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Bibliography on: covid-19

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Robert J. Robbins is a biologist, an educator, a science administrator, a publisher, an information technologist, and an IT leader and manager who specializes in advancing biomedical knowledge and supporting education through the application of information technology. More About:  RJR | OUR TEAM | OUR SERVICES | THIS WEBSITE

RJR: Recommended Bibliography 12 Jun 2026 at 01:43 Created: 

covid-19

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

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

Citations The Papers (from PubMed®)

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RevDate: 2026-06-11
CmpDate: 2026-06-11

Segal NL (2025)

What's in Twins' Names? Mixed Credit Reports/Twin Research Review: Treating Twins with Central Nervous System Infection; Twin Insights into COVID-19; Septal Aneurism in Monozygotic Twins; Twin Births via Assisted Reproduction vs. Natural Conception; Tribute to Dr. Helen E. Fisher/ Human Interest: Twins Rally for Twin Hostages; Tribute to the National Mothers of Twins Clubs Founder; Quadruplet Birth; Identical Twin Politician; Identical Twin Actresses.

Twin research and human genetics : the official journal of the International Society for Twin Studies, 28(1):112-115.

Giving twins similar names places them at increased risk for mixed credit reports as they enter young adulthood and beyond. Attorneys specializing in this area of the law are often required to manage lawsuits againt the agencies responsible for such errors. This overview is followed by summaries of twin research and reports of treating twins with central nervous system infection, twins with COVID-19, and twins with septal aneurism, as well as a review of the comparative outcomes of twins born via assisted reproduction versus natural conception and a tribute to the late Dr Helen E. Fisher. Human interest items include a twins' rally for Israeli twins held hostage in Gaza, a tribute to the founding member of the National Mothers of Twins Clubs (now Multiples of America), a quadruplet birth, an identical twin politician, and identical twin actresses.

RevDate: 2026-06-10
CmpDate: 2026-01-07

Murata A, Tanaka M, Takayoshi M, et al (2026)

Osmotic nephropathy as a potentially underrecognized cause of acute kidney injury during SGLT2 inhibitor therapy: a case report and literature review.

CEN case reports, 15(1):16.

In recent years, sodium-glucose cotransporter 2 (SGLT2) inhibitors have become essential therapeutic agents in the management of chronic kidney disease (CKD), owing to their established renoprotective effects. Although acute kidney injury (AKI) may occasionally occur during SGLT2 inhibitor therapy, its pathological features remain incompletely understood. Here, we report a case of AKI caused by osmotic nephropathy in a patient with underlying CKD following the initiation of an SGLT2 inhibitor. We also review previously reported cases of SGLT2 inhibitor-associated osmotic nephropathy. A 71-year-old man with type 2 diabetes and CKD developed oliguric AKI, with his serum creatinine level increasing from 2.0 to 8.3 mg/dL, one month after initiating dapagliflozin. During this period, he experienced transient appetite loss associated with a COVID-19 infection. Despite initial management for presumed prerenal AKI, his renal function did not improve with intravenous fluid therapy, and he required hemodialysis. Kidney biopsy revealed characteristic features of osmotic nephropathy, including numerous isometric vacuoles within the epithelial cells of proximal tubules with preserved brush borders. His renal function began to improve approximately two weeks after discontinuation of the SGLT2 inhibitor, and eventually returned to baseline. This case and literature review highlight the potential for osmotic nephropathy as a rare but reversible complication of SGLT2 inhibitor therapy, which may be triggered by volume depletion, particularly in diabetic patients with pre-existing renal dysfunction. Recognition of this underdiagnosed entity is crucial for timely diagnosis and appropriate management.

RevDate: 2026-06-11
CmpDate: 2026-01-31

Llanes AC, Bandhlish A, Pipavath S, et al (2026)

Refining the Radiologic Recognition of Pulmonary Alveolar Proteinosis: A Crazy-Paving Pattern Approach.

Seminars in roentgenology, 61:150961.

Pulmonary alveolar proteinosis (PAP) is a rare airspace disease classically associated with the crazy-paving pattern on high-resolution computed tomography (HRCT). While highly suggestive, this imaging pattern is not pathognomonic and appears across a wide spectrum of pulmonary pathologies. In this review, we adopt a phenotype-first approach, using representative imaging cases to walk the reader through the differential diagnosis of crazy-paving, with attention to radiologic distribution, clinical context, and disease acuity. We emphasize distinguishing features between PAP and its mimics-including pulmonary edema, diffuse alveolar hemorrhage, organizing pneumonia, mucinous adenocarcinoma, exogenous lipoid pneumonia, acute fulminant PAP, and COVID-19 pneumonia-using side-by-side imaging and contextual pearls. Special attention is given to the radiologic clues favoring autoimmune versus secondary PAP, including geographic distribution of ground-glass opacities, subpleural sparing, and lower lobe predominance. The review concludes with a summary of diagnostic strategies, pathologic correlation, and treatment options, including insights from post-pandemic diagnostic pitfalls. This pattern-based framework is designed for the radiologist and serves as a practical guide for recognizing PAP within the broader spectrum of airspace diseases.

RevDate: 2026-06-10
CmpDate: 2026-01-12

Maleev VV, Fomin VV, Manakhov KM, et al (2025)

[Cardio-renal syndrome: perspectives of research in infectious diseases].

Terapevticheskii arkhiv, 97(11):902-907.

Clinical and prognostic significance of cardio-renal syndrome in various infectious diseases are discussed. Incidence and prognosis, as well as pathogenesis of cardio-renal syndrome in patients with infectious diseases, admitted to ICU of infectious hospitals, as well as hemorrhagic fever with renal syndrome and in COVID-19 are reviewed.

RevDate: 2026-06-10
CmpDate: 2026-01-14

Pechanova O, L Paulis (2025)

Nitric Oxide at the Nexus of ACE2 Biology and COVID-19: Implications for Cardiovascular and Neurodegenerative Comorbidities.

Physiological research, 74(Suppl 2):S171-S184.

SARS-CoV-2 engages ACE2 for cell entry, perturbing the counter-regulatory ACE2/Ang-(1-7)/Mas axis and shifting the renin angiotensin system toward ACE/Ang II/AT1 signaling, with a concomitant reduction in nitric oxide (NO) bioavailability. NO sits at the crossroads of these pathways, acting both as an antiviral modulator of spike-ACE2 interactions and as a downstream mediator of Mas-dependent endothelial protection. This review summarizes evidence on NO across three layers: (i) viral entry (S nitrosylation of spike/ACE2, protease modulation), (ii) cardiovascular comorbidities (hypertension, obesity, diabetes) where ACE2 downregulation impairs endothelial NO synthase (eNOS)-dependent NO production and promotes thrombosis and microvascular dysfunction, and (iii) neurovascular/ neurodegenerative sequelae, in which renin-angiotensin-aldosterone system (RAAS) dysregulation along with imbalance between protective eNOS/nNOS and inflammatory iNOS fosters blood-brain barrier disruption, microthrombosis, and cognitive impairment. Shared mechanisms - endotheliitis, microvascular dysfunction, and neuroinflammation may explain convergent risks for cardiac injury and cognitive decline in long COVID-19. Putative therapeutic strategies may include restoring physiological NO (via Mas agonism, Ang-(1-7), inhibition of Ang 1-7 degradation and recombinant ACE2), pulmonary-selective inhaled NO, hybrid S nitrosylated agents, and selective attenuation of iNOS/peroxynitrite alongside endothelial support. Targeted modulation - enhancing eNOS/nNOS while constraining iNOS offers a unified framework to mitigate both cardiovascular and neurodegenerative consequences of COVID-19.

RevDate: 2026-06-11
CmpDate: 2026-02-20

Bhattacharya S, Easmin N, Panja A, et al (2025)

mRNA-Based Cancer Vaccines: A Review of the Current Scenario and Future Prospects.

Protein and peptide letters, 32(11):776-790.

Messenger RNA (mRNA) has gained increasing attention as a valuable tool to cure various human diseases, particularly malignant tumors. Such growing interest has been triggered largely by the phenomenal clinical success of mRNA vaccines developed using lipid nanoparticle (LNP) technology against COVID-19. mRNA may be used to produce cancer immunotherapies in numerous different ways, including cancer vaccines to induce or enhance immunity to tumor-specific antigens (TSAs) or tumor-associated antigens (TAAs). mRNA can also be used to adoptively transfer T-cells for the expression of antigen receptors, such as chimeric antigen receptors (CARs), therapeutic antibodies, and immunomodulatory proteins to re-engineer the tumor microenvironment. However, the therapeutic potential of mRNA-based cancer immunotherapy is not fully utilized due to a few limitations, such as mRNA instability, production of immunogenicity, and a lack of efficient in-vivo delivery methods. This review provides an overview of the current advancements and future directions of mRNA-based cancer therapies, including various delivery routes and therapeutic platforms. It addresses the mechanistic basis of mRNA cancer vaccines, non-replicating and self-amplifying mRNA, as well as their clinical development, personalized vaccines, and applications of mRNA for encoding antigen receptors, antibodies, and immunomodulatory proteins. Moreover, the review addresses nanoparticle-based platforms, such as lipid nanoparticles (LNPs), polymeric nanoparticles, and peptide-based nanoparticles, all used to improve the therapeutic effectiveness of mRNA-based drugs by improving their targeted delivery to tissues. This review aims to provide insights into the use of state-of-the-art mRNA-based cancer immunotherapy.

RevDate: 2026-06-10
CmpDate: 2026-03-06

Petakh P, Halabitska I, Petrecka H, et al (2026)

Complex interactions between stress, nutrition, gut microbiota, and infectious diseases and their impact on health in global conflicts: A narrative review.

The Journal of nutritional biochemistry, 151:110267.

Following the global recovery from the COVID-19 pandemic, wars and conflicts have escalated to levels unseen since the Cold War. It is well known that conflict is accompanied not only by significant losses among both military personnel and civilians but also by rising levels of stress and stress-related disorders within the general population. Stress is bidirectionally connected with the state of the gut microbiota through the gut-brain axis. Dietary factors and eating behaviours also play crucial roles in shaping gut microbiota composition. On the one hand, conflict negatively affects food availability and dietary patterns, leading to reduced meal frequency and potentially diminishing microbiota diversity. On the other hand, stress-induced alterations in eating behaviour, such as bulimia or anorexia, can further impair gut microbiota composition. Additionally, individuals in conflict zones face heightened risks of infectious diseases due to disrupted vaccination schedules, poor sanitation, and limited access to clean drinking water. Stress-related immune changes may increase susceptibility to infections and raise the likelihood of adverse outcomes. Moreover, the frequent use of antibiotics to treat infections during conflicts contributes to reduced gut microbiota diversity. This review narratively examines the complex interactions among stress, immune responses, dietary patterns, infectious diseases, and gut microbiota in conflict-affected areas, and provides new perspectives on the role of artificial intelligence in modelling such comorbid pathologies.

RevDate: 2026-06-11
CmpDate: 2026-01-19

Okinaka K, JT Schiffer (2026)

Strategies for mitigating severe COVID-19 in patients with haematological malignancy during the omicron era.

The Journal of antimicrobial chemotherapy, 81(2):.

Despite a decrease in disease severity since the emergence of the severe acute respiratory syndrome coronavirus 2 Omicron variant, coronavirus disease-2019 (COVID-19) continues to pose a significant threat to patients with haematological malignancies (HM). Although repeated booster vaccinations enhance protection against severe illnesses in immunocompromised individuals, they remain at heightened risk of adverse outcomes. This underscores the crucial need for effective pharmacologic strategies to prevent and treat infection. This review examines current strategies for preventing severe COVID-19 in patients with HM, focusing on pre-exposure prophylaxis and early treatment of COVID-19. New monoclonal antibodies have been developed, offering effective pre-exposure prophylaxis. Antiviral agents and monoclonal antibodies demonstrated efficacy in limiting severe COVID-19 outcomes in patients with HM, though some patients, particularly the elderly, remain at risk of critical illness and death. Prolonged infection over months is also common, particularly in patients with lymphoid malignancies. Sustained viral shedding and ongoing mutation may be associated with chronic symptoms and is the likely source of several novel variants of concern that prolonged the pandemic. While HM subtype and advanced age are risk factors for severe or persistent COVID-19, there are no accurate tools for predicting individual risk. Given this uncertainty, prompt medical consultation, timely prescription of antiviral agents, and close monitoring are essential to minimize the risk of adverse outcomes in this vulnerable population.

RevDate: 2026-06-11
CmpDate: 2026-01-20

D'angelo MA, Nicolai R, Di Nicolantonio S, et al (2025)

Comparison of Teledentistry and Traditional Clinical Examination for Detection of DMFT Index in Children: A Systematic Review.

Pediatric dentistry, 47(6):380-387.

Purpose: This study systematically analyzed the published literature to evaluate the reliability of the caries experience index detection conducted in children (younger than 18 years of age) through teledental systems, comparing it with data obtained through traditional dental consultations. The question to be explored was whether dentists could use teledentistry to assess the caries risk index by calculating the DMFT (decayed, missing, and filled permanent teeth) score, thereby potentially reducing consultation time. Methods: A systematic English-language literature review was conducted, including the period from 2014 to 2024, that included the MeSH terms (("telemedicine"[Mesh]) AND "dental caries"[Mesh]) AND "DMF index"[Mesh]). Inclusion and exclusion criteria were defined according to the PICO methodology. A total of 11 manuscripts met the inclusion criteria. The methodological quality of these studies was assessed using the Newcastle-Ottawa Scale (NOS) with specific tools for cross-over studies. Results: From the 11 studies reviewed, it was suggested that teledentistry, through the use of intraoral photographs or video recordings, may represent a reliable, noninvasive, and efficient alternative for the detection of the caries experience index, compared to clinical examinations performed according to the traditional method. In most cases, the results were comparable between the two approaches. Conclusion: Incorporating teledentistry in combination with regular dental appointments could streamline clinical processes, enable effective treatment planning, and facilitate remote monitoring of the oral health status of patients, making it a timely and contemporary solution for a connected and health-conscious society-which is particularly valuable during public health crises such as the COVID-19 pandemic.

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

Shi Y, Li B, Zheng Y, et al (2026)

Therapeutic effect of anti-neuroinflammatory supplement combined with olfactory training on post-covid olfactory dysfunction: a systematic review and meta-analysis.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 283(6):3503-3512.

BACKGROUND: There is no established specific treatment for post-COVID olfactory dysfunction (PCOD) currently. Olfactory training (OT) is the only effective intervention supported by clinical evidence. The anti-neuroinflammatory supplement palmitoylethanolamide and luteolin (PEA-LUT) has shown potential in alleviating the symptoms of post-COVID, but its therapeutic effect on olfactory dysfunction and the gain effect when combined with OT remain to be evaluated.

METHODS: We comprehensively searched the online databases EMBASE, PubMed, ScienceDirect, Web of Science, Cochrane Library, Google Scholar, and ClinicalTrials.govfor the literature related to the treatment of PCOD, identified studies reporting the efficacy of PEA-LUT combined with OT, extracted the treatment outcome data, and performed data synthesis.

