@article {pmid37741013,
year = {2023},
author = {Torres, M and Serra-Sutton, V and Soriano, JB and Ferrer, M and Trejo, A and Benavides, FG and Lumbreras, B and Pérez-Gómez, B and Pijoan, JI and Monguet, JM and Barbé, F and Pollán, M and Alonso, J and Espallargues, M and Serrano-Blanco, A},
title = {Consensus on post COVID in the Spanish national health system: Results of the CIBERPOSTCOVID eDelphi study.},
journal = {Journal of infection and public health},
volume = {16},
number = {11},
pages = {1784-1792},
doi = {10.1016/j.jiph.2023.08.022},
pmid = {37741013},
issn = {1876-035X},
mesh = {Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Consensus ; *COVID-19/complications/epidemiology/diagnosis ; Delphi Technique ; Post-Acute COVID-19 Syndrome ; Quality of Life ; SARS-CoV-2 ; Spain/epidemiology ; },
abstract = {BACKGROUND: In 2021, the Spanish Ministry of Health launched the CIBERPOSTCOVID project to establish what post COVID was. The present study reports the level of agreement among stakeholders on post COVID and its clinical and diagnostic characteristics in the Spanish health system.

METHODS: The agreement on post COVID among clinicians, public health managers, researchers and patients' representatives was explored in a real-time, asynchronous online Delphi. In a two-wave consensus, respondents rated from 1 (total disagreement) to 6 (total agreement) 67 statements related to terminology, duration, etiology, symptoms, impact on quality of life, severity, elements to facilitate diagnosis, applicability in the pediatric population, and risk factors. Consensus was reached when 70 % of ratings for a statement were 5 or 6, with an interquartile range equal or less than 1.

FINDINGS: A total of 333 professionals and patients participated in this eDelphi study. There was agreement that post COVID was "a set of multi-organic symptoms that persist or fluctuate after acute COVID-19 infection and are not attributable to other causes" with a minimum duration of 3 months. The highest levels of agreement were found in the most frequent symptoms and its impacts on everyday activities. Aspects related to the diagnostic process and the measurement of its severity reached a lower level of consensus. There was agreement on the need to rule out previous health problems and assess severity using validated functional scales. However, no agreement was reached on the risk factors or specific features in the pediatric population.

INTERPRETATION: This policy-based consensus study has allowed the characterization of post COVID generating collective intelligence and has contributed to an operational definition applicable in clinical practice, health services management and useful for research purposes in Spain and abroad. Agreements are consistent with existing evidence and reference institutions at European and international level.},
}

Adult
Child
Female
Humans
Male
Middle Aged
Consensus
*COVID-19/complications/epidemiology/diagnosis
Delphi Technique
Post-Acute COVID-19 Syndrome
Quality of Life
SARS-CoV-2
Spain/epidemiology

@article {pmid40329670,
year = {2026},
author = {Exner, B and Frielitz-Wagner, IV and Frielitz, FS},
title = {Telemedicine and digital health for chronic conditions in pediatrics: A systematic review.},
journal = {Journal of telemedicine and telecare},
volume = {32},
number = {3},
pages = {165-211},
doi = {10.1177/1357633X251334423},
pmid = {40329670},
issn = {1758-1109},
mesh = {Humans ; *Telemedicine/organization & administration ; Chronic Disease/therapy ; Child ; Adolescent ; COVID-19/epidemiology ; *Pediatrics/methods ; SARS-CoV-2 ; Digital Health ; },
abstract = {BackgroundThe prevalence of chronic diseases in children and adolescents has significantly increased. The COVID-19 pandemic accelerated telemedicine adoption, leading to improved healthcare access and outcomes. Despite its benefits, telemedicine is still not fully integrated into standard care. Previous reviews have been limited in scope. This systematic review aims to provide a comprehensive overview of recent trials on web or app-based telemedicine for chronically ill children and adolescents, identifying interventions and outcomes for future healthcare strategies.MethodsA comprehensive search was conducted on PubMed on November 21, 2023, and updated on January 9, 2025. Results were filtered to include prospective intervention studies involving children and adolescents with chronic conditions and limited to publications from 2017 onwards. A total of 8699 results were retrieved, and 1506 titles were screened for eligibility, resulting in 116 studies included in the review.ResultsThese studies covered 45 different conditions, with the highest numbers for diabetes, asthma, and obesity. Telemedicine interventions varied, including gamification, video meetings, integrated devices, psychological components, symptom tracking, and educational content. Most studies reported high feasibility and patient satisfaction. Clinical outcomes improved in some cases, and none were worse than standard care. The heterogeneity limited direct comparisons and meta-analysis, and small sample sizes in many studies affected the generalizability and statistical significance of the findings.ConclusionsOur study highlights the potential of telemedicine in managing chronic illnesses among children, emphasizing the need for standardized methodologies, larger sample sizes, and continued investment in infrastructure and equitable policies to fully realize its benefits in improving accessibility, convenience, cost savings, and overall health outcomes.},
}

Humans
*Telemedicine/organization & administration
Chronic Disease/therapy
Child
Adolescent
COVID-19/epidemiology
*Pediatrics/methods
SARS-CoV-2
Digital Health

@article {pmid40432559,
year = {2026},
author = {Cao, Y and Dong, Y and Shi, L and Chappell, K and Jia, Z and Yan, T and Gao, Y},
title = {Occupational Burnout in Nurses Is due to Long-Term Work Stress Rather Than COVID-19 Pandemic Event.},
journal = {Journal of advanced nursing},
volume = {82},
number = {4},
pages = {3598-3616},
doi = {10.1111/jan.17085},
pmid = {40432559},
issn = {1365-2648},
mesh = {Humans ; *COVID-19/psychology/epidemiology/nursing ; *Burnout, Professional/psychology/epidemiology ; China/epidemiology ; Female ; *Occupational Stress/psychology ; Adult ; SARS-CoV-2 ; Male ; *Nursing Staff, Hospital/psychology ; Pandemics ; Middle Aged ; Adaptation, Psychological ; Qualitative Research ; },
abstract = {AIM: This study aims to explore occupational burnout among Chinese nurses from two perspectives: first, by comparing changes in emotional exhaustion, depersonalisation and personal accomplishment before and after the COVID-19 pandemic; and second, by identifying long-term work-related stressors and structural factors contributing to burnout.

DESIGN: A mixed-methods approach was adopted, combining a systematic review with qualitative interviews. The qualitative component involved semi-structured interviews with 53 hospital-employed nurses from various departments and regions across China, focusing on the three core dimensions of occupational burnout.

METHODS: The systematic review included both Chinese and English-language studies published between 2016 and 2023 that used the Maslach Burnout Inventory to assess burnout among nurses. A total of 22 studies met the inclusion criteria, selected independently by two researchers using the JBI critical appraisal tool. In parallel, the qualitative interviews explored nurses' subjective experiences and coping strategies related to work stress, emotional fatigue and professional identity.

RESULTS: Bayesian factor analysis indicated no significant differences in emotional exhaustion (BF01 = 2.202), depersonalisation (BF01 = 2.761) or personal accomplishment (BF01 = 2.747) before and after the pandemic. Qualitative findings revealed that burnout was primarily driven by long-standing systemic stressors, including promotion pressure, clinical workload, organisational demands and work-family conflict. Although many nurses relied on self-regulation strategies to maintain psychological stability, they continued to experience ongoing physical and emotional exhaustion. Some reported emotional numbness, but most retained empathy and a strong sense of responsibility. Their sense of personal accomplishment often stemmed from patient recovery and recognition of professional value.

CONCLUSION: Occupational burnout among Chinese nurses remained largely stable before and after the COVID-19 pandemic. Its root causes stem from persistent work-related stressors and systemic issues, rather than the pandemic itself. Effective mitigation requires institutional strategies, including better staffing, clear career pathways and sustained emotional support.

IMPACT: Short-term crisis responses alone are insufficient to address enduring burnout. Nursing leadership should prioritise systemic reforms-such as optimising shift schedules, defining promotion channels and integrating regular psychological support-to enhance nurse well-being and care quality.

No patient or public contribution.},
}

Humans
*COVID-19/psychology/epidemiology/nursing
*Burnout, Professional/psychology/epidemiology
China/epidemiology
Female
*Occupational Stress/psychology
Adult
SARS-CoV-2
Male
*Nursing Staff, Hospital/psychology
Pandemics
Middle Aged
Adaptation, Psychological
Qualitative Research

@article {pmid41605818,
year = {2026},
author = {Keels, JN and LaPlante, RD and Lee, CS and Dwyer, AA},
title = {Prevalence of new-onset diabetes following COVID-19 infection: A systematic review and meta-analysis.},
journal = {Diabetes, obesity & metabolism},
volume = {28},
number = {4},
pages = {3182-3192},
doi = {10.1111/dom.70508},
pmid = {41605818},
issn = {1463-1326},
support = {1F31NR021624-01/NR/NINR NIH HHS/United States ; 1F31NR021624-01/NR/NINR NIH HHS/United States ; },
mesh = {Humans ; *COVID-19/complications/epidemiology ; Prevalence ; *Diabetes Mellitus, Type 2/epidemiology ; *Diabetes Mellitus, Type 1/epidemiology ; SARS-CoV-2 ; Male ; Adult ; Female ; *Diabetes Mellitus/epidemiology ; Middle Aged ; },
abstract = {AIM: To estimate the prevalence of new-onset diabetes in adults (≥ 18 years) following SARS-CoV-2 infection.

MATERIALS AND METHODS: This meta-analysis includes studies written in English that measured the number of adults (≥ 18 years) diagnosed with diabetes following SARS-CoV-2 infection. Studies underwent dual independent review; quality was assessed by using the New Castle Ottawa Scale. A random-effects meta-analysis was conducted to obtain the pooled estimate of new-onset diabetes. To understand the relationship between patient characteristics (age, sex) and study variable (duration of follow-up), a random effects meta-regression was used.

RESULTS: A total of 33 articles were retained for analysis. The overall estimated prevalence of new-onset diabetes (combined T1DM and T2DM or undefined) was 8.33% (95% CI 7.47, 9.18%, z = 19.04, p < 0.001; Q = 6791.24, I[2], 99.68%). The overall estimated prevalence of new-onset T2DM in COVID-19 was 8.92% (95% CI 7.88%, 9.96%, z = 16.77, p < 0.001; Q = 27659.74; p < 0.001, I[2] = 99.96%). The overall estimated prevalence of new-onset T1DM was 0.86% (95% CI 0.0072%, 0.0099%, z = 12.59, p < 0.001; Q = 9456.28; p < 0.001, I[2] = 99.94%). At the study level, there was no significant relationship identified with age, sex, or follow-up duration.

CONCLUSIONS: This systematic review and meta-analysis revealed a notable increase in T2DM or combined (T1DM, T2DM, or undefined) conditions. As such, it may be important to understand the underlying factors contributing to increased prevalence.},
}

Humans
*COVID-19/complications/epidemiology
Prevalence
*Diabetes Mellitus, Type 2/epidemiology
*Diabetes Mellitus, Type 1/epidemiology
SARS-CoV-2
Male
Adult
Female
*Diabetes Mellitus/epidemiology
Middle Aged

@article {pmid41663803,
year = {2026},
author = {Karimi, F and Rajaie, S and Azari, S and Abbaszadeh, MS and Karimi, Z},
title = {Economic evaluation of direct oral anticoagulants (DOACs) for venous thromboembolism with different etiologies: a systematic review.},
journal = {Health economics review},
volume = {16},
number = {1},
pages = {},
pmid = {41663803},
issn = {2191-1991},
abstract = {BACKGROUND: Venous thromboembolism (VTE) imposes significant clinical and economic burdens. While direct oral anticoagulants (DOACs) offer favorable efficacy and safety, their cost-effectiveness across diverse VTE etiologies remains incompletely synthesized.

OBJECTIVE: To systematically evaluate the cost-effectiveness of DOACs versus comparators for VTE management stratified by etiology.

METHODS: A PRISMA-compliant systematic search was conducted in MEDLINE, Web of Science, Scopus, and NHS EED (2020–2025). Economic evaluations reporting cost-effectiveness or cost-utility outcomes were included. Study quality was assessed using the Drummond checklist.

RESULTS: Twenty studies were included (9 CAT, 3 post-surgical, 6 hospitalized VTE, 2 COVID-19). DOACs were cost-effective or dominant in 18/20 studies. For cancer-associated thrombosis (CAT), DOACs dominated LMWHs and were cost-effective versus placebo (ICERs: $5,794–$11,947/QALY). DOACs were also dominant for post-surgical prophylaxis and in general hospitalized VTE (ICERs: -$1,862/QALY to $125.68/QALY), while rivaroxaban was cost-effective for post-COVID-19 prophylaxis (ICER: $5,386/QALY).

CONCLUSION: DOACs, particularly apixaban and rivaroxaban, are an economically dominant strategy for VTE across most etiologies. Their adoption as a first-line therapy can improve patient outcomes while significantly reducing healthcare costs.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13561-026-00741-z.},
}

@article {pmid41668172,
year = {2026},
author = {Kim, DY and Youn, J and Kang, N and Cho, SI and Ha, IH},
title = {Potential application of brain-gut axis-based treatments in Long COVID and ME/CFS: a case-based systematic review.},
journal = {Journal of translational medicine},
volume = {24},
number = {1},
pages = {},
pmid = {41668172},
issn = {1479-5876},
mesh = {Humans ; *COVID-19/complications/therapy/physiopathology ; *Fatigue Syndrome, Chronic/therapy/physiopathology ; Electroacupuncture ; SARS-CoV-2 ; *Brain-Gut Axis/physiology ; Male ; *Brain/physiopathology ; Adult ; Female ; Middle Aged ; },
abstract = {BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID share clinical features including persistent fatigue, post-exertional malaise (PEM), and gastrointestinal (GI) dysfunction. Growing evidence implicates brain-gut axis dysregulation, characterized by dysbiosis, neuroinflammation within the central nervous system (CNS), increased intestinal permeability, and microbial translocation in their pathophysiology. However, therapeutic strategies targeting these pathways remain poorly defined.

METHODS: We report a case of post-COVID ME/CFS successfully treated with electroacupuncture (EA)-based deep peroneal nerve stimulation which was employed to potentiate the vagal reflex. Fatigue trajectories were assessed using the Multidimensional Fatigue Inventory over 12 weeks. Based on the case, a systematic review of randomized controlled trials (RCTs) evaluating brain-gut axis-modulating interventions in ME/CFS or Long COVID was conducted.

RESULTS: The patient exhibited a significant reduction in total fatigue, with early improvements in motivation and mental fatigue, and delayed improvement in physical fatigue following transient systemic symptom flares. Across included RCTs (n = 8, 790 participants), four investigated gut microbiome-modulating therapies and four employed nerve stimulation. Synbiotic and herbal interventions demonstrated benefits for fatigue or PEM, accompanied by alterations in specific bacterial populations or CNS metabolisms. Regarding nerve stimulation, transcranial direct current stimulation (tDCS) combined with exercise program improved fatigue, whereas standalone tDCS, auricular or peripheral TENS showed limited efficacy.

CONCLUSION: Brain-gut axis-based interventions may alleviate fatigue in ME/CFS and Long COVID by potentially modulating neuroinflammation, restoring microbiome balance, and improving epithelial barrier function. EA-based vagal stimulation represents a feasible option for patients with severe or treatment-resistant symptoms. Larger mechanistic studies and rigorously designed RCTs are needed to establish therapeutic targets and optimize intervention strategies.},
}

Humans
*COVID-19/complications/therapy/physiopathology
*Fatigue Syndrome, Chronic/therapy/physiopathology
Electroacupuncture
SARS-CoV-2
*Brain-Gut Axis/physiology
Male
*Brain/physiopathology
Adult
Female
Middle Aged

@article {pmid41672424,
year = {2026},
author = {Gracidas, C and Levy, R and Varon, J and Halma, M},
title = {Lactate, Capnia, and Fat Oxidation as Therapeutic Axes for SARS-CoV-2 Spike Protein-Induced Sequelae.},
journal = {Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme},
volume = {58},
number = {3},
pages = {90-102},
doi = {10.1055/a-2794-9646},
pmid = {41672424},
issn = {1439-4286},
mesh = {Humans ; *COVID-19/metabolism/complications ; *Spike Glycoprotein, Coronavirus/metabolism ; Oxidation-Reduction ; *SARS-CoV-2/metabolism ; *Lactic Acid/metabolism ; Post-Acute COVID-19 Syndrome ; Fatty Acids/metabolism ; COVID-19 Vaccines/adverse effects ; },
abstract = {Metabolic alterations characterize a large subset of those with post-acute COVID-19 syndrome, and similar symptoms affect those with post-acute COVID-19 vaccination syndrome. These symptoms are characterized by the triumvirate of post-acute COVID-19 (vaccination) syndrome symptoms: post-exertional malaise, fatigue, and cognitive impairment, commonly referred to as brain fog. These symptoms can be recreated through perturbations that disrupt mitochondria, and spike protein has been observed to disrupt mitochondria in vitro, providing mechanistic support for this relationship. Post-acute COVID-19 (vaccination) syndrome patients suffer from a severely decreased lactate threshold and can experience symptoms of overexertion even at low power output. Furthermore, biopsies have revealed disrupted mitochondria, and energetics and physiological studies have shown that lipid oxidation constitutes a significantly reduced fraction of total energy production/consumption in post-acute COVID-19 (vaccination) syndrome patients. This review explores the therapeutic axes of lactate, carbon dioxide, and fatty acid oxidation for resolving the energy production challenges in post-acute COVID-19 (vaccination) syndrome, suggesting interventions that increase the lactate threshold, increase tissue oxygenation (paradoxically through increasing partial pressure of CO2), and increase the rates at which lipids are oxidized relative to carbohydrates. Analogies from the world of exercise science are introduced, comparing post-acute COVID-19 (vaccination) syndrome to an overabundance of fast-twitch muscle fibers, with oxygenation similar to that experienced at high altitude, and presenting as an inverse 'fat adaptation' phenomenon, as observed in endurance athletes, especially those adopting low-carbohydrate diets.},
}

Humans
*COVID-19/metabolism/complications
*Spike Glycoprotein, Coronavirus/metabolism
Oxidation-Reduction
*SARS-CoV-2/metabolism
*Lactic Acid/metabolism
Post-Acute COVID-19 Syndrome
Fatty Acids/metabolism
COVID-19 Vaccines/adverse effects

@article {pmid41822849,
year = {2026},
author = {Hintermeier, M and Bozorgmehr, K and Gottlieb, N and Mohsenpour, A and Sarma, N and Biallas, R and Biddle, L},
title = {Unintended Consequences of COVID-19 Public Health and Social Measures in Camps and Camp-Like Settings: A Systematic Review and Conceptual Analysis.},
journal = {Public health reviews},
volume = {47},
number = {},
pages = {1608732},
pmid = {41822849},
issn = {0301-0422},
abstract = {OBJECTIVES: This study examines unintended consequences (UIC) of public health and social measures (PHSM) in camps and camp-like settings and assesses the pathways through which these UIC arise.

METHODS: We conducted a systematic review and conceptual analysis of UIC from PHSM aimed at preventing SARS-CoV-2 spread in these settings. PHSM were classified using the WHO taxonomy and the CONSEQUENT framework to analyse UIC pathways. The most frequent PHSM groups were: a) surveillance and response, b) social and physical distancing, and c) operational measures.

RESULTS: We identified 113 predominantly negative UIC impacting physical and mental health, healthcare access, economic stability, and social interactions. UIC occurred in both high- and low-income countries. Key mechanisms linking PHSM to UIC included mistrust, increased risk factors, lack of information, and uncertainty.

CONCLUSION: This study reveals the complex interactions between PHSM and UIC and their broad mostly negative effects on marginalised populations. To reduce UIC in future health emergencies, they must be considered in pandemic planning with all stakeholders. Trust-building should be central in health interventions and PHSM design for more effective and equitable responses.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42022384673.},
}

@article {pmid41823400,
year = {2026},
author = {Abrahamsen, C and Beadsworth, M and Bostock, W and Chalder, T and Flottorp, S and Fors, EA and Garner, P and Hadfield, S and Kennedy, B and Kuehn, R and Landmark, L and Launes, G and Liira, H and Linnestad, L and Rotkirch Virrantaus, H and Vangelova-Korpinen, V},
title = {Persistent physical symptoms not explained by structural abnormalities or disease processes: a primary care approach to promote recovery.},
journal = {Scandinavian journal of primary health care},
volume = {44},
number = {1},
pages = {2633765},
pmid = {41823400},
issn = {1502-7724},
mesh = {Humans ; *Primary Health Care ; Quality of Life ; *Medically Unexplained Symptoms ; Fatigue ; Pain ; *Somatoform Disorders/therapy/diagnosis ; Headache ; },
abstract = {Background: A substantial proportion of people consulting primary care practitioners have symptoms that persist even after structural problems and diseases have been excluded. They experience distressing somatic complaints - such as fatigue, pain, headaches, and brain fog - lasting months or longer which impair quality of life and workability. In this article, we refer to these as persistent physical symptoms (PPS). When diagnosis, advice and care are based solely on a biomedical interpretation of symptoms, patients may not improve. This can result in repeated and often frustrating consultations and investigations. Aim: To outline contemporary theories around PPS for general practitioners, and offer practical, evidence-informed pathways to use in primary care. Methods: Narrative literature review and consensus development with experienced practitioners. Synopsis:Contemporary theories Contemporary theories of PPS provide a coherent framework for understanding symptom persistence and guide treatment. These theories propose that symptoms may arise from brain-based responses to perceived threat, influenced by expectations and learned associations. Such responses can become unhelpful when benign sensations are interpreted as dangerous. Biopsychosocial factors unique to each individual influence these mechanisms which need to be considered when assessing PPS and working towards symptom resolution with the patient. Evidence-informed pathways Key strategies include validating patients' symptoms and emotional experiences, providing clear explanations of symptom persistence, and developing personalised management plans that combine biological, psychological, and social approaches. Such strategies can reduce or resolve symptoms, foster hope and a sense of agency, and often lead to recovery.},
}

Humans
*Primary Health Care
Quality of Life
*Medically Unexplained Symptoms
Fatigue
Pain
*Somatoform Disorders/therapy/diagnosis
Headache

@article {pmid41823417,
year = {2026},
author = {Biering, SB and Puerta-Guardo, H and Pahmeier, F and Kril, V and Harris, E},
title = {The contribution of viral toxins to infection and pathogenesis.},
journal = {mBio},
volume = {},
number = {},
pages = {e0042125},
doi = {10.1128/mbio.00421-25},
pmid = {41823417},
issn = {2150-7511},
abstract = {The process by which viruses cause disease, viral pathogenesis, is the result of both infection of cells and the host immune response. A less studied but equally important contributor to viral pathogenesis is viral dissemination, the capacity of a virus to move from the primary site of infection, traverse physiological barriers, and gain access to secondary sites of infection. This dictates viral tropism and pathogenesis, but the mechanisms governing barrier crossing are incompletely understood. While the presence of viral receptors on cells is a major determinant of viral tropism and a prerequisite for infection, it does not completely explain the capacity of viruses to enter a tissue. Our recent work has begun to characterize the contribution of soluble viral proteins, acting as "viral toxins," to viral dissemination, tissue tropism, and overall pathogenesis within an infected host. In this review, we discuss the characteristics of these viral toxins, which are soluble or surface-exposed viral proteins that can interact with endothelial and/or epithelial barriers, as well as immune cells, to trigger signaling pathways, resulting in the transient breakdown of cellular structures maintaining barrier integrity. The disruption of these barriers induces vascular leak and facilitates virus dissemination, influencing viral tropism and pathogenesis. Importantly, blocking this process prevents leak, viral dissemination, and severe disease during infection, highlighting the value of therapeutic intervention against viral toxin activity. Here, we summarize our current understanding of recently discovered viral toxins from the Flaviviridae, Coronaviridae, Nairoviridae, and Filoviridae.},
}

@article {pmid41824815,
year = {2026},
author = {Hasen, AA and Seid, AA and Mohammed, AA and Mamed, GE and Wolde, AD and Tadesse, EC and Mulugeta, G and Seid, HA},
title = {Teenage pregnancy and its associated factors through COVID-19 in East Africa: Systematic review and meta-analysis.},
journal = {Medicine},
volume = {105},
number = {11},
pages = {e48069},
pmid = {41824815},
issn = {1536-5964},
mesh = {Humans ; *Pregnancy in Adolescence/statistics & numerical data ; *COVID-19/epidemiology ; Pregnancy ; Adolescent ; Female ; Africa, Eastern/epidemiology ; Prevalence ; Risk Factors ; SARS-CoV-2 ; },
abstract = {BACKGROUND: In East Africa, COVID-19 has impacted the lives of girls and women. COVID-19 control measures were considered as major factors of teenage pregnancy. It is essential to provide comprehensive evidence and to focus on the well-being of teenagers during COVID-19 and future emergency situation in East Africa. The present study aimed to explore the pooled prevalence and associated factors of teenage pregnancy during COVID-19 in East Africa.

METHODS: Systematic searches were conducted in PubMed, Google Scholar, and African journals online and included articles published from December 2019 to June 2024. The quality of eligible studies was assessing using Newcastle-Ottawa Scale. A DerSimonian-Laird random-effects meta-analysis was used to estimate the pooled effect size of the outcome measures with their 95% confidence interval. Stata version 14.0 (StataCorp, College Station, Texas) was used for statistical analysis.

RESULTS: A total of 4 studies reported the prevalence of teenage pregnancy during COVID-19 in East Africa is 37% (95% confidence interval: 0.07-66.70, I2 = 99.4%, P = .000. The prevalence of teenage pregnancy during the COVID-19 pandemic in East Africa is not homogeneous across countries, publication years and sampling methods. In addition, key determinants contributing to the prevalence of teenage pregnancy are systematically summarized.

