@article {pmid42467983,
year = {2026},
author = {Tholo, N and Markey, G and Harrigan, R and Pandey, P and Prasad, B and Barai, RS and Gibson, DS and Shukla, P},
title = {The critical role of artificial intelligence and bioinformatics in accelerating peptide-based vaccine discovery for tackling global infectious diseases.},
journal = {Briefings in bioinformatics},
volume = {27},
number = {4},
pages = {},
doi = {10.1093/bib/bbag260},
pmid = {42467983},
issn = {1477-4054},
support = {//Department for the Economy/ ; },
mesh = {Humans ; *Artificial Intelligence ; *Computational Biology/methods ; Protein Subunit Vaccines ; Immunoinformatics ; *Vaccines, Subunit/immunology ; *Vaccine Development ; Epitopes, T-Lymphocyte/immunology ; Machine Learning ; COVID-19 Vaccines/immunology ; COVID-19/prevention & control/immunology ; *Communicable Diseases/immunology ; Epitopes, B-Lymphocyte/immunology ; },
abstract = {Peptide-based vaccines, enabled by bioinformatics and machine learning (ML), have emerged as one of the most promising approaches for rapid, safe, and cost-effective vaccine design against infectious diseases. Unlike conventional approaches that depend heavily on whole-pathogen cultures or recombinant protein expression, peptide vaccines can be designed in silico and synthesized quickly. Rational and targeted in silico approaches for the discovery of peptide-based vaccine candidates include B-cell and T-cell epitope prediction, immunogenicity, antigenicity, allergenicity, autoimmunity, population coverage, sequence conservation, molecular docking, molecular dynamics simulation, in silico cloning, and immunological simulation analyses. The combination of these comprehensive computational methods can effectively generate high-quality vaccine candidates for subsequent validation via in vitro and in vivo experiments. This review contextualizes the historical trajectory of peptide-based vaccinology, from early linear epitope discoveries in the 1960s to multi-epitope constructs and clinically tested candidates such as UB-612 and PepGNP-Covid19. It examines critical challenges in immunoinformatics, including performance gaps in epitope prediction tools, complexities in human leucocyte antigen (HLA) mapping, and the need for extensive manual intervention in pipelines. Artificial intelligence-driven approaches, spanning deep learning, and interpretable ML, are positioned to transform epitope prediction, reduce human error, and standardize reproducibility. These advances have the potential to support global outbreak response targets such as the Coalition for Epidemic Preparedness Innovations (CEPI) 100 Days Mission and the World Health Organization (WHO) Research and Development (R&D) Blueprint. However, their performance remains constrained by data quality, dataset imbalance, limited benchmark standardization, and persistent underrepresentation of many HLA alleles and population groups. Key Points Peptide-based vaccines, accelerated by bioinformatics and machine learning, offer a potentially rapid, relatively safe, and cost-effective alternative to traditional vaccine design, enabling in silico development and swift synthetic manufacturing. Computational methods such as B-cell and T-cell epitope prediction, immunogenicity analysis, and molecular simulations allow for rational and targeted vaccine candidate discovery, enhancing quality and efficiency. The field has evolved from early linear epitope discoveries in the 1960s to sophisticated multi-epitope constructs and clinically tested candidates like UB-612 and PepGNP-Covid19. Major challenges in immunoinformatics include performance limitations in epitope prediction tools, complexities in HLA mapping, and the necessity for manual intervention in data pipelines. Artificial intelligence-driven models, including deep learning and interpretable machine learning, promise to overcome these challenges by improving prediction accuracy, reducing errors, and supporting global epidemic response efforts such as CEPI's 100 Days Mission and the WHO R&D Blueprint.},
}

Humans
*Artificial Intelligence
*Computational Biology/methods
Protein Subunit Vaccines
Immunoinformatics
*Vaccines, Subunit/immunology
*Vaccine Development
Epitopes, T-Lymphocyte/immunology
Machine Learning
COVID-19 Vaccines/immunology
COVID-19/prevention & control/immunology
*Communicable Diseases/immunology
Epitopes, B-Lymphocyte/immunology

@article {pmid42468359,
year = {2026},
author = {Kelly, JB and Brodie, G and Zeden, MS},
title = {Antisense oligonucleotides: design, implementation and future perspectives in microbiology.},
journal = {Current opinion in microbiology},
volume = {93},
number = {},
pages = {102794},
doi = {10.1016/j.mib.2026.102794},
pmid = {42468359},
issn = {1879-0364},
abstract = {Advances in molecular biology have expanded antimicrobial strategies that traditionally targeted proteins or metabolic pathways to now include RNA, enabling a previously unattainable precision through control of gene expression. The clinical potential of RNA-therapeutics was demonstrated during the COVID-19 pandemic, when mRNA vaccines marked a transformative milestone for RNA-based interventions for viral infections. Increasingly, similar principles are emerging for the treatment of bacterial infections. Antisense oligonucleotides (ASOs) bind complementary mRNA sequences to induce RNase H-mediated degradation or block their translation. Initially developed for genetic and neurodegenerative disorders, ASOs are now emerging as next-generation antibacterials, termed ASOBiotics, designed to silence essential bacterial genes. In this review, we explore the advances of ASO technologies with applications in bacterial pathogens, outlining design considerations while discussing the challenges and opportunities for making precision antibacterial therapeutics.},
}

@article {pmid40685732,
year = {2026},
author = {Tabassum, H and Ankita, and Deo, V},
title = {Review of Nanomedicine Research Proposals Received at ICMR: Gaps in Research and Further Opportunities.},
journal = {Combinatorial chemistry & high throughput screening},
volume = {29},
number = {5},
pages = {808-817},
pmid = {40685732},
issn = {1875-5402},
mesh = {*Nanomedicine/economics ; Humans ; India ; *Biomedical Research ; COVID-19 ; Translational Research, Biomedical ; Neoplasms/diagnosis ; },
abstract = {INTRODUCTION: Nanomedicine integrates nanotechnology with healthcare, offering targeted diagnostics, therapeutic solutions, and preventive applications. India, through agencies such as the Indian Council of Medical Research (ICMR), the Department of Biotechnology (DBT), and the Department of Science & Technology (DST), has prioritized nanomedicine to address public health challenges. Despite significant progress, gaps persist in clinical translation and interdisciplinary applications.

OBJECTIVE: To analyze the scope, gaps, and opportunities in nanomedicine research in India, focusing on ICMR-funded projects.

METHODS: Data on nanomedicine proposals submitted to ICMR (2018-2022) were reviewed using keyword-based searches from databases and survey responses from principal investigators. Metrics included funding trends, research objectives, and outcomes. Quantitative and qualitative analyses assessed scientific progress and translational potential.

RESULTS: Over the past five years, the ICMR has funded over 250 projects, with a focus on cancer therapy, infectious diseases, and diagnostics. Achievements include nanoparticle-based drug delivery systems and diagnostics, with notable innovations like Albupax® and gold nanoparticlebased sensors. Research activity increased over the years, with a slight slowdown during the COVID-19 period. Funding was primarily allocated to states with established research infrastructures, underscoring the need for more equitable support nationwide.

DISCUSSION: Nanomedicine research in India has made significant progress, primarily in cancer; however, limited research has been observed in non-cancer applications and long-term safety studies. Differences in funding across various regions and difficulties in turning ideas into marketable products were major problems. Integrating nanomedicine with genetic tools offers promise for more targeted treatments.

CONCLUSION: The ICMR's support has advanced nanomedicine research in India, particularly in the field of oncology. To strengthen India's position in the field, future efforts must address unmet needs, including non-cancer applications, clinical translation, and regulatory harmonization. Collaborative initiatives and equitable funding distribution can accelerate advancements and strengthen the implementation of nanomedicine research.},
}

*Nanomedicine/economics
Humans
India
*Biomedical Research
COVID-19
Translational Research, Biomedical
Neoplasms/diagnosis

@article {pmid42138851,
year = {2026},
author = {Silva, AS and Dornelas, R and Silva, JRLE},
title = {COVID-19-related voice disorders: a scoping review.},
journal = {CoDAS},
volume = {38},
number = {3},
pages = {e20250243},
pmid = {42138851},
issn = {2317-1782},
mesh = {Humans ; *Voice Disorders/virology/etiology ; *COVID-19/complications ; SARS-CoV-2 ; Adult ; Voice Quality ; },
abstract = {PURPOSE: To map the available evidence on voice changes in non-intubated adults diagnosed with mild to moderate COVID-19.

RESEARCH STRATEGIES: Scoping review conducted according to PRISMA-ScR guidelines, including studies published between 2019 and 2025. Systematic searches were performed in the MEDLINE (PubMed), EMBASE, LILACS, Scopus, Web of Science, and Cochrane Library databases and in grey literature sources (Google Scholar, MedRxiv, and ProQuest). Controlled descriptors and free terms related to COVID-19 and voice disorders were combined using Boolean operators.

SELECTION CRITERIA: The review included studies with adults (18-65 years) with a confirmed diagnosis of mild to moderate COVID-19 and excluded studies with individuals undergoing endotracheal intubation and with a previous history of voice disorders or respiratory comorbidities. The selection was performed by two independent reviewers.

DATA ANALYSIS: The data were extracted and analyzed descriptively and quantitatively, considering study characteristics, vocal assessment methods, and main outcomes.

RESULTS: Of the 35,497 records identified, 19 studies met the inclusion criteria. The most frequent voice disorders were dysphonia, hoarseness, reduction in maximum phonation time, and changes in acoustic measures such as jitter, shimmer, and harmonic-to-noise ratio. Associated symptoms included vocal fatigue, cough, dyspnea, and laryngeal discomfort, as well as a negative impact on voice-related quality of life.

CONCLUSION: Mild to moderate COVID-19 can lead to clinically relevant vocal impairments, reinforcing the need for speech-language-hearing follow-up and research to support vocal assessment and rehabilitation protocols in the post-infection period.},
}

Humans
*Voice Disorders/virology/etiology
*COVID-19/complications
SARS-CoV-2
Adult
Voice Quality

@article {pmid42149126,
year = {2026},
author = {Akinbolade, S and Potter, R and Inskip, A and Nesworthy, J and Brock, K and Norman, G},
title = {Repurposed Medicines for Viruses With Epidemic or Pandemic Potential: A Horizon Scan.},
journal = {Pharmacology research & perspectives},
volume = {14},
number = {3},
pages = {e70271},
pmid = {42149126},
issn = {2052-1707},
support = {HSRIC-2016-10 009//National Institute for Health and Care Research/ ; },
mesh = {Humans ; *Drug Repositioning/methods ; *Antiviral Agents/therapeutic use/pharmacology ; SARS-CoV-2 ; Pandemics ; Animals ; COVID-19 ; *Pneumonia, Viral/drug therapy/epidemiology ; *Coronavirus Infections/drug therapy ; COVID-19 Drug Treatment ; },
abstract = {Viruses such as Ebola, Marburg, influenza, mpox, MERS-CoV, SARS-CoV, and SARS-CoV-2 may be considered pathogens of epidemic or pandemic concern. Developing novel antiviral medicines can be time-consuming and resource intensive. Repurposing existing medicines with known or potential antiviral activity offers a faster, cost-effective strategy to expand treatment options during public health emergencies. This scan aimed to map current investigational activity involving repurposed medicines for these viruses. A horizon scanning approach was employed, starting with a targeted search in Embase followed by a systematic search of ClinicalTrials.gov to identify developmental stages of relevant technologies. Eligible technologies included UK- or EU-licensed medicines being investigated for antiviral use, while vaccines, unlicensed medicines, and treatments already approved for the target viruses were excluded. From the literature, 196 repurposed technologies were identified, and the expanded search on the clinical trials registry revealed 58 technologies in active clinical development. Interventional trial activity was limited to influenza and SARS-CoV-2, with 29 technologies for SARS-CoV-2 and two influenza technologies advancing to phase III evaluation. For other viruses, candidate repurposed technologies were identified only at preclinical or exploratory stages. Frequently investigated pharmacological classes included direct-acting antivirals, immunomodulators, and anti-inflammatory agents. While repurposing represents a potentially rapid strategy for therapeutic deployment, inclusion in this horizon scan does not imply clinical efficacy. Rigorous preclinical validation, pharmacokinetic feasibility assessment, and mechanistic confirmation remain essential before clinical translation.},
}

Humans
*Drug Repositioning/methods
*Antiviral Agents/therapeutic use/pharmacology
SARS-CoV-2
Pandemics
Animals
COVID-19
*Pneumonia, Viral/drug therapy/epidemiology
*Coronavirus Infections/drug therapy
COVID-19 Drug Treatment

@article {pmid42149692,
year = {2026},
author = {Amahong, K and Liu, Y and Zhang, Z and Tao, L and Sarshad, AA and Zhu, F},
title = {An integrative meta-analysis of SARS-CoV-2 RNA-protein interactomes identifies conserved host factors shared with other RNA viruses.},
journal = {Briefings in functional genomics},
volume = {25},
number = {},
pages = {},
pmid = {42149692},
issn = {2041-2657},
mesh = {Humans ; *SARS-CoV-2/metabolism/genetics ; *RNA, Viral/metabolism/genetics ; *Host-Pathogen Interactions ; *RNA-Binding Proteins/metabolism ; *RNA Viruses/metabolism/genetics ; Influenza A virus/metabolism/genetics ; Dengue Virus/metabolism/genetics ; COVID-19/virology/metabolism ; Zika Virus/metabolism/genetics ; },
abstract = {RNA viruses cause substantial global disease burden and depend on host RNA-binding proteins and translation machinery. However, it remains unclear which host factors are robustly engaged across independent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA interactome studies and to what extent these factors are shared with other RNA viruses. Here, we perform an integrative meta-analysis of eight published SARS-CoV-2 RNA-protein interactomes and compare them with corresponding Influenza A virus, Zika virus, and Dengue virus datasets to define conserved host networks and prioritize candidate host-directed antiviral targets. By integrating multiple datasets and applying ClusterProfiler together with curated pathway resources (KEGG, Reactome, WikiPathways, and Gene Ontology), we systematically characterize the functional landscape of SARS-CoV-2 RNA-protein interactions. The consensus SARS-CoV-2 interactome is enriched for mRNA processing, translation, RNA surveillance and innate immune functions. Cross-viral comparison identifies 275 host proteins shared across all four RNA viruses, forming interconnected modules that include key translation factors (EEF1A1, EIF4A1, EIF3H) and RNA-binding proteins (Nucleolin, ILF3). Drug-target annotation prioritizes 21 proteins with 35 approved or investigational modulators for host-directed antiviral repurposing. Together, these findings generate a consensus map of conserved host dependencies and highlight prioritized targets for future mechanistic and translational studies. Research Highlights Integrated SARS-CoV-2 datasets and compared with, Influenza A virus, Zika virus, Dengue virus. Identified 275 host proteins shared across these four pathogens. Conserved proteins were enriched in translation, RNA processing, and innate immune pathways. Prioritized 21 host targets and 35 drugs for antiviral repurposing.},
}

Humans
*SARS-CoV-2/metabolism/genetics
*RNA, Viral/metabolism/genetics
*Host-Pathogen Interactions
*RNA-Binding Proteins/metabolism
*RNA Viruses/metabolism/genetics
Influenza A virus/metabolism/genetics
Dengue Virus/metabolism/genetics
COVID-19/virology/metabolism
Zika Virus/metabolism/genetics

@article {pmid42171504,
year = {2026},
author = {Brüssow, H},
title = {Extending the Targets for Coronavirus Antivirals Beyond That of Approved Drugs: Insights From Preclinical Research.},
journal = {Microbial biotechnology},
volume = {19},
number = {5},
pages = {e70376},
pmid = {42171504},
issn = {1751-7915},
mesh = {*Antiviral Agents/pharmacology/therapeutic use ; Humans ; SARS-CoV-2/drug effects ; *Betacoronavirus/drug effects ; COVID-19 Drug Treatment ; Animals ; Spike Glycoprotein, Coronavirus/metabolism/antagonists & inhibitors ; Drug Evaluation, Preclinical ; *Coronavirus Infections/drug therapy/virology ; COVID-19 ; Viral Nonstructural Proteins/antagonists & inhibitors/metabolism ; *Pneumonia, Viral/drug therapy/virology ; Pandemics ; },
abstract = {Antiviral drugs have been approved for the treatment of COVID-19. However, they present pharmacological limitations, a mixed efficacy profile and target just two coronavirus proteins. To extend the range of druggable coronavirus proteins, researchers explored small molecule N-glycan binders as inhibitors of SARS-CoV-2 spike protein interaction with the cell receptor. Other groups investigated lipopeptides as inhibitors of cell fusion by viral spikes. High throughput screening of chemical libraries yielded viral maturation inhibitors that targeted the viral M protein. Massive screening led to inhibitors of the non-structural coronavirus protein NSP14, a methyltransferase involved in viral mRNA cap synthesis. Machine learning-driven scans of chemical space revealed inhibitors of non-structural coronavirus protein NSP3, a papain-like protease subverting innate immune response to viral infection. A chimera of a nucleotide analogue coupled to an RNase L attractor bound the RNA-dependent RNA polymerase NSP12 and mediated degradation of the viral RNA. Several of these compounds showed comparable or even superior antiviral efficacy as approved COVID-19 drugs in preclinical animal tests. Parallel efforts were made to develop chemical compounds targeting host proteins needed for viral multiplication. Peptidomimetic tetrapeptides acted as inhibitors of the host protease TMPRSS2 involved in cell fusion by the viral spike protein. A repurposed TMPRSS2 inhibitor was tested in COVID-19 patients without demonstrating efficacy. A genetic screen demonstrated an enzyme involved in sphingomyelin synthesis and its inhibitor which impaired SARS-CoV-2 replication. A viral-cell protein interactome study showed 332 cellular proteins interacting with 26 coronaviral proteins. A chemoinformatic search found inhibitors for the interaction of NSP9 with host elongation factor eIF4A and for NSP13 with elongation factor eEF1A. Plitidepsin, a clinically used eEF1A inhibitor, was tested in human clinical trials with COVID-19 patients demonstrating in vivo antiviral activity and a trend for clinical amelioration in an underpowered phase 3 clinical trial.},
}

*Antiviral Agents/pharmacology/therapeutic use
Humans
SARS-CoV-2/drug effects
*Betacoronavirus/drug effects
COVID-19 Drug Treatment
Animals
Spike Glycoprotein, Coronavirus/metabolism/antagonists & inhibitors
Drug Evaluation, Preclinical
*Coronavirus Infections/drug therapy/virology
COVID-19
Viral Nonstructural Proteins/antagonists & inhibitors/metabolism
*Pneumonia, Viral/drug therapy/virology
Pandemics

@article {pmid42191274,
year = {2026},
author = {Parikesit, AA and Ansori, ANM and Kharisma, VD and Purnobasuki, H and Nugraha, Y},
title = {Advances in bioinformatics: Integration of biomolecular simulations and virtual reality for revolutionizing disease mechanism elucidation and therapeutic development.},
journal = {International review of cell and molecular biology},
volume = {402},
number = {},
pages = {211-236},
doi = {10.1016/bs.ircmb.2025.11.004},
pmid = {42191274},
issn = {1937-6448},
mesh = {Humans ; *Molecular Dynamics Simulation ; *Virtual Reality ; *Computational Biology/methods ; COVID-19/virology ; SARS-CoV-2 ; },
abstract = {Virtual reality and biomolecular simulations currently lie at the leading edge in dissecting the molecular pathways underlying the disease. This chapter will discuss how the integrations of various technologies will extend knowledge about complex biological processes and their contribution to disease pathophysiology. Advances in molecular dynamics (MD) simulations currently make it possible to record the behavior of proteins and other biomolecules with accurate temporal resolution and full atom detail. Such simulations include information on critical structural changes related to diseases, interactions with possible medication, and functionality of proteins. With recently improved speed, accuracy, and accessibility, MD. has become a basic research and drug development tool. From the researcher's point of view, virtual reality has revolutionized how one can conceptualize and interact with molecular structures. Virtual reality (VR) is a method that uses the three-dimensional presentation of biomolecules as manipulable virtual objects for intuitive insight into molecular interactions and structural connections. In this way, virtual technology can be very helpful in investigating complex chemical systems and creating new theories. It facilitates the Cloud-based co-creation of environments in cloud systems for molecular modeling. The same technologies allow real-time research collaboration by sharing and changing virtual molecules. These cooperative situations reward the generation of new ideas and information, which might provide novel discoveries that more direct approaches could not realize. This chapter will discuss the range of computational methods applied to elucidate molecular recognition mechanisms and will cover improved sampling methods and in silico screening. It will also describe how such techniques may be applied to investigate viral proteins and help develop vaccines and drugs during the COVID-19 pandemic. The combination of the predictive power of MD. Simulations with intuitive visualization capabilities from VR would allow researchers to achieve an unprecedented understanding of the molecular origin of many diseases. This should inspire innovation in therapeutic intervention and accelerate discovery in molecular biology.},
}

Humans
*Molecular Dynamics Simulation
*Virtual Reality
*Computational Biology/methods
COVID-19/virology
SARS-CoV-2

@article {pmid42453219,
year = {2026},
author = {Neogi, SB and Saroha, E and Mishra, SS and Tolani, H and Samtani, R},
title = {Telemedicine: An exploration of global impact and Indian perspectives on healthcare delivery, effectiveness, and challenges.},
journal = {Journal of family medicine and primary care},
volume = {15},
number = {4},
pages = {1473-1478},
pmid = {42453219},
issn = {2249-4863},
abstract = {Telemedicine represents a transformative approach to healthcare delivery, leveraging information and communication technologies to bridge geographical barriers between patients and healthcare providers. This paper explores telemedicine's historical development, global applications, and specific relevance in India, particularly focusing on the eSanjeevani program. Despite its potential, telemedicine faces challenges, such as the digital divide, regulatory frameworks, patient acceptance, and technical limitations. Addressing these challenges requires collaborative efforts among stakeholders to ensure equitable access, data security, and interoperability of telemedicine platforms. Telemedicine has demonstrated its efficacy in enhancing access to healthcare services, particularly in underserved regions, and has emerged as a vital tool during the COVID-19 pandemic. The eSanjeevani program in India serves as a prominent example of successful telemedicine implementation, facilitating millions of consultations and bridging the urban-rural healthcare divide. Looking ahead, telemedicine holds promise in revolutionizing healthcare delivery, fostering ecological responsibility, and advancing toward universal health coverage. Embracing telemedicine represents a significant step toward a healthier, greener, and more sustainable future for healthcare systems worldwide.},
}

@article {pmid42453257,
year = {2026},
author = {Rajeh, DA and Amer, KA and Alasmari, R and Brema, I and Aljumah, M and Aljuaid, S},
title = {Diabetic ketoacidosis after COVID-19 infection in newly diagnosed patients with diabetes in the Middle East and African countries: A systematic review and meta-analysis.},
journal = {Journal of family medicine and primary care},
volume = {15},
number = {4},
pages = {1527-1539},
pmid = {42453257},
issn = {2249-4863},
abstract = {INTRODUCTION: The risk of diabetic ketoacidosis (DKA) is increased following the severe acute respiratory syndrome coronavirus 2 infection, "COVID-19," however, little evidence is available regarding the prevalence and outcomes of DKA in newly diagnosed patients with diabetes in the Middle East and African countries. Our objective was to conduct a systematic review of case reports detailing the prevalence and outcomes of DKA in COVID-19 infected in the above referenced countries.

METHODS AND SUBJECTS: Our search encompassed Medline (via PubMed), Embase (via OVID), Web of Science, Scopus, grey literature sources such as Open Access Theses and Dissertations (OATD), and the reference lists of the included studies.

RESULTS: The results of the current meta-analysis study showed that 17 studies met the search criteria and a total of 22 patients (15 patients with newly type 1 diabetes and seven patients with newly diagnosed type 2 diabetes). About 69.5% of the patients were of Arabian ethnicity. Body mass index (BMI) was reported only for seven patients, with a mean of 25.04 k g/m[2]. Two patients died in patients with newly diagnosed type 2 diabetes, giving a mortality rate of 14.3%, while all patients were in type 1 diabetes, who had DKA survived.

CONCLUSIONS: Covid 19 infection in patients with new diabetes from the Middle East and African countries was associated with increased risk of DKA with high mortality in patients with newly diagnosed type 2 diabetes.},
}

@article {pmid42453521,
year = {2026},
author = {Hsu, PC and Tsai, CC and Chu, TY and Kuo, CY},
title = {Jing-Si Herbal Tea as a multitargeted complementary therapy: Evidence from preclinical and clinical studies.},
journal = {Tzu chi medical journal},
volume = {38},
number = {3},
pages = {289-299},
pmid = {42453521},
issn = {2223-8956},
abstract = {Jing-Si Herbal Tea (JSHT) is a traditional multi-herbal preparation composed of flavonoids, polyphenols, triterpenoid saponins, glycyrrhizin, and other bioactive constituents that collectively contribute to a wide spectrum of biological activities. Emerging laboratory and clinical studies indicate that JSHT is associated with modulation of oxidative stress, inflammatory responses, and immune-related pathways, with reported antiviral and cytoprotective effects primarily observed in experimental models and exploratory clinical settings. This review synthesizes current evidence describing the diverse pharmacological actions of JSHT and its potential applications across oncologic, inflammatory, metabolic, and infectious disease contexts. Experimental findings suggest that JSHT may be associated with modulation of tumor progression-related processes, including epithelial-mesenchymal transition and aberrant nuclear factor kappa B activity, while being associated with intracellular oxidative stress-related activation of apoptosis- and ferroptosis-related pathways in cancer cell models. Its immunoregulatory capacity is reflected in the attenuation of pro-inflammatory cytokines and the promotion of anti-inflammatory macrophage phenotypes. In respiratory and infectious diseases such as coronavirus disease 2019 and chronic obstructive pulmonary disease, JSHT has been reported to attenuate hyperinflammatory responses and preserve cellular or organ function and has been associated with clinical improvement in selected observational studies, which should be interpreted cautiously. Early clinical data, including results from a randomized study in functional dyspepsia, suggest benefits for gastrointestinal symptoms and anxiety, accompanied by increases in serum butyrate that may indicate involvement of the gut-brain axis. Across available studies, JSHT has shown good tolerability with few reported adverse effects. Overall, the accumulating evidence suggests that JSHT may have potential relevance as a multitarget complementary approach, pending confirmation through well-controlled clinical studies. Nonetheless, more extensive, well-controlled clinical investigations are warranted to validate its efficacy and clarify its mechanistic pathways.},
}

@article {pmid42454043,
year = {2026},
author = {Wendt, K and Schieck, M and Gille, C and Marschollek, M and Illig, T and Wolff, D and Nee, S},
title = {Biomarkers of post-acute infection syndrome: a systematic literature review.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1741761},
pmid = {42454043},
issn = {1664-3224},
mesh = {Humans ; *Biomarkers/metabolism ; Post-Acute COVID-19 Syndrome ; *COVID-19/complications ; *SARS-CoV-2 ; *Fatigue Syndrome, Chronic/diagnosis ; },
abstract = {BACKGROUND: Post-acute infection syndrome (PAIS) remained underrecognized before the COVID-19 pandemic, which further increased exposure by introducing a novel global cause. The global burden of post-acute COVID syndrome (PACS) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) alone is estimated at several tens of millions affected worldwide. Biomarker discovery is central to improving PAIS diagnosis and may provide therapeutic targets. This review summarizes current knowledge on biomarkers for PAIS, including PACS and ME/CFS.

METHODS: A systematic literature search was conducted in PubMed and Web of Science. Inclusion criteria were: (1) studies including PAIS patients; (2) reporting laboratory or omics biomarkers; and (3) investigating biomarkers or pathomechanisms of PAIS. Although Guillain-Barré syndrome (GBS) is not PAIS, we have included it as a separate mechanistic comparator due to its prevalence in search results and its clinical and immunological similarities to PAIS.

RESULTS: A total of 142 studies analyzing PAIS biomarkers were included. GBS was analyzed separately and later compared with the other results. Overall, the reviewed studies employed heterogeneous approaches. While similar types of data were frequently investigated, analytical methods varied and often focused only on a subset of molecules. The results indicate that amino acid, energy, and lipid metabolism, microbiome, mitochondrial stress, and miRNA networks are affected. All pathways are connected via NF-κB.

DISCUSSION: PAIS is a multisystem disorder rooted in persistent immune activation, metabolic reprogramming, and systemic inflammation, driven not by active viral infection, but by dysregulated host responses. The NF-κB pathway serves as a unifying hub, connecting molecular, cellular, and clinical phenotypes. Our framework enables a shift from symptom-based to mechanism-based classification, paving the way for biologically grounded interventions.

CONCLUSION: This review synthesizes a broad spectrum of biomarkers in PAIS, integrating findings across pathogens and molecular levels rather than restricting to individual conditions or symptom clusters. This study highlights the differences and commonalities among pathogens and diseases that lead to post-acute sequelae, fills a critical knowledge gap, and provides a foundation for future research and clinical practice. Future studies incorporating multi-omics approaches, longitudinal designs, and larger patient cohorts are needed to validate specific biomarkers and advance the understanding of PAIS.},
}

Humans
*Biomarkers/metabolism
Post-Acute COVID-19 Syndrome
*COVID-19/complications
*SARS-CoV-2
*Fatigue Syndrome, Chronic/diagnosis

@article {pmid42454050,
year = {2026},
author = {Sanz-Muñoz, I and Farre-Avella, M and Barroso-Santos, PJ and Eiros, JM},
title = {State-of-the-art of the high dose influenza vaccine in Spain.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1843611},
pmid = {42454050},
issn = {1664-3224},
mesh = {Humans ; *Influenza Vaccines/administration & dosage/immunology ; Spain/epidemiology ; *Influenza, Human/prevention & control/immunology/epidemiology ; Vaccination ; Aged ; *COVID-19/prevention & control/epidemiology ; Middle Aged ; SARS-CoV-2 ; },
abstract = {High-dose (HD) influenza vaccines have demonstrated robust effectiveness in preventing severe influenza-related outcomes, including pneumonia, cardiorespiratory complications, and mortality, with evidence from randomized clinical trials, meta-analyses, and real-world studies consistently showing superiority over standard-dose (SD) vaccines and supporting international recommendations for adults aged ≥60 years. This is increasingly relevant in the context of global aging and immunosenescence, which weakens vaccine-induced immune responses and heightens biological frailty, functional decline, and the risk of severe complications in older adults, especially those with comorbidities. The objective of this work is to describe the introduction, uptake, and current use of HD influenza vaccines in Spain and to summarize the evidence supporting their broader adoption in adults ≥60 years of age. Methods include a narrative synthesis of clinical evidence and an analysis of vaccination strategies implemented across Spanish autonomous communities since the introduction of HD vaccines during the COVID-19 pandemic. Available evidence supports extending HD vaccine use as a population-based strategy to enhance protection and promote equitable access. The results show that the incorporation of HD influenza vaccines marked a significant shift in national vaccination strategies, with heterogeneous uptake across regions: while some prioritized institutionalized or dependent populations, others implemented mixed approaches that also included community-dwelling adults aged ≥60 years. In conclusion, a clear trend toward wider adoption is emerging, with an increasing number of autonomous communities incorporating HD vaccines into their programs and progressively lowering the recommended age threshold, in alignment with international guidance and the biological rationale for strengthened protection in older adults.},
}

Humans
*Influenza Vaccines/administration & dosage/immunology
Spain/epidemiology
*Influenza, Human/prevention & control/immunology/epidemiology
Vaccination
Aged
*COVID-19/prevention & control/epidemiology
Middle Aged
SARS-CoV-2

@article {pmid42456241,
year = {2026},
author = {Dietrich, N and Stubbert, B},
title = {Artificial intelligence for chest imaging in hantavirus pulmonary syndrome: A review of practical considerations for rare-disease imaging.},
journal = {Clinical imaging},
volume = {138},
number = {},
pages = {110895},
doi = {10.1016/j.clinimag.2026.110895},
pmid = {42456241},
issn = {1873-4499},
abstract = {Hantavirus pulmonary syndrome (HPS) is an uncommon zoonotic respiratory illness with a high case fatality rate. Recent travel-associated Andes orthohantavirus clusters have renewed interest in early radiographic recognition of the disease outside its usual geographic range. Artificial intelligence (AI) tools developed during the COVID-19 pandemic now inform several radiology workflows, but the application of AI to HPS chest imaging remains largely unexplored. This narrative review summarises the imaging features of HPS across modalities, considers lessons from AI applications in COVID-19 and viral pneumonia imaging, and discusses practical development considerations for HPS-aware imaging AI, including dataset development, label standardisation, realistic comparator inclusion, candidate modelling approaches, external validation, and clinical workflow integration. The review also considers challenges to HPS-aware imaging AI, including data scarcity, low pretest probability in non-endemic settings, overlapping imaging findings, and translational pitfalls from recent AI literature. As HPS is unlikely to support conventional disease-specific model development without coordinated data collection, future work will likely require multi-institutional datasets, prevalence-aware evaluation, and multimodal workflow integration that combines imaging with clinical, laboratory, and epidemiologic context.},
}

@article {pmid42459265,
year = {2026},
author = {Vera, E and Galanis, P and Mangoulia, P and Pesiridis, T},
title = {Factors affecting nurses' professional quality of life in Europe - A systematic review.},
journal = {AIMS public health},
volume = {13},
number = {2},
pages = {485-512},
pmid = {42459265},
issn = {2327-8994},
abstract = {BACKGROUND: Nursing care involves both cognitive and emotional aspects, significantly impacting nurses' professional quality of life (ProQOL). This systematic review investigated the factors affecting nurses' professional quality of life in Europe.

METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting framework and was registered in the International Prospective Register of Systematic Reviews (registration number: CRD420251133948). Searches were conducted in PubMed, Scopus, CINAHL, ScienceDirect, and EBSCOhost from inception to August 2025. Eligible peer-reviewed quantitative studies from European Union countries utilized the ProQOL instrument, reporting on all three dimensions: compassion satisfaction, burnout, and secondary traumatic stress. Two reviewers independently screened records, extracted data, and appraised methodological quality using the Joanna Briggs Institute critical appraisal tool.

RESULTS: A total of 3407 records were initially identified, and 35 studies were ultimately included, comprising 8580 nursing staff across diverse clinical settings, predominantly hospitals, with 13 studies conducted during the coronavirus disease period in 2019. Most studies reported moderate levels of compassion satisfaction and moderate levels of burnout and secondary traumatic stress. Higher compassion satisfaction was generally associated with greater age and professional experience, relevant education and training, work engagement, supportive work environments, better perceived control over workload, and stronger psychosocial resources, including resilience, psychological flexibility, self-compassion, mindfulness, and social support. Higher burnout and secondary traumatic stress related to indirect exposure were consistently linked to a high workload, overtime, rotating schedules, job stress, workplace violence, employment in high-intensity clinical areas, and adverse psychological states, including persistent stress, fear related to the coronavirus disease, and moral distress.

CONCLUSIONS: Professional quality of life among European nursing staff is influenced by a combination of demographic, occupational, and psychosocial factors. Multilevel strategies addressing organizational stressors while strengthening individual and team-based resources are warranted to improve compassion satisfaction and reduce burnout and secondary traumatic stress.},
}

@article {pmid42459266,
year = {2026},
author = {Du, D and Sun, G and Yuan, L and Yao, Y and Yang, T and Gao, J and Zhang, L},
title = {Internet healthcare in Chinese public hospitals: Towards high-quality development (1986-present).},
journal = {AIMS public health},
volume = {13},
number = {2},
pages = {598-621},
pmid = {42459266},
issn = {2327-8994},
abstract = {BACKGROUND: Internet healthcare has become a key part of China's hospital-centered health system. Driven by "Internet Plus Healthcare", Healthy China 2030, and public-hospital high-quality development policies, it has evolved from remote consultation experiments into regulated online-offline care pathways. This review traces its development from the first documented remote medical practice in 1986 to the present, focusing on policy, institutional models, clinical evidence, governance challenges, and reform.

METHODS: We conducted a structured narrative review of English- and Chinese-language sources on internet healthcare in Chinese public hospitals. PubMed/MEDLINE, Web of Science Core Collection, China National Knowledge Infrastructure (CNKI), and official policy sources were searched. Eligible sources addressed internet hospitals, telemedicine, online follow-ups, remote monitoring, e-prescriptions, insurance payments, digital governance, clinical outcomes, patient safety, equity, or implementation barriers in mainland China.

RESULTS: Internet healthcare progressed through early telemedicine, institutional network expansion, internet-hospital development, and pandemic-driven normalization. The 2018 regulatory framework positioned internet hospitals as extensions of licensed physical medical institutions, thereby permitting online follow-ups for common and chronic diseases while preserving offline accountability. During COVID-19, online consultation, e-prescriptions, drug delivery, and insurance payments rapidly expanded. Evidence suggests benefits for chronic disease management, medication adherence, cardiovascular secondary prevention, and reduced travel burden. However, evidence remains limited for diagnostic accuracy, adverse events, emergency escalation, and long-term outcomes. Persistent barriers include quality variation, workload, cybersecurity, data fragmentation, artificial intelligence (AI) accountability, reimbursement design, regional inequity, and digital exclusion among older adults.

CONCLUSION: China's model may be understood as a hospital-centered extension of public-hospital functions rather than a stand-alone virtual-care system. Future development should prioritize outcome-based evaluations, safety governance, equitable access, data interoperability, and accountability for internet-based and AI-assisted care.},
}

@article {pmid42459503,
year = {2026},
author = {Larrain, D and Parker, CM},
title = {Beyond Prison Walls: A Scoping Review of Incarceration's Public Health Impacts in Latin America.},
journal = {Wellcome open research},
volume = {11},
number = {},
pages = {193},
pmid = {42459503},
issn = {2398-502X},
abstract = {BACKGROUND: Incarceration has vast and unequal impacts on public health beyond prison walls. Research from the United States documents these collateral consequences, including elevated mental illness and morbidity for the children and partners of incarcerated individuals, alongside community-level effects such as increased rates of teenage pregnancy and multidrug-resistant tuberculosis. In Latin America, however, these broader health impacts remain critically understudied. A significant barrier is the absence of data collection efforts or theoretical frameworks for mapping how Latin America's prisons affect the health of families and surrounding communities.

OBJECTIVE: This scoping review synthesises existing evidence on the collateral health consequences of incarceration in Latin America by conducting a comprehensive search in 2025 that included English, Spanish and Portuguese language peer-reviewed studies.

RESULTS: From 17 included documents, prisons emerge as epicentres for tuberculosis transmission to visiting families and surrounding communities. The evidence reveals significant mental and physical health burdens on families. Women with incarcerated partners experience depression and anxiety whilst managing economic strain and expanded caregiving responsibilities, often neglecting their own health. Children of incarcerated parents show marked emotional distress, and incarcerated mothers alongside their young children face severely inadequate healthcare access within detention spaces.

CONCLUSIONS: Despite collecting demographic data, most studies overlook how these burdens fall unequally across racialised populations. Future research must centre ethnoracial disparities and situated knowledge.},
}

@article {pmid42460684,
year = {2026},
author = {Foláyan, MO and Arobo, A and Oyeyemi, E and Bhayat, A and Tantawi, ME},
title = {Integrating Oral Health Into Pandemic Preparedness and Response: Missed Opportunities and Strategic Imperatives for Global Health System Resilience and Security.},
journal = {Community dentistry and oral epidemiology},
volume = {},
number = {},
pages = {},
doi = {10.1111/cdoe.70092},
pmid = {42460684},
issn = {1600-0528},
abstract = {BACKGROUND: Despite evidence linking oral health to severe COVID-19 outcomes and its potential role in surveillance and service delivery, integration remained absent. This study enquired about: (1) representation of oral health in national COVID-19 taskforces and funding; (2) policy-level barriers to inclusion; (3) lessons from maintaining essential services; and (4) strategies for mobilizing oral health professionals in future emergencies.

METHODS: We conducted a scoping review guided by the PRISMA-ScR framework. Systematic searches were performed in PubMed/MEDLINE and Scopus (2000-2025) using tailored search strings combining key terms: oral health, pandemic preparedness, COVID-19, dentistry, health systems and related MeSH terms. Eligible evidence included peer-reviewed studies, reviews, policy documents and commentaries in English. Non-human studies were excluded. Data were charted using the WHO Health System Building Blocks framework.

RESULTS: After dual-reviewer screening, 2569-3860 records were screened, yielding 5-8 eligible studies per question (26 studies total). The evidence revealed a consistent narrative of systemic exclusion yet operational resilience. For representation, oral health professionals were almost universally absent from national COVID-19 task forces, with dedicated financial support entirely lacking. Regarding barriers, policy integration was hindered by the framing of oral care as non-essential, its omission from global health security architectures like the International Health Regulations, and limited professional advocacy. In contrast, lessons from service adaptation demonstrated that essential care was maintained through the rapid adoption of triage, teledentistry, robust infection control and effective communication. On workforce mobilization, while consensus existed on the potential for OHPs to expand into roles such as vaccination and surveillance, implementation was obstructed by a lack of pre-emergency training, formal deployment mechanisms and regulatory frameworks with minimal linkage to international instruments.

CONCLUSION: The review reflects systemic neglect of oral health, with the literature dominated by descriptions of clinical and operational adaptations rather than formal policy integration. We identify missed opportunities in leveraging OHPs for pandemic response and propose embedding oral health within One Health governance, financing, surveillance and emergency response structures to build more resilient health systems.},
}

@article {pmid42461048,
year = {2026},
author = {Översti, S and Lytras, S and Kawakubo, S and Ito, J and Ghafari, M},
title = {From sites to structure to serology: a roadmap for structure-aware molecular evolution of antigenically evolving viruses.},
journal = {Journal of virology},
volume = {},
number = {},
pages = {e0168725},
doi = {10.1128/jvi.01687-25},
pmid = {42461048},
issn = {1098-5514},
abstract = {The genomic deluge has pushed viral molecular evolution into a site-resolved era. For antigenically evolving viruses such as influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), dense genomic sampling now supports mutation-annotated phylogenies and per-site estimates of mutation and substitution processes. These data highlight strong effects of sequence context, genomic region, RNA structure, and protein-level constraints that are blurred by classic uniform substitution models. In parallel, accurate structure prediction and emerging structure-aware phylogenetic and machine-learning approaches provide practical ways to map mutations onto three-dimensional constraints, identify structurally plausible escape routes, and interpret evolutionary rate variation through solvent exposure, packing, stability, glycosylation, receptor-binding interfaces, and epitope geometry. Finally, antigenic cartography translates some forms of genetic change into an epidemiologically meaningful phenotype-antigenic distance-while predictive modeling increasingly enables sequence-to-antigenicity inference for variants that have not yet been tested experimentally. Here, we outline a practical framework linking sites, structure, and serology for viruses in which antigenic evolution is a major component of immune escape and lineage turnover; highlight why genetic and antigenic "clocks" can diverge; and discuss how integrating genomic surveillance data, phylogenetics, structural analysis, and predictive modeling could support more prospective variant assessment and improved vaccine and therapeutic design.},
}

@article {pmid42461075,
year = {2026},
author = {Hashemi, S and Pati, D},
title = {Healthcare Design for Pandemic Resilience: A Systems Thinking Approach.},
journal = {HERD},
volume = {},
number = {},
pages = {19375867261466289},
doi = {10.1177/19375867261466289},
pmid = {42461075},
issn = {2167-5112},
abstract = {BackgroundThe COVID-19 pandemic created unprecedented operational challenges (such as surge-capacity demands and infection-control requirements) that disturbed the equilibrium of healthcare work systems worldwide. Physical environments can play a pivotal role in mitigating or exacerbating these challenges.PurposeThis article aims to strengthen healthcare-system resilience in future pandemics by synthesizing the findings of existing literature to identify environmental factors that supported or hindered healthcare work systems during the COVID-19 pandemic.MethodsWe conducted a systematic search of the CINAHL, MEDLINE, PubMed, and ScienceDirect databases and complemented this search with handsearching. We included studies if they addressed the COVID-19 pandemic, focused on physical healthcare environments, and were published in English in peer-reviewed journals. With a focus on environmental influences, we deductively coded the findings using components of the Systems Engineering Initiative for Patient Safety (SEIPS) model.ResultsForty-two studies met the inclusion criteria. The analysis revealed six major operational challenges: (1) surge capacity, (2) infection control, (3) increased risk of errors, (4) rethinking of care models, (5) financial losses, and (6) the pandemic's adverse psychological impacts on staff and patients. The article documents environmental factors that influenced either the overall healthcare work system or its individual components during the COVID-19 pandemic. We identified three overarching roles for these environmental factors: they served as barriers, solutions, or facilitators.ConclusionsUsing the SEIPS framework can enable well-orchestrated pandemic-response planning by guiding the creation of design strategies that will strengthen resilience, flexibility, and safety in future health crises.},
}

@article {pmid42461270,
year = {2026},
author = {Farrag, MA},
title = {The Role of Artificial Intelligence and Machine Learning in Predictive Virology: Forecasting, Tracking, and Combating Viral Threats.},
journal = {Vector borne and zoonotic diseases (Larchmont, N.Y.)},
volume = {},
number = {},
pages = {15303667261469037},
doi = {10.1177/15303667261469037},
pmid = {42461270},
issn = {1557-7759},
abstract = {The escalating threat of viral pandemics, dramatically illustrated by the COVID-19 crisis, has exposed the critical shortcomings of conventional reactive virology in addressing rapidly evolving pathogens. This review introduces predictive virology (PV) as an artificial intelligence (AI)-driven discipline within broader epidemic intelligence and public health surveillance that uses advanced computational tools to forecast viral threats and accelerate countermeasure design. The current review systematically examines how AI-driven approaches (e.g., machine learning and deep learning) are reshaping virology by integrating vast genomic datasets, multimodal surveillance signals, and advanced computational models to anticipate viral emergence and evolution before widespread transmission occurs. Core pillars of PV discussed include zero-shot mutational fitness and antigenic escape prediction using large protein language models; multimodal early-warning systems that fuse wastewater monitoring, digital epidemiology, mobility data, and social media; neural differential equation-based transmission modeling; generative AI for de novo design of broad-spectrum antivirals and vaccines; and ecological risk assessment of zoonotic spillovers. In retrospective benchmarks against deep mutational scanning experiments and real-world epidemiological outcomes (SARS-CoV-2 variants, influenza, and other outbreaks), several AI-powered tools have demonstrated performance comparable to or exceeding traditional methods, although prospective validation at scale remains limited. Despite remarkable progress, significant challenges persist, including data bias, overfitting to historical patterns, lack of prospective validation, and limited generalizability across settings. In addition, there are concerns about mechanistic interpretability, equitable global data integration, and responsible deployment. This review also critically addresses the ethical, governance, and equity implications of deploying predictive capabilities at a global scale. By consolidating cutting-edge AI methodologies with virological insights and acknowledging current limitations, this work provides a comprehensive framework for transitioning virology from a reactive to a truly predictive discipline, ultimately strengthening global health security and pandemic preparedness.},
}

@article {pmid42461676,
year = {2026},
author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A},
title = {Disaster preparedness for vulnerable populations during a pandemic: Part 1: Pandemics: Overview, history, and vulnerability for a pandemic.},
journal = {American journal of disaster medicine},
volume = {21},
number = {2},
pages = {109-118},
doi = {10.5055/ajdm.0531},
pmid = {42461676},
issn = {1932-149X},
mesh = {Humans ; *Vulnerable Populations ; *Pandemics/history ; COVID-19/epidemiology ; *Disaster Planning/organization & administration ; Pandemic Preparedness ; SARS-CoV-2 ; *Surge Capacity/organization & administration ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; United States ; },
abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity, with a particular focus on vulnerable populations during a pandemic.

DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCNs) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern, disaster, COVID-19, vulnerable population, individuals with access and functional needs, special healthcare needs (SHCN), surge capacity, and CMIST (communications, medical care, independence, supervision, and transportation). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.

RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.

CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population, but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.},
}

Humans
*Vulnerable Populations
*Pandemics/history
COVID-19/epidemiology
*Disaster Planning/organization & administration
Pandemic Preparedness
SARS-CoV-2
*Surge Capacity/organization & administration
*Pneumonia, Viral/epidemiology
*Coronavirus Infections/epidemiology
United States

@article {pmid42461677,
year = {2026},
author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A},
title = {Disaster preparedness for vulnerable populations during a pandemic: Part 2: The origins of a pandemic: Emerging infectious diseases, bioterrorism, and laboratory accidents.},
journal = {American journal of disaster medicine},
volume = {21},
number = {2},
pages = {119-131},
doi = {10.5055/ajdm.0527},
pmid = {42461677},
issn = {1932-149X},
mesh = {Humans ; *Vulnerable Populations ; *Pandemics ; *Bioterrorism ; *Disaster Planning/organization & administration ; COVID-19 ; *Communicable Diseases, Emerging/epidemiology ; Surge Capacity/organization & administration ; Pandemic Preparedness ; SARS-CoV-2 ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; },
abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.

DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, COVID-19, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and CMIST (communications, medical care, independence, supervision, and transportation). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.

RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are -possible.

CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.},
}

Humans
*Vulnerable Populations
*Pandemics
*Bioterrorism
*Disaster Planning/organization & administration
COVID-19
*Communicable Diseases, Emerging/epidemiology
Surge Capacity/organization & administration
Pandemic Preparedness
SARS-CoV-2
*Pneumonia, Viral/epidemiology
*Coronavirus Infections/epidemiology

@article {pmid42461678,
year = {2026},
author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A},
title = {Disaster preparedness for vulnerable populations during a pandemic: Part 3: Surge capacity and communications in a pandemic.},
journal = {American journal of disaster medicine},
volume = {21},
number = {2},
pages = {133-148},
doi = {10.5055/ajdm.0525},
pmid = {42461678},
issn = {1932-149X},
mesh = {Humans ; *Vulnerable Populations ; *Pandemics ; *Surge Capacity/organization & administration ; COVID-19/epidemiology ; *Disaster Planning/organization & administration ; Pandemic Preparedness ; SARS-CoV-2 ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; United States ; },
abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.

DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, COVID-19, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and communications, medical care, independence, supervision, and transportation (CMIST). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.

RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.

CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.},
}

Humans
*Vulnerable Populations
*Pandemics
*Surge Capacity/organization & administration
COVID-19/epidemiology
*Disaster Planning/organization & administration
Pandemic Preparedness
SARS-CoV-2
*Pneumonia, Viral/epidemiology
*Coronavirus Infections/epidemiology
United States

@article {pmid42461679,
year = {2026},
author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A},
title = {Disaster preparedness for vulnerable populations during a pandemic: Part 4: Pandemics: Planning for those with access and functional needs in a pandemic.},
journal = {American journal of disaster medicine},
volume = {21},
number = {2},
pages = {149-159},
doi = {10.5055/ajdm.0526},
pmid = {42461679},
issn = {1932-149X},
mesh = {Humans ; *Vulnerable Populations ; *Disaster Planning/organization & administration ; *Pandemics ; *Surge Capacity/organization & administration ; *Health Services Accessibility ; Pandemic Preparedness ; COVID-19/epidemiology ; Health Services Needs and Demand ; },
abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.

DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and communications, medical care, independence, supervision, and transportation (CMIST). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.

RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.

CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.},
}

Humans
*Vulnerable Populations
*Disaster Planning/organization & administration
*Pandemics
*Surge Capacity/organization & administration
*Health Services Accessibility
Pandemic Preparedness
COVID-19/epidemiology
Health Services Needs and Demand

@article {pmid42461883,
year = {2026},
author = {Sheybani, F and Haddad, M},
title = {Community-Acquired CNS Infections in Western Asia (2010-2025): A Systematic Review.},
journal = {Neuroepidemiology},
volume = {},
number = {},
pages = {1-22},
doi = {10.1159/000553536},
pmid = {42461883},
issn = {1423-0208},
abstract = {UNLABELLED: Background / Objective: This systematic review aimed to summarize the epidemiology, etiology, diagnostic challenges, antimicrobial resistance, and clinical outcomes of community-acquired central nervous system (CNS) infections in Western Asian countries.

METHODS: A systematic search of PubMed was conducted for studies published from January 2010 to July 2025. Eligible studies included original research and case reports on CNS infections, while unrelated studies or studies outside Western Asia were excluded. Data were extracted and synthesized narratively by pathogen group. Risk of bias was assessed based on study design, sample size, and methodological quality.

RESULTS: Of 1,790 retrieved articles, 450 studies met the inclusion criteria, including case reports and observational studies across neonates, children, and adults. Streptococcus pneumoniae and Neisseria meningitidis were the most common bacterial pathogens; Listeria monocytogenes and multidrug-resistant Gram-negative organisms were notable. Among viral pathogens, Enteroviruses, herpes simplex virus type 1, and West Nile virus predominated, with increasing reports of post-COVID-19 autoimmune encephalitis. Tuberculous meningitis and neurobrucellosis remained significant causes of chronic CNS infections in endemic areas. Pneumococcal penicillin resistance exceeded 40% in some countries. Molecular diagnostic capacity and surveillance were limited.

LIMITATIONS: Evidence was limited by heterogeneity in study design, regional data gaps, and variable reporting of antimicrobial resistance, which may affect the comprehensiveness of the review. Conclusions / Interpretation: Community-acquired CNS infections continue to impose a substantial health burden in Western Asia. Expanded vaccination, improved molecular diagnostics, strengthened surveillance, and regional antimicrobial resistance monitoring are essential to reduce preventable mortality and long-term neurological sequelae.},
}

@article {pmid42462434,
year = {2026},
author = {Wołowiec, Ł and Wesołowska, W and Skibicka, K and Jaśniak, A and Banach, J and Osiak, J and Wołowiec, A and Skibicki, T and Grześk, G},
title = {Pleiotropic effects of direct oral anticoagulants on the coagulation-inflammation-endothelium axis: A phenotype-stratified narrative review.},
journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie},
volume = {202},
number = {},
pages = {119768},
doi = {10.1016/j.biopha.2026.119768},
pmid = {42462434},
issn = {1950-6007},
abstract = {AIMS: Direct oral anticoagulants (DOACs) - dabigatran (a thrombin inhibitor) and rivaroxaban, apixaban, and edoxaban (factor Xa [FXa] inhibitors) - modify oxidative stress, endothelial inflammation, and barrier integrity beyond anticoagulation. We ask whether this reflects distinct pharmacology or silencing of proteases at protease-activated receptors (PARs), and propose a three-condition framework for when it becomes clinically measurable.

METHODS: Narrative review (PubMed, Scopus, Web of Science; primary search 2019-2026, with foundational earlier references retained) with claims graded on a six-tier hierarchy; A‡ marks trials formally negative or inconclusive owing to insufficient statistical power.

RESULTS: DOAC effects largely converge on one node - reduced PAR-1 signalling under thrombin inhibition and dual PAR-1/PAR-2 blockade under FXa inhibition - rather than independent targets; the FXa-PAR-2 axis is cross-validated across macrophages, liver sinusoidal endothelial cells, and neutrophils; and dabigatran plausibly differs qualitatively rather than only in degree - a working hypothesis whose mechanistic linchpin (residual exosite-I signalling) currently rests on a single unreplicated in-vitro study (level D). Clinically the signal sorts by phenotype and disease phase, not class: low-dose rivaroxaban benefits stable atherosclerosis (COMPASS) but not heart failure in sinus rhythm (COMMANDER-HF), and COVID-19 benefit appears only in convalescence (MICHELLE), not acutely or in outpatients (ACTIV-4B, A‡). A nationwide cohort linked DOACs to lower acute kidney injury and chronic kidney disease progression than vitamin K antagonists, pending separation from their nephrotoxicity.

CONCLUSIONS: Pleiotropy emerges where three conditions coincide - the protease is available at PARs, its generation is chronic, and PAR signalling is rate-limiting. This supports within-indication molecule selection (selection, not extension) and biomarker co-primary trials, not extension of indications.},
}

@article {pmid42463201,
year = {2026},
author = {Byambasuren, O and Atkins, T and Baptista, S and Glasziou, P and Chakraborty, S},
title = {Effect of low-dose naltrexone for long COVID: a systematic review and meta-analysis.},
journal = {BMJ open},
volume = {16},
number = {7},
pages = {e111253},
doi = {10.1136/bmjopen-2025-111253},
pmid = {42463201},
issn = {2044-6055},
mesh = {Humans ; *Naltrexone/administration & dosage/therapeutic use ; Post-Acute COVID-19 Syndrome ; *COVID-19 Drug Treatment ; *Narcotic Antagonists/administration & dosage/therapeutic use ; Quality of Life ; Fatigue/drug therapy/etiology ; *COVID-19/complications ; SARS-CoV-2 ; },
abstract = {OBJECTIVE: Long covid is a debilitating chronic condition, and the effect of low-dose naltrexone (LDN) on its symptoms is unclear. We aimed to determine the effectiveness of LDN on symptoms of long covid.

DESIGN: Systematic review and meta-analysis.

DATA SOURCES: PubMed, Embase and Cochrane Library for published studies; ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) for registered ongoing studies were searched through 5 May 2026.

ELIGIBILITY CRITERIA: We included randomised controlled trials and pre-post studies of patients with long covid reporting on fatigue, quality of life, cognitive symptoms or function and other long covid symptoms.

DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search, screen and select included studies. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models.

RESULTS: Of 397 titles and abstracts screened, no randomised controlled trials were identified. Four observational pre-post studies from the USA and Ireland (n=155) met inclusion criteria. LDN doses varied from 1 mg/day to 6 mg/day. Pooled pre-post analyses showed moderate effects for reducing fatigue (Hedges' g=-0.74; 95% CI -1.11 to -0.37; p<0.001), brain fog (Hedges' g=-0.53; 95% CI -1.01 to -0.05; p=0.03) and improving sleep quality (Hedges' g=-0.60; 95% CI -0.91 to -0.30; p=0.0001), and large effects for pain (Hedges' g=-0.93; 95% CI -1.29 to -0.57; p<0.001) and daily functioning (Hedges' g=-0.93; 95% CI -1.29 to -0.57; p<0.0001) in favour of LDN. Heterogeneity ranged from 0% to 62%. No serious adverse events were reported in the two studies that assessed safety.

CONCLUSION: Limited evidence from small pre-post studies suggests LDN may improve fatigue, cognition, sleep, pain and functioning in long covid. However, certainty of evidence is low. Well-powered trials are needed to confirm efficacy, determine dosing and duration and identify subgroups most likely to benefit.

TRIAL REGISTRATION: https://doi.org/10.17605/OSF.IO/C2VKX.},
}

Humans
*Naltrexone/administration & dosage/therapeutic use
Post-Acute COVID-19 Syndrome
*COVID-19 Drug Treatment
*Narcotic Antagonists/administration & dosage/therapeutic use
Quality of Life
Fatigue/drug therapy/etiology
*COVID-19/complications
SARS-CoV-2

@article {pmid42464199,
year = {2026},
author = {Pham, ANQ and Akram, I and Tiwana, MH and Smith, J},
title = {Waiting times for primary care appointments among older adults: a scoping review.},
journal = {BMC public health},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12889-026-28406-w},
pmid = {42464199},
issn = {1471-2458},
abstract = {BACKGROUND: Healthcare service waiting times have worsened due to the COVID-19 pandemic, particularly impacting older adults who need timely access to primary care to manage chronic conditions and prevent hospitalizations. This scoping review aims to fill a research gap by examining whether delays in primary care appointments for older adults occurred and, if so, how these delays have affected their access to primary care, with a focus on the role of social determinants of health.

METHODS: Following PRISMA guidelines, a systematic search was conducted across three health databases-MEDLINE (Ovid), CINAHL, and EMBASE-as well as one AI platform (typeset.io). To be included, articles needed to discuss waiting times for primary care appointments, include older adults in their target population, and be published in English since 2014. Non-English articles were excluded due to language proficiency constraints among the review team. The review also examined the impact of social determinants of health on equity in access to care.

RESULTS: This review identified a significant lack of research on primary care waiting times for older adults, with only twelve studies addressing the issue. Findings indicate that prolonged wait times act as a major barrier to accessing timely care, resulting in patient frustration, delayed treatment, and increased reliance on emergency services. The COVID-19 pandemic has exacerbated these challenges, particularly through care interruptions and the shift to virtual care, which is understudied regarding its impact on waiting times.

CONCLUSIONS: Prolonged waiting times for primary care disproportionately affect older adults, exacerbated by age-related health conditions and intersecting social determinants. Healthcare systems must address these barriers and prioritize research into tailored interventions to ensure equitable access to care for older adults.},
}

@article {pmid42465772,
year = {2026},
author = {Feya, Q and Mkhize-Kwitshana, ZL and Milase, RN and Wadee, A and Naidoo, N and Maiga, M and Senzani, S and Nakiyingi, L and Mvubu, NE},
title = {Molecular signaling in coinfection: how M. tuberculosis and respiratory viruses rewire host immunity and alter TB outcomes.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1863302},
pmid = {42465772},
issn = {1664-3224},
mesh = {Humans ; *Coinfection/immunology ; *Mycobacterium tuberculosis/immunology ; Signal Transduction/immunology ; Animals ; *Tuberculosis/immunology ; Immunity, Innate ; Host-Pathogen Interactions/immunology ; *Respiratory Tract Infections/immunology ; },
abstract = {Tuberculosis (TB) caused by Mycobacterium tuberculosis (M. tuberculosis) and respiratory viral infections remain major, intersecting global health challenges, and their co-occurrence imposes a disproportionate burden in high-HIV/high-TB regions such as sub-Saharan Africa. Coinfection biology is heterogeneous and dynamic, driven by viral diversity including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A/B, Respiratory Syncytial Virus (RSV), parainfluenza, metapneumovirus, rhinovirus, adenovirus, and bocavirus, and by the underlying TB stage, from latent and subclinical to active and reactivation disease. Innate sensing pathways, such as Toll-like receptors (TLR), retinoic acid-inducible gene I (RIG-I), and cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING), converge during coinfection, reshaping type I interferon (IFN-I), Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB), and AP-1-driven responses and triggering a network of autocrine and paracrine signaling that reprograms macrophages, dendritic cells, and T-cell subsets. This immune rewiring alters granuloma equilibrium through suppressed Th1/IFN-γ coordination, exaggerated Th17/IL-17-driven neutrophilia, and regulatory T-cell or IL-10-mediated dampening, which together destabilize macrophage activation and tissue architecture. Oxidative stress, mitochondrial dysfunction, and Matrix Metalloproteinases (MMP)-driven matrix remodeling further integrate with these pathways, converting inflammatory signals into epithelial damage, cavitation, and fibrosis. Consequently, disease outcomes depend critically on timing, viral burden, pathogen order, host immune endotype, and TB stage, such that the same virus can either preserve containment or drive progression depending on the local immunological context. Importantly, the effects of respiratory viral coinfection vary across the TB disease continuum, influencing early granuloma formation, latent infection, reactivation risk, and established disease through distinct immunological mechanisms. Host-directed therapies (HDT) targeting interferon, IL-1, TNF, inflammasome, or metabolic checkpoints hold mechanistic promise but exhibit variable clinical translation, underscoring the need for precision approaches that integrate stage- and endotype-specific biomarkers. This narrative review proposes an integrated systems framework that links viral sensing, immune rewiring, granuloma biology, and tissue-remodeling to TB-respiratory virus coinfection, and emphasizes how timing-aware, biomarker-guided strategies can refine diagnosis, clinical management, prognosis, and vaccine design in vulnerable populations.},
}

Humans
*Coinfection/immunology
*Mycobacterium tuberculosis/immunology
Signal Transduction/immunology
Animals
*Tuberculosis/immunology
Immunity, Innate
Host-Pathogen Interactions/immunology
*Respiratory Tract Infections/immunology

@article {pmid42466633,
year = {2026},
author = {Li, Z and Han, X and Ren, Y},
title = {Global epidemiological and aetiological patterns of hand, foot, and mouth disease: a country-level scoping synthesis.},
journal = {Journal of global health},
volume = {16},
number = {},
pages = {04220},
doi = {10.7189/jogh.16.04220},
pmid = {42466633},
issn = {2047-2986},
mesh = {*Hand, Foot and Mouth Disease/epidemiology/etiology/virology ; Humans ; *Global Health/statistics & numerical data ; Incidence ; Disease Outbreaks ; Enterovirus ; COVID-19/epidemiology ; },
abstract = {BACKGROUND: Hand, foot, and mouth disease (HFMD) has historically been predominantly reported in the Asia-Pacific region, while its global epidemiology and aetiology remain fragmented and incompletely characterised. We aimed to synthesise currently available country-level evidence to describe global epidemiological and aetiological patterns of HFMD.

METHODS: We conducted a country-level scoping synthesis of published studies and publicly available surveillance reports through August 2025. Studies were eligible for inclusion if they reported epidemiological or aetiological data on HFMD at the national or subnational level, including case numbers, incidence, outbreaks, and enterovirus (EV) serotype distributions. We qualitatively synthesised the data, with a focus on surveillance availability, epidemiological trends, and major circulating EV serotypes.

RESULTS: Reported HFMD incidence declined during the COVID-19 pandemic and subsequently rebounded in many settings, in some settings exceeding pre-pandemic levels. Aetiological evidence suggests an increasing circulation of coxsackievirus A6 in multiple regions, with coxsackievirus A16 and EV A71 continuing to co-circulate in specific settings. However, routine epidemiological and aetiological surveillance remained largely concentrated in the Asia-Pacific region. In many other countries, available data were limited and primarily derived from outbreak-driven or sporadic studies. Heterogeneity was observed in surveillance systems and data availability across countries.

CONCLUSIONS: Global HFMD epidemiological and aetiological patterns are characterised by disparities in surveillance capacity and data availability. Developing standardised surveillance and aetiological monitoring is essential to further understand the global landscape of HFMD, improve data comparability, support early detection of epidemiological changes, and inform evidence-based prevention and control strategies.},
}

*Hand, Foot and Mouth Disease/epidemiology/etiology/virology
Humans
*Global Health/statistics & numerical data
Incidence
Disease Outbreaks
Enterovirus
COVID-19/epidemiology

@article {pmid42466786,
year = {2026},
author = {Szynal, D and Olszowski, T},
title = {Nurse burnout as a public health issue and Its impact on patient care quality. A narrative review.},
journal = {Roczniki Panstwowego Zakladu Higieny},
volume = {77},
number = {1},
pages = {21-32},
doi = {10.32394/rpzh/225226},
pmid = {42466786},
issn = {0035-7715},
mesh = {Humans ; *Burnout, Professional/psychology/prevention & control/epidemiology ; *Quality of Health Care ; Quality of Life ; *Nurses/psychology ; Workload/psychology ; Public Health ; Emotional Exhaustion ; },
abstract = {Occupational burnout among nurses is a significant public health issue. It affects both nurses' well-being and the quality of patient care. The aim of this narrative review is to provide a comprehensive synthesis of four key aspects of occupational burnout among nurses, namely its prevalence, determinants, consequences for patient care and mental health, and available prevention strategies. Literature was identified through searches of PubMed and Google Scholar. Articles published in English between 2015 and 2026 were reviewed and selected according to predefined inclusion and exclusion criteria. Burnout develops through the interaction of organizational, psychosocial, and individual factors. The most important contributors include work overload, staffing shortages, low autonomy, psychosocial stress, personality traits, and health status. Higher burnout levels are associated with increased medical errors, patient falls, and missed nursing care. Burnout also contributes to lower patient satisfaction and poorer perceived quality of care. Prolonged stress increases the risk of depression, anxiety, sleep disturbances, reduced psychological resilience, and intentions to leave the profession, negatively impacting nurses' quality of life and social functioning. Effective preventive and therapeutic strategies include mindfulness-based programs, cognitive-behavioral therapy, physical exercise, and resilience training. These interventions may be delivered both in person and digitally. Their effectiveness improves in supportive environments with allocated participation time and leadership engagement. Interventions at individual, team, and system levels reduce emotional exhaustion and depersonalization, enhance staff well-being, and improve patient safety. In the context of a global nursing shortage and increased workloads following the COVID-19 pandemic, multi-level strategies to prevent occupational burnout are essential for protecting nurses' mental health and maintaining high-quality healthcare. The review highlights the importance of multi-level preventive interventions to reduce burnout and improve healthcare outcomes.},
}

Humans
*Burnout, Professional/psychology/prevention & control/epidemiology
*Quality of Health Care
Quality of Life
*Nurses/psychology
Workload/psychology
Public Health
Emotional Exhaustion

@article {pmid42467815,
year = {2026},
author = {Mastrovito, B and Abou Chakra, CN and Mahé, C and Nunes, MC},
title = {How Pandemics Have Reshaped the Respiratory Virus Data Landscape in Europe: Scoping Review.},
journal = {Journal of medical Internet research},
volume = {28},
number = {},
pages = {e92917},
doi = {10.2196/92917},
pmid = {42467815},
issn = {1438-8871},
mesh = {Humans ; Europe/epidemiology ; *Respiratory Syncytial Virus Infections/epidemiology ; *Pandemics ; *Influenza, Human/epidemiology ; *COVID-19/epidemiology ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Acute respiratory infections caused by influenza, respiratory syncytial virus (RSV), and SARS-CoV-2 remain a major public health challenge in Europe. Although surveillance systems for these pathogens are well established, the past 2 decades have seen a rapid diversification of data streams supporting surveillance and research. This expanding data landscape, combined with fragmentation across institutions, sectors, and countries, may limit timely evidence synthesis and effective public health decision-making.

OBJECTIVE: This scoping review aimed to identify and characterize data sources used for surveillance and research on influenza, RSV, and SARS-CoV-2 in Europe over the past 20 years, and to examine their evolution over time, their alignment with research objectives, and geographic variation in data availability and use.

METHODS: We conducted a scoping review using an objective-driven analytical framework. Empirical reports published between January 2005 and September 2025 were identified in MEDLINE, Web of Science, and Embase. Eligible reports focused on influenza, RSV, or SARS-CoV-2 and included data from 12 European countries. Clinical and interventional studies were excluded. Reports were classified according to 4 research objectives: epidemiological monitoring, evaluation of interventions, assessment of disease burden and health outcomes, and analyses of population adherence and trust toward public health measures. Data sources were grouped into 9 categories, including surveillance systems, electronic health records (EHRs), registries, claims, surveys, digital, environmental, integrated datasets, and others.

RESULTS: A total of 2564 empirical reports were included. Over time, respiratory virus research relied on an increasingly diverse set of data streams. While surveillance systems remained central, particularly for epidemiological monitoring, their relative dominance declined. From 2020 onward, there was a marked expansion in the use of EHRs, registries, claims data, digital sources, and linked or integrated datasets, alongside increased use of open-access data. Data source use varied by research objective: surveillance data predominated in monitoring and intervention evaluation; EHRs in studies of risk factors and treatment effectiveness; surveys in seroprevalence and public trust analyses; and claims data in assessments of economic burden. Substantial geographic disparities were observed. Northern European countries more frequently used linked and multisource datasets, whereas Southern Europe relied more often on open-access or single-source data.

CONCLUSIONS: This scoping review provides a multipathogen, cross-country mapping of data sources for respiratory virus surveillance and research in Europe over 2 decades, applying an innovative objective-driven framework. Unlike prior reviews focused on single pathogens or data types, it offers a consolidated, comparative perspective based on 2564 reports to inform public health decision-making. The COVID-19 pandemic accelerated innovation in data generation and access, but progress remained largely centered on SARS-CoV-2, while structural fragmentation continues to limit timely, integrated data across Europe. Strengthening preparedness will require interoperable infrastructures, federated analysis platforms, sustainable funding for surveillance innovations, and cross-sectoral data sharing.},
}

Humans
Europe/epidemiology
*Respiratory Syncytial Virus Infections/epidemiology
*Pandemics
*Influenza, Human/epidemiology
*COVID-19/epidemiology
SARS-CoV-2

@article {pmid42100538,
year = {2026},
author = {Muturiki, M and Mapukata, NO and Chauke, L and Jewett, S},
title = {Mental health patterns and associated social determinants among university and college students in sub-Saharan Africa during the COVID-19 pandemic era: a scoping review.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1800724},
pmid = {42100538},
issn = {2296-2565},
mesh = {Humans ; *Social Determinants of Health ; *COVID-19/epidemiology/psychology ; *Students/psychology/statistics & numerical data ; Universities ; *Mental Health/statistics & numerical data ; Africa South of the Sahara/epidemiology ; Sub-Saharan African People ; Pandemics ; *Mental Disorders/epidemiology ; },
abstract = {BACKGROUND: Evidence on student mental health in sub-Saharan Africa (SSA) remains limited, particularly studies examining how mental health patterns intersect with social determinants within higher education institutions (HEIs). This scoping review identifies gaps in the literature documenting student mental health and associated social determinants during the COVID-19 period and highlights priorities for future research in SSA.

METHODS: Eight databases (MEDLINE, PsycInfo, Open Access Journals, CINAHL, Google Scholar, Cochrane Library, ProQuest, Scopus) and grey literature were searched for English-language studies from 2020 to 2023. Sixty-seven studies from 214 full-text articles screened met the inclusion criteria.

RESULTS: The included studies varied widely in their examination of student mental health and its links to social determinants of health (SDOH). Mental health was most frequently assessed in terms of depression, anxiety, suicidality, substance use disorders, and psychological distress. Mood disorders were the most commonly reported outcomes. Few studies explored help-seeking behavior. Reported social determinants aligned with structural factors (socioeconomic and political contexts, cultural norms, gender disparities) and intermediary factors such as academic stress, service access, and behavioral patterns including substance use, physical activity, sleep, and diet.

CONCLUSION: Although many studies addressed social determinants of student mental health in SSA, none provided comparable, multi-country data across HEIs. Most research focused on undergraduate particularly medical students, with limited attention to postgraduate populations. Future work should prioritize multi-country comparative studies and context-specific approaches that strengthen help-seeking and support for at-risk students across diverse SSA settings.},
}

Humans
*Social Determinants of Health
*COVID-19/epidemiology/psychology
*Students/psychology/statistics & numerical data
Universities
*Mental Health/statistics & numerical data
Africa South of the Sahara/epidemiology
Sub-Saharan African People
Pandemics
*Mental Disorders/epidemiology

@article {pmid42448413,
year = {2026},
author = {Viknesh, K and Vijayalakshmi, P and Alex, AM and Muthumani, LN and Muthupandian, S and Desai, D and Ramanathan, S and Likson, A and Selvaraj, C},
title = {Energetic landscapes and fuzzy complexes: Computational targeting of viral intrinsically disordered proteins.},
journal = {Advances in protein chemistry and structural biology},
volume = {153},
number = {},
pages = {351-407},
doi = {10.1016/bs.apcsb.2026.04.009},
pmid = {42448413},
issn = {1876-1631},
mesh = {Humans ; *Intrinsically Disordered Proteins/chemistry/metabolism/antagonists & inhibitors ; *Viral Proteins/chemistry/metabolism/antagonists & inhibitors ; *Antiviral Agents/chemistry/pharmacology ; SARS-CoV-2 ; Machine Learning ; },
abstract = {The increased recognition of intrinsically disordered proteins (IDPs) as critical mediators in viral infections has shifted attention toward fuzzy drug targets, challenging the conventional structure-based paradigms of drug discovery due to their inherent conformational flexibility. The binding of viral IDPs and IDRs to host factors occurs in dynamic, multivalent, and context-dependent interactions and constitute flexible complexes, which form the basis of pathogenicity and immune evasion. In this review, the disordered proteins of viruses are considered with a combination of molecular, computational, and translational insights to assess the next-generation antiviral targets. In this, we have discuss about the energetic landscapes that control the disorder, functional disorder order transitions and the fuzzy interfaces as centers of the networks of virus-host interactions. Special focus is kept on the new lines of computational and AI-directed technologies such as ensemble-based docking, machine-learning computational models of IDP ligand recognition, and multi-omics-driven target prioritization. The experimental approaches that are modified to characterize disordered systems, including NMR spectroscopy and hybrid structural biology, are also reviewed. The translational applicability of the targeting of viral fuzziness is highlighted by case studies of HIV-1, influenza, SARS-CoV-2, and emerging viral pathogens. We also provide directions about the future involving adaptive pharmacophores, customized antiviral approaches, and AI-driven ensemble targeting making disordered viral proteins a paradigm shift in antiviral drug discovery.},
}

Humans
*Intrinsically Disordered Proteins/chemistry/metabolism/antagonists & inhibitors
*Viral Proteins/chemistry/metabolism/antagonists & inhibitors
*Antiviral Agents/chemistry/pharmacology
SARS-CoV-2
Machine Learning

@article {pmid42449828,
year = {2026},
author = {Hetta, HF and Haseeb, A and Bukhari, SQ and Alatawi, Z and Mahrous, AJ and Elrggal, ME and Masri, MA and Kotb, AA},
title = {Emerging Multimodal Point-of-Care Diagnostic Strategies for Rapid Detection and Management of Respiratory Viruses: A State-of-the-Art Review.},
journal = {Diagnostics (Basel, Switzerland)},
volume = {16},
number = {13},
pages = {},
doi = {10.3390/diagnostics16132048},
pmid = {42449828},
issn = {2075-4418},
support = {26UQU4310470GSSR02//Umm al-Qura University/ ; 26UQU4310470GSSR03//Umm al-Qura University/ ; },
abstract = {The co-circulation of respiratory viruses, including SARS-CoV-2, influenza A/B, and respiratory syncytial virus (RSV), represents a significant global health challenge that requires rapid, accurate, and differential diagnosis to support infection control and appropriate clinical decision-making. This narrative review summarizes emerging multimodal point-of-care testing (POCT) strategies for the detection and management of these respiratory viruses. Relevant studies were identified through literature searches of major scientific databases, including PubMed, Scopus, and Web of Science, focusing on recent advances in molecular diagnostics, biosensors, microfluidics, and digital health technologies. To improve clinical interpretation and comparative assessment, current POCT platforms were organized into four operational tiers based on infrastructure dependence, degree of portability, and level of decentralization of testing. Tier 1 (Professional Clinical Systems) includes fully integrated automated molecular diagnostic platforms designed for use in hospital and emergency care settings. Tier 2 (Field-Deployable Systems) comprises portable molecular and isothermal amplification technologies designed for use in decentralized or resource-limited environments. Tier 3 (Hardware-Lite Assays) includes simplified diagnostic approaches that minimize instrument requirements and are suitable for near-patient or low-infrastructure settings. Tier 4 (Consumer-Digital Diagnostics) encompasses emerging smartphone- and IoT-integrated diagnostic platforms that support user-driven testing and digital health connectivity. This tier-based framework reflects a proposed stratification of POCT technologies along a decentralization continuum and aims to facilitate comparison and selection of diagnostic strategies across diverse healthcare settings.},
}

@article {pmid42450061,
year = {2026},
author = {Lim, S and Martina, B},
title = {Immune Mechanisms and Translational Study Design in Viral Vaccine Development.},
journal = {International journal of molecular sciences},
volume = {27},
number = {13},
pages = {},
doi = {10.3390/ijms27135790},
pmid = {42450061},
issn = {1422-0067},
mesh = {Humans ; Animals ; *Translational Research, Biomedical ; *Viral Vaccines/immunology ; *Vaccine Development/methods ; COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; Adaptive Immunity ; Immunity, Innate ; COVID-19 Vaccines/immunology ; },
abstract = {Viral vaccine development requires both mechanistic understanding of protective immunity and translational study designs that connect preclinical data with human outcomes. Animal models remain important for early assessment of safety, immunogenicity and protective efficacy, but their predictive value depends on the question being asked, the pathophysiology of infection, the immune mechanisms expected to mediate protection, and the biomarkers chosen to bridge animal and human data. This review focuses on viral vaccines and examines innate and adaptive mechanisms of vaccine-induced protection, including B cell and antibody responses, Fc-mediated functions, Fc glycosylation, T cell memory and CD8+ cytotoxic responses. We discuss common reasons for clinical failure and show how preclinical endpoints can be classified as human-counterpart, surrogate or comparative/mechanistic readouts. Influenza and COVID-19 examples illustrate how different models can be combined across discovery, challenge, transmission and late-stage bridging studies. Emerging tools such as systems serology, omics, AI/ML and new approach methods can improve candidate prioritization, but their value depends on assay standardization, biological validation and cautious interpretation. A mechanism-driven model cascade, paired with human-relevant immunological readouts, can improve preclinical interpretation and reduce the risk of advancing candidates that are unlikely to succeed in clinical trials.},
}

Humans
Animals
*Translational Research, Biomedical
*Viral Vaccines/immunology
*Vaccine Development/methods
COVID-19/prevention & control/immunology
SARS-CoV-2/immunology
Adaptive Immunity
Immunity, Innate
COVID-19 Vaccines/immunology

@article {pmid42450077,
year = {2026},
author = {Russjan, E and Zając, D and Kaczyńska, K},
title = {Therapeutic Potential of Glucagon-like Peptide-1 Receptor Agonists in Respiratory Disorders.},
journal = {International journal of molecular sciences},
volume = {27},
number = {13},
pages = {},
doi = {10.3390/ijms27135803},
pmid = {42450077},
issn = {1422-0067},
mesh = {Humans ; *Glucagon-Like Peptide-1 Receptor Agonists ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Glucagon-Like Peptide-1 Receptor/metabolism ; Glucagon-Like Peptide 1/metabolism ; Animals ; COVID-19/metabolism ; Asthma/drug therapy ; Pulmonary Fibrosis/drug therapy ; Sleep Apnea, Obstructive/drug therapy ; SARS-CoV-2 ; },
abstract = {Glucagon-like peptide-1 (GLP-1) is an incretin hormone secreted in response to food intake that acts biologically by binding to GLP-1 receptors. The primary function of GLP-1 is to stimulate insulin secretion and inhibit glucagon secretion, which helps limit after-meal spikes in blood glucose. GLP-1 reduces intestinal contractility, slows down gastrointestinal motility and emptying, and also acts directly on the hypothalamus, thereby regulating appetite and food intake. Due to its metabolic effects, GLP-1 forms the basis of medications currently used to treat type 2 diabetes (T2DM) and obesity. However, it has also been observed that the use of GLP-1 agonists in the treatment of obesity or diabetes has a beneficial effect on comorbid respiratory conditions. This narrative review analyzes the scientific literature and describes the most recent information on the impact of GLP-1 receptor agonist (GLP-1 RA) therapies on the most common respiratory disorders-both the beneficial and undesirable effects. We discuss evidence that acute lung injury, COVID-19, pulmonary fibrosis, asthma, chronic obstructive pulmonary disease (COPD), and obstructive sleep apnea can benefit from therapies with various GLP-1 RAs. They can complement existing lung-targeted treatments, but as research progresses, they are likely to play an ever more important role in the treatment of respiratory diseases.},
}

Humans
*Glucagon-Like Peptide-1 Receptor Agonists
Pulmonary Disease, Chronic Obstructive/drug therapy
Glucagon-Like Peptide-1 Receptor/metabolism
Glucagon-Like Peptide 1/metabolism
Animals
COVID-19/metabolism
Asthma/drug therapy
Pulmonary Fibrosis/drug therapy
Sleep Apnea, Obstructive/drug therapy
SARS-CoV-2

@article {pmid42450260,
year = {2026},
author = {Angamarca-Iguago, J and Parise-Vasco, JM and Reytor-González, C and Cagua-Ordoñez, J and Simancas-Racines, D},
title = {Temporal Dynamics of Innate Immune Activation and Viral Interference During Sequential Co-Infection with Influenza A Virus and SARS-CoV-2: Molecular Mechanisms, Clinical Evidence, and Therapeutic Implications.},
journal = {International journal of molecular sciences},
volume = {27},
number = {13},
pages = {},
doi = {10.3390/ijms27135994},
pmid = {42450260},
issn = {1422-0067},
mesh = {Humans ; *Immunity, Innate ; Animals ; *Influenza A virus/immunology ; *Influenza, Human/immunology/virology/drug therapy ; *SARS-CoV-2/immunology/physiology ; *COVID-19/immunology/virology ; *Coinfection/immunology/virology ; *Viral Interference ; Host-Pathogen Interactions/immunology ; Interferons ; Antiviral Agents/therapeutic use ; },
abstract = {The concurrent circulation of influenza A virus (IAV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has unveiled complex host-pathogen interactions governed by temporal dynamics of innate immune activation. This narrative review synthesizes evidence from human air-liquid interface (ALI) epithelial models, animal studies (hamster, ferret), clinical cohorts, and randomized controlled trials (2015-2026) to delineate the molecular mechanisms underlying viral interference between these two major respiratory pathogens. Prior IAV infection induces a robust type I/III interferon (IFN) response and broad interferon-stimulated gene (ISG) upregulation that restricts subsequent SARS-CoV-2 replication within a critical 24-72 h temporal window. Conversely, SARS-CoV-2 employs a multi-layered immune evasion strategy that blunts IFN induction, providing minimal heterologous protection. Simultaneous co-infection tends to exacerbate disease severity. Host genetic determinants, including OAS1 and TLR7 variants, modulate interference capacity. Therapeutically, early pegylated IFN-λ shows clinical benefit, while experimental evidence from in vitro and animal models suggests oseltamivir may paradoxically reduce IAV-induced interference. These findings underscore the need for multi-pathogen diagnostics, temporally informed clinical decision-making, and IFN-based therapeutic strategies during co-circulation periods.},
}

Humans
*Immunity, Innate
Animals
*Influenza A virus/immunology
*Influenza, Human/immunology/virology/drug therapy
*SARS-CoV-2/immunology/physiology
*COVID-19/immunology/virology
*Coinfection/immunology/virology
*Viral Interference
Host-Pathogen Interactions/immunology
Interferons
Antiviral Agents/therapeutic use

@article {pmid42450302,
year = {2026},
author = {Basu, S and Adhikary, D and Ghosh, K and Chattopadhyay, S and Deb, S and Mondal, R and Roy, J and Chowdhury, A and Benito-León, J},
title = {Machine Learning and Deep Learning Frameworks for Human-Virus Protein-Protein Interaction Prediction: Emerging Architectures, Methods, Benchmarks, and Challenges.},
journal = {International journal of molecular sciences},
volume = {27},
number = {13},
pages = {},
doi = {10.3390/ijms27136034},
pmid = {42450302},
issn = {1422-0067},
mesh = {Humans ; *Deep Learning ; *Machine Learning ; SARS-CoV-2 ; COVID-19/virology ; *Viral Proteins/metabolism ; Host-Pathogen Interactions ; *Protein Interaction Mapping/methods ; Protein Interaction Maps ; Prediction Algorithms ; Betacoronavirus/metabolism ; Benchmarking ; },
abstract = {The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged as one of the most significant global health crises in recent history. Coronaviruses are a diverse group of RNA viruses classified into alpha, beta, gamma, and delta genera, with SARS-CoV-2 belonging to the beta-coronavirus family. The virus exhibits high transmissibility and causes a wide spectrum of clinical manifestations ranging from mild respiratory symptoms to severe complications such as acute respiratory distress syndrome, multi-organ failure, and death, particularly among elderly and immunocompromised individuals. Structurally, SARS-CoV-2 possesses a large single-stranded RNA genome encoding major structural proteins, including spike (S), envelope (E), membrane (M), and nucleocapsid (N) proteins, which play critical roles in host-cell recognition and viral infection. Understanding the molecular mechanisms of virus-host interactions, especially protein-protein interactions (PPIs), is essential for uncovering viral pathogenesis and identifying potential therapeutic targets. Traditional experimental techniques for PPI detection, such as yeast two-hybrid and affinity purification methods, are often expensive, labor-intensive, and prone to inaccuracies. Consequently, computational approaches based on machine learning (ML) and deep learning (DL) have gained significant attention for efficient and scalable PPI prediction. These methods use diverse biological information, including protein sequences, structural features, genomic data, Gene Ontology annotations, and interaction networks, to model complex biological relationships. This survey reviews computational approaches to PPI prediction, highlighting ML- and DL-based techniques, methodological advances, performance evaluation practices, and limitations that affect benchmark comparability. It also discusses biological databases and data sources commonly used in PPI studies and explicitly considers how models trained in coronavirus-centered settings may generalize to other viral families with different mechanisms of host interaction.},
}

Humans
*Deep Learning
*Machine Learning
SARS-CoV-2
COVID-19/virology
*Viral Proteins/metabolism
Host-Pathogen Interactions
*Protein Interaction Mapping/methods
Protein Interaction Maps
Prediction Algorithms
Betacoronavirus/metabolism
Benchmarking

@article {pmid42450918,
year = {2026},
author = {Latzer, Y and Stein, D},
title = {The Impact of Recent Collective Trauma in Israel on Eating Disorders and Disordered Eating: An Overview and Clinical Perspective.},
journal = {Healthcare (Basel, Switzerland)},
volume = {14},
number = {13},
pages = {},
doi = {10.3390/healthcare14131908},
pmid = {42450918},
issn = {2227-9032},
abstract = {Background: Periods of collective crises are associated with substantial deterioration in mental health. Whereas trauma-related psychopathology has received considerable clinical and policy attention during such periods, eating disorders (EDs) and disordered eating (DE) remain comparatively under-recognized. EDs and DE are well recognized in the Israeli context; however, accumulating evidence indicates a significant increase in their prevalence during periods of collective crisis. Objective: We sought to synthesize empirical findings and clinical observations in Israel about the impact of the COVID-19 pandemic and the October 2023 War on the emergence and exacerbation of DE and EDs, and to examine the implications for clinical practice and mental health policy. Methods: We conducted a narrative review integrating epidemiological data, findings from Israeli healthcare organizations, scientific studies, and clinical insights from specialized ED services. Results: Across both crises, Israel experienced a marked increase in the full spectrum of eating-related disturbances, ranging from emotional eating and subclinical DE to severe full-blown EDs. Adolescents and young adults were particularly affected, but increased ED-related disturbance was also observed among adults and individuals with pre-existing EDs. These findings coincide with a prolonged duration period before receiving treatment and with limited service capacity. In response, the mental health system attempted to implement rapid adaptations, including expanded telemedicine, short-term targeted interventions, and new ambulatory and day treatment programs. Conclusions: Our findings indicate that DE and EDs constitute a significant and escalating mental health burden during periods of collective crises that is comparable to other trauma-related conditions. Just as comprehensive short- and long-term intervention frameworks have been developed for trauma-related conditions, similar models are urgently required for EDs.},
}

@article {pmid42452468,
year = {2026},
author = {Rada, M and Petculescu, IM and Pah, AM and Avram, A and Velimirovici, DE and Velciov, AB and Tudoran, C and Iurciuc, S and Utu, D and Gheorghe, DR and Craciun, ML},
title = {Valvular Heart Disease and Heart Failure in the Post-COVID-19 Era: A Narrative Review of Mechanisms, Diagnosis, Differential Assessment, and Clinical Outcomes.},
journal = {Journal of clinical medicine},
volume = {15},
number = {13},
pages = {},
doi = {10.3390/jcm15135007},
pmid = {42452468},
issn = {2077-0383},
support = {Victor Babeș University of Medicine and Pharmacy Timișoara//Victor Babeș University of Medicine and Pharmacy Timișoara/ ; },
abstract = {Background/Objectives: Cardiovascular involvement is among the most consequential sequelae of SARS-CoV-2 infection. Myocardial injury, arrhythmia, and thromboembolic disease have been characterized in depth, yet the relationship between COVID-19 and valvular heart disease (VHD), and its interplay with heart failure (HF), has received comparatively limited synthesis. This narrative review consolidates current evidence on the mechanisms, diagnosis, differential assessment, and clinical outcomes linking acute and post-acute COVID-19 to valvular dysfunction and to incident or worsening heart failure, with emphasis on practical implications for cardiologists and internists. Methods: We searched PubMed, Scopus, and Web of Science (January 2020-January 2026) for studies on valvular dysfunction, heart failure, myocardial injury, and endothelial pathology in SARS-CoV-2 infection, and synthesized findings narratively. Results: Convergent pathways-endothelial injury, systemic hyperinflammation, micro- and macrovascular thrombosis, and pressure-volume overload-contribute to functional and, less frequently, structural valvular changes. Available evidence suggests that clinically relevant post-COVID valvular abnormalities are more often secondary/functional (mitral and tricuspid regurgitation) than primary structural lesions, although dedicated prospective valvular studies remain scarce. Pre-existing severe VHD markedly worsens acute COVID-19 prognosis. Elevated NT-proBNP, troponin, and interleukin-6 consistently predict decompensation and mortality, and a substantial minority of survivors show persistent fibrotic pulmonary changes and restrictive ventilatory defects on follow-up (pulmonary rather than cardiac findings). Conclusions: Post-COVID valvular dysfunction appears, on currently available but largely indirect evidence, predominantly functional and inflammation-related, and may overlap with HFpEF phenotypes in selected patients when objective diagnostic criteria are fulfilled. Biomarker-guided, multimodality follow-up is reasonable in high-risk survivors, and prospective longitudinal studies with standardized valvular endpoints remain a priority. Dedicated longitudinal evidence on valvular outcomes specifically remains very limited.},
}

@article {pmid42452593,
year = {2026},
author = {Kasiak, P and Procyk, G},
title = {COACH Study: COVID-19 Influence on Cardiorespiratory Fitness in Athletes-A Systematic Review and Meta-Analysis.},
journal = {Journal of clinical medicine},
volume = {15},
number = {13},
pages = {},
doi = {10.3390/jcm15135133},
pmid = {42452593},
issn = {2077-0383},
abstract = {Objectives: We aimed to systematically review and meta-analyze the impact of COVID-19 infection on cardiorespiratory fitness (CRF): (1) within-athlete (the same participants before and after infection), and (2) between-athlete (infected vs. healthy reference participants). Methods: In this systematic review (PROSPERO Registry: CRD42024540430) we included observational studies enrolling recreational or competitive athletes ≥18 years old with laboratory confirmation of SARS-CoV-2 infection. The primary outcome was change in relative maximal oxygen uptake (VO2max). Secondary outcomes included changes in absolute VO2max, maximal ventilation (VEmax), and maximal heart rate (HRmax). We searched Embase, PubMed, Medline, Scopus, and Web of Science up to August 9th, 2025. Risk of bias was assessed with the JBI critical appraisal tool. Meta-analyses were performed with a random-effects model. Results: Twelve studies enrolling a total of 1595 participants met the eligibility criteria. COVID-19 infection was associated with lower relative VO2max (MD = -1.83 mL·kg[-1]·min[-1]; 95%CI [-3.16, -0.49]; p = 0.007; I[2] = 54%) and absolute VO2max (MD = -0.15 L·min[-1]; 95%CI [-0.29, -0.01]; p = 0.03; I[2] = 0%). COVID-19 infection was associated with lower VEmax (MD = -7.99 L·min[-1]; 95%CI [-12.94, -3.04]; p = 0.002; I[2] = 0%) but not with HRmax (MD = -0.34 bpm; 95%CI [-1.54, 0.86]; p = 0.58; I[2] = 0%). High heterogeneity of included studies was addressed with subgroup analyses. The risk of bias in most studies was high. The certainty of evidence was very low for each outcome. Conclusions: COVID-19 infection in athletes was associated with reduced VO2max and VEmax. The relationships were highly dependent on the quality of the studies. CRF and athlete profile should be considered when making shared decisions regarding safe return to sport after infection.},
}

@article {pmid42452704,
year = {2026},
author = {Olarewaju, A and Adebowale, A and Odutola, P and Arnold, A},
title = {Use of Natriuretic Peptides in Critically Ill Patients: A Narrative Review.},
journal = {Journal of clinical medicine},
volume = {15},
number = {13},
pages = {},
doi = {10.3390/jcm15135244},
pmid = {42452704},
issn = {2077-0383},
abstract = {Background: Natriuretic peptides, including B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), are established biomarkers of myocardial stress and circulatory overload. Although originally validated for diagnosis and exclusion of heart failure, their diagnostic and prognostic applications have expanded significantly in the context of critical illness. However, interpretation in critically ill patients is complicated by confounding factors such as systemic inflammation and renal dysfunction. Objective: This review synthesizes current evidence on the diagnostic, monitoring, and prognostic applications of natriuretic peptides in critically ill adults. It further outlines practical considerations, confounding variables, and emerging complementary biomarkers pertinent to clinical decision-making. Methods: A structured search of PubMed, Embase, and the Cochrane Library (January 2000 to October 2025) identified studies evaluating BNP, NT-proBNP, and atrial natriuretic peptide (ANP) in intensive care unit (ICU) patients. Eligible studies and review articles assessed diagnostic utility, volume status, hemodynamic monitoring, and prognostic performance. Narrative synthesis was employed using information obtained from eligible studies. Results: Twenty-four studies met the inclusion criteria. BNP and NT-proBNP facilitate differentiation between cardiogenic and noncardiogenic respiratory failure, identification of mixed shock states, and assessment of volume status when used in association with other modalities such as echocardiography and ultrasonography. Elevated natriuretic peptide concentrations consistently predict mortality, acute kidney injury, prolonged mechanical ventilation, and adverse outcomes in several disease states, including sepsis, acute respiratory distress syndrome [ARDS], postoperative cardiac dysfunction, and COVID-19-related critical illness. However, interpretation remains limited by confounders, including renal impairment, age, systemic inflammation, brain injury, mechanical ventilation, and right-ventricular strain/dysfunction. Conclusions: Natriuretic peptides serve as valuable adjuncts for diagnostic assessment, hemodynamic monitoring, and risk stratification in the ICU. When interpreted with attention to biological kinetics and clinical context, these biomarkers enhance multimodal monitoring and support individualized management. Future research should refine ICU-specific cutoffs and assess natriuretic peptide-guided therapeutic strategies in prospective multicenter trials.},
}

@article {pmid36754956,
year = {2023},
author = {Levy, ML and Bacharier, LB and Bateman, E and Boulet, LP and Brightling, C and Buhl, R and Brusselle, G and Cruz, AA and Drazen, JM and Duijts, L and Fleming, L and Inoue, H and Ko, FWS and Krishnan, JA and Mortimer, K and Pitrez, PM and Sheikh, A and Yorgancıoğlu, A and Reddel, HK},
title = {Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update.},
journal = {NPJ primary care respiratory medicine},
volume = {33},
number = {1},
pages = {7},
pmid = {36754956},
issn = {2055-1010},
mesh = {Adult ; Child ; Adolescent ; Humans ; *Anti-Asthmatic Agents/therapeutic use ; *Asthma/diagnosis/drug therapy ; Formoterol Fumarate/therapeutic use ; Adrenal Cortex Hormones/therapeutic use ; Administration, Inhalation ; Primary Health Care ; },
abstract = {The Global Initiative for Asthma (GINA) was established in 1993 by the World Health Organization and the US National Heart Lung and Blood Institute to improve asthma awareness, prevention and management worldwide. GINA develops and publishes evidence-based, annually updated resources for clinicians. GINA guidance is adopted by national asthma guidelines in many countries, adapted to fit local healthcare systems, practices, and resource availability. GINA is independent of industry, funded by the sale and licensing of its materials. This review summarizes key practical guidance for primary care from the 2022 GINA strategy report. It provides guidance on confirming the diagnosis of asthma using spirometry or peak expiratory flow. GINA recommends that all adults, adolescents and most children with asthma should receive inhaled corticosteroid (ICS)-containing therapy to reduce the risk of severe exacerbations, either taken regularly, or (for adults and adolescents with "mild" asthma) as combination ICS-formoterol taken as needed for symptom relief. For patients with moderate-severe asthma, the preferred regimen is maintenance-and-reliever therapy (MART) with ICS-formoterol. Asthma treatment is not "one size fits all"; GINA recommends individualized assessment, adjustment, and review of treatment. As many patients with difficult-to-treat or severe asthma are not referred early for specialist review, we provide updated guidance for primary care on diagnosis, further investigation, optimization and treatment of severe asthma across secondary and tertiary care. While the GINA strategy has global relevance, we recognize that there are special considerations for its adoption in low- and middle-income countries, particularly the current poor access to inhaled medications.},
}

Adult
Child
Adolescent
Humans
*Anti-Asthmatic Agents/therapeutic use
*Asthma/diagnosis/drug therapy
Formoterol Fumarate/therapeutic use
Adrenal Cortex Hormones/therapeutic use
Administration, Inhalation
Primary Health Care

@article {pmid36941668,
year = {2023},
author = {Bos, LDJ and de Grooth, HJ and Tuinman, PR},
title = {A structured diagnostic algorithm for patients with ARDS.},
journal = {Critical care (London, England)},
volume = {27},
number = {1},
pages = {94},
pmid = {36941668},
issn = {1466-609X},
mesh = {Humans ; Critical Care ; *Emergency Medicine ; *Respiratory Distress Syndrome/diagnosis ; Algorithms ; Intensive Care Units ; },
abstract = {This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2023. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2023 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901 .},
}

Humans
Critical Care
*Emergency Medicine
*Respiratory Distress Syndrome/diagnosis
Algorithms
Intensive Care Units

@article {pmid40708523,
year = {2026},
author = {Lewis, GK and Ciupe, S and Sajadi, M},
title = {Unveiling an Immunological Mystery: Deciphering the Durability Divide in Vaccine-Elicited Antibody Responses.},
journal = {Current HIV research},
volume = {23},
number = {6},
pages = {494-509},
pmid = {40708523},
issn = {1873-4251},
support = {R01 GM152743/GM/NIGMS NIH HHS/United States ; },
mesh = {Humans ; Plasma Cells/immunology ; *Antibody Formation/immunology ; *Antibodies, Viral/immunology ; *COVID-19 Vaccines/immunology ; Animals ; *COVID-19/immunology/prevention & control ; SARS-CoV-2/immunology ; Receptors, Complement 3d/immunology ; AIDS Vaccines/immunology ; Epitopes/immunology ; },
abstract = {Achieving durable antibody-mediated protection remains critical in vaccine development, particularly for viral diseases like COVID-19 and HIV. We discuss factors influencing antibody durability, highlighting the role of long-lived plasma cells (LLPCs) in the bone marrow, which are essential for sustained antibody production over many years. The frequencies and properties of bone marrow LLPC are critical determinants of the broad spectrum of antibody durability for different vaccines. Vaccines for diseases like measles and mumps elicit long-lasting antibodies; those for COVID-19 and HIV do not. High epitope densities in the vaccine are known to favor antibody durability, but we discuss three underappreciated variables that also play a role in long-lived antibody responses. First, in addition to high epitope densities, we discuss the importance of CD21 as a critical determinant of antibody durability. CD21 is a B cell antigen receptor (BCR) complex component. It significantly affects BCR signaling strength in a way essential for generating LLPC in the bone marrow. Second, all antibody-secreting cells (ASC) are not created equal. There is a four-log range of antibody secretion rates, and we propose epigenetic imprinting of different rates on ASC, including LLPC, as a factor in antibody durability. Third, antibody durability afforded by bone marrow LLPC is independent of continuous antigenic stimulation. By contrast, tissue-resident T-bet+CD21low ASC also persists in secondary lymphoid tissues and continuously produces antibodies depending on persisting antigen and the tissue microenvironment. We discuss these variables in the context of making an HIV vaccine that elicits broadly neutralizing antibodies against HIV that persist at protective levels without continuous vaccination over many years.},
}

Humans
Plasma Cells/immunology
*Antibody Formation/immunology
*Antibodies, Viral/immunology
*COVID-19 Vaccines/immunology
Animals
*COVID-19/immunology/prevention & control
SARS-CoV-2/immunology
Receptors, Complement 3d/immunology
AIDS Vaccines/immunology
Epitopes/immunology

@article {pmid41582574,
year = {2026},
author = {Chaudhary, V and Singh, AP and Sharma, H and Taumar, D},
title = {Advances in Fragment-based Drug Design: Lessons and Innovations from the Post-COVID Drug Discovery Landscape.},
journal = {Mini reviews in medicinal chemistry},
volume = {26},
number = {7},
pages = {497-509},
pmid = {41582574},
issn = {1875-5607},
mesh = {Humans ; *Drug Discovery/methods ; *Drug Design ; SARS-CoV-2/drug effects ; *Antiviral Agents/chemistry/pharmacology/therapeutic use ; Artificial Intelligence ; COVID-19 ; *COVID-19 Drug Treatment ; *Protease Inhibitors/chemistry/pharmacology ; Pandemics ; },
abstract = {Fragment-based drug discovery (FBDD) has emerged as a transformative strategy in modern medicinal chemistry, offering a rational and efficient alternative to traditional highthroughput screening (HTS). By utilizing small, low-molecular-weight fragments with moderate binding affinity, FBDD enables systematic optimization into potent lead compounds with improved physicochemical properties. Its modular and ligand-centric nature has proven particularly advantageous in accelerating early-stage drug discovery. The COVID-19 pandemic highlighted the adaptability of FBDD, as fragment screening and computational modeling rapidly identified inhibitors of the SARS-CoV-2 main protease (M[pro]). Integration with artificial intelligence (AI) and cloud-based platforms further enhanced the speed and global accessibility of fragment campaigns, setting a precedent for collaborative, open-science initiatives. Beyond infectious diseases, FBDD has demonstrated significant promise in oncology, antibacterial therapy, and neurodegenerative disorders, reflecting its versatility across diverse therapeutic landscapes. Recent technological advances have expanded the scope of FBDD. High-resolution cryo-electron microscopy and AI-driven structural prediction now enable the exploration of previously inaccessible or dynamic protein targets. Emerging modalities, such as PROTACs and RNA-targeted therapeutics, also intersect with fragment-based strategies, opening avenues for addressing so-called "undruggable" proteins. Despite persistent challenges, including the need for sensitive biophysical methods and sophisticated infrastructure, the approach continues to evolve. Looking ahead, the convergence of FBDD with machine learning, open-access fragment libraries, and global research collaboration positions it as a scalable, adaptive platform for drug discovery. As future health threats demand rapid innovation, FBDD is poised to remain a cornerstone of both academic and industrial research pipelines.},
}

Humans
*Drug Discovery/methods
*Drug Design
SARS-CoV-2/drug effects
*Antiviral Agents/chemistry/pharmacology/therapeutic use
Artificial Intelligence
COVID-19
*COVID-19 Drug Treatment
*Protease Inhibitors/chemistry/pharmacology
Pandemics

@article {pmid41588957,
year = {2026},
author = {Vineeth, ES and Saha, S and Nishtala, VB},
title = {A Mini Review on Metal Complexes as Potential Anti-SARS-CoV-2 Agents: Insights from Molecular Docking Studies.},
journal = {Mini reviews in medicinal chemistry},
volume = {26},
number = {6},
pages = {399-411},
pmid = {41588957},
issn = {1875-5607},
mesh = {*Antiviral Agents/chemistry/pharmacology/therapeutic use ; *Molecular Docking Simulation ; Humans ; *SARS-CoV-2/drug effects ; *Coordination Complexes/chemistry/pharmacology/therapeutic use ; *COVID-19 Drug Treatment ; Spike Glycoprotein, Coronavirus/metabolism/antagonists & inhibitors/chemistry ; },
abstract = {There is an urgent need to develop effective antiviral treatments against SARS-CoV-2. Despite the availability of vaccines, drug discovery remains critical for combating emerging variants. Molecular docking studies have become a vital computational tool for identifying antiviral drugs capable of inhibiting different SARS-CoV-2 proteins. This review explores the role of metal complexes as promising viral inhibitors through in silico molecular docking approaches. The binding abilities of several coordination complexes derived from iron, copper, palladium, and zinc ions have been evaluated against major viral proteins such as the spike glycoprotein, RNA-dependent RNA polymerase (RdRp), and the main protease (Mpro), which are responsible for viral infection. Comparative docking studies of specific metal-based compounds with conventional antiviral drugs highlight their superior binding affinities and inhibitory potential. Furthermore, ADME (Absorption, Distribution, Metabolism, and Excretion) analyses, molecular dynamics simulations, and drugdelivery strategies are discussed to assess pharmacokinetics and therapeutic viability. Overall, this review emphasizes the importance of molecular docking in the rational design of metal complexes as antiviral agents and its relevance for developing effective therapeutic strategies to combat COVID-19.},
}

*Antiviral Agents/chemistry/pharmacology/therapeutic use
*Molecular Docking Simulation
Humans
*SARS-CoV-2/drug effects
*Coordination Complexes/chemistry/pharmacology/therapeutic use
*COVID-19 Drug Treatment
Spike Glycoprotein, Coronavirus/metabolism/antagonists & inhibitors/chemistry

@article {pmid41879458,
year = {2026},
author = {de Oliveira, GT and Ikegaki, ABKB and de Souza, ILI and Agostini, SBN and Marques, MBF and de Araujo, MB},
title = {Minoxidil as a Prodrug: Review of Chemical, Pharmacological, and Technological Aspects in Alopecia Therapeutics.},
journal = {Mini reviews in medicinal chemistry},
volume = {26},
number = {9},
pages = {623-631},
doi = {10.2174/0113895575433118260115212307},
pmid = {41879458},
issn = {1875-5607},
mesh = {Humans ; *Minoxidil/chemistry/pharmacology/therapeutic use/pharmacokinetics ; *Alopecia/drug therapy ; *Prodrugs/chemistry/therapeutic use/pharmacology/pharmacokinetics ; Animals ; },
abstract = {Alopecia is a prevalent condition that affects both sexes, characterised by miniaturisation of hair follicles and changes in the dynamics of the hair cycle, such as androgenetic alopecia associated with various systemic factors, including the COVID-19 pandemic. Minoxidil (base), initially developed as an oral antihypertensive, is currently used in the treatment of alopecia, acting as a prodrug that requires hepatic sulphation to generate its active metabolite, minoxidil sulphate. Topical formulations use minoxidil sulphate, the active pharmaceutical ingredient, directly on the hair follicles. Pharmacogenomic studies highlight the critical role of SULT1A1 enzyme variability in modulating treatment response, supporting personalised therapeutic strategies. Despite challenges related to low water solubility, high permeability, and narrow therapeutic index, emerging pharmaceutical technologies, including minitablets, orodispersible forms, sublingual preparations, and modified release systems, offer the potential to optimise absorption, increase dosing accuracy, and reduce adverse effects. This review consolidates current knowledge on the chemistry, pharmacology, pharmacogenomics, and technological aspects of minoxidil (base) for systemic use, emphasising translational developments that may redefine its clinical applications and contribute to safer and more standardised therapies. The integration of medicinal chemistry, pharmaceutical technology, clinical pharmacology, and regulatory guidance is expected to promote oral minoxidil as a reliable, effective, and patient-centred therapeutic option for alopecia.},
}

Humans
*Minoxidil/chemistry/pharmacology/therapeutic use/pharmacokinetics
*Alopecia/drug therapy
*Prodrugs/chemistry/therapeutic use/pharmacology/pharmacokinetics
Animals

@article {pmid41897014,
year = {2026},
author = {Berg, A and Richter, C and Meyer, G},
title = {Internationally studied parameters related to the COVID-19 pandemic in nursing homes: a scoping review.},
journal = {Systematic reviews},
volume = {15},
number = {1},
pages = {},
pmid = {41897014},
issn = {2046-4053},
mesh = {*Nursing Homes/organization & administration ; *COVID-19/epidemiology ; Humans ; *Pandemics ; SARS-CoV-2 ; Nursing Home Residents ; },
abstract = {BACKGROUND: Nursing homes were severely affected by the COVID-19 pandemic. Standardised parameters are essential to understand and monitor the unintended consequences of pandemic control measures and changes in work processes. In this scoping review, we aimed to identify COVID-19-related parameters studied in nursing homes that could form a minimum data set suitable for database development. We focused on the perspectives of all interest-holders: facilities, residents, their relatives and nursing home staff.

METHODS: We searched MEDLINE and CINAHL and included quantitative studies published in English since the beginning of the pandemic (2020 to 2024). The extracted parameters were initially categorised according to five dimensions: pandemic-related data, facility level, staff level, residents and relatives. Within each dimension, the original terms were compared and inductively organised into (sub-)categories based on conceptual similarities, with synonymous terms subsequently standardised.

RESULTS: From 82 included articles, 96 different parameters related to COVID-19 in nursing homes were identified. Infection and mortality rates emerged as the pandemic-related data most often reported, particularly within this dimension but also across all dimensions. However, we found a broad range of resident-related parameters. Our most often identified facility-related parameters include the number of staff and the provision of personal protective equipment. Staff-related parameters most often studied were personal burden and stress. Only a few parameters (n = 9) were considered for relatives.

CONCLUSIONS: The diversity of the reported parameters indicates that a comprehensive database is required to adequately assess a pandemic situation in this vulnerable population. In terms of pandemic preparedness, our overview of the reported parameters offers a basis for the development of country- and context-specific data capture approaches.},
}

*Nursing Homes/organization & administration
*COVID-19/epidemiology
Humans
*Pandemics
SARS-CoV-2
Nursing Home Residents

@article {pmid41914684,
year = {2026},
author = {Brüssow, H},
title = {Antivirals Targeting Coronavirus RNA-Dependent RNA Polymerase and Main Protease: From Mechanisms of Action to Outcomes in COVID-19 Clinical Trials.},
journal = {Microbial biotechnology},
volume = {19},
number = {4},
pages = {e70342},
pmid = {41914684},
issn = {1751-7915},
mesh = {Humans ; *Antiviral Agents/therapeutic use/pharmacology ; *SARS-CoV-2/drug effects/enzymology ; Clinical Trials as Topic ; COVID-19 ; Animals ; *Coronavirus RNA-Dependent RNA Polymerase/antagonists & inhibitors ; COVID-19 Drug Treatment ; *Betacoronavirus/drug effects/enzymology ; Coronavirus 3C Proteases/antagonists & inhibitors ; *Coronavirus Infections/drug therapy/virology ; *Viral Nonstructural Proteins/antagonists & inhibitors ; Proline/analogs & derivatives/therapeutic use ; Treatment Outcome ; Cytidine/analogs & derivatives ; Hydroxylamines ; },
abstract = {The rapid global spread of SARS-CoV-2 triggered an unprecedented effort to develop effective antivirals. Among the first approved agents was remdesivir, an injectable nucleoside analogue developed by Gilead Sciences, that led to chain termination of viral RNA synthesis and showed broad antiviral activity against RNA viruses. Early clinical results were mixed: The US ACTT-1 trial reported an accelerated recovery and reduced mortality in treated patients, while the WHO Solidarity and a European trial revealed no impact of remdesivir on mortality. In contrast, a US trial in outpatients demonstrated a clear clinical benefit when treatment was administered early. Molnupiravir, an orally applicable nucleoside analogue developed by Merck, induces lethal mutations in the viral genome rather than chain termination. Molnupiravir showed in vivo antiviral activity against coronaviruses in different animals. In MOVe-OUT trials, molnupiravir reduced the rate of hospitalisation in treated outpatients. In the PANORAMIC trial, molnupiravir reduced the time to recovery in outpatients but not their rate of hospitalisation. No drug effect of molnupiravir was seen in the RECOVERY trial with hospitalised COVID-19 patients. Using structural biology and medicinal chemistry approaches, Pfizer developed nirmatrelvir, an oral inhibitor of the major coronavirus protease. In high-risk but not in standard-risk COVID-19 patients, the combination nirmatrelvir/ritonavir reduced the rate of hospitalisation (EPIC HR and SR trials). Retrospective cohort studies showed treatment effects in defined patient groups. This review compares the efficacy and clinical performance of different antivirals, including emerging drugs such as obeldesivir and alternative protease inhibitors (lopinavir, simnotrelvir). It further examines their roles in prophylaxis, treatment of long covid symptoms, pharmacological considerations and antiviral resistance. Particular attention is given to factors underlying variable outcome of the trials, including viral variant evolution, population immunity increases, disease severity changes and timing of therapy initiation.},
}

Humans
*Antiviral Agents/therapeutic use/pharmacology
*SARS-CoV-2/drug effects/enzymology
Clinical Trials as Topic
COVID-19
Animals
*Coronavirus RNA-Dependent RNA Polymerase/antagonists & inhibitors
COVID-19 Drug Treatment
*Betacoronavirus/drug effects/enzymology
Coronavirus 3C Proteases/antagonists & inhibitors
*Coronavirus Infections/drug therapy/virology
*Viral Nonstructural Proteins/antagonists & inhibitors
Proline/analogs & derivatives/therapeutic use
Treatment Outcome
Cytidine/analogs & derivatives
Hydroxylamines

@article {pmid41920064,
year = {2026},
author = {Splane, J and Hotta, TA and Lillington, S and Ulhman, M and Ippoliti, M and Castaneda, R},
title = {Canadian Clinical Practice Recommendations for Preventing Infections in Aesthetic Medicine.},
journal = {Plastic and aesthetic nursing},
volume = {46},
number = {2},
pages = {101-113},
pmid = {41920064},
issn = {2770-3517},
mesh = {Humans ; Canada ; *COVID-19/prevention & control/epidemiology ; *Infection Control/standards/methods ; *Practice Guidelines as Topic ; *Cross Infection/prevention & control ; SARS-CoV-2 ; },
abstract = {The COVID-19 pandemic exposed critical gaps in infection protection and control (IPC) protocols across health care settings, underscoring the urgent need for health care systems, organizations, and providers to prioritize robust safety standards to protect patient, provider, and public well-being. In aesthetic medicine-where demand for procedures continues to rise-maintaining stringent IPC practices is more important than ever. This article reviews fundamental IPC principles, current best-practices specific to aesthetic medicine, and facility-level recommendations in Canada. As IPC standards continue to evolve, their application within aesthetic settings remains essential to protecting patient, provider, and public health. Ongoing adaptation and improvement in response to emerging risks and rising procedural volumes are crucial to maintaining the integrity and safety of aesthetic practice.},
}

Humans
Canada
*COVID-19/prevention & control/epidemiology
*Infection Control/standards/methods
*Practice Guidelines as Topic
*Cross Infection/prevention & control
SARS-CoV-2

@article {pmid41922045,
year = {2026},
author = {Gupta, J and Pinjari, D and Aggarwal, Y and Kumar, D and Syal, K and Bhattacharyya, R and Banerjee, D},
title = {Vitamin D in health and disease and potential shield against COVID-19.},
journal = {Advances in clinical chemistry},
volume = {132},
number = {},
pages = {223-254},
doi = {10.1016/bs.acc.2025.12.001},
pmid = {41922045},
issn = {2162-9471},
mesh = {Humans ; *Vitamin D/therapeutic use/analogs & derivatives/blood ; COVID-19 ; SARS-CoV-2 ; Pandemics ; Dietary Supplements ; *Coronavirus Infections/drug therapy/prevention & control ; *Pneumonia, Viral/drug therapy/prevention & control ; Betacoronavirus ; Vitamins/therapeutic use ; COVID-19 Drug Treatment ; },
abstract = {Vitamin D acts as a micronutrient, hormone, and immunomodulator. While well known for supporting bone health and preventing rickets, researchers are now exploring its potential to help fight infection, including COVID-19. Certain laboratory studies and observational research suggest that vitamin D supplementation may lower the risk of developing serious illnesses. Unfortunately, clinical studies have generated mixed results. This gap between laboratory findings and real-world outcomes highlights the need for high-quality research in the field. Another promising domain is the utilization of vitamin D analogs that can provide similar or even better benefits than native vitamin D, but with fewer side effects. Additionally, the standardization of vitamin D measurement from biologic samples in clinical and research laboratories must be improved to successfully manage individual patients and clinical research. All these aspects are dealt with in detail in this chapter.},
}

Humans
*Vitamin D/therapeutic use/analogs & derivatives/blood
COVID-19
SARS-CoV-2
Pandemics
Dietary Supplements
*Coronavirus Infections/drug therapy/prevention & control
*Pneumonia, Viral/drug therapy/prevention & control
Betacoronavirus
Vitamins/therapeutic use
COVID-19 Drug Treatment

@article {pmid41924267,
year = {2026},
author = {Ohta, E and Okada, E and Sawada, Y},
title = {Pustular psoriasis flare following COVID-19 infection: a case report and literature review.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1740000},
pmid = {41924267},
issn = {1664-3224},
mesh = {Humans ; Female ; *COVID-19/complications/immunology ; *Psoriasis/drug therapy/pathology/immunology/etiology ; Middle Aged ; *SARS-CoV-2/immunology ; },
abstract = {Generalized pustular psoriasis (GPP) is a rare, potentially life-threatening inflammatory disease characterized by neutrophilic pustules and systemic inflammation. We report a case of severe GPP triggered by SARS-CoV-2 infection in a 46-year-old woman with a long history of psoriasis. Eleven days after recovery from COVID-19 pneumonia, she developed widespread pustules and fever. Histopathology revealed subcorneal spongiform pustules and dermal neutrophilic infiltration consistent with GPP. Systemic corticosteroids followed by etretinate and deucravacitinib achieved complete remission. A literature review identified 11 infection- and 10 vaccine-related GPP cases. Compared with vaccine-associated cases, infection-related flares showed longer latency and higher corticosteroid use. Mechanistically, both SARS-CoV-2 infection and vaccination may be associated with IL-36 axis activation, potentially via spike protein-driven, Toll-like receptor-mediated innate immune signaling. This case highlights that distinct immune kinetics may underlie infection- and vaccine-related GPP, while supporting a putative role of IL-36-driven inflammation in COVID-19-associated disease exacerbation.},
}

Humans
Female
*COVID-19/complications/immunology
*Psoriasis/drug therapy/pathology/immunology/etiology
Middle Aged
*SARS-CoV-2/immunology

@article {pmid41933448,
year = {2026},
author = {Medina, YF and Rodríguez Grande, EI and Galindo, JL and Vargas Pinilla, OC and Soler, F and Espitia, GV},
title = {Non-pharmacological rehabilitation strategies for pulmonary and physical recovery in ICU survivors after COVID-19: A systematic review.},
journal = {Chronic respiratory disease},
volume = {23},
number = {},
pages = {14799731261439941},
pmid = {41933448},
issn = {1479-9731},
mesh = {Humans ; *COVID-19/rehabilitation/complications/physiopathology ; Survivors ; Intensive Care Units ; SARS-CoV-2 ; Recovery of Function ; Critical Care/methods ; Pandemics ; },
abstract = {BackgroundSurvivors of severe COVID-19 requiring intensive care frequently experience persistent pulmonary and functional impairment consistent with post-critical illness sequelae. The effectiveness of non-pharmacological rehabilitation in this severity-specific subgroup remains uncertain.MethodsA systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Epistemonikos, LILACS, and Google Scholar were searched for randomized and observational studies evaluating non-pharmacological rehabilitation in adult ICU survivors of COVID-19. Risk of bias was assessed using RoB 2 and ROBINS-I tools. Given substantial clinical and methodological heterogeneity, quantitative meta-analysis was not performed; a structured narrative synthesis was undertaken.ResultsFourteen studies met inclusion criteria. Five incorporated comparator groups, while nine employed uncontrolled pre-post designs. Interventions ranged from early ICU mobilization to inpatient and outpatient pulmonary rehabilitation. Controlled studies reported variable between-group benefits in dyspnea and functional outcomes, whereas observational studies consistently described within-group improvement over time. However, most studies were at moderate to serious risk of bias, and heterogeneity in intervention timing, dosage, and outcome assessment limited comparability.ConclusionsNon-pharmacological rehabilitation in ICU survivors of COVID-19 is associated with improvement over time; however, the certainty of causal effectiveness remains low. ICU survivors constitute a distinct recovery population within the broader post-COVID spectrum. Adequately powered, multicenter randomized trials with standardized protocols and harmonized outcomes are required to establish long-term effectiveness.},
}

Humans
*COVID-19/rehabilitation/complications/physiopathology
Survivors
Intensive Care Units
SARS-CoV-2
Recovery of Function
Critical Care/methods
Pandemics

@article {pmid41934674,
year = {2026},
author = {Gillini, L and Sevilla-Hernández, C and Cavaleri, M},
title = {COVID-19 and its short- and long-term effects on the operations of the EMA: fostering innovation in the EU during and beyond time of crisis.},
journal = {European journal of public health},
volume = {36},
number = {2},
pages = {},
pmid = {41934674},
issn = {1464-360X},
mesh = {Humans ; COVID-19 ; European Union ; *Pandemics/prevention & control ; SARS-CoV-2 ; *Coronavirus Infections/epidemiology/drug therapy ; *Pneumonia, Viral/epidemiology/drug therapy ; *Government Agencies/organization & administration ; },
abstract = {The European Medicines Agency (EMA) played a crucial role in responding to the COVID-19 pandemic by implementing various innovations that facilitated the development and approval of vaccines and treatments. This article analyses some of those innovations on the agency's operations through literature on innovation in the public sector using a literature review, publications on EU policy along with internal knowledge by the authors. The agency's innovative approaches such as the establishment of the COVID-19 Emergency Task Force and the effective use of real-world evidence enabled the agency to provide rapid advice to developers and ensure the provision of scientific feedback to the authorities and the public during crisis. The changes implemented led to new legislation allowing long-term effects within the agency. The EMA has emerged from the COVID-19 pandemic strengthened by innovative approaches leading to new legislation enabling an expanded mandate of the agency. To sustain innovation at the EMA, the agency might have to consider a structured and comprehensive approach to innovation, including the importance of fostering an innovation culture within the organization.},
}

Humans
COVID-19
European Union
*Pandemics/prevention & control
SARS-CoV-2
*Coronavirus Infections/epidemiology/drug therapy
*Pneumonia, Viral/epidemiology/drug therapy
*Government Agencies/organization & administration

@article {pmid42445051,
year = {2026},
author = {Balcha, WF and Kassahun, EA and Nega, AT and Abie, A and Demsie, DG and Negesse, CT and Feyisa, K and Mekonnen, BA and Biadigilign, TM and Addisu, ZD and Ayenew, W and Siraj, EA and Zewdie, S and Anagaw, YK and Alene, GM and Yismaw, MB and Yehualaw, A and Kebede, SY and Mihiretie, EA and Awoke, AM and Bante, SA and Tesfu, AA and Sendeku, FW and Demissie, BA and Shiferaw, WG and Megule, SM and Abebe, YM and Tessema, LW and Chekole, FA},
title = {Labor Pain Management Practices and Associated Factors Among Licensed Obstetric Care Providers in Ethiopia: A Systematic Review and Meta-Analysis.},
journal = {Health science reports},
volume = {9},
number = {7},
pages = {e72770},
pmid = {42445051},
issn = {2398-8835},
abstract = {BACKGROUND AND AIMS: Labor pain is a multidimensional experience influenced by emotional, cognitive, and cultural factors. It can be managed using pharmacological, non-pharmacological, or combined approaches. Licensed obstetric care providers (OCPs) are ethically obligated to ensure maternal comfort while safeguarding fetal safety. Evidence on labor pain management practices (LPMP) in Ethiopia remains inconsistent, as prior studies often included students or had unclear inclusion criteria. This systematic review and meta-analysis estimated the pooled prevalence of LPMP among licensed OCPs, identified associated factors, and examined trends before and during the COVID-19 pandemic.

METHODS: We searched major databases and repositories for studies published between January 1, 2018 and October 3, 2025. Risk of bias was assessed using the Joanna Briggs Institute checklist and modified Newcastle-Ottawa Scale, with inter-rater reliability analyses. Meta-analysis was conducted in STATA 17 using random or fixed-effects models. Heterogeneity was assessed using Cochran's Q test and quantified with I[2] statistic. Certainty of evidence rated using GRADE.

RESULTS: Twenty studies involving 7,202 participants were included. LPMP prevalence varied substantially across studies and settings. The pooled prevalence of overall LPMP was 46.9% (95% CI: 42.7-51.1; I[2] = 92.4%). Non-pharmacological practice was 42.8% (95% CI: 36.6-49.1), whereas pharmacological practice was 21.1% (95% CI: 12.5-29.7), decreasing to 15.2% after adjustment for publication bias. Pharmacological practice was modestly higher during COVID-19 (23.7% vs. 18.0%). Factors positively associated with LPMP included provider knowledge, attitudes, training, drug/protocol availability, supportive environments, higher education, longer experience, positive perceptions, being a midwife, and female sex. Certainty of evidence ranged from low to moderate.

CONCLUSION: LPMP prevalence varied considerably across studies and settings. While the pooled estimate suggests that fewer than half of Ethiopian OCPs practiced LPMP, substantial unexplained heterogeneity warrants cautious interpretation. Non-pharmacological methods were more commonly used than pharmacological approaches, highlighting opportunities to strengthen provider training, institutional support, and resource availability.},
}

@article {pmid42445255,
year = {2026},
author = {Jha, S and Chaliha, LB and Pandey, K and Patel, R},
title = {Reimagining tuberculosis elimination in India: diagnostics, drug resistance, and digital health strategies.},
journal = {Frontiers in epidemiology},
volume = {6},
number = {},
pages = {1868261},
pmid = {42445255},
issn = {2674-1199},
abstract = {Tuberculosis (TB) remains a major global public health challenge and one of the leading infectious causes of mortality worldwide, with India contributing approximately 26% of the global TB burden. Despite substantial progress under the National Tuberculosis Elimination Programme (NTEP), India's efforts to achieve the ambitious 2025 TB elimination target continue to face major challenges due to the COVID-19 pandemic, multidrug-resistant tuberculosis (MDR-TB), healthcare disparities, and limitations in surveillance and reporting systems. This review provides a comprehensive overview of the epidemiology of TB in India and critically evaluates the impact of COVID-19, drug resistance, healthcare accessibility, and emerging diagnostic technologies on TB control efforts. A structured literature search was conducted using PubMed, Scopus, and Google Scholar, along with reports from the World Health Organization and the Government of India. The reviewed evidence indicates that the COVID-19 pandemic significantly disrupted TB diagnosis, treatment, surveillance, and healthcare accessibility, leading to declines in case notification and the possible accumulation of undiagnosed TB cases. In addition, the increasing burden of MDR/RR-TB, fragmented private healthcare systems, underreporting, and unequal access to diagnostics and treatment continue to hinder progress toward TB elimination. Although advancements including molecular diagnostics, digital surveillance platforms such as Nikshay, AI-assisted screening, and patient-support programmes have strengthened TB control strategies, important challenges related to implementation, infrastructure, scalability, and antimicrobial stewardship remain unresolved. This review highlights the need for integrated and patient-centred TB control strategies that combine rapid diagnostics, strengthened surveillance, public-private healthcare integration, health systems strengthening, and interventions addressing broader socioeconomic determinants such as poverty, malnutrition, and healthcare inequity. Coordinated multisectoral approaches will be essential for accelerating TB elimination efforts in India in the post-COVID era.},
}

@article {pmid42446912,
year = {2026},
author = {Li, N and Yan, Y and Li, Y and Ni, J and Gao, J and Piao, X and Hou, X},
title = {The effect of high-dose of vitamin C on mortality among aged patients with severe COVID-19: A systematic review and meta-analysis.},
journal = {Clinical and investigative medicine. Medecine clinique et experimentale},
volume = {49},
number = {2},
pages = {31-42},
doi = {10.3138/CIM-2024-0302},
pmid = {42446912},
issn = {1488-2353},
mesh = {Humans ; *Ascorbic Acid/administration & dosage/therapeutic use ; *COVID-19/mortality ; Aged ; Critical Illness/mortality ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; Randomized Controlled Trials as Topic ; },
abstract = {BACKGROUND: Critically ill patients are frequently deficient in vitamin C. Given the significant mortality rates in the elderly population associated with COVID-19, we aimed to systematically review the literature and evaluate whether high-dose vitamin C can reduce COVID-19 mortality in this population.

METHODS: Multiple data sources (PubMed, Web of Science, ScienceDirect, and medRxiv) were searched using the keywords "COVID-19" AND "vitamin C" up to November 2024. Randomized controlled trials (RCTs) involving COVID-19 patients with relevant data were collected. We used a random or fixed effects meta-analysis to calculate the pooling effect.

RESULTS: Eight RCTs comprising 2,104 patients were ultimately included in the meta-analysis. The pooling effect (odds ratio [OR] 0.97[95% CI 0.80-1.18, P = 0.76) suggested no significant difference in mortality rates between patients treated with high-dose vitamin C and those who were not.

CONCLUSIONS: Vitamin C supplementation might reduce the risk of COVID-19 mortality in critically ill patients; however, this effect varied by study. Additional research is necessary to arrive at a definitive conclusion on this subject.},
}

Humans
*Ascorbic Acid/administration & dosage/therapeutic use
*COVID-19/mortality
Aged
Critical Illness/mortality
SARS-CoV-2
*COVID-19 Drug Treatment
Randomized Controlled Trials as Topic

@article {pmid42447883,
year = {2026},
author = {Naidoo, T and Morgenstern, C and Doohan, P and Earl, R and Rawson, T and Sheppard, RJ and Hicks, JT and Radhakrishnan, S and Johnson, R and Hartner, AM and Cattarino, L and McCain, K and Vicco, A and Imai-Eaton, N and Elsland, SV and Cori, A and McCabe, R and Bhatia, S and , },
title = {A systematic review of Nipah virus disease epidemiological parameters, outbreaks, and mathematical models.},
journal = {The Lancet. Infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/S1473-3099(26)00239-2},
pmid = {42447883},
issn = {1474-4457},
abstract = {Our systematic review, based on PRISMA guidelines (PROSPERO CRD42023393345), characterised the epidemiology, outbreaks, and mathematical models of Nipah virus, an important public health threat in south and southeast Asia. We searched PubMed and Web of Science from database inception to March 14, 2025, and extracted 243 parameters, 89 risk factors, 39 models, and 23 distinct outbreaks from 119 papers. IgG seroprevalence estimates in the general population ranged from 0% to 12·5%. Nipah virus causes severe disease, with pooled case-fatality ratio estimates ranging widely from 9·1% (95% CI 0·2-41·3) in Singapore to 81·9% (95% CI 71·9-88·9) in Bangladesh. The infection timeline and clinical course of Nipah virus remain poorly characterised; we estimated a median incubation period of 8·77 days (165, 95% CI 7·53-10·02) from eight estimates in seven articles with sufficient information. Transmission parameter estimates were scarce, and all but one of five central estimates of the basic reproduction number were less than one. Nipah virus mathematical models (39) were rarely fitted to data (eight). All extracted information is accessible via our R package, epireview.},
}

@article {pmid42448011,
year = {2026},
author = {Thapa, N and Jin, Y and Han, JH},
title = {Innate immune surveillance and nucleic acid sensing: Gatekeepers of inflammatory cell death in respiratory infectious diseases.},
journal = {Pharmacological research},
volume = {},
number = {},
pages = {108340},
doi = {10.1016/j.phrs.2026.108340},
pmid = {42448011},
issn = {1096-1186},
abstract = {Respiratory infections caused by viral pathogens, including influenza A virus, respiratory syncytial virus, and SARS-CoV-2, as well as bacterial pathogens, remain major contributors to global morbidity and mortality. The outcomes of these infections are largely determined by how the host innate immune system detects pathogen-derived nucleic acids and regulates subsequent inflammatory responses. Pattern recognition receptors (PRRs) located in endosomal and cytosolic compartments, including Toll-like receptors, RIG-I-like receptors, absent in melanoma 2, and Z-DNA-binding protein 1, as well as the cyclic GMP-AMP synthase-stimulator of interferon genes pathway, recognize viral and bacterial nucleic acids and initiate signaling cascades that promote cytokine production and antimicrobial defense. However, dysregulated PRR activation can trigger inflammatory programmed cell death, including apoptosis, pyroptosis, necroptosis, and PANoptosis. This review summarizes recent advances in understanding how nucleic acid sensing orchestrates inflammatory cell death during respiratory infections, with particular emphasis on pathogen- and cell type-specific mechanisms that shape disease outcomes. We further highlight the dual nature of these pathways, which are essential for pathogen clearance but can drive immunopathology when excessively activated. Defining how nucleic acid-sensing pathways shape inflammatory cell death in respiratory infections may guide host-directed therapies that enhance pathogen clearance while preserving lung function. Overall, the field remains constrained by the predominance of virus-focused and murine preclinical studies, whereas bacterial nucleic acid sensing during respiratory infections remains poorly defined. Future studies should integrate major bacterial infection models with human-relevant respiratory epithelial systems to better translate PRR-mediated immune mechanisms into host-directed therapeutic strategies.},
}

@article {pmid34814859,
year = {2021},
author = {Doherty, A and Benedetto, V and Harris, C and Boland, P and Christian, DL and Hill, J and Bhutani, G and Clegg, AJ},
title = {The effectiveness of psychological support interventions for those exposed to mass infectious disease outbreaks: a systematic review.},
journal = {BMC psychiatry},
volume = {21},
number = {1},
pages = {592},
pmid = {34814859},
issn = {1471-244X},
mesh = {*Cognitive Behavioral Therapy ; Counseling ; Disease Outbreaks ; *Eye Movement Desensitization Reprocessing ; Humans ; Psychosocial Intervention ; },
abstract = {BACKGROUND: Mass outbreaks such as pandemics are associated with mental health problems requiring effective psychological interventions. Although several forms of psychological interventions may be advocated or used, some may lack strong evidence of efficacy and some may not have been evaluated in mass infectious disease outbreaks. This paper reports a systematic review of published studies (PROSPERO CRD:42020182094. Registered: 24.04.2020) examining the types and effectiveness of psychological support interventions for the general population and healthcare workers exposed to mass infectious disease outbreaks.

METHODS: A systematic review was conducted. Randomised Controlled Trials (RCT) were identified through searches of electronic databases: Medline (Ovid), Embase (Ovid), PsycINFO (EBSCO) and the Cochrane Library Database from inception to 06.05.2021 using an agreed search strategy. Studies were included if they assessed the effectiveness of interventions providing psychological support to the general population and / or healthcare workers exposed to mass infectious disease outbreaks. Studies were excluded if they focused on man-made or natural disasters or if they included armed forces, police, fire-fighters or coastguards.

RESULTS: Twenty-two RCTs were included after screening. Various psychological interventions have been used: therapist-guided therapy (n = 1); online counselling (n = 1); 'Emotional Freedom Techniques' (n = 1); mobile phone apps (n = 2); brief crisis intervention (n = 1); psychological-behavioural intervention (n = 1); Cognitive Behavioural Therapy (n = 3); progressive muscle relaxation (n = 2); emotional-based directed drawing (n = 1); psycho-educational debriefing (n = 1); guided imagery (n = 1); Eye Movement Desensitization and Reprocessing (EMDR) (n = 1); expressive writing (n = 2); tailored intervention for patients with a chronic medical conditions (n = 1); community health workers (n = 1); self-guided psychological intervention (n = 1), and a digital behaviour change intervention (n = 1). Meta-analyses showed that psychological interventions had a statistically significant benefit in managing depression (Standardised Mean Difference [SMD]: -0.40; 95% Confidence Interval [CI]: - 0.76 to - 0.03), and anxiety (SMD: -0.72; 95% CI: - 1.03 to - 0.40). The effect on stress was equivocal (SMD: 0.16; 95% CI: - 0.19 to 0.51). The heterogeneity of studies, studies' high risk of bias, and the lack of available evidence means uncertainty remains.

CONCLUSIONS: Further RCTs and intervention studies involving representative study populations are needed to inform the development of targeted and tailored psychological interventions for those exposed to mass infectious disease outbreaks.},
}

*Cognitive Behavioral Therapy
Counseling
Disease Outbreaks
*Eye Movement Desensitization Reprocessing
Humans
Psychosocial Intervention

@article {pmid35604475,
year = {2022},
author = {Ryan, P and Redenbaugh, V and McGucken, J and Kindle, G and Devlin, LA and Coulter, T and Buckland, MS and Seppänen, MRJ and Conlon, NP and Feighery, C and Edgar, JDM},
title = {Inborn Errors of Immunity on the Island of Ireland - a Cross-Jurisdictional UKPID/ESID Registry Report.},
journal = {Journal of clinical immunology},
volume = {42},
number = {6},
pages = {1293-1299},
pmid = {35604475},
issn = {1573-2592},
mesh = {Adult ; *Delayed Diagnosis ; Humans ; Immunoglobulins ; *Immunologic Deficiency Syndromes/diagnosis/epidemiology ; Registries ; United Kingdom/epidemiology ; },
abstract = {The epidemiology of inborn errors of immunity (IEI) in the Republic of Ireland was first published in 2005 but has not been updated since. IEI prevalence data from Northern Ireland was last published in 2018. Using data from the United Kingdom Primary Immune Deficiency (UKPID) and European Society for Immunodeficiencies (ESID) registries, we reviewed all registered cases of IEI affecting adult patients ≥ 18 years of age from the two largest immunology specialist centres in Northern Ireland and the Republic of Ireland, respectively and calculated the combined minimum adult prevalence of IEI on the island of Ireland for the first time. We also recorded data pertaining to presenting symptoms of IEI, diagnostic delay, immunoglobulin data, and genetic testing, as well as briefly reporting data pertaining to secondary immunodeficiency in both countries. As of 1 May 2020, we identified a minimum adult IEI prevalence in Ireland of 8.85/100,000 population.},
}

Adult
*Delayed Diagnosis
Humans
Immunoglobulins
*Immunologic Deficiency Syndromes/diagnosis/epidemiology
Registries
United Kingdom/epidemiology

@article {pmid35674870,
year = {2022},
author = {Arena, G and Sharma, K and Agyeah, G and Krüger, R and Grünewald, A and Fitzgerald, JC},
title = {Neurodegeneration and Neuroinflammation in Parkinson's Disease: a Self-Sustained Loop.},
journal = {Current neurology and neuroscience reports},
volume = {22},
number = {8},
pages = {427-440},
pmid = {35674870},
issn = {1534-6293},
mesh = {Animals ; *Gastrointestinal Microbiome ; Humans ; Inflammation/metabolism ; Neuroinflammatory Diseases ; Neurons/metabolism ; *Parkinson Disease/metabolism ; },
abstract = {PURPOSE OF REVIEW: Neuroinflammation plays a significant role in Parkinson's disease (PD) etiology along with mitochondrial dysfunction and impaired proteostasis. In this context, mechanisms related to immune response can act as modifiers at different steps of the neurodegenerative process and justify the growing interest in anti-inflammatory agents as potential disease-modifying treatments in PD. The discovery of inherited gene mutations in PD has allowed researchers to develop cellular and animal models to study the mechanisms of the underlying biology, but the original cause of neuroinflammation in PD is still debated to date.

RECENT FINDINGS: Cell autonomous alterations in neuronal cells, including mitochondrial damage and protein aggregation, could play a role, but recent findings also highlighted the importance of intercellular communication at both local and systemic level. This has given rise to debate about the role of non-neuronal cells in PD and reignited intense research into the gut-brain axis and other non-neuronal interactions in the development of the disease. Whatever the original trigger of neuroinflammation in PD, what appears quite clear is that the aberrant activation of glial cells and other components of the immune system creates a vicious circle in which neurodegeneration and neuroinflammation nourish each other. In this review, we will provide an up-to-date summary of the main cellular alterations underlying neuroinflammation in PD, including those induced by environmental factors (e.g. the gut microbiome) and those related to the genetic background of affected patients. Starting from the lesson provided by familial forms of PD, we will discuss pathophysiological mechanisms linked to inflammation that could also play a role in idiopathic forms. Finally, we will comment on the potential clinical translatability of immunobiomarkers identified in PD patient cohorts and provide an update on current therapeutic strategies aimed at overcoming or preventing inflammation in PD.},
}

Animals
*Gastrointestinal Microbiome
Humans
Inflammation/metabolism
Neuroinflammatory Diseases
Neurons/metabolism
*Parkinson Disease/metabolism

@article {pmid35962190,
year = {2022},
author = {Mohsen, MO and Bachmann, MF},
title = {Virus-like particle vaccinology, from bench to bedside.},
journal = {Cellular & molecular immunology},
volume = {19},
number = {9},
pages = {993-1011},
pmid = {35962190},
issn = {2042-0226},
mesh = {*Vaccines, Virus-Like Particle/chemistry ; Vaccinology ; *Viruses ; },
abstract = {Virus-like particles (VLPs) have become key tools in biology, medicine and even engineering. After their initial use to resolve viral structures at the atomic level, VLPs were rapidly harnessed to develop antiviral vaccines followed by their use as display platforms to generate any kind of vaccine. Most recently, VLPs have been employed as nanomachines to deliver pharmaceutically active products to specific sites and into specific cells in the body. Here, we focus on the use of VLPs for the development of vaccines with broad fields of indications ranging from classical vaccines against viruses to therapeutic vaccines against chronic inflammation, pain, allergy and cancer. In this review, we take a walk through time, starting with the latest developments in experimental preclinical VLP-based vaccines and ending with marketed vaccines, which earn billions of dollars every year, paving the way for the next wave of prophylactic and therapeutic vaccines already visible on the horizon.},
}

*Vaccines, Virus-Like Particle/chemistry
Vaccinology
*Viruses

@article {pmid36056175,
year = {2022},
author = {Aksan, A and Zepp, F and Anand, S and Stein, J},
title = {Intravenous ferric carboxymaltose for the management of iron deficiency and iron deficiency anaemia in children and adolescents: a review.},
journal = {European journal of pediatrics},
volume = {181},
number = {11},
pages = {3781-3793},
pmid = {36056175},
issn = {1432-1076},
mesh = {Administration, Intravenous ; Adolescent ; *Anemia, Iron-Deficiency/drug therapy/etiology ; Child ; Ferric Compounds/adverse effects ; Humans ; Iron/therapeutic use ; *Iron Deficiencies ; Maltose/adverse effects/analogs & derivatives ; Prospective Studies ; Retrospective Studies ; Treatment Outcome ; },
abstract = {UNLABELLED: Iron deficiency is the primary cause of anaemia worldwide and is particularly common among children and adolescents. Intravenous (IV) iron therapy is recommended for paediatric patients with certain comorbidities or if oral iron treatment has been unsuccessful. IV ferric carboxymaltose (FCM) has recently been approved by the US Food and Drug Administration for use in children aged > 1 year. This narrative review provides an overview of the available publications on the efficacy and safety of IV FCM in children and adolescents. A literature search using PubMed and Embase yielded 153 publications; 33 contained clinical data or reports on clinical experience relating to IV FCM in subjects < 18 years of age and were included in the review. No prospective, randomised controlled studies on the topic were found. Most publications were retrospective studies or case reports and included patients with various underlying conditions or patients with inflammatory bowel disease. Efficacy data were included in 27/33 publications and improvements in anaemia, and/or iron status parameters were reported in 26 of them. Safety data were included in 25/33 publications and were in line with the adverse events described in the prescribing information.

CONCLUSION: The available publications indicate that IV FCM, a nanomedicine with a unique and distinctive therapeutic profile, is an effective and generally well-tolerated treatment for iron deficiency or iron deficiency anaemia in children and adolescents. Despite the wealth of retrospective evidence, prospective, randomised controlled trials in the paediatric setting are still necessary.

WHAT IS KNOWN: • Iron deficiency and iron deficiency anaemia are usually managed using oral iron therapy, but intravenous iron therapy is recommended for certain paediatric patients. • Intravenous ferric carboxymaltose (FCM) has recently been approved in the US for use in children aged > 1 year.

WHAT IS NEW: • Despite evidence that FCM is effective and generally well tolerated in children and adolescents, so far, only retrospective studies, non-randomised uncontrolled prospective studies, or case reports have been published in full. • There is a strong need for prospective, randomised controlled trials on FCM in the paediatric setting.},
}

Administration, Intravenous
Adolescent
*Anemia, Iron-Deficiency/drug therapy/etiology
Child
Ferric Compounds/adverse effects
Humans
Iron/therapeutic use
*Iron Deficiencies
Maltose/adverse effects/analogs & derivatives
Prospective Studies
Retrospective Studies
Treatment Outcome

@article {pmid36662439,
year = {2023},
author = {Otu, A and Kosmidis, C and Mathioudakis, AG and Ibe, C and Denning, DW},
title = {The clinical spectrum of aspergillosis in chronic obstructive pulmonary disease.},
journal = {Infection},
volume = {51},
number = {4},
pages = {813-829},
pmid = {36662439},
issn = {1439-0973},
mesh = {Humans ; *Aspergillosis/complications ; *Pulmonary Disease, Chronic Obstructive/complications ; *Pulmonary Aspergillosis/complications/diagnosis ; Aspergillus ; },
abstract = {Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. In this review, we present the clinical spectrum and pathogenesis of syndromes caused by Aspergillus in COPD namely invasive aspergillosis (IA), community-acquired Aspergillus pneumonia, chronic pulmonary Aspergillosis and Aspergillus sensitisation. Some of these entities are clearly linked to COPD, while others may coexist, but are less clearly liked directly to COPD. We discuss current uncertainties as these pertain to IA in COPD cohorts and explore areas for future research in this field.},
}

Humans
*Aspergillosis/complications
*Pulmonary Disease, Chronic Obstructive/complications
*Pulmonary Aspergillosis/complications/diagnosis
Aspergillus

@article {pmid41860269,
year = {2026},
author = {Slama Schwok, A},
title = {[Post-COVID neurological sequelae, proposed mechanisms and therapeutic approaches].},
journal = {Medecine sciences : M/S},
volume = {42},
number = {3},
pages = {280-289},
doi = {10.1051/medsci/2026036},
pmid = {41860269},
issn = {1958-5381},
mesh = {Humans ; *COVID-19/complications ; *Nervous System Diseases/therapy/etiology/epidemiology/virology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Female ; Pandemics ; *Coronavirus Infections/complications/therapy/epidemiology ; *Pneumonia, Viral/complications/therapy ; *Betacoronavirus ; Neuroinflammatory Diseases/etiology/therapy ; Adult ; },
abstract = {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.},
}

Humans
*COVID-19/complications
*Nervous System Diseases/therapy/etiology/epidemiology/virology
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Female
Pandemics
*Coronavirus Infections/complications/therapy/epidemiology
*Pneumonia, Viral/complications/therapy
*Betacoronavirus
Neuroinflammatory Diseases/etiology/therapy
Adult

@article {pmid41860271,
year = {2026},
author = {Cracowski, JL and Molimard, M and Richard, V and Roustit, M and Khouri, C},
title = {[Assessing the risk-benefit balance of medicines: Some lessons from Covid-19].},
journal = {Medecine sciences : M/S},
volume = {42},
number = {3},
pages = {295-305},
doi = {10.1051/medsci/2026040},
pmid = {41860271},
issn = {1958-5381},
mesh = {Humans ; Pharmacovigilance ; COVID-19/epidemiology ; Risk Assessment/methods ; *COVID-19 Drug Treatment ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Pharmacoepidemiology/methods ; Clinical Trials as Topic ; SARS-CoV-2 ; Drug Interactions ; },
abstract = {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.},
}

Humans
Pharmacovigilance
COVID-19/epidemiology
Risk Assessment/methods
*COVID-19 Drug Treatment
Drug-Related Side Effects and Adverse Reactions/epidemiology
Pharmacoepidemiology/methods
Clinical Trials as Topic
SARS-CoV-2
Drug Interactions

@article {pmid41860319,
year = {2026},
author = {Kortz, TB and Hidalgo, JL and Akech, SO and Myatra, SN and Maves, RC and Perez-Fernandez, J and Acharya, SP and Coopersmith, CM and Jacob, ST and Johnston, C and Kissoon, N and Machado, FR and Molyneux, E and Morrow, BM and Pérez Cornejo, MS and Permpikul, C and Piyavechviratana, K and Rhodes, A and Ulisubisya, MM and Kumar, VK and Patel, H and Woznica, D and Nadkarni, VM},
title = {10 Steps to Improve Sepsis Care in Low-Resource Settings.},
journal = {Critical care medicine},
volume = {54},
number = {4},
pages = {939-949},
doi = {10.1097/CCM.0000000000007090},
pmid = {41860319},
issn = {1530-0293},
mesh = {Humans ; *Resource-Limited Settings ; *Sepsis/therapy/prevention & control/diagnosis ; *Quality Improvement/organization & administration ; Critical Care/standards ; Practice Guidelines as Topic ; Consensus ; },
abstract = {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.},
}

Humans
*Resource-Limited Settings
*Sepsis/therapy/prevention & control/diagnosis
*Quality Improvement/organization & administration
Critical Care/standards
Practice Guidelines as Topic
Consensus

@article {pmid41860328,
year = {2026},
author = {Myatra, SN and Boyer, KM and Hidalgo, JL and Maves, RC and Acharya, SP and Jacob, ST and Kortz, TB and Nadkarni, VM and Pérez Cornejo, MS and Perez-Fernandez, J and Johnston, C and Machado, FR and Morrow, BM and Coopersmith, CM and Kissoon, N and Molyneux, E and Permpikul, C and Piyavechviratana, K and Rhodes, A and Ulisubisya, MM and Kumar, VK and Patel, H and Woznica, D and Akech, SO},
title = {Gaps and Strategies for Management of Sepsis in Low-Resource Settings: Expert Consensus Statements Using a Delphi Method.},
journal = {Critical care medicine},
volume = {54},
number = {5},
pages = {1209-1224},
doi = {10.1097/CCM.0000000000007102},
pmid = {41860328},
issn = {1530-0293},
mesh = {Humans ; *Sepsis/therapy/diagnosis/prevention & control ; Resource-Limited Settings ; Delphi Technique ; Developing Countries ; Consensus ; },
abstract = {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.},
}

Humans
*Sepsis/therapy/diagnosis/prevention & control
Resource-Limited Settings
Delphi Technique
Developing Countries
Consensus

@article {pmid41860329,
year = {2026},
author = {Hidalgo, JL and Akech, SO and Acharya, SP and Coopersmith, CM and Jacob, ST and Johnston, C and Kissoon, N and Machado, FR and Maves, RC and Molyneux, E and Morrow, BM and Myatra, SN and Pérez Cornejo, MS and Perez-Fernandez, J and Permpikul, C and Piyavechviratana, K and Rhodes, A and Kortz, TB and Kumar, VK and Ulisubisya, MM and Nadkarni, V},
title = {The Frame of Survival for Sepsis: A Practical Systems Framework for Time-Sensitive Critical Illness in Low-Resource Settings.},
journal = {Critical care medicine},
volume = {54},
number = {5},
pages = {1202-1208},
doi = {10.1097/CCM.0000000000007093},
pmid = {41860329},
issn = {1530-0293},
mesh = {Resource-Limited Settings ; *Sepsis/therapy/mortality/diagnosis ; Humans ; *Critical Illness/therapy/mortality ; Quality Improvement/organization & administration ; *Critical Care/organization & administration/standards ; },
abstract = {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.},
}

Resource-Limited Settings
*Sepsis/therapy/mortality/diagnosis
Humans
*Critical Illness/therapy/mortality
Quality Improvement/organization & administration
*Critical Care/organization & administration/standards

@article {pmid41861257,
year = {2026},
author = {Madhugiri, R and Slanina, H and Saleem-Batcha, R and Ziebuhr, J},
title = {The Coronavirus Replication-Transcription Complex.},
journal = {Annual review of biochemistry},
volume = {95},
number = {1},
pages = {317-346},
doi = {10.1146/annurev-biochem-052621-091439},
pmid = {41861257},
issn = {1545-4509},
mesh = {*Virus Replication ; Humans ; *Coronavirus/genetics/physiology ; *RNA, Viral/genetics/biosynthesis/metabolism ; *RNA Replication ; Animals ; *Transcription, Genetic ; },
abstract = {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.},
}

*Virus Replication
Humans
*Coronavirus/genetics/physiology
*RNA, Viral/genetics/biosynthesis/metabolism
*RNA Replication
Animals
*Transcription, Genetic

@article {pmid41862100,
year = {2026},
author = {Cordeiro, J and Macela, C and Kleiner, R and Vaskovich-Koubi, D and Moura, LIF and Satchi-Fainaro, R and Florindo, HF},
title = {Harnessing the power of microbiome, nanotechnology, and immunity against cancer.},
journal = {Journal of controlled release : official journal of the Controlled Release Society},
volume = {394},
number = {},
pages = {114839},
doi = {10.1016/j.jconrel.2026.114839},
pmid = {41862100},
issn = {1873-4995},
mesh = {Humans ; *Microbiota/immunology ; *Neoplasms/immunology/therapy/microbiology ; *Nanotechnology/methods ; Animals ; Immunotherapy/methods ; Tumor Microenvironment/immunology ; },
abstract = {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.},
}

Humans
*Microbiota/immunology
*Neoplasms/immunology/therapy/microbiology
*Nanotechnology/methods
Animals
Immunotherapy/methods
Tumor Microenvironment/immunology

@article {pmid41862909,
year = {2026},
author = {Khalid, K and Abdullah, ADI and Lim, HX and Ali, RAR},
title = {Pharmacological and non-pharmacological management of long COVID.},
journal = {Virology journal},
volume = {23},
number = {1},
pages = {},
pmid = {41862909},
issn = {1743-422X},
mesh = {Humans ; *COVID-19/therapy/complications ; Post-Acute COVID-19 Syndrome ; Probiotics/therapeutic use ; SARS-CoV-2 ; Dysbiosis ; Pandemics ; *Coronavirus Infections/therapy ; },
abstract = {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.},
}

Humans
*COVID-19/therapy/complications
Post-Acute COVID-19 Syndrome
Probiotics/therapeutic use
SARS-CoV-2
Dysbiosis
Pandemics
*Coronavirus Infections/therapy

@article {pmid41862917,
year = {2026},
author = {Luo, S and Zheng, Z and Karimi, L and Plebanski, M and Lankatillake, C and Sheahan, J and Anderson, K and Jovanovski, N and Seal, EL and Cockshaw, W and Wollersheim, D and Cleary, S and El-Ansary, D and Flanagan, KL and Jessup, R and Abrahamson, S and Whyler, N and Fineberg, D and Scoullar, MJL and Seeley, MC and Tippett, E and Xenos, S and Itsiopoulos, C},
title = {Between silence and solutions: a global guideline review of long COVID care and services in Australia.},
journal = {BMC health services research},
volume = {26},
number = {1},
pages = {},
pmid = {41862917},
issn = {1472-6963},
mesh = {Humans ; *COVID-19/therapy/epidemiology ; Australia ; *Practice Guidelines as Topic ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Primary Health Care ; Delivery of Health Care ; },
abstract = {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.},
}

Humans
*COVID-19/therapy/epidemiology
Australia
*Practice Guidelines as Topic
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Primary Health Care
Delivery of Health Care

@article {pmid41863157,
year = {2026},
author = {Mori, Y and Silwal, S and Wan Mohd Yunus, WMA and Sourander, A},
title = {Long-Term Trends in Screen Time Use Among Children and Adolescents: A Systematic Review Including Pre- and Post-COVID Periods.},
journal = {Clinical child psychology and psychiatry},
volume = {},
number = {},
pages = {13591045261432532},
doi = {10.1177/13591045261432532},
pmid = {41863157},
issn = {1461-7021},
abstract = {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.},
}

@article {pmid41863427,
year = {2026},
author = {Barzoki, MG and Farahmand, M and Mahmodi, MJ and Amirjannati, N and Malekshahi, SS},
title = {The Impact of SARS-CoV-2 on Male Infertility: A Systematic Review and Meta-Analysis of Cohort Studies.},
journal = {Reviews in medical virology},
volume = {36},
number = {2},
pages = {e70128},
doi = {10.1002/rmv.70128},
pmid = {41863427},
issn = {1099-1654},
support = {4021102//National Institute for Medical Research Development/ ; },
mesh = {Male ; Humans ; *Infertility, Male/virology/etiology/epidemiology ; *COVID-19/complications/virology ; *SARS-CoV-2/pathogenicity ; Spermatozoa/virology/pathology ; Sperm Motility ; Semen Analysis ; Sperm Count ; Cohort Studies ; Semen/virology ; DNA Fragmentation ; },
abstract = {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.},
}

Male
Humans
*Infertility, Male/virology/etiology/epidemiology
*COVID-19/complications/virology
*SARS-CoV-2/pathogenicity
Spermatozoa/virology/pathology
Sperm Motility
Semen Analysis
Sperm Count
Cohort Studies
Semen/virology
DNA Fragmentation

@article {pmid41864480,
year = {2026},
author = {Rauf, M and Naveed, A and Asghar, MU},
title = {Post-acute sequelae of COVID-19: A disorder of impaired innate immune resolution - A narrative review.},
journal = {Clinical immunology (Orlando, Fla.)},
volume = {285},
number = {},
pages = {110701},
doi = {10.1016/j.clim.2026.110701},
pmid = {41864480},
issn = {1521-7035},
mesh = {Humans ; *Immunity, Innate/immunology ; *COVID-19/immunology/complications ; Post-Acute COVID-19 Syndrome ; *SARS-CoV-2/immunology ; Trained Immunity ; Alarmins/immunology ; Inflammation/immunology ; Inflammasomes/immunology ; Innate Immunity Recognition ; },
abstract = {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.},
}

Humans
*Immunity, Innate/immunology
*COVID-19/immunology/complications
Post-Acute COVID-19 Syndrome
*SARS-CoV-2/immunology
Trained Immunity
Alarmins/immunology
Inflammation/immunology
Inflammasomes/immunology
Innate Immunity Recognition

@article {pmid41865876,
year = {2026},
author = {Prichett, LM and Young, AS and Wu, EG and Yolken, RH and Severance, EG and Prandovszky, E and Carmichael, D and Badio, J and Kumra, T},
title = {Uneven Recovery: Intersectional Disparities in Youth Mental Health After COVID-19.},
journal = {Academic pediatrics},
volume = {26},
number = {4},
pages = {103299},
doi = {10.1016/j.acap.2026.103299},
pmid = {41865876},
issn = {1876-2867},
}

@article {pmid41866483,
year = {2026},
author = {Liu, HQ and Liu, Y and Gu, KN and Song, YLQ},
title = {Meta-analysis of factors influencing depression in the elderly before and after the COVID-19 pandemic in 2023.},
journal = {BMC geriatrics},
volume = {26},
number = {1},
pages = {},
pmid = {41866483},
issn = {1471-2318},
mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Depression/epidemiology/psychology/diagnosis/etiology ; Aged ; *Pandemics ; Female ; Risk Factors ; SARS-CoV-2 ; },
abstract = {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.},
}

Humans
*COVID-19/psychology/epidemiology
*Depression/epidemiology/psychology/diagnosis/etiology
Aged
*Pandemics
Female
Risk Factors
SARS-CoV-2

@article {pmid41866665,
year = {2026},
author = {Tao, S and Zhou, Z and Li, X and Wang, XW and Liu, X and Kang, D},
title = {Recent Advances of Non-Nucleoside Polymerase Inhibitors With Broad-Spectrum Antiviral Activities.},
journal = {Medicinal research reviews},
volume = {46},
number = {4},
pages = {945-965},
doi = {10.1002/med.70041},
pmid = {41866665},
issn = {1098-1128},
support = {tsqn 202408055//Taishan Scholar Program of Shandong Province/ ; 2023YFC2308900//National Key Research and Development Program/ ; 2023YFE0206500//National Key Research and Development Program/ ; SYS202205//Shandong Laboratory Program/ ; //Qilu Young Scholars Program of Shandong University/ ; },
mesh = {*Antiviral Agents/pharmacology/chemistry/therapeutic use ; Humans ; *Enzyme Inhibitors/pharmacology/chemistry ; Animals ; SARS-CoV-2/drug effects/enzymology ; },
abstract = {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.},
}

*Antiviral Agents/pharmacology/chemistry/therapeutic use
Humans
*Enzyme Inhibitors/pharmacology/chemistry
Animals
SARS-CoV-2/drug effects/enzymology

@article {pmid41867155,
year = {2026},
author = {Valero-Gaspar, T and Garriga, C and Unim, B and Feteira-Santos, R and Palmieri, L and Díaz, A and Rodríguez-Blázquez, C and Forjaz, MJ},
title = {Indirect impact of COVID-19 pandemic on health and wellbeing: a narrative review.},
journal = {Annali dell'Istituto superiore di sanita},
volume = {62},
number = {1},
pages = {53-66},
doi = {10.4415/ANN_26_01_08},
pmid = {41867155},
issn = {2384-8553},
mesh = {Humans ; *COVID-19/psychology/economics/epidemiology ; *Quality of Life ; Mental Health ; *Cost of Illness ; *Health Status ; Life Expectancy ; Pandemics ; Disability-Adjusted Life Years ; Psychological Well-Being ; Quality-Adjusted Life Years ; },
abstract = {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.},
}

Humans
*COVID-19/psychology/economics/epidemiology
*Quality of Life
Mental Health
*Cost of Illness
*Health Status
Life Expectancy
Pandemics
Disability-Adjusted Life Years
Psychological Well-Being
Quality-Adjusted Life Years

@article {pmid41868370,
year = {2026},
author = {Li, H and Wang, T and Xiang, T and Xu, L and Zheng, Z and Zheng, X},
title = {Secondary fungal infections in severe acute viral diseases: clinical features and underlying immune mechanisms.},
journal = {Frontiers in microbiology},
volume = {17},
number = {},
pages = {1780547},
pmid = {41868370},
issn = {1664-302X},
abstract = {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.},
}

@article {pmid41869111,
year = {2026},
author = {Bartley, G and Waugh, S and Gopalan, V},
title = {Evaluating Study Techniques for Australian Medical Students During Clinical Placement: A Scoping Review.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e103802},
pmid = {41869111},
issn = {2168-8184},
abstract = {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.},
}

@article {pmid41869535,
year = {2026},
author = {Singh, H and Tripathi, G and Khan, AA and Verma, A and Singh, A},
title = {Autophagy, telomerase, and endothelial dysfunction in COVID-19-induced cardiac injury: an evidence-graded genetic and epigenetic synthesis.},
journal = {Frontiers in cardiovascular medicine},
volume = {13},
number = {},
pages = {1769828},
pmid = {41869535},
issn = {2297-055X},
abstract = {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.},
}

@article {pmid41869602,
year = {2026},
author = {Frodsham, C and Harvey, SB and Collins, D and Krakue, K and Dalgaard, VL and Lipscomb, R and Hotopf, M and Deady, M and Bryant, R and Gayed, A},
title = {Prevalence of post-traumatic stress disorder in healthcare workers before and during COVID-19: a systematic review and meta-analysis.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1735552},
pmid = {41869602},
issn = {2296-2565},
mesh = {Humans ; *Stress Disorders, Post-Traumatic/epidemiology ; *COVID-19/epidemiology/psychology ; Prevalence ; *Health Personnel/psychology/statistics & numerical data ; Frontline Workers ; Pandemics ; SARS-CoV-2 ; },
abstract = {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.},
}

Humans
*Stress Disorders, Post-Traumatic/epidemiology
*COVID-19/epidemiology/psychology
Prevalence
*Health Personnel/psychology/statistics & numerical data
Frontline Workers
Pandemics
SARS-CoV-2

@article {pmid41869844,
year = {2026},
author = {Weiss, SL and Peters, MJ and Oczkowski, SJW and Belley-Cote, E and Buysse, C and Choong, KLM and Deep, A and Inwald, DP and Flori, HR and Kneyber, MCJ and Menon, K and Murthy, S and Nunnally, ME and Parker, MM and Schlapbach, LJ and Oliveira, CF and Sorce, LR and Agus, M and Argent, AC and Balamuth, F and Bansal, A and Bem, RA and Brierley, J and Burns, KEA and Carlton, EF and Carrol, ED and Carroll, CL and Carter, MJ and Conlon, TW and Daniels, R and De Luca, D and Di Nardo, M and Dulfer, K and Faust, SN and Fernandez-Sarmiento, J and Fitzgerald, JC and Hall, M and Hsu, BS and Javouhey, E and Joosten, K and Karam, O and Kelly, SP and Lang, HJ and Lee, JH and Lemson, J and MacLaren, G and Manning, JC and Mehta, N and Morin, L and Morrow, BM and Nadel, S and Nishisaki, A and Pong, S and Raman, S and Randolph, AG and Ranjit, S and Ray, S and Remy, KE and Scott, HF and Sick-Samuels, AC and Souza, DC and Swan, T and Tibby, SM and Valla, FV and Watson, RS and Wiens, MO and Wolf, J and Zimmerman, JJ and Tissieres, P and Kissoon, N},
title = {Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.},
journal = {Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies},
volume = {27},
number = {4},
pages = {379-434},
doi = {10.1097/PCC.0000000000003927},
pmid = {41869844},
issn = {1529-7535},
mesh = {Humans ; *Shock, Septic/therapy ; *Sepsis/therapy ; Child ; Evidence-Based Medicine/standards ; Adolescent ; Infant ; Child, Preschool ; Practice Guidelines as Topic ; },
abstract = {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.},
}

Humans
*Shock, Septic/therapy
*Sepsis/therapy
Child
Evidence-Based Medicine/standards
Adolescent
Infant
Child, Preschool
Practice Guidelines as Topic

@article {pmid41870078,
year = {2026},
author = {Bayurova, E and Kostyushev, D and Tikhonov, A and Chulanov, V and Gordeychuk, I},
title = {Broad-acting antivirals: the pursuit of pan-viral therapeutics in the era of pandemics.},
journal = {Journal of virology},
volume = {100},
number = {5},
pages = {e0007726},
pmid = {41870078},
issn = {1098-5514},
support = {25-65-00010//Russian Science Foundation/ ; },
mesh = {*Antiviral Agents/therapeutic use/pharmacology ; Humans ; *SARS-CoV-2/drug effects ; *COVID-19 Drug Treatment ; Host-Directed Therapy ; Pandemics ; Drug Repositioning ; Animals ; COVID-19/virology ; Drug Resistance, Viral ; },
abstract = {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.},
}

*Antiviral Agents/therapeutic use/pharmacology
Humans
*SARS-CoV-2/drug effects
*COVID-19 Drug Treatment
Host-Directed Therapy
Pandemics
Drug Repositioning
Animals
COVID-19/virology
Drug Resistance, Viral

@article {pmid41870559,
year = {2026},
author = {Weiss, SL and Peters, MJ and Oczkowski, SJW and Belley-Cote, E and Buysse, C and Choong, KLM and Deep, A and Inwald, DP and Flori, HR and Kneyber, MCJ and Menon, K and Murthy, S and Nunnally, ME and Parker, MM and Schlapbach, LJ and Oliveira, CF and Sorce, LR and Agus, M and Argent, AC and Balamuth, F and Bansal, A and Bem, RA and Brierley, J and Burns, KEA and Carlton, EF and Carrol, ED and Carroll, CL and Carter, MJ and Conlon, TW and Daniels, R and De Luca, D and Di Nardo, M and Dulfer, K and Faust, SN and Fernandez-Sarmiento, J and Fitzgerald, JC and Hall, M and Hsu, BS and Javouhey, E and Joosten, K and Karam, O and Kelly, SP and Lang, HJ and Lee, JH and Lemson, J and MacLaren, G and Manning, JC and Mehta, N and Morin, L and Morrow, BM and Nadel, S and Nishisaki, A and Pong, S and Raman, S and Randolph, AG and Ranjit, S and Ray, S and Remy, KE and Scott, HF and Sick-Samuels, AC and Souza, DC and Swan, T and Tibby, SM and Valla, FV and Watson, RS and Wiens, MO and Wolf, J and Zimmerman, JJ and Tissieres, P and Kissoon, N},
title = {Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.},
journal = {Intensive care medicine},
volume = {52},
number = {5},
pages = {937-983},
pmid = {41870559},
issn = {1432-1238},
mesh = {Humans ; *Shock, Septic/therapy ; *Sepsis/therapy ; Child ; Evidence-Based Medicine ; *Practice Guidelines as Topic ; Adolescent ; Infant ; Child, Preschool ; },
abstract = {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.},
}

Humans
*Shock, Septic/therapy
*Sepsis/therapy
Child
Evidence-Based Medicine
*Practice Guidelines as Topic
Adolescent
Infant
Child, Preschool

@article {pmid41871039,
year = {2026},
author = {Kubica, J and Topoliński, T and Gajda, R and Musz, P and Kubica, A and Szarpak, Ł and Nowicki, K and Ziółkowski, M and Meszyński, S and Grzelak, S and Sokolov, O and Ratajczak, J and Umińska, JM and Niezgoda, P and Grzelakowska, K and Podhajski, P and Obońska, K and Laskowska, E and Piotrowicz, R and Tycińska, A and Specchia, G and Frantz, S and Störk, S and Navarese, EP},
title = {Artificial intelligence as the missing integrator in heart failure care - from remote monitoring to personalized therapy.},
journal = {Cardiology journal},
volume = {33},
number = {},
pages = {e00226032},
pmid = {41871039},
issn = {1898-018X},
mesh = {Humans ; *Heart Failure/therapy/diagnosis ; *Artificial Intelligence ; Remote Patient Monitoring ; COVID-19 ; *Precision Medicine/methods ; Digital Health ; Pandemics ; SARS-CoV-2 ; *Coronavirus Infections/epidemiology ; Telemedicine ; *Pneumonia, Viral/epidemiology ; Intelligent Systems ; },
abstract = {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.},
}

Humans
*Heart Failure/therapy/diagnosis
*Artificial Intelligence
Remote Patient Monitoring
COVID-19
*Precision Medicine/methods
Digital Health
Pandemics
SARS-CoV-2
*Coronavirus Infections/epidemiology
Telemedicine
*Pneumonia, Viral/epidemiology
Intelligent Systems

@article {pmid41871621,
year = {2026},
author = {Sartori, F and Crisafulli, E and Cariqueo, M and Di Chiara, C and Sartori, G and Fantin, A and Torres, A},
title = {Role of Vaccination in the Prevention of ECOPD.},
journal = {Seminars in respiratory and critical care medicine},
volume = {47},
number = {3},
pages = {323-333},
doi = {10.1055/a-2837-8778},
pmid = {41871621},
issn = {1098-9048},
mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/prevention & control/complications/immunology/physiopathology ; *Vaccination/methods ; Pneumococcal Vaccines/therapeutic use ; COVID-19 Vaccines/therapeutic use ; Influenza Vaccines/therapeutic use ; Respiratory Syncytial Virus Vaccines/therapeutic use ; COVID-19/prevention & control ; *Respiratory Tract Infections/prevention & control ; Influenza, Human/prevention & control ; Disease Progression ; },
abstract = {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.},
}

Humans
*Pulmonary Disease, Chronic Obstructive/prevention & control/complications/immunology/physiopathology
*Vaccination/methods
Pneumococcal Vaccines/therapeutic use
COVID-19 Vaccines/therapeutic use
Influenza Vaccines/therapeutic use
Respiratory Syncytial Virus Vaccines/therapeutic use
COVID-19/prevention & control
*Respiratory Tract Infections/prevention & control
Influenza, Human/prevention & control
Disease Progression

@article {pmid41871844,
year = {2026},
author = {Mullen, AK and Richardson, ET and Bassett, MT and Darity, WA},
title = {A plan for black American reparations.},
journal = {BMJ global health},
volume = {11},
number = {Suppl 1},
pages = {},
pmid = {41871844},
issn = {2059-7908},
mesh = {Humans ; United States ; *Black or African American ; Politics ; Health Policy ; Health Status Disparities ; COVID-19 ; Socioeconomic Disparities in Health ; },
abstract = {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.},
}

Humans
United States
*Black or African American
Politics
Health Policy
Health Status Disparities
COVID-19
Socioeconomic Disparities in Health

@article {pmid41872830,
year = {2026},
author = {Hu, C and Ying, L and Zhan, Y and Wang, J and Ye, J and Lu, J and Jin, H and Tan, X and Gu, L and Yao, Y and Jiang, N},
title = {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.},
journal = {BMC nephrology},
volume = {27},
number = {1},
pages = {},
pmid = {41872830},
issn = {1471-2369},
support = {Grant No.: 82370743//National Natural Science Foundation of China/ ; },
mesh = {Humans ; Female ; *Kidney Transplantation ; Middle Aged ; *Cryptococcosis/complications/diagnosis/drug therapy ; *COVID-19/complications/therapy ; *Pulmonary Aspergillosis/complications/diagnosis/drug therapy ; Antifungal Agents/therapeutic use ; Immunocompromised Host ; Coinfection ; SARS-CoV-2 ; },
abstract = {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.},
}

Humans
Female
*Kidney Transplantation
Middle Aged
*Cryptococcosis/complications/diagnosis/drug therapy
*COVID-19/complications/therapy
*Pulmonary Aspergillosis/complications/diagnosis/drug therapy
Antifungal Agents/therapeutic use
Immunocompromised Host
Coinfection
SARS-CoV-2

@article {pmid41873169,
year = {2026},
author = {Abunijela, S and Greiner, T and Haas, W and Kerber, R and Pütz, P and Schattschneider, A and Schumacher, J and Buchholz, U},
title = {Frequency, dynamics, and duration of faecal shedding in SARS-CoV-2-infected individuals, a scoping review.},
journal = {Epidemiology and infection},
volume = {154},
number = {},
pages = {e44},
pmid = {41873169},
issn = {1469-4409},
support = {//Bundesministerium für Gesundheit/ ; },
mesh = {Humans ; *COVID-19/virology ; *Feces/virology ; *Virus Shedding ; *SARS-CoV-2 ; *Betacoronavirus ; Pandemics ; *Coronavirus Infections/epidemiology/virology ; *Pneumonia, Viral/virology/epidemiology ; RNA, Viral ; Viral Load ; },
abstract = {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.},
}

Humans
*COVID-19/virology
*Feces/virology
*Virus Shedding
*SARS-CoV-2
*Betacoronavirus
Pandemics
*Coronavirus Infections/epidemiology/virology
*Pneumonia, Viral/virology/epidemiology
RNA, Viral
Viral Load

@article {pmid41873421,
year = {2026},
author = {Zhang, D and Wang, Y},
title = {The research progress on the role of glucose-6-phosphate dehydrogenase in immune regulation.},
journal = {PeerJ},
volume = {14},
number = {},
pages = {e20971},
pmid = {41873421},
issn = {2167-8359},
mesh = {Humans ; *Glucosephosphate Dehydrogenase/immunology/metabolism ; Glucosephosphate Dehydrogenase Deficiency/immunology ; Animals ; Autoimmune Diseases/immunology ; Immunity, Innate ; Neoplasms/immunology/enzymology ; T-Lymphocytes/immunology ; },
abstract = {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.},
}

Humans
*Glucosephosphate Dehydrogenase/immunology/metabolism
Glucosephosphate Dehydrogenase Deficiency/immunology
Animals
Autoimmune Diseases/immunology
Immunity, Innate
Neoplasms/immunology/enzymology
T-Lymphocytes/immunology

@article {pmid41873444,
year = {2026},
author = {Kim, T},
title = {Lessons From the Coronavirus Disease 2019 Pandemic: Implications for Antimicrobial Stewardship for COVID-19 Management.},
journal = {Journal of Korean medical science},
volume = {41},
number = {11},
pages = {e72},
pmid = {41873444},
issn = {1598-6357},
mesh = {Humans ; *Antimicrobial Stewardship ; COVID-19 ; SARS-CoV-2 ; Pandemics ; *Anti-Bacterial Agents/therapeutic use ; *Coronavirus Infections/drug therapy ; Coinfection ; *Pneumonia, Viral/drug therapy ; },
abstract = {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.},
}

Humans
*Antimicrobial Stewardship
COVID-19
SARS-CoV-2
Pandemics
*Anti-Bacterial Agents/therapeutic use
*Coronavirus Infections/drug therapy
Coinfection
*Pneumonia, Viral/drug therapy

@article {pmid41873445,
year = {2026},
author = {Choe, YJ},
title = {Pediatric COVID-19 in Korea: Lessons and Strategies for Future Disease-X Preparedness.},
journal = {Journal of Korean medical science},
volume = {41},
number = {11},
pages = {e75},
pmid = {41873445},
issn = {1598-6357},
mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; Republic of Korea/epidemiology ; Child ; SARS-CoV-2 ; COVID-19 Vaccines ; Pandemic Preparedness ; Adolescent ; Child, Preschool ; Pandemics ; },
abstract = {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.},
}

Humans
*COVID-19/epidemiology/prevention & control
Republic of Korea/epidemiology
Child
SARS-CoV-2
COVID-19 Vaccines
Pandemic Preparedness
Adolescent
Child, Preschool
Pandemics

@article {pmid41873446,
year = {2026},
author = {Choi, JY},
title = {Severe COVID-19 in the Republic of Korea: Epidemiology, Risk Factors, Therapeutics, and Prognostic Models From Nationwide Data.},
journal = {Journal of Korean medical science},
volume = {41},
number = {11},
pages = {e96},
pmid = {41873446},
issn = {1598-6357},
support = {RS-2024-00439160/NRF/National Research Foundation/Korea ; },
mesh = {Humans ; *COVID-19/epidemiology/therapy/diagnosis ; Risk Factors ; Prognosis ; Republic of Korea/epidemiology ; SARS-CoV-2/isolation & purification ; Antiviral Agents/therapeutic use ; Comorbidity ; Severity of Illness Index ; Female ; },
abstract = {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.},
}

Humans
*COVID-19/epidemiology/therapy/diagnosis
Risk Factors
Prognosis
Republic of Korea/epidemiology
SARS-CoV-2/isolation & purification
Antiviral Agents/therapeutic use
Comorbidity
Severity of Illness Index
Female