates appear to return to pre-pandemic levels, although these levels remain concerningly high. These findings support the call for targeted interventions to protect healthcare worker wellbeing, particularly during healthcare emergencies.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42022364955, unique identifier is CRD42022364955.

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

Weiss SL, Peters MJ, Oczkowski SJW, et al (2026)

Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 27(4):379-434.

OBJECTIVES: To update evidence-based management recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with sepsis or septic shock.

DESIGN: A panel of 68 international experts, representing 13 international organizations, as well as six methodologists, was convened. A formal conflict-of-interest policy was developed at the onset of the process and applied throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and subgroup leads as well as within subgroups, served as an integral part of the guideline development process.

METHODS: New priority topics and recommendations from the prior guideline iteration were used to identify Population, Intervention, Control, and Outcomes (PICO) questions likely to have new or updated evidence. We conducted a systematic review to identify the best available evidence, summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or conditional, or as a good practice statement. "In our practice," statements were included when evidence was inconclusive to issue a recommendation but the panel felt that some guidance based on practice patterns may be appropriate.

RESULTS: The panel provided 61 statements on the management of children with sepsis or septic shock. Overall, five were strong recommendations, 24 were conditional recommendations, and ten were good practice statements. For 22 PICO questions, no recommendations could be made, but, for seven of these, "in our practice" statements were provided. Compared with the 2020 guidelines, 20 recommendations were new, 13 were updated for clarity and/or new evidence, six were reviewed but not changed, and 22 were carried forward based on consensus of the panel that new evidence was not available. Only three recommendations were based on high or moderate certainty of evidence.

CONCLUSIONS: Updated management guidelines were issued by a panel of international experts for the best care of children with sepsis or septic shock, acknowledging that most aspects of care continue to have relatively low quality of evidence.

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

Bayurova E, Kostyushev D, Tikhonov A, et al (2026)

Broad-acting antivirals: the pursuit of pan-viral therapeutics in the era of pandemics.

Journal of virology, 100(5):e0007726.

The ever-present threat of new viral epidemics makes the scientific community relentlessly work on the development of universal methods of antiviral therapy. The development of broad-spectrum antivirals (BSAs) focuses either on substances acting directly on viral proteins (direct-acting antivirals [DAA]) or on substances directed at the cell's own proteins (host-targeting antivirals [HTA]). Decades of development have led to the market entry of a number of DAAs with a wide range of antiviral activities; however, their clinical approval has been obtained for individual infections. HTAs have a number of advantages over DAAs, such as a wider range of antiviral activities and a high genetic barrier to viral resistance, which is undoubtedly important when preparing for a battle with an unknown pathogen. The COVID-19 pandemic has allowed for multiple clinical trials for repurposed HTAs, previously licensed for the treatment of other diseases, including cancer. Despite the enormous work done, the arsenal of BSAs capable of protecting against future pandemics caused by pathogen X is very limited. In this review, we described data on the most studied DAAs and HTAs, effective against at least two unrelated viral pathogens, focusing on those that have been studied in late preclinical and clinical trials. In the end, we highlighted alternative new approaches such as CRISPR-Cas therapy.

RevDate: 2026-06-15
CmpDate: 2026-06-12

Weiss SL, Peters MJ, Oczkowski SJW, et al (2026)

Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.

Intensive care medicine, 52(5):937-983.

OBJECTIVE: To update evidence-based management recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with sepsis or septic shock.

DESIGN: A panel of 68 international experts, representing 13 international organizations, as well as six methodologists, was convened. A formal conflict-of-interest policy was developed at the onset of the process and applied throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and subgroup leads, as well as within subgroups, served as an integral part of the guideline development process.

METHODS: New priority topics and recommendations from the prior guideline iteration were used to identify Population, Intervention, Control, and Outcomes (PICO) questions likely to have new or updated evidence. We conducted a systematic review to identify the best available evidence, summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or conditional, or as a good practice statement. "In our practice," statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate.

RESULTS: The panel provided 61 statements on the management of children with sepsis or septic shock. Overall, five were strong recommendations, 24 were conditional recommendations, and ten were good practice statements. For 22 PICO questions, no recommendations could be made, but for seven of these, "in our practice" statements were provided. Compared with the 2020 guidelines, 20 recommendations were new, 13 were updated for clarity and/or new evidence, six were reviewed but not changed, and 22 were carried forward based on consensus of the panel that new evidence was not available. Only three recommendations were based on high or moderate certainty of evidence.

CONCLUSIONS: Updated management guidelines were issued by a panel of international experts for the best care of children with sepsis or septic shock, acknowledging that most aspects of care continue to have relatively low quality of evidence.

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

Kubica J, Topoliński T, Gajda R, et al (2026)

Artificial intelligence as the missing integrator in heart failure care - from remote monitoring to personalized therapy.

Cardiology journal, 33:e00226032.

Heart failure (HF) remains a leading cause of morbidity, mortality, and healthcare utilization worldwide, despite the availability of effective evidence-based therapies. The principal challenge is no longer the absence of treatment options but the limited capacity of traditional care models to deliver guidelinedirected medical therapy (GDMT) consistently and at scale. The COVID-19 pandemic exposed the fragility of hospital-centered HF care, highlighting the need for more resilient, patient-centered management strategies. Remote monitoring (RM) has been proposed as a solution, yet its clinical impact has been inconsistent due to fragmented data streams, declining patient adherence, and heavy reliance on continuous human oversight. Artificial intelligence (AI) offers an opportunity to address these limitations by integrating multidimensional clinical data, enabling earlier detection of deterioration, supporting adherence, and prioritizing clinically meaningful interventions. Emerging evidence suggests that AI-assisted workflows can accelerate GDMT optimization and improve surrogate and clinical outcomes when implemented within supervised care pathways. This has led to the concept of next-generation remote monitoring (NGRM), in which AI analyzes longitudinal physiological and behavioral signals to generate context-aware alerts and actionable recommendations while reducing clinical workload. Successful implementation, however, requires rigorous validation, clear governance, integration with clinical workflows, and safeguards for safety, equity, and accountability. When embedded within structured HF care pathways, AI-enabled monitoring may help bridge the persistent gap between evidence and real-world implementation.

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

Sartori F, Crisafulli E, Cariqueo M, et al (2026)

Role of Vaccination in the Prevention of ECOPD.

Seminars in respiratory and critical care medicine, 47(3):323-333.

Exacerbations of chronic obstructive pulmonary disease (ECOPD) represent key events in the natural history of COPD and are associated with several adverse outcomes. Respiratory infections are major and potentially modifiable triggers of ECOPD, with viral pathogens such as the influenza virus, respiratory syncytial virus (RSV), and SARS-CoV-2, as well as bacterial infections caused by Streptococcus pneumoniae, playing a central role. This narrative review examines the current evidence supporting vaccination as a preventive strategy for ECOPD and discusses its translation into clinical practice. The biological rationale for vaccination in COPD is reviewed, including disease-related immune dysregulation, impaired mucociliary clearance, and increased susceptibility to respiratory pathogens. Evidence from randomized clinical trials, observational studies, meta-analyses, and real-world data is summarized for pneumococcal, influenza, SARS-CoV-2, and RSV vaccines. Pneumococcal vaccination has been shown to reduce the burden of community-acquired pneumonia and invasive pneumococcal disease, with conjugate and higher-valent vaccines providing enhanced immunogenicity in older and high-risk adults. Influenza vaccination consistently reduces severe exacerbations, hospitalizations, and mortality, with additional cardioprotective effects of relevance in COPD. SARS-CoV-2 vaccination markedly lowers the risk of severe COVID-19 and related respiratory deterioration in COPD, while recently licensed RSV vaccines offer a novel opportunity to prevent RSV-associated lower respiratory tract disease and potentially reduce exacerbation risk. Patient populations most likely to benefit from vaccination include frequent exacerbators, older adults, individuals with severe airflow limitation, multimorbidity, immune dysfunction, infection-prone phenotypes, and socially vulnerable groups. Future perspectives include precision vaccination strategies, novel vaccine platforms, coadministration approaches, and interventions to improve vaccine uptake. Vaccination emerges as a cornerstone of ECOPD prevention, with substantial potential to reduce exacerbation burden and improve long-term outcomes in COPD.

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

Mullen AK, Richardson ET, Bassett MT, et al (2026)

A plan for black American reparations.

BMJ global health, 11(Suppl 1):.

The frequent criticism of a programme of reparations for Black Americans is that, however justified, no feasible blueprint exists for its implementation. We provide a detailed outline of a viable plan for reparations for Black American descendants of persons enslaved in the USA. Central to the plan are monetary payments calculated to eliminate the racial wealth gap, the foremost economic indicator of the cumulative, intergenerational effects of White supremacy. Closing the racial wealth gap can, in turn, contribute significantly to reducing racial disparities in health, including overall life expectancy. By providing a comprehensive and actionable plan, it becomes clear that the primary obstacle to adoption of reparations by the US Congress is political resistance. The article concludes with a discussion of the current political climate regarding reparations in the USA and an assessment of whether there are grounds for optimism for progress in the reparations movement.

RevDate: 2026-06-29
CmpDate: 2026-06-28

Hu C, Ying L, Zhan Y, et al (2026)

Coexistence of pulmonary aspergillosis and cryptococcosis following treatment for SARS-CoV-2 infection in a kidney transplant recipient: a rare case report and literature review.

BMC nephrology, 27(1):.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)- associated pneumonia increases patients’ susceptibility to fungal superinfections, particularly among immunocompromised individuals. CASE PRESENTATION: A 60-year-old woman with history of kidney transplantation was admitted for recurrent fever and positive SARS-CoV-2 antigen on pharyngeal swab testing. The patient developed rapid-onset respiratory distress secondary to progressive pulmonary infection and received assisted mechanical ventilation. Microbiological sequencing and culture of bronchoalveolar lavage fluid and sputum, as well as serological tests, revealed the presence of Aspergillus fumigatus, Aspergillus lentulus and Cryptococcus neoformans, along with multiple bacterial and viral pathogens. Following a course of combined antifungal, antibacterial, and antiviral therapies, the patient was successfully weaned off mechanical ventilation. The lung exudates and the large cavitary abscess were absorbed completely. CONCLUSIONS: We reported successful treatment of a rare case of concurrent aspergillosis and cryptococcosis following SARS-CoV-2 pneumonia in a kidney transplantation recipient. The severe fungal infection was probably attributed to the immunosuppressive status associated with a history of solid organ transplantation, as well as prolonged administration of glucocorticoid and antibiotics.

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

Abunijela S, Greiner T, Haas W, et al (2026)

Frequency, dynamics, and duration of faecal shedding in SARS-CoV-2-infected individuals, a scoping review.

Epidemiology and infection, 154:e44.

To estimate illness incidence or prevalence from wastewater data, modelling approaches may benefit from incorporating faecal shedding parameters. We systematically searched PubMed and a public repository on shedding data and included 33 studies that met at least one of our objectives. Among 32 studies, the proportion of SARS-CoV-2-infected individuals with detectable virus in stool ranged from 18 to 100%, with a pooled estimate of 54% (95% CI: 52-56%). Stratification by four clinical severity categories, ranging from asymptomatic to critically ill, showed no significant differences among categories (p-value = 0.49). The proportion of individuals with detectable SARS-CoV-2 RNA in stool was higher in children (61%) than in adults (53%; p-value = 0.02). In half of the individuals who initially shed the virus in stool, it remained detectable for an estimated 22 days post-symptom onset. Three studies documented viral load kinetics, indicating a peak between days 3 and 9. Twenty-five studies reported maximum shedding durations ranging from 2 to 12 weeks. Our review summarizes the frequency, dynamics, and duration of SARS-CoV-2 shedding in stool and may serve as a valuable foundation for modelling efforts involving faecal shedding indicators.

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

Zhang D, Y Wang (2026)

The research progress on the role of glucose-6-phosphate dehydrogenase in immune regulation.

PeerJ, 14:e20971.

Glucose-6-phosphate dehydrogenase (G6PD), the rate-limiting enzyme of the pentose phosphate pathway (PPP), plays a pivotal role in immune regulation by regulating metabolic reprogramming and redox homeostasis of immune cells. It mediates the production of nicotinamide adenine dinucleotide phosphate (NADPH) and ribose-5-phosphate (R5P), which are essential for the activation, proliferation, and effector function of T lymphocytes, B lymphocytes, macrophages, and neutrophils-specifically promoting T/B cell-mediated adaptive immunity and macrophage/neutrophil-mediated innate immune responses. Abnormal G6PD activity (deficiency or overexpression) is closely associated with the pathogenesis of immune-related diseases: G6PD deficiency increases susceptibility to autoimmune diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus) and infectious diseases (e.g., hepatitis, malaria, COVID-19) by inducing oxidative stress and immune cell dysfunction; in tumor immunity, G6PD dualistically promotes tumor cell proliferation while regulating anti-tumor immunity via modulating cytoxic D8[+] T cell exhaustion and macrophage polarization. Additionally, G6PD-targeted immunotherapies, including small-molecule inhibitors and gene therapy, have shown promising preclinical potential for treating immune-related diseases. These findings highlight G6PD as a key metabolic-immune hub, providing critical theoretical basis for understanding immune regulation mechanisms and developing novel diagnostic and therapeutic strategies for autoimmune diseases, infectious diseases, and tumors.

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

Kim T (2026)

Lessons From the Coronavirus Disease 2019 Pandemic: Implications for Antimicrobial Stewardship for COVID-19 Management.

Journal of Korean medical science, 41(11):e72.

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in millions of deaths worldwide and has now become a major respiratory infectious disease. Beyond the direct effects of the viral infection, one of the most significant and concerning issues to emerge is the exacerbated threat of antimicrobial resistance (AMR) by the indirect impacts of COVID-19. Early in the pandemic, widespread empirical antibiotic prescribing occurred despite low bacterial co-infection rates. In addition, azithromycin, whose antiviral effect remains unproven, was frequently used. This high, often unnecessary consumption, coupled with disrupted antimicrobial stewardship (AMS) and infection prevention and control (IPC) programs, created conditions favoring the emergence and spread of AMR. In patients with severe COVID-19, multidrug-resistant organisms were frequently implicated in secondary infections, particularly in intensive care units (ICUs). Nevertheless, previous studies analyzing AMR metrics before and during the COVID-19 pandemic have shown inconsistent results. Strategies to mitigate the COVID-19 pandemic, such as enhanced surveillance, social distancing resulting in lower respiratory infections, and strengthened IPC and targeted AMS interventions, could play protective roles to inhibit the development of AMR. Additionally, targeted interventions-such as prospective audit and feedback, biomarker-guided antibiotic discontinuation, diagnostic stewardship using a rapid molecular test to distinguish viral from bacterial infections, embedding AMS decision support into electronic medical records, and tailoring interventions to high-risk settings such as ICUs-demonstrated the feasibility of reducing unnecessary antimicrobial use (AMU) even during crisis conditions. Also, vaccination against SARS-CoV-2 may indirectly reduce AMU and AMR by lowering the incidence of severe disease and secondary bacterial infections. Future COVID-19-specific AMS frameworks must integrate these experiences during the pandemic. This review synthesizes current evidence on the interplay between COVID-19, AMR, and AMU, and outlines stewardship strategies to reduce AMR in COVID-19 management.

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

Choe YJ (2026)

Pediatric COVID-19 in Korea: Lessons and Strategies for Future Disease-X Preparedness.

Journal of Korean medical science, 41(11):e75.