RESULTS: A total of 7 eligible RCTs published between 2021 and 2024 were included, comprising 525 patients with PCOD. Of the seven studies, five (71.4%) used the full Threshold-Discrimination-Identification (TDI) scoresystem to assess olfactory function, while two (28.6%) used only the Identification ("I") subscale; 332 patients (63.2%) received PEA-LUT + OT therapy and 203 (38.8%) received OT alone. Meta-analysis of these studies showed that patients receiving PEA-LUT combined with OT had significantly higher TDI scores compared to those receiving OT alone (Standard mean difference (SMD) = 0.90; 95% CI: 0.24-1.58; P < 0.01). The overall response rate was also significantly higher in the combination group (Risk difference (RD) = 0.33; 95% CI: 0.01-0.64; P = 0.04).

CONCLUSION: The neuroprotective properties of PEA-LUT appear to enhance recovery from post-COVID olfactory dysfunction. When combined with olfactory training, this treatment shows promising potential as a novel therapeutic approach.

RevDate: 2026-06-11
CmpDate: 2026-02-14

Galletta MAK, Hashimoto AS, de Almeida Estrambk G, et al (2026)

Prevalence of postpartum depression in the COVID-19 pandemic and associated factors: systematic review and meta-analysis.

BMC pregnancy and childbirth, 26(1):157.

BACKGROUND: The COVID-19 pandemic created a disruptive scenario with an increase in the prevalence of postpartum depression (PPD) and new associated risk factors, which deserve to be better studied, in different global contexts, which led to the present systematic review study.

METHODS: Observational studies published in English, Portuguese, and Spanish between 2020 and 2025 were included, and a meta-analysis was conducted using a random-effects model.

RESULTS: An initial survey of 1741 articles, of which 90 studies were selected with a total of 64,6994 women evaluated for PPD, with a range between 50 (1) and 5,134 (2) women. The overall prevalence of postpartum depression during the COVID-19 pandemic was 28.48% (25.14-31.94), with rates of 23.52% (18.961-28.40) in studies that used the Edinburgh Postnatal Depression Scale (EPDS) as a diagnostic instrument with a cutoff point ≥ 13. Studies from 31 countries were included, with higher prevalence observed in Latin America (34.08%), with lower rates in Europe (31.50%), the Middle East (29.31%), USA/Canada (24.26%), and Asia (22.32%). There was a higher prevalence of PPD in countries with a lower Human Development Index (HDI) (30.95%), with higher COVID-19 CFR (32.56%), higher maternal mortality (30.43%); and with the highest Gender Inequality Index (GII) (35.41%). PPD rates increased with postpartum time, varying between 18.31% (up to 1 month), 20.78% (up to 3 months), 34.67% (up to 6 months) and 36.55% (up to 12 months). Additionally, 11 protective factors and 53 risk factors were identified, most related to the pandemic, but also with the presence of factors already consolidated in the literature before the pandemic.

DISCUSSION: There was a global increase in the prevalence of PPD during the pandemic, with an intensification of pre-existing regional differences, causing the impact of the pandemic to be different according to the region.

CONCLUSIONS: The social and health crisis of the pandemic negatively impacted postpartum mental health, with significant regional differences.

TRIAL REGISTRATION: The study was registered in PROSPERO with the code CRD42023392973.

RevDate: 2026-06-11
CmpDate: 2026-03-25

Ahmad A, Gundeti MS, R M, et al (2026)

Status of evidence on efficacy and safety of Indian traditional medicine (Ayush) for COVID-19: a qualitative review and evidence map synthesis.

Systematic reviews, 15(1):.

BACKGROUND: The novel coronavirus (COVID-19), caused by SARS-CoV-2, was first reported in Wuhan, China, in December 2019. Its rapid spread, high mutation rate, and challenges in containment led the WHO to declare it a global pandemic on March 11, 2020. Traditional medicine played a supportive role during the COVID-19 pandemic by offering immune-boosting and symptom-relieving remedies, especially in regions with limited access to conventional healthcare. Several countries, including India, have integrated traditional therapies with modern treatment protocols to enhance patient outcomes and reduce disease burden.

OBJECTIVES: This review aims to critically synthesize the existing evidence on the efficacy and safety of Ayush interventions in the management of COVID-19 in India. It seeks to qualitatively analyze published literature and clinical trial data, and to develop an evidence map categorizing interventions by type and associated clinical outcomes.

METHODS: A comprehensive literature search was conducted across seven electronic databases, including the National Repository on R&D Initiatives of the Ministry of Ayush, WHO COVID-19 dashboard for clinical trials, AYUSH Research Portal, PubMed, Cochrane Library, WHO ICTRP, and CTRI. Studies published between 2019 and June 2024 were considered. A total of 3626 records were identified (2572 from indexed databases and 1054 from trial registries). After removing 640 duplicates, 2986 studies were screened for title and abstract. Following exclusion of 802 records, full-text assessment was performed on the remaining studies. After screening, 304 studies were included in the final review (178 Ayurveda, 22 Siddha, 31 Homeopathy, 22 Unani, and 51 Yoga). Risk of bias was assessed using the ROB 2 and ROBINS-I tools. Data extraction and collation were performed in accordance with the PRISMA guidelines. The study protocol was registered in PROSPERO.

RESULTS: A total of 304 studies were included, comprising 58 (19.1%) prophylaxis studies, 151 (49.7%) treatment studies, and 17 (5.6%) post-COVID rehabilitation studies across different Ayush systems. Ayurveda accounted for the largest proportion of publications (n = 178), followed by Yoga (n = 51). Among the randomized controlled trials, approximately half were assessed as having low-to-moderate risk of bias, whereas the remaining studies exhibited high or unclear risk of bias, primarily due to inadequate reporting of randomization procedures, allocation concealment, and blinding. Considerable methodological variability was observed across studies, including differences in intervention type, duration, outcome measures, and quality assessment scores.

CONCLUSION: While there is significant data on Ayush and COVID-19, current studies vary too widely to be definitive. Future research must prioritize rigorous scientific standards if these systems are to be effectively integrated into public health responses.

RevDate: 2026-06-12
CmpDate: 2026-02-23

Chao CM, Liu JW, Tang HJ, et al (2026)

The escalating threat of multidrug-resistant organisms: COVID-19 impact, global burden, and the Taiwanese experience.

Expert review of anti-infective therapy, 24(1):63-73.

INTRODUCTION: The COVID-19 pandemic has intensified global health challenges, including a silent but escalating crisis: multidrug-resistant organisms (MDROs). As healthcare systems strained under viral outbreaks, infection control and antimicrobial stewardship efforts suffered, accelerating the spread of antimicrobial resistance (AMR).

AREAS COVERED: This review examines the indirect effects of the COVID-19 pandemic on AMR, emphasizing changes in antibiotic utilization, healthcare-associated infections, and resistance trends. Global and regional epidemiological data are presented, with a special focus on Taiwan's evolving MDROs landscape, clinical burden, and strategic responses.

EXPERT OPINION: COVID-19 has both exposed and intensified vulnerabilities in AMR control. While the pandemic fostered certain infection control practices, it also disrupted antimicrobial oversight, leading to surges in MDROs prevalence. Taiwan's experience underscores the value of coordinated guidelines, real-time diagnostics, and artificial intelligence-driven stewardship. Rebuilding and future-proofing AMR responses requires integrated global policies, sustained surveillance, and innovation in diagnostics and therapeutics. Unless comprehensive action is taken, MDROs may emerge as the defining post-pandemic threat to modern medicine.

RevDate: 2026-06-10
CmpDate: 2026-03-26

Morimoto Y, Higashi H, Izumi H, et al (2026)

[Factors that contribute to the death/severity and onset of COVID-19 infection in working generation: Investigation of general health examination items by narrative review].

Sangyo eiseigaku zasshi = Journal of occupational health, 68(2):39-54.

The coronavirus disease 2019 (COVID-19) pandemic that affected Japan remains vivid in our collective memory. Currently classified as a Category 5 virus (for which medical institutions and individuals primarily implement preventive measures independently, without significant administrative intervention such as isolation), COVID-19 infections continue to peak biannually, currently driven by the Nimbus variant, a derivative of the Omicron strain. This situation necessitates ongoing vigilance in infection prevention efforts. While it is well-established that environmental factors, such as proper ventilation, are crucial in mitigating the risk of COVID-19 transmission, it has become evident that variations in individual susceptibility exist; some individuals contract the virus while others do not, even in identical environments. Personal factors, including pre-existing medical conditions, influence this disparity. This narrative review examines personal factors related to general health assessments within the workplace, incorporating data from systematic reviews and meta-analyses, as well as insights from both international and domestic academic societies. Although the strength of evidence varies, factors such as male gender, smoking, alcohol consumption, obesity, inadequate sleep, insufficient physical activity, hypertension, hyperlipidemia, diabetes, and chronic obstructive pulmonary disease have been identified as contributors to the severity and onset of COVID-19, as well as its associated mortality.

RevDate: 2026-06-11
CmpDate: 2026-01-25

Malemnganba T, Baghel K, Mehrotra S, et al (2026)

Unlocking the power of antimicrobial peptides to combat infectious agents.

Advances in protein chemistry and structural biology, 149:203-244.

The rapid rise of antibiotic-resistant bacteria has become a major clinical challenge, creating an urgent need for alternative therapeutic strategies. Antimicrobial peptides (AMPs) have emerged as promising candidates in the fight against these resistant pathogens. Naturally produced by a wide variety of organisms, AMPs are a crucial part of the innate immune system, offering a broad-spectrum antimicrobial effect against bacteria, fungi, viruses, and parasites. Unlike traditional antibiotics, AMPs primarily target microbial membranes, which reduces the likelihood of resistance development. Beyond their pathogen-destroying properties, AMPs enhance immune responses, aid in wound healing, and exhibit anticancer properties. Their ability to act swiftly and in synergy with the host immune system offers a distinct advantage over conventional antibiotics. Furthermore, AMPs hold the potential to be developed into novel treatments for infections that have become resistant to all available therapies. However, bacterial resistance mechanisms to AMPs-such as membrane modifications, protease production, and biofilm formation-underscore the complex interactions between hosts and pathogens. Despite these challenges, AMPs present an exciting avenue across multiple sectors, including medicine, agriculture, and food safety. Recent research also highlights their potential in treating viral infections, including COVID-19, showcasing their versatile applications. This chapter discusses the role of AMPs in addressing antibiotic resistance, their mechanisms of action, and their diverse therapeutic applications beyond bacterial infections.

RevDate: 2026-06-10
CmpDate: 2026-06-05

Song X, Lian Z, Wang R, et al (2026)

The Phases of Living Evidence Synthesis Using AI AI: Living Evidence Synthesis (Version 1).

Journal of medical Internet research, 28:e76130.

BACKGROUND: Living evidence (LE) synthesis refers to the method of continuously updating systematic evidence reviews to incorporate new evidence. It has emerged to address the limitations of the traditional systematic review process, particularly the absence of or delays in publication updates. The emergence of COVID-19 accelerated the progress in the field of LE synthesis, and currently, the applications of artificial intelligence (AI) in LE synthesis are expanding rapidly. However, in which phases of LE synthesis should AI be used remains an unanswered question.

OBJECTIVE: This study aims to (1) document the phases of LE synthesis where AI is used and (2) investigate whether AI improves the efficiency, accuracy, or utility of LE synthesis.

METHODS: We searched Web of Science, PubMed, the Cochrane Library, Epistemonikos, the Campbell Library, IEEE Xplore, medRxiv, COVID-19 Evidence Network to support Decision-making, and McMaster Health Forum. We used Covidence to facilitate the monthly screening and extraction processes to maintain the LE synthesis process. Studies that used or developed AI or semiautomated tools in the phases of LE synthesis were included.

RESULTS: A total of 24 studies were included, including 17 on LE syntheses, with 4 involving tool development, and 7 on living meta-analyses, with 3 involving tool development. First, a total of 34 AI or semiautomated tools were involved, comprising 12 AI tools and 22 semiautomated tools. The most frequently used AI or semiautomated tools were machine learning classifiers (n=5) and the Living Interactive Evidence synthesis platform (n=3). Second, 20 AI or semiautomated tools were used for the data extraction or collection and risk of bias assessment phase, and only 1 AI tool was used for the publication update phase. Third, 3 studies demonstrated the improvement in efficiency achieved based on time, workload, and conflict rate metrics. Nine studies applied AI or semiautomated tools in LE synthesis, obtaining a mean recall rate of 96.24%, and 6 studies achieved a mean F1-score of 92.17%. Additionally, 8 studies reported precision values ranging from 0.2% to 100%.

CONCLUSIONS: AI and semiautomated tools primarily facilitate data extraction or collection and risk of bias assessment. The use of AI or semiautomated tools in LE synthesis improves efficiency, leading to high accuracy, recall, and F1-scores, while precision varies across tools.

RevDate: 2026-06-11
CmpDate: 2026-06-05

Dunn M, 't Hoen E, Boulet P, et al (2026)

TRIPS flexibilities help change policy and practice to increase access to medicines: evidence from 2001 to 2024.

BMJ global health, 11(1):.

INTRODUCTION: Millions of people lack access to safe and effective pharmaceuticals because they are unaffordable or unavailable, particularly in 'developing' and 'least-developed' countries (DCs, LDCs), and increasingly in high-income countries (HICs). Management of intellectual property (IP) related to new medicines has a significant impact on access to safe, affordable and effective medicines. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) provides the international legal framework for IP protection and mandates 20-year patents in all technological fields, including pharmaceuticals. TRIPS contains flexibilities, such as compulsory licensing (CL) and transition provisions for LDCs, which governments can use to facilitate access to health technologies. The use of these flexibilities is underreported in the literature, and a thorough analysis has not been undertaken since the COVID-19 pandemic.

METHODS: A scoping review of three medical and legal databases and temporal analysis of all known instances of use or potential use of CLs and the LDC pharmaceutical transition measure between 2001-2024.

RESULTS: 61% of the 149 CL instances were executed. The relative rates of CL use between countries have shifted: HICs represent over half of CL instances in the last decade. CLs are increasingly considered for chronic, non-communicable and rare diseases. The threat of CL use continues to provide impetus for price negotiations, voluntary licences or other measures to improve access. Almost all eligible countries have invoked the right to use the LDC transition measure.

CONCLUSIONS: TRIPS flexibilities have been used to facilitate access to medicines (including vaccines) over the quarter-century since the adoption of the World Trade Organization's Doha Declaration on TRIPS and Public Health. The flexibilities play a vital role in ensuring that new medicines are affordable and are likely to continue to be in a future where geopolitical forces have drastically altered the financing structures of medicines provision in DCs and LDCs.

RevDate: 2026-06-11
CmpDate: 2026-03-17

Keels JN, LaPlante RD, Lee CS, et al (2026)

Prevalence of new-onset diabetes following COVID-19 infection: A systematic review and meta-analysis.

Diabetes, obesity & metabolism, 28(4):3182-3192.

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.

RevDate: 2026-06-11
CmpDate: 2026-02-21

Kyriakopoulos AM, McCullough PA, S Seneff (2026)

Taurine intake ameliorates lactic acidosis and hyperferritinemia occurring after mRNA SARS-CoV-2 vaccination in a patient with β-thalassemia trait: a case report and review of literature.

Journal of medical case reports, 20(1):.