CONCLUSION: The prevalence of teenage pregnancies in East Africa during the COVID-19 pandemic has increased due to various factors such as disrupted access to sexual and reproductive health services, increased poverty, and decreased access to education. Proper and timely interventions to minimize the effects of public health and related crises on teenagers are vital.},
}

Humans
*Pregnancy in Adolescence/statistics & numerical data
*COVID-19/epidemiology
Pregnancy
Adolescent
Female
Africa, Eastern/epidemiology
Prevalence
Risk Factors
SARS-CoV-2

@article {pmid41825988,
year = {2026},
author = {Puri, N and Yohannes, S},
title = {Organization and Management of Critical Care Services: Unexpected Challenges in Leading a Critical Care Organization.},
journal = {Critical care clinics},
volume = {42},
number = {2},
pages = {425-440},
doi = {10.1016/j.ccc.2025.11.005},
pmid = {41825988},
issn = {1557-8232},
mesh = {Humans ; *Critical Care/organization & administration ; *Leadership ; Organizational Culture ; COVID-19 ; *Intensive Care Units/organization & administration ; },
abstract = {Uncertainty is the only constant in critical care medicine leadership, ranging from unexpected staff attrition to global pandemics. Developing skills to retain experienced staff, manage conflict, and handle failure are essential to be effective. Successful leaders have knowledge of the challenges experienced by front-line clinicians and clearly communicate with their teams. By creating a culture of safety and making clinicians feel valued, leaders can help their Critical Care Organization not just survive, but thrive.},
}

Humans
*Critical Care/organization & administration
*Leadership
Organizational Culture
COVID-19
*Intensive Care Units/organization & administration

@article {pmid41826433,
year = {2026},
author = {Kapischke, T and Herrmann, ST and Bertzbach, LD and Pfaender, S and Kaderali, L},
title = {Ordinary differential equation models of SARS-CoV-2 replication dynamics and antiviral drug efficacies.},
journal = {Npj viruses},
volume = {4},
number = {1},
pages = {},
pmid = {41826433},
issn = {2948-1767},
support = {462165342//Deutsche Forschungsgemeinschaft/ ; 462165342//Deutsche Forschungsgemeinschaft/ ; 101191666//HORIZON EUROPE European Research Council/ ; 101191666//HORIZON EUROPE European Research Council/ ; },
abstract = {There is a critical need for precise analysis of virus-host interactions to improve our understanding of infection processes. The integration of quantitative measurements with dynamic mathematical modeling has changed how we perceive cellular infection processes, offering profound insights into how viruses function at the cellular level. Here, we systematically review target cell-limited (TCL) ordinary differential equation (ODE) models related to SARS-CoV-2. We examine the spectrum of available models from basic TCL frameworks to more complex models incorporating antiviral treatments-and highlight key findings, discuss strengths and limitations, and identify a shortage of comprehensive datasets, emphasizing structural identifiability issues.},
}

@article {pmid41826848,
year = {2026},
author = {Saito, H and Inada, M and Miike, S and Yoshida, M and Tsuzuki, S and Ichimura, Y and Ohki, U and Kimura, N and Yoshimi, I and Kawano, K and Hashimoto, Y and Moriuchi, A and Kurisu, M and Yoshida, H and Kamata, K and Ujiie, M and Jindai, K and Ichihara, N},
title = {A scoping review of randomized controlled trials in the early phase of the COVID-19 pandemic: country-level research response to COVID-19 therapeutics and vaccines.},
journal = {BMC infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12879-026-13039-6},
pmid = {41826848},
issn = {1471-2334},
support = {JPMJPR23R7//PRESTO, Japan Science and Technology Agency/ ; },
abstract = {BACKGROUNDS: Clinical trials are central in pandemic preparedness and response (PPR). This scoping review aimed to illustrate the landscape of COVID-19-related randomized controlled trials (RCTs), focusing on the countries' capacity to conduct and coordinate RCTs, and on the operational features.

METHODS: RCTs on COVID-19 therapeutics and vaccines that were published between November 1, 2019 and November 30, 2021 were identified through EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and CINAHL. Data were collected on study design; intervention; participating countries; responsible party; funding source; and design and operational features, such as platform trial, informed consent, and decentralization. We compared the differences based on whether the study was led by high-income countries (HICs) or low- and middle-income countries (LMICs).

RESULTS: The final analysis included 328 of the 22,392 screened trials, including 47 multi-country trials, majority of which (46, 97.9%) were led by HICs. Both for therapeutics and vaccines, trials led by HICs enrolled a larger number of study participants than those by LMICs (median 207 vs. 57.5 for therapeutics, and 805 vs. 334 for vaccines). Intervention duplication was observed in 68.6% (81/118) of therapeutic interventions in trials led by HICs and 85.8% (133/155) in those led by LMICs (p-value = 0.001). Of the 42 investigational new drugs trials on therapeutics, 26 and 16 were led by HICs and LMICs, respectively, with a larger proportion led by HICs (odds ratio 2.5, 95% confidence interval 1.3-4.8). Among the 29 platform trials, 28 were led by HICs, all of which focused on therapeutics. Decentralization approaches and consent methods other than the written format were utilized in 15.5% and 19.2% of the trials, respectively.

CONCLUSIONS: Globally, LMICs were under-represented among the published trials during the first two years of the pandemic. Global collaboration and coordination are essential to improve clinical trial ecosystem during health emergencies, and pragmatic approaches and improved design and operational features of clinical trials can strengthen the global clinical trial infrastructure.

CLINICAL TRIAL: Not applicable.},
}

@article {pmid32548837,
year = {2020},
author = {Benzarti, S and Triki, MA and Othman, Y and Dammak, N and Boussetta, R and Ben Fredj, A and Abid, A and Ben Ayache, ML and Ben Abdelaziz, A},
title = {COVID-19 and Management of Orthopedic Emergencies. Producing a Consensus of Experts.},
journal = {La Tunisie medicale},
volume = {98},
number = {5},
pages = {348-354},
pmid = {32548837},
issn = {2724-7031},
mesh = {Humans ; Consensus ; *Coronavirus Infections/epidemiology ; COVID-19 ; Delphi Technique ; *Emergencies ; *Musculoskeletal Diseases/physiopathology/therapy ; *Orthopedic Procedures/statistics & numerical data ; Pandemics ; *Pneumonia, Viral/epidemiology ; Surveys and Questionnaires ; Tunisia/epidemiology ; },
abstract = {OBJECTIVE: Report the results of a participatory approach in Tunisian orthopedic surgery, for the development of a consensus of experts, on the identification of the list of pathologies to always be considered as non-postponable emergencies, during the COVID-19 pandemic.

MATERIAL AND METHODS: This descriptive study of the opinions of Tunisian experts covered all orthopedic morbidities classified into three homogeneous groups: trauma, infections and tumors of the musculoskeletal system. The attitudes of the interviewees were collected using the "Delphi" method, using a "Google-Form" questionnaire, sent by email to all of the Tunisian university orthopedic surgeons in practice, and registered at the SOTCOT. Consensus has been established for an item, if validated by at least 80% of the experts. The analysis of the results focused on the first 30 responses to this "online" form.

RESULTS: Tunisian experts agreed on the continuity of the urgency of taking in charge all the items of orthopedic morbidity during the COVID-19 pandemic, apart from the following affections: aseptic nonunions in the upper and lower limbs, aggressive giant cell tumors, and hyperalgesic disc herniations, where agreement rates were only at 8%, 12%, 58% and 77%.

CONCLUSION: Relative to its disciplinary and professional specificities, the majority the of orthopedic conditions were still considered as emergencies, during the COVID-19 pandemic, which did not lend to postponement of the surgery. However, their management should obey to the recommendations of "Sorting" and the " COVID-19 Patient Pathway ", established by national authorities.},
}

Humans
Consensus
*Coronavirus Infections/epidemiology
COVID-19
Delphi Technique
*Emergencies
*Musculoskeletal Diseases/physiopathology/therapy
*Orthopedic Procedures/statistics & numerical data
Pandemics
*Pneumonia, Viral/epidemiology
Surveys and Questionnaires
Tunisia/epidemiology

@article {pmid34078684,
year = {2021},
author = {Sharma, A and U, V and Dong, V and Raut, A and Tawfik, GM and Ng, SJ and Ramly, TAE and Nam, NH and Pavlenko, D and Alied, M and Elnazir, P and Marabea, ME and Dumre, SP and Elsayad, A and Alqudah, Q and Hegab, MA and Zakaria, SY and Nguyen, APN and ElHawary, AS and Huy, NT},
title = {Universal checklist for COVID-19 control measures: consensus via a Delphi method.},
journal = {Clinical medicine (London, England)},
volume = {21},
number = {Suppl 2},
pages = {25-26},
doi = {10.7861/clinmed.21-2-s25},
pmid = {34078684},
issn = {1473-4893},
mesh = {Humans ; *Checklist ; Clinical Competence ; Consensus ; *COVID-19 ; Delphi Technique ; SARS-CoV-2 ; },
}

Humans
*Checklist
Clinical Competence
Consensus
*COVID-19
Delphi Technique
SARS-CoV-2

@article {pmid40610953,
year = {2025},
author = {Kamga, LSK and Voordouw, ACG and De Vries, MC and Koopmans, MPG and Timen, A},
title = {Which sectors should be involved in public health emergency preparedness, response, and recovery decision-making? A RAND-modified consensus procedure among European Union country experts.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {2359},
pmid = {40610953},
issn = {1471-2458},
mesh = {Humans ; *Civil Defense/organization & administration ; Consensus ; *COVID-19/epidemiology ; *Decision Making ; Delphi Technique ; *Disaster Planning/organization & administration ; European Union ; Pandemics ; *Public Health ; },
abstract = {BACKGROUND: The COVID-19 pandemic has demonstrated the imperative for multisectoral collaboration and a whole-of-society approach to managing public health emergencies (PHE). However, there are currently no guidelines available on which sectors should be included in public health emergency preparedness and response (PHEPR). There is also a lack of guidance on how to encourage multisectoral collaboration during emergencies. This study gathers insights from European experts to identify key sectors for PHE preparedness, response, and recovery.

METHODS: A multi-stage Delphi study was conducted with European PHE experts to compile (i) a consensus-driven list of priority sectors for PHE decision-making, and (ii) a list of recommendations on how to incorporate multisectoral collaboration in PHEPR plans.

RESULTS: Of the 28 predefined sectors, consensus was reached among experts on 12 sectors that should be included in decision-making during preparedness, response, and recovery. One additional sector was identified as relevant during the response phase. Furthermore, consensus was reached for ten suggested recommendations on how to incorporate multisectoral collaboration in national PHEPR plans.

CONCLUSIONS: This study provides the collective opinion of European PHE experts on a list of 13 sectors that should be included in decision-making during PHE preparedness, response, and/or recovery. It also provides ten recommendations on how to improve multisectoral collaboration. These can be used as systematic checklists when PHEPR experts consider how to integrate different sectors and multisectoral collaboration in PHE management.

TRIAL REGISTRATION: Not applicable.},
}

Humans
*Civil Defense/organization & administration
Consensus
*COVID-19/epidemiology
*Decision Making
Delphi Technique
*Disaster Planning/organization & administration
European Union
Pandemics
*Public Health

@article {pmid40737376,
year = {2025},
author = {Cunha, AS and Raposo, B and V Cordeiro, J and Marques, MJ and Pedro, AR},
title = {[Unmet Challenges in COVID-19 Prevention for Immunocompromised Individuals: A Consensus Analysis from Portugal].},
journal = {Acta medica portuguesa},
volume = {38},
number = {9},
pages = {538-547},
doi = {10.20344/amp.9949},
pmid = {40737376},
issn = {1646-0758},
mesh = {Humans ; Consensus ; *COVID-19/prevention & control/immunology ; COVID-19 Vaccines ; Delphi Technique ; *Immunocompromised Host ; Portugal/epidemiology ; },
abstract = {INTRODUCTION: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulted in significant disease burden and mortality. Despite vaccination successes, new virus variants persist, affecting unvaccinated and immunocompromised individuals (ICI) severely. These high-risk groups face elevated mortality and hospitalization rates. Vigilance and targeted health measures remain crucial post-pandemic. The aim of this study was to develop consensus on the unmet needs in COVID-19 prevention among ICI.

METHODS: We performed a Delphi study involving 45 experts, including physicians, health managers, policymakers, public health experts, members of medical societies and patient organizations. Consensus was achieved at 65% for each identified strategy using a scale ranging from "strongly agree" to "strongly disagree." Three Delphi rounds were conducted to address four key questions: identifying unmet needs in COVID-19 prevention for ICI; identifying the characteristics that distinguish ICI as a susceptible group; determining the main outcomes of COVID-19 in ICI; and indicating action plans for protecting ICI. The first round involved voting on pre-identified indicators. The second and third rounds involved analyzing the gathered information and voting on each indicator to achieve consensus.

RESULTS: A retention rate of 80% was achieved. Out of 89 valid indicators analyzed, 23 achieved consensus. These included: eight indicators highlighting the importance of raising awareness about COVID-19 and vaccination outcomes, ensuring safety and understanding, and developing targeted immunization strategies for ICI; five indicators identifying susceptible groups within ICI, such as individuals undergoing chemotherapy or radiotherapy, those with primary immunodeficiencies, solid organ transplant recipients, patients with chronic kidney disease, and bone marrow transplant recipients; two indicators showing improvements in clinical outcomes and reduced hospitalizations; and eight indicators recommending the development of effective therapies, more immunogenic vaccines, and treatments for viral infections in ICI.

CONCLUSION: The study emphasized the importance of targeted immunization strategies, monitoring, and tailored education to address diverse needs of ICI. These findings provide a foundation for future policies to effectively manage and protect ICI during and beyond the COVID-19 pandemic.},
}

Humans
Consensus
*COVID-19/prevention & control/immunology
COVID-19 Vaccines
Delphi Technique
*Immunocompromised Host
Portugal/epidemiology

@article {pmid40828992,
year = {2025},
author = {Nazif-Munoz, JI and Ouimet, MC},
title = {Impact of Canada's Cannabis Act on drug- and alcohol-related collisions in Québec: an interrupted time-series analysis of five major cities.},
journal = {Traffic injury prevention},
volume = {26},
number = {sup1},
pages = {S77-S85},
doi = {10.1080/15389588.2025.2537145},
pmid = {40828992},
issn = {1538-957X},
mesh = {*Driving Under the Influence/prevention & control/statistics & numerical data ; Quebec/epidemiology ; Interrupted Time Series Analysis ; *Accidents, Traffic/mortality/statistics & numerical data ; *Cannabis/adverse effects/legislation & jurisprudence ; *Commerce/legislation & jurisprudence/statistics & numerical data ; *Alcohol Drinking/adverse effects ; Cities/statistics & numerical data ; Humans ; },
abstract = {OBJECTIVE: This study examines the impact of non-medical cannabis laws (NMCLs) on road safety outcomes, specifically focusing on drug- and alcohol-related traffic crashes. Using cannabis sales data as a proxy for consumption trends, the study aims to assess how changes in cannabis availability may influence road safety outcomes, particularly exploring the potential for drugs and alcohol to have distinct yet related influences on impaired driving.

METHODS: An interrupted time-series design was used to assess the impact of NMCLs on daily drug- and alcohol-related traffic crashes, including fatalities and severe injuries (KSI). The analysis covered five cities in the province of Québec-Montréal, Québec, Laval, Longueuil, and Sherbrooke-using data from January 1, 2015; to December 31, 2022. The dependent variables included KSI, drug-related crashes, and alcohol-related crashes, while the independent variables were daily cannabis legal sales (kg) and total legal and estimated illegal cannabis sales. Control variables accounted for temperature, time trends, and the COVID-19 non-pharmaceutical interventions' index for the province of Québec (QCnPI-Index). To estimate effects, we applied Generalized Linear Models using Negative binomial regression, followed by a random-effects meta-analysis to assess overall effects across cities.

RESULTS: Higher total cannabis sales were significantly associated with a 12% increase in drug-related crashes (IRR: 1.12; 95% CI: 1.01-1.27) and a 12% rise in alcohol-related crashes (IRR: 1.12; 95% CI: 1.06-1.18) across all cities combined. In Montréal, cannabis sales were linked to an 87% increase in drug-related crashes (IRR: 1.87; 95% CI: 1.54-2.28) and a 93% increase in alcohol-related crashes (IRR: 1.93; 95% CI: 1.58-2.36). In Longueuil, drug-related crashes rose by 76% (IRR: 1.76; 95% CI: 1.02-3.02) and alcohol-related crashes by 43% (IRR: 1.43; 95% CI: 1.08-1.92). Québec City only showed a 44% increase in alcohol-related crashes (IRR: 1.44; 95% CI: 1.28-1.64). No significant associations were found in Laval or Sherbrooke.

CONCLUSION: The findings suggest that increased cannabis availability, as measured by cannabis sales, is associated with higher rates of both drug- and alcohol-related crashes, particularly in Montréal and Longueuil. These results support the hypothesis that changes in cannabis availability may influence two distinct impaired driving patterns, highlighting the need for region-specific road safety interventions.},
}

*Driving Under the Influence/prevention & control/statistics & numerical data
Quebec/epidemiology
Interrupted Time Series Analysis
*Accidents, Traffic/mortality/statistics & numerical data
*Cannabis/adverse effects/legislation & jurisprudence
*Commerce/legislation & jurisprudence/statistics & numerical data
*Alcohol Drinking/adverse effects
Cities/statistics & numerical data
Humans

@article {pmid41678920,
year = {2026},
author = {Ogawa, T and Sunyi, J and Kawachi, K and Murakami, J and Masuta, S and Fukuchi, J and Yoshida, S and Sawanobori, K and Matsukura, Y},
title = {Regulatory approaches for platform-based vaccine development in Japan: Insights from PMDA's experience with COVID-19 and RSV vaccines.},
journal = {Vaccine},
volume = {76},
number = {},
pages = {128315},
doi = {10.1016/j.vaccine.2026.128315},
pmid = {41678920},
issn = {1873-2518},
mesh = {Humans ; Japan/epidemiology ; *COVID-19 Vaccines/immunology ; *Respiratory Syncytial Virus Vaccines/immunology ; *Vaccine Development/legislation & jurisprudence/methods ; *COVID-19/prevention & control ; *Respiratory Syncytial Virus Infections/prevention & control ; SARS-CoV-2/immunology ; Vaccines, Synthetic ; },
abstract = {The concept of a "platform" in vaccine development and regulatory evaluation has emerged as a strategic framework for accelerating responses to infectious disease outbreaks. By leveraging prior knowledge and applying consistent manufacturing and analytical procedures across multiple products-such as mRNA, viral vector and recombinant protein vaccines-platform approaches enable streamlined development and efficient regulatory reviews. This article presents a Japanese regulatory perspective on platform-based vaccine development, drawing on the Pharmaceuticals and Medical Devices Agency (PMDA)'s experience with both emergency and routine evaluations. Through case-based analyses of COVID-19 vaccines reviewed under emergency conditions and the subsequent post-pandemic evaluation of RSV vaccines under standard timelines, we illustrate how prior knowledge and regulatory flexibility supported timely and robust reviews. These insights contribute to the global dialogue on regulatory science and offer practical considerations for future vaccine innovation.},
}

Humans
Japan/epidemiology
*COVID-19 Vaccines/immunology
*Respiratory Syncytial Virus Vaccines/immunology
*Vaccine Development/legislation & jurisprudence/methods
*COVID-19/prevention & control
*Respiratory Syncytial Virus Infections/prevention & control
SARS-CoV-2/immunology
Vaccines, Synthetic

@article {pmid41819640,
year = {2026},
author = {Janssen, RS and Coffman, RL},
title = {A narrative review of immune-mediated adverse events in clinical trials of CpG oligonucleotide toll-like receptor 9 agonists.},
journal = {Vaccine},
volume = {79},
number = {},
pages = {128437},
doi = {10.1016/j.vaccine.2026.128437},
pmid = {41819640},
issn = {1873-2518},
abstract = {There is a concern that stimulating the innate immune system with vaccine adjuvants could, hypothetically, lead to autoimmunity; however, evidence is lacking to support these concerns. We review and evaluate immune-mediated adverse events from three sets of clinical studies using toll-like receptor 9 (TLR9) agonists (CpG-ODN) as vaccine adjuvants and therapeutic agents in patients with cancer: 1) a comparison of immune-mediated adverse events across phase 1-3 clinical trials of the hepatitis B vaccine HEPLISAV-B (HepB-CpG) with the alum-adjuvanted hepatitis B vaccine (HepB-alum); 2) an analysis of the rates of immune-mediated adverse events across clinical trials of COVID-19 vaccines using the CpG 1018 adjuvant; and 3) the rates of immune-mediated conditions in a study of the CpG-ODN nelitolimod (SD-101) combined with the immune checkpoint inhibitor pembrolizumab in patients with advanced melanoma or head and neck cancer, compared with rates in historical studies of pembrolizumab monotherapy. In the current analysis, the rate of potential immune-mediated adverse events was similar for HepB-CpG (0.32%) and HepB-alum (0.38%). Few adverse events of special interest (including immune-mediated events) were observed with any of the CpG 1018-adjuvanted COVID-19 vaccines (0-2.1% across studies), and rates were similar to placebo (0.6-3.3%). The rate of immune-mediated events for patients who received nelitolimod and pembrolizumab was 21.8% versus 19.8% for those who received pembrolizumab alone. No increased risk of potential immune-mediated adverse events was observed with HepB-CpG or CpG 1018-adjuvanted COVID-19 vaccines. In patients with cancer treated with programmed cell death protein 1 blockade, repeated treatment with nelitolimod did not increase the frequency of such events. Data evaluated in this review show no increased risk for potential autoimmune disorders with HepB-CpG or CpG 1018-adjuvanted COVID-19 vaccines. Combining CpG-ODN with a checkpoint inhibitor did not increase the rate of immune-mediated conditions.},
}

@article {pmid41819980,
year = {2026},
author = {Mahmud, S and van Zandvoort, K and Guo, L and Li, Y and Nair, H and Feikin, DR and Sparrow, E and Chowdhury, F and Cohen, C and Dbaibo, GS and Gentile, A and Gill, CJ and Gordon, A and Horton, KC and Cao, Q and Stolyarov, K and Clark, AD and , },
title = {Age distribution of respiratory syncytial virus disease in children younger than 5 years in low-income and middle-income countries: a systematic review and meta-analysis.},
journal = {The Lancet. Child & adolescent health},
volume = {10},
number = {4},
pages = {245-254},
doi = {10.1016/S2352-4642(25)00349-9},
pmid = {41819980},
issn = {2352-4650},
mesh = {Humans ; *Respiratory Syncytial Virus Infections/epidemiology ; Infant ; *Developing Countries ; Child, Preschool ; Age Distribution ; Infant, Newborn ; Hospitalization/statistics & numerical data ; Bayes Theorem ; },
abstract = {BACKGROUND: Low-income and middle-income countries (LMICs) bear the greatest burden of respiratory syncytial virus (RSV) disease. WHO recommends passive immunisation to protect infants younger than 6 months and, in some strategies, infants up to age 12 months, but detailed age data are needed to determine optimal timing and impact. Our study estimates age distributions for the full range of RSV outcomes among children younger than 5 years in LMICs.

METHODS: We conducted a systematic review and meta-analysis of RSV age distributions for seven health or health-care outcomes (hereafter, RSV outcomes): community cases, outpatient or clinic visits, emergency room visits, inpatient ward admissions, intensive care unit (ICU) admissions, facility deaths, and non-facility deaths. Inclusion required at least 30 laboratory-confirmed counts of RSV disease in children younger than 5 years, for a single RSV outcome from a single LMIC in the pre-COVID-19 decade (Jan 1, 2010, to Dec 31, 2019). We invited authors of included studies to share RSV counts by week or month of age. Using a Bayesian hierarchical model, we fitted parametric age distributions (by week for children <5 years) to each dataset, and derived pooled estimates of the mode, median, and mean age for each RSV outcome. The study was registered with PROSPERO (CRD42023435080).

FINDINGS: We included 160 datasets with 131 124 RSV counts in children younger than 5 years. The mode (peak) age was 3 weeks (95% credible interval 1-6) for non-facility deaths (57% <6 months), 4 weeks (1-8) for facility deaths (57% <6 months), 7 weeks (6-8) for ICU admissions (60% <6 months), 17 weeks (14-19) for inpatient ward admissions (41% <6 months), 10 weeks (5-17) for emergency room visits (40% <6 months), 28 weeks (22-32) for outpatient or clinic visits (19% <6 months), and 22 weeks (17-28) for community cases (26% <6 months). Considering the most severe RSV outcomes, 20% of ICU admissions and 23% of facility deaths were in infants younger than 8 weeks.

INTERPRETATION: Our findings reaffirm the importance of immunising the youngest infants who bear the greatest burden of severe RSV outcomes. Our estimates should allow more precise quantification of the potential impact of RSV prevention strategies across the full range of RSV disease severity in children younger than 5 years.