The coronavirus disease 2019 (COVID-19) pandemic has had distinct public health and societal impacts on children worldwidely, prompting calls to prepare for the next pandemic by incorporating children's needs. Republic of Korea's experience provides insights into pediatric-focused pandemic response. This review analyzes the impact of COVID-19 on children in Korea and evaluates the national response. This review encompasses the Korea Disease Control and Prevention Agency COVID-19 response white paper, National Medical Center response report, Ministry of Education and Seoul Metropolitan Office of Education white papers, focusing on pediatric data and policies. Key findings were supplemented with international studies on pediatric COVID-19 epidemiology, vaccination, and educational impacts. Children in Korea accounted for a substantial number of COVID-19 cases during omicron wave, yet severe outcomes remained rare. Surveillance adaptations included dedicated monitoring of pediatric multisystem inflammatory syndrome through antibody testing. The healthcare system rapidly adjusted to pediatric needs by allowing home isolation for mild cases and by permitting caregiver accompaniment during pediatric hospital isolation. Vaccine rollout for adolescents began in 2021 and for ages 5-11 in 2022, with an initial policy focusing on high-risk children and voluntary uptake for others. In the education sector, Korea implemented remote learning infrastructure, distributing devices and expanding internet access to bridge the digital divide. Korea's pandemic response illustrates the importance of pediatric-specific strategies: surveillance, child-friendly healthcare protocols, risk communication to improve vaccine acceptance, and treating schools and child services as essential infrastructure.

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

Choi JY (2026)

Severe COVID-19 in the Republic of Korea: Epidemiology, Risk Factors, Therapeutics, and Prognostic Models From Nationwide Data.

Journal of Korean medical science, 41(11):e96.

Severe coronavirus disease 2019 (COVID-19) has posed ongoing clinical and public health challenges worldwide, with Korea providing a unique perspective due to its comprehensive surveillance system and extensive real-world data. This review summarizes evidence from nationwide registries, cohort studies, and clinical trials in Korea, alongside global findings, to describe the epidemiology, risk factors, therapeutic interventions, and prognostic models for severe COVID-19. Between January 2020 and August 2023, Korea reported more than 34 million confirmed cases, with 38,112 classified as severe and 35,608 deaths, yielding one of the lowest case fatality rates among member countries comprising the Organisation for Economic Co-operation and Development. Severity was strongly associated with advanced age and comorbidities such as cardiovascular disease, diabetes mellitus, cancer, psychiatric disorders, and immunocompromised states, including solid organ transplantation and hematologic malignancies. Other risk modifiers included obesity, chronic kidney disease, asthma, and prolonged glucocorticoid therapy. Protective factors included vaccination, regular physical activity, and, in some studies, specific pharmacologic agents. The effectiveness of vaccines was consistently demonstrated, with booster doses markedly reducing hospitalization and mortality, including in high-risk groups such as pregnant women, patients with cancer, and transplant recipients. Antiviral therapies, notably nirmatrelvir/ritonavir and molnupiravir, significantly reduced severe outcomes, while immunomodulators such as dexamethasone and tocilizumab improved recovery in patients with severe disease. Advanced interventions, including extracorporeal membrane oxygenation and lung transplantation, were used for refractory respiratory failure, with favorable survival observed in selected patients. Prognostic models integrating clinical, radiological, and machine learning approaches have been developed to predict disease progression, supporting early risk stratification and resource allocation. The rapid generation of evidence on predicting, preventing, and treating severe disease is a critical element of pandemic preparedness. Although COVID-19 has transitioned to an endemic disease, sustaining and advancing the research expertise and infrastructure developed during the pandemic remains essential for responding to future emerging infectious disease outbreaks.

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

Jang Y, Jung J, KR Peck (2026)

Integrated Clinical and Social Impacts of the COVID-19 Pandemic in Korea: A Combined Systematic and Narrative Review.

Journal of Korean medical science, 41(11):e103.

Coronavirus disease 2019 (COVID-19) imposed substantial health and social burdens worldwide, disrupting healthcare delivery and challenging public health governance. Korea's early, coordinated response was associated with low mortality and maintained essential services, yet the prolonged pandemic exposed structural inequalities, workforce strain, and psychosocial impacts. To comprehensively understand these multidimensional effects, this review synthesizes systematic and narrative evidence on the clinical, epidemiologic, and societal consequences of COVID-19 in Korea. We conducted a combined systematic and narrative review of Korean evidence (2020-2025). The systematic review included studies from PubMed, Embase, KoreaMed, and KMbase, supplemented by manual journal searches. Eligible studies addressed key epidemiologic indicators, including seroprevalence, mortality among patients with comorbidities, severe outcomes in high-risk groups, and vaccination coverage by comorbidity. Quality was assessed using Joanna Briggs Institute tools. We additionally examined government white papers, national reports, policy briefs, and peer-reviewed articles to contextualize epidemiologic findings, synthesizing materials across health burden, healthcare system changes, social consequences, and policy responses. Twenty-four epidemiologic studies and 72 narrative sources were included. Seroprevalence remained below 1% during the early pandemic, increasing sharply after omicron's emergence. Patients with chronic illnesses consistently experienced higher risks of severe outcomes and mortality, while high-risk groups showed elevated odds of intensive care use and complications. Alongside clinical patterns, national data documented substantial reductions in outpatient visits, elective procedures, emergency care, and pediatric services. Burnout and psychological distress intensified among healthcare workers, while prolonged distancing and economic disruption contributed to widening social fatigue. Policy responses and vaccination improved population outcomes, although gaps persisted in communication strategies and addressing disparities across age, socioeconomic status, and comorbidity groups. Korea's experience underscores that preparedness must align clinical efficiency with social equity. Strengthening primary and emergency care, ensuring fair compensation and workforce protection, and maintaining transparent risk communication are essential for building a resilient, inclusive public health system to withstand future pandemics.

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

Hwang YH, WB Park (2026)

COVID-19 Vaccination Strategy and Evidence in Korea.

Journal of Korean medical science, 41(11):e114.

Coronavirus disease 2019 (COVID-19) has created major global challenges, with vaccination remaining the most effective measure to reduce severe outcomes and mortality. In Korea, six vaccines were approved, and the rapid rollout initiated in February 2021 contributed to comparatively low global mortality. As the epidemiological landscape of COVID-19 evolved and evidence on vaccine immunogenicity and safety accumulated, Korea adapted its vaccination strategies. During the 2024-2025 season, two mRNA vaccines (Pfizer-BioNTech and Moderna) and one recombinant protein vaccine (Novavax) targeting JN.1 lineage were administered primarily to high-risk groups. Beginning in October 2025, two mRNA vaccines (Pfizer-BioNTech and Moderna) adapted to LP.8.1 variant have been introduced as the updated 2025-2026 season formulations. Although safety concerns arose initially, Korean studies confirmed that COVID-19 vaccines provided strong effectiveness and acceptable safety, consistent with international findings. To enhance preparedness for future pandemics and epidemics, sustaining surveillance systems and maintaining updated vaccination policies are critical to ensure effective public health responses.

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

Drake JM, Rohani P, A Winter (2026)

Can vaccine-preventable disease resurgence be anticipated? Leading indicators and tipping points.

Future microbiology, 21(3):321-327.

Vaccination programs have averted millions of childhood deaths, yet vaccine-preventable diseases (VPDs) continue to resurge as coverage declines and pathogen evolution undermines previously successful vaccines. Anticipating resurgence is a public health priority. We review theoretical and empirical advances in the study of early warning signals (EWS) of epidemic transitions, with a focus on critical slowing down (CSD) - a phenomenon in which recovery from perturbations becomes slower near the epidemic threshold. We summarize the mechanisms that generate CSD, indicators that can be extracted from surveillance data, and the conditions under which signals may be detectable. We then examine case studies to illustrate the opportunities and challenges of applying EWS to VPD resurgence. Theory and computer simulations show that CSD can precede both elimination and resurgence, with increases in variance and autocorrelation calculated from disease surveillance reports emerging as consistent indicators. Empirical evidence supports this potential, though performance depends on noise structure, seasonality, spatial clustering, and outbreak responses. Case studies highlight both successful applications and contexts where signals were weak or absent. EWS offer a promising framework for anticipating VPD resurgence, but further research is required to refine methods, integrate mechanistic and social-behavioral drivers, and evaluate applicability across pathogens and settings.

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

Smatana M, LĂśffler Ľ, PaĹžitnĂ˝ P, et al (2025)

Slovakia: Health System Review.

Health systems in transition, 27(2):1-300.

This analysis of the Slovak health system reviews developments in governance, organization, financing and delivery of care, health reforms and health system performance. Slovakia, a central European country with a population of 5.4 million, continues to face significant health and health care system challenges. Slovakia's health system is founded on universal coverage with compulsory health insurance, a broad benefits package and a competitive insurance model. Although life expectancy improved between 2000 and 2019, the COVID-19 pandemic reversed gains, and in 2023 Slovak life expectancy remained three years below the European Union (EU) average. Circulatory diseases and cancer are the leading causes of death, and noncommunicable diseases such as diabetes and mental illness are rising. Nearly one third of all mortality is linked to behavioural risk factors, including poor diet, high smoking rates, low physical activity and obesity. Slovakia's health care system features competition among three insurers - one state-owned (Vťeobecnå zdravotnå poisżovňa, VťZP) and two private. Since major reforms in 2004, the system has decentralized responsibilities and adopted selective contracting to enhance efficiency. However, structural weaknesses remain, particularly in financial sustainability, accessibility and equity. Health spending from public sources was 8.3% of gross domestic product (GDP) in 2024, yet out-of-pocket (OOP) payments account for nearly 19% of expenditures, disproportionately burdening low-income households. Workforce shortages, especially in nursing and primary care, are worsened by emigration and an ageing staff. Urban-rural disparities persist, with modern infrastructure and specialized services concentrated in cities. Digital health advancements, such as the National Health Information System (NHIS), aim to modernize care and facilitate telemedicine, though implementation is uneven. Ongoing reforms target cost containment, infrastructure optimization and integration of long-term care (LTC). Key priorities include addressing regional disparities, improving workforce retention, reducing waiting times and enhancing eHealth adoption. Despite universal coverage, Slovakia must address persistent gaps in health outcomes, resource distribution and system resilience to meet the needs of its population.

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

Ali T, McConnell A, Gill CR, et al (2026)

Healing the Divide: Bridging Physicians and Healthcare Administrators for Value-Based Care.

American journal of medical quality : the official journal of the American College of Medical Quality, 41(3):151-159.

Misalignment between physicians and hospital administrators has long challenged US healthcare systems. The COVID-19 pandemic magnified these tensions, with physicians reporting increased burnout and administrators grappling with severe financial pressures. This narrative review synthesizes findings from peer-reviewed studies, national surveys, organizational case examples, and policy reports to evaluate physician-administrator relationships. The analysis identifies 6 thematic areas: shared vision and transparency, governance engagement, incentive alignment, administrative burden, physician well-being, technology and innovation, and organizational trust and culture. The literature consistently documents the persistence of misalignment: physicians cite loss of autonomy and administrative overload, while administrators must manage costs and ensure compliance. Evidence from health systems such as Mayo Clinic, Cleveland Clinic, and rural hospitals demonstrates that structured engagement strategies can mitigate these divides. Bridging the physician-administrator divide is critical for value-based care. In rural areas where hospital closures and workforce shortages are acute, collaborative models are urgently needed. The proposed framework highlights actionable strategies to reduce burnout, enhance retention, and strengthen patient-centered outcomes.

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

Goh GK, Foster JA, VN Uversky (2026)

Clues to Long COVID Linked to Virulence and Infectivity Found in Shell Proteins.

Advances in respiratory medicine, 94(2):.

Clinical, experimental, and computational evidence of COVID-19 virulence and infectivity has been linked to SARS-CoV-2 shell disorder. A strong link was first discovered using an AI disorder-predicting tool, which detected an unusually hard (low disorder) outer shell among all SARS-CoV-2-related viruses but not in the 2003 SARS-CoV-1. This could account for the high infectivity found in SARS-CoV-2-but not in SARS-CoV-1-as it is believed that hard shells protect viral particles from the onslaught of the antimicrobial enzymes present in the respiratory system and saliva. As a result, much larger quantities of particles are shed by COVID-19 patients. Abnormally hard outer shells (M) are associated with burrowing animals, e.g., pangolins, and SARS-CoV-2 likely acquired these shells due to its long-term evolutionary interactions with pangolins. As for virulence, the inner shell of SARS-CoV-2 (N) has been found to exhibit lower disorder than that of SARS-CoV-1. This lower disorder is consistent with the fact that SARS-CoV-2 is less virulent than SARS-CoV-1, as higher disorder in the inner shell is associated with more efficient protein-protein binding during replication. The link between N/M disorder and virulence or infectivity falls under the umbrella of shell disorder models (SDMs), which can connect virulence, infectivity, and long COVID under one coherent concept. Evidence of the reliability and reproducibility of SDMs as applied to COVID-19 is examined. The hard M that is resisting the antimicrobial enzymes in the respiratory system can be extended to immunological enzymes, especially those found in phagocytes such as macrophages, which can therefore become a reservoir for the virus.

RevDate: 2026-03-26
CmpDate: 2026-03-24

Benucci M, Cioffi E, Li Gobbi F, et al (2026)

Dermatomyositis with Anti-MDA5 Autoantibodies After SARS-CoV-2 mRNA Vaccination Treated with Tofacitinib: Integrating Literature Evidence and a Novel Observation.

Antibodies (Basel, Switzerland), 15(2):.

COVID-19 mRNA vaccines activate type I interferon pathways and in genetically or immunologically predisposed individuals may trigger autoimmune responses, including autoantibodies against melanoma differentiation-associated protein 5 (MDA5). Although cases of dermatomyositis (DM), particularly anti-MDA5-positive DM, have been increasingly reported after SARS-CoV-2 vaccination, its clinical spectrum and management remain incompletely defined. We conducted a narrative review of the literature on post-vaccination dermatomyositis, focusing on clinical features, autoantibody profiles, therapeutic approaches, and outcomes. The review was enriched by the inclusion of a new case: a 60-year-old woman who developed anti-MDA5-positive dermatomyositis two weeks after receiving her fourth dose of the BNT162b2 (Pfizer/BioNTech) vaccine. She presented predominantly with cutaneous and articular manifestations in the absence of interstitial lung disease. Treatment with oral prednisone, intravenous alprostadil, and the Janus kinase inhibitor tofacitinib resulted in marked clinical improvement. This case, together with the literature review, illustrates both typical and atypical presentations of vaccine-associated anti-MDA5 DM, highlights diagnostic challenges without lung involvement, and suggests JAK inhibition as a potential therapeutic option, contributing to a more comprehensive understanding of post-vaccination dermatomyositis.

RevDate: 2026-06-26
CmpDate: 2026-06-26

Stoop MHP, Driessen GJA, Cohen AF, et al (2026)

Digital diagnostics, biomarkers and therapeutics in an evolving healthcare system: From promise to practice.

British journal of clinical pharmacology, 92(7):2016-2027.

Health care is shifting towards a digital-guided system, integrating digital diagnostics, biomarkers and therapeutics in many care pathways. However, despite rapid technological advancement and preliminary adoption accelerated by the COVID-19 pandemic, a significant implementation gap persists. This narrative review explores the causes of this gap, highlighting several examples from early development to final implementation. These show that technical validation alone is insufficient. Success depends on alignment with clinical need, robust external validation, patient empowerment and sustainable funding models. Furthermore, other systemic barriers include data privacy concerns and lack of transparency by commercial companies. To improve adoption and translate promise to practice, more international alignment of regulations and international collaboration is needed. Lessons must be learned from promising initiatives that did not reach clinical care, as much as from their successful counterparts. Ultimately, a comprehensive redesign of healthcare will be undertaken, with digital diagnostics and therapeutics both embedded as critical components rather than add-ons. This demands a multi-stakeholder effort involving governments, regulatory bodies, insurance providers, industry, research funders, hospital leadership, clinicians and, most importantly, patients.

RevDate: 2026-03-25

Mathias K, de Rezende VL, Dal BĂł Tiscoski A, et al (2026)

From lungs to brain: the neuroimmune impact of respiratory microbiota.

Expert review of respiratory medicine [Epub ahead of print].

INTRODUCTION: The bidirectional communication between the lungs and the central nervous system, known as the lung-brain axis, has emerged as an important framework for understanding systemic mechanisms influencing neurological health. Increasing evidence indicates that pulmonary inflammation, respiratory microbiota alterations, and environmental exposures can modulate neuroinflammation, blood-brain barrier integrity, and microglial activation.

AREAS COVERED: This review summarizes current experimental and clinical evidence describing the molecular, microbial, and neuroimmune mechanisms underlying the lung-brain axis. Particular emphasis is placed on the role of the respiratory microbiota across the upper and lower airways and its interaction with immune signaling pathways. In addition, the neurological consequences of pulmonary diseases and infections, including asthma and COVID-19, are discussed, highlighting neuroanatomical, humoral, and immunological routes linking pulmonary and brain physiology.

EXPERT OPINION: Emerging data suggest that the respiratory system functions as an immunometabolic interface capable of influencing neuroimmune regulation and brain function. Integrative approaches combining respiratory microbiota profiling, immune biomarkers, and neuroimaging may help clarify causal mechanisms and support the development of novel diagnostic and therapeutic strategies for neurological and post-infectious conditions.

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

Liu C, Dan L, Wang X, et al (2026)

Gut microbiota impact on lung diseases: a mini review of clinical evidence.

Infection and immunity, 94(4):e0043025.

The gut-lung axis represents a bidirectional communication network through which the gut microbiota (GM) influences respiratory health. This mini-review synthesizes clinical evidence on the role of the GM in lung diseases. We focused exclusively on human clinical trials, randomized controlled trials, meta-analyses, and systematic reviews, sourced from major databases after duplicate removal. The evidence indicates that GM dysbiosis is a significant risk factor for the susceptibility and severity of various respiratory conditions, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), and infections, such as COVID-19 and pneumonia. Specific microbial signatures and metabolic profiles, particularly involving short-chain fatty acids (SCFAs), are associated with disease states and outcomes. Interventions like probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) show promise in modulating the GM and improving clinical parameters, though their efficacy can be inconsistent and influenced by confounding factors. In conclusion, the GM is a promising therapeutic target for lung diseases. However, future research must prioritize large-scale, longitudinal clinical trials and deeper mechanistic investigations to establish causality and develop effective, personalized microbiome-based therapies.

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

Chen L, Lan H, Liu W, et al (2026)

Widespread structural and functional brain alterations in COVID-19: a systematic review of MRI studies.

Cerebral cortex (New York, N.Y. : 1991), 36(3):.

The coronavirus disease 2019 (COVID-19) pandemic has not only challenged global public health but also generated interest in its neurological basis. A growing number of neuroimaging studies have used quantitative magnetic resonance imaging (MRI) to quantify brain alterations in COVID-19 patients. We conducted a comprehensive review to synthesize brain regions with abnormal MRI metrics of microstructure and function in COVID-19 patients compared to healthy controls. Drawing upon 49 studies sourced from PubMed, Embase, and Web of Science databases, our review showcases structural and functional brain abnormalities across many brain regions in COVID-19. Across multimodal MRI studies, alterations were predominantly in frontal regions, temporal regions, parietal regions, limbic system, and subcortical nuclei. Our findings may help understanding of the neurophysiological basis of acute neurological symptoms and long-term neurological sequelae associated with COVID-19.

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

Duquenne P, Liposits G, Vonnes CO, et al (2026)

Prediction models for overall survival and all-cause mortality risk in older adults with cancer: a systematic review.

The lancet. Healthy longevity, 7(3):100829.

Mortality risk prediction models can support decision making in older adults with cancer; however, existing models are associated with a high risk of bias. This systematic review assessed published prediction models for overall and all-cause mortality in adults with cancer aged 65 years or older. We searched for publications in Ovid Embase, Ovid Medline, Cochrane CENTRAL, and EBSCO CINAHL on Nov 25, 2022, and updated the search on Feb 24, 2024. We included 250 studies, of which 182 (72¡8%) reported both model development and internal validation. 176 (70¡4%) of 250 models predicted overall survival; 40 (16¡0%) models focused on lung cancer and 30 (12¡0%) models on colorectal cancer. 43 (17¡2%) models were specifically developed for older adults; 138 (55¡2%) models did not incorporate geriatric variables such as comorbidities, nutrition, and cognition. Risk of bias was high in all models, largely owing to inappropriate handling of continuous predictors, univariable selection of predictors, and inadequate control for overfitting. These limitations preclude clinical use. Future models predicting overall and all-cause mortality in older adults with cancer should adhere to existing methodological guidelines and incorporate geriatric domains.

RevDate: 2026-03-25

Van Aswegen R, Lanigan S, Lyne JP, et al (2026)

The impact of the COVID-19 pandemic on psychiatric morbidity and emergency mental health presentations in Ireland: a systematic review.

Irish journal of psychological medicine pii:S0790966726101852 [Epub ahead of print].

OBJECTIVES: To examine the impact the COVID-19 pandemic in Ireland on symptoms and functioning in individuals across a range of mental health disorders.

METHODS: A systematic bibliographic search of case reports, cross-sectional and longitudinal studies was conducted between March 12[th], 2020, and December 20[th], 2024, among studies evaluating the impact of the COVID-19 pandemic on symptoms and functioning for individuals with pre-existing mental health disorders and for those who presented with self-harm or died by probable suicide in the Republic of Ireland. Studies were independently screened by two reviewers according to inclusion and exclusion criteria, with selected variables extracted and summarised. Risk of bias assessments and narrative synthesis of included studies were conducted.

RESULTS: Twenty-eight studies met inclusion criteria. Findings were heterogeneous and disorder specific. An increase in presentations of self-harm, anxiety disorders, and eating disorders to child and adolescent mental health services and emergency departments was noted, with relative stability of symptoms in other cohorts including bipolar disorder and treatment-resistant schizophrenia. Significant symptom deterioration, with poor quality of life and functioning was demonstrated in individuals with emotionally unstable personality disorder both cross-sectionally and longitudinally.

CONCLUSIONS: Most people with pre-existing mental disorders did not experience significant exacerbation associated with the pandemic, with exception of those with eating disorders and EUPD.

RevDate: 2026-03-25
CmpDate: 2026-03-25

Zekis T, Grammatopoulou E, Tsimouris D, et al (2026)

The effectiveness of respiratory training as a preventive strategy against cognitive decline: a mini review.

Frontiers in rehabilitation sciences, 7:1778837.

Cognitive decline and dementia represent a growing global health burden, particularly among older adults and populations with cardiopulmonary and vascular risk factors. While physical exercise has been shown to exert protective effects on cognition, the role of respiratory muscle training (RMT) remains unclear. The aim of this review was to investigate the effects of RMT on cognitive function and cognitive decline. Respiratory muscle training has been implemented in older adults with elevated blood pressure, post-COVID-19 patients, patients with chronic obstructive pulmonary disease (COPD), and patients with obstructive sleep apnea (OSA). There is only preliminary evidence regarding the effectiveness of inspiratory muscle training (IMT) on cognitive function, with only one study reporting statistically significant between-group differences (i.e., respiratory muscle training vs. control) in specific cognitive domains. Although respiratory muscle training appears to be a potentially promising intervention for improving cognitive function, the current evidence is limited. Further well-designed randomized controlled trials are required to draw definitive conclusions regarding its preventive role in cognitive decline and dementia.

RevDate: 2026-03-25
CmpDate: 2026-03-25

Chalghaf N, Chokri I, Dhahbi W, et al (2026)

Burnout Across Healthcare, Educational, and Professional Populations: A Comprehensive Scoping Review.

Journal of multidisciplinary healthcare, 19:564113.

BACKGROUND: Burnout, defined by emotional exhaustion, depersonalization, and reduced personal accomplishment, is increasingly recognized as a significant threat to staff wellbeing, organizational performance, and patient safety in healthcare and related sectors. Although research on burnout has grown rapidly, the evidence base remains fragmented, limiting understanding of cross-population patterns, measurement approaches, and the effectiveness of interventions.

OBJECTIVE: This scoping review systematically maps and synthesizes the existing literature on burnout among healthcare workers, students, teachers, night shift workers, and other professional populations, with particular emphasis on its implications for staff well-being and quality of care.

METHODS: Following Arksey and O'Malley's framework and PRISMA-ScR guidelines, systematic searches were conducted in MEDLINE, Embase, PsycINFO, CINAHL, Scopus, Web of Science, and Cochrane from inception to December 2024. Eligible studies used validated instruments to assess burnout. Data synthesis employed narrative thematic analysis and systematic literature mapping.

RESULTS: Sixty-five studies were included (healthcare workers n=29; students n=18; teachers n=9; night shift workers n=6; other populations n=3). Six key themes emerged: prevalence variations (25-72%), with healthcare workers demonstrating the highest rates (35-68%) and strongest associations with compromised patient safety; diversity of measurement tools; intervention effectiveness patterns, wherein combined individual-organizational approaches demonstrated superiority over single-component strategies (effect size d=0.67, 95% CI: 0.42-0.91 at 12-month follow-up); organizational versus individual risk factors; temporal trends including COVID-19 impacts; and implementation challenges. Methodological heterogeneity limited cross-population comparability and the standardization of interventions.

CONCLUSION: Burnout represents a critical occupational health and patient safety concern. This scoping review highlights significant gaps in cross-population research, the need for standardized measurement approaches, and the importance of multilevel, evidence-based interventions. The findings provide essential insights for researchers, healthcare administrators, and policymakers aiming to design sustainable strategies to protect staff wellbeing and ensure safe, high-quality care.

RevDate: 2026-03-25
CmpDate: 2026-03-25

Choi S, Huda MN, John JR, et al (2026)

The Effectiveness of Non-Pharmacological Interventions in Treating Adolescents and Young Adults with Neuropsychiatric Symptoms of Long COVID: A Systematic Review and Meta-Analysis.

Neuropsychiatric disease and treatment, 22:570223.

BACKGROUND: The management of persistent symptoms for long COVID (eg, fatigue, concentration difficulties, sleep difficulties, loss of appetite and taste, depression, and anxiety) has not been widely studied among adolescents and young adults (AYA). This systematic review and meta-analysis aimed to synthesise and review evidence on the effectiveness of non-pharmacological interventions for AYA aged 13-25 years, presenting with long COVID symptoms.

METHODS: A systematic literature search was conducted in four electronic databases (PubMed, EMBASE, PsycInfo, and ProQuest) in addition to manual searches for studies from January 2020 to May 2025 (PROSPERO: CRD42024516016). The studies were screened for eligibility, and methodological quality was assessed using the Joanne Briggs Institute Critical Appraisal tool by two independent reviewers. Findings were summarised using a narrative synthesis approach, and where possible, a meta-analysis was conducted using a random effects model with standardised mean differences (SMD) and a 95% confidence interval (CI).

RESULTS: Of the 325 screened articles, seven studies were included, which discussed six interventions. Three studies reported on the effectiveness of three multidisciplinary rehabilitation programs (eg, neuropsychological rehabilitation program, multidisciplinary post-COVID rehabilitation program, micro-choice-based concentrated group rehabilitation), three on alternative medicine practices (eg, forest bathing, traditional Thai Medicine), and one on mechanical therapy (eg, enhanced external counterpulsation). Findings suggested that interventions, although varied in duration and follow-up, were effective in improving mental health (SMD: 0.64, 95%, p<0.0497). There were also non-statistical improvements in fatigue (SMD: 1.74, 95%, p = 0.1307), quality of life (SMD: -1.34, 95%, p = 0.2787), and cognitive function (SMD: 1.05, p = 0.2989).

CONCLUSION: This review's findings suggest that non-pharmacological interventions may effectively treat neuropsychiatric symptoms of long COVID in AYA, ensuring better outcomes. Nevertheless, further research must be conducted with longer-term follow-up and robust methodology to explore sustained benefits, which may better inform treatment decisions.

TRIAL REGISTRATION: This systematic review is registered in Prospero (CRD42024516016).

RevDate: 2026-03-25
CmpDate: 2026-03-25

Kayesh MEH, Kohara M, K Tsukiyama-Kohara (2026)

Therapeutic potential of pycnogenol: antioxidant, anti-inflammatory, immunomodulatory, antiviral, and anticancer effects.

Frontiers in pharmacology, 17:1755175.

Pycnogenol (PYC), a standardized extract derived from the bark of the French maritime pine (Pinus pinaster ssp. atlantica), exhibits a broad spectrum of biological activities, including antioxidant, anti-inflammatory, immunomodulatory, antiviral, and anticancer effects. These effects are attributed to the rich profile of polyphenolic compounds, which confer potent antioxidant and anti-inflammatory properties. Viral infections frequently induce oxidative stress, inflammation, and immune dysregulation, thereby posing substantial challenges to global public health. Accordingly, the development of effective antiviral agents applicable across diverse viral outbreak settings remains a critical goal. PYC has demonstrated antioxidant, anti-inflammatory, and antiviral potential against several viruses, including hepatitis C virus, dengue virus, and severe acute respiratory syndrome coronavirus 2. In addition, PYC exhibited anticancer activity by modulating cell signaling pathways, inhibiting tumor cell proliferation, inducing apoptosis, and suppressing angiogenesis. However, further research and clinical validation are required to confirm its therapeutic applications. Accordingly, this review summarizes the current understanding regarding the antioxidant, anti-inflammatory, and anticancer mechanisms of PYC. Moreover, the review highlights its immunomodulatory properties to inform future antiviral and anticancer drug development and therapeutic strategies.

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

AraĂşjo M, Gurjar D, Grandchamp N, et al (2026)

GenIV vaccines: bridging innovation to equity in neglected tropical diseases.

Frontiers in immunology, 17:1756570.

Recent breakthroughs in molecular vaccinology have defined a new generation of vaccines that integrate synthetic mRNA, self-amplifying RNA, and nanomaterial-based platforms. These fourth-generation vaccines offer exceptional adaptability, rapid design, and strong immunogenicity, as demonstrated during the COVID-19 pandemic. Their potential now extends to neglected tropical diseases (NTDs), where conventional vaccine strategies have failed to deliver durable protection. This review traces the evolution from whole-pathogen to precision molecular vaccines, highlighting the mechanisms, delivery systems, and translational advances that underpin the GenIV paradigm. Using leishmaniasis as a case study, we discuss how these technologies can bridge innovation and equity through technology transfer, regional manufacturing, and global collaboration. By integrating scientific, ethical, and implementation perspectives, this work outlines how next-generation vaccines can transform both epidemic preparedness and the equitable control of endemic diseases.

RevDate: 2026-03-25
CmpDate: 2026-03-25

Zhang C, Jiang F, Li J, et al (2025)

Exploring the role of trained surgical care nurses in cricothyrotomy and other emergency procedures: a systematic review and meta-analysis.

Frontiers in surgery, 12:1562039.

BACKGROUND: There is a severe shortage of healthcare professionals, emphasized in a stark manner by the recent COVID-19 pandemic, where the mortality rate was primarily a consequence of medical professionals lacking the technical know-how for conducting specialized procedures. Therefore, this systematic review and meta-analysis aimed to evaluate the success rates of nurse-performed emergency surgeries, focusing on trauma care (e.g., cricothyrotomy), rural obstetric emergencies (e.g., caesarean section, hysterectomy), and general procedures (e.g., laparotomy, appendectomy).

METHODS: A systematic search was conducted across eight major databases (PubMed, Embase, CINAHL, Scopus, Web of Science, PsycINFO, Cochrane Library, ProQuest) following PRISMA guidelines. Four eligible studies were identified, and data were pooled using a fixed-effects model.

RESULTS: The synthesis of data across the four selected studies revealed a pooled relative risk (RR) of 0.88 (95% CI: 0.78, 1.00) and odds ratio (OR) of 0.80 (95% CI: 0.65, 0.99) about the efficacy in emergency surgeries conducted by nurses. These four studies were the only ones meeting our strict inclusion criteria of reporting outcome data on nurse-performed emergency procedures. An analysis of heterogeneity demonstrated minimal variability among the studies, with a Chi[2] value of 1.54, df = 3, P = 0.67, and I[2] = 0%. The test for overall effect yielded a statistically significant Z statistic of 2.03 (P = 0.04), indicating a meaningful finding. The observed inferences also showed that the surgical procedures exhibited minimal complications.

CONCLUSION: This study suggests that trained nurses can safely and effectively perform selected emergency surgical procedures. While encouraging, the limited number of studies highlights the need for further research to confirm these findings and guide clinical practice.

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

Isshak R, Habib R, Sorathia AZ, et al (2026)

"First Reported Case of Rapidly Progressive Pyogenic Liver Abscess with Isolation of Priestia megaterium: Case Report and Literature Review".

Journal of investigative medicine high impact case reports, 14:23247096261436690.

Priestia megaterium (formerly Bacillus megaterium) is a Gram-positive, spore-forming environmental bacillus rarely associated with human infection. In this report, we present a case of a rapidly progressive polymicrobial pyogenic liver abscess with subsequent isolation of P. megaterium in a 69-year-old woman with type II diabetes mellitus, chronic kidney disease, metabolic liver disease, and extensive antibiotic allergies. She initially presented with progressive abdominal pain and fever, with negative early imaging studies. Three weeks later, computed tomography (CT) demonstrated new hepatic abscesses. Interventional radiology drainage cultures initially grew Streptococcus intermedius, guiding targeted antimicrobial therapy; however, the patient clinically deteriorated with recurrent abscess formation despite drainage and broad-spectrum coverage. Subsequent aspirate cultures from the abscess fluid later grew P. megaterium, though this result was finalized after the patient's death on day 12 of admission despite intensive care and source control attempts. This case suggests that P. megaterium, traditionally regarded as nonpathogenic, may be recovered in severe infections in immunocompromised hosts; however, alternative explanations-including polymicrobial infection, antibiotic-mediated suppression of co-pathogens, iatrogenic introduction during drainage procedures, or culture contamination-must be carefully considered. Contributing factors likely included her underlying comorbidities, concurrent COVID-19 infection, delayed pathogen identification, and restrictions imposed by multiple drug allergies. Diagnostic challenges underscore the importance of repeated culture sampling, careful interpretation of microbiology results, and awareness of rare organisms when standard therapy is unsuccessful. This report expands the spectrum of diseases associated with P. megaterium. It emphasizes the need for multidisciplinary collaboration and heightened clinical vigilance in cases of rapidly progressive intra-abdominal infections that are unresponsive to conventional treatment.

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

Boubakri S, Barkous B, Ben Lazreg N, et al (2025)

Reconsidering isolated FEV1 reduction: A case report of early-stage asthma with bronchial hyperreactivity and literature review.

La Tunisie medicale, 103(10):1525-1530 pii:/article/view/6028.

INTRODUCTION: Isolated low forced expiratory volume in one second (FEV1) spirometric impairment (ILFSI) is characterized by a decreased FEV1 while both forced vital capacity (FVC) and the FEV1/FVC ratio remain within normal ranges. This pattern may hide an underlying respiratory disorder that warrants further examination. Notably, the 2022 European respiratory society/American thoracic society (2022-ERS/ATS) guidelines do not classify ILFSI as pathological, a stance that has sparked some controversy. This teaching report discussed the case of a woman with ILFSI who developed mild bronchial hyperreactivity after undergoing a methacholine bronchial challenge test (MBCT) and exhibited positive skin prick tests (SPTs) for dust mites.

OBSERVATION: A 28-year-old professional interior designer, who has no history of smoking or exposure to wood smoke and allergens, and who previously experienced a mild case of coronavirus disease-2019, consulted a pulmonologist for chronic cough, sputum production, and recurrent sneezing episodes. Asthma was suspected, leading to the performance of SPTs, spirometry, and either a bronchodilator test (in case of an obstructive ventilatory impairment) or MBCT (in case of a normal spirometry) as requested in the pulmonologist referral letter. The spirometry results indicated ILFSI, with a low FEV1 (z-score = -1.74, 79%) while FVC (z-score = -0.97, 88%) and the FEV1/FVC ratio (z-score = -1.35) remained normal. According to the 2022-ERS/ATS guidelines, these findings are considered normal spirometry because of the maintained FVC and FEV1/FVC ratio. The MBCT confirmed mild bronchial hyperreactivity, showing a 20% drop in FEV1 at a dose of 96 µg. Furthermore, SPTs were positive for dust mites (Dermatophagoides pteronyssinus and farinae).

CONCLUSION: The results of this report suggested a possible association between ILFSI and early allergic asthma, indicating that ILFSI should be re-examined in future revisions of the 2022-ERS/ATS guidelines for interpreting spirometric tests.

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

Ashique S, Das J, Bhui U, et al (2026)

Drug repurposing against viral infections (2020-2025): clinical trials, computational strategies, and therapeutic interventions.

Inflammopharmacology, 34(4):2193-2218.

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.

RevDate: 2026-03-25

Garriga-SalvĂł C, Navarro E, LidĂłn-Moyano C, et al (2026)

Psychological interventions for individuals with long COVID: a systematic review and meta-analysis.

Health psychology review [Epub ahead of print].

Introduction: Long COVID involves a variety of persistent symptoms after initial SARS-CoV-2 infection, affects multiple functional areas and requires multidisciplinary treatment. Objective: This study aimed to explore the available evidence about psychological interventions for individuals with long COVID and their effectiveness in reducing some prevalent symptoms, such as fatigue, anxiety or depression, among others, and improving patient quality of life. Methodology: A systematic review and meta-analysis were conducted following the PRISMA 2020 guidelines. Two independent reviewers performed study selection and data extraction using Web of Science, Scopus, and PubMed databases prior to March 2024. Data synthesis was performed via random-effects meta-analysis, with heterogeneity assessed using the I2 statistic. Results: Of the 1041 articles obtained, 19 were included in the systematic review and 14 in the meta-analysis. Results showed significant reductions in symptoms of anxiety [SMD = -0.64 (95% CI: -1.18 to -0.10)], depression [SMD = -0.41 (95% CI: -0.73 to -0.10)] and fatigue [SMD = -1.37 (95% CI: -2.48 to -0.26)]. Significant improvements were only registered in self-perceived health-related quality of life [SMD = 7.59 (95% CI: 3.70-11.48)]. Conclusion: Results showed improvements in anxiety, depression or fatigue, highlighting the potential role of psychological interventions in patient recovery.

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

Alturki MS, MS Gomaa (2026)

Medicinal chemistry strategies targeting viral proteases: From classical design to next-generation therapeutics.

European journal of medicinal chemistry, 310:118779.

Viral proteases are central targets in antiviral drug discovery and development because they play essential roles in viral replication and maturation. Although protease inhibitors have achieved major clinical success, traditional design strategies face challenges, including resistance development, poor oral exposure of early peptidomimetics, and off-target toxicity of highly reactive covalent warheads. Classical approaches, such as peptidomimetics, macrocyclization, and covalent warhead engineering, are discussed alongside contemporary strategies, including allosteric modulation and targeted protease degradation via proteolysis-targeting chimeras (PROTAC) technology. Particular emphasis is placed on how these strategies address key obstacles, such as resistance evolution, selectivity, metabolic stability, and oral bioavailability. Several quantitative case studies have also demonstrated the growing significance of computational tools in contemporary antiviral discovery. For SARS-CoV-2 main protease (Mpro), these workflows were enabled by the rapid availability of high-resolution experimental crystal structures of the target protein. The evolution of a weak fragment (Kd ≈ 1.7 mM; ΔG ≈ -3.6 kcal/mol) into a covalent inhibitor (QUB-00006-Int-07) with enzymatic inhibition (IC50 ≈ 830 nM) was successfully guided by molecular dynamics (MD) simulations and absolute binding free energy calculations. This was subsequently confirmed experimentally using NMR, ESI-MS, and FRET assays. Furthermore, out of 25 computationally prioritized candidates with Ki values less than 4 μM, 15 active Mpro inhibitors were identified using accelerated free-energy perturbation-based repurposing campaigns. Long-range allosteric pathways connecting the catalytic site to resistance-associated regions and experimentally verified allosteric pockets have also been discovered using dynamic nonequilibrium MD. Together, these integrated in silico approaches enable the early prioritization of high-affinity ligands, mechanistic understanding of resistance, and significant reduction of late-stage attrition in antiviral drug discovery. Through detailed case studies on SARS-CoV-2 main protease (Mpro), Zika virus NS2B-NS3 protease, and Dengue virus NS2B-NS3 protease, the review illustrates how medicinal chemistry principles translate molecular insights into clinically relevant antivirals. Finally, a forward-looking development roadmap is proposed that integrates potency, selectivity, pharmacokinetics, manufacturability, and resistance management toward the goal of broad-spectrum, durable, and adaptable protease-targeted therapeutics development.

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

Safir AH, Bird MM, ME Orczykowski (2026)

Development of effective 3D digital models for first-time learners of musculoskeletal anatomy.

Anatomical sciences education, 19(7):1060-1071.

Musculoskeletal anatomy is a critical component of allied health curricula. With the ubiquity of technology in the classroom and the recent COVID-19 pandemic creating accessibility barriers for students, there is a need for viable digital resources to enhance learning by supplementing traditional textbook studying. This article describes the creation of an annotated, interactive, three-dimensional digital model and presents preliminary data on its effectiveness for students learning musculoskeletal structures of the hip and knee for the first time. The 3D model was developed in Blender using open-source files and was uploaded to the Sketchfab platform. Eighty-one students in the musculoskeletal anatomy course at a large midwestern university took an assessment to measure their baseline anatomical knowledge, studied the testable structures from either the model or textbook images for 10 min, and took a follow-up assessment. Students in the 3D Model Group saw greater increases from their baseline scores and also reported higher confidence in what they had learned, increased ability to visualize anatomical structures, and greater enjoyment of their resource than students who used textbook images. The findings presented here suggest that creating effective, accessible 3D digital resources is feasible for educators without training in technology-related fields and that having access to these resources can be beneficial to first-time learners of anatomy.

RevDate: 2026-06-24
CmpDate: 2026-06-12

Yeo HY, Hung TM, Nghiem N, et al (2026)

The Economic Value of Non-pharmaceutical Interventions for Influenza and COVID-19: A Systematic Review.

Applied health economics and health policy, 24(4):655-670.

BACKGROUND: Non-pharmaceutical interventions (NPIs) are central to mitigating COVID-19 and influenza, yet comparative economic evaluations remain scarce. This systematic review assessed the cost effectiveness and reporting quality of NPI evaluations across both diseases. The study was registered with PROSPERO (CRD42024552613).

METHODS: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, we searched five medical (PubMed, Scopus, EMBASE, CINAHL, and EconLit) and four health technology assessment databases (NHS HTA, CRD DARE, NHS EED, and INAHTA) up to December 2025, including only full economic evaluations. The search strategy incorporated four domains-'influenza,' 'COVID-19,' 'NPIs,' and 'economic evaluation'-and was guided by the WHO NPI framework, encompassing five domains: personal protective, environmental, physical distancing, travel-related, and educational measures. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) checklist.

RESULTS: Thirty-three studies (13 influenza, 20 COVID-19), predominantly from high-income countries, were included. School closures, the most frequently evaluated NPI, were generally not cost effective except during severe pandemics or bundled with other measures. Workforce and business closures were cost effective only in high-severity influenza, with inconsistent findings for COVID-19. Social distancing was cost effective for COVID-19 but not for H1N1 influenza. Isolation, lockdowns, and travel restrictions were cost effective only when implemented early. Face masks and hand hygiene, assessed solely for COVID-19, were generally cost effective when implemented alongside other measures. The median CHEERS score was 75.0%, with one study rated excellent.

CONCLUSION: Our review highlights heterogeneity in cost effectiveness by pandemic severity, intervention type, bundling of measures, and timing. Strategies that combined low-cost NPIs like masks or hand hygiene demonstrated better value, while socially disruptive measures like school and business closure incurred high costs with inconsistent cost-effectiveness outcomes. Integration with vaccines or antivirals further enhanced cost effectiveness. Evidence gaps include the scarcity of evaluations from low-resource settings and variability in country-specific value thresholds. Addressing these gaps is essential for guiding efficient and cost-effective pandemic preparedness.

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

Lima GG, Segati AF, Oliveira GS, et al (2026)

COVID-19 and Pregnancy: Key Findings.

Scandinavian journal of immunology, 103(4):e70109.

Pregnant individuals were prioritised for COVID-19 research due to concerns about increased susceptibility and limited clinical trial data. This narrative review synthesises evidence on maternal infection, immunological adaptations, placental susceptibility, and antibody transfer following maternal SARS-CoV-2 vaccination. Symptomatic COVID-19 during pregnancy increases risks of severe outcomes, whereas vertical transmission remains rare. Placental pathology is characterised mainly by maternal vascular malperfusion and inflammation, with limited evidence of direct viral infection. Maternal vaccination-particularly with mRNA vaccines-induces robust IgG responses with efficient transplacental and lactational transfer, conferring passive neonatal protection. Key uncertainties include optimal vaccine timing, durability of neonatal immunity, and variant-specific responses. Strengthening standardised research and ensuring inclusion of pregnant individuals is essential for global maternal health policy.

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

Eliseev P, Bayrakova A, Vakhrusheva D, et al (2026)

Prevalence of non-tuberculous mycobacteria in various regions of the Russian Federation.

BMC infectious diseases, 26(1):.

BACKGROUND: Non-tuberculous mycobacteria (NTM) are increasingly recognized as significant pathogens causing pulmonary and extrapulmonary diseases worldwide, including Russia. Despite a rising incidence, comprehensive data on the geographic distribution and species diversity of NTM across Russia remain limited. This study aims to analyze the prevalence and NTM species diversity in various Russian regions, highlighting regional variability and diagnostic challenges.

METHODS: A systematic review and analysis of published data and regional studies on NTM detection in different regions of Russia from 2010 to 2024 were conducted. Identification methods included GenoType Mycobacterium CM/AS assays, PCR, mass spectrometry (MALDI-TOF MS) and whole-genome sequencing. Data from multiple regions, including Moscow, Saint Petersburg, the Siberian Federal District and others, were analyzed to assess species diversity and epidemiological patterns.

RESULTS: The species spectrum of NTM in Russia is broad and heterogeneous. M. avium is the predominant species with an average frequency of 30-40%. A secondary group, including M. gordonae (13-25%) and M. intracellulare (12-20%), demonstrates significant prevalence. The remaining species, such as M. fortuitum, M. lentiflavum, M. kansasii, and M. abscessus, exhibit lower but notable frequencies ranging from 3% to 20%. Other species such as M. malmoense, M. xenopi, M. simiae etc. were less common, with frequencies below 5%. Regional differences in species prevalence were pronounced, with M. avium-intracellulare complex dominating in many areas reaching more than 50% of all NTM, while species like M. lentiflavum were more common in specific regions such as the Republic of Komi (44% of all NTM in the region). The COVID-19 pandemic (2020-2023) impacted epidemiological surveillance but did not substantially alter species diversity. Advanced molecular techniques, including whole-genome sequencing, revealed subspecies-level diversity, notably among M. avium and M. abscessus complexes.

CONCLUSIONS: This study underscores the significant geographic variability and species diversity of NTM in the Russian Federation. The detection rates and species spectrum depend on the diagnostic methods employed, highlighting the need for standardized, advanced molecular diagnostics. Continued surveillance and molecular characterization are crucial for improving diagnosis, guiding therapy, and understanding the epidemiology of NTM infections in Russia.

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

Nishimura H (2025)

[The multidisciplinary study, "Aerosol virology/Aerovirology"-A new frontier].

Uirusu, 75(2):121-134.

The COVID-19 pandemic has spurred vigorous research in a field that is old but new, a fusion of aerosol science and virology, each with its own history. I tentatively refer to this interdisciplinary field as "aerosol virology". This review article aims to convey the appeal of research in this field to virologists unfamiliar with aerosol science, covering fundamental knowledge of aerosols. In fact, preceding this article, I had published in the Japanese Journal of Aerosol Science a companion review with this, titled "An Introduction to Aerosol Virology"1), which included basic virological knowledge for members less familiar with viruses, aiming to spark their interest in the field. To advance "aerosol virology", it is necessary to approach research goals with knowledge of both aerosol science and virology, not just one field. This represents a largely unexplored frontier even for virology. I hope members of the Virology Society will venture into this frontier. Both reviews were written with this aspiration in mind.

RevDate: 2026-07-08
CmpDate: 2026-07-02

Yang B, Leader J, Bowes B, et al (2026)

Implementation and Evaluation of Virtual Care in Canadian Health Care Systems: A Scoping Review.

Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 32(7):662-681.

OBJECTIVE: This scoping review examined available evidence in implementation and evaluation of virtual care in Canada. Virtual care saw recent uptake due to the COVID-19 pandemic; however, to ensure quality of care, rigorous implementation and evaluation frameworks are needed.

METHODS: Peer-reviewed and gray literature were searched to determine extent, range, and nature of evidence surrounding implementation and evaluation of virtual care based on the guidelines of the Joanna Briggs Institute. Although virtual care can encompass synchronous and asynchronous modalities, this review focused on synchronous virtual care, defined as real-time interactions between patients and providers via videoconferencing or telephone. Search included MEDLINE, EMBASE, Psych Info, and CINAHL databases and national and provincial health system, professional organization, and regulatory websites. Inclusion criteria included videoconferencing or telephone and English and French Canadian sources. Citations were screened by two researchers at title, abstract, and full-text levels.

RESULTS: Two hundred and eight (208) manuscripts were included for analysis. High numbers of studies on patient satisfaction, process outcomes, and barriers were identified, with underrepresentation of health and systems outcomes and impact evaluations. There were very few studies examining hybrid care, planetary health, and use of virtual care with equity-deserving groups.

DISCUSSION: This scoping review identified areas of importance for future research, including the use of virtual care in rural and remote regions, inpatient, long-term, and emergency settings, hybrid care, economic and planetary health impacts, and artificial intelligence. As well, enhancing standardization of implementation and evaluation guidelines will optimize quality of care and best practice.

RevDate: 2026-03-26
CmpDate: 2026-03-26

Montoya S, Alvarez Ramirez D, ChavarrĂ­a R, et al (2026)

Anesthesia in Patients With Long COVID or Post-infectious Respiratory Sequelae Undergoing Emergency Surgery: Clinical Challenges and Perioperative Strategies.

Cureus, 18(2):e104067.

The COVID-19 pandemic has left lasting health consequences that extend beyond the acute infection phase, with long COVID emerging as a complex multisystem condition that poses significant challenges in the perioperative setting. Patients with post-infectious respiratory or cardiovascular sequelae present an increased anesthetic risk due to persistent inflammation, pulmonary fibrosis, reduced lung compliance, and myocardial dysfunction. These alterations predispose to hypoxemia, arrhythmias, and hemodynamic instability during surgery, making preoperative assessment and individualized anesthetic planning essential. Comprehensive evaluation, including functional tests, cardiac and pulmonary imaging, and laboratory analysis, allows early identification of residual organ dysfunction that can compromise perioperative safety. Anesthetic management must be adapted to the patient's physiological condition, emphasizing lung-protective ventilation, cautious fluid therapy, and close hemodynamic monitoring. Regional anesthesia is preferred when feasible to minimize airway manipulation and reduce respiratory complications, while total intravenous anesthesia represents a safer option when general anesthesia is required. Postoperative care focuses on extended respiratory monitoring, multimodal analgesia to limit opioid use, and the implementation of pulmonary physiotherapy and antithrombotic prophylaxis to prevent complications. Psychological support is also recommended to address post-COVID anxiety and fatigue, contributing to holistic recovery. Although clinical guidelines provide useful recommendations, current evidence remains limited and heterogeneous. Further research is required to clarify the pathophysiological mechanisms of long COVID, evaluate anesthetic drug interactions, and develop validated risk stratification tools. Establishing standardized, evidence-based perioperative protocols is essential to improve outcomes and ensure patient safety in individuals with long COVID undergoing emergency surgery.

RevDate: 2026-03-26
CmpDate: 2026-03-26

Panda PK, R Garg (2026)

Rethinking COVID-19 seasonality: A summer respiratory virus in the tropics, contrast to influenza.

World journal of virology, 15(1):116492.

This opinion challenges the conventional view that coronavirus disease 2019 behaves as a uniformly winter-dominant respiratory infection. Analysis of multi-year surveillance data across hemispheres reveals that severe acute respiratory syndrome coronavirus-2 exhibits seasonal divergence, with consistent summer surges in tropical regions, such as India, and winter peaks in temperate climates. We propose that this pattern arises primarily from human (host) behavioural responses to multi-animal tropism to climatic (environment) extremes, which recreate high-risk indoor transmission settings under both heat and cold. Unlike influenza, severe acute respiratory syndrome coronavirus-2 (agent) combines thermal resilience, broad tissue tropism, and efficient pre-symptomatic transmission, allowing persistence beyond classical winter bounds. Recognizing coronavirus disease 2019 as a behaviourally modulated (through agent-host-environment triad) seasonal virus may help tailor regional surveillance, ventilation, and vaccination strategies in an era of accelerating climatic change.

RevDate: 2026-03-26
CmpDate: 2026-03-26

Younas S, Farooq S, Sahu S, et al (2026)

Next-generation mucosal vaccines for respiratory viruses: Immunological correlates, platform design and clinical translation.

World journal of virology, 15(1):116939.

Influenza, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 continue to cause substantial morbidity and mortality. Currently licensed intramuscular (IM) vaccines effectively reduce severe disease and death but only partially suppress infection and transmission because they induce limited immunity in the respiratory mucosa. This minireview summarizes next-generation mucosal vaccines for respiratory viruses, focusing on the immunological correlates of protection, platform design, and clinical translation. The literature was identified through focused searches of PubMed and Scopus, prioritizing human studies and late-stage preclinical data published between 2000 and 2025. We outline the key mucosal immune correlates required to block viral entry at the airway epithelium, including secretory IgA and tissue-resident memory T cells, and review advances across major vaccine platforms. Current clinical experience with coronavirus disease 2019, influenza, and RSV mucosal vaccines is discussed, along with challenges related to immune measurement, delivery optimization, evaluation of transmission outcomes, and scalable global implementation, including heterologous systemic-mucosal prime-boost strategies. Overall, accumulating evidence positions mucosal vaccination as a promising complement to IM vaccines, with the potential to shift respiratory virus control from disease mitigation to prevention of infection and transmission.

RevDate: 2026-03-26
CmpDate: 2026-03-26

Capobianco M, Cappellani F, Visalli F, et al (2026)

Phlyctenular keratoconjunctivitis with viral triggers.

World journal of virology, 15(1):117124.

Phlyctenular keratoconjunctivitis (PKC) goes beyond limbal nodules. This pediatric ocular surface condition caused by delayed-type hypersensitivity to microbial antigens. The trigger is context-dependent: Mycobacterial antigens in tuberculosis-endemic areas; staphylococcal eyelid disease and rosacea in high-income areas. Although classically bacterial-driven, virus-associated presentations like herpes simplex virus (HSV)-linked phlyctenular disease, pediatric PKC during acute coronavirus disease 2019 (COVID-19) infection, and molluscum contagiosum-driven keratoconjunctivitis suggest the same antigen-mediated pathway. Photophobia and discomfort are prevalent, and corneal involvement can cause neovascularization, scarring, amblyopia, and perforation. This minireview combines epidemiologic, clinical, and immunopathologic data to identify causes and update care. Practical takeaways: (1) Treat the antigen source (blepharitis/rosacea, chlamydia, parasites) and screen for tuberculosis when risk factors exist. Consider viral triggers when history or exam suggest HSV, recent COVID-19, or eyelid molluscum; (2) Suppress inflammation promptly with a short, carefully tapered course of topical corticosteroids; (3) Use topical cyclosporine as a steroid-sparing agent in recurrent or steroid-dependent disease; and (4) Reduce antigen load with lid hygiene and targeted antimicrobials. Start antitubercular treatment for tuberculosis. If a viral cause is anticipated, add antiviral medication or molluscum lesion eradication to the steroid-sparing regimen. Trigger-focused, steroid-sparing treatment reduces recurrences, vision-threatening consequences, and steroid exposure.

RevDate: 2026-03-26
CmpDate: 2026-03-26

Ayoubkhani D, Atchison CJ, Banerjee A, et al (2026)

Considerations for epidemiological studies investigating emerging post-acute infection syndromes: Long Covid as a case study.

EClinicalMedicine, 94:103833.

Epidemiological research studies into Long Covid, currently defined by prolonged symptoms after SARS-CoV-2 infection, have reported widely varying prevalence estimates. As well as rapidly evolving scientific knowledge of Long Covid, these differences are partly driven by substantial methodological heterogeneity between studies, including the outcome definition of Long Covid; duration of follow-up; study design, period and population; sampling frame; data source; and the statistical techniques employed. Having a robust understanding of the prevalence of and risk factors for Long Covid is essential for informing treatment pathways, service provision and policy decisions. In preparation for the public health response to future epidemics and pandemics, this review outlines key epidemiological and statistical considerations and recommendations when designing studies of emerging post-acute infection syndromes, focussing on Long Covid as a case study.

RevDate: 2026-07-13
CmpDate: 2026-06-28

Bilezikian JP, di Filippo L, Bianchi A, et al (2026)

Vitamin D in Gut and Systemic Immune Tolerance and in Infections' Risk: An International Evidence-Based Consensus Statement.

Reviews in endocrine & metabolic disorders, 27(2):183-200.

Vitamin D, classically linked to calcium-phosphate metabolism and skeletal health, is increasingly recognized as a pleiotropic hormone with effects on gastrointestinal and systemic immune functions. This International Consensus aims to critically evaluate the role of vitamin D in gastrointestinal homeostasis, infection prevention, and immune regulation. A multidisciplinary panel of experts conducted a comprehensive review of the literature, distinguishing between associative evidence from observational studies and causal inferences derived from interventional trials addressing gut barrier integrity, dysbiosis, intestinal cancer prevention, respiratory infections, and autoimmune diseases. While vitamin D deficiency has been consistently associated with alterations in gut microbiota composition, increased intestinal permeability, impaired immune tolerance, and increased susceptibility to infections and autoimmune conditions, evidence from interventional studies remains more variable. Clinical outcomes are influenced by baseline 25(OH)D status, supplementation dose and formulation, timing of intervention, and disease context. Vitamin D supplementation has shown potential benefits in selected settings (i.e., autoimmune diseases and acute respiratory infections), and particularly in cases of documented deficiency. Given its pleiotropic role and favourable safety profile, appropriate screening and optimization of vitamin D represent a low-cost and potentially impactful strategy to support gut barrier function and immune competence. While further research is needed to define these therapeutic applications, maintaining vitamin D concentrations above 20 or 30 ng/mL in individuals at skeletal or immunological risk emerges as a reasonable clinical target. This Consensus Panel supports the integration of vitamin D assessment and correction into routine care for at-risk populations and calls for greater awareness of its extra-skeletal relevance.

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

Rosso A, Riccio M, Renzi E, et al (2026)

The role of school-based health education in promoting childhood and adolescent vaccination: A systematic review and Meta-analysis.

Vaccine, 79:128479.

BACKGROUND: Childhood and adolescent vaccination is a cornerstone of public health, yet coverage has stagnated or declined in several regions, partly due to vaccine hesitancy. Schools offer a unique setting to promote vaccination by reaching children and adolescents during formative years. This systematic review and meta-analysis aimed to synthesize evidence on the effectiveness of school-based health education interventions in improving vaccine-related knowledge, attitudes, intentions, and uptake.

METHODS: Following PRISMA guidelines, we searched six databases up to August 2024 for interventional studies evaluating school-based educational programmes targeting students aged 6-18 years. Randomized controlled trials and quasi-experimental studies assessing outcomes related to vaccine knowledge, attitudes, intention to vaccinate, or uptake were included. Studies focusing on COVID-19 vaccination were excluded. Risk of bias was assessed using validated tools. A random-effects meta-analysis was conducted for HPV vaccination uptake.

RESULTS: Thirty-eight studies (1985-2024) were included: 9 RCTs/cluster-RCTs, 14 controlled quasi-experimental studies, and 15 pre-post studies. HPV vaccination was the most frequently studied vaccine (26/38). Most interventions significantly improved vaccine knowledge, while effects on attitudes and intention were less consistent. Eleven studies assessed vaccine uptake, with most reporting post-intervention increases. Meta-analysis of randomized trials showed a significant effect on HPV uptake (RR 4.18, 95% CI 1.41-12.37), although heterogeneity was high and methodological quality varied.

CONCLUSIONS: School-based health education appears to improve vaccine knowledge and may contribute to increased uptake, particularly for HPV. However, evidence is limited by heterogeneity and risk of bias. More rigorous, theory-informed, and sustainable whole-school approaches are needed.

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

Silva LL, Lopes VDS, da Silva DCB, et al (2026)

Global overview of vaccine trust: Evidence from a scoping review.

Vaccine, 79:128482.

BACKGROUND: Vaccine trust is essential for achieving high coverage rates and sustaining immunization programs worldwide. However, hesitancy intensified by the COVID-19 pandemic and the spread of misinformation has challenged trust in vaccines, healthcare professionals, and institutions. This scoping review maps global evidence on the determinants, challenges, and strategies to strengthen vaccine trust.

METHOD: The review followed the JBI Brazilian Centre for Evidence-Based Health Care methodology and the PRISMA-ScR guidelines, with a protocol registered on the Open Science Framework. Searches were conducted in seven databases and additional sources. Studies that directly addressed vaccine trust in any population were included. Data extraction and analysis combined descriptive statistics with narrative synthesis.

RESULTS: A total of 66 studies published between 2020 and 2024 were included, most of them conducted in the United States and focused on COVID-19. Vaccine trust was found to be influenced by perceptions of safety and effectiveness, trust in health systems, professionals, and institutions, as well as individual beliefs and cultural factors. The pandemic increased uncertainty but also encouraged new strategies for community engagement. Health literacy and the involvement of trusted professionals were identified as key elements in strengthening trust. Evidence gaps remain concerning groups such as adolescents, older adults, migrants, and populations in vulnerable situations. Several measurement instruments were mapped, but standardization remains limited.

CONCLUSION: Vaccine trust is a complex and context-dependent phenomenon. Strengthening it requires clear communication, context-specific strategies, active community engagement, and the involvement of healthcare professionals as trusted sources. Future research should include understudied populations, use validated instruments, and assess trust-building interventions to inform more equitable and effective immunization policies.

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

Zheng Y, Li Y, Zeyneloglu C, et al (2026)

Risk and Protective Factors for Infection, Severe Disease, and Mortality in Epidemic Respiratory Viruses.

Allergy, 81(5):1397-1432.

The post-COVID pandemic era has witnessed a concerning resurgence of respiratory viruses, driving a global increase in acute respiratory infections. This trend may stem from relaxed non-pharmaceutical interventions, waning herd immunity, immunological imprinting limiting heterosubtypic protection, or viral antigenic evolution. This review aims to identify and characterize risk and protective factors associated with infection, hospitalization, severe illness, and mortality, while elucidating the drivers of the rising incidence of respiratory virus infections post-pandemic. Evidence on SARS-CoV-2 sublineages, influenza, respiratory syncytial virus, rhinovirus, adenovirus, human metapneumovirus, human parainfluenza virus, human coronaviruses, and cytomegalovirus has been collected and identified. Identified risk factors include demographic characteristics such as pediatrics and older age, male sex, race (Black, Hispanic, American Indian or Alaska native), preterm birth, and HLA-DQA1, IFNAR2, ST6GAL, and B3GALT5 genetic susceptibility. Behavioral, socioeconomic (low socioeconomic status, crowded living conditions), environmental influences (cold seasons, pollution), smoking, obesity and malnutrition could also exacerbate the risk of infection and adverse outcomes. Comorbidities, such as chronic conditions and immunocompromised states, significantly increase the risk of severe disease and hospitalization. Laboratory indices linked to severe disease outcomes include neutrophilia or neutropenia, lymphopenia, eosinopenia, and elevated C-reactive protein. Viral subtypes, viral load kinetics, vaccination status, and antiviral therapies further delineate risk profiles. Epithelial barrier impairment and underlying chronic airway diseases characterized by type 2 immunity also play a detrimental role in the development and severity of respiratory viral infections. Our findings highlight the need for stratified prevention strategies, which combine universal measures targeting shared determinants with virus-specific interventions addressing unique virological and transmission dynamics. It will provide a critical framework for optimizing precision public health strategies to counter repeated respiratory threats in the evolving post-COVID-19 pandemic landscape.

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

Lam CHM, Cheung KC, Mason T, et al (2026)

COVID-19's disruptions to cancer care pathways and widening of health inequalities in the UK: a systematic review.

BMC health services research, 26(1):.

BACKGROUND: The COVID-19 pandemic has significantly impacted cancer care services in the United Kingdom (UK), potentially exacerbating pre-existing health inequalities. While emerging studies have documented service disruptions, a comprehensive synthesis of how these disruptions have widened disparities remains absent. This systematic review examines the extent to which the pandemic disrupted the cancer care pathway and intensified existing disparities across the UK, identifying key sociodemographic and geographical factors influencing access to services. METHODS: A systematic search of PubMed, Scopus, and CINAHL was conducted for studies published between January 2020 and October 2024. Eligible studies included observational and empirical research examining disparities in cancer screening, diagnosis, treatment, and outcomes during the COVID-19 pandemic, as well as the corresponding mitigation strategies. Data extraction followed a structured approach using a custom-developed extraction form designed for this review. Study quality was appraised using a bespoke scoring system, classifying studies as high, moderate, or low importance. Narrative synthesis, following the framework outlined by Popay et al., was then employed to identify key themes and explore relationships between findings. RESULTS: 30 out of 457 studies met the inclusion criteria. The review found that socioeconomic status (SES) emerged as the most significant determinant, with individuals from deprived areas experiencing greater barriers to screening, urgent referrals, and treatment access, leading to poorer patient outcomes. Ethnic minorities, particularly Black patients, faced disproportionate reductions in hospital admissions and cancer screening participation. Age-related disparities were also evident, as older adults maintained higher screening rates but faced greater COVID-19 risks, while younger adults from lower-income backgrounds encountered delays in diagnosis and treatment. CONCLUSIONS: The review highlights that the COVID-19 pandemic has exacerbated existing inequalities in UK cancer care, with SES, ethnicity, and age emerging as key determinants. Targeted interventions are essential, including the establishment of COVID-free “cold sites”, deployment of mobile screening units, and culturally tailored outreach programmes for ethnic minority communities. Strengthening regional healthcare capacity and conducting longitudinal assessments will be crucial in addressing disparities and ensuring equitable cancer care. Future research should focus on the long-term consequences of these disruptions on cancer outcomes and healthcare resilience. SYSTEMATIC REVIEW REGISTRATION: The protocol for this systematic review was registered on PROSPERO under the ID CRD42024602280.

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

Zhu B, Qu S, Li J, et al (2026)

The mechanisms underlying COVID-19 induced insulin resistance: a narrative review.

Frontiers in endocrinology, 17:1781679.

The COVID-19 pandemic, caused by SARS-CoV-2, has resulted in a significant increase in insulin resistance and new-onset diabetes among recovered individuals. This review examines the multifactorial mechanisms underlying these metabolic complications, including activation of the immune system and inflammatory cascades, lifestyle changes, nutritional deficiencies, imbalances in amino acid metabolism, alterations in ketogenesis, disruptions in the gut microbiome, psychological impacts, and COVID-19 vaccines. We discuss how these factors collectively contribute to insulin resistance, particularly in the context of COVID-19, and highlight potential therapeutic strategies, such as dietary interventions and ACE2 activators, that may mitigate these effects. Our analysis underscores the need for targeted approaches to prevent and treat insulin resistance in post-COVID-19 patients, emphasizing the importance of understanding the pandemic's long-term metabolic consequences.

RevDate: 2026-03-27
CmpDate: 2026-03-27

Sadat Hoseini AS, Divani A, Nadali J, et al (2025)

Social Stigma Associated with COVID-19 in Healthcare Workers: A Concept Analysis.

Journal of caring sciences, 14(4):278-292.

INTRODUCTION: Despite the presence of "COVID-19-related social stigma" in health literature, there is no clear definition of this concept in healthcare setting. It is often confused with related terms such as shame, discrimination, and prejudice, leading to imprecise research questions and ineffective evaluations. The aim of this study was to elucidate the concept of social stigma associated with COVID-19 in healthcare workers using Rodgers' evolutionary concept analysis method.

METHODS: Rodgers' evolutionary method of concept analysis was employed to clarify COVID-19-related social stigma in healthcare workers. A literature review was conducted using key terms "COVID-19", "social stigma", and related terms in PubMed, Scopus, Cochrane, ProQuest databases, and Google Scholar from January 2019 to September 2024. Among 3993 studies found, 46 were selected for analysis. Data were analyzed using thematic analysis.

RESULTS: COVID-19-related social stigma among healthcare workers is a multidimensional concept characterized by three primary attributes: Alienation, Humiliation, and Ignorance. The antecedents identified include Fear, Fake news, and the Contagious Nature of the virus. Consequences of this stigma encompass Psychological Issues, Feelings of Worthlessness, Impaired Functionality, and Job Attrition.

CONCLUSION: Social stigmatization associated with COVID-19 exerts significant pressure on healthcare workers. It is crucial to understand the factors that exacerbate this issue. Identifying the dimensions of this stigma can provide valuable insights for policymakers and the media. The implementation of preventive measures, such as clear protocols tailored to the public's educational level and addressing fears of contamination, can improve the situation and reduce the financial strain caused by the loss of healthcare personnel, ultimately enhancing the quality of care.

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

Zhang K, Zhu S, Zhang M, et al (2026)

Convergent hub pathways targeted by IAV, SARS-CoV-2, and RSV in type II alveolar epithelial cells: molecular mechanisms and therapeutic implications.

Frontiers in immunology, 17:1781447.

Type II alveolar epithelial cells (AEC2s) maintain surfactant homeostasis, support distal-lung repair, and contribute to antiviral innate defense. Influenza A virus (IAV), SARS-CoV-2, and respiratory syncytial virus (RSV) use distinct entry receptors, yet severe disease is repeatedly marked by AEC2 dysfunction, alveolar barrier failure, and dysregulated inflammation. We synthesize cross-virus evidence for convergence on a small set of host hubs: innate sensing and interferon signaling, mitochondria-centered immunometabolism and oxidative stress, post-translational signaling modules, barrier and surfactant programs, and regulated cell-death checkpoints. We summarize structural and post-translational mechanisms by which viral proteins disrupt pattern recognition receptor (PRR)-mitochondrial antiviral signaling protein (MAVS) signaling, couple mitochondrial injury to weakened antiviral responses, and bias epithelial fate toward inflammatory lytic injury. Where AEC2-specific evidence is incomplete, especially for integrated PANoptosis-like programs, we label these elements as working models and highlight validation needs. We compare model systems used to study AEC2 infection, including ALI cultures, organoids, lung-on-chip platforms, and single-cell or network analyses. Finally, we discuss host-directed therapeutic opportunities along the cascade, separating near-term approaches from longer-term platform strategies such as targeted protein degradation and targeted nanodelivery, and noting constraints in distal-lung delivery, onset kinetics, and safety. This AEC2-centered convergence framework supports mechanism-driven interpretation of severe viral pneumonia and guides broader-spectrum intervention concepts.

RevDate: 2026-03-27

Nakae A, Matsubara T, Hattori T, et al (2026)

Telework-related health outcomes in Japan and globally: Implications for avatar-based work standards.

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

BackgroundThe COVID-19 pandemic has driven a global shift in teleworking, serving as a real-world experiment in remote labor. As workplaces advance toward technologically mediated environments, including avatar-based systems for remote interaction, understanding the health implications of teleworking is crucial for future occupational health standards.ObjectiveThis review examined the health-related outcomes of teleworking during the pandemic, comparing Japan and other countries to inform health-supportive remote work systems.MethodsA structured narrative review was conducted using MEDLINE (PubMed) and IEEE Xplore through January 9, 2026. Studies were included if they examined teleworking in adult workplace environments and reported physical, mental, behavioral, or performance-related outcomes. Data from 67 eligible studies (12 from Japan and 55 from other countries) were analyzed for the physical health, mental health, lifestyle factors, and work performance domains. Cultural and institutional factors were examined to understand the regional differences.ResultsTelework has been linked to musculoskeletal discomfort, sedentary behavior, psychological stress, and unhealthy lifestyle choices. Japanese and international studies have identified these challenges, although the manifestations vary by context. In Japan, inflexible teleworking, inadequate home infrastructure, and an office-centric culture exacerbate negative outcomes, particularly for women and caregivers. International studies have highlighted the benefits of flexible scheduling and organizational support. Cultural norms and institutional readiness mediated these effects.ConclusionsThis review demonstrates the need for evidence-based health standards for next-generation remote work environments including avatar-based systems. We propose recommendations incorporating ergonomic design, health monitoring, organizational flexibility, and cultural adaptation. As remote work technologies evolve, policy frameworks must prioritize worker well-being.

RevDate: 2026-03-29
CmpDate: 2026-03-27

Cui Y, Liang Z, H Cong (2026)

From Design to Clinical Use: mRNA Vaccines for Infectious Diseases and Cancer.

Vaccines, 14(3):.

mRNA vaccines represent a revolutionary advance in vaccinology, boasting advantages like rapid development, robust immunogenicity and flexible antigen design over traditional vaccines. This review systematically summarizes the core research progress of mRNA vaccines, including their structural composition with five functional elements and novel subtypes (linear mRNA, self-amplifying RNA, circular RNA) with unique biological characteristics and application value. It elaborates on the immune activation mechanism of mRNA vaccines, which mimic natural viral infection to trigger both innate and adaptive immunity, and analyzes mainstream delivery systems (lipid nanoparticles, dendritic cells, protamine, exosomes, polymers) with their respective performance, advantages and bottlenecks. This review also details the clinical application status of mRNA vaccines in infectious diseases (influenza, rabies, monkeypox, SARS-CoV-2, HIV, parasites) and cancer therapy, highlighting promising preclinical and clinical results of candidate vaccines and combined therapeutic regimens. Additionally, it addresses the current limitations of mRNA vaccines, such as delivery inefficiency, production costs, and cold chain constraints. Finally, this review prospects the future development direction, emphasizing that the optimization of delivery systems, antigen design and production processes will further promote the clinical translation and diversified application of mRNA vaccines in disease prevention and treatment.

RevDate: 2026-03-29
CmpDate: 2026-03-27

Siniscalchi C, Basaglia M, Tufano A, et al (2026)

Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT): An Immunopathogenic Model of Dysregulated Vaccine-Triggered Immunity.

Vaccines, 14(3):.

BACKGROUND/OBJECTIVES: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but severe immune-mediated adverse event associated with adenoviral vector-based SARS-CoV-2 vaccines. Beyond its clinical relevance, VITT provides a unique human model of vaccine-triggered autoimmunity and immune-thrombosis. This review critically reassesses the immunopathogenic framework of VITT in light of recent evidence.

METHODS: We conducted a structured narrative review of studies published between 2021 and 2025, focusing on clinical, epidemiological, and mechanistic data relevant to PF4 immunogenicity, platelet activation, and long-term outcomes.

RESULTS: Current evidence supports a multistep model in which adenoviral vector components form immunogenic PF4-polyanion complexes that induce high-affinity anti-PF4 IgG antibodies. These antibodies activate platelets via FcγRIIa, amplify complement signaling, promote neutrophil extracellular trap formation, and drive endothelial perturbation, establishing a self-sustaining thrombo-inflammatory loop. Recent longitudinal studies refine earlier interpretations by distinguishing persistent anti-PF4 seropositivity from sustained platelet-activating capacity. Epidemiological data support platform-enriched risk rather than absolute platform exclusivity, with a proposed mechanistic "border zone" for incomplete phenotypes.

CONCLUSIONS: VITT represents a tractable human model of vaccine-induced autoimmunity in which innate immune activation and multivalent antigen presentation converge to break tolerance. Updated evidence clarifies antibody persistence, platform enrichment, and translational implications, while highlighting unresolved questions regarding host susceptibility and long-term immune regulation.

RevDate: 2026-03-29
CmpDate: 2026-03-27

Huang S, Yu S, Zhang M, et al (2026)

From Innate to Adaptive: Paradigm Shifts and Frontier Challenges in Next-Generation Vaccine Design.

Vaccines, 14(3):.

The unprecedented success of mRNA vaccines during the COVID-19 pandemic marks a fundamental paradigm shift in vaccinology, moving the field from empirical pathogen modification toward the rational engineering of host immunity. This review synthesizes recent breakthroughs to construct a conceptual framework for understanding how modern vaccines function as programmable immune instructions. We first analyze the innate immune system as an instructional center, where recognition of vaccine components dictates the quality of ensuing adaptive responses. We then examine the germinal center (GC) as a micro-evolutionary engine for antibody maturation, the output of which can be tuned by vaccine design. The discussion centers on three integrated pillars of next-generation vaccines: computationally designed immunogens, spatiotemporally controlled adjuvant systems, and intelligent delivery platforms, emphasizing that their synergy is essential for achieving broad, durable protection against complex pathogens. Finally, we explore how the convergence of systems vaccinology, artificial intelligence, and personalized medicine is guiding the field toward a more predictable and rapid-response future, while also outlining key advances and persistent challenges.

RevDate: 2026-03-29
CmpDate: 2026-03-27

Pjanova D, A Rafeeque (2026)

SARS-CoV-2 Infection and Vaccination, Immune Dysregulation, and Cancer.

Vaccines, 14(3):.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection induces heterogeneous immune responses that influence both acute disease severity and long-term immune remodeling. A key question in the context of infection and vaccination is whether SARS-CoV-2 exerts direct oncogenic effects or instead acts as a transient immunological stressor capable of reinforcing tumor-permissive pathways. Current evidence does not support classical viral oncogenesis. Rather, severe infection is characterized by early interferon (IFN) imbalance followed by NF-ÎşB-dominant inflammatory amplification, promoting sustained IL-6/JAK-STAT3 and MAPK signaling, chronic cytokine production, metabolic reprogramming, and impaired antitumor immune surveillance. At the molecular level, viral structural proteins modulate host signaling networks. The spike (S1) protein engages TLR2/TLR4-MyD88 pathways, activating NF-ÎşB and MAPK cascades, while the membrane (M) protein reinforces NF-ÎşB-STAT3 circuits linked to epithelial-mesenchymal transition and inflammatory gene expression. These mechanisms intensify pre-existing oncogenic signaling without initiating malignant transformation. Tissue-specific responses are further shaped by IFN competence, renin-angiotensin system balance, and metabolic context. In parallel, immune evasion programs shared by chronic viral infection and cancer, including checkpoint upregulation, impaired antigen presentation, and suppressive myeloid expansion, may be transiently reinforced following severe infection. In contrast, SARS-CoV-2 vaccination induces spatially restricted, self-limited innate activation without sustained inflammatory signaling or persistent antigen exposure. By preventing severe disease and chronic immune dysregulation, vaccination interrupts pathways hypothesized to intersect with cancer biology, with no evidence of increased cancer incidence. Ongoing longitudinal studies are required to clarify the long-term oncologic implications of post-infectious immune remodeling.

RevDate: 2026-03-29
CmpDate: 2026-03-27

Asaad M, Mustafa MO, Al-Haneedi Y, et al (2026)

The Feasibility of Developing a Universal SARS-CoV-2 Vaccine.

Vaccines, 14(3):.

As SARS-CoV-2 continues to evolve with increased transmissibility and immune evasion, the need for vaccines that provide broader and more durable protection has become increasingly urgent. The extensive research spurred by the pandemic has accelerated the development of diverse vaccine platforms, including mRNA, DNA, virus-like particles (VLPs), recombinant proteins, and mosaic mono- and polyvalent vaccines. While several of these platforms have reached regulatory approval and widespread clinical employment, others remain under evaluation or in various stages of clinical development. These vaccines have significantly reduced infection rates, severe disease, and hospitalizations, particularly among high-risk group. Nevertheless, the ongoing emergence of novel variants and subvariants has challenged the efficacy of both existing and newly developed vaccines. This evolving landscape underscores the urgent need for a universal SARS-CoV-2 vaccine platform capable of providing comprehensive and long-lasting immunity. In this review, we evaluate current and emerging strategies for SARS-CoV-2 universal vaccine development, with a focus on antigen design, breadth of immune protection, and clinical feasibility. Attention is given to various universal vaccine platforms such as the mosaic polyvalent spike construct, multi-epitope vaccines targeting the receptor-binding domain (RBD), and approaches centered on the conserved S2 subunit of the spike protein. We also discuss strategies leveraging additional conserved viral proteins and T helper (Th) and cytotoxic T lymphocyte (CTL) epitopes from across coronaviruses. By highlighting the advances in these areas, this review provides a framework to guide the rational design of next-generation universal vaccines capable of delivering broad and durable protection against SARS-CoV-2 variants.

RevDate: 2026-03-29
CmpDate: 2026-03-27

Kamransarkandi M, Varyushina EA, Gorshkov AN, et al (2026)

SARS-CoV-2 and Influenza Co-Circulation and Co-Vaccination: A Narrative Review.

Vaccines, 14(3):.

BACKGROUND/OBJECTIVES: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus are dangerous respiratory pathogens with high pandemic potential. Since 2021, these two viruses have been co-circulating, which implies additional risks of co-infection with both pathogens. Prophylactic vaccination is widely recognized as the most effective way to prevent COVID-19 and influenza and to reduce the severity of these diseases. This review analyzes recent data on the simultaneous circulation of influenza and SARS-CoV-2 viruses worldwide, including epidemiological data and the pathogenetic mechanisms of co-infection. Next, we focus on current approaches to simultaneous and combined vaccination against influenza and COVID-19. We outline the types of vaccines and summarize the available findings on the effectiveness and safety of co-vaccination.

METHODS: A comprehensive search was conducted using PubMed, Scopus, Web of Science, and ClinicalTrials to identify data relevant to SARS-CoV-2 and influenza co-circulation and dual vaccination.

RESULTS: Influenza and SARS-CoV-2 cause similar symptoms, and co-infection can significantly enhance the risks of pneumonia and acute respiratory distress syndrome progressing with a poor outcome, especially among children and the elderly. A range of influenza and COVID-19 vaccines built on different technological platforms is currently available on the market, with proven effectiveness, immunogenicity, and safety. A co-vaccination approach is more convenient for patients and is associated with better response to treatment, while also improving vaccine coverage and compliance and offering significant resource savings for healthcare systems.

CONCLUSIONS: The concurrent circulation of SARS-CoV-2 and influenza viruses presents a growing public health challenge. Simultaneous and combination vaccination strategies have emerged as effective tools to streamline immunization, enhance protection, and reduce healthcare burden. Future studies should elucidate the mechanisms of the exacerbation of respiratory disease caused by co-infection, as well as the optimal strategies for co-administering influenza and COVID-19 vaccines for long-term control of seasonal and potentially pandemic respiratory viruses.

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

Li Y, Fan Z, Wang Y, et al (2026)

A review of UVC air disinfection for built environments: Inactivation mechanisms, kinetic models, and influencing determinants.

Journal of environmental management, 404:129461.

The COVID-19 pandemic has significantly heightened public awareness of air quality and its implications for human health, propelling air sterilization technologies to the forefront research. This Review synthesizes recent progress in ultraviolet C (UVC)-based air disinfection, integrating inactivation mechanisms, irradiance distribution models and microbial inactivation kinetics. We compare major UVC light sources and examine how optical properties, spatial deployment and environmental conditions govern dose delivery and disinfection efficacy. Key physical and biological factors-including wavelength, airflow, humidity and microbial heterogeneity-are discussed in the context of predictive modelling and system optimization. We highlight critical limitations related to safety, penetration depth and energy efficiency, and outline future directions centred on far-UVC technologies, solid-state light sources and intelligent control strategies. Together, this Review provides a conceptual framework for the rational design and safe implementation of UVC air disinfection systems in public and built environments.

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

Tscherne A, F Krammer (2026)

Seven decades after the Asian influenza pandemic: A historical review about immunity and vaccines against H2N2.

Vaccine, 79:128467.

In 1957, a reassortant influenza A virus (IAV) H2N2 subtype emerged in humans and encountered a population that was antigenically naĂŻve to this subtype. The lack of pre-existing immunity to the H2 hemagglutinin (HA) facilitated efficient human-to-human transmission, and by the end of the Summer of 1957, most countries around the world reported increasing influenza cases caused by the new influenza virus subtype. The pandemic lasted until 1958, resulting in millions of infections globally, with 1-4 million estimated deaths. The first vaccines targeting specifically the H2N2 subtype were available in autumn 1957, but their limited immunogenicity hampered a successful fight against the "Asian influenza pandemic". After the pandemic, H2N2 became seasonal in the following years. Most individuals developed immunity against both the H2 HA and N2 neuraminidase (NA) proteins of the virus, and vaccines administered in the early 1960s successfully boosted this immunity. In 1968, the circulating H2N2 was replaced by the H3N2 subtype, and individuals with pre-existing N2 immunity were partially cross-protected against severe H3N2 infection, as the two N2 NAs were antigenically similar. Since the disappearance of H2N2 from the human population in 1968, global H2 immunity has been decreasing. This raises concerns about a possible re-emergence of the H2 subtype from animal reservoirs, where the virus has circulated for decades, into the human population. As preparedness for future pandemics, research on H2-specific vaccines is currently ongoing, with several candidates being tested in preclinical studies and early-phase clinical trials. In contrast to 1957, vaccine technology platforms, but also the assays used to assess vaccine immunogenicity, and efficacy, have significantly improved. This review aims to summarize the key historical milestones of the Asian influenza pandemic, the impact of H2N2 immunity during and after the 1957 pandemic, the immunogenicity of H2N2-specific vaccines in both a pandemic and pre-pandemic situation, and H2N2-specific antiviral treatment.

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

Karthik S S, Jadhav P, Paul A, et al (2026)

Understanding gut microbiota dysbiosis as a plausible link between obstructive sleep apnea (OSA), viral infections, and lifestyle diseases.

Microbial pathogenesis, 215:108466.

Obstructive sleep apnea (OSA) is a multifactorial disorder which is influenced by intermittent hypoxia, sleep fragmentation, and systemic inflammation. Recent evidence suggests that lifestyle diseases and viral infections further exacerbate OSA severity through common inflammatory and metabolic pathways. Parallelly, gut dysbiosis has gained recognition as a key mediator which links respiratory, metabolic, and infectious disease processes via the gut-lung axis. This review explores the convergent role of gut microbial dysbiosis across OSA, lifestyle-associated comorbidities such as obesity, diabetes, and cardiovascular disease and viral infections including respiratory syncytial virus (RSV), influenza, dengue, Human Immunodeficiency Virus (HIV), and SARS-CoV-2. Across these conditions, a recurring pattern of reduced beneficial commensals (e.g., Bifidobacterium, Faecalibacterium prausnitzii, Roseburia, Akkermansia muciniphila) and a noted increase of pro-inflammatory taxa (e.g., Escherichia, Streptococcus, Enterobacteriaceae) has been observed. It contributes to epithelial barrier breakdown, endotoxemia, metabolic dysfunction, and immune dysregulation. In OSA patients, intermittent hypoxia is observed that causes gut barrier impairment and microbial translocation, thus amplifying systemic inflammation. Similarly, viral infections reshape the gut ecology, bringing adverse effects to host immunity and respiratory outcomes. The review highlights upon the therapeutic potentials of prebiotics and probiotics supplementation for modulating gut dysbiosis. It discusses the role of these therapeutic interventions in improving metabolic homeostasis, reducing inflammation, and potentially mitigating OSA-related complications. Collectively, this analysis highlights gut dysbiosis as a plausible unifying mechanism connecting lifestyle diseases, viral infections, and OSA, presenting a compelling avenue for integrated, microbiome-targeted interventions.

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

Fehrer A, Windzio L, Schoening S, et al (2026)

Expert perspectives on Myalgic encephalomyelitis/chronic fatigue syndrome - Insights from the 3[rd] International Conference of the CharitĂŠ Fatigue Center.

Autoimmunity reviews, 25(5):104043.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multisystemic disorder mostly triggered by viral infections, with core symptoms including post-exertional malaise (PEM), fatigue, pain, and cognitive dysfunction. Its prevalence has increased significantly in the context of the coronavirus disease 2019 (COVID-19) pandemic. Despite its severity and impact on patients' quality of life, ME/CFS remains poorly understood. On May 12 and 13, 2025, the 3[rd] International Conference hosted by the CharitĂŠ Fatigue Center brought together nearly 200 researchers from various disciplines on-site, and around 3,700 participants online to discuss recent advances in ME/CFS research, diagnostics, clinical care, and therapeutic trials. The program featured 33 lectures by international experts on key topics such as post-COVID syndrome (PCS), care structures, and pathophysiological mechanisms including cardiovascular dysregulation, immune dysregulation, autoimmune mechanisms, and metabolic dysfunction. In addition, results from clinical trials addressing disease mechanisms, including those specifically targeting autoantibodies, were presented. While public awareness and funding opportunities have increased in the wake of the pandemic and the emergence of PCS, ME/CFS remains severely underresearched. Sustained and adequately funded research efforts are urgently required to advance understanding, identify diagnostic markers, and develop targeted therapeutic interventions.

RevDate: 2026-07-13

Farag NH, Ozen A, Spaulding AB, et al (2026)

Lessons learnt from the COVID-19 pandemic: Middle East and North Africa regional perspective for future preparedness.

BMJ global health, 11(3):.

The COVID-19 pandemic revealed critical gaps in preparedness and response capacities globally. These gaps were evident in the Middle East and North Africa (MENA) region, as the region faces unique challenges due to ongoing humanitarian crises, political instability and large-scale religious gatherings, which further exacerbate the risk of spread of infectious diseases.In April 2024, a conference hosted by the US Centres for Disease Control and Prevention MENA Regional Office and National Institutes of Allergy and Infectious Diseases, in collaboration with the Mohammed Bin Rashid University of Medicine and Health Sciences, brought together 200 scientists and public health professionals from 16 countries to discuss lessons learnt from the COVID-19 pandemic and strategies to strengthen future preparedness and response. This report presents the key barriers to regional collaboration and data sharing identified during the conference, along with the proposed solutions, including establishing regional collaboration platforms, increasing public-private partnerships, operationalising the one health approach and leveraging technological advances.Reflections on the global pandemic response emphasise the need for improved communication, preparedness extending beyond the health sector and distribution of resources. The collective insights and recommendations in this report aim to provide a roadmap for strengthening emergency preparedness and response in the MENA region and globally, ensuring improved readiness for future public health emergencies.

RevDate: 2026-03-27

Lee MM, TR Talbot (2026)

The Role of Infection Prevention in Monitoring and Preventing Healthcare-Associated Viral Respiratory Infection.

Infectious disease clinics of North America pii:S0891-5520(26)00022-X [Epub ahead of print].

Health care-associated viral respiratory infections are common and cause increased patient morbidity and mortality. Although the threat of viral respiratory infection was underscored by the COVID-19 pandemic, respiratory viruses continue to have a significant impact in health care settings. Studies report decreased nosocomial transmission when aggressive infection control measures are implemented with more success using a multicomponent approach. This review focuses on the epidemiology, transmission, and role of infection prevention in the control of health care-associated respiratory viral infections.

RevDate: 2026-03-30
CmpDate: 2026-03-28

Guillari A, Abagnale M, Palazzo C, et al (2026)

Nurse Retention in Hospitals: A Multilevel Integrative Review of Organizational Determinants.

Healthcare (Basel, Switzerland), 14(6):.

Background/Objectives: Nurse retention remains a major global challenge for healthcare systems, intensified by workforce aging, rising care complexity, and the long-term impact of the COVID-19 pandemic. Despite extensive research, the evidence on nurse retention remains fragmented and frequently focuses on isolated determinants. This review aimed to synthesize the multifactorial determinants of nurse retention by integrating organizational, relational, and individual perspectives. Methods: An integrative review was conducted following Whittemore and Knafl's approach and reported according to PRISMA 2020 guidelines where applicable. A systematic search of six databases identified studies published between 2016 and 2026 addressing nurse retention in hospital settings. Included studies underwent methodological quality appraisal using validated tools, and findings were synthesized narratively. Results: Twenty-five articles were included. The analysis revealed differences in perspective between nurse managers and nurses regarding the factors that influence retention. Transformational and participative leadership among nurse managers enhanced staff retention through supportive organizational climates and higher professional commitment. For staff nurses, positive work environments, collegial support, and psychological resources such as self-efficacy and resilience were key predictors of intention to stay. These findings can be interpreted through Herzberg's Two-Factor Theory, Self-Determination Theory and Theory of Planned Behavior, which collectively highlight how recognition, autonomy, and competence satisfaction drive nurses' intention to remain in their roles. Conclusions: Nurse retention reflects dynamic, multilevel processes rather than the influence of single determinants. Integrated, theory-informed approaches targeting organizational structures, relational climates, and individual psychological resources are required to strengthen workforce sustainability and support high-quality care delivery.

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

Hatfield JS, Thielen BK, SM Goyal (2026)

Avian Metapneumovirus: Virology, Epidemiology, and Insights from a Comparative Analysis with Human Metapneumovirus-A Review.

Biomolecules, 16(3):.

Metapneumoviruses comprise a genus of negative-sense RNA viruses that cause significant respiratory disease across human and avian hosts. Human metapneumovirus (hMPV) is a globally prevalent pathogen associated with acute lower respiratory tract infections in infants, older adults, and immunocompromised individuals. Avian metapneumovirus (aMPV) imposes substantial economic losses on the poultry industry through respiratory disease, reproductive impairment, and high mortality in the presence of secondary infections. Despite their distinctive host ranges, hMPV and aMPV share a conserved genomic architecture and encode homologous structural and non-structural proteins that mediate viral entry, replication, assembly, and evasion of host innate immunity. Comparative analysis highlights that both have deeply conserved polymerase and nucleocapsid functions, and yet have a wide range of diversity in the attachment glycoprotein (G) and small hydrophobic protein (SH), reflecting divergent evolutionary pressures in human versus avian hosts that have led to such distinctive differences. The recent emergence and detection of aMPV/A and aMPV/B across the previously aMPV-free United States beginning in late 2023, combined with rising cases globally of hMPV post-SARS-CoV-2 pandemic, underscore the continued challenges of metapneumovirus surveillance and control in humans and animals. This review aims to highlight the current knowledge on the history, molecular virology, pathogenesis, epidemiology, diagnostics, and control strategies for aMPV while drawing mechanistic parallels to hMPV. By contextualizing shared biology and structure alongside host-specific adaptations, we aim to identify key gaps that shape vaccine design, antiviral development, and future research priorities aimed at mitigating the health and economic burden posed by metapneumoviruses found in both birds and humans.

RevDate: 2026-03-30
CmpDate: 2026-03-28

Ciullo R, Femminò S, Brizzi MF, et al (2026)

Oxidative Stress in Takotsubo Syndrome: Insights into Extracellular Vesicles and Their Potential Clinical Relevance.

Antioxidants (Basel, Switzerland), 15(3):.

Takotsubo syndrome (TTS) is an acute and reversible form of heart failure characterized by transient left ventricular dysfunction, typically triggered by acute stress stimuli. TTS, also referred to as "stress cardiomyopathy", may paradoxically be triggered not only by negative stressors but also by intense positive emotional experiences. Interestingly, TTS was sharply incremented during and following the COVID-19 pandemic. Despite increased clinical recognition, reliable biomarkers for early diagnosis and prognosis remains limited. Oxidative stress is increasingly recognized as a key mechanism in TTS, acting downstream of sympathetic overactivation, thus contributing to myocardial stunning, endothelial dysfunction, and inflammation. In this context, extracellular vesicles (EVs) have emerged as key mediators of intercellular communication and as potential circulating biomarkers, as they reflect the molecular state of their cells of origin. In this review, we summarize the current diagnostic approaches for TTS, including the InterTAK Diagnostic Score, imaging gold standards, and emerging biomarkers such as circulating miRNAs and EV cargo associated with TTS. Furthermore, we critically examine the mechanistic interplay between oxidative stress and EVs in TTS, highlighting translational perspectives and future directions for integrating EV-based biomarkers into personalized clinical management.

RevDate: 2026-03-30
CmpDate: 2026-03-28

Alzahrani AJ (2026)

Molecular Point-of-Care Testing for Respiratory Infections: A Comprehensive Literature Review (2006-2026).

Diagnostics (Basel, Switzerland), 16(6):.

Molecular point-of-care testing (POCT) for respiratory infections has undergone remarkable advancement over the past two decades, driven by technological innovation and urgent clinical needs highlighted by the COVID-19 pandemic. This comprehensive systematic review was conducted following PRISMA 2020 guidelines, synthesizing evidence from 254 peer-reviewed studies published between 2006 and 2026, with detailed analysis of the 30 most relevant papers selected through a rigorous four-stage screening process. The review examines the evolution of molecular POCT technologies, including reverse transcription polymerase chain reaction (RT-PCR), loop-mediated isothermal amplification (LAMP), recombinase polymerase amplification (RPA), and CRISPR-based detection systems. Key findings demonstrate that modern molecular POCT platforms achieve diagnostic performance comparable to laboratory-based testing, with sensitivities ranging from 88% to 100% and specificities from 98% to 100%, while delivering results in 15 to 80 min. These technologies enable rapid, accurate detection of major respiratory pathogens, including SARS-CoV-2, influenza A/B, respiratory syncytial virus (RSV), and atypical bacteria. The integration of microfluidic systems, portable devices, and smartphone-based analysis has expanded access to testing in resource-limited settings, emergency departments, and wearable platforms. This review provides critical insights for clinicians, researchers, and policymakers regarding the current state, clinical applications, and future directions of molecular POCT for respiratory infections.

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

Higuchi R, L McBride (2026)

A Memoir of Inventing Real-Time PCR and Developing the ABI 7700.

International journal of molecular sciences, 27(6):.

Real-time PCR (qPCR) is today's definitive quantitative technology in molecular biology and diagnostics. Until 30 years ago, PCR product analyses were generally performed after amplification using gel-based methods. Quantification typically relied on visual inspection or densitometry of end-point products and was therefore relatively unreliable and poorly suited to high-throughput automation. To celebrate real-time PCR's 30-year anniversary of commercial availability, Professor Stephen Bustin, Guest Editor for the special edition, "Advancing Molecular Science Through Reproducible qPCR: MIQE Guidelines and Beyond," asked Russell Higuchi to give a historical account on how his idea of real-time PCR was conceived and brought to fruition. Dr. Higuchi then asked his collaborator, Lincoln McBride, who drove the development of the ABI 7700-the high-throughput real-time PCR instrument that gave researchers access to this technology-to co-author this dual memoir. This story is told from the perspectives of the two scientists most directly responsible for making real-time PCR practical and widely accessible. Taking turns, Russell Higuchi describes the conceptual and experimental steps at Cetus and then Roche that led from homogeneous PCR detection to continuous fluorescence monitoring, whilst Lincoln McBride details ABI's parallel efforts to commercialize Russ's invention. Together, they trace how experimental insight, engineering constraints, product development, and commercial decision-making shaped the Applied Biosystems 7700 Sequence Detection System and established real-time PCR as a practical and reliable quantitative technology. Their team's efforts persevered through technological uncertainty and within a complex corporate collaboration. They share key historical documents in their original form. Their accounts show how the 7700 system emerged as the convergence of chemistry, optics, software, and product development. The eventual global reliance on real-time PCR during the COVID-19 pandemic demonstrated, at unprecedented scale, the profound and enduring impact of these early technical and organizational choices.

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

Oshitari T (2026)

Pathogenesis of Non-Arteritic Anterior Ischemic Optic Neuropathy Associated with COVID-19.

International journal of molecular sciences, 27(6):.

Non-arteritic ischemic optic neuropathy (NAION) results from vascular insufficiency within the optic nerve head. The precise pathogenesis of NAION remains unclear; however, insufficient blood supply from the short posterior ciliary arteries and the choroidal circulation has been associated with its development. Although major risk factors include diabetes, hypertension, and hyperlipidemia, coronavirus disease 2019 (COVID-19) may also contribute to the development of NAION. This literature review presents our case of NAION associated with COVID-19 infection and summarizes previously reported cases of NAION following COVID-19 infection published in the English-language literature worldwide. Because direct infection of ocular tissues, including ocular vessels, via the angiotensin-converting enzyme 2 receptor is thought to contribute to the development of NAION, cases of NAION associated with COVID-19 vaccination were excluded from this review. Furthermore, we discuss the possible molecular mechanisms underlying the development of NAION after COVID-19 infection and highlight the potential risks of COVID-19 for clinical ophthalmologists.

RevDate: 2026-03-30
CmpDate: 2026-03-28

Alkhalifah SA, Alshahrani WA, Alshehri AM, et al (2026)

Clinical Outcomes with the Use of Dipeptidyl Peptidase-4 (DPP-4) Inhibitor Among Patients with Diabetes Mellitus and COVID-19: A Systematic Review of Observational Studies.

Journal of clinical medicine, 15(6):.

Background: Diabetics with coronavirus disease 2019 (COVID-19) manifest more adverse clinical outcomes with elevated rates of death. It has been suggested that the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pathway of entrance into the host cell might be assisted by dipeptidyl peptidase-4 (DPP4), leading to inflammation and cytokine storm, with replication into the airways and unfavorable effects in the lungs. Consequently, the goal of this systematic review is to investigate the most recent data on the effect of DPP-4i (dipeptidyl peptidase-4 inhibitor) medications on clinical outcomes, mainly mortality among COVID-19 patients. Methods: By conducting a systematic search using PubMed and the Cochrane library, observational studies were identified to examine the association between DPP-4i medications and clinical outcomes including mortality, intensive care unit and hospital admissions. The methodologies of included studies were assessed utilizing the Newcastle-Ottawa Scale (NOS). Results: A total of nineteen studies were included with sample sizes varying from over 100 patients to 2.8 million and variant follow-up durations from 30 days up to discharge or death. Most of the population across the studies had COVID-19 for the first time, and the majority were hospitalized. Similarly, mortality definition varied among studies with different time points consisting of 30-day mortality, in-hospital mortality, or all-cause mortality. The majority of the studies identified no effect on mortality by DPP-4i, while a considerable proportion revealed beneficial effects; only four studies showed increased mortality. Conclusions: Real-world data from this review suggested a safe use of DPP-4i among COVID-19 patients; however, randomized clinical trials are required to confirm the beneficial outcomes and safe use.

RevDate: 2026-03-30
CmpDate: 2026-03-28

Boccatonda A, Brighenti A, Piamonti D, et al (2026)

The Role of CEUS in the Diagnosis and Follow-Up of Pleuropulmonary Diseases and Interventional Procedures.

Journal of clinical medicine, 15(6):.

Background: Contrast-enhanced ultrasound (CEUS) recently emerged as a valuable imaging modality for evaluating pleuropulmonary diseases. By combining morphological information from conventional B-mode ultrasound with real-time assessment of microvascular perfusion, CEUS can provide functional insights that improve diagnostic accuracy, guide interventions, and support patient surveillance. Methods: This review summarizes the current evidence on the use of CEUS in major pleuropulmonary disorders, including pneumonia, pleural effusion, pulmonary embolism, neoplasms, and COVID-19-related lung injury. The most relevant clinical studies and meta-analyses were analyzed, focusing on CEUS parameters, diagnostic performance, and integration with other imaging techniques. Results: CEUS enables the differentiation between inflammatory, ischemic, and malignant lesions through qualitative and quantitative analyses of enhancement patterns. Early and homogeneous enhancement is typical of inflammatory or infectious processes, whereas heterogeneous or delayed enhancement with early washout strongly suggests malignancy or ischemia. In pneumonia and pleural infections, CEUS identifies non-perfused or necrotic areas, guiding drainage and evaluating therapeutic responses. In pulmonary embolism, it reveals avascular consolidations corresponding to infarction, even when CT angiography is inconclusive. For peripheral lung tumors, CEUS assesses angiogenesis and vascular supply, correlating perfusion parameters with histopathology, and improving biopsy targeting. Furthermore, in COVID-19 pneumonia, CEUS can detect microvascular alterations related to thrombosis and fibrosis. Conclusions: CEUS is a safe, noninvasive, and radiation-free technique that provides unique real-time information on pulmonary perfusion. Its integration with conventional ultrasound enhances diagnostic precision, optimizes interventional guidance, and allows for dynamic monitoring of treatment response. Future developments in quantitative analysis, artificial intelligence, and targeted contrast agents are expected to further expand CEUS clinical applications in pleuropulmonary imaging.

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

Motebang ME, Ramphalla P, J Tsoka-Gwegweni (2026)

Scoping Review of the Models for Case-Based Health Programs in Africa: Towards Case-Based Surveillance for HIV in Lesotho.

International journal of environmental research and public health, 23(3):.

The review aims at exploring models for case-base health programs across Africa that could best help Lesotho succeed in its efforts to establish a case-based surveillance (CBS) system for their HIV program. The review involves looking through several sources and databases including EBSCOHOST, Google Scholar, Science Direct and PubMed. The insights of suitable models were from the following Africa countries: South Africa, Kenya, Guinea, Tanzania, Ghana, Mozambique and Zambia. The study articles were published within the last 10 years, specifically from 2014 to 2024. This range was used as part of their inclusion criteria to ensure relevance of the articles. The studied models focused on infectious diseases such as measles, HIVand COVID-19. The key takeaway is that setting up electronic medical records systems (EMRs) is critical as a first step for any effective CBS. Using unique identifiers, establishing clear data governance policies and building strong infrastructure is a necessity in making CBS work. For a successful establishment of CBS, Lesotho should adopt these strategies that can be sustainable, improve disease tracking, response and ultimately health outcomes for Basotho.

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

Topolewska A, Zahorska A, Łakocka A, et al (2026)

Z-Drugs in the Environment: A Review.

Molecules (Basel, Switzerland), 31(6):.

According to the World Health Organization (WHO), substance dependence and mental health disorders, such as anxiety, depression, post-traumatic stress disorder (PTSD), insomnia, bipolar disorder, and schizophrenia, affect >360 million people worldwide. As a result the increasing use of psychoactive pharmaceuticals, including non-benzodiazepines (also referred to as Z-drugs), has been observed. The COVID-19 pandemic has also had an additional significant negative effect on people's mental health. Among the aforementioned mental health disorders, chronic insomnia is reported to affect approximately 10% of the adult population. Z-drugs are frequently used in the treatment of insomnia due to their rapid onset of action. They are metabolized in the human organism, but noticeable amounts of the original compound are released to the environment via household wastewater. The extensive use of these pharmaceuticals has led to growing concern about the occurrence of their residues in the environment. Unfortunately, the information on the analytical methods for determining Z-drugs, their main metabolites and transformation products in the environment, efficiency of their removal in wastewater treatment plants, their fate, their presence in environmental matrices, and their ecotoxicological effects is limited. This review paper focuses on summarizing data on these topics. To the best of our knowledge, such a comprehensive review has not yet been published.

RevDate: 2026-03-30
CmpDate: 2026-03-28

Feng Y, M La (2026)

Overview in Machine-Learning-Assisted Sensing Techniques for Monitoring COVID-19.

Micromachines, 17(3):.

Viruses suddenly emerging from obscurity or anonymity affect our quality of life and increase incidence rate and mortality. A typical example is the global coronavirus disease 2019 (COVID-19) pandemic. Although severe acute respiratory syndrome coronavirus 2, known as the pathogen of COVID-19 has been significantly eliminated, its monitoring is still crucial, as the infectious disease may break out again. Therefore, it is necessary to develop simple and effective tools for monitoring COVID-19 and other diseases. Here, we summarize the progress of machine-learning-based biosensors in the monitoring and management of COVID-19. This article mainly includes three sections: machine learning algorithms, machine-learning-assisted biosensors, and challenges and future perspectives. We believe that this work is valuable for developing artificial-intelligence-based innovative analytical devices for healthcare monitoring and management of COVID-19 and other infectious diseases.

RevDate: 2026-03-30
CmpDate: 2026-03-28

Hommos L, Gohil H, Rob M, et al (2026)

Long-Term Thyroid Complications Post-COVID-19: A Systematic Review.

Microorganisms, 14(3):.

Coronavirus disease 2019 (COVID-19) is increasingly shown to be a multisystem disorder with long-term complications, including endocrine system complications. The thyroid gland is also susceptible, as it contains ACE2 receptors, making it exposed to both direct viral damage and autoimmune-mediated dysfunction. Recent reports document the various thyroid complications that persist well after the acute infection phase. This systematic review investigates the long-term thyroid complications in individuals with a history of SARS-CoV-2 infection. A comprehensive literature search across several databases was conducted. Eligible studies reported new onset long-term thyroid complications occurring post-COVID-19 infection. Abstract and full-text screening as well as data extraction and quality assessment was performed by two independent reviewers. Only 28 studies met our inclusion criteria, reporting 419 patients from 18 countries. These studies included case reports, case series, cohort, and cross-sectional studies. Reported thyroid disorders included subacute thyroiditis, thyrotoxicosis, hyperthyroidism (including Graves' disease), isolated high T3/T4, hypothyroidism, central hypothyroidism, and non-thyroidal illness syndrome (NTIS). While many of these eventually resolved, a significant portion persisted or recurred, especially autoimmune thyroiditis. COVID-19 is associated with a range of long-term thyroid complications. Although some cases are temporary, others last, especially autoimmune thyroid disorders. Proposed mechanisms include direct viral cytotoxicity, cytokine-mediated Hypothalamic-Pituitary-Thyroid (HPT) axis suppression, post-viral autoimmunity, vascular injury, and neuroendocrine disruption. Routine thyroid function monitoring in COVID-19 survivors, particularly those with severe disease or persistent symptoms is recommended, and larger prospective studies are needed to better understand incidence and outcomes.

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ESP Quick Facts

ESP Origins

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

ESP Support

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

ESP Rationale

Although the methods of molecular biology can seem almost magical to the uninitiated, the original techniques of classical genetics are readily appreciated by one and all: cross individuals that differ in some inherited trait, collect all of the progeny, score their attributes, and propose mechanisms to explain the patterns of inheritance observed.

ESP Goal

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

ESP Usage

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

ESP Content

When the site began, no journals were making their early content available in digital format. As a result, ESP was obliged to digitize classic literature before it could be made available. For many important papers — such as Mendel's original paper or the first genetic map — ESP had to produce entirely new typeset versions of the works, if they were to be available in a high-quality format.

ESP Help

Early support from the DOE component of the Human Genome Project was critically important for getting the ESP project on a firm foundation. Since that funding ended (nearly 20 years ago), the project has been operated as a purely volunteer effort. Anyone wishing to assist in these efforts should send an email to Robbins.

ESP Plans

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

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

Electronic Scholarly Publishing
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Papers in Classical Genetics

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

Digital Books

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

Timelines

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

Biographies

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

Selected Bibliographies

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

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