BACKGROUND: Taurine is a powerful antioxidant necessary for mitochondrial function. Lactic acidosis is a complication encountered in the condition mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS), which can be successfully treated with supplemental taurine. Furthermore, taurine regulates the production of iron-dependent proteins such as ferritin that can act as chelating agents to sequester labile iron.

CASE PRESENTATION: A 38-year-old Greek male with a β-zero thalassemia trait developed multiple severe symptoms soon after his first and only mRNA (Pfizer) SARS-CoV-2 vaccination that included hematological stress to be a candidate for blood transfusion. Amongst the hematological readings, the patient had lactate levels > 4 mmol/ml, indicating lactic acidosis, and ferritin levels > 820 ng/ml, representing hyperferritinemia. Moreover, the patient has organic acid and plasma metabolite levels in the urine that are indicative of mitochondrial dysfunction. Regular taurine intake (500 mg/day) for years helped the patient control lactate and ferritin levels and avoid more serious clinical decompensation.

CONCLUSION: Regular taurine intake helps to avoid lactic acidosis and reverse hyperferritinemia after mRNA SARS-CoV-2 vaccination in a patient with β-zero thalassemia trait with no obvious genetic trait linked to mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes. Taurine seemed to be protective for mitochondria.

RevDate: 2026-06-11
CmpDate: 2026-02-11

Kharkivska Y, Shkel O, YK Kim (2026)

Syntenins at the crossroads of host-virus interactions.

Methods (San Diego, Calif.), 247:175-183.

Syntenin is a multifunctional PDZ-domain adaptor protein that orchestrates membrane trafficking, cytoskeletal remodeling, and exosome biogenesis. Initially identified as a syndecan-binding molecule, syntenin has since emerged as a central hub connecting membrane receptors to intracellular signaling pathways that regulate adhesion, motility, immune signaling, and cellular plasticity. While extensively studied in cancer and neural development, recent discoveries reveal that a wide range of viruses exploit syntenin to facilitate their replication, assembly, or dissemination. This review consolidates current evidence across diverse viral infections to elucidate the molecular mechanisms underlying the interaction between syntenin and viruses. Coronaviruses utilize syntenin to link PDZ-binding motifs to p38 MAPK-driven inflammation and endosomal entry. Papillomaviruses and Epstein-Barr virus hijack the CD63-syntenin-ALIX complex to control vesicle-mediated trafficking. Hepatitis C virus employs it to secrete E2-coated, antibody-resistant exosomes. Dengue virus harnesses its mosquito homolog AeSyntenin to package sfRNA for transmission. Human T-cell leukemia virus type 1 employs its Tax-1 oncoprotein to bind the PDZ domains of syntenin, remodel extracellular vesicle cargo, and promote viral spread. In contrast, during human immunodeficiency virus infection, syntenin restricts viral fusion at the plasma membrane, though the nucleocapsid mimics its PDZ tandem to promote virion release. Collectively, these findings establish syntenin as a dynamic regulator at the host-virus interface, capable of exerting both proviral and antiviral effects. Emerging pharmacological strategies targeting syntenin PDZ domains further underscore its potential as a broad-spectrum, host-directed antiviral target.

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

Chigozie VU, Nnamani MN, Igwe KN, et al (2026)

Integrating infodemiology and infodemics management to address antimicrobial resistance and vaccine hesitancy challenges in Nigeria/Africa.

Journal of communication in healthcare, 19(2):131-153.

BACKGROUND: Antimicrobial resistance (AMR) and vaccine hesitancy (VH) are significant public health threats in Nigeria/Africa, due to limited healthcare infrastructure and health literacy, thus encouraging misinformation, which further exacerbates these issues.

METHODS: This review examines recent literature to explore how Infodemiology and Infodemics management can be integrated into strategies addressing AMR and VH in Nigeria and Africa. A narrative review methodology was employed, sourcing studies mostly from 2020 onwards to ensure contemporary relevance.

RESULTS: Infodemiology offers tools for addressing the dual public health threats of AMR and VH in Nigeria/Africa. Evidence reveals AMR behaviors are strongly influenced by misconceptions about antibiotics, such as their efficacy against viral infections, perpetuated by social media and word-of-mouth misinformation. Similarly, VH is fueled by cultural beliefs and mistrust in health systems, amplified during the COVID-19 pandemic, where myths about infertility and harmful ingredients led to skepticism. Infodemiology enables real-time tracking of misinformation trends through digital tools, allowing health authorities to identify hotspots and intervene with targeted campaigns.

CONCLUSION: Integrating infodemiology into AMR and VH management strategies enhances public health outcomes by addressing misinformation at its roots and promoting evidence-based practices. By leveraging digital tools and engaging trusted local figures, health systems can foster trust and literacy among communities. African governments must invest in digital health infrastructure, establish supportive policies, and foster partnerships with social media platforms to sustainably manage infodemics. These strategies are ivotal for reducing AMR and increasing vaccine acceptance, ultimately safeguarding health across human, animal, and environmental domains.

RevDate: 2026-06-11
CmpDate: 2026-05-18

Martins C, Mitchell MJ, Peer D, et al (2026)

The RNA delivery dilemma-lipid versus polymer nanoparticle platforms.

Drug delivery and translational research, 16(6):1667-1684.

Since the first market authorization of RNA therapies, just eight years ago, the field has witnessed an extraordinary expansion, ranging from hepatic delivery for rare genetic diseases to global-scale vaccination during the COVID-19 pandemic, and now to cutting-edge cancer vaccines and gene editing strategies entering late-stage clinical trials. In parallel, the RNA therapeutics landscape has evolved rapidly, progressing from small interfering RNAs to next-generation and combinatorial RNA modalities. None of these breakthroughs would have been possible without the development of sophisticated RNA delivery technologies capable of navigating complex biological environments, enabling precise cellular targeting, and facilitating efficient intracellular trafficking. In this Editorial Note, we take a step back to reflect on key lessons learned throughout the RNA delivery journey. Featuring insights from leading and experienced voices in the field, this manuscript highlights critical milestones, persistent challenges, and the roles of lipid nanoparticles (LNPs) and polymer nanoparticles (PNPs) as RNA delivery platforms. These experts reflect on the features that have positioned LNPs as the current RNA delivery gold standard, while also exploring the untapped potential and distinctive advantages of polymer-based nanosystems. Collectively, these perspectives underscore a striking truth: we are only beginning to unlock the full therapeutic potential of RNA, and nanomedicine will certainly continue to shape the future clinical translation of RNA-based therapies.

RevDate: 2026-06-11
CmpDate: 2026-01-30

Beran J, J Slíva (2025)

The last ten years with inosine pranobex - from an "old" therapeutic agent to vaccine research, including anti-cancer vaccines.

Casopis lekaru ceskych, 164(7-8):321-323.

Inosine pranobex (IP), also known as inosine pranobex dimepranol, is an immunomodulatory drug with a history spanning more than fifty years. It was first introduced in the 1970s and has since been licensed in more than 50 countries around the world. It was originally considered a potential drug for AIDS, which raised high hopes at the time of the discovery of the HIV virus. However, after initial interest, its use in this area declined, and for a long time, IP was no longer discussed significantly in professional literature or clinical practice. Renewed interest came only in the last decade, when IP began to reappear in connection with the treatment of acute respiratory infections, diseases caused by human papillomavirus (HPV), and other viral diseases, including COVID-19. It also began to be used as an adjuvant in the foot-and-mouth disease vaccine, and research began on an IP-based anti-tumor vaccine.

RevDate: 2026-06-11
CmpDate: 2026-01-31

Nesari AM, MotieGhader H, S Ghorbian (2026)

Advances and challenges in single-cell RNA sequencing data analysis: a comprehensive review.

Briefings in bioinformatics, 27(1):.

Single-cell RNA sequencing (scRNA-seq) has transformed the resolution of cellular heterogeneity, offering insights into dynamic biological processes from tumor evolution to immune regulation. However, its clinical translation is limited by challenges such as data sparsity, batch effects (differences caused by technical variation rather than biology), and the absence of standardized benchmarks for core pipelines like Seurat and Scanpy. This review outlines emerging computational strategies that address these limitations: (A) robust preprocessing, including SCTransform for zero-inflation(an excess of zero counts in gene-expression data) correction and Harmony for batch integration-achieving 30% faster alignment than BBKNN in cohorts exceeding 100,000 cells; (B) transformer-based annotation tools such as scGPT and CellTypist, which reach >95% accuracy in immune profiling using models pretrained on 33 million cells; and (C) multimodal integration with spatial transcriptomics (e.g., 10x Visium, cell2location v2), which delineate microenvironmental niches and rare CX3CR1+ T-cell subsets in disease contexts like glioblastoma and severe COVID-19. We further assess how scANVI bridges scRNA-seq and ATAC-seq to uncover epigenetic mechanisms underlying therapy resistance, and how spatial methods elucidate tumor-immune crosstalk at subcellular resolution. Despite these advances, ethical risks remain, particularly around re-identification of rare patient-derived clones such as pre-metastatic cells. To promote clinical adoption, we propose a roadmap that prioritizes benchmarked workflows (e.g., scverse ecosystem), privacy-aware data sharing via federated learning, and causal AI approaches to disentangle biological signal from technical artifact. By synthesizing computational innovations with translational case studies, this review equips researchers to navigate both the analytical and ethical complexities of scRNA-seq in pursuit of actionable diagnostics.

RevDate: 2026-06-11
CmpDate: 2026-02-02

Kshatriya M, Syal R, Als D, et al (2026)

Implementation of health and health-related sustainable development goals: progress, challenges and opportunities-a systematic literature review update.

BMJ global health, 11(2):.

INTRODUCTION: A prior systematic review assessed progress in health and health-related sustainable development goals (HHSDGs) from 2015 to 2019, identifying an important need for countries to strengthen implementation of multisectoral work, capacity building, financial stability and data availability. We undertook an updated systematic review to assess additional progress, challenges and opportunities for HHSDG implementation from 2019 to 2025, including the pandemic periods. This update aims to assess where countries are presently in HHSDG implementation and if further recommendations can be made in the final stretch to the 2030 targets.

METHODS: We followed a comparable comprehensive search strategy as the first review, focusing on implementation and acceleration strategies for HHSDGs. We undertook a qualitative synthesis from peer-reviewed and grey literature for specific databases, including studies and reports published from June 2019 to January 2025.

RESULTS: A total of 192 publications were included in the review of which 150 provided national-level information and 42 provided multicountry or regional information. Findings suggest a high level of political commitment in most countries and many HHSDG efforts being aligned with existing national development strategies. There was a noteworthy shift towards decentralised, subnational approaches to provide contextually relevant interventions. Multisectoral, multistakeholder, integrated approaches for implementation are increasing and proving to be effective. Diverse monitoring and evaluation strategies were employed, and (cross-country) knowledge sharing was instrumental to SDG policy and programme planning. Service disruptions incurred by the COVID-19 pandemic, lack of quality data and obtaining sustainable funding were frequently cited challenges to implementation.

CONCLUSIONS: Ensuring continuous financial investments and strengthening data availability are essential to accelerate HHSDG implementation. Recommendations for progress include strengthening primary healthcare, fostering multisectoral collaboration and addressing deep-rooted societal perceptions around gender inequity. Future research should examine the interplay of multiple SDGs, and the impact of factors such as cost-effective cross-regional approaches for project implementation.

RevDate: 2026-06-11
CmpDate: 2026-02-03

Fan C, Dai Y, Du H, et al (2026)

Successful treatment of severe cerebral malaria with artificial liver blood purification technology: A case report.

Medicine, 105(5):e47528.

RATIONALE: Plasmodium falciparum infection can lead to acute thrombocytopenia, severe hemolytic anemia, and acute liver and kidney failure, among which the fatality rate of cerebral malaria is as high as 20% to 30%. Continuous bedside blood purification technology is an important intervention measure for severe malaria. The artificial liver blood purification technology, with its multimode clearance advantage, is widely used in the treatment of critical conditions such as liver failure, sepsis, and novel coronavirus infection. We described a case of severe cerebral malaria complicated with severe liver and kidney injury, cerebral edema and heart failure. The patient was cured after treatment with artificial liver blood purification technology. A literature review was also conducted.

PATIENT CONCERNS: A 43-year-old male patient was admitted to our hospital due to fever and confusion. The patient had frequently traveled to Nigeria on business in the past 10 years. Three days ago, he developed high fever and confusion. Blood smear examination revealed infection with Plasmodium falciparum. He also suffered from acute liver and kidney function impairment, severe thrombocytopenia, coagulation dysfunction, cerebral edema, and anuria.

DIAGNOSES: Peripheral blood smear, for the diagnosis of malignant malaria parasite infection.

INTERVENTIONS: The patient received treatments such as artemether for antimalarial parasites, artificial liver blood purification, and ICU support.

OUTCOMES: Through continuous renal replacement therapy combined with artificial liver blood purification technology for fluid management, immune complex clearance, and correction of water, electrolyte and acid-base disorders, the patient was successfully treated.

LESSONS: The integration of artificial liver blood purification with continuous renal replacement therapy may serve as an effective rescue therapy for severe malaria with multi-organ failure, potentially by mitigating the systemic inflammatory response and supporting organ recovery. This case highlights the potential of combined extracorporeal support in managing critical tropical infections.

RevDate: 2026-06-11
CmpDate: 2026-02-03

Alruwaita AA, Lang AE, C Ganos (2026)

Functional tics and tic-like behaviors.

Handbook of clinical neurology, 215:55-62.

Functional tics and tic-like behaviors belong to the wide spectrum of functional movement disorders. Until the early 2010s, functional tic disorders were rather uncommon in the differential diagnosis of tics, and only few cases describing their features had been published. However, over the past 10 years there has been a steady increase in the frequency of these cases that peaked throughout the COVID-19 pandemic. On the one hand, the rise in functional tic cases created new challenges of diagnosis and treatment. At the same time, it also pushed the field forward to delineate helpful clinical clues, as well as to work toward specific consensus diagnostic criteria for functional tics and tic-like behaviors. Here, we first provide a historical summary on the debate between neurodevelopmental and functional tics. We then track relevant literature on functional tics and tic-like cases and discuss their salient features, such as an acute onset with severe symptoms and complex repetitive behaviors that typically occur in late adolescence or early adulthood, a large variability of symptoms including spontaneous symptom remissions and re-emergence, and a high prevalence of phonations and vocalizations with the common use of swearwords or variable sentences. In addition, it is common to see an overlap with additional functional neurologic symptoms, such as functional tremor or nonepileptic seizures. In diagnostically challenging cases, neurophysiologic evaluation, including surface electromyography and electroencephalography, may be useful, and markers such as the premotor potential (Bereitschaftspotential) and event-related desynchronization/synchronization may hold promise. Effective management of functional tics begins with an accurate diagnosis and often requires a multidisciplinary approach. Cognitive-behavioral therapy and the Comprehensive Behavioral Intervention for Tics may be particularly useful, alongside addressing comorbid psychiatric conditions. Currently there is an absence of standardized treatment protocols; individualized care plans tailored to each patient's specific needs are generally the most effective approach.