FUNDING: WHO.},
}

Humans
*Respiratory Syncytial Virus Infections/epidemiology
Infant
*Developing Countries
Child, Preschool
Age Distribution
Infant, Newborn
Hospitalization/statistics & numerical data
Bayes Theorem

@article {pmid41820161,
year = {2026},
author = {Yang, Q and Yang, Y and Liu, B and Xu, L and Ma, Y and Zhou, J and Wang, Y and Hao, C and Jiang, W},
title = {Global perspectives on pertussis epidemiology, macrolide resistance, and management in the post-COVID-19 era (2020-2024).},
journal = {Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jmii.2026.03.002},
pmid = {41820161},
issn = {1995-9133},
abstract = {Pertussis, caused by Bordetella pertussis, remains a substantial public health threat despite long-standing vaccination programs. Widespread non-pharmaceutical interventions (NPIs) during COVID-19 were accompanied by marked declines in reported pertussis activity in many settings. However, relaxation of containment measures has been followed by resurgence, characterized by atypical outbreak patterns and shifts in case distribution, bacterial genotypes, and affected populations. Emerging evidence suggests that these changes are multifactorial, including altered contact patterns and immunity gap, disruptions and recovery in routine immunization and surveillance, waning or suboptimal vaccine-induced protection, pathogen adaptation, and improved case detection through expanded diagnostic capabilities. Addressing these challenges will require coordinated strategies to restore and optimize immunization delivery, strengthen surveillance and laboratory capacity (including resistance monitoring), and update clinical management guidance in the context of macrolide-resistant B. pertussis. Continued research is needed to define setting-specific drivers and to inform next-generation vaccines and integrated control strategies in the post-pandemic era.},
}

@article {pmid41821384,
year = {2026},
author = {Daniyarova, KR and Sarkulova, ZN and Tamadon, A and Tokshilykova, AB and Sarkulov, MN and Kalieva, BM and Mussin, NM and Sharoffidin, RS},
title = {Global Research Trends on Endothelial Glycocalyx in Sepsis: A Bibliometric Analysis.},
journal = {BioMed research international},
volume = {2026},
number = {1},
pages = {e9720166},
pmid = {41821384},
issn = {2314-6141},
mesh = {*Sepsis/metabolism/pathology ; Humans ; *Glycocalyx/metabolism/pathology ; *Bibliometrics ; COVID-19 ; *Biomedical Research/trends ; SARS-CoV-2 ; Biomarkers/metabolism ; },
abstract = {BACKGROUND: Sepsis remains a major global health challenge, with glycocalyx dysfunction playing an important role in its pathogenesis. Recent research highlights EG degradation as a key contributor to vascular permeability, inflammation, and organ failure. Despite growing interest, a comprehensive bibliometric analysis of global research trends on EG in sepsis is lacking.

METHODS: We conducted a bibliometric analysis using data from Web of Science and Scopus (2005-2025). Inclusion criteria were original English-language research articles. Bibliometrix R-package was employed to analyze publication trends, citation metrics, collaboration networks, and keyword co-occurrence.

RESULTS: Among 217 publications, research output increased 13-fold (2005-2023), with Shock and Critical Care as leading journals. The United States, Japan, and Australia were top contributors, with strong international collaborations. Key themes included EG biomarkers, microcirculatory dysfunction, and therapeutic strategies. Emerging trends involved COVID-19-associated EG injury and novel imaging techniques.

CONCLUSION: This study maps the evolution of EG research in sepsis, highlighting exponential growth, key contributors, and thematic shifts. Future directions include validating EG biomarkers, developing targeted therapies, and enhancing global research equity.},
}

*Sepsis/metabolism/pathology
Humans
*Glycocalyx/metabolism/pathology
*Bibliometrics
COVID-19
*Biomedical Research/trends
SARS-CoV-2
Biomarkers/metabolism

@article {pmid41821660,
year = {2026},
author = {Kapoor, G and Bhutani, R},
title = {Propolis: a brief overview of its diverse pharmacological functions.},
journal = {3 Biotech},
volume = {16},
number = {4},
pages = {132},
pmid = {41821660},
issn = {2190-572X},
abstract = {Propolis, a natural wax-like resinous substance present in bee hives, has been extensively used in dietary supplements and as folk medicine for the treatment of several diseases, including neurological disorders. Propolis has been used as a traditional medicine for the treatment of depression and other neurological disorders. This review aims to investigate the clinical studies and various therapeutic potentials associated with propolis, direct the future scope of research, and discuss possible clinical implications. A total of 143 papers were selected using a database comprising Google Scholar, Scopus, PubMed, and Web of Science. Diverse keywords, such as propolis, bee, phytochemistry, pharmacology, and clinical study, were used to search the content. This review highlights the diverse biological activities of propolis, as evidenced by preclinical and clinical studies. In experimental models, propolis extract exhibited antidepressant-like and vasculoprotective effects, primarily through its anti-inflammatory and antioxidant potential. These benefits were associated with the suppression of pro-inflammatory cytokines, chemokines, and angiogenic factors. Propolis extract was found to delay the progression of atherosclerosis by improving lipid metabolism and modulating apoptosis. Furthermore, both in vitro and in vivo investigations suggest that propolis may protect vascular endothelial function due to its antiproliferative activity. Notably, anticancer potential was observed against the ovarian cancer cell line M12.C3.F6. Clinical studies also provided encouraging findings. In patients with type 2 diabetes mellitus, propolis extract has been shown to improve wound healing parameters in diabetic foot ulcers. Another trial reported promising outcomes with propolis extract formulated as niosomal oromucosal-adhesive films for recurrent aphthous ulcers. Overall, these results underline the multifaceted therapeutic promise of propolis across neurological, vascular, oncological, and wound-healing domains. This review summarizes clinical and experimental evidence on the therapeutic potential of propolis. It highlights its immunomodulatory, antioxidant, antimicrobial, antifungal, anticancer (skin, oral, lung, breast, cervical), antidepressant, anxiolytic, cardiovascular, chemopreventive, and anti-angiogenic properties. Several studies, including clinical trials, suggest its potential role in combating COVID-19 and other health conditions. Overall, findings indicate that propolis possesses significant medicinal promise and may serve as a lead candidate for developing novel therapeutic agents.},
}

@article {pmid41821730,
year = {2026},
author = {Gao, SX and Gao, J},
title = {Unveiling the hidden link: diabetes mellitus as a catalyst for orbital apex syndrome.},
journal = {Frontiers in endocrinology},
volume = {17},
number = {},
pages = {1770045},
pmid = {41821730},
issn = {1664-2392},
mesh = {Humans ; *COVID-19/epidemiology/complications ; *Orbital Diseases/epidemiology/etiology ; *Diabetes Mellitus/epidemiology ; SARS-CoV-2 ; *Diabetes Complications/epidemiology ; Syndrome ; },
abstract = {BACKGROUND: Orbital Apex Syndrome (OAS) is a disease of multiple brain nerves at the orbital apex leading to vision loss and neurological impairments. Diabetes Mellitus (DM), a metabolic disorder with cardiovascular, immunological and neurological effects, is involved in OAS pathogenesis. However, the association between DM and OAS is not well studied. DM and OAS are poorly understood and may not be diagnosed correctly, especially when outbreaks such as COVID-19 are being investigated.

METHODS: A systematic review of 33 studies published between 2000 and 2025 was conducted to analyze DM-related OAS epidemiology, pathophysiology, clinical phenotypes, and treatment outcomes, focusing on the mechanistic links, pandemic trends, and glycemic control effect on therapeutic effectiveness.

RESULTS: Chronic hyperglycemia induced orbital apex microvascular damage (endothelial dysfunction, thrombosis, vascular senescence), immunosuppression induced opportunistic infections (mostly mucormycosis), and diabetic neuropathy induced neuromuscular dysfunction. During COVID-19, diabetic patients had the highest OAS incidence (more than 70% of cases involved rhino-orbital mucormycosis). Optimal glycemic control is associated with a 32% higher antifungal treatment effectiveness and a 28% lower rate of surgical complications. Epidemiological data showed that DM was the main predisposing factor, with 71.4%-81.8% infectious OAS cases occurred in diabetic populations.

CONCLUSION: DM is underreported as a critical catalyst for OAS with complications directly increasing severity and progression. Routine DM screening (e.g., glycated hemoglobin monitoring) and integrated glycemic management are essential for OAS prevention and treatment. Long-term studies on inflammatory factors and personalized multidisciplinary care are needed to address mechanistic gaps and improve visual and neurological outcomes in high-risk diabetic patients.},
}

Humans
*COVID-19/epidemiology/complications
*Orbital Diseases/epidemiology/etiology
*Diabetes Mellitus/epidemiology
SARS-CoV-2
*Diabetes Complications/epidemiology
Syndrome

@article {pmid41822480,
year = {2026},
author = {Wasilewski, A and Serrafi, A},
title = {Identification of metabolic signatures of immune response following mRNA and inactivated vaccines against COVID-19: a systematic review.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1783878},
pmid = {41822480},
issn = {1664-3224},
mesh = {Humans ; *COVID-19 Vaccines/immunology ; Vaccines, Inactivated/immunology ; *SARS-CoV-2/immunology ; *COVID-19/immunology/prevention & control/metabolism ; mRNA Vaccines/immunology ; Metabolomics ; Vaccination ; Kynurenine/metabolism ; *Metabolome ; Biomarkers ; Antibodies, Viral/blood ; },
abstract = {BACKGROUND: Metabolomic profiling offers insights into immune responses, yet a synthesis of systemic metabolic changes after COVID-19 vaccination is lacking. This review aims to characterize vaccination-induced metabolomic alterations and identify correlative biomarkers of responsiveness.

METHODS: Following PRISMA 2020 guidelines (PROSPERO 1181037), four databases (PubMed, Embase, Scopus, Web of Science) were searched for studies using LC-MS, GC-MS, or NMR to analyse venous blood after COVID-19 vaccination. Inclusion criteria focused on original human studies. Risk of bias was assessed using ROBINS-I and RoB 2.

RESULTS: Ten studies (n > 1,200) evaluating mRNA and inactivated vaccines were included. Vaccination consistently altered amino acid pathways, specifically glutamine, phenylalanine, and tryptophan. Early activation of the kynurenine pathway (1-2 days post-dose) emerged as a predictor of stronger antibody responses. Inactivated vaccines triggered a "Warburg-like" metabolic switch, characterized by increased glycolysis and reduced TCA intermediates. Lipidomic changes were prominent; high baseline ceramides predicted low response, while sphingomyelins and short-chain fatty acids associated with positive immunity. Most studies showed a moderate risk of bias due to post-hoc grouping and confounding factors.

CONCLUSIONS: COVID-19 vaccination induces reproducible changes in amino acid, energy, and lipid metabolism. Kynurenine activity, baseline amino acids, and sphingolipid signatures are potential predictors of vaccine efficacy, supporting personalized immunization strategies.},
}

Humans
*COVID-19 Vaccines/immunology
Vaccines, Inactivated/immunology
*SARS-CoV-2/immunology
*COVID-19/immunology/prevention & control/metabolism
mRNA Vaccines/immunology
Metabolomics
Vaccination
Kynurenine/metabolism
*Metabolome
Biomarkers
Antibodies, Viral/blood

@article {pmid41822497,
year = {2026},
author = {Bakacs, T and Chumakov, K},
title = {Host-targeted oral avian vaccine virus demonstrates broad antiviral activity and safety in patients.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1760109},
pmid = {41822497},
issn = {1664-3224},
mesh = {Humans ; Animals ; *Viral Vaccines/immunology/administration & dosage/adverse effects ; *Infectious bursal disease virus/immunology ; Administration, Oral ; COVID-19/immunology/prevention & control ; Antiviral Agents ; SARS-CoV-2/immunology ; },
abstract = {The absence of an immediately deployable, broad-spectrum antiviral remains a critical vulnerability in global pandemic preparedness. Host-directed agents that activate innate immunity offer a pathogen-agnostic strategy, yet no such therapy is currently stockpiled or authorized for emergency use. Infectious Bursal Disease Virus (IBDV)-a non-replicating avian dsRNA vaccine virus with a 60-year safety record in poultry-induces robust interferon responses in mammals and has been administered orally in marmosets and more than 50 human patients with hepatitis A, B, C, SARS-CoV-2, and herpes zoster infections. These observations include a randomized phase II trial in 84 acute HBV/HCV patients. Although the evidence base is limited, the consistency of clinical responses and absence of serious safety signals justify renewed scientific examination. This review synthesizes the mechanistic rationale, comparative advantages over synthetic Pattern Recognition Receptor (PRR) agonists, clinical observations, One Health implications, and regulatory precedents relevant to evaluating IBDV as a temporary, compassionate-use antiviral during pandemics while the reverse-engineered human candidate (IBDV-R903/78) progresses through formal development. The goal is not to endorse clinical deployment, but to initiate a rigorous, multidisciplinary debate on whether an established veterinary dsRNA vaccine virus could serve as an off-the-shelf host-directed live viral adjuvant therapy in future public health emergencies.},
}

Humans
Animals
*Viral Vaccines/immunology/administration & dosage/adverse effects
*Infectious bursal disease virus/immunology
Administration, Oral
COVID-19/immunology/prevention & control
Antiviral Agents
SARS-CoV-2/immunology

@article {pmid41490687,
year = {2026},
author = {Sousa Almeida, PR and Sarmento, G and Gruner, H and Veríssimo, R and Duque, S},
title = {[Vaccination of Older Adults in Portugal: Recommendations from the Geriatrics Study Group of the Portuguese Society of Internal Medicine].},
journal = {Acta medica portuguesa},
volume = {39},
number = {3},
pages = {223-234},
doi = {10.20344/amp.23786},
pmid = {41490687},
issn = {1646-0758},
mesh = {Humans ; Aged ; Portugal ; Influenza Vaccines/administration & dosage ; *Vaccination/standards ; Middle Aged ; Pneumococcal Vaccines/administration & dosage ; Geriatrics ; *COVID-19 Vaccines/administration & dosage ; Aged, 80 and over ; COVID-19/prevention & control ; Influenza, Human/prevention & control ; },
abstract = {Older persons are more susceptible to infections and have a higher risk of serious complications, with a worse functional and vital prognosis. Vaccination is an effective strategy with a favorable safety profile for preventing infections and promoting healthy aging. In view of the clinical evidence and the vaccines available in Portugal in the first half of 2025, the Geriatrics Study Group of the Portuguese Society of Internal Medicine presents a proposal for vaccination of adults aged 65 years or older. The experts also point out the need to create a national lifelong vaccination program that includes older people to increase vaccination coverage and reduce the impact of infections in this population. Although the document focuses on people aged 65 years or older, vaccination against some diseases should start earlier. This article outlines five main recommendations: 1) Annual influenza and COVID-19 vaccination for all adults aged 50 years or older, with those aged 65 years or older receiving the high-dose trivalent influenza vaccine; 2) Respiratory syncytial virus vaccination for all adults aged 60 years or older and adults aged 18 - 59 years with risk factors, prioritizing people aged 75 years or older and those aged 50 years or older with risk factors; 3) Pneumococcal vaccination with the 20-valent or 21-valent pneumococcal conjugate vaccine for all adults aged 50 years or older and adults aged 18 - 49 years with risk factors; 4) Herpes zoster vaccination with the recombinant vaccine for all adults aged 50 years or older and adults aged 18 - 49 years at high risk of herpes zoster; 5) From the age of 65 years, booster vaccination against tetanus, diphtheria and pertussis every 10 years.},
}

Humans
Aged
Portugal
Influenza Vaccines/administration & dosage
*Vaccination/standards
Middle Aged
Pneumococcal Vaccines/administration & dosage
Geriatrics
*COVID-19 Vaccines/administration & dosage
Aged, 80 and over
COVID-19/prevention & control
Influenza, Human/prevention & control

@article {pmid41818779,
year = {2026},
author = {Greco, AA and Faiz, SA and Kaul, V and Reitzner, J and MacGregor, D and Garbarino, A and , },
title = {Best practices from the Association of Pulmonary and Critical Care Medicine Program Directors for social media use with emphasis on virtual recruitment.},
journal = {ATS scholar},
volume = {7},
number = {1},
pages = {67-73},
doi = {10.1093/atsscholar/aapaf002},
pmid = {41818779},
issn = {2690-7097},
mesh = {*Social Media ; Humans ; *Personnel Selection/methods ; COVID-19/epidemiology ; *Pulmonary Medicine/education ; *Critical Care ; SARS-CoV-2 ; },
abstract = {Since the COVID-19 pandemic, the need to develop innovative strategies for virtual engagement and interaction has emerged. There has been a growing emphasis on online recruitment strategies for most medical specialties. For the last several interview seasons, many national organizations have recommended that fellowship interviews be conducted virtually for all applicants. Social media represents a powerful tool for both the program and the applicants. However, there remains a paucity of data published on social media use for virtual recruitment in pulmonary and critical care medicine (PCCM). Here, we review the available data for virtual recruitment and propose best practices for PCCM programs. Our social media strategy outlines specific and practical steps that form the framework for a social media charter including defining the goal and audience, following institutional guidelines, choosing appropriate platform(s), identifying and defining an account management plan, devising a strategy for content generation and posting, and continuing to reassess and optimize the process. Our best practices provide a practice framework for PCCM programs, both novice and advanced, for social media use. They also emphasize a need for more research on social media's impact on future recruitment cycles while providing a better understanding of current practices for applicant program selection and virtual recruitment.},
}

*Social Media
Humans
*Personnel Selection/methods
COVID-19/epidemiology
*Pulmonary Medicine/education
*Critical Care
SARS-CoV-2

@article {pmid41818888,
year = {2026},
author = {Paudel, KR and Hegarty, KJ and Shrestha, J and Budden, KF and Awatade, NT and Sadaf, T and Malyla, V and Waters, S and Papagianis, PC and Bourke, JE and Wark, PA and Hansbro, PM},
title = {Innovative methodologies for elucidating bushfire smoke-induced pathophysiological mechanism.},
journal = {The Science of the total environment},
volume = {1025},
number = {},
pages = {181645},
doi = {10.1016/j.scitotenv.2026.181645},
pmid = {41818888},
issn = {1879-1026},
abstract = {Over the last century, the awareness of air pollution awareness and its harm to public health have resulted in the implementation of new protective measures to try and limit exposure. Bushfires generate waves of air pollution with orders of magnitudes higher than normal background pollution, necessitating studies to understand the physiological impact. Previous work has strongly linked bushfire smoke to respiratory disease (chronic obstructive pulmonary disease COPD, asthma, lung cancer) cardiovascular disease (myocardial infarction, stroke), and increased susceptibility to infection (COVID-19). Nevertheless, the underlying mechanisms of pathogenesis remain unclear. There is little consensus on what in vitro and in vivo techniques are best used to examine disease mechanisms. Individual investigations are useful but a lack of standard methods creates variability and makes comparisons difficult. Developing adaptable in vitro and in vivo models that are replicable, physiologically relevant, and affordable may reduce variability enabling comparisons. These models should also be capable of integrating multiple types of pollutants or reference materials to develop standards that other studies can follow, facilitating comparisons. Here, we discuss advance in vitro and in vivo experimental models to study the impact of bushfire smoke exposure induced pathophysiology. The goal is to improve comparison and translation across studies, and to lay the groundwork for future research into the mechanisms that underpin bushfire smoke-induced pathogenesis to enable the development of preventative measures and effective therapies.},
}

@article {pmid41819358,
year = {2026},
author = {Liu, W and Liu, W and Rong, Z and Song, S and Zhou, Y and Pang, X},
title = {Therapeutic strategies for the fatty-acid-binding pocket of the spike protein: advances and perspectives.},
journal = {Drug discovery today},
volume = {},
number = {},
pages = {104638},
doi = {10.1016/j.drudis.2026.104638},
pmid = {41819358},
issn = {1878-5832},
abstract = {The trimeric spike protein plays a crucial part in the lifecycle of SARS-CoV-2 by facilitating viral entry. The SARS-CoV-2 spike protein harbors a fatty-acid-binding pocket (FABP) at the interface between two adjacent receptor-binding domains. Ligand engagement at the FABP locks the spike into a non-infectious, closed conformation, thereby impairing the virus's ability to infect new cells. Herein, we summarize the small-molecule inhibitors targeting the FABP that have been described to date, analyzing their binding modes, SAR and mechanisms of action. Because this pocket is conserved across highly pathogenic coronaviruses, targeting it offers a promising strategy for developing novel antivirals with broad-spectrum anti-coronavirus activity. We hope this review will stimulate further research on FABP inhibitors and promote the discovery of broad-spectrum anti-SARS-CoV-2 therapeutics.},
}

@article {pmid41817243,
year = {2026},
author = {Ragagnin, K and da Silva-Oolup, S and Yu, H and Balaji, S and Côté, P and Hogg-Johnson, S and Murnaghan, K and Wong, JJ},
title = {Burden and Associated Factors of Unmet Health Care Needs in Individuals With Osteoarthritis: A Systematic Review.},
journal = {ACR open rheumatology},
volume = {8},
number = {3},
pages = {e90007},
doi = {10.1002/acr2.90007},
pmid = {41817243},
issn = {2578-5745},
abstract = {OBJECTIVE: This systematic review aimed to describe the prevalence, incidence, and associated factors of unmet health care needs among adults with osteoarthritis.

METHODS: We searched Medline (Ovid), Embase (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid) from inception through May 15, 2024. Eligible studies were cross-sectional, cohort, and case-control studies investigating the prevalence, incidence, associated factors, or risk factors of unmet health care needs in adults with osteoarthritis. We restricted to articles published in English, French, Italian, and Chinese for feasibility. Reviewers independently screened articles, assessed risk of bias using the Joanna Briggs Institute Checklists, and extracted data. We descriptively synthesized results from low/moderate risk-of-bias studies, stratifying results by age (<60 vs ≥60 years).

RESULTS: Of 3,589 citations screened, 7 cross-sectional studies with low/moderate risk-of-bias were included in the synthesis (3 from South Korea, 4 from the United States). In South Korea, the 12-month prevalence of unmet health care needs was 31.6% (95% confidence interval [CI] 29.9%-33.3%) among adults aged ≥50 years with osteoarthritis and 31% (95% CI 30.9%-31.1%) among those aged ≥65 years with arthritis. In the United States, the 12-month prevalence of unmet needs in the general population due to unaffordability ranged from 15% to 30% in adults with osteoarthritis or arthritis. Prevalence was higher among those who exclusively used complementary and alternative medicine and varied during the COVID-19 pandemic, peaking in the summer of 2020. Evidence suggests that unmet needs are associated with lower income, no insurance, and activity limitations.

CONCLUSION: Unmet health care needs are common in adults with osteoarthritis, particularly those facing socioeconomic disadvantages or functional limitations. Given the paucity of high-quality studies, additional research is needed.},
}

@article {pmid41816409,
year = {2026},
author = {Chai, X and Qi, H and Liu, X and Zhou, F and Jiang, Y and Wu, M and Lian, S and Wang, L and Bao, Y},
title = {A narrative review of SARS-CoV-2 variants and long COVID.},
journal = {Journal of thoracic disease},
volume = {18},
number = {2},
pages = {164},
pmid = {41816409},
issn = {2072-1439},
abstract = {BACKGROUND AND OBJECTIVE: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the onset of the pandemic, there has been a continuous rise in cases of both COVID-19 and long COVID. It is acknowledged that long COVID is a multisystem disorder with a wide range of symptoms; its primary symptoms and indicators include fatigue, dyspnea, anosmia, myalgia, cough, and hyposmia. SARS-CoV-2 has continuously evolved since the wild strain first appeared, resulting in numerous genetic variants. These strains exhibit significant differences in terms of pathogenicity and immune evasion. Key scientific questions remain regarding whether and how these variations influence the development and clinical course of long COVID. This review aims to examine associations between SARS-CoV-2 strains and long COVID, synthesize current evidence, identify research gaps, and provide recommendations for subsequent rehabilitation treatments.

METHODS: Literature searches were conducted using PubMed, focusing on publications from January 2020 to August 2025. Relevant literature on long COVID and SARS-CoV-2 variants was systematically reviewed and summarized, and included in this review.

KEY CONTENT AND FINDINGS: This review highlights the ongoing genetic evolution of SARS-CoV-2 as a key temporal dynamic during the pandemic. Different SARS-CoV-2 variants result in varying severity of long COVID. Anti-inflammatory treatments demonstrate significant efficacy for long COVID patients. COVID-19 vaccination prior to SARS-CoV-2 infection reduces the risk of long COVID, and another successful treatment option for persistent COVID symptoms is physical therapy.

CONCLUSIONS: Long COVID remains a significant public health challenge. The relationship between SARS-CoV-2 variants and long COVID requires further elucidation. This condition may cause significant economic and medical burdens in the future. To completely protect the physical and mental health of long COVID patients, it is essential to broaden therapeutic options and create individualized therapy programs. Therefore, understanding the connection between long COVID and SARS-CoV-2 variants is crucial. Based on this knowledge, effective strategies must be designed to empower individuals in proactively addressing and managing long COVID.},
}

@article {pmid41816349,
year = {2026},
author = {González-Rivera, L and Luna-Gutiérrez, R and Cárdenas, S and Merino-González, C and Handy, A and Pepper, I and López, MN},
title = {Regulatory T cells in hypoxic environments.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1755928},
pmid = {41816349},
issn = {1664-3224},
mesh = {Humans ; *T-Lymphocytes, Regulatory/immunology/metabolism ; *Hypoxia/immunology/metabolism ; Animals ; Cell Differentiation ; Cellular Microenvironment/immunology ; },
abstract = {Oxygen availability is considered as an important determinant of immune regulation, yet its impact on regulatory T cells remains incompletely understood. In this review, we synthesize current evidence on how chronic and intermittent hypoxia influence the differentiation, stability and function of regulatory T cells across diverse physiological and pathological settings. We describe the main cellular pathways engaged during hypoxic adaptation, with emphasis on the role of hypoxia-inducible factors in shaping regulatory T cell metabolism and lineage integrity. We then evaluate findings from clinical contexts characterized by sustained or cyclical oxygen deprivation, including chronic lung disease, sleep-disordered breathing and severe viral infection. Across these conditions, hypoxia is associated with alterations in regulatory T cell phenotype and its suppressive function, although patterns vary according to microenvironment and disease stage. A clearer understanding of how distinct hypoxic patterns modulate regulatory T cell biology will be essential for identifying therapeutic strategies aimed at restoring immune balance in hypoxia-associated disease.},
}

Humans
*T-Lymphocytes, Regulatory/immunology/metabolism
*Hypoxia/immunology/metabolism
Animals
Cell Differentiation
Cellular Microenvironment/immunology

@article {pmid41723461,
year = {2026},
author = {Mulumba, M and Oga, J and Baguma, C and Nantaba, J and Ruano, AL},
title = {Health equity and the global social contract: beyond incrementalism and illusionary solidarity.},
journal = {International journal for equity in health},
volume = {25},
number = {1},
pages = {},
pmid = {41723461},
issn = {1475-9276},
abstract = {The Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs) have been celebrated as global social contracts, yet their reliance on voluntary commitments and aspirational targets conceals a structural flaw. By divorcing poverty and inequity from colonial histories, debt regimes, and extractive global finance, these frameworks function as a neocolonial placebo: soothing global conscience while entrenching asymmetries of power and resources. Drawing on examples from debt distress, vaccine apartheid, and intellectual property monopolies during COVID-19, this commentary demonstrates that global health governance operates less as solidarity than as economic containment. Reparative justice provides the necessary rupture. A post-2030 Global Social Contract must impose enforceable obligations on former colonial powers, embed structural restitution through debt and tax justice, and democratise health governance under the principle of Common but Differentiated Responsibilities. Anything less risks reproducing selective generosity while abandoning equity to the logics of extraction and impunity.},
}

@article {pmid41816346,
year = {2026},
author = {Liu, L and Zhao, H and Qiao, J and Liu, N and Tao, W and Wei, S},
title = {Relationship between COVID-19 and "three inflammations and one deafness": a systematic review and meta-analysis.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1690788},
pmid = {41816346},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/epidemiology/complications ; *SARS-CoV-2 ; *Deafness/epidemiology ; *Inflammation ; *Tinnitus/epidemiology ; *Otitis Media/epidemiology ; *Rhinitis, Allergic/epidemiology ; },
abstract = {BACKGROUND: The relationship between "three inflammations and one deafness" (allergic rhinitis, pharyngitis, otitis media, tinnitus, and deafness) and coronavirus disease 2019 (COVID-19) is currently unclear, and this study aims to investigate their correlation.

METHODS: We searched the relevant literature in three databases (Embase, Cochrane Library, and PubMed) from their inception through July 2024, and the investigator strictly reviewed the literature according to the screening criteria to determine the included studies. We extracted relevant data information and conducted quality assessment and meta-analysis.

RESULTS: From 5,950 records screened, five cohort studies were included. The pooled analysis using a random-effects model showed no statistically significant association between COVID-19 and "three inflammations and one deafness" (OR = 1.03, 95% CI: 0.85-1.26, P = 0.74), with substantial heterogeneity (I² = 89%, P < 0.001). Critically, subgroup analyses revealed that the diagnostic criteria for "three inflammations and one deafness" were a key source of this heterogeneity. A significant association was observed in studies using physician-diagnosed outcomes (OR = 1.30, 95% CI: 1.08-1.56, P = 0.006, I² = 0%), whereas no significant association was found in studies based on self-reported symptoms (OR = 0.89, 95% CI: 0.69-1.15, P = 0.38, I² = 96%). Analyses by specific conditions yielded mixed results: No significant association was observed for hearing loss (OR = 0.93, 95% CI: 0.69-1.25, P = 0.62). For allergic rhinitis (OR = 1.19, 95% CI: 0.47-3.02, P = 0.71) and tinnitus (OR = 1.11, 95% CI: 0.88-1.39, P = 0.38), the point estimates suggested potential positive trends, but the associations were not statistically significant, and confidence intervals were wide. Subgroup analyses by some regions and COVID-19 diagnostic criteria did not reveal consistent significant associations.

CONCLUSIONS: This meta-analysis found no consistent association between COVID-19 and "three inflammations and one deafness," primarily due to significant heterogeneity. Evidence suggests a link between COVID-19 and physician-diagnosed "three inflammations and one deafness," which strongly depends on the rigor of outcome assessment, highlighting the need for standardized clinical diagnoses in future research.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023438076.},
}

Humans
*COVID-19/epidemiology/complications
*SARS-CoV-2
*Deafness/epidemiology
*Inflammation
*Tinnitus/epidemiology
*Otitis Media/epidemiology
*Rhinitis, Allergic/epidemiology

@article {pmid41815827,
year = {2026},
author = {Nath, D and Al Noman, A and Pradhan, S and Sharma, PD and Ahmed, S and Begum, F and Al Hafiz, M and Abdallah, EM},
title = {Receptor-mediated mechanisms underlying neurological complications in COVID-19: from viral entry to neuroinflammation.},
journal = {3 Biotech},
volume = {16},
number = {4},
pages = {128},
pmid = {41815827},
issn = {2190-572X},
abstract = {Neurological complications of COVID-19 encompass acute syndromes and persistent post-acute sequelae, yet their mechanistic basis remains incompletely defined. Integrated clinical, neuropathological, neuroimaging, and molecular evidence indicates that SARS-CoV-2-associated neurological injury is driven predominantly by receptor-mediated immune and vascular mechanisms rather than widespread productive central nervous system infection. Angiotensin-converting enzyme 2 (ACE2) remains the principal viral entry receptor, while neuropilin-1 (NRP1) facilitates neurovascular and olfactory access in specific contexts. In contrast, CD147 and dipeptidyl peptidase-4 (DPP4) appear to exert indirect modulatory roles through endothelial dysfunction and immune activation rather than acting as dominant neurotropic entry receptors. Toll-like receptors, particularly TLR2, TLR4, and TLR7, amplify neuroinflammatory signaling and contribute to blood-brain barrier disruption, microvascular injury, and sustained microglial activation. Cerebrospinal fluid biomarkers and neuroimaging findings consistently support a dual-pathway model combining limited direct viral presence with predominant immune-mediated injury. Current therapeutic strategies targeting receptor-mediated entry and neuroinflammation remain largely investigational, underscoring the need for biomarker-guided and phase-specific interventions. These findings refine the mechanistic framework of NeuroCOVID and identify translational priorities for acute and long-term neurological management.},
}

@article {pmid41814863,
year = {2026},
author = {Fix, J and Lee, S and Nachbar, J and Sadadia, P and Lövgren Bengtsson, K and Stertman, L and Palm, AE and Walker, R and Draghia Akli, R and Sellers, S},
title = {Safety of Matrix-M-adjuvanted COVID-19, seasonal influenza, combination influenza-COVID-19, and malaria vaccines: a review of the evidence.},
journal = {Expert review of vaccines},
volume = {},
number = {},
pages = {2638828},
doi = {10.1080/14760584.2026.2638828},
pmid = {41814863},
issn = {1744-8395},
abstract = {INTRODUCTION: The saponin-based Matrix-M adjuvant induces potent and durable immunity through producing long-lasting memory B-cells and broad-based T-cell immunity, across a variety of vaccine platforms. Matrix-M - adjuvanted vaccines have a history of successful development for protection against a broad range of infectious diseases with high public health urgency. Two authorized Matrix-M - adjuvanted vaccines, NUVAXOVID (COVID-19) and R21/Matrix-M (Plasmodium falciparum malaria), have been administered to >10 million people worldwide.

AREAS COVERED: This review is a comprehensive evaluation of published reactogenicity and safety data from 66 clinical trials and post-marketing studies of Matrix-M - adjuvanted COVID-19, seasonal influenza, combination COVID-19-influenza (CIC), and malaria vaccines retrieved from PubMed and Embase with no restricted start date and last search performed on 1 November 2025.

EXPERT OPINION: Overall, 64,101 participants received ≥ 1 Matrix-M - adjuvanted vaccine dose (143,170 doses): 55,939 COVID-19, 2477 influenza, 1422 CIC, and 4263 malaria vaccinees. All authorized and candidate vaccines within each disease area were well tolerated, including among a wide range of geographies, immunocompromised populations, and children. Active-comparator clinical trials and post-marketing studies demonstrate favorable reactogenicity profiles of Matrix-M - adjuvanted vaccines compared with licensed vaccines for the same diseases, particularly, lower reactogenicity rates post - NUVAXOVID versus mRNA COVID-19 vaccination. Research is ongoing to better characterize Matrix-M immune-stimulating mechanisms, continue technology improvements, and identify new applications to enhance vaccines and therapeutics.},
}

@article {pmid41814585,
year = {2026},
author = {Caliman-Sturdza, OA and Gheorghita, R and Lobiuc, A and Filip, R and Soldanescu, I and Mangul, S and Dimian, M},
title = {Management of long COVID-19 in children and adolescents: from diagnosis to therapeutically approaches.},
journal = {Annals of medicine},
volume = {58},
number = {1},
pages = {2642510},
doi = {10.1080/07853890.2026.2642510},
pmid = {41814585},
issn = {1365-2060},
mesh = {Humans ; *COVID-19/therapy/complications/diagnosis ; Child ; Adolescent ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; },
abstract = {INTRODUCTION: Long Coronavirus disease 2019 (COVID-19), also termed post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC), has emerged as a complex multisystem condition in children and adolescents worldwide. It can occur even after mild or asymptomatic acute infections, with symptoms that may persist, fluctuate, or relapse over time. This review aims to comprehensively explore the characteristic manifestations, management and current therapeutic possibilities of pediatric Long COVID-19 (L-C19).

METHODS: A systematic search was conducted in multiple databases such as PubMed, Scopus, Web of Science, and Google Scholar, for literature published between January 2020 and October 2025.

RESULTS: Diagnosing pediatric L-C19 is challenging due to the heterogeneity of symptoms and lack of specific diagnostic biomarkers. Most young patients experience gradual improvement over months, but a significant subset remains symptomatic for >1 year with substantial disability, underscoring the need for timely diagnosis and intervention. Current clinical consensus emphasizes an individualized, multidisciplinary management approach focused on symptom relief and functional rehabilitation. No definitive cure exists for L-C19; thus, care is tailored to each patient's predominant issues. Therapeutic strategies combine supportive self-management (e.g. energy conservation and pacing) with both non-pharmacological and pharmacological interventions. Multimodal rehabilitation programs - including graded exercise therapy and cognitive behavioral therapy - have shown promise in improving fatigue, mental health, and overall quality of life. Targeted treatments for specific sequelae (such as autonomic dysfunction or chronic pain) are applied on a case-by-case basis, although high-quality evidence for medications remains limited. Globally, interdisciplinary collaborations have been established to provide harmonized diagnostic and treatment protocols, and major research initiatives are underway to evaluate novel therapies and include children in L-C19 clinical trials.

CONCLUSION: Ongoing international efforts to develop standardized diagnostic tools, outcome measures, and evidence-based interventions are crucial to optimize care and long-term outcomes for children and adolescents affected by L-C19.},
}

Humans
*COVID-19/therapy/complications/diagnosis
Child
Adolescent
SARS-CoV-2
Post-Acute COVID-19 Syndrome

@article {pmid41814525,
year = {2026},
author = {Schoene, D and Deckert, S and Barlinn, K and Huttner, HB and Kösters, M and Siepmann, T},
title = {Neurocardiac Autonomic Dysfunction in Patients With Post-COVID-19 Condition: A Systematic Review and Meta-Analysis.},
journal = {European journal of neurology},
volume = {33},
number = {3},
pages = {e70561},
doi = {10.1111/ene.70561},
pmid = {41814525},
issn = {1468-1331},
mesh = {Humans ; *COVID-19/complications/physiopathology ; *Heart Rate/physiology ; *Autonomic Nervous System Diseases/physiopathology/etiology ; SARS-CoV-2 ; Pandemics ; },
abstract = {BACKGROUND: Neurocardiac autonomic impairment with reduced heart rate variability (HRV) has been linked to SARS-CoV-2 infection and may persist in patients with post-COVID-19 syndrome. We synthesised meta-analytic data on HRV in post-COVID-19 syndrome.

METHODS: Our systematic review and meta-analysis were guided by PRISMA standards. We used MEDLINE, Embase and Web of Science to identify non-randomised studies of HRV in patients with post-COVID-19 syndrome, conducted more than 3 months after infection and compared with healthy controls. The search covered the period from 01/2020 to 09/2023. We pooled data on the following HRV parameters: standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (rMSSD) and low-frequency to high-frequency ratio (LF/HF ratio). We applied a random effects model to account for heterogeneity. Risk of bias was assessed.

RESULTS: From 856 initially identified records, we included 11 studies with a total of 1162 participants (593 post-COVID-19 patients and 565 healthy controls). We observed a trend toward lower HRV in post-COVID patients compared to controls, with small to medium effects for SDNN (SMD: 0.26, 95% CI: -0.03 to 0.56, p = 0.09), rMSSD (SMD: 0.11, 95% CI: -0.15 to 0.36, p = 0.41) and LF/HF ratio (SMD: -0.271, 95% CI: -0.61 to 0.07, p = 0.12). Moderate to high statistical heterogeneity of the effects was observed (I[2] = 83% for SDNN and 78% for rMSSD) and nine of 11 studies had a high risk of bias.

CONCLUSION: This meta-analysis suggests a possible association between post-COVID condition and alterations in neurocardiac autonomic function.},
}

Humans
*COVID-19/complications/physiopathology
*Heart Rate/physiology
*Autonomic Nervous System Diseases/physiopathology/etiology
SARS-CoV-2
Pandemics

@article {pmid41814520,
year = {2026},
author = {Avila, T and Jefferies, D and Ramjan, LM},
title = {The Impact, Role and Experiences of Nurses Working in Medical Quarantine During the COVID-19 Pandemic: A Narrative Review.},
journal = {Nursing open},
volume = {13},
number = {3},
pages = {e70463},
doi = {10.1002/nop2.70463},
pmid = {41814520},
issn = {2054-1058},
mesh = {Humans ; *COVID-19/nursing/epidemiology/prevention & control ; *Quarantine/psychology ; *Nurse's Role/psychology ; SARS-CoV-2 ; Pandemics ; *Nurses/psychology ; },
abstract = {AIM: To understand the impact, role and experience of nurses working in medical hotel quarantine during the COVID-19 pandemic.

BACKGROUND: Medical Hotel Quarantine was staffed predominantly by nurses to prevent the spread of COVID-19 when people who were COVID-19 positive were unable to isolate safely in their communities.

REVIEW METHODS: A narrative review was conducted to understand how nurses made meaning of their experience. Seven databases were searched (Google Scholar, CINAHL, COCHRANE, MEDLINE, Joanna Briggs Institute, PsychInfo and Scopus) following the PRISMA Methodological Guideline (between August 2021 and January 2022). A summary table was developed with the headings: author and year, country, study design and data collection, participants, critical appraisal rating and results. Using a Critical Realist lens, the data were analysed using thematic analysis and a stratified ontology of the Real, the Actual and the Empirical domains in medical hotel quarantine to understand how the complex nature of nursing care worked within this unique environment.

RESULTS: Nurses were pivotal to the success of medical hotel quarantine. The Critical realist lens demonstrated how this was a stressful environment as health information was updated and policies and requirements changed. Although there were reports of stigma outside work, many nurses reported that they felt a sense of duty caring for patients experiencing isolation.

DISCUSSION: There is little research about nurses working in medical hotel quarantine during COVID-19.

CONCLUSION: Further research is required to understand how nurses managed these facilities to protect the community when future pandemics occur.

It is important that the lessons from medical hotel quarantine are recorded so that future nurses can be guided by the experience of nurses who worked in hotel quarantine if they are required to work in this unique area of practice.},
}

Humans
*COVID-19/nursing/epidemiology/prevention & control
*Quarantine/psychology
*Nurse's Role/psychology
SARS-CoV-2
Pandemics
*Nurses/psychology

@article {pmid41814505,
year = {2026},
author = {Tovar, V and Sánchez, IP and Rugeles, MT and Taborda, NA and Hernandez, JC},
title = {Cellular Immune Response Induced by mRNA Vaccines Against SARS-CoV-2.},
journal = {Immunity, inflammation and disease},
volume = {14},
number = {3},
pages = {e70375},
doi = {10.1002/iid3.70375},
pmid = {41814505},
issn = {2050-4527},
support = {//Universidad Cooperativa de Colombia/ ; //Corporación Universitaria Remington/ ; //Universidad de Antioquia/ ; },
mesh = {Humans ; *SARS-CoV-2/immunology ; *COVID-19/immunology/prevention & control ; *COVID-19 Vaccines/immunology ; *Immunity, Cellular ; mRNA Vaccines/immunology ; *T-Lymphocytes/immunology ; Vaccines, Synthetic/immunology ; },
abstract = {The disease caused by SARS-CoV-2 is known as COVID-19, and it can range from mild symptoms to severe clinical manifestations, including respiratory failure, pneumonia, and organ failure. Since its emergence in 2019, more than 7 million deaths have been reported worldwide. Vaccines have been the most effective strategy for preventing severe illness and death in patients who acquire the infection. Vaccines induce both humoral and cell-mediated immune responses; the latter is crucial in the immune response against SARS-CoV-2, as the effector mechanisms of T-cells are less affected by the high mutation rate of the virus and prevail through memory phenotypes, ensuring long-term protection. mRNA vaccines have been primarily used worldwide to control the COVID-19 pandemic. This platform can protect against different circulating variants and is characterized by generating a robust T-cell response. This review discusses the immune response of T-cells induced by mRNA vaccines against SARS-CoV-2. It explores their effect on different population groups, including people with special clinical conditions, such as cancer and organ transplant recipients with a compromised immune system.},
}

Humans
*SARS-CoV-2/immunology
*COVID-19/immunology/prevention & control
*COVID-19 Vaccines/immunology
*Immunity, Cellular
mRNA Vaccines/immunology
*T-Lymphocytes/immunology
Vaccines, Synthetic/immunology

@article {pmid41813522,
year = {2026},
author = {Davidson, M and Schnell, N and Sickbert-Bennett, E},
title = {Optimizing Hand Hygiene Compliance.},
journal = {Infectious disease clinics of North America},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.idc.2025.12.005},
pmid = {41813522},
issn = {1557-9824},
abstract = {Although hand hygiene is considered a fundamental defense against infection spread, maintaining high, consistent compliance remains an ongoing challenge. Even after the COVID-19 pandemic placed hand hygiene in the spotlight, initially high compliance levels dropped, facilitating the spread of multidrug-resistant pathogen transmission in some settings. This article details the various methodologies for monitoring hand hygiene with diverse solutions for feedback. Ultimately, infection preventionists and hospital epidemiologists must consider what will be most effective for their facility when determining how to optimize hand hygiene based on the capabilities, opportunities, and motivations of their staff.},
}

@article {pmid41813354,
year = {2026},
author = {Silva, AL and Segundo, MA and Prior, JAV},
title = {Advances in virus detection using carbon and quantum dot technologies: a review.},
journal = {Analytica chimica acta},
volume = {1398},
number = {},
pages = {345252},
doi = {10.1016/j.aca.2026.345252},
pmid = {41813354},
issn = {1873-4324},
mesh = {*Quantum Dots/chemistry ; *Carbon/chemistry ; *Biosensing Techniques/methods ; Humans ; *Viruses/isolation & purification ; SARS-CoV-2/isolation & purification ; },
abstract = {BACKGROUND: The diagnosis of viral infections still depends largely on traditional lab methods like PCR and ELISA, which are often costly, time-consuming, and unsuitable for large-scale or low-resource testing. Because of these issues, researchers are exploring new approaches using nanotechnology. Quantum dots (QDs) and carbon dots (CDs) are two types of fluorescent nanodots with special optical and surface properties, becoming promising tools for detecting viruses. However, their different physical and chemical characteristics, biocompatibility, and integration potential lead to distinct analytical performances, highlighting the need for a comparative assessment of their applicability in viral biosensing.

RESULTS: This review systematically analyses recent advances in QD- and CD-based biosensors for viral detection, covering both nucleic acid- and protein-based assays. QDs show advanced techniques, with integration into fluorescence, FRET, ECL, PEC, and lateral-flow formats, enabling multiplexed detection of several viruses, including dengue, HAV, HBV, and SARS-CoV-2. In contrast, CDs are mainly used for single-target fluorescence or electrochemical assays, indicating they are in an earlier stage of development. Comparative studies reveal that QDs-based viral assays can detect targets such as HIV-1 nucleic acids at levels as low as 6.5 × 10[-16] M, which is generally one order of magnitude lower than CDs, though the latter show better biocompatibility and stability. QDs offer a wider range of sensitivity and performance, while CDs provide safer, simpler, and more sustainable sensing options. These differing features define their unique analytical roles and potential for practical use.

SIGNIFICANCE: By bringing together findings from recent literature studies, this review bridges fundamental nanochemistry with practical virus diagnostics. It explains how QDs and CDs contribute differently to sensitivity, multiplexing, and biosensor integration, providing guidance for selecting suitable nanomaterials in analytical design. The comparative insights highlight pathways for developing cost-effective, safe, and portable viral detection platforms, supporting the transition of nanodot-based assays from the laboratory to clinical and field applications.},
}

*Quantum Dots/chemistry
*Carbon/chemistry
*Biosensing Techniques/methods
Humans
*Viruses/isolation & purification
SARS-CoV-2/isolation & purification

@article {pmid41812294,
year = {2026},
author = {Shaver, N and Colijn, C and Heffernan, J and Asamoah, GD and Piggott, T and Cooper, C and Bagheri, S and Crawley, AM and Kagina, BM and Bowdish, DME and Langlois, MA and Little, J},
title = {Lack of harmonisation in immunological data: challenges in synthesising data during the COVID-19 pandemic.},
journal = {EBioMedicine},
volume = {126},
number = {},
pages = {106204},
doi = {10.1016/j.ebiom.2026.106204},
pmid = {41812294},
issn = {2352-3964},
abstract = {The COVID-19 pandemic drove the rapid development of assays to ascertain immune responses, and laboratories were required to adapt to difficult and quickly changing circumstances. While flexibility and innovation were essential, they also introduced heterogeneity in methods, reagents, and reporting practices between labs. This lack of harmonisation made it difficult to compare findings across studies, slowing evidence synthesis, and limiting the usefulness of data for modelling efforts and policy guidance. Drawing on our team's experience synthesising and modelling vaccine immunogenicity data during the pandemic, we discuss the long-term challenges of standardising human immunology research that were highlighted by the COVID-19 pandemic. We argue that vaccine immunogenicity studies require standardised reporting and quality assessment tools. We propose practical solutions to support comparability of laboratory-based practices, while preserving methodological diversity. By implementing changes before the next public health crisis, future research can avoid waste, strengthen certainty, and maximise policy and practice impact.},
}

@article {pmid41349216,
year = {2026},
author = {Leung, C and Syeda, A and Zdanowicz, A},
title = {Immunogenicity and protective efficacy of canine enteric coronavirus vaccine: a systematic review and meta-analysis.},
journal = {Journal of the American Veterinary Medical Association},
volume = {264},
number = {4},
pages = {464-470},
doi = {10.2460/javma.25.08.0539},
pmid = {41349216},
issn = {1943-569X},
mesh = {Animals ; Dogs ; *Dog Diseases/prevention & control/virology ; *Viral Vaccines/immunology ; *Coronavirus Infections/veterinary/prevention & control/virology ; *Coronavirus, Canine/immunology ; Virus Shedding ; *Immunogenicity, Vaccine ; Diarrhea/veterinary/prevention & control/virology ; },
abstract = {BACKGROUND: Canine enteric coronavirus (CECoV) causes diarrhea and vomiting, often leading to outbreaks in kennels and shelters. The World Small Animal Veterinary Association does not recommend vaccination due to limited evidence of efficacy. This meta-analysis assesses CECoV vaccine immunogenicity and protective efficacy against diarrhea and viral shedding.

METHODS: PubMed, Scopus, and Google Scholar were searched for experimental or observational studies of dogs vaccinated against CECoV, published from inception to September 29, 2025. Included studies confirmed dogs were free of CECoV infection and neutralizing antibodies before study. Exclusions applied to noncompliant studies. The Systematic Review Centre for Laboratory Animal Experimentation and funnel plots assessed bias risk. To assess vaccine immunogenicity, ELISA optical density (OD) values and log2 virus neutralization (VN) titers were regressed; pooled risk ratios evaluated protective efficacy.

RESULTS: From 415 studies, 5 experimental studies with unclear bias risks were included. Most reported dog age but omitted sex or breed. Inactivated vaccines significantly increased both OD values and VN titers, whereas attenuated vaccines significantly increased OD values but not VN titers. Vaccination reduced diarrhea risk by 72% (risk ratio, -1.28; 95% CI, -2.05 to -0.51), but did not decrease viral shedding (risk ratio, -0.25; 95% CI, -0.70 to 0.21).

CLINICAL RELEVANCE: CECoV vaccines are immunogenic and reduce diarrhea, but do not significantly reduce viral shedding, potentially masking infections in clinical settings and thus complicating disease control in communal environments. Limited literature and studies from similar research groups suggest removing CECoV vaccines from guidelines. Standardized reporting is recommended to improve future canine epidemiological research reliability.},
}

Animals
Dogs
*Dog Diseases/prevention & control/virology
*Viral Vaccines/immunology
*Coronavirus Infections/veterinary/prevention & control/virology
*Coronavirus, Canine/immunology
Virus Shedding
*Immunogenicity, Vaccine
Diarrhea/veterinary/prevention & control/virology

@article {pmid41810466,
year = {2026},
author = {Egorova, VS and Kolesova, EP and Voronina, MV and Denisova, ER and Syrocheva, AO and Pallaeva, T and Hakemi, MG and Zamyatnin, AA and Ivanov, KI and Kostyushev, D and Brezgin, S and Kostyusheva, A and Parodi, A},
title = {From bench to bedside: Unveiling the background and benefits of nanovaccines tested in clinics.},
journal = {Asian journal of pharmaceutical sciences},
volume = {21},
number = {1},
pages = {101116},
pmid = {41810466},
issn = {2221-285X},
abstract = {Despite the growing body of literature on nanovaccines, focused analyses of platforms tested in and undergoing clinical investigation remain limited. This review addresses this gap by critically examining recent advancements and highlighting nanovaccine technologies that have undergone human clinical trials. Using an extensive search on clinicaltrials.org, we explored the diverse applications of nanovaccines, including leading SARS-CoV-2 candidates and platforms targeting other infectious diseases and cancers. We also highlighted foundational research that has enabled clinical investigation of nanovaccines over the past decade, highlighting their potential to address a range of medical conditions. While many technologies have been developed to combat SARS-CoV-2, several key innovations targeted a broader spectrum of diseases. This review details these technologies, focusing on their materials and mechanisms of action in inducing immune protection, while also exploring how nanomedicine facilitates nanovaccine development and introduces novel adjuvant concepts. Finally, we provided a retrospective analysis of the development journey of these platforms, offering insights into the intellectual and technological efforts behind their clinical translation. By bridging the gap between research and application, this review aims to give readers a comprehensive understanding of how nanovaccines progress from the laboratory to clinical practice.},
}

@article {pmid41810312,
year = {2026},
author = {Lihemo, G and Blunt, M and Dadari, I and Underwood, T and Ochoa Toasa, AE and Velias, A and Hopkins, KL and Thomson, A and Kanwagi, R and Gillespie, A and Pokharel, DR and Singh, S},
title = {The impact of COVID-19 on general vaccine acceptance in low- and middle-income countries: a systematic review.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1764389},
pmid = {41810312},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *Vaccination Hesitancy/psychology/statistics & numerical data ; *Developing Countries ; *COVID-19 Vaccines/administration & dosage ; *Patient Acceptance of Health Care/psychology ; *Vaccination/psychology/statistics & numerical data ; },
abstract = {BACKGROUND: The COVID-19 pandemic caused a major decline in childhood vaccination, especially in low- and middle-income countries (LMICs). However, its specific impact on vaccine hesitancy in the immediate post-pandemic years, particularly toward non-COVID-19 vaccines, remains unclear. Understanding the social and behavioral factors influencing vaccine acceptance following a public health emergency such as the COVID-19 pandemic is critical to improving immunization coverage. This systematic review examined the impact of the COVID-19 pandemic on general vaccine acceptance in LMICs to inform strategies to improve vaccine uptake.

METHODS: This systematic review assessed people's thinking and feeling, motivations, practical issues, and social processes around vaccination, conceptualized by the World Health Organization's Behavioural and Social Drivers framework. Studies were included if they were interventional or observational in design, examined the impact of the COVID-19 pandemic on vaccine hesitancy or acceptance for non-COVID-19 vaccines, and were published in English between 2020 and 2023.

RESULTS: A total of 23 studies were included in the review, with most studies conducted in middle-income settings and focused on healthcare workers or parents/caregivers of children. Findings belonging to the "Thinking and Feeling" category were the most commonly reported in 91% (n = 21/23) of studies. Over half (61%) of studies reported findings relating to the 'Motivation' construct, while 43% of studies reported outcomes related to 'Practical Issues' and 'Social Processes'. Studies reported both increases and decreases in vaccine hesitancy and intention to vaccinate due to the pandemic. Overall, studies most commonly reported that the COVID-19 pandemic had a negative or neutral effect on attitudes, intentions, and actions regarding vaccine acceptance.

CONCLUSION: This systematic review illustrates how the COVID-19 pandemic influenced vaccine acceptance and decision-making in complex, context-dependent ways, impacting people's thinking and feeling, motivations, practical issues, and social processes around vaccination. The findings highlight the need to understand the specific drivers of vaccine acceptance to design more effective, targeted strategies to improve immunization uptake. The insights from this study can be used to inform evidence-based vaccination catch-up strategies to regain pandemic losses and mitigate factors that deter individuals from seeking vaccination.},
}

Humans
*COVID-19/prevention & control/epidemiology
*Vaccination Hesitancy/psychology/statistics & numerical data
*Developing Countries
*COVID-19 Vaccines/administration & dosage
*Patient Acceptance of Health Care/psychology
*Vaccination/psychology/statistics & numerical data

@article {pmid41809895,
year = {2025},
author = {Shi, Y and Sun, K and Hu, Y and Lou, Z and Wang, Y and You, J},
title = {The strategies and advances of mRNA translation booster.},
journal = {Asian journal of pharmaceutical sciences},
volume = {20},
number = {6},
pages = {101090},
pmid = {41809895},
issn = {2221-285X},
abstract = {The therapeutic efficacy and safety of mRNA-based drugs in immunological and nonimmunological applications are critically dependent on the translated protein yield, which requires precise modulation of mRNA expression kinetics. Among the factors influencing mRNA translation, immunogenicity and stability are pivotal in determining the longevity of protein production. Current optimization strategies have integrated (1) molecular engineering (e.g., modified nucleotides), (2) advanced delivery systems (e.g., lipid nanoparticles), and (3) adjuvant drug synergy. This review focuses on co-delivered adjuvant drugs and introduces the concept of "mRNA translation boosters" for the first time. mRNA translation boosters are classified as small-molecule compounds and macromolecular agents that improve translational fidelity through mechanisms including blockade of pattern recognition receptors, modulation of inflammatory cascades, facilitation of endosomal escape, and protection against enzymatic degradation. As clinically validated with COVID-19 mRNA vaccines, these boosters have now demonstrated expanded utility in gene editing therapies and protein replacement applications. This review addresses the immunological challenges encountered during mRNA transfection and translation while summarizing existing mRNA translation boosters that optimize protein expression kinetics. By establishing a mechanistic framework for booster selection and employment, this work provides translational guidance for advancing nucleic acid therapeutics towards their maximum clinical potential.},
}

@article {pmid41809272,
year = {2026},
author = {Zarkadi, A and Katotomichelakis, M and Chaidas, K},
title = {Long-Term Olfactory Dysfunction in COVID-19 Patients: A Systematic Review.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e103143},
pmid = {41809272},
issn = {2168-8184},
abstract = {Olfactory dysfunction (OD) emerged early in the COVID-19 pandemic as a prevalent and often persistent symptom. While most individuals recover within weeks, a significant proportion continue to suffer from long-term impairments, including both quantitative and qualitative sensory deficits. Our review aimed to summarize current evidence on long-term post-COVID-19 OD with a duration of at least three months, including prevalence, recovery trajectory, and prognostic factors. The PubMed and Scopus databases were searched for relevant studies up to August 2024 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-one studies were ultimately included, involving over 4,000 individuals. A remarkable proportion of patients continue to experience persistent dysfunction post-infection for a period ranging from several months to over two years. Qualitative disorders, such as parosmia and phantosmia, frequently appeared during recovery. Prognosis seemed to be related to age, initial severity, duration of OD, co-existing symptoms, and potentially sex. A consistent discrepancy between subjective reports and objective psychophysical test results was observed. Methodological heterogeneity limited comparability across studies. Olfactory dysfunction is a significant and often overlooked long-term complication of COVID-19. Standardized diagnostic criteria, validated outcome measures, and prospective longitudinal research are urgently needed to guide evidence-based management and improve patient outcomes.},
}

@article {pmid41808188,
year = {2026},
author = {Mahon, N and Hays, LMC and Coy, E and Ainscough, K and Burrell, A and Gordon, AC and Rochwerg, B and Wang, CM and Harvey, D and Parekh, D and Goligher, E and Toal, F and Saito, H and Marshall, JC and Stewart, J and Gobat, N and Webb, S and Tolppa, T and McAuley, DF and Nichol, AD},
title = {Views on consent approaches used in emergency and critical care research: a rapid, systematic review.},
journal = {Trials},
volume = {},
number = {},
pages = {},
doi = {10.1186/s13063-026-09592-9},
pmid = {41808188},
issn = {1745-6215},
support = {CTN-2021-010/HRBI_/Health Research Board/Ireland ; DIFA-2023-025/HRBI_/Health Research Board/Ireland ; APRO-2023-017/HRBI_/Health Research Board/Ireland ; NIHR155209//Health Technology Assessment Programme/ ; NIHR154493//Efficacy and Mechanism Evaluation Programme/ ; },
abstract = {BACKGROUND: Obtaining informed consent can be challenging in emergency and critical care research due to the acute and severe nature of the patient's condition. However, such research is urgently needed to inform practice and optimise patient outcomes. While alternative consent approaches have been commonly used, opinions may vary, particularly among diverse and underserved patient groups and in the context of the recent COVID-19 pandemic. The objective of this review was to assess views of alternative consent methods in emergency and critical care research.

METHODS: We conducted a rapid systematic review to understand diverse opinions of alternative consent models used in emergency and critical care research with searches of MEDLINE, EMBASE, PsycINFO, Web of Science and CENTRAL carried out to July 31, 2024. We included quantitative and qualitative studies and summarised findings using narrative synthesis. We specifically investigated underserved groups and consent in the pandemic setting.

RESULTS: From 9974 citations, we screened 289 full-text articles, and included 145 eligible studies from 26 countries. Consent methods included prospective informed consent, deferred consent, surrogate decision maker consent, healthcare professional consent and waived consent. Groups represented included previous trial participants, relatives of trial participants, patients, members of the general public, healthcare providers, researchers, site staff, and research ethics committees. It was recognised that prospective informed consent from the patient is not possible in all scenarios. In general, alternative consent models were acceptable, with emphasis on the inclusion of the patient and relatives in the decision-making process whenever possible. Acceptability of alternative consent models was influenced by previous research participation, experience of critical or emergency illness, perceived risk of participation, and invasiveness of the intervention. Study staff highlighted potential limitations of some alternative consent models, such as unavailability of relatives. Pandemic studies showed an increased need for alternative consent methods, and greater preparedness and engagement with ethics committees to facilitate implementation. Sub-analysis evaluating the views of underserved groups did not show consensus, and accommodations were largely not reported.

CONCLUSION: Alternative consent models used for emergency, critical care and pandemic research including deferred consent, relative/surrogate decision maker consent, and physician consent were generally acceptable.

TRIAL REGISTRATION: PROSPERO CRD42023408305 (April 19, 2023).},
}

@article {pmid41807825,
year = {2026},
author = {Ott, PA},
title = {The promises and challenges of neoantigen cancer vaccines.},
journal = {Nature biotechnology},
volume = {},
number = {},
pages = {},
pmid = {41807825},
issn = {1546-1696},
support = {R01 CA229261/CA/NCI NIH HHS/United States ; },
abstract = {Transformational advances in genomic sequencing capabilities, vastly improved HLA class I epitope prediction algorithms and powerful delivery platforms have facilitated the clinical development of vaccines targeting neoantigens encoded by tumor mutations. Early clinical trials indicate that vaccination against neoantigens can induce robust and durable T cell immunity that may persist for decades. mRNA vaccines, originally developed for cancer applications, have demonstrated considerable promise due to their efficacy and scalable production, as evidenced during the SARS-CoV-2 pandemic. However, the optimal cancer vaccine platform and delivery strategy is not yet known, as current approaches have not been compared head-to-head and substantial technological advances to improve immunogenicity and potentially clinical efficacy are achievable. For example, lipid-based formulations, while necessary for the effective delivery of mRNA vaccines, may also improve the immunogenicity of peptides and other delivery strategies. Here we review the current state of neoantigen vaccines in the clinic and highlight emerging opportunities for advancement in the field.},
}

@article {pmid41806061,
year = {2026},
author = {Moyue, X and Liang, S and Ying, X and Yang, Y and Dongang, Z},
title = {Research progress of nucleocapsid protein of novel coronavirus: structure, function and targeted therapy.},
journal = {Archives of virology},
volume = {171},
number = {4},
pages = {},
pmid = {41806061},
issn = {1432-8798},
support = {National Natural Science Foundation of China//National Natural Science Foundation of China/ ; },
}

@article {pmid41805020,
year = {2026},
author = {Uddin, ME and Asaduzzaman, M and Ahmad, T and Ahmed, S and Kundu, SK and Khan, MMH and Islam, MM and Hossen, MM and Sheikh, MR and Sheikh, MMI},
title = {Vitamin D and Zinc in SARS-CoV-2 Infection: Immunomodulatory Mechanisms and Clinical Evidence.},
journal = {Viral immunology},
volume = {},
number = {},
pages = {8828245261426982},
doi = {10.1177/08828245261426982},
pmid = {41805020},
issn = {1557-8976},
abstract = {The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in approximately 778 million reported cases and over 7 million deaths worldwide as of August 2025 (WHO COVID-19 Dashboard), predominantly due to variable acute and chronic lung infections accompanied by inflammatory responses within the pulmonary tract and vasculature. Despite ongoing research, no definitive cure has been identified. Preventive measures, including vaccines and monoclonal antibody-based interventions, have been developed to protect vulnerable populations, and hundreds of therapeutic candidates have been evaluated worldwide. Complementing these strategies, vitamin D and zinc (Zn) supplementation have emerged as promising, accessible adjunctive strategies due to their immunomodulatory and anti-inflammatory properties. This review synthesizes current experimental, clinical, and epidemiological evidence on the roles of vitamin D and Zn in modulating immune responses relevant to SARS-CoV-2 infection. Available data suggest that adequate vitamin D and Zn status may support immune function, reduce excessive inflammation, and potentially mitigate disease severity, particularly in deficient individuals. However, clinical trial outcomes remain heterogeneous. Overall, vitamin D and Zn supplementation may be considered supportive, adjunctive preventive measures. Further well-designed randomized controlled trials are required to define their optimal use in COVID-19 prevention and management.},
}

@article {pmid41805007,
year = {2026},
author = {Bhattacharjee, M and Bérubé, J and Durand, M and Rousseau, S and Zawati, MH},
title = {The Biobanque Québécoise de la COVID-19: Anticipate to Innovate.},
journal = {Biopreservation and biobanking},
volume = {},
number = {},
pages = {19475535261429759},
doi = {10.1177/19475535261429759},
pmid = {41805007},
issn = {1947-5543},
abstract = {The COVID-19 pandemic underscored the urgent need for strong biobanking infrastructures to facilitate rapid research and innovation in public health emergencies. The COVID-19 Québec Biobank (BQC19), launched in March 2020, serves as a pioneering initiative to address this demand, enabling the collection, storage, and sharing of biological samples and data to advance diagnostics, therapeutics, and epidemiological research. This article examines the development and operational framework of BQC19, highlighting five key themes central to its success. First, BQC19's anticipatory governance model emphasizes adaptability, leveraging strategic foresight to maintain ethical and efficient operations during the pandemic. Second, the initiative's harmonized yet flexible consent processes ensured participant autonomy and compliance with evolving clinical and public health contexts. Third, BQC19's collaborative governance framework facilitated seamless interinstitutional cooperation, supported by standardized operating procedures and localized manuals of procedures. Fourth, streamlined data access mechanisms, managed by an independent data access committee, promoted ethical and equitable data sharing, balancing privacy considerations with research accessibility. Last, BQC19 demonstrates the transferability of its infrastructure to other health challenges, providing a scalable, ethical, and collaborative model for future public health crises. Through centralized data management, preestablished legal agreements, and tiered access protocols, BQC19 has significantly reduced response times and operational inefficiencies. Its achievements showcase the potential of biobanks in fostering global health collaboration, enabling rapid research mobilization, and addressing emerging health threats. BQC19's legacy lies in its ability to integrate innovation, ethics, and collaboration into a sustainable framework for public health preparedness.},
}

@article {pmid41802806,
year = {2026},
author = {Tan, JH and Mainali, P and Zhang, W and Ow, DS},
title = {Armored RNA technology as a clinical diagnostics tool for future pandemic preparedness.},
journal = {Journal of microbiology (Seoul, Korea)},
volume = {64},
number = {2},
pages = {e2510016},
doi = {10.71150/jm.2510016},
pmid = {41802806},
issn = {1976-3794},
support = {//Agency for Science, Technology and Research/ ; M24N8c0107//Young Investigator Research/ ; },
mesh = {Humans ; *COVID-19/diagnosis/virology ; *SARS-CoV-2/genetics/isolation & purification ; *RNA, Viral/genetics ; Pandemics ; *Molecular Diagnostic Techniques/methods ; Nucleic Acid Amplification Techniques/methods ; Pandemic Preparedness ; },
abstract = {The COVID-19 pandemic highlighted the critical role of reliable molecular diagnostics in outbreak response and the vulnerabilities of existing systems to delays and reagent instability. Armored RNA technology, which packages RNA within bacteriophage-derived capsids, offers a robust solution by combining nuclease resistance, safety, and versatility into a single platform. Armored RNA has become a trusted internal and external control for RT-qPCR and RT-LAMP, enabling accurate detection across a wide range of viral pathogens. Also, recent advances in alternative expression systems, such as plant-based and cell-free platforms, as well as the use of more stable scaffolds from bacteriophage Qβ, are enhancing yield, stability, and accessibility of armored RNA. Engineering innovations, including capsid polymorphism and optimized downstream purification, further improve efficiency and broaden possible applications. Looking ahead, armored RNA holds promise not only as a diagnostic standard but also as a delivery vehicle for vaccines and therapeutics. Encapsulation of self-amplifying RNA, small interfering RNA, or microRNA could open new pathways for rapid-response vaccines and targeted therapies, aligning this technology with the future of precision medicine. By uniting stability, scalability, and adaptability, armored RNA represents a critical component of global health preparedness, with the potential to strengthen diagnostic resilience and accelerate biomedical countermeasures in future pandemics.},
}

Humans
*COVID-19/diagnosis/virology
*SARS-CoV-2/genetics/isolation & purification
*RNA, Viral/genetics
Pandemics
*Molecular Diagnostic Techniques/methods
Nucleic Acid Amplification Techniques/methods
Pandemic Preparedness

@article {pmid41802499,
year = {2026},
author = {Sheehan, C and Liu, J and Zhang, P and Wang, H and Chang, A},
title = {Excipients: New opportunities for complex challenges USP's approaches to addressing complex challenges related to excipients.},
journal = {European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V},
volume = {},
number = {},
pages = {115045},
doi = {10.1016/j.ejpb.2026.115045},
pmid = {41802499},
issn = {1873-3441},
abstract = {The quality of excipients is important since they can make up to about 90% of the total mass/volume of the drug product. Traditionally, excipients specifications were established with a focus on quality for intended use in the drug product and less on excipient composition, and physical and chemical properties, however, the increasing demand for high quality excipients used in the development of nanomedicines and novel delivery systems requires higher quality and purity, e.g., use of phospholipids in development of Covid-19 vaccine nanomedicine delivery systems. USP is collaborating with stakeholders to address the lack of standardized test methods for complex/polymeric type excipients (e.g., phospholipids/LG polymers) offering new solutions and help with excipient compositional and variability issues along with associated environmental aspects. By expanding its offerings through its "emerging standards" new model for stakeholder engagement, USP is more flexible in its solutions offerings that favor earlier interaction in the genesis of quality standards in a more iterative way. This publication will provide an overview of evolving compendial approaches (e.g., standalone chapters) and expanded solutions and offerings (use of analytical reference materials (ARMS), associated application (App) notes, and technical guides).},
}

@article {pmid41800523,
year = {2026},
author = {Esposito, N and Buonomo, AR and Di Filippo, I and Forte, E and Trucillo, E and Gentile, I and Schiano Moriello, N},
title = {Lessons from examining the safety of drugs for COVID-19 during pregnancy.},
journal = {Expert opinion on drug safety},
volume = {},
number = {},
pages = {},
doi = {10.1080/14740338.2026.2637649},
pmid = {41800523},
issn = {1744-764X},
abstract = {INTRODUCTION: Pregnant women represent a vulnerable population during the COVID-19 pandemic, facing increased risks of severe disease and adverse obstetric outcomes, yet they have been largely excluded from pivotal therapeutic clinical trials, leaving a critical evidence gap for treatment decisions.

AREAS COVERED: This review examines the available evidence on the safety and efficacy of COVID-19 therapies during pregnancy, including oral antivirals (nirmatrelvir/ritonavir, molnupiravir), intravenous remdesivir, monoclonal antibodies, corticosteroids, and immunomodulators (tocilizumab, baricitinib). A literature search was conducted using MEDLINE/PubMed for English-language articles published from March 2020 to December 2023, including studies of any design reporting maternal and neonatal outcomes.

EXPERT OPINION: The COVID-19 pandemic exposed a critical gap in clinical research through the systematic exclusion of pregnant women from therapeutic trials. Current evidence, though largely observational, supports vaccination as the primary preventive strategy, nirmatrelvir/ritonavir for outpatients at risk of progression, and remdesivir plus corticosteroids for hospitalized patients requiring oxygen supplementation.},
}

@article {pmid41799482,
year = {2026},
author = {Leon-Rojas, JE},
title = {Tele-neurology in Latin America: digital solutions for a treatment gap.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1779415},
pmid = {41799482},
issn = {2296-2565},
mesh = {Humans ; *Telemedicine/organization & administration ; Latin America ; COVID-19/epidemiology ; *Neurology/methods/organization & administration ; *Health Services Accessibility ; *Nervous System Diseases/therapy ; SARS-CoV-2 ; Ecuador ; },
abstract = {Neurological disorders remain a leading cause of disability across Latin America, yet access to specialist care is affected by important workforce shortages, geographic disparities, and under-resourced health systems. Tele-neurology has emerged as a promising strategy to mitigate these barriers, particularly in the wake of the COVID-19 pandemic, which resulted in rapid digital health adoption. This review article examines the development and implementation of tele-neurology initiatives across Latin America, with a focus on Ecuador; drawing on examples such as TeleEEG, telestroke networks, and Project ECHO, I illustrate how digital tools have expanded the reach of neurological services in underserved regions. Despite demonstrable benefits, challenges persist, including uneven digital infrastructure, regulatory gaps, and disparities in access. I argue that tele-neurology must be deliberately integrated into national public health strategies, not merely as a pandemic contingency but as a potential long-term solution for health equity, if done properly. Strategic investments in broadband access, clinician training, sustainable financing, and regional collaboration are essential to scale these innovations. When anchored in strong policy frameworks and aligned with global neurological health goals, tele-neurology could offer a path toward closing the treatment gap and advancing equitable neurological care throughout Latin America.},
}

Humans
*Telemedicine/organization & administration
Latin America
COVID-19/epidemiology
*Neurology/methods/organization & administration
*Health Services Accessibility
*Nervous System Diseases/therapy
SARS-CoV-2
Ecuador

@article {pmid41799381,
year = {2026},
author = {Raheel, H and Ferguson, A and Leslie, SL and Guardado-Menjivar, V and Chen, K and Merceron, A and Arciniegas, J and Lovvorn, AE and Higgins, M and Barr, DB and Saikawa, E and Handley, MA and Thompson, LM},
title = {Behavioral interventions related to plastic waste management in low-and middle-income countries: a systematic review using the behavior change wheel and the theoretical domains framework.},
journal = {Environmental research letters : ERL [Web site]},
volume = {21},
number = {5},
pages = {053003},
pmid = {41799381},
issn = {1748-9326},
abstract = {Addressing the mounting plastic waste problem requires system-level solutions, along with interventions that promote behavioral change. In low-resource countries, inadequate, if not absent, waste management systems lead to unsafe disposal practices, including open burning. While theory-informed approaches are essential for identifying enablers and barriers to target behavior change, their application is limited in these settings. Given the lack of a theory-driven synthesis of behavioral strategies to address plastic waste, this systematic review aimed to: (1) synthesize behavioral interventions related to plastic waste management in low-resource countries; (2) map these interventions to the behavior change wheel (BCW), using the capability-opportunity-motivation-behavior model, and the theoretical domains framework (TDF); and (3) classify implementation strategies to inform theory-driven intervention design. This review is the first to use the BCW to examine behavioral interventions related to plastic waste management in low-resource countries. Nine bibliographic databases: APA PsycInfo, CINAHL, Embase, Environment Complete, Global Health, GreenFile, Health Source: Nursing Academic, PubMed, and Web of Science Core Collection were searched. We included English-language human studies up to 9 April 2025, that evaluated interventions or policies targeting individual- or community-level behaviors related to plastic waste management in low-, lower-middle, or upper-middle income countries. We excluded studies from high-income countries, and those focused on environmental impacts, industrial or municipal waste streams, ecosystems or animals without human behavioral components, COVID-19-specific waste, or hypothetical modeling without real-life interventions. Forty-three studies met the inclusion criteria. Study quality was assessed using the mixed methods appraisal Tool. Interventions spanned 27 low-resource countries and targeted diverse populations, including schoolchildren, households, market vendors, and community organizations. Education was the most frequent BCW intervention function (76.7%), followed by environmental restructuring, incentivization, persuasion, and training. Mapping revealed that behavioral interventions relied most frequently on the TDF domains of environmental context, knowledge, skills, and social influences. Some domains, such as beliefs about capabilities, reinforcement, and identity, received moderate attention, while appealing to emotion or the use of behavioral regulation, were underutilized. Behavioral interventions for plastic waste management in low-resource countries have predominantly emphasized awareness-raising but insufficiently leveraged other BCW intervention functions and TDF domains. Integration of motivational, emotional, and identity-based strategies alongside structural support can enhance the sustainability of behavior change.},
}

@article {pmid41798883,
year = {2026},
author = {Timpka, T and Gursky, EA and Nyce, JM},
title = {Making US public health a good idea again.},
journal = {Lancet regional health. Americas},
volume = {57},
number = {},
pages = {101423},
pmid = {41798883},
issn = {2667-193X},
abstract = {The stress test the COVID-19 pandemic imposed on the US public health system illuminated predictable yet surprisingly unplanned for fault lines. A perceived lack of choice associated with nonpharmaceutical and pharmaceutical interventions led many Americans to question both measures and processes for mitigating disease consequences, such as masking and mass vaccination. A cultural-historical examination shows that a central impediment for US efforts to control the pandemic was the limited sense of common good. Many factors and beliefs, including also that the scientific-biotechnological innovation system did not serve the interests of all people equally, and the public health community's equating disease with how people perceived illness, weakened vaccination acceptance and disease control efforts. We conclude that US public health must renegotiate the social contract with the American people to recover a shared understanding of its relevance and to effectively respond to future health challenges and pandemics.},
}

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

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

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

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

Humans
*Clozapine/adverse effects/therapeutic use
*COVID-19/epidemiology
*Antipsychotic Agents/adverse effects/therapeutic use
Retrospective Studies
*Schizophrenia, Treatment-Resistant/drug therapy
Longitudinal Studies
Male
Adult
Female

@article {pmid41652425,
year = {2026},
author = {Halder, P and Khaiwal, R and Goel, S and Kumar, N and Sarkar, M and Soni, M and Nongkynrih, B and Prabhakar, MC and Mamgai, A and Rathor, S},
title = {Burden of chronic obstructive pulmonary disease among Indian adults: systematic review and meta‑analysis.},
journal = {BMC pulmonary medicine},
volume = {26},
number = {1},
pages = {},
pmid = {41652425},
issn = {1471-2466},
abstract = {BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a long-standing respiratory illness marked by ongoing airflow obstruction and inflammation. It continues to be a major contributor to global disease, and death, with low- and middle-income countries (LMICs) experiencing a disproportionate impact. India, as one of the largest LMICs, plays a significant role in global COPD-related mortality and disability-adjusted life years (DALYs). In India, COPD continues to be underrecognized owing to limited spirometry availability, inconsistent diagnostic approaches, and weak surveillance systems. Previous prevalence estimates are both outdated and methodologically inconsistent, while the COVID-19 pandemic may have further shifted disease trends. This systematic review and meta-analysis seeks to bridge these gaps by delivering current, standardized, and comprehensive prevalence data.

OBJECTIVE: To estimate the pooled prevalence of spirometry-confirmed COPD among Indian adults and identify key demographic and environmental correlates through a systematic review and meta-analysis of observational studies.

METHODS: This systematic review and meta-analysis aimed to determine the prevalence of spirometry-confirmed COPD among Indian adults. The study was registered in PROSPERO (CRD420251140678) and conducted in accordance with PRISMA guidelines. Literature searches were carried out in PubMed, EMBASE, Scopus, and Web of Science up to June 9, 2025, using relevant MeSH terms and keywords on COPD, prevalence, and India. Eligible studies included observational designs reporting spirometry-based COPD prevalence in adults; studies relying on non-spirometry diagnosis, qualitative designs, interventions, or non-English publications were excluded. Three reviewers independently screened records, extracted study and population data, and evaluated methodological quality using the Joanna Briggs Institute (JBI) checklist. Pooled prevalence was calculated using a random-effects model. Heterogeneity was assessed with I[2] and Cochran’s Q, complemented by Baujat and Galbraith plots. Subgroup and sensitivity analyses examined variations by diagnostic criteria, demographics, and exposures, while publication bias was tested using funnel plots, Egger’s and Begg’s methods, and trim-and-fill analysis.

RESULTS: Twenty-three studies comprising 27,319 Indian adults were included. The pooled prevalence of COPD was 13% (95% CI: 9%–18%), with substantial heterogeneity (I[2] = 99.8%). Higher prevalence was observed among smokers (37%), elderly adults (≥ 60 years: 27%), males (16%), and biomass fuel users (8%). Studies using GOLD criteria reported a higher prevalence (15%) than those using FEV₁/FVC < LLN (10%). Hospital-based studies showed a greater prevalence (27%) than community-based ones (12%). Regional variation was notable, with North India reporting the highest prevalence (19%) and West India the lowest (7%). Sensitivity analyses confirmed the robustness of findings; publication bias was minimal and did not significantly affect pooled estimates.

CONCLUSION: COPD remains a significant and underrecognized public health challenge in India. As all included studies were appraised as good quality using the JBI tool, the evidence base is strong and supports reliable pooled estimates. Therefore, our conclusions emphasize the importance of routine spirometry-based screening, targeted interventions for high-risk groups, and integration of COPD surveillance into India’s NCD framework, while reinforcing gender-sensitive strategies and clean fuel initiatives as evidence-based measures to reduce disease burden and guide policy planning.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-026-04134-0.},
}

@article {pmid37620009,
year = {2023},
author = {Bevilacqua, L and Fox-Smith, L and Lewins, A and Jetha, P and Sideri, A and Barton, G and Meiser-Stedman, R and Beazley, P},
title = {Impact of COVID-19 on the mental health of children and young people: an umbrella review.},
journal = {Journal of epidemiology and community health},
volume = {77},
number = {11},
pages = {704-709},
doi = {10.1136/jech-2022-220259},
pmid = {37620009},
issn = {1470-2738},
mesh = {Humans ; *COVID-19/psychology/epidemiology ; Child ; Adolescent ; *Mental Health ; *Mental Disorders/epidemiology ; Female ; SARS-CoV-2 ; Male ; Pandemics ; },
abstract = {BACKGROUND: Over the past 3 years, a multitude of studies have highlighted the impact of the COVID-19 pandemic on the mental health of children and young people (CYP). In this umbrella review, we synthesise global evidence on the impact of COVID-19 on the mental health of CYP from existing systematic reviews with and/or without meta-analysis.

METHODS: Adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we evaluated 349 citations and identified 24 eligible reviews with medium to high methodological quality to be reviewed narratively.

RESULTS: Most of the reviews reported a high prevalence of anxiety disorders, depression, suicidal behaviour, eating disorders and other mental health problems. Most studies that used data at multiple time points indicate a significant increase in mental health problems in CYP, particularly in females and older adolescents.

CONCLUSIONS: Multipronged psychosocial care services, policies and programmes are needed to alleviate the burden of mental health problems in CYP as a consequence of the COVID-19 pandemic and associated global health measures.

PROSPERO REGISTRATION NUMBER: CRD42021276312.},
}

Humans
*COVID-19/psychology/epidemiology
Child
Adolescent
*Mental Health
*Mental Disorders/epidemiology
Female
SARS-CoV-2
Male
Pandemics

@article {pmid41798665,
year = {2026},
author = {Maruyama, T and Hieda, M and Fukata, M},
title = {Current Trends and Future Perspectives of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Narrative Review.},
journal = {Cureus},
volume = {18},
number = {3},
pages = {e104731},
pmid = {41798665},
issn = {2168-8184},
abstract = {BRASH syndrome is defined as a clinical condition in which bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia interact to form a self-perpetuating negative spiral. Geriatric practitioners are increasingly likely to encounter elderly patients with this syndrome who are taking AV nodal blocking agents, such as calcium channel blockers (CCBs) or β-blockers. However, it remains unclear how the heart failure (HF) pandemic and coronavirus disease 2019 (COVID-19) have influenced the incidence, triggers, management, and clinical course of BRASH syndrome. Therefore, open-access databases were searched for publications from 1980 to 2025, identifying 41 eligible articles reporting a total of 54 patients with BRASH syndrome. The mean age of affected patients was 69.0 ± 15.1 years. Hypertension (HTN, 74%), chronic kidney disease (CKD, 61%), and diabetes (54%) were the most common comorbidities. More than half of the patients (52%) were prescribed angiotensin-suppressing agents (angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), or angiotensin receptor-neprilysin inhibitors (ARNI)) for HTN or HF. Two elderly patients were diagnosed with BRASH syndrome triggered by COVID-19. This literature review clarifies that BRASH syndrome commonly occurs in elderly patients with HTN or CKD and is often associated with everyday clinical events such as anorexia, vomiting, diarrhea, bleeding, and infection, including COVID-19. Our database search supports recognizing BRASH syndrome as an important clinical entity in geriatric emergency medicine. Geriatric practitioners should be aware of this condition to enable early diagnosis and appropriate management in the modern HF and post-COVID-19 era.},
}

@article {pmid41798556,
year = {2026},
author = {Armstrong, JL and Bennis, S and Smock, JN and Kesselman, MM},
title = {Teledermatology for Older Adults With a Focus on Nursing Home Residents: A Scoping Review of Clinical and System-Level Benefits.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e102891},
pmid = {41798556},
issn = {2168-8184},
abstract = {Teledermatology (TD), which involves providing dermatology services, including diagnosis and management, remotely, has grown as a result of the COVID-19 pandemic, becoming a critical tool for delivering dermatologic care, especially to aging populations. Specifically, for nursing home residents who often face mobility and cognitive limitations, multimorbidity, and an increased risk of complications, TD may allow for earlier diagnoses, improved access to care and quality of life, and timely management. A scoping review of studies published between 2015 and 2025 was conducted to evaluate clinical and system-level outcomes. A comprehensive search was conducted by three independent researchers using multiple databases, including Ovid MEDLINE, EMBASE, and Web of Science. To analyze the most common dermatologic diagnoses in nursing homes, the inclusion criteria included geriatric patients (>60 years old), nursing home patients, and studies published in English between 2015 and 2025. For analyzing the overall benefits of using TD, the inclusion criteria were identical except that dermatology patients of any age were eligible. Exclusion criteria for analyzing the most common dermatologic diagnoses in nursing homes and the benefits of using TD included articles that were older than 15 years and case reports. Overall, this review will provide a comprehensive analysis of the benefits of using TD as a diagnostic and management tool for dermatologic conditions in the elderly nursing home setting.},
}

@article {pmid41798405,
year = {2026},
author = {Singh, G and Hartnett, R and Silva, BM and Fekrat, SMM and Prasad, S and Gill, G and Gunturu, S},
title = {Comparison of Antipsychotics in the Treatment of COVID-19-Induced First-Episode Psychosis: A Review of Case Studies.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e103021},
pmid = {41798405},
issn = {2168-8184},
abstract = {This study aims to systematically review COVID-19-associated first-episode psychosis cases, comparing antipsychotic selection, dosing strategies, treatment response timelines, adverse effects, and relapse rates to inform evidence-based pharmacological management. We conducted a structured narrative review of published case reports and series describing COVID-19-Induced first-episode psychosis treated with antipsychotics. A comprehensive search of PubMed and Google Scholar (Jan 2020-Apr 2023) identified 42 eligible cases based on predefined inclusion/exclusion criteria. Data were extracted using a standardized template and summarized descriptively due to clinical heterogeneity. Variables included demographics, psychiatric features, antipsychotic(s) used, clinical course, and outcomes. First-episode psychosis (FEP) was higher in males (24, 57.1%) and the 30-39 age group (10, 23.8%). Olanzapine was the most commonly used single antipsychotic (6, 28.6%), while the combination of haloperidol and aripiprazole was the most frequently used antipsychotic regimen (4, 19.0%). Atypical antipsychotics were preferred (54.8%), with olanzapine (23, 54.8%) being the most commonly used at a mean dose of 10.9 mg/day. Reported side effects included fatigue, weight gain, akathisia, leukocytosis, and QT-interval prolongation (5, 11.9%), with a relapse rate of (2, 4.8%). This review evaluates the treatment methods for COVID-19 FEP and develops a deeper understanding of various antipsychotics used in managing psychosis and its outcomes.},
}

@article {pmid41798379,
year = {2025},
author = {Newnham, A and Tattersall, T and Odendaal, J},
title = {Do Medical Schools Need to Adapt Their Curriculum in Order to Teach Medical Students 'Webside' Manner? A Systematic Review.},
journal = {Medical science educator},
volume = {35},
number = {6},
pages = {3173-3183},
pmid = {41798379},
issn = {2156-8650},
abstract = {BACKGROUND: Remote consulting was exponentially implemented secondary to the COVID-19 pandemic, and remains a staple of modern healthcare. Telemedicine consulting requires a different set of consultation skills collectively coined 'webside manner'. Evidence suggests inadequate training is a barrier to effective teleconsulting. This review aims to systematically assess the effect of telemedicine consultation skills training for medical students.

METHODS: A systematic literature search was conducted using MEDLINE, PsycINFO, and EMBASE. Two independent reviewers screened articles from 1 January 2010 onwards. A mixed-methods approach was undertaken. Thematic analysis identified three reporting themes. Quantitative data was reported within these themes using descriptive statistics. Study quality was assessed using the MERSQI score.

FINDINGS: In total, 241 articles were obtained, 38 extracted for full text review, and 11 included. Three themes were identified: communication skills, doctor-patient relationship, and confidence in performing virtual consultations. Six out of seven studies reported improved communication skills following telemedicine training. Three studies report a positive impact on the doctor-patient relationship. Student confidence showed improvement in all reporting studies.

CONCLUSION: This review demonstrates a positive association between telemedicine training and improved virtual consultation skills for medical students. The results are limited by the low quality and heterogeneity of included studies.},
}

@article {pmid41798257,
year = {2026},
author = {Liu, J and Wu, X},
title = {Fecal microbiota transplantation in ulcerative colitis: evidence, mechanisms, and practice considerations.},
journal = {Therapeutic advances in gastroenterology},
volume = {19},
number = {},
pages = {17562848261426284},
pmid = {41798257},
issn = {1756-283X},
abstract = {Ulcerative colitis (UC) is a chronic inflammatory bowel disease strongly associated with intestinal dysbiosis, reduced microbial diversity, and disrupted microbial metabolite profiles. Fecal microbiota transplantation (FMT) aims to restore microbial homeostasis and has shown a signal of benefit for induction of remission in some trials, but results are heterogeneous and long-term maintenance efficacy remains uncertain. In this narrative review, we synthesize randomized controlled trials (RCTs), systematic reviews/meta-analyses, and recent guideline and regulatory updates on FMT in UC, and integrate mechanistic insights from microbiome and metabolomics research. Across RCTs, intensive lower-gastrointestinal regimens using pooled, multidonor material, and/or anaerobic processing have most consistently achieved modestly higher steroid-free clinical and endoscopic remission than placebo in mild-to-moderate UC (approximately 25%-32% vs 5%-10% in representative studies), whereas upper-gastrointestinal delivery or oral lyophilized formulations and highly restrictive donor selection have yielded mixed or negative results. Mechanistically, responders commonly demonstrate engraftment of short-chain fatty acid producing taxa and restoration of secondary bile acid pathways. Safety profiles in trials are generally comparable to placebo for common mild adverse events, but rare severe transmissions (e.g., multidrug-resistant Escherichia coli and SARS-CoV-2) have driven stricter donor screening and have limited routine use outside regulated programs. Current guidelines recommend against FMT for UC outside clinical trials. Future work should prioritize standardized protocols, biomarker-guided personalization, combination strategies (diet/priming), and development of defined microbial therapeutics to improve efficacy and safety.},
}

@article {pmid41797310,
year = {2026},
author = {Campbell, LA and Canales, MK and Spiser, K and Lopez, T and Mattimoe, G},
title = {Building Community Trust: A Rural Health Department's Journey Toward Health Equity.},
journal = {Public health nursing (Boston, Mass.)},
volume = {},
number = {},
pages = {},
doi = {10.1111/phn.70104},
pmid = {41797310},
issn = {1525-1446},
abstract = {BACKGROUND: Rural health departments face unique challenges in advancing health equity, particularly during times of political polarization. These challenges intensified during the COVID-19 pandemic, highlighting the complex interplay between public health authorities, political dynamics, and community trust.

OBJECTIVE: To document how a rural local county health department (LCHD) navigated political barriers and systemic inequities to conduct a community health assessment (CHA) during and after the COVID pandemic.

APPROACH: This CHA, conducted during 2021-2023, employed mixed methods data collection strategies: a bilingual community survey, listening sessions in English and Spanish, and informal interviews. Utilizing a health equity lens, the analysis focused on identifying power dynamics, systemic barriers, and community perspectives on health.

RESULTS: Survey data revealed differences between Hispanic and non-Hispanic respondents' health concerns and perceived barriers. Healthcare access was the only statistically significant barrier for Hispanic respondents. Lessons learned from the CHA process are provided.

CONCLUSION: The strategies employed during the CHA demonstrate how rural health departments can advance health equity while navigating complex political landscapes. Success requires careful attention to language, strategic coalition building, and persistent focus on elevating marginalized voices. The LCHD built community trust despite political resistance by modifying language around equity issues and strategic coalitions.},
}

@article {pmid41796915,
year = {2026},
author = {Lasagna, A and Del Re, M and Danesi, R and Andreoni, M and Tessitore, D and Di Maio, M and Silvestris, N and Pedrazzoli, P},
title = {Bispecific antibodies in solid tumors: An Italian Association of Medical Oncology (AIOM) multidisciplinary perspective on immunology and vaccination.},
journal = {Critical reviews in oncology/hematology},
volume = {221},
number = {},
pages = {105253},
doi = {10.1016/j.critrevonc.2026.105253},
pmid = {41796915},
issn = {1879-0461},
abstract = {The clinical use of bispecific antibodies (BsAbs) in solid tumors is rapidly expanding, yet evidence-based guidance on infection prevention and vaccination in this setting remains limited. We performed a critical narrative review integrating immunological mechanisms, available clinical data, and multidisciplinary expert opinion to inform vaccination strategies for patients with solid tumours treated with BsAbs. BsAbs can induce transient or sustained immune perturbations, including T-cell hyperactivation, lymphocyte redistribution, functional exhaustion, cytokine-mediated immune dysregulation, and, in selected contexts, B-cell impairment. These effects may reduce vaccine-induced humoral and cellular responses and increase vulnerability to infectious complications. Optimization of vaccination status before BsAb initiation is therefore advisable, as pre-treatment immunisation is more likely to achieve effective immune priming. Inactivated vaccines, including influenza, pneumococcal, SARS-CoV-2, hepatitis B (HBV), and recombinant herpes zoster vaccines, can be administered before or, when necessary, during therapy, whereas live attenuated vaccines should be avoided during active treatment. Vaccination timing during BsAb therapy should be individualised, taking into account the treatment schedule and immune recovery. Current recommendations rely largely on indirect evidence from haematological malignancies and other T-cell redirecting therapies. These considerations are essential to support treatment continuity, reduce preventable morbidity, and guide future prospective studies in patients with solid tumors treated with BsAbs.},
}

@article {pmid41796425,
year = {2026},
author = {Peñaherrera-Vásquez, D and Reina, A and Merlo, F and Fajardo-Loaiza, T and Zambrano-Sánchez, G and Rivadeneira, J and Fuenmayor-González, L},
title = {Unveiling the genitourinary phenotype of long COVID: a systematic review and meta-analysis.},
journal = {International urology and nephrology},
volume = {},
number = {},
pages = {},
pmid = {41796425},
issn = {1573-2584},
abstract = {IMPORTANCE: Long COVID has been associated with persistent multisystemic manifestations. However, genitourinary alterations have not been formally recognized as a distinct phenotype despite growing reports suggesting their relevance for long-term morbidity and quality of life.

OBJECTIVES: To determine the frequency and characteristics of genitourinary manifestations in patients with long COVID and to evaluate the evidence supporting the possible emergence of a genitourinary phenotype within long COVID.

DATA SOURCES: For this Systematic review and meta-analysis, a comprehensive search was conducted in PubMed (MEDLINE), Scopus, Web of Science, Embase, SciELO, and Bireme-BvS from inception to October 2025, without language or publication date restrictions. Observational studies (cross-sectional, cohort, or case-control) assessing individuals with one or more genitourinary symptoms-such as menstrual alterations, erectile dysfunction, urinary tract symptoms, or renal function decline-persisting ≥ 12 weeks after SARS-CoV-2 infection were included. Studies addressing only acute-phase manifestations, vaccine-related effects, or pre-existing genitourinary conditions were excluded.

DATA EXTRACTION AND SYNTHESIS: Data extraction was performed independently by two reviewers following PRISMA guidelines. Risk of bias (RoB) was assessed using the Joanna Briggs Institute checklist for prevalence studies. A random-effects meta-analysis using the Freeman-Tukey double arcsine transformation was applied to estimate pooled proportions, and heterogeneity was quantified using the I[2] statistic, Cochran's Q test, and the between-study variance (τ[2]).

MAIN OUTCOMES AND MEASURES: The primary outcomes were the pooled frequencies of genitourinary manifestations in long COVID, including menstrual disorders, erectile dysfunction, and renal function decline.

RESULTS: Nine primary studies encompassing 2332 participants from eight countries were included. Most studies (88.9%) presented a low RoB. The pooled frequency of menstrual disorders was 49% (95% CI 24-74), erectile dysfunction 21% (95% CI 16-28), and renal function decline 29% (95% CI 20-39).

CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis provide evidence supporting the possible emergence of a genitourinary phenotype of long COVID, encompassing menstrual irregularities, erectile dysfunction, cystitis-like symptoms, and renal impairment. Recognition of this potential phenotype is crucial for improving diagnostic accuracy, patient follow-up, and multidisciplinary management. Further high-quality studies are warranted to elucidate the underlying mechanisms and long-term clinical implications.},
}

@article {pmid37777609,
year = {2023},
author = {Haward, MF and Lucena, MH and Fuloria, M},
title = {Research Ethics in Pregnancy: The Maternal-Fetal Dyad.},
journal = {NeoReviews},
volume = {24},
number = {10},
pages = {e607-e615},
doi = {10.1542/neo.24-10-e607},
pmid = {37777609},
issn = {1526-9906},
mesh = {Humans ; Female ; Pregnancy ; COVID-19 ; *Ethics, Research ; *Pregnant People/psychology ; *Maternal-Fetal Relations ; Personal Autonomy ; },
abstract = {Pregnant persons and their physicians often make decisions for health care without clinical evidence to guide their choices. Years of exclusionary practices in research, dominated by fears of fetal harm, have resulted in limited evidence on therapies for pregnancy-specific conditions. It has also eroded pregnant persons' rights as autonomous individuals capable of weighing risks and benefits to make choices for themselves and their infants based on sound evidence. A paradigm shift from "routine exclusion" to "fair inclusion" of pregnant persons in clinical trials is needed to ensure that ethical principles are upheld when undertaking research in this population. This article will provide a brief review of the historical aspects of clinical research ethics for pregnant persons, focus on some key concepts within the context of the maternal-fetal dyad, and include a recent example from the coronavirus disease 2019 (COVID-19) pandemic to understand how society has interpreted tensions among the ethical principles of justice, beneficence, nonmaleficence, and autonomy. Note: This review uses the term "pregnant person(s)" to include women and people who are pregnant and do not identify themselves as women.},
}

Humans
Female
Pregnancy
COVID-19
*Ethics, Research
*Pregnant People/psychology
*Maternal-Fetal Relations
Personal Autonomy

@article {pmid37763662,
year = {2023},
author = {Lin, CS and Chang, CH},
title = {Disseminated Herpes Zoster Following Protein Subunit and mRNA COVID-19 Vaccination in Immunocompetent Patients: Report of Two Cases and Literature Review.},
journal = {Medicina (Kaunas, Lithuania)},
volume = {59},
number = {9},
pages = {},
pmid = {37763662},
issn = {1648-9144},
mesh = {Humans ; Male ; *Herpes Zoster/etiology/drug therapy/diagnosis ; Aged ; Middle Aged ; *COVID-19 Vaccines/adverse effects ; 2019-nCoV Vaccine mRNA-1273/adverse effects ; *COVID-19/prevention & control ; Immunocompetence ; Vaccines, Subunit/adverse effects ; Vaccination/adverse effects ; },
abstract = {Disseminated herpes zoster (DHZ), resulting from the reactivation of the varicella-zoster virus (VZV), typically occurs in immunocompromised persons. To date, only four cases of DHZ following mRNA, viral vector, or inactivated COVID-19 vaccinations have been reported in immunocompetent patients. Herein, we present the first case of DHZ following the protein subunit COVID-19 vaccination (case 1, 64 years old) and a case of DHZ following mRNA COVID-19 vaccination (case 2, 67 years old) in elderly, immunocompetent male patients. Both cases were generally healthy, without a remarkable underlying disease and without a history of immunosuppressant use. Case 1 developed DHZ (left C3-5 predominant) 1 month after receiving the third dose of the SARS-CoV-2 spike protein vaccine (MVC-COV1901). Case 2 developed DHZ (right V1-3 predominant) 7 days after receiving the second dose of the mRNA-1273 SARS-CoV-2 vaccine. Through skin examination, Tzanck smears, and dermoscopy, the diagnosis of COVID-19 vaccination-related DHZ was established in both cases. Oral famciclovir (250 mg, three times/day for 7 days) was administered, and both cases achieved total remission of skin lesions without visceral involvement or severe post-herpetic neuralgia. Our cases demonstrate that DHZ, as a rare cutaneous adverse event in immunocompetent patients, can be secondary not only to mRNA COVID-19 vaccination but also to the protein subunit COVID-19 vaccination. It is speculated that the spike protein of SARS-CoV-2 could be the common trigger for the reactivation of VZV among different types of vaccinations.},
}

Humans
Male
*Herpes Zoster/etiology/drug therapy/diagnosis
Aged
Middle Aged
*COVID-19 Vaccines/adverse effects
2019-nCoV Vaccine mRNA-1273/adverse effects
*COVID-19/prevention & control
Immunocompetence
Vaccines, Subunit/adverse effects
Vaccination/adverse effects

@article {pmid37755074,
year = {2023},
author = {Liyanage, NM and Nagahawatta, DP and Jayawardena, TU and Sanjeewa, KKA and Jayawrdhana, HHACK and Kim, JI and Jeon, YJ},
title = {Sulfated Polysaccharides from Seaweeds: A Promising Strategy for Combatting Viral Diseases-A Review.},
journal = {Marine drugs},
volume = {21},
number = {9},
pages = {},
pmid = {37755074},
issn = {1660-3397},
mesh = {*Seaweed/chemistry ; *Polysaccharides/chemistry/isolation & purification/pharmacology ; Humans ; Animals ; *Sulfuric Acid Esters/chemistry/isolation & purification/pharmacology ; *Antiviral Agents/isolation & purification/pharmacology ; SARS-CoV-2/drug effects ; },
abstract = {The limited availability of treatments for many infectious diseases highlights the need for new treatments, particularly for viral infections. Natural compounds from seaweed are attracting increasing attention for the treatment of various viral diseases, and thousands of novel compounds have been isolated for the development of pharmaceutical products. Seaweed is a rich source of natural bioactive compounds, including polysaccharides. The discovery of algal polysaccharides with antiviral activity has significantly increased in the past few decades. Furthermore, unique polysaccharides isolated from seaweeds, such as carrageenan, alginates, fucoidans, galactans, laminarians, and ulvans, have been shown to act against viral infections. The antiviral mechanisms of these agents are based on their inhibition of DNA or RNA synthesis, viral entry, and viral replication. In this article, we review and provide an inclusive description of the antiviral activities of algal polysaccharides. Additionally, we discuss the challenges and opportunities for developing polysaccharide-based antiviral therapies, including issues related to drug delivery and formulation. Finally, this review highlights the need for further research for fully understanding the potential of seaweed polysaccharides as a source of antiviral agents and for developing effective treatments for viral diseases.},
}

*Seaweed/chemistry
*Polysaccharides/chemistry/isolation & purification/pharmacology
Humans
Animals
*Sulfuric Acid Esters/chemistry/isolation & purification/pharmacology
*Antiviral Agents/isolation & purification/pharmacology
SARS-CoV-2/drug effects

@article {pmid37691280,
year = {2023},
author = {Kyriazopoulou, E and Giamarellos-Bourboulis, EJ and Akinosoglou, K},
title = {Biomarkers to guide immunomodulatory treatment: where do we stand?.},
journal = {Expert review of molecular diagnostics},
volume = {23},
number = {11},
pages = {945-958},
doi = {10.1080/14737159.2023.2258063},
pmid = {37691280},
issn = {1744-8352},
mesh = {Humans ; *Biomarkers ; *Immunotherapy/methods ; COVID-19/immunology/therapy ; *Neoplasms/therapy/immunology ; *Immunomodulation ; Precision Medicine/methods ; Critical Illness/therapy ; SARS-CoV-2 ; },
abstract = {INTRODUCTION: This review summarizes current progress in the development of biomarkers to guide immunotherapy in oncology, rheumatology, and critical illness.

AREAS COVERED: An extensive literature search was performed about biomarkers classifying patients' immune responses to guide immunotherapy in oncology, rheumatology, and critical illness. Surface markers, such as programmed death-ligand 1 (PD-L1), genetic biomarkers, such as tumor mutation load, and circulating tumor DNA are biomarkers associated with the effectiveness of immunotherapy in oncology. Genomics, metabolomics, and proteomics play a crucial role in selecting the most suitable therapeutic options for rheumatologic patients. Phenotypes and endotypes are a promising approach to detect critically ill patients with hyper- or hypo-inflammation. Sepsis trials using biomarkers such as ferritin, lymphopenia, HLA-DR expression on monocytes and PD-L1 to guide immunotherapy have been already conducted or are currently ongoing. Immunotherapy in COVID-19 pneumonia, guided by C-reactive protein and soluble urokinase plasminogen activator receptor (suPAR) has improved patient outcomes globally. More research is needed into immunotherapy in other critical conditions.

EXPERT OPINION: Targeted immunotherapy has improved outcomes in oncology and rheumatology, paving the way for precision medicine in the critically ill. Transcriptomics will play a crucial role in detecting the most suitable candidates for immunomodulation.},
}

Humans
*Biomarkers
*Immunotherapy/methods
COVID-19/immunology/therapy
*Neoplasms/therapy/immunology
*Immunomodulation
Precision Medicine/methods
Critical Illness/therapy
SARS-CoV-2

@article {pmid37670699,
year = {2023},
author = {Mohtasham, N and Bargi, R and Farshbaf, A and Shahri, MV and Hesari, KK and Mohajertehran, F},
title = {Salivary Antiviral and Antibacterial Properties in the Encounter of SARS-CoV-2.},
journal = {Current pharmaceutical design},
volume = {29},
number = {27},
pages = {2140-2148},
doi = {10.2174/1381612829666230904150823},
pmid = {37670699},
issn = {1873-4286},
mesh = {Humans ; *Saliva/chemistry/metabolism/immunology ; *Antiviral Agents/pharmacology/therapeutic use ; *SARS-CoV-2/drug effects ; *Anti-Bacterial Agents/pharmacology/therapeutic use ; COVID-19/virology ; *COVID-19 Drug Treatment ; Antimicrobial Peptides/pharmacology ; },
abstract = {Due to the high mortality rate of COVID-19 and its high variability and mutability, it is essential to know the body's defense mechanisms against this virus. Saliva has numerous functions, such as digestion, protection, and antimicrobial effects. Salivary diagnostic tests for many oral and systemic diseases will be available soon because saliva is a pool of biological markers. The most important antiviral and antibacterial compounds identified in saliva include lysozyme, lactoferrin (LF), mucins, cathelicidin, salivary secretory immunoglobulin (SIgA), chromogranin A, cathelicidin, salivary agglutinin (SAG) (gp340, DMBT1), α, β defensins, cystatin, histatins, secretory leukocyte protease inhibitor (SLPI), heat shock protein (HSP), adrenomedullin and microRNA (miRNAs). Antimicrobial peptides (AMPs) in saliva could be used in the future as models for designing effective oral microbial antibiotics. The antiviral properties of the peptides in saliva may be one of the future treatments for the COVID-19 virus. In this review, we investigate compounds with antiviral and antibacterial properties in saliva and the importance of these compounds in saliva in exposure to the COVID-19 virus. Due to the transmission route of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) into the oral cavity in the lower and upper respiratory tract, studies of salivary antiviral properties in these patients are very important. Some of the antiviral effects of saliva, especially mucin, α, β-defensins, IgA, IgG, IgM, lysozyme, SAG, SLPI, and histatins, may play a greater role in neutralizing or eliminating COVID-19.},
}

Humans
*Saliva/chemistry/metabolism/immunology
*Antiviral Agents/pharmacology/therapeutic use
*SARS-CoV-2/drug effects
*Anti-Bacterial Agents/pharmacology/therapeutic use
COVID-19/virology
*COVID-19 Drug Treatment
Antimicrobial Peptides/pharmacology

@article {pmid37644796,
year = {2023},
author = {Shi, Y and He, D and Zhang, X and Yuan, M and Liu, X},
title = {Research Progress in Nanopharmaceuticals with Different Delivery Routes in the Antivirus Field.},
journal = {Current pharmaceutical design},
volume = {29},
number = {25},
pages = {1975-1991},
doi = {10.2174/1381612829666230830105817},
pmid = {37644796},
issn = {1873-4286},
support = {2020GXNSFAA297178//Natural Science Foundation of Guangxi Province/ ; },
mesh = {*Antiviral Agents/administration & dosage/chemistry ; Humans ; *Nanoparticles/chemistry/administration & dosage ; *Drug Delivery Systems ; COVID-19 Drug Treatment ; COVID-19 ; SARS-CoV-2/drug effects ; Animals ; *Virus Diseases/drug therapy ; Drug Administration Routes ; *Nanoparticle Drug Delivery System ; },
abstract = {Human health is significantly threatened by infectious diseases caused by viral infection. Over the years, there have been numerous virus epidemics worldwide, causing millions of deaths. Traditional antiviral medications have many problems, including poor solubility and antiviral resistance. Additionally, because different drug delivery methods have different biological barriers to overcome, the drug's bioavailability will be significantly affected. Therefore, it is essential that researchers create more effective antiviral drugs. To serve as a guide for the future development of nanosized antiviral drugs with stronger and more precise therapeutic effects, research has been performed on nanotechnology in the field of antiviral therapy. This review summarizes the recent developments in antiviral nanopharmaceuticals with different delivery routes. Research on 7 typical viruses, including COVID-19, has been included in this review. After being loaded into nanoparticles, antiviral drugs can be delivered through several drug modes of delivery, overcoming biological barriers. Moreover, some nanoparticles themselves have the ability to combat infections, so they can be used in conjunction with antiviral medication. The use of nanoparticle medications through various routes of administration can result in their unique benefits. They can be capable of overcoming its limitations as well as retaining the advantages of this method of delivery. This will motivate researchers to conducted a new investigation on nanoparticle medicines from the standpoint of the route of administration in order to increase the practicability of antiviral medications.},
}

*Antiviral Agents/administration & dosage/chemistry
Humans
*Nanoparticles/chemistry/administration & dosage
*Drug Delivery Systems
COVID-19 Drug Treatment
COVID-19
SARS-CoV-2/drug effects
Animals
*Virus Diseases/drug therapy
Drug Administration Routes
*Nanoparticle Drug Delivery System

@article {pmid37624141,
year = {2023},
author = {Dasgupta, S and Chandra, A},
title = {Rational quality and cost of critical care systems are more important than individual considerations: a view from India.},
journal = {Postgraduate medical journal},
volume = {99},
number = {1177},
pages = {1207-1209},
doi = {10.1093/postmj/qgad068},
pmid = {37624141},
issn = {1469-0756},
mesh = {Humans ; India ; *Critical Care/economics/standards ; *Intensive Care Units/economics/standards ; *Quality of Health Care/economics ; Cost-Benefit Analysis ; *Health Care Costs ; Telemedicine/economics ; COVID-19/epidemiology ; },
abstract = {Critical or Intensive Care Units (CCU/ICUs) play a crucial role in treating critically ill patients, but they contribute significantly to healthcare costs. In India and many other resource-limited countries, private ICU treatment is largely unaffordable for the poor and even a section of the middle class, who are not substantially insured. It is essential for all stakeholders involved in critical care to prioritize quality and cost-effectiveness. To ensure quality assurance, legally binding quality standards must be developed collaboratively by the government, professional bodies, hospital administrators, and domain experts. Regulatory benchmarks relevant to different types of ICUs can enforce adherence and transparency. Telemedicine, referral systems, and interhospital transport need improvement. Addressing attrition rates among staff and greater empowerment of formally qualified registered intensivists in the private hospitals can enhance outcomes and cost control. Long-term post-ICU recovery care is often unaffordable or unavailable in many parts of the world. Engaging families in home care and providing training in basic caregiving tasks can improve outcomes and reduce costs. In areas with limited access to qualified professionals, training of lay community caregivers and practitioners can be beneficial. Multidisciplinary post-ICU clinics and necessary telephonic handholding can support home-based patients and their families. Standardizing prices of essential necessities and promoting rational practices are crucial. System-wide efforts and novel approaches like decentralization of critical care services are necessary to ensure holistic quality and cost-effectiveness, particularly in densely populated countries with resource limitations. These innovations will not only improve care but also enhance preparedness for future pandemics.},
}

Humans
India
*Critical Care/economics/standards
*Intensive Care Units/economics/standards
*Quality of Health Care/economics
Cost-Benefit Analysis
*Health Care Costs
Telemedicine/economics
COVID-19/epidemiology

@article {pmid37611787,
year = {2023},
author = {Wong, WM and Wang, X and Wang, Y},
title = {The intersection of COVID-19 and air pollution: A systematic literature network analysis and roadmap for future research.},
journal = {Environmental research},
volume = {237},
number = {Pt 2},
pages = {116839},
doi = {10.1016/j.envres.2023.116839},
pmid = {37611787},
issn = {1096-0953},
mesh = {*COVID-19/epidemiology ; *Air Pollution/adverse effects/analysis ; Humans ; SARS-CoV-2 ; Bibliometrics ; Air Pollutants/analysis ; Nitrogen Dioxide/analysis ; },
abstract = {This paper employs systematic literature network analysis, including a literature review and bibliometric network analysis, to explore the COVID-19 and air pollution literature. A total of 1208 relevant documents from the Scopus database were analyzed using VOSviewer and SciMAT to examine author, keyword, and country interconnections. The paper addresses three research questions: (1) the latest studies on COVID-19 and air pollution, (2) influential authors, documents, and sources in the field, and (3) the study's findings as a roadmap for future research. Visual representations of author and country networks highlight influential entities based on citation rate. Keyword cluster analysis via VOSviewer summarizes connections based on link strength. The strategic diagram generated by SciMAT offers insights into future research directions in specific thematic keywords: (1) air pollution, (2) nitrogen dioxide, (3) epidemiology, and (4) atmospheric aerosol. This analysis enhances understanding of COVID-19 and air pollution and guides future research endeavors.},
}

*COVID-19/epidemiology
*Air Pollution/adverse effects/analysis
Humans
SARS-CoV-2
Bibliometrics
Air Pollutants/analysis
Nitrogen Dioxide/analysis

@article {pmid37598054,
year = {2023},
author = {Yu, SY and Choi, M and Cheong, C and Ryoo, S and Huh, K and Yoon, YK and Choi, J and Kim, SB},
title = {Clinical efficacy and safety of SARS-CoV-2-neutralizing monoclonal antibody in patients with COVID-19: A living systematic review and meta-analysis.},
journal = {Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi},
volume = {56},
number = {5},
pages = {909-920},
doi = {10.1016/j.jmii.2023.07.009},
pmid = {37598054},
issn = {1995-9133},
mesh = {Humans ; *Antibodies, Neutralizing/therapeutic use/adverse effects ; *SARS-CoV-2/immunology ; *Antibodies, Monoclonal/therapeutic use/adverse effects ; *COVID-19/mortality/therapy/immunology ; *COVID-19 Drug Treatment ; Randomized Controlled Trials as Topic ; Treatment Outcome ; *Antibodies, Viral/therapeutic use ; },
abstract = {This study evaluated the efficacy and safety of neutralizing monoclonal antibodies (mAbs) with usual care in patients with coronavirus disease 2019 (COVID-19). Randomized controlled trials comparing the efficacy and safety of neutralizing mAb treatment in patients with COVID-19 were identified using electronic database searches through March 10, 2023. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Overall, 13 trials (23 articles) involving 25,646 patients were included in this systematic review. Compared with usual care, neutralizing mAbs were associated with significantly reduced all-cause mortality in outpatients with COVID-19 (pooled risk ratios [RR], 0.41; 95% confidence interval (CI), 0.20-0.83; 12 studies), but not in inpatients. In the subgroup analysis, only outpatients infected prior to the emergence of Delta variant or those with mAb-VOC match had significantly reduced mortality, while no significant benefit was observed in patients infected with Delta and post-Delta variants or mAb-VOC mismatch. Moreover, the rate of hospitalization and number of hospital visits had significantly reduced only in outpatients infected prior to the emergence of the Delta variant and those with mAb-VOC match. Our systematic review used majority of the high-certainty evidence. Our study found neutralizing mAbs were beneficial for outpatients infected prior to Delta variant or mAb-VOC match. In the face of the continuous emergence of new COVID-19 variants, additional clinical data are needed to determine whether neutralizing mAb treatment will be effective for the newly emerging variants.},
}

Humans
*Antibodies, Neutralizing/therapeutic use/adverse effects
*SARS-CoV-2/immunology
*Antibodies, Monoclonal/therapeutic use/adverse effects
*COVID-19/mortality/therapy/immunology
*COVID-19 Drug Treatment
Randomized Controlled Trials as Topic
Treatment Outcome
*Antibodies, Viral/therapeutic use

@article {pmid37592246,
year = {2023},
author = {Dulude, C and Sutherland, S and Vanderhout, S and King, WJ and Zuijdwijk, C and Major, N and Audcent, T and Howley, H and Cloutier, P and Buba, M and Jain, R and Litwinska, J and Findlay, L and Malic, C and Macaulay, K and Parker, K and Kouri, C and Goldbloom, EB},
title = {A pediatric virtual care evaluation framework and its evolution using consensus methods.},
journal = {BMC pediatrics},
volume = {23},
number = {1},
pages = {402},
pmid = {37592246},
issn = {1471-2431},
mesh = {Child ; Humans ; Consensus ; *COVID-19 ; *Health Equity ; Health Facilities ; Pandemics ; *Program Evaluation/standards ; },
abstract = {BACKGROUND: The use of virtual care has increased dramatically in response to the COVID-19 pandemic, yet evidence is lacking regarding the impact of virtual care on patient outcomes, particularly in pediatrics. A standardized evaluation approach is required to support the integration of virtual care into pediatric health care delivery programs. The objective of this work was to develop a comprehensive and structured framework for pediatric virtual care evaluation. This framework is intended to engage and guide care providers, health centres, and stakeholders towards the development of a standardized approach to the evaluation of pediatric virtual care.

METHODS: We brought together a diverse multidisciplinary team, including pediatric clinicians, researchers, digital health leads and analysts, program leaders, a human factors engineer, a family advisor and our manager of health equity and diversity. The team reviewed the literature, including published evaluation frameworks, and used a consensus-based method to develop a virtual care evaluation framework applicable to a broad spectrum of pediatric virtual care programs. We used an iterative process to develop framework components, including domains and sub-domains, examples of evaluation questions, measures, and data sources. Team members met repeatedly over seven months to generate and provide feedback on all components of the framework, making revision as needed until consensus was reached. The framework was then applied to an existing virtual care program.

RESULTS: The resulting framework includes four domains (health outcomes, health delivery, individual experience, and program implementation) and 19 sub-domains designed to support the development and evaluation of pediatric virtual care programs. We also developed guidance on how to use the framework and illustrate its utility by applying it to an existing pediatric virtual care program.

CONCLUSIONS: This virtual care evaluation framework expands on previously developed frameworks by providing additional detail and a structure that supports practical application. It can be used to evaluate a wide range of pediatric virtual care programs in a standardized manner. Use of this comprehensive yet easy to use evaluation framework will inform appropriate implementation and integration of virtual care into routine practice and support its sustainability and continuous improvement.},
}

Child
Humans
Consensus
*COVID-19
*Health Equity
Health Facilities
Pandemics
*Program Evaluation/standards

@article {pmid37572095,
year = {2023},
author = {Serrano Córdova, C and Torres, I and López-Cevallos, D},
title = {Exploring the impact of Ecuador's policies on the right to health of Venezuelan migrants during the COVID-19 pandemic: a scoping review.},
journal = {Health policy and planning},
volume = {38},
number = {9},
pages = {1099-1112},
pmid = {37572095},
issn = {1460-2237},
support = {//Deutsche Forschungsgemeinschaft/ ; },
mesh = {Ecuador/epidemiology ; Humans ; *COVID-19/epidemiology/prevention & control ; Venezuela/ethnology/epidemiology ; *Transients and Migrants/legislation & jurisprudence ; *Right to Health/legislation & jurisprudence ; SARS-CoV-2 ; Pandemics ; *Health Policy ; Refugees ; },
abstract = {Venezuela's ongoing economic and political crisis has forced >6 million people to emigrate from the country since 2014. In the Andean region, Ecuador is one of the main host countries for Venezuelan migrants and refugees. During the coronavirus disease 2019 (COVID-19) pandemic, specific measures were implemented in the country to control the spread of the disease and its associated impacts. In this context, we conducted a scoping review to understand how policies implemented by the Ecuadorian government during the pandemic impacted Venezuelan migrants' right to health. The literature search focused on scientific and grey publications between 2018 and 2022 in electronic databases and institutional websites, complemented by snowball sampling and expert advice. Our thematic analysis revealed discrepancies between the rights granted to migrants in Ecuador's legal framework and their practical implementation during the pandemic, with several instances of policy and programmatic infringement. The disruption of services further complicated migrant's options for regularization. Some measures, like border closures, negatively impacted migrants' health, including increased exposure to abuse and violence. While migrants were included in the country's COVID-19 vaccination plan, they were excluded from other national aid programmes. There are indications of an increase in xenophobia and discrimination stigmatizing migrants as 'disease carriers' and 'resource takers', resulting in a prioritization of services for the Ecuadorian population. We found limited research on the emergent topic of migrants' vulnerability and related health system challenges. Future research should include working in border zones, consider socioeconomic factors and further explore the poor implementation of Ecuador's legal framework towards upholding migrants' right to health.},
}

Ecuador/epidemiology
Humans
*COVID-19/epidemiology/prevention & control
Venezuela/ethnology/epidemiology
*Transients and Migrants/legislation & jurisprudence
*Right to Health/legislation & jurisprudence
SARS-CoV-2
Pandemics
*Health Policy
Refugees

@article {pmid37522540,
year = {2023},
author = {Madukwe, DUP and Mike-Ogburia, MI and Nduka, N and Nzeobi, J},
title = {Smart Microfluidics: Synergy of Machine Learning and Microfluidics in the Development of Medical Diagnostics for Chronic and Emerging Infectious Diseases.},
journal = {Critical reviews in biomedical engineering},
volume = {51},
number = {1},
pages = {41-58},
doi = {10.1615/CritRevBiomedEng.2023047211},
pmid = {37522540},
issn = {1943-619X},
mesh = {Humans ; *Machine Learning ; *COVID-19/diagnosis ; *Microfluidics/methods ; *Communicable Diseases, Emerging/diagnosis ; Lab-On-A-Chip Devices ; SARS-CoV-2 ; Chronic Disease ; Point-of-Care Systems ; *Microfluidic Analytical Techniques ; },
abstract = {The COVID-19 pandemic, emerging/re-emerging infections as well as other non-communicable chronic diseases, highlight the necessity of smart microfluidic point-of-care diagnostic (POC) devices and systems in developing nations as risk factors for infections, severe disease manifestations and poor clinical outcomes are highly represented in these countries. These POC devices are also becoming vital as analytical procedures executable outside of conventional laboratory settings are seen as the future of healthcare delivery. Microfluidics have grown into a revolutionary system to miniaturize chemical and biological experimentation, including disease detection and diagnosis utilizing μPads/paper-based microfluidic devices, polymer-based microfluidic devices and 3-dimensional printed microfluidic devices. Through the development of droplet digital PCR, single-cell RNA sequencing, and next-generation sequencing, microfluidics in their analogous forms have been the leading contributor to the technical advancements in medicine. Microfluidics and machine-learning-based algorithms complement each other with the possibility of scientific exploration, induced by the framework's robustness, as preliminary studies have documented significant achievements in biomedicine, such as sorting, microencapsulation, and automated detection. Despite these milestones and potential applications, the complexity of microfluidic system design, fabrication, and operation has prevented widespread adoption. As previous studies focused on microfluidic devices that can handle molecular diagnostic procedures, researchers must integrate these components with other microsystem processes like data acquisition, data processing, power supply, fluid control, and sample pretreatment to overcome the barriers to smart microfluidic commercialization.},
}

Humans
*Machine Learning
*COVID-19/diagnosis
*Microfluidics/methods
*Communicable Diseases, Emerging/diagnosis
Lab-On-A-Chip Devices
SARS-CoV-2
Chronic Disease
Point-of-Care Systems
*Microfluidic Analytical Techniques

@article {pmid37517166,
year = {2023},
author = {Schweizer, S and Lawson, RP and Blakemore, SJ},
title = {Uncertainty as a driver of the youth mental health crisis.},
journal = {Current opinion in psychology},
volume = {53},
number = {},
pages = {101657},
doi = {10.1016/j.copsyc.2023.101657},
pmid = {37517166},
issn = {2352-2518},
mesh = {Humans ; Uncertainty ; Adolescent ; *COVID-19/psychology ; *Mental Health ; *Anxiety/psychology ; *Depression/psychology ; },
abstract = {Mental health problems in young people have been on the rise for over a decade, with that trend accelerating during the pandemic. This review proposes that the catalyst effect of the pandemic offers insights into a key driver of increases in youth depression and anxiety: greater uncertainty. Uncertainty about many aspects of everyday life, including social connections, education, job security and health, increased during the pandemic, and this coincided with increasing rates of depression and anxiety. Lab-based developmental cognitive and clinical neuroscience research on tolerance of uncertainty and adolescent mental health shows that when adolescents fail to show age-typical tolerance of uncertainty, they are at greater risk of mental health problems. Avenues for future research to understand and promote tolerance of uncertainty in adolescents are proposed.},
}

Humans
Uncertainty
Adolescent
*COVID-19/psychology
*Mental Health
*Anxiety/psychology
*Depression/psychology

@article {pmid37460309,
year = {2023},
author = {Connolly, DJ and Eraslan, E and Gilchrist, G},
title = {Coronavirus (COVID-19) and sexualised drug use among men who have sex with men: a systematic review.},
journal = {Sexual health},
volume = {20},
number = {5},
pages = {375-384},
doi = {10.1071/SH23071},
pmid = {37460309},
issn = {1449-8987},
mesh = {Humans ; *COVID-19/epidemiology ; Male ; *Homosexuality, Male/statistics & numerical data/psychology ; *Substance-Related Disorders/epidemiology ; *Sexual and Gender Minorities/statistics & numerical data ; SARS-CoV-2 ; HIV Infections/prevention & control ; Sexual Behavior ; Methamphetamine ; },
abstract = {Drug-related harms, including harms from sexualised drug use (SDU), are disproportionately experienced by sexual and gender minority people, relative to their majority counterparts. Chemsex, a type of SDU practiced mainly by MSM, is associated with methamphetamine use and increased HIV seropositivity or risk of acquisition. Therefore, participants are at increased risk of immunocompromise. Existing evidence suggests that drug use increases following natural disasters. The impact of coronavirus disease 2019 (COVID-19) on chemsex is unknown. A PRISMA-adherent systematic review was conducted to synthesise reports of changes in the prevalence, frequency, or characteristics of drug use (and factors associated with these changes) following the onset of the COVID-19 pandemic. This report presents findings related to SDU/chemsex among MSM. A comprehensive search across nine databases, supplemented with backward-forward citation searching and contact with key opinion leaders, was conducted. Two reviewers carried out title-abstract screening, full-text screening, and data extraction. Following a final, single database search, nine studies were included in the narrative synthesis. More than half the sample were studies investigating HIV pre-exposure prophylaxis use. Twenty percent of participants in most studies reported chemsex participation. In four, participants reported a net increase or maintenance of chemsex participation during the pandemic and five reported a net decrease. Increased chemsex participation was associated with loneliness, cravings, and working during the pandemic. Decreased chemsex practice was associated with COVID-19-related fear. This synthesis suggests that chemsex practice continued, and for some MSM increased, throughout COVID-19 pandemic 'lockdowns'. This may have increased COVID-19 transmission and severity among potentially vulnerable MSM.},
}

Humans
*COVID-19/epidemiology
Male
*Homosexuality, Male/statistics & numerical data/psychology
*Substance-Related Disorders/epidemiology
*Sexual and Gender Minorities/statistics & numerical data
SARS-CoV-2
HIV Infections/prevention & control
Sexual Behavior
Methamphetamine

@article {pmid37453136,
year = {2023},
author = {Sienkiewicz-Oleszkiewicz, B and Oleszkiewicz, A and Bock, MA and Hummel, T},
title = {Intranasal insulin's effects on the sense of smell.},
journal = {Rhinology},
volume = {61},
number = {5},
pages = {404-411},
doi = {10.4193/Rhin23.036},
pmid = {37453136},
issn = {0300-0729},
mesh = {Humans ; Administration, Intranasal ; *Insulin/administration & dosage/pharmacology ; *Olfaction Disorders/drug therapy ; *Smell/drug effects ; COVID-19/complications ; Olfactory Mucosa/drug effects ; *Hypoglycemic Agents/administration & dosage ; },
abstract = {Intranasal insulin (IN) administration is a promising way to deliver the peptide to the central nervous system (CNS), bypassing the blood-brain-barrier and gastrointestinal absorption inhibition. IN receptors are localized in the olfactory mucosa and the brain, mainly in the olfactory bulb, hypothalamus, hippocampus, amygdala, cerebral cortex, and cerebellum. The pleiotropic mechanism of insulin action is characterized by its anti-inflammatory properties, antithrombotic, vasodilatory, and antiapoptotic effects. It prevents energy failure and has regenerative properties, affects neuro-regeneration and counteracts insulin resistance. Hence, insulin has been suggested for various pathological states including neurocognitive disorders, obesity, and as a therapeutic option for smell loss. A sharply increased prevalence of olfactory dysfunction was observed due to the COVID-19 pandemic. The pandemic also emphasized the lack of therapeutic options for smell loss. Intranasal insulin administration has therefore been suggested to serve as potential treatment, influencing the regenerative capacities of the olfactory mucosa. This narrative review summarizes current knowledge on possible effects of intranasal insulin on the sense of smell.},
}

Humans
Administration, Intranasal
*Insulin/administration & dosage/pharmacology
*Olfaction Disorders/drug therapy
*Smell/drug effects
COVID-19/complications
Olfactory Mucosa/drug effects
*Hypoglycemic Agents/administration & dosage

@article {pmid37448181,
year = {2023},
author = {Cosentino, F and Verma, S and Ambery, P and Treppendahl, MB and van Eickels, M and Anker, SD and Cecchini, M and Fioretto, P and Groop, PH and Hess, D and Khunti, K and Lam, CSP and Richard-Lordereau, I and Lund, LH and McGreavy, P and Newsome, PN and Sattar, N and Solomon, S and Weidinger, F and Zannad, F and Zeiher, A},
title = {Cardiometabolic risk management: insights from a European Society of Cardiology Cardiovascular Round Table.},
journal = {European heart journal},
volume = {44},
number = {39},
pages = {4141-4156},
doi = {10.1093/eurheartj/ehad445},
pmid = {37448181},
issn = {1522-9645},
mesh = {Humans ; *COVID-19/epidemiology/complications ; Diabetes Mellitus, Type 2/therapy/epidemiology/complications ; Obesity/therapy/epidemiology/complications ; Renal Insufficiency, Chronic/therapy/epidemiology/complications ; SARS-CoV-2 ; *Cardiovascular Diseases/therapy/epidemiology ; Europe ; Cardiometabolic Risk Factors ; Liver Diseases/therapy/epidemiology ; Cardiology ; },
abstract = {Metabolic comorbidities are common in patients with cardiorenal disease; they can cause atherosclerotic cardiovascular disease (ASCVD), speed progression, and adversely affect prognosis. Common comorbidities are Type 2 diabetes mellitus (T2DM), obesity/overweight, chronic kidney disease (CKD), and chronic liver disease. The cardiovascular system, kidneys, and liver are linked to many of the same risk factors (e.g. dyslipidaemia, hypertension, tobacco use, diabetes, and central/truncal obesity), and shared metabolic and functional abnormalities lead to damage throughout these organs via overlapping pathophysiological pathways. The COVID-19 pandemic has further complicated the management of cardiometabolic diseases. Obesity, T2DM, CKD, and liver disease are associated with increased risk of poor outcomes of COVID-19 infection, and conversely, COVID-19 can lead to worsening of pre-existing ASCVD. The high rates of these comorbidities highlight the need to improve recognition and treatment of ASCVD in patients with obesity, insulin resistance or T2DM, chronic liver diseases, and CKD and equally, to improve recognition and treatment of these diseases in patients with ASCVD. Strategies to prevent and manage cardiometabolic diseases include lifestyle modification, pharmacotherapy, and surgery. There is a need for more programmes at the societal level to encourage a healthy diet and physical activity. Many pharmacotherapies offer mechanism-based approaches that can target multiple pathophysiological pathways across diseases. These include sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, selective mineralocorticoid receptor antagonists, and combined glucose-dependent insulinotropic peptide/glucagon-like peptide-1 receptor agonist. Non-surgical and surgical weight loss strategies can improve cardiometabolic disorders in individuals living with obesity. New biomarkers under investigation may help in the early identification of individuals at risk and reveal new treatment targets.},
}

Humans
*COVID-19/epidemiology/complications
Diabetes Mellitus, Type 2/therapy/epidemiology/complications
Obesity/therapy/epidemiology/complications
Renal Insufficiency, Chronic/therapy/epidemiology/complications
SARS-CoV-2
*Cardiovascular Diseases/therapy/epidemiology
Europe
Cardiometabolic Risk Factors
Liver Diseases/therapy/epidemiology
Cardiology

@article {pmid36999423,
year = {2024},
author = {Junqueira Ribeiro, MM},
title = {Computer-aided Drug Discovery Approaches in the Identification of Natural Products against SARS-CoV-2: A Review.},
journal = {Current computer-aided drug design},
volume = {20},
number = {4},
pages = {313-324},
doi = {10.2174/1573409919666230329090403},
pmid = {36999423},
issn = {1875-6697},
mesh = {*Biological Products/pharmacology/chemistry/therapeutic use ; Humans ; *SARS-CoV-2/drug effects ; *Drug Discovery/methods ; *COVID-19 Drug Treatment ; *Antiviral Agents/pharmacology/chemistry/therapeutic use ; Molecular Docking Simulation ; *Computer-Aided Design ; COVID-19 ; },
abstract = {The COVID-19 pandemic is raising a worldwide search for compounds that could act against the disease, mainly due to its mortality. With this objective, many researchers invested in the discovery and development of drugs of natural origin. To assist in this search, the potential of computational tools to reduce the time and cost of the entire process is known. Thus, this review aimed to identify how these tools have helped in the identification of natural products against SARS-CoV-2. For this purpose, a literature review was carried out with scientific articles with this proposal where it was possible to observe that different classes of primary and, mainly, secondary metabolites were evaluated against different molecular targets, mostly being enzymes and spike, using computational techniques, with emphasis on the use of molecular docking. However, it is noted that in silico evaluations still have much to contribute to the identification of an anti- SARS-CoV-2 substance, due to the vast chemical diversity of natural products, identification and use of different molecular targets and computational advancement.},
}

*Biological Products/pharmacology/chemistry/therapeutic use
Humans
*SARS-CoV-2/drug effects
*Drug Discovery/methods
*COVID-19 Drug Treatment
*Antiviral Agents/pharmacology/chemistry/therapeutic use
Molecular Docking Simulation
*Computer-Aided Design
COVID-19

@article {pmid36698239,
year = {2024},
author = {Bjørklund, G and Lysiuk, R and Semenova, Y and Lenchyk, L and Dub, N and Doşa, MD and Hangan, T},
title = {Herbal Substances with Antiviral Effects: Features and Prospects for the Treatment of Viral Diseases with Emphasis on Pro-Inflammatory Cytokines.},
journal = {Current medicinal chemistry},
volume = {31},
number = {4},
pages = {393-409},
doi = {10.2174/0929867330666230125121758},
pmid = {36698239},
issn = {1875-533X},
mesh = {Humans ; *Antiviral Agents/therapeutic use/pharmacology/chemistry ; *Cytokines/metabolism/immunology ; Animals ; *Virus Diseases/drug therapy/immunology ; COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; },
abstract = {Viral diseases have a significant impact on human health, and three novel coronaviruses (CoV) have emerged during the 21st century. In this review, we have emphasized the potential of herbal substances with antiviral effects. Our investigation focused on the features and prospects of viral disease treatment, with a particular emphasis on proinflammatory cytokines. We conducted comprehensive searches of various databases, including Science Direct, CABI Direct, Web of Science, PubMed, and Scopus. Cytokine storm mechanisms play a crucial role in inducing a pro-inflammatory response by triggering the expression of cytokines and chemokines. This response leads to the recruitment of leukocytes and promotes antiviral effects, forming the first line of defense against viruses. Numerous studies have investigated the use of herbal medicine candidates as immunomodulators or antivirals. However, cytokine-storm-targeted therapy is recommended for patients with acute respiratory distress syndrome caused by SARS-CoV to survive severe pulmonary failure. Our reviews have demonstrated that herbal formulations could serve as alternative medicines and significantly reduce complicated viral infections. Furthermore, they hold promising potential as specific antiviral agents in experimental animal models.},
}

Humans
*Antiviral Agents/therapeutic use/pharmacology/chemistry
*Cytokines/metabolism/immunology
Animals
*Virus Diseases/drug therapy/immunology
COVID-19 Drug Treatment
SARS-CoV-2/drug effects

@article {pmid33619127,
year = {2022},
author = {Hodgson, L and Phillips, G and Saggers, RT and Sharma, S and Papadakis, M and Readhead, C and Cowie, CM and Massey, A and Weiler, R and Mathema, P and Larkin, J and Gordon, J and Maclean, J and Rossiter, M and Elliott, N and Hanson, J and Spencer, S and Jaques, R and Patricios, J},
title = {Medical care and first aid: an interassociation consensus framework for organised non-elite sport during the COVID-19 pandemic.},
journal = {British journal of sports medicine},
volume = {56},
number = {2},
pages = {68-79},
doi = {10.1136/bjsports-2020-103622},
pmid = {33619127},
issn = {1473-0480},
mesh = {Humans ; Consensus ; *COVID-19 ; First Aid ; *Pandemics ; SARS-CoV-2 ; },
abstract = {The cessation of amateur and recreational sport has had significant implications globally, impacting economic, social and health facets of population well-being. As a result, there is pressure to resume sport at all levels. The ongoing prevalence of SARS-CoV-2 and subsequent 'second waves' require urgent best practice guidelines to be developed to return recreational (non-elite) sports as quickly as possible while prioritising the well-being of the participants and support staff.This guidance document describes the need for such advice and the process of collating available evidence. Expert opinion is integrated into this document to provide uniform and pragmatic recommendations, thereby optimising on-field and field-side safety for all involved persons, including coaches, first responders and participants.The nature of SARS-CoV-2 transmission means that the use of some procedures performed during emergency care and resuscitation could potentially be hazardous, necessitating the need for guidance on the use of personal protective equipment, the allocation of predetermined areas to manage potentially infective cases and the governance and audit of the process.},
}

Humans
Consensus
*COVID-19
First Aid
*Pandemics
SARS-CoV-2

@article {pmid41795913,
year = {2026},
author = {Thorpe, DW and Jones, LA and Martin, AM and Coleman, RA and Allman, C and Peterson, RA and Keating, DJ},
title = {The role of peripheral serotonin in SARS-CoV-2 infectivity, COVID-19 treatment and long COVID.},
journal = {Immunology and cell biology},
volume = {},
number = {},
pages = {},
doi = {10.1111/imcb.70097},
pmid = {41795913},
issn = {1440-1711},
abstract = {Gastrointestinal symptoms have emerged as a common, but underappreciated, cause of morbidity in relation to SARS-CoV-2 infection and the COVID-19 pandemic. This manifests as a range of indications including diarrhea, anorexia, nausea, vomiting and abdominal pain. In addition, the gastrointestinal tract may represent a route of viral entry via the epithelial cell layer lining the gut wall. This route of entry could be a significant component of disease pathogenesis, including effects on the nervous system via the gut-brain axis. In this review, we provide an assessment of the effects of COVID-19 on the gastrointestinal system, its involvement in disease severity and potential pathways for viral entry and infection in the gastrointestinal tract. We also examine evidence that gut-derived serotonin is affected by SARS-CoV-2 infection, how this may link to symptoms and disease pathogenesis and the potential link to the efficacy of selective serotonin reuptake inhibitors in reducing COVID-19 severity.},
}

@article {pmid41793162,
year = {2026},
author = {Kim, DH and Lim, S and Eisenhut, M and Kronbichler, A and Kim, E and Kim, MS and Papatheodorou, SI and Stebbing, J and Peng, Y and Oh, SS and Shin, JI and Smith, L},
title = {The Impact of Study Size on COVID-19 Treatment Outcomes: A Meta-Epidemiological Study Comparing Large and Small Randomized Controlled Trials: A Systematic Review and Meta-Analyses.},
journal = {Reviews in medical virology},
volume = {36},
number = {2},
pages = {e70125},
pmid = {41793162},
issn = {1099-1654},
support = {//Yonsei Fellowship/ ; },
mesh = {Humans ; *Randomized Controlled Trials as Topic ; *COVID-19/therapy/epidemiology/virology ; SARS-CoV-2/drug effects ; Treatment Outcome ; *COVID-19 Drug Treatment ; Sample Size ; },
abstract = {Small randomized controlled trials (RCTs) in COVID-19 meta-analyses have been associated with more favourable treatment effects and reduced result stability. This study assessed how trial size impacts effect estimates, statistical stability, and risk of bias. Following PRISMA guidelines, we identified meta-analyses of COVID-19 treatments included in WHO, NIH, and the LIVING Project. Trials were classified by log-scale sample size, and separate pooled meta-analyses were conducted for large-only, small-only, and combined trials. Comparative metrics included the Ratio of Odds Ratios (ROR), Kappa statistics, Fragility Index (FI), Reverse Fragility Index (RFI), and Cochrane Risk of Bias assessments. Sensitivity analyses applied alternative size thresholds (≥ 1000 participants and median-based cutoffs) and stratified results by treatment and outcome type. Across 25 meta-analyses including 221 RCTs (46 large, 175 small), small trials produced more extreme estimates in 19 analyses and wider confidence intervals in 23. The pooled ROR was 0.85 (95% CI: 0.76-0.95; P = 0.004), decreasing to 0.81 (95% CI: 0.68-0.95; P = 0.011) when limited to small trials published before the first large trial. RORs remained below 1 across treatment and outcome types. Agreement between small and large trials was minimal, while large trials showed substantial agreement with overall estimates. Stability and bias profiles favoured large trials (FI: 14.0 vs. 4.0; RFI: 10.0 vs. 5.0). In conclusion, small RCTs tend to overestimate treatment effects and yield less precise, less stable results. Meta-analyses should prioritise large, high-quality trials and interpret small-study findings with caution, particularly in rapidly evolving research contexts.},
}

Humans
*Randomized Controlled Trials as Topic
*COVID-19/therapy/epidemiology/virology
SARS-CoV-2/drug effects
Treatment Outcome
*COVID-19 Drug Treatment
Sample Size

@article {pmid41792534,
year = {2026},
author = {Del Riccio, M and Maggi, S and Wieczorowska-Tobis, K and Newell, K and Czech, M and Botelho-Nevers, E and Michel, JP and Hummers, E and Duque, S and Lundgren, J and Barrat, J and Tan, L and Wysocki, J and Boccalini, S and Bechini, A and Jindal, S and Hendrickx, G and Van Damme, P and Bonanni, P and Pattyn, J},
title = {Advancing Vaccination Strategies for Older Adults: Insights of the Adult Immunization Board Meeting.},
journal = {Drugs & aging},
volume = {},
number = {},
pages = {},
pmid = {41792534},
issn = {1179-1969},
abstract = {As Europe's population ages, optimizing vaccination strategies for older adults is an increasing public health priority. Vaccine-preventable infections pose significant risks, including increased morbidity and mortality, reduced quality of life, and substantial healthcare costs. Prevention, particularly adult vaccination, plays a vital role in mitigating these outcomes and supporting healthy ageing. While childhood immunization remains essential, a life-course approach including routine older adult vaccination is needed. Coverage among older adults across Europe remains suboptimal owing to factors such as heterogeneous (sub)national policies, health literacy issues, financial barriers, access issues, and persistent structural and societal barriers. To meet these challenges, the Adult Immunization Board (AIB) convened a technical meeting in May 2025, to discuss strategies for improving vaccination in older adults. The meeting explored how older adults are defined in immunization policies (for the meeting, an operational threshold of ≥ 50 years was used, while acknowledging that many national age-based programs commonly start around 60-65 years) and reviewed current adult vaccines and programmatic implementation across six vaccines. Discussions highlighted the need for a life-course approach with coordinated (inter)national policies, clear adult vaccination schedules, dedicated infrastructure and programs, stronger surveillance, and structured follow-up. Key recommendations included shifting from fragmented efforts to cohesive, system-wide approaches. This approach requires addressing organizational challenges with programmatic strategies such as integrating adult vaccination into routine healthcare, providing co-administration guidance, and adapting successful pediatric models for adult programs. This summary presents insights shared during the AIB meeting, highlighting gaps and promising solutions for advancing older adult immunization in Europe. Vaccination must be recognized as an investment in healthy ageing, which is also able to generate a return in economic terms, as part of a holistic health package for older adults, not as an optional add-on to treatment. With older adults now outnumbering children under 5 years globally, it is time to invest equally in their vaccination.},
}

@article {pmid37771583,
year = {2023},
author = {Ferrazzo, F and Leto, S and Malara, N},
title = {The 1926 novel, "One, no one, one hundred thousand", metaphorizes the potential danger when the immune system is exposed to a repetitive antigen stimulation.},
journal = {Frontiers in immunology},
volume = {14},
number = {},
pages = {1254853},
pmid = {37771583},
issn = {1664-3224},
mesh = {Humans ; *Immune System/immunology ; *Antigens/immunology ; Animals ; Vaccines/immunology ; Vaccination ; },
abstract = {In the worldwide scenario of infection prevention and control, the vaccine strategies are destined to increase rapidly. The availability of numerous vaccination options allows you to plan individually on how to boost your immune system. The immune system is a highly plastic cognitive dynamic network and performs its function by recognition of the uniqueness of the organism defined as self. The identification and attack of non-self antigens contribute to improving the strategies of self/non-self discrimination. However, repetitive antigen stimulation of the immune system may lead to several outcomes reassumed in three principal risks: (i) loss of the unique self codification (one), (ii) loss of own identifying (no one), and (iii) the increase of idiotype/anti-idiotype entities (one hundred thousand). Controlled production of idiotype/anti-idiotype antibodies protects against autoimmune diseases and immunodeficiency. The title of the famous novel by Nobel Prize for Literature winner Luigi Pirandello, "One, no one, one hundred thousand", recaps the three risks and the protagonist's journey exploring the complexities of personal identity, and warns to preserve the uniqueness of the organism. Taking inspiration from this metaphor, the authors propose to monitor antibody idiotype response for personalizing vaccine plans with the aim of preserving the uniqueness of the immune system and assuring safe protection.},
}

Humans
*Immune System/immunology
*Antigens/immunology
Animals
Vaccines/immunology
Vaccination

@article {pmid37770169,
year = {2023},
author = {Kumari, S and Singh, K and Singh, N and Khan, S and Kumar, A},
title = {Phage display and human disease detection.},
journal = {Progress in molecular biology and translational science},
volume = {201},
number = {},
pages = {151-172},
doi = {10.1016/bs.pmbts.2023.03.022},
pmid = {37770169},
issn = {1878-0814},
mesh = {Humans ; *COVID-19/diagnosis/virology ; *Cell Surface Display Techniques/methods ; *Peptide Library ; SARS-CoV-2 ; Bacteriophages/genetics ; Neoplasms/diagnosis ; },
abstract = {Phage display is a significant and active molecular method and has continued crucial for investigative sector meanwhile its unearthing in 1985. This practice has numerous benefits: the association among physiology and genome, the massive variety of variant proteins showed in sole collection and the elasticity of collection that can be achieved. It suggests a diversity of stages for manipulating antigen attachment; yet, variety and steadiness of exhibited library are an alarm. Additional improvements, like accumulation of non-canonical amino acids, resulting in extension of ligands that can be recognized through collection, will support in expansion of the probable uses and possibilities of technology. Epidemic of COVID-19 had taken countless lives, and while indicative prescriptions were provided to diseased individuals, still no prevention was observed for the contamination. Phage demonstration has presented an in-depth understanding into protein connections included in pathogenesis. Phage display knowledge is developing as an influential, inexpensive, quick, and effectual method to grow novel mediators for the molecular imaging and analysis of cancer.},
}

Humans
*COVID-19/diagnosis/virology
*Cell Surface Display Techniques/methods
*Peptide Library
SARS-CoV-2
Bacteriophages/genetics
Neoplasms/diagnosis

@article {pmid37587818,
year = {2023},
author = {Zhu, Y and Zhang, S and Wang, Z and Wang, Z and Zhu, S},
title = {ACE2 Receptor: A Potential Pharmacological Target in COVID-19.},
journal = {Current protein & peptide science},
volume = {24},
number = {9},
pages = {701-710},
doi = {10.2174/1389203724666230816092518},
pmid = {37587818},
issn = {1875-5550},
mesh = {Humans ; *Angiotensin-Converting Enzyme 2/metabolism/chemistry/genetics ; *COVID-19 Drug Treatment ; COVID-19/metabolism/virology ; SARS-CoV-2 ; Animals ; Serine Endopeptidases/metabolism/genetics ; },
abstract = {Studies have shown that injection of recombinant angiotensin-converting enzyme 2 (ACE2) significantly increased circulatory levels of ACE2 activity, reduced cardiac hypertrophy and fibrosis, and effectively lowered blood pressure. In addition, recombinant ACE2 ameliorated albuminuria and might contribute to renal protection. Meanwhile, potential pharmacological treatments based on ACE2 are attracting increasing attention from scientists following a growing understanding of the role of the ACE2 receptor in the pathogenesis of coronavirus disease 2019 (COVID-19). In this article, we comprehensively summarized the literature on the structure, distribution, and function of ACE2. More importantly, we draw a conclusion that ACE2 decoys such as sACE2, hrsACE2 and ACE2-derived peptides, drugs down-regulating the ACE2 or TMPRSS2 gene expression, and the application of epigenetic modifiers and Traditional Chinese Medicine might represent promising approaches for the future of COVID-19 treatment.},
}

Humans
*Angiotensin-Converting Enzyme 2/metabolism/chemistry/genetics
*COVID-19 Drug Treatment
COVID-19/metabolism/virology
SARS-CoV-2
Animals
Serine Endopeptidases/metabolism/genetics

@article {pmid37573588,
year = {2023},
author = {Liebell, D},
title = {Part 3: Perspectives on Olfactory and Gustatory Dysfunction Pathophysiology, Management and Relevance to COVID-19: Rationale for Auricular Cranial Nerve Stimulation.},
journal = {Alternative therapies in health and medicine},
volume = {29},
number = {7},
pages = {52-61},
pmid = {37573588},
issn = {1078-6791},
mesh = {Humans ; *COVID-19/complications/physiopathology ; *Taste Disorders/therapy/physiopathology/etiology ; *Olfaction Disorders/therapy/physiopathology/etiology ; SARS-CoV-2 ; *Electric Stimulation Therapy/methods ; *Cranial Nerves ; *Acupuncture, Ear/methods ; },
abstract = {The rapid global emergence of distortions of the senses of smell and taste consequential to COVID-19 has provoked an unprecedented demand for investigation into treatments capable of addressing such medical phenomena. While the pandemic's principal focus rests on interventions intended to prevent the infection and its spread, much attention must be devoted to amelioration of these common symptomatic sequelae of it. The medical historical record reveals a shocking paucity of serious consideration of olfactory and gustatory dysfunction (OGD), hardly exclusive to SARS-CoV-2 infection (as discussed in Part 1 of this article series). To date, no treatment approach has ever delivered noteworthy clinical results for chronic cases. Numerous studies and reviews have addressed the epidemiology and hypotheses of OGD pathophysiology. Past and recent studies have produced vague findings and conclusions devoid of practical clinical applications for patients who continue to experience chronic sensory distortions and deficits. It is urgent that focused exploration be aggressively pursued for therapeutic and restorative modalities to ameliorate OGD across all medical disciplines, with no bias towards any one approach. It is imperative that approaches outside the pharmacological realm are studied; no effective medication of any merit exists. Thus, innovative and new approaches potentially capable of supporting natural self-regulation and restoration of healthy neurophysiology must be investigated, post-haste. Specifically, stimulation of cranial nerves via their auricular branches, by means of various modalities, may hold promise. A vast body of evidence exists to support its investigation. Its inclusion as an extremely safe and inexpensive approach to endeavor to resolve chronic OGD (not merely for post-COVID19 infection) is warranted. The 3-phase auricular acupuncture microsystem may be the most precise form of targeting and positively influencing specific neurological structures affected by COVID-19.},
}

Humans
*COVID-19/complications/physiopathology
*Taste Disorders/therapy/physiopathology/etiology
*Olfaction Disorders/therapy/physiopathology/etiology
SARS-CoV-2
*Electric Stimulation Therapy/methods
*Cranial Nerves
*Acupuncture, Ear/methods

@article {pmid37563314,
year = {2023},
author = {Wienhold, J and Kemper, I and Czaplik, M and Follmann, A and Rossaint, R and Derwall, M},
title = {[Teleconsultation for preoperative evaluation and informed consent-Are we ready for a paradigm shift?].},
journal = {Die Anaesthesiologie},
volume = {72},
number = {10},
pages = {697-702},
pmid = {37563314},
issn = {2731-6866},
mesh = {Humans ; *Informed Consent/legislation & jurisprudence ; *Preoperative Care/methods/trends ; *Remote Consultation/legislation & jurisprudence/trends ; Germany ; *Telemedicine/legislation & jurisprudence/trends ; COVID-19 ; },
abstract = {In Germany, approximately 17 million anaesthesiological procedures and, consequently, roughly the same number of preoperative consultations are conducted each year. So far, these have predominantly taken place in person. However, recent developments in technology, medical-legal aspects, and politics, combined with the catalyzing effect of the pandemic situation, have led to a significant boost in telemedicine. In the field of anaesthesia, there are new approaches to implementing telemedicine in the pre- and postoperative setting. This article focuses on the preoperative setting and presents general requirements for a teleconsultation as preoperative evaluation, the current state of technology, and medical-legal aspects.},
}

Humans
*Informed Consent/legislation & jurisprudence
*Preoperative Care/methods/trends
*Remote Consultation/legislation & jurisprudence/trends
Germany
*Telemedicine/legislation & jurisprudence/trends
COVID-19