RevDate: 2026-06-11
CmpDate: 2026-03-21

Ogoti B, Riitho V, Wildemann J, et al (2026)

Epidemiology and genomic features of MERS coronavirus in Africa: a systematic and meta-analysis review.

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 165:108456.

OBJECTIVES: We explored factors contributing to the low human MERS-CoV prevalence in Africa by assessing MERS-CoV epidemiological and genomic features.

METHODS: We followed the PRISMA guidelines. We searched for articles on epidemiological and virological MERS-CoV characteristics in humans and camels in Africa until August 2025. We used a generalised linear mixed-effects model to calculate pooled proportions. We identified relevant polymorphisms in African MERS-CoV lineages compared with the prototypic EMC/2012 and contemporary Arabian MERS-CoV (clade B5).

RESULTS: We included 53 articles, with 31 used in the meta-analysis. Kenya, Egypt, and Ethiopia contributed to 66.03% of all included studies. Pooled MERS-CoV RNA positivity in African dromedaries was 6.09%, with juveniles (15.29%) having a higher incidence than adults (4.51%). The pooled MERS-CoV seroprevalence was 73.67%, with adults (80.96%) higher than juveniles (36.02%). In human-focused studies, only nine PCR-confirmed MERS cases were reported, six travel-associated and three autochthonous cases, despite a pooled seroprevalence of 2.4%. Genomic analyses identified MERS-CoV clade C-specific polymorphisms in the Spike and accessory genes with putative phenotypic impact.

CONCLUSION: We found the highest MERS-CoV RNA positivity in young dromedaries. Elevated MERS-CoV seroprevalence in mainly asymptomatic camel-exposed humans suggests an underestimation of MERS-CoV infections in Africa. The ongoing MERS-CoV evolution emphasises the need for active genomic surveillance to monitor signatures of human adaptation.

RevDate: 2026-06-11
CmpDate: 2026-04-21

Qaseem A, Obley AJ, Yost J, et al (2026)

Outpatient Treatment of Confirmed COVID-19 in Symptomatic Adults: Living, Rapid Practice Points From the American College of Physicians (Version 3).

Annals of internal medicine, 179(4):559-563.

DESCRIPTION: The American College of Physicians (ACP) maintains living, rapid practice points on antiviral treatment in the outpatient setting for COVID-19.

METHODS: The Population Health and Medical Science Committee (PHMSC) developed this version 3 based on evidence from a focused update of a living, rapid review conducted by the ACP Center for Evidence Reviews at Cochrane Austria. This version addresses the SARS-CoV-2 Omicron variant and reaffirms previous practice points on the use of antiviral treatments of confirmed COVID-19 in unvaccinated or vaccinated and symptomatic patients in the outpatient setting.

PRACTICE POINT 1: Consider nirmatrelvir-ritonavir combination therapy to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease.

PRACTICE POINT 2: Consider molnupiravir to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease.

PRACTICE POINT 3: Do not use ivermectin to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.

PRACTICE POINT 4: Do not use sotrovimab to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.

RETIREMENT FROM LIVING STATUS: The PHMSC is retiring this topic from living status considering that this update and previous surveillance have not yielded important changes to the practice points.

RevDate: 2026-06-11
CmpDate: 2026-06-11

Oda M, Yoshimori Y, Yamada T, et al (2026)

Health of teleworkers: a scoping review on the assessment of the work-from-home environment.

Journal of occupational health, 68(1):.

OBJECTIVES: Inappropriate telework environments, including work-from-home (WFH) settings, have been linked to physical and mental health problems. However, no systematic assessment has been conducted regarding the WFH environment (WFH-E). The aim of this study was to clarify the current methods used to assess the WFH-E and its association with health- and work-related outcomes through a scoping review.

METHODS: We searched PubMed, Web of Science, and Ichushi for literature published since 2010 on WFH-E assessment. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, assessment methods were summarized using 18 items categorized into 9 domains. Additionally, associations between the WFH-E and health- and work-related outcomes were reviewed.

RESULTS: Of 1669 articles collected, 37 studies published from 2020 were ultimately included in this review. Thirty-four articles involved subjective assessments, and 9 involved objective assessments. The most frequently assessed item was artificial lighting, followed by thermal conditions and noise. Items such as color, greenery, building materials, and odor were rarely assessed. Most studies showed significant associations between the WFH-E and health- and work-related outcomes.

CONCLUSIONS: Studies on the WFH-E increased following the COVID-19 pandemic, showing significant associations between the WFH-E and health- and work-related outcomes. However, most assessments were subjective, with objective assessments remaining rare. Additionally, the assessment items were limited and biased, indicating that interior design elements were insufficiently assessed. Developing additional objective and comprehensive methods for assessing the WFH-E is needed.

RevDate: 2026-06-11
CmpDate: 2026-03-12

Lailaturrahmi L, Caliph S, Vu T, et al (2026)

Teaching clinical skills online in pharmacy education: a scoping review.

Currents in pharmacy teaching & learning, 18(5):102607.

Background The integration of online teaching and learning in pharmacy curricula has increased since the worldwide rapid transition to remote teaching during the COVID-19 pandemic. However, how clinical skills were taught online in pharmacy education, including the types of skills, approaches and technologies used, and the outcomes remain poorly understood. Objective To provide an overview of the types of clinical skills taught online in pharmacy education; and to identify the purposes, teaching strategies, technologies used, educational settings, enabling and limiting factors, and reported outcomes to inform future curriculum development in pharmacy education. Methods The scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) Scoping Review methodology. A systematic literature search was conducted in MEDLINE, CINAHL, and ERIC databases using predefined inclusion and exclusion criteria, and the records were independently screened by four reviewers. Any discrepancies during the screening process were resolved through discussion. The data were extracted and then analyzed using content analysis and thematic analysis. Results A total of 349 studies were retrieved and proceeded to title and abstract screening. After applying the inclusion and exclusion criteria, 152 full-text articles were assessed for eligibility, of which sixty-four articles were included in the final review. Online synchronous, asynchronous, and blended learning were implemented in pharmacy education to teach clinical skills, including communication skills and therapeutic decision-making skills. Clinical skills were most often taught online to improve the learning process. Learning outcomes measured by self-assessment or by educators were most commonly reported. Enablers, including institutional readiness and technology infrastructure, and barriers, including institutional unpreparedness and inadequate design, were also identified. Conclusion This scoping review provides guiding information to integrate online teaching and learning into pharmacy curricula, particularly for clinical skills development. By including multiple stakeholders' perspectives, this review offers useful insight for academics and faculty leaders to successfully teach clinical skills online to pharmacy students.

RevDate: 2026-06-11
CmpDate: 2026-02-16

Martinez-Morga M, Garrigos D, Martinez-Morga S, et al (2026)

[Consequences of congenital COVID-19 on the cognitive development of affected children].

Medicina, 86 Suppl 1:2-7.

Congenital COVID-19 refers to infection with the SARS-CoV-2 virus acquired in utero as a result of maternal infection during pregnancy. Although vertical transmission of the virus from mother to fetus appears to be relatively infrequent, growing clinical and epidemiological evidence indicates that prenatal exposure to SARSCoV-2, as well as to the maternal immune response it elicits, may have significant implications for early neurological development. Therefore, understanding the potential cognitive consequences of congenital COVID-19 is essential for the long-term monitoring of child health in affected individuals and for the implementation of early intervention strategies. This post-pandemic perspective on the consequences for neural development has been supported by observations showing that neonates exposed to congenital COVID-19 infection have a tenfold higher incidence of developmental delay compared with those not exposed to the virus. In this review, we examine the pathogenic mechanisms that may explain the increased incidence of neurodevelopmental alterations.

RevDate: 2026-06-11
CmpDate: 2026-02-17

Yadegari H (2026)

Von Willebrand Factor at the Crossroads of Hemostasis and Inflammation.

Hamostaseologie, 46(1):34-43.

Von Willebrand factor (VWF) is a large multimeric glycoprotein critical for hemostasis, mediating platelet adhesion to injured vessels and stabilizing circulating factor VIII. However, accumulating evidence reveals a complex, context-dependent role for VWF in inflammation and innate immunity that extends well beyond coagulation. VWF acts not only as a biomarker of endothelial activation but also as an active participant in immune responses. VWF directly interacts with major immune cell types-including macrophages, polymorphonuclear leukocytes (neutrophils), and dendritic cells-through both its endothelial-anchored and plasma forms. VWF facilitates leukocyte recruitment and transmigration across the vessel wall, while its interactions also promote macrophage and neutrophil activation as well as NET formation. VWF's immunomodulatory functions are further highlighted by its binding to extracellular DNA, smooth muscle cells, complement components (C1q and C3), and bacterial pathogens under flow conditions. Furthermore, VWF indirectly influences inflammation via its crucial role in Weibel-Palade body formation, a process that co-packages vital inflammatory mediators like P-selectin and angiopoietin-2. Markedly elevated VWF levels are consistently observed across acute and chronic inflammatory conditions such as sepsis, COVID-19, and autoimmune disorders, confirming its relevance as both a diagnostic marker and a therapeutic target. A comprehensive understanding of VWF's diverse functions in vascular inflammation is crucial for developing targeted therapeutics-including nanobodies, ADAMTS13 variants, and VWF interaction inhibitors-capable of modulating pathological thrombo-inflammation while preserving physiological hemostasis.

RevDate: 2026-06-11
CmpDate: 2026-03-28

Abuhay AE, Assaye MM, Zeleke TA, et al (2026)

Knowledge and attitude toward monkeypox (mpox) among healthcare providers in Sub-Saharan Africa: a systematic review and meta-analysis.

Systematic reviews, 15(1):.

BACKGROUND: Mpox is an emerging global health threat with increasing frequency and geographic spread recently. Healthcare providers play a pivotal role in outbreak prevention, early detection, isolation, and response. This systematic review and meta-analysis aimed to assess the pooled prevalence of knowledge and attitude toward Mpox among healthcare providers in Sub-Saharan Africa (SSA).

METHODS: This systematic review and meta-analysis was conducted in accordance with the PRISMA guidelines. A comprehensive literature search was performed in PubMed, ScienceDirect, Hinari, and Google Scholar to identify eligible studies published between 2 July 2015 and 2 July 2025. Data were extracted and managed using Microsoft Excel and analyzed using STATA version 17. Pooled prevalence estimates were calculated using a random-effects model. The methodological quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Publication bias was examined using funnel plots and Egger's regression test, and statistical heterogeneity was assessed using the I[2] statistic. The review protocol was registered in PROSPERO (CRD420251123652).

RESULTS: This systematic review and meta-analysis included seven studies from Sub-Saharan Africa, comprising a total of 3379 healthcare providers. The pooled prevalence of adequate knowledge and a positive attitude toward Mpox was 40.52% (95% CI, 30.17-50.88) and 51.20% (95% CI, 44.48-57.91), respectively, with high heterogeneity (I[2] > 90%). Factors associated with higher knowledge included age over 40 years (AOR = 5.90; 95% CI, 1.27-27.41), being married (AOR = 1.58; 95% CI, 1.24-2.01), being a physician (AOR = 6.82; 95% CI, 1.38-33.56), having 5-10 years of work experience (AOR = 7.02; 95% CI, 1.51-32.74), prior information about Mpox (AOR = 1.82; 95% CI, 1.11-2.97), and a history of COVID-19 vaccination (AOR = 1.98; 95% CI, 1.47-2.68). Regarding attitude, higher education (AOR = 2.09; 95% CI, 1.38-3.18) and male sex (AOR = 1.50; 95% CI, 1.12-1.91) were positively associated. Prevalence was pooled through meta-analysis, while associated factors were reported individually from each study, as pooling adjusted odds ratios was not appropriate due to differences in covariates and outcome definitions. These findings should be interpreted with caution due to high heterogeneity, the small number of studies, and uneven geographic representation.

CONCLUSIONS: The findings of this systematic review and meta-analysis indicate that knowledge and attitudes toward Mpox among healthcare providers in Sub-Saharan Africa are generally suboptimal. However, these results should be interpreted with caution due to high heterogeneity across studies, the limited number of included studies, and uneven geographic representation. Nonetheless, the findings underscore the need for context-specific capacity-building interventions, including targeted training, improved access to up-to-date clinical guidelines, and enhanced preparedness strategies to support healthcare providers in responding to Mpox and other emerging infectious diseases.

RevDate: 2026-06-11
CmpDate: 2026-04-01

Belland KM, CA DeJohn (2026)

Comprehensive Review: Ultraviolet-C (UVC) Disinfection in Aircraft Cabins.

Health security, 24(1):35-38.

Ultraviolet-C (UVC) disinfection has gained considerable attention as a continuous, real-time method to mitigate the transmission of airborne pathogens within aircraft cabins. Recent investigations have demonstrated its potential to inactivate viruses such as SARS-CoV-2, influenza, and other emerging infectious agents in situ, thereby reducing both immediate infection risks and broader public health burdens. This commentary evaluates how continuous UVC disinfection-applied in tandem with established preventive measures-may effectively curtail disease transmission, reassure passengers, and inform the future direction of in-flight health and safety standards.

RevDate: 2026-06-11
CmpDate: 2026-06-11

Li Q, Zeng M, Lv W, et al (2026)

Current landscape of clinical trials for mRNA-based therapeutics.

Human vaccines & immunotherapeutics, 22(1):2635868.

Beyond coronavirus disease 2019 (COVID-19) vaccines, messenger RNA (mRNA)-based therapeutics have increasingly demonstrated potential across other treatment areas. To summarize the clinical research landscape for such products and provide valuable references for researchers working in related fields, mRNA clinical trials registered on ClinicalTrials.gov (CTg) and the Chinese Clinical Trial Registry (ChiCTR) up to June 7, 2025, were analyzed. Twelve key items, including registration number, study title, target disease, interventions, blinding, sponsor, phases, enrollment, funder type, study type and start date, and locations, were analyzed to describe trial characteristics. A total of 557 clinical trials of mRNA-based therapeutics were identified. Most of these studies were conducted in phases 0-3 (n = 412, 73.97%), primarily focusing on infectious diseases (n = 410, 73.61%), and predominantly open-label designs (n = 338, 60.68%). Interventional studies accounted for 85.82% (n = 478) of all registered trials. Industry sponsors were the primary source of funding (n = 299, 53.68%). Approximately 45.06% of the projects (n = 251) aimed to enroll 0-100 participants. Most of the studies involved mRNA vaccines (n = 507, 91.02%). Further, 22 trials investigated mRNA-based therapeutics for rare diseases. Among the newly registered projects in 2024 and 2025, the proportion of phase 0-1 trials significantly increased, accounting for 61.67% and 78.13%, respectively. The top three regions that conducted mRNA clinical studies were North America (n = 186; primarily the United States [n = 178]), Asia (n = 184; China [n = 72]), and Europe (n = 90), based on studies registered in both CTg and ChiCTR. Most mRNA products remain in preapproval clinical trials. Further phase 3 clinical evidence will be essential to support its broader application.

RevDate: 2026-06-10
CmpDate: 2026-03-06

Zhao W, Htike WYM, YW Kam (2026)

Quantifying the evidence and burden of smoking behaviour on tuberculosis incidence among adult population: a systematic review and meta-analysis.

Journal of global health, 16:04079.

BACKGROUND: Tuberculosis (TB) remains a major public health challenge in China and worldwide, with smoking being a key modifiable risk factor. Given China's large population and rising smoking rates, this paper aims to examine the link between smoking and TB incidence.

METHODS: We systematically searched six databases from inception for studies reporting smoking exposure, TB outcomes, and smoker-non-smoker comparisons. Two reviewers independently screened records, extracted data, and assessed bias. We analysed smoking-TB associations using random-effects meta-analysis of odds ratios (ORs) and hazard ratios (HRs).

RESULTS: We included 17 studies reporting ORs and 7 studies reporting HRs in the quantitative synthesis. The pooled OR for TB incidence among smokers compared with non-smokers was 1.77 (95% confidence interval (CI) = 1.29-2.43), indicating a statistically significant increase in risk of TB. For studies reporting hazard ratios, the pooled estimate was 2.39 (95% CI = 1.28-4.45), showing a significant association between smoking and increased TB incidence.

CONCLUSIONS: Both active and passive smoking significantly elevate the risk of TB and worsen its outcomes in China. Our result indicate that COVID-19 pandemic may have indirectly exacerbated smoking-related risks through disruptions to TB services, heightened psychosocial stress, and shifts in smoking behaviours, with potential implications for TB risk and outcomes. Thus, integrating smoking cessation strategies into TB programmes, focusing on heavy smokers in especially high-prevalence areas, and raising public awareness could enhance efforts to prevent and control TB worldwide.

REGISTRATION: PROSPERO: CRD420251070123.

RevDate: 2026-06-11
CmpDate: 2026-06-11

De Sousa-De Sousa L, Espinosa HG, Maté-Muñoz JL, et al (2026)

A decade of concussion in rugby: a 2014-2024 systematic review and meta-analysis update.

British journal of sports medicine, 60(11):811-826 pii:bjsports-2025-110774.

OBJECTIVE: To quantify the incidence of concussions identified through clinical assessments or diagnostic protocols in rugby union (RU) (sevens and XVs) and rugby league (RL) over the past decade and analyse differences by sex, playing level, match versus training exposure and concussion assessment protocols (Head Injury Assessment (HIA) vs non-HIA).

DESIGN: Systematic review and meta-analysis.

DATA SOURCES: PubMed, Web of Science, Scopus, Embase, SPORTDiscus, PsycINFO and CINAHL were searched in February 2025 for studies published between 2014 and 2025.

Studies were eligible if they reported concussions identified through clinical assessment or diagnostic protocols in rugby with extractable exposure data (match-player-hours and/or training-player-hours) and incidence rates per 1000 player-hours.

RESULTS: 98 studies, comprising 10 591 concussions across 3 275 130 player-hours, met the inclusion criteria. Studies included data from 2003 to 2023. The pooled overall concussion incidence was 9.74 per 1000 player-hours (95% CI 8.54 to 10.95) in RU and 9.20 (95% CI 7.38 to 11.02) in RL, with no significant difference between codes (p=0.891). When analysed by subgroups, no statistically significant overall sex-based differences in concussion incidence were observed in either RU or RL; however, post hoc analyses identified higher concussion incidence among female youth players (<18 years) compared with males. Match play showed a markedly higher incidence than training (RU: 10.98 per 1000 match-player-hours vs 0.34 per 1000 training-player-hours; RL: 10.45 per 1000 match-player-hours vs 0.32 per 1000 training-player-hours; p<0.001). Studies using HIA protocols reported nearly double the incidence compared with non-HIA protocols (RU: 15.35 vs 7.72; rate ratio=1.83; p<0.001). Concussion trends reflected external factors, including COVID-19 disruptions and policy changes.

CONCLUSION: Concussion incidence in rugby appears to be strongly influenced by match intensity and assessment protocol. Structured diagnostic approaches, such as the HIA protocol, are associated with higher reported concussion incidence, likely reflecting improved detection.

PROSPERO REGISTRATION: CRD42023480774.

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

Liu R, Fan Y, Xiong S, et al (2026)

Drivers of and implementation strategies for influenza vaccination for cardiovascular populations in China: a scoping review.

Vaccine, 86:128761.

INTRODUCTION: Understanding the drivers of influenza vaccine hesitancy, acceptance, demand, and uptake especially in low- and middle-income countries is a priority in preventing seasonal influenza as outlined in the World Health Organization (WHO) global influenza strategy. Individuals with cardiovascular disease (CVD) are a key target group recommended by WHO, yet influenza vaccine coverage in China is reported to be extremely low. We aim to explore drivers of this and implementation strategies used to increase the influenza vaccine coverage among CVD populations in China.

METHODS: We conducted a scoping review using academic databases, the Chinese Clinical Trial Registry, and Chinese grey literature repositories from database inception till August 2025, based on predetermined inclusion criteria. Data on potential determinants of vaccine uptake and intervention details were extracted and analyzed using a narrative synthesis. Implementation strategies were mapped to the Availability, Accessibility, Acceptability, and Quality (AAAQ) health service delivery framework.

FINDINGS: Thirteen publications published between 2009 and 2024 were included, with an increase in outputs since the COVID-19 pandemic. Lower vaccine uptake appeared to be associated with lower socioeconomic status and poorer health literacy. Physician recommendations, accessible vaccine clinics, and adequate vaccine supply appeared to be health system related facilitators to vaccination. Four studies reported implementation strategies comprising provider education and recommendations, public funding, and follow-up on vaccination status. Incorporating strategies that addressed a greater number of AAAQ domains appeared to result in higher influenza vaccine uptake.

CONCLUSION: Drivers and implementation strategies of influenza vaccination have not been widely studied among CVD populations in China. Available information suggests that higher patient sociodemographic status, greater health literacy, presence of physician recommendations, accessible vaccine clinics, and affordable vaccines may positively drive influenza vaccination. Addressing gaps in the AAAQ domains through targeted implementation strategies could improve influenza vaccination. Future strategies should undergo rigorous evaluation.

REGISTRATION DETAILS: Our protocol is registered at Open Science Foundation (OSF) with registration DOI https://doi.org/10.17605/OSF.IO/XDMBT.

RevDate: 2026-06-11
CmpDate: 2026-06-11

Kraselnik A, McGowan H, Amiali IA, et al (2026)

Factors Influencing the Uptake of Digital Health Interventions for Cardiovascular Disease Prevention Among Healthcare Providers: A Systematic Review.

Global heart, 21(1):45.

BACKGROUND: Digital health interventions (DHIs) offer major potential for improving cardiovascular disease (CVD) primary and secondary prevention, but their adoption by healthcare providers (HCPs) remains inconsistent.

OBJECTIVE: To identify barriers and facilitators to DHI uptake in CVD primary and secondary prevention from HCPs' perspectives.

METHODS: We conducted a systematic review of studies published between 2020 and 2024 that investigated HCPs' perceptions of DHI implementation for CVD primary and secondary prevention. We appraised individual study quality using a validated tool. We performed a qualitative synthesis of reported barriers and facilitators, categorized according to country income level and according to the World Heart Federation Roadmap domains: HCPs, patients, technology, and health systems.

RESULTS: We included 125 primary studies (101 qualitative, 15 quantitative, 9 mixed methods). The most frequently cited barrier was excessive workload, both from existing responsibilities and additional tasks introduced by DHIs. The leading facilitator was the perceived positive clinical impact of DHIs-such as improved adherence, reduced hospital readmissions, and better outcomes. HCP motivation, adequate training, and system integration also facilitated adoption. Many factors-like effects on HCP-patient relationships and workflow-functioned as either barriers or facilitators, depending on the setting. Patient-related barriers included limited digital access and literacy; facilitators included perceived gains in patient-centered care. Health system factors such as organizational structure, financing, and policy support were commonly mentioned, with mixed views. Technology-related facilitators included usability, adaptability, and integration with electronic records; instability was a key barrier.

CONCLUSIONS: This is the first systematic review to synthesize post-COVID-19 literature on HCPs' perceptions of DHIs in CVD primary and secondary prevention. While offering a rich, global overview, limitations include a predominance of qualitative studies and lack of data from low-income countries. Effective implementation must address workload, align with workflows, and build trust through training and leadership.

LAY SUMMARY: This research analyzed 125 studies from 33 countries to understand the factors that influence healthcare professionals' uptake of digital health tools, such as apps and wearable devices, for preventing cardiovascular disease.The leading facilitator for adoption is the perceived positive clinical impact; doctors and nurses are highly motivated to use digital tools when they help patients follow treatments better, reduce hospital readmission rates, and improve overall heart health.The most significant barrier is the perceived excessive workload. While some digital health tools can be time-saving, many providers feel that they add burdensome technical tasks to their already busy schedules, which undermines their acceptance.Uptake is also influenced by patient-related factors, such as digital literacy and internet access, as well as technological factors like how easily a tool integrates into existing hospital computer systems.To improve the future of cardiovascular care, digital tools should be co-designed with clinicians to ensure they fit seamlessly into daily work routines and are supported by proper training and strong institutional leadership.

RevDate: 2026-06-10

Lequipe Mamani C, Salazar MDT, Poma Plata GL, et al (2026)

Clinical characteristics and factors associated with mortality in critically ill COVID-19 patients at high altitude.

Journal of critical care, 95:155650 pii:S0883-9441(26)00228-5 [Epub ahead of print].

OBJECTIVE: To investigate factors associated with mortality in critically ill COVID-19 patients at 3640 m above sea level (m.a.s.l.), focusing on the interaction between altitude-induced secondary erythrocytosis and virus-induced hyperviscosity.

METHODS: We conducted a retrospective cohort study of 59 adult patients with severe ARDS admitted to the ICU in La Paz, Bolivia. Severe ARDS was defined using altitude-adapted criteria.

RESULTS: Non-survivors exhibited significantly higher median hematocrit (53.4% vs 49.7%; p = 0.0001) and D-dimer (29,729 vs 16,521 ng/mL; p = 0.0001) compared to survivors. An "APACHE II paradox" was observed, as survivors had significantly higher admission scores than non-survivors (24 vs 17; p = 0.01). While initial ventilatory mechanics were comparable (14.3 vs 14.1 cm H₂O; p = 0.81), non-survivors experienced exclusive complications, including pneumothorax (24.2%) and pulmonary embolism (18.2%).

CONCLUSIONS: Hyperviscosity, exacerbated by altitude-induced erythrocytosis, is a primary factor associated with mortality in this environment. Traditional severity scores may not adequately stratify risk in high-altitude contexts, highlighting the need for altitude-specific protocols focusing on rheological control.

RevDate: 2026-06-10

Salehinejad MA, Jouzdani AF, Bandeira ID, et al (2026)

Global prevalence and disability burden of brain disorders: Impact of neurological, mental, and substance use disorders.

Neuroscience and biobehavioral reviews pii:S0149-7634(26)00265-4 [Epub ahead of print].

Brain disorders-encompassing neurological, mental, and substance use disorders-account for 10 of the top 25 causes of disability worldwide in 2021. Despite such an impact, they have not been centrally analyzed in prior Global Burden of Disease (GBD) studies. This review synthesizes the latest disability-focused GBD study to quantify the prevalence and disability burden of 35 conditions from 2010 to 2021, a period marking the first decline in global health outcomes in three decades. It further incorporates disability metrics from 2021 to 2023 to contextualize post-pandemic trends. The review covers the prevalence and disability burden of neurological, mental, and substance use disorders along with COVID-19 using DALYs and YLDs metrics. From 2010 to 2021, Parkinson's, Alzheimer's, and motor neuron diseases (in neurological disorders), major depressive, anxiety, and eating disorders (in mental disorders), and opioid and drug use disorders (in substance use disorders) showed the greatest increases in age-adjusted prevalence rates across all sexes. In 2021, neurological disorders were the primary cause of DALYs, while depressive and anxiety disorders ranked as the 2[nd] and 6[th] leading causes of global YLDs. Alzheimer's disease/dementias, Parkinson's disease, autism spectrum disorder, depressive and anxiety disorders, and opioid and drug use disorders show the largest increases in burden within their respective categories between 2010 and 2021. In the 2021-2023 extension analysis, disability data showed increases in prevalence and disability of several brain disorders, mostly anxiety disorders, while the COVID-19 disability burden declined markedly by 2023. Sex-specific burden metrics, key insights from each disorder, and limitations/confounds are discussed.

RevDate: 2026-06-10

Louvet A, Ntandja Wandji LC, P Mathurin (2026)

Updates in clinical science: Alcohol-related hepatitis.

Journal of hepatology pii:S0168-8278(26)00219-9 [Epub ahead of print].

Alcohol-related hepatitis (AH) is a complex disease associated with numerous unmet needs, particularly in diagnosis and treatment. The epidemiology of AH has evolved in recent years, reflecting changes in alcohol consumption during the COVID-19 pandemic and the increasing incidence of AH following bariatric surgery. Advances have also been made in the non-invasive diagnosis of AH, helping to reduce the need for liver biopsy, as well as in the management of infection. Several novel therapeutic strategies have been evaluated, including faecal microbiota transplantation, IL-1 receptor antagonists, oxysterols, and reduced exposure to corticosteroids or antibiotics. Although the results of these trials have been relatively disappointing, they have helped identify promising directions for future research. In patients with the most severe form of AH, particularly those who do not respond to corticosteroids, several studies have suggested that the indications for early liver transplantation could be expanded. Overall, developments over recent years have generated increased optimism regarding the management of patients with severe AH.

RevDate: 2026-06-10

Sanyal D, B Chaubey (2026)

SARS-CoV-2 3CL protease interaction with host factors - identifying novel drug targets.

Archives of virology, 171(7):.

SARS-CoV-2 3CL protease (3CL[Pro]) plays crucial role in the viral life cycle by releasing different non-structural proteins from viral polyproteins. It also interacts with several host factors and orchestrates different host cell pathways by cleaving key cellular factors involved in immune modulation, cellular metabolism and cell death. Several host factors have been identified as high confidence substrates of 3CL[Pro] which regulates host cellular environment both in an enzyme-dependent and enzyme-independent manner. Degradation of RIG-I, TRIM25 and NLRP12 by 3CL[Pro] downregulates the innate immune response while enzyme-independent interaction with host factors like MAVS promote both its degradation and upregulation. Cellular transcription and translation are altered by interaction of 3CL[Pro] with host proteins. It affects cell-death by interacting with factors like Gal-8, NDP52 and GSDMD. Post-COVID neurodegenerative disorders have been observed due to the downregulation of neuronal factors like NEMO and UBE3A. The spectrum of 3CL[Pro] interaction with the key host factors indicates the alternate role of viral protease that modulates host response during infection. Several 3CL[Pro] targets and their cleavage sites on the target proteins have been identified. This review highlights the crosstalk between 3CL[Pro] and different host factors as possible alternate therapeutic targets to inhibit the viral propagation as well as address the post COVID clinical issues.

RevDate: 2026-06-10

Kuai M, Li B, Shi Z, et al (2026)

Molecular Insights Into Endometriosis for Early Detection and Therapeutic Targets.

Reproductive sciences (Thousand Oaks, Calif.) [Epub ahead of print].

Endometriosis is a hormone-dependent chronic inflammatory disease associated with pain and infertility, remains diagnostically and therapeutically challenging due to its multifactorial nature. Molecular mechanisms of the dynamic changes during disease pathogenesis may help identify potential diagnostic biomarkers and therapeutic targets. This paper reviews the molecular pathological alterations in endometriosis, focusing on the regulation of sex hormones, the endometrial microenvironment, immune dysregulation, and relevant signaling pathways. The lack of reliable early detection biomarkers significantly contributes to diagnostic delays. We summarize the research progress on biomarkers for endometriosis, providing the latest information on early diagnosis. We also review the therapeutic strategies targeting anti-proliferative/pro-apoptotic pathways and inflammatory responses. Although challenges persist in translating mechanistic discoveries into clinical applications, preclinical evidence suggests that addressing diagnostic delays and advancing innovative therapies may hold potential for yielding targeted management strategies for this complex disease.

RevDate: 2026-06-11

Javed MN, Khan SM, Hussain JM, et al (2026)

Effectiveness of telerehabilitation in patients with post-COVID-19: an updated systematic review and meta-analysis of randomized controlled trials.

BMC pulmonary medicine pii:10.1186/s12890-026-04377-x [Epub ahead of print].

INTRODUCTION: Post-COVID-19 syndrome affects 10-15% of survivors, causing multisystem complications and significant economic burden. Telerehabilitation (TR) has emerged as a scalable solution to deliver care remotely. This study aims to re-evaluate the effectiveness of TR in improving physical and psychological outcomes in post-COVID-19 patients.

METHODS: Registered on PROSPERO (CRD420251082578) under PRISMA guidelines, we searched PubMed, Cochrane, and Scopus from April 2024 till July 2025 for randomized trials. Primary outcomes included clinical symptoms (Borg score, dyspnea) and physical function (30-s sit-to-stand test, 6-min walking distance). A random-effects model assessed pooled outcomes with heterogeneity (I[2]) and sensitivity analyses along with subgroup analysis. Additionally, publication bias and certainty of evidence using Gradepro was performed. Risk of bias was evaluated using the Cochrane ROB2 tool.

RESULTS: Twenty-eight randomized controlled trials (RCT's) comprising approximately 1,400 participants were included. TR significantly improved physical function, including the 30 s-STS (MD = 2.07; 95% CI: 1.24 to 2.90; p < 0.00001) and 6MWD (MD = 85.83 m; 95% CI: 67.14 to 104.52; p < 0.00001). Significant reductions were observed in dyspnea (Borg overall MD = -3.74, p = 0.003) and fatigue (VASF MD = -1.83, p < 0.0001). However, no significant differences were found for HADS-Anxiety (p = 0.27) or HADS-Depression (p = 0.11). Pulmonary function showed significant gains only in FEV1 change scores (p = 0.008). Preliminary data suggests a favorable safety profile; while no serious adverse events were reported across the trials, safety was infrequently listed as a primary outcome.

CONCLUSION: TR appears to be a promising and well-tolerated modality for enhancing physical capacity and alleviating fatigue in post-COVID-19 patients, though further large-scale studies with safety as a primary endpoint are warranted to definitively establish its safety profile. While physical gains are robust, additional targeted interventions may be necessary to address psychological and pulmonary sequelae.

RevDate: 2026-06-11

Jan A, Waheed B, Hussein GA, et al (2026)

Prevalence, Comparative Risk, and Predictors of Shock in Children With Multisystem Inflammatory Syndrome Associated With COVID-19: A Systematic Review and Meta-Analysis.

Journal of paediatrics and child health [Epub ahead of print].

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a severe hyperinflammatory condition associated with SARS-CoV-2 infection and is frequently complicated by cardiovascular dysfunction, particularly shock. Early recognition of shock in MIS-C is critical to reduce morbidity and mortality.

OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the prevalence, comparative risk, and predictors of shock among children with MIS-C, enhancing clinical management and informing future research.

METHODS: A systematic search of PubMed, Embase and Web of Science was conducted from database inception to 15 July 2025. Observational studies reporting prevalence, comparative risk or predictors of shock in children with MIS-C were included. Random-effects meta-analysis with Freeman-Tukey double arcsine transformation was used to estimate pooled prevalence with 95% confidence intervals (CI). Relative risks (RR) were pooled for comparative analyses. Subgroup analyses, sensitivity analyses and meta-regression were performed to explore heterogeneity. Publication bias was assessed using funnel plots and Egger's regression test.

RESULTS: Seventy studies involving 13 263 children with MIS-C were included. The pooled prevalence of shock was 56% (95% CI: 49%-63%), although substantial heterogeneity was observed (I[2] = 98.4%). Sensitivity analyses excluding studies with sample sizes < 50 and < 100 participants yielded pooled prevalence estimates of 50% (95% CI: 40%-59%) and 46% (95% CI: 33%-59%), respectively. Subgroup analyses demonstrated variation according to publication year and diagnostic criteria. Children with MIS-C had a significantly increased risk of shock compared with Kawasaki disease cohorts (RR = 8.52, 95% CI: 1.24-58.41; p < 0.05) and acute/severe COVID-19 cohorts without MIS-C (RR = 4.42, 95% CI: 2.44-8.02; p < 0.001). Echocardiographic abnormalities, myocardial dysfunction, elevated inflammatory markers and acute kidney injury were consistently associated with shock.

CONCLUSION: The certainty of evidence ranged from very low to low because of substantial heterogeneity, imprecision and methodological variability across studies. Despite these limitations, shock remains a frequent and serious complication of MIS-C, highlighting the importance of early cardiovascular assessment and timely recognition of high-risk children.

RevDate: 2026-06-11
CmpDate: 2026-06-11

Alhumaid S, Alshehri SM, Sabr Z, et al (2026)

Persistence, chronicity, and recurrence of infection-associated urticaria following viral infections in children and adults: a systematic review.

Frontiers in allergy, 7:1847423.

BACKGROUND: Viral infections are recognized triggers of acute urticaria; however, the long-term outcomes of infection-associated urticaria, including persistence, recurrence, and progression to chronic disease, remain incompletely characterized.

OBJECTIVE: To systematically review the available evidence on the persistence, chronicity, and recurrence of infection-associated urticaria following viral infections in children and adults.

METHODS: A systematic review was conducted in accordance with PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420261319656). Electronic databases (PubMed, Embase, CINAHL, Scopus, and Web of Science) were searched from inception to 17 March 2026. Observational studies reporting long-term outcomes of infection-associated urticaria following viral infection were included. Data extraction and risk of bias assessment using the Newcastle-Ottawa Scale were performed independently by two reviewers. Due to substantial heterogeneity, findings were synthesized narratively.

RESULTS: Five studies involving 596 participants were included. Most cases of infection-associated urticaria occurred during the acute phase of infection and resolved within weeks to months. However, persistence beyond 6 months was reported in up to 9.5% of cases, and a small proportion demonstrated persistent symptoms extending beyond 1 year. Reported recurrence and chronicity rates ranged from approximately 7% to 30%, although several estimates were derived from mixed-etiology cohorts in which infection-related cases were not analyzed separately. Delayed-onset urticaria, particularly following SARS-CoV-2 infection, was associated with an increased likelihood of progression to chronic spontaneous urticaria. However, interpretation is limited by the inclusion of mixed-etiology cohorts in which viral infection was not always laboratory-confirmed or analyzed separately.

CONCLUSION: Infection-associated urticaria is typically self-limiting; however, a small but potentially clinically relevant subset of patients may develop persistent or chronic symptoms. Recognition of potential risk patterns, particularly delayed-onset urticaria in the context of SARS-CoV-2 infection, may support improved patient counselling and follow-up. Current evidence remains limited by heterogeneous study designs, mixed aetiologies, and inconsistent pathogen-specific reporting. Further prospective studies with standardized definitions and pathogen-specific analyses are needed.

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1319656, identifier CRD420261319656.

RevDate: 2026-06-11
CmpDate: 2026-06-11

Shi P, Zhang Z, He W, et al (2026)

Leveraging single B cell antibody platforms to develop countermeasures against animal viral diseases: recent advances and future perspectives.

Frontiers in veterinary science, 13:1854176.

The discovery and application of monoclonal antibodies (mAbs) have fundamentally revolutionized clinical medicine, driving significant paradigm shifts in disease prevention, precise diagnosis and targeted treatment. The demand for high-affinity antibodies continues to surge, yet traditional discovery platforms such as hybridoma and phage display suffer from low efficiency, disrupted native pairing, and time-consuming workflows. Single B cell antibody technology overcomes these limitations by directly retrieving naturally paired heavy and light chain sequences from antigen-specific B cells, thereby preserving authentic affinity and specificity. Following its remarkable success in combating human emergencies like COVID-19, this platform is now being rapidly adapted to veterinary viral diseases, a critical effort under the "One Health" framework to safeguard both animal and public health. This review systematically outlines the core principles and workflows of single B cell-based mAb discovery. It then summarizes recent advances in applying this technology to viruses that infect animals and zoonotic viruses, emphasizing how native antibody repertoires have been harnessed to generate high-affinity mAbs. Ultimately, the article concludes with a discussion of current technical challenges, proposing future research directions to improve both the accessibility and efficacy of veterinary immunotherapeutics.

RevDate: 2026-06-11

Mhade S, Bhosekar U, Hill MD, et al (2026)

Mapping the landscape of individual-based models for respiratory pathogen transmission in the pandemic and post-pandemic era (2020-2024): A systematic review.

Epidemics, 56:100924 pii:S1755-4365(26)00040-X [Epub ahead of print].

Individual-based models (IBMs) provide a mechanistic framework in which population-level outcomes emerge from interactions between individuals. We conducted a systematic review on IBMs for respiratory pathogens published in 2020-2024. We identified 855 eligible studies. Publications peaked in 2021, with a geographical distribution positively correlated with national GDP, leaving regions understudied. Most studies focused on SARS-CoV-2 and assessed public health interventions. Research priorities evolved over time, shifting from social distancing to vaccination. Age was included in 72.4% of studies; other sociodemographic factors (e.g., race/ethnicity) were rarely considered. This review maps the IBM landscape, offering a framework to guide future modeling efforts.

RevDate: 2026-06-10
CmpDate: 2026-01-13

Lotfi M, L Kaderali (2026)

Data-driven strategies for model-informed decision-making during the COVID-19 pandemic: a systematic review.

BMJ open, 16(1):e107660.

OBJECTIVES: To systematically review data-driven modelling studies that evaluated the effectiveness of interventions implemented during the COVID-19 pandemic and to identify which measures were most frequently reported as effective in controlling disease spread.

DESIGN: Systematic review of modelling studies focused on data-driven, model-informed decision-making for COVID-19 interventions.

DATA SOURCES: A comprehensive literature search was conducted in PubMed, Web of Science and Embase, covering publications from 1 January 2020 to 16 October 2024.

ELIGIBILITY CRITERIA: Studies were included if they: (1) used real-world data; (2) had sufficient sample sizes and (3) assessed at least one intervention with measurable outcomes.Meta-analyses and purely theoretical modelling studies were excluded. Papers were further filtered using a structured screening process to ensure empirical and intervention-based modelling.

DATA EXTRACTION AND SYNTHESIS: Data were extracted from eligible studies and categorised according to modelling approaches, data sources, intervention types and reported effectiveness. Descriptive synthesis was performed to summarise modelling trends and intervention performance. Studies were classified into major intervention categories, including tracing, testing and isolation (TTI); physical and social distancing (PSD); vaccination; lockdowns; mask-wearing; home office or stay-at-home (HOSH) and health infrastructure enhancement (HIE).

RESULTS: Out of 2297 studies identified, 126 met inclusion criteria. Compartmental models were the most frequently used approach, primarily relying on case and death counts to assess intervention impact. The most commonly reported effective interventions were TTI, PSD, vaccination, lockdowns, mask-wearing and HOSH. When considering effectiveness relative to study frequency, the top six interventions were TTI, HOSH, mask-wearing, HIE, PSD and lockdowns. The relatively lower representation of vaccination reflects that most included studies were conducted during the early stages of the pandemic, before widespread vaccine rollout and availability of empirical vaccination data.

CONCLUSIONS: This review highlights the critical role of data-driven models in guiding COVID-19 response strategies. Evidence supports the combined effectiveness of non-pharmaceutical interventions, robust testing and tracing systems and health infrastructure strengthening. Real-world impact, however, remains dependent on local healthcare capacity, socioeconomic conditions and cultural contexts. Continued research is essential to refine adaptive modelling approaches and strengthen preparedness for future public health emergencies.

RevDate: 2026-06-10
CmpDate: 2026-06-04

Rae-Dupree J (2025)

From Melanoma Detection to Diabetes Monitoring: The Promise of Microneedle Patches.

IEEE pulse, 16(5):13-16.

Postage-stamp-sized arrays of infinitesimal needles are being developed that may one day provide the foundation for at-home cancer detection kits and wearable biosensors that can alert diabetes patients in real time as their blood sugar fluctuates. Microneedle arrays-medical patches embedded with micro-scale projections-are an emerging class of devices that are creating pain-free access to the interstitial fluid that surrounds cells just under the surface of the skin. Packed with the same enzymes and metabolites as blood, interstitial fluid also contains many unique biomarkers not found in blood. Researchers have demonstrated that the arrays can be used for inexpensive, biopsy-free melanoma detection, reported using a test strip similar to at-home COVID-19 detectors, and in a diabetes management wristband that combines continuous glucose monitoring with other chemical and cardiovascular signals to alert patients to dangerous trends that today's glucose monitors would miss.

RevDate: 2026-06-10
CmpDate: 2026-01-22

Jiang ZJ, Jin PF, Zhang MR, et al (2026)

[Progress in research of influence of gene polymorphisms on vaccine immune response].

Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi, 47(1):180-186.

To introduce the recent progress in the research of gene polymorphisms and differences in vaccine immune responses, this paper systematically summarizes current findings of the associations between human leukocyte antigen (HLA) polymorphisms and other key immunoregulatory gene variations with vaccine responses across different domains, including COVID-19 and influenza vaccines. Furthermore, it discusses the impact of different genotypes on antibody production, immune protection, and the risk for breakthrough infections. To address the challenges posed by genetic polymorphisms, this paper further summarizes several key strategies for vaccine optimization, including conserved epitope targeting, multivalent vaccine design, and peptide-carrier conjugation approaches. Although genomics has laid a theoretical foundation for precise vaccine design, multiple challenges still persist in current research, such as the complexity of gene-environment interactions and ethical concerns regarding data sharing and privacy protection. Future investigations should further evaluate the effects of specific gene polymorphisms, such as detailed HLA subtypes, on the variations in vaccine immune responses, and elucidate underlying mechanisms by integrating functional studies Exploring and establishing genomics and multi-omics-based precise immunization strategies will provide more effective solutions for vaccine-preventable diseases.

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

Mahallawi WH (2026)

Artificial Intelligence in Dialysis Therapies: Applications in Hemodialysis and Peritoneal Dialysis for Managing Infectious Diseases and Complications.

Saudi medical journal, 47(6):998-1007.

This narrative review synthesizes evidence from a systematic literature search (2019-2025) on artificial intelligence (AI) applications in hemodialysis and peritoneal dialysis for managing infections and complications. Dialysis patients face infection rates 100-fold higher than the general population and sepsis mortality exceeding 35%. The AI, utilizing machine learning algorithms such as XGBoost, deep neural networks, and explainable AI tools, revolutionizes care through precise diagnostics, prognostics, and therapeutics. Key models demonstrate high accuracy in predicting bloodstream infections (area under the curve [AUC] 0.914), classifying peritonitis (F1 0.93), detecting SARS-CoV-2 (AUROC 0.82), and forecasting mortality (AUC 0.979). Therapeutically, AI guides antibiotic stewardship, reducing inappropriate use by 18-67%, and mitigates intradialytic hypotension via ultrafiltration adjustments, reducing incidence by 25-40%. Despite promising results, challenges include data scarcity, algorithmic bias, and the integration of these tools into clinical workflows. Future directions involve diverse datasets, explainable AI, and real-time decision support systems. The AI holds transformative potential for personalizing dialysis management and improving patient outcomes.

RevDate: 2026-06-10

Yu J, Li W, Xu Y, et al (2026)

Gut microbiota-derived short-chain fatty acids (SCFAs): immunomodulatory effects and therapeutic potential in infections.

Clinical microbiology reviews [Epub ahead of print].

SUMMARYThe human gut microbiotas constitute a complex microecosystem essential for host homeostasis. Among its metabolites, short-chain fatty acids (SCFAs) act as key signaling molecules linking microbial activity to host immunity and barrier function. Based on existing literature, we conducted a comprehensive analysis of the interaction between SCFAs and 11 key gut pathogens. These pathogens include bacteria (i.e., Staphylococcus aureus, Clostridioides difficile, Salmonella spp., Campylobacter jejuni, Klebsiella pneumoniae, Vibrio cholerae), fungi (i.e., Candida albicans), and viruses (i.e., SARS-CoV-2, influenza virus, respiratory syncytial virus, rotavirus). In terms of antibacterial effects, SCFAs exhibit antibacterial activity against most gut microorganisms, but they support the colonization of a few species (i.e., Campylobacter jejuni). Given the complex interactions between SCFAs and the gut microbiota, as well as their regulatory roles in infection, further investigation of the microbiota-SCFA axis is essential for developing effective strategies to prevent and treat infectious diseases. This review systematically summarizes the mechanism and clinical evidence of SCFAs in microbial infections to provide novel ideas for infectious disease management.

RevDate: 2026-06-08

Coker KL, EL Morgan (2026)

High-Risk HPV in Men: A Hidden Threat to Public Health?.

Reviews in medical virology, 36(2):e70115.

High-risk human papillomavirus (HR-HPV) infection is a leading cause of several cancers, including those of the genital and oropharyngeal regions. While public health efforts have largely focused on women due to its link to cervical cancer, HPV also poses significant risks to men, particularly in the oropharyngeal regions. HR-HPV prevalence in men is high, with global estimates of 21% for male genital infections. While the HPV vaccination programme has expanded to include boys, challenges remain, including a decline in vaccine uptake due to COVID-19 disruptions, vaccine hesitancy, and misinformation. These barriers hinder the full potential of vaccination efforts. Furthermore, HPV transmission is complex and multifactorial, making it difficult to track, while its prevalence, clearance, and persistence vary based on factors such as sexual behaviour and immune status. Additionally, data from lower socio-economic regions is limited, highlighting a critical gap in research. Specific data on these epidemiological characteristics for male patients is lacking, prompting the need for gender-balanced approaches. Here, we explore the prevalence, risks, and public health implications of high-risk HPV (HR-HPV) in men. We suggest a more inclusive approach to HPV prevention, emphasising the need for targeted vaccination and screening programs for men. A gender-neutral approach is crucial to reducing the global burden of HPV-related diseases and moving closer to the goal of eradicating HPV infections worldwide.

RevDate: 2026-06-08
CmpDate: 2026-03-07

Ortiz-Tallo A, Izquierdo A, Calvo A, et al (2026)

A systematic review of the bidirectional relationship between psychosis and loneliness.

Journal of psychiatric research, 196:115-122.

BACKGROUND: and hypothesis: Loneliness, defined as a subjective feeling of isolation, has been significantly correlated with psychotic experiences in general and clinical populations, although less is known about the direction of this relationship. This paper aims to systematically review the longitudinal relationship between loneliness and psychosis spectrum continuum, addressing two fundamental questions: (1) is loneliness a risk factor for the development of psychosis, and (2) does psychosis increase the risk of experiencing loneliness?

STUDY DESIGN: A comprehensive search of 5 electronic databases yielded a total of 4386 records, from which 10 observational studies were finally included.

STUDY RESULTS: Six studies investigated the first research question, and all of them identified a significant association between loneliness and the subsequent incidence of psychosis (question 1). Conversely, 4 studies explored the second research question, with 3 suggesting that individuals within the psychosis spectrum may face heightened susceptibility to loneliness (question 2). The remaining study, conducted during the COVID-19 pandemic, did not yield significant findings. Assessment of methodological quality indicated predominantly moderate-to-high-quality studies.

CONCLUSIONS: The findings underscore the need for further research, particularly longitudinal prospective studies, to clarify whether the observed association between loneliness and psychosis is direct or whether it is instead moderated or mediated by other variables. Overall, the available evidence provides stronger support for loneliness as a potential risk factor for the onset of psychosis, although the number of longitudinal studies addressing this question remains very limited. Addressing these gaps in knowledge could inform the development of targeted prevention programs and interventions for people with psychotic spectrum disorders.

RevDate: 2026-06-09
CmpDate: 2026-02-23

Shang X, Zheng J, Liu X, et al (2026)

Climatic factors drive global viral respiratory infections with regional heterogeneity: A systematic review and meta-analysis.

Environment international, 208:110120.

BACKGROUND: Climate change is altering global respiratory virus transmission, yet pathogen-specific climate sensitivities remain unclear across diverse geographical settings.

METHODS: We searched six databases (inception-10 May 2024) for studies quantifying associations between climate factors and virus respiratory infections (VRIs). Random-effects models pooled relative risks (RRs) per unit increase in temperature, relative humidity, precipitation, and wind speed, with climate sensitivity assessed by Köppen-Geiger zones.

RESULTS: From 108 studies comprising 9.22 million VRI cases, three climate patterns emerged. First, temperature was the dominant driver: each 1°C increase reduced respiratory syncytial virus (RSV; RR 0.13, 95% CI 0.08-0.22), influenza virus (IV; RR 0.37, 95% CI 0.23-0.58), human metapneumovirus (HMPV; RR 0.48, 95% CI 0.32-0.73), SARS-CoV-2 (RR 0.52, 95% CI 0.35-0.78), and human coronavirus (HCoV; RR 0.21, 95% CI 0.07-0.61) risks, but increased parainfluenza virus (PIV; RR 2.35, 95% CI 1.46-3.77) and human bocavirus (HBoV; RR 1.86, 95% CI 1.04-3.32) risks. Second, other climate factors showed selective effects: higher humidity decreased IVB risk (RR 0.61, 95% CI 0.40-0.94) but increased enterovirus risk (RR 2.21, 95% CI 1.08-4.51); precipitation decreased IV risk (RR 0.67, 95% CI 0.51-0.89) but increased PIV risk (RR 1.91, 95% CI 1.21-2.99); wind speed amplified IV (RR 1.51, 95% CI 1.01-2.27) and HCoV transmission (RR 5.36, 95% CI 3.43-8.38). Third, climate-zone analyses revealed substantial heterogeneity: in temperate regions, low temperature and humidity increased the risk of most infections (except PIV and HBoV); risks of SARS-CoV-2 and SARS-CoV risks decreased in temperate but increased in continental regions; RSV and HMPV showed greater sensitivity in tropical regions; while in arid regions, MERS-CoV risk increased with temperature but decreased with humidity and wind speed.

CONCLUSION: This analysis identified climate-sensitive VRIs with temperature as key predictor, pathogen-specific sensitivities, and distinct regional patterns, informing targeted climate-based intervention strategies.

RevDate: 2026-06-08
CmpDate: 2026-02-16

Deane-King J, Howell J, R Maguire (2026)

Experiences of Individuals With Chronic Obstructive Pulmonary Disease and Their Caregivers During the Pandemic: A Systematic Review.

Nursing open, 13(2):e70462.

AIM: To explore the experiences of individuals with Chronic Obstructive Pulmonary Disease (IwCOPD) and their caregivers during the COVID-19 pandemic.

DESIGN: Systematic review, adhering to PRISMA guidelines (PROSPERO ID: CRD42022327424).

DATA SOURCES: PsycINFO, PubMed, EMBASE and Web of Science.

METHODS: Databases were searched in April 2022 using keywords relating to COPD, caregivers/patients and COVID-19. Studies collecting data on experiences of IwCOPD or their informal caregivers during the COVID-19 pandemic were included. Following screening and quality appraisal by two reviewers, a qualitative synthesis was conducted.

RESULTS: Of 2931 abstracts screened, 24 articles met the inclusion criteria. For IwCOPD, pandemic impacts on physical and mental health were found, including fears of contracting COVID-19, changes in exacerbation levels, reductions in physical activity, and increases in depression and anxiety. Changes to healthcare management, including access to telemedicine, and positive adaptations, such as increased medication adherence, self-preservation and self-care, were also reported in the studies reviewed. Caregivers expressed fear of their care recipient contracting COVID-19 and changes in the home environment.

CONCLUSION: While the pandemic led to considerable negative experiences for IwCOPD, review findings suggest that some positive experiences were also reported.

Findings may help inform the development of physical and mental health supports for IwCOPD and their caregivers.

IMPACT: This study sheds light on the limited evidence regarding experiences of IwCOPD and their caregivers during the height of the COVID-19 pandemic. As many IwCOPD continue to be impacted by COVID-19, these findings have the potential to inform healthcare providers how they may better support IwCOPD and their caregivers in numerous aspects of their healthcare management and their daily lives.

The lead author's experience as a COPD caregiver acted as Public and Patient involvement input. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: (1) The review sheds light on the considerable impact the pandemic had on the mental and physical health of IwCOPD. (2) It identifies vulnerable areas where support could be improved for IwCOPD and their caregivers, and how support could be improved.

RELEVANCY TO NURSING OPEN: People with chronic obstructive pulmonary disease require considerable care and support from nursing professionals. This review highlights the care needs and support that may be beneficial for this group and is relevant to Nursing Open on nursing practice and research.

RevDate: 2026-02-18
CmpDate: 2026-02-16

Chatzidou P, Stratos A, Chint M, et al (2026)

Denture-Associated Candidiasis and Mucormycosis in Post-COVID-19 Older Adults Managed Through an Integrated Prosthodontic and Infectious Disease Approach: A Narrative Review.

Cureus, 18(2):e103448.

The COVID-19 pandemic has exposed significant vulnerabilities among older adults, particularly denture wearers, to opportunistic fungal infections, including mucormycosis and oral candidiasis. This narrative review, following PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Narrative Reviews) guidelines, collected evidence from 2020 to 2025 to examine the connection between denture use, systemic comorbidities, and fungal complications in elderly individuals after COVID-19. A total of 21 of 104 studies were included, covering case-control, cross-sectional, cohort, and retrospective studies from India, Europe, the Middle East, and North America. Several studies have reported higher rates of oral fungal colonization among denture wearers,with Candida albicans being the most frequently isolated species, followed by resistant strains such as Candida auris. However, these observations are primarily derived from heterogeneous observational studies and should therefore be interpreted as associative rather than causal. COVID-19-related mucormycosis (CAM) was primarily reported as rhino-orbito-cerebral disease, with oral manifestations including palatal necrosis, gingival ulcers, and tooth mobility. Key risk factors identified include diabetes mellitus, corticosteroid therapy, prolonged intensive care unit (ICU) stays, and poor denture hygiene. Mortality related to CAM ranged from 18% to 56%, while candidiasis, though less deadly, significantly affected oral function, nutrition, and overall quality of life. Diagnostic methods included clinical and intraoral examinations, microbiological cultures, imaging techniques, and emerging salivary biomarkers. Treatments included systemic antifungal medications, surgical removal, and prosthesis disinfection, highlighting the important role of prosthodontists in prevention and rehabilitation. Knowledge gaps remain regarding the predictive value of oral lesions for systemic infections, the long-term effects of COVID-19 on the oral microbiome, and the need to standardize denture hygiene protocols. This review emphasizes the importance of integrated dental and medical care in reducing morbidity and mortality among denture-wearing older adults recovering from COVID-19, while recognizing that early oral findings may serve as warning indicators rather than definitive predictors of systemic infection.

RevDate: 2026-02-18
CmpDate: 2026-02-16

Ince I, Sposito F, Charras A, et al (2026)

How loss-of-function mutations in IFIH1 contribute to infectious and/or inflammatory disease - a systematic review.

Journal of translational autoimmunity, 12:100353.

The IFIH1 gene encodes for the cytoplasmic innate immune receptor Melanoma Differentiation-Associated protein 5 (MDA5) that detects viral double-stranded RNA to initiate type I interferon (IFN) responses. While gain-of-function mutations in IFIH1 have been linked with systemic inflammatory diseases, loss-of-function remains less well understood. This systematic review, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidance, explored how IFIH1/MDA5 loss-of-function affects susceptibility to virus infections and/or contributes to inflammatory diseases. Sixteen loss-of-function variants affecting IFIH1 were discussed across 33 studies. Loss-of-function variants were consistently associated with increased susceptibility and/or severity of virus infections, including severe acute respiratory syndrome coronavirus (SARS-CoV2) and human immunodeficiency virus (HIV). Several rare biallelic IFIH1 mutations lead to profound immunodeficiency, while heterozygous mutations associate with milder clinical presentations. Likely through dampening IFN responses, several variants protect from the development of inflammatory diseases, including type 1 diabetes and hypothyroidism. However, IFIH1 deficiency is also implicated in the development of inflammatory diseases, including inflammatory bowel disease. Moreover, the presence of inactivating anti-MDA5 antibodies may alter the clinical phenotypes and prognosis of dermatomyositis and infections with SARS-CoV2. Though their exact impact on MDA5 function has not been confirmed experimentally, anti-MDA5 antibodies may result in loss-of-function and impaired host defence against viruses. Loss of IFIH1/MDA5 activity has diverse effects on anti-viral immunity, associated damage and susceptibility to inflammatory disease, but also protection against organ-specific immune-mediated pathology. Findings highlight the importance of IFIH1 in immune regulation and warrant future studies exploring its potential as a diagnostic and therapeutic target.

RevDate: 2026-02-18
CmpDate: 2026-02-16

Hanifian H, M Nateghpour (2026)

Iran's Journey Through Malaria: From Past Challenges to Future Elimination-A Narrative Review.

Journal of tropical medicine, 2026:4251955.

BACKGROUND: Malaria remains a persistent public health concern in Iran, particularly in southeastern regions bordering Afghanistan and Pakistan. Despite substantial progress over recent decades, challenges such as cross-border transmission, insecticide resistance, and health system disruptions continue to threaten elimination goals.

METHODS: This narrative review synthesized evidence from the World Health Organization (WHO) World Malaria Reports, national surveillance summaries, and peer-reviewed publications indexed in PubMed and Scopus from 2000 to 2025. Emphasis was placed on case trends, intervention coverage, and cross-border dynamics.

RESULTS: Iran reduced indigenous malaria cases dramatically from thousands in the early 2000s to fewer than 300 annually by the mid-2010s and subsequently recorded multiple consecutive years with zero indigenous transmission, according to the WHO surveillance reports. Key achievements included integrated vector management, community engagement, and strengthened cross-border initiatives. However, interruptions during the COVID-19 pandemic and a resurgence of malaria in 2022, largely associated with imported infections, operational disruptions, and emerging vector threats, highlighted vulnerabilities in elimination-phase systems. Additional challenges such as insecticide resistance and the spread of Anopheles stephensi further complicate the elimination trajectory.

CONCLUSION: Iran's experience illustrates the need for adaptive, multisectoral approaches to malaria control in complex socioecological settings. While elimination remains within reach, achieving the WHO certification will require transparent surveillance metrics, reinforce cross-border collaboration, and sustain political and financial commitment.

RevDate: 2026-02-18
CmpDate: 2026-02-16

Rezaei Z, Khorraminia A, Shi D, et al (2026)

Network-based artificial intelligence in mental healthcare: A systematic review of chatbots, artificial intelligence/machine learning models and ethical considerations in global healthcare networks.

Digital health, 12:20552076261421688.

OBJECTIVE: This systematic review examines how artificial intelligence (AI), including machine learning (ML) models and AI-powered chatbots, contributes to the diagnosis, treatment and ethical governance of mental healthcare. It explores how AI-driven systems form interconnected healthcare networks that enhance accessibility, personalization and resilience of mental health services, aligning with the United Nations Sustainable Development Goal 3: Good Health and Well-Being.

METHODS: A comprehensive search across PubMed, IEEE Xplore and Google Scholar (2017-2024) was conducted using Boolean combinations of "AI," "machine learning," "chatbots" and "mental health." Screening followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, yielding 37 high-quality studies for qualitative synthesis. Extracted data were categorized into three domains: (1) AI- and ML-based diagnostic models, (2) chatbot-enabled mental health support systems and (3) ethical and privacy considerations. Analytical dimensions included algorithmic performance, clinical outcomes, data governance and equity of access.

RESULTS: AI-driven interventions improved accessibility, diagnostic accuracy and therapeutic personalization. Chatbots such as Woebot, Wysa and Tess effectively reduced symptoms of depression and anxiety, increased user engagement and provided scalable support, particularly during the COVID-19 pandemic. ML models, including MentalBERT, MentalRoBERTa and SR-BERT, achieved F1 scores of 68-93% in mental health classification tasks. However, limitations included dataset bias, lack of longitudinal evidence and limited cross-cultural generalizability. Ethical analyses revealed persistent challenges concerning privacy, informed consent, algorithmic bias and accountability.

CONCLUSION: AI technologies, when integrated with human oversight, offer transformative potential for global mental health systems by creating interconnected and adaptive care networks. These technologies can enhance efficiency, reduce barriers to care and support data-driven public health strategies. However, successful deployment depends on clear ethical frameworks that promote transparency, respect cultural contexts and preserve human oversight. Future research should prioritize longitudinal studies, inclusive datasets and ethical frameworks that maintain human-centered values in AI-enabled mental health systems.

RevDate: 2026-02-18
CmpDate: 2026-02-16

de Araújo AB, S Azul FVC, Carneiro YC, et al (2026)

Neuroinflammation and Oxidative Stress in Parkinson's Disease, Alzheimer's Disease, and COVID-19: Microglia-Neutrophil Interaction.

ACS omega, 11(5):6922-6938.

Abnormal activation of the immune system and oxidative stress are crucial factors in neurodegenerative disorders, such as Parkinson's disease and Alzheimer's disease. Microglia, neutrophils, oxidative stress mediators such as reactive oxygen species (ROS), lipid peroxidation products (e.g., malondialdehyde), and nitrosative stress markers (e.g., nitrite and nitrate) play important roles in neuroinflammatory mechanisms. Microglial cells acquire a proinflammatory phenotype through interactions with endogenous or exogenous compounds, including cell debris, abnormally modified proteins (including Aβ species and alpha-synuclein), and pathogens (e.g., SARS-CoV-2). They produce many inflammatory mediators and promote the activation of adjacent brain cells and leukocyte infiltration, including polymorphonuclear neutrophils. Accumulation of neutrophils in the central nervous system (CNS) leads to the secretion of more proinflammatory mediators, such as cytokines, proteases, and oxidants, and the formation of neutrophil extracellular traps (NETs). These processes are associated with the pathological activation of microglial cells, cell death, consequent influence on neuronal functions, or even neuronal death, which is a hallmark of CNS disorders. In this review, we address the importance of inflammatory mechanisms and oxidative stress in the CNS associated with Parkinson's disease, Alzheimer's disease, and the neuronal effects observed in coronavirus disease 2019 (COVID-19), as observed by the abnormal activation of central and peripheral immune cells, such as microglia and neutrophils. We also discuss emerging evidence linking SARS-CoV-2 infection to neuroinflammatory mechanisms that could contribute to neurodegenerative complications.

RevDate: 2026-02-18
CmpDate: 2026-02-16

Nguyen Hai C (2026)

Invasive pulmonary aspergillosis in the post-COVID-19 era: diagnosis, treatment, and what lies ahead.

Therapeutic advances in infectious disease, 13:20499361251406189.

Invasive pulmonary aspergillosis (IPA) is a severe opportunistic fungal infection that predominantly affects immunocompromised individuals, including those with hematologic malignancies, organ transplants, and, more recently, patients with post-COVID-19 immune dysregulation. Despite advancements in medical mycology, IPA continues to pose significant diagnostic and therapeutic challenges, contributing to high global morbidity and mortality. Diagnostic accuracy remains limited due to nonspecific clinical manifestations and the suboptimal performance of conventional tools such as bronchoalveolar lavage culture and galactomannan testing. However, recent innovations including polymerase chain reaction-based molecular assays, lateral flow devices, and immuno-positron emission tomography/magnetic resonance imaging offer improved sensitivity, specificity, and speed. Therapeutically, triazoles remain the cornerstone of IPA management, complemented by echinocandins and liposomal amphotericin B in refractory cases. The role of combination therapy and antifungal susceptibility testing is growing in response to rising azole resistance. Additionally, novel antifungal agents and immunotherapeutic approaches are currently under clinical investigation. Effective management of IPA requires a timely, multidisciplinary approach that combines advanced diagnostics with personalized antifungal strategies. Continued research is essential to standardize molecular techniques, refine immunotherapy, and expand access to next-generation antifungals to reduce the global burden of this life-threatening infection. This review aims to synthesize current evidence on the diagnosis and treatment of IPA, critically evaluate the strengths and limitations of existing diagnostic and therapeutic approaches, and explore emerging strategies to enhance clinical outcomes in the context of rising antifungal resistance.

RevDate: 2026-02-18
CmpDate: 2026-02-16

Badran EF, Rayyan A, Al Jaberi M, et al (2025)

Infectious disease burden and surveillance challenges in Jordan and Palestine: a systematic review and meta-analysis.

Frontiers in digital health, 7:1713089.

BACKGROUND: Jordan and Palestine face public health challenges due to infectious diseases, with the added detrimental factors of long-term conflict, forced relocation, and lack of resources. Added to these are the increased rates of morbidity and mortality from having limited healthcare services available due to a lack of funding, poor disease surveillance systems, and entrenched systemic weaknesses. The purpose of this systematic review was to report the prevalence of infectious diseases in Jordan and Palestine in order to inform the development of targeted public health programs that use both standard and novel approaches to reduce the region's disease burden.

METHOD: As defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review included prospective, retrospective, cross-sectional, and case series studies published from January 2021 to February 2024. Non-English studies were excluded due to resource limitations, as were studies published before the COVID-19 pandemic (i.e., before January 2021) to focus on post-COVID-19-pandemic trends. We used diagnostic techniques (screening, laboratory, and confirmatory tests) to test for microorganisms in adults and children from at-risk populations in Jordan and Palestine. Test-negative controls were contrasted with patients who had positive test results. A manual reference screening process was added to a systematic search of PubMed and Scopus. Full-text, English-language publications published after January 2021 were eligible; protocols, reviews, case reports, and articles written in languages other than English were not. The Rayyan platform was used by two reviewers to independently screen studies. Infection type, causative microorganism, symptoms, mortality, risk factors, seasonal fluctuations, and study details (author, year, location, design, and participant characteristics) were among the extracted data. The Hoy 2012 Checklist was used to evaluate the risk of bias. Open Meta (Analyst) was used to analyze the 13 studies that satisfied the inclusion criteria. Study design, risk of bias, heterogeneity, publication bias, indirection, imprecision, effect size, and residual confounding were all considered when grading the quality of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

RESULTS: The results revealed that four studies addressed the prevalence of Brucella infection in Jordan and Palestine. The pooled estimate was 42.2% (95% CI: 18.8%-65.6%, I [2]: 99.7%, P: 0.001, n = 4 studies, 4,483 patients). In the studies that addressed diarrhea, in 31 of 159 (19.5%) cases, 20 were caused by Entamoeba (12.6%), 10 were caused by Blastocystis (6.3%), and 1 (0.6%) was caused by Cryptosporidium. As some cases had more than one parasite, the certainty of evidence (COE) was assessed as very low. The pooled estimate for viral causative agents of respiratory tract infections was 60% (95% CI: 11.8%-100%), while for bacterial causes, the pooled estimate was 24.4% (95% CI: 0%-68.3%). Respiratory syncytial virus (RSV) was the most common agent, with a pooled estimate of 57.9% (95% CI: 29.8%-85.9%), while influenza had a pooled estimate of 28.4% (95% CI: 5.3%-51.5%). Furthermore, two studies addressed the prevalence of meningitis in pediatric patients. In adult patients, of 192 patients known to have meningitis, a causative agent was identified in only 86 cases, with 83 (49%) classified as aseptic meningitis.

CONCLUSION: The review addressed the limitations of diagnostic capacity, reporting systems, and population-level data concerning high-burden and emerging pathogens within Jordan and Palestine. Specifically, the growth in the number of cases with respiratory tract infections, protozoal diarrheal diseases, and brucellosis indicates that improvements in surveillance systems and diagnostic processes need to be standardized and implemented throughout Jordan and Palestine to provide accurate and reliable diagnoses. In addition, improving the quality and quantity of the data and incorporating new technologies and other innovative approaches as a complement to existing public health indicators within Jordan and Palestine would be beneficial for better detecting these diseases at the earliest possible time and would provide the opportunity to establish evidence-based disease management strategies within the region.

RevDate: 2026-06-08

Yu P, Zhu P, Kudiza A, et al (2025)

Help, near and far: a systematic review of post-COVID digital mental health solutions for domestic violence victims.

Frontiers in public health, 13:1687396.

INTRODUCTION: Domestic violence (DV), as a global pandemic, poses a significant challenge within the field of public health, gravely impacting the mental and physical health of victims. Modern digital technologies have been proposed as promising interventions for DV-related mental health problems. We therefore evaluated their effectiveness.

OBJECTIVE: To systematically review digital interventions targeting the mental health of DV survivors and to summarize implications for health professionals and policy makers.

METHODS: We searched PubMed, EBSCO, and Web of Science (January 1, 2020-April 23, 2024) following PRISMA guidelines. Two reviewers independently screened records, applied predefined eligibility criteria, and extracted data. Owing to heterogeneity, we performed a narrative synthesis. Meanwhile, based on the results of the literature review, this paper proposes a series of policy recommendations from a post-COVID-19 era perspective, integrating societal context and relevant policies.

RESULTS: Nine studies met the inclusion criteria. Three reported no significant mental-health benefits, whereas the remainder showed improvements in outcomes such as depression, anxiety, PTSD symptoms, emotion regulation, perceived support, or safety preparedness using tools including mobile apps, web-based programs, virtual reality, chatbots, and video adjuncts.

CONCLUSION: Digital interventions show promise for improving mental-health outcomes among DV survivors, but their implementation requires attention to safety, engagement, cultural adaptation, and integration with offline services.

PROSPERO, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023488560.

RevDate: 2026-06-08
CmpDate: 2026-02-16

Camara B, D Buonsenso (2026)

Biomarkers of long COVID in children and young adults: a scoping review.

European journal of pediatrics, 185(3):132.

UNLABELLED: Following the SARS-CoV-2 pandemic, a significant percentage of people are now experiencing long-term symptoms, despite a continuing lack of concrete documentation of physiological and risk profiles that hinders diagnosis and treatment, particularly in pediatric contexts. This review aims to highlight the existing evidence for measurable physiological markers for post-acute sequelae of SARS-CoV-2 infection (long COVID) in children, adolescents, and young adults. Titles providing data related to measurable biomarkers distinguishing young long COVID patients from controls were compiled and analyzed. Results were displayed in table and diagram form for optimal qualitative evaluation of the relationship between markers and symptomatology within the context of each organ system. Only human studies published in English, Italian, Portuguese, German, and Spanish between the 5th of February 2025 and the 31st of December 2025 were considered, and no other time constraints were applied. Following search and criteria evaluation, nine studies were included, totaling 41 occurrences identified in diseased patients with statistically significant variation from healthy controls. Markers suggest the presence of organic manifestations based on published literature, although more data and future studies will be necessary to establish clear connections.

CONCLUSION: The data compiled for this review adds to the body of evidence indicating a physiological manifestation of long COVID and its consequences. Further investigation into potential risk factors, pre- and post-pubescent manifestations, and specific inflammatory and immune pathways will be necessary for a more concrete understanding of long COVID and its effects on children, adolescents, and young adults.

WHAT IS KNOWN: • Long COVID is estimated to affect a significant population of patients, despite the lack of concrete physiological diagnostic and prognostic measures. • Pediatric incidence of the disease is still largely debated, and published data are scarce.

WHAT IS NEW: • A total of 41 biomarker occurrences were identified by selected studies, which were consistent with expected physiology behind reported symptoms. • The body of data discussed suggests the presence of physiological phenomena behind the long-term symptoms experienced by pediatric long- COVID patients.

RevDate: 2026-06-08

Sheikholeslami MA, Parvardeh S, Ghafghazi S, et al (2026)

Modulation of immune responses by opioids through toll-like and P2X receptor signaling in COVID-19.

Purinergic signalling, 22(2):22.

The pathogenesis of COVID-19 involves complex interactions between viral replication and host immune dysregulation, mediated by toll-like receptors (TLRs) and P2X receptors (P2XRs). These receptors detect pathogen- and damage-associated molecular patterns (PAMPs and DAMPs), triggering inflammatory cascades. Opioids, beyond their analgesic role, modulate innate and adaptive immune responses via opioid receptors and indirectly through TLR and P2X signaling. This narrative review integrates experimental, clinical, and bioinformatic evidence to explore the mechanistic crosstalk between opioid signaling, TLRs (notably TLR2, TLR4, TLR9), and P2XRs (notably P2X4 and P2X7) in COVID-19 immunopathology. Chronic opioid exposure may either enhance or suppress inflammation depending on dose, duration, and immune context. In COVID-19, the hyperactivation of TLR4, TLR7, and TLR9 drives cytokine storms, while the release of ATP from damaged cells activates P2X7, thereby amplifying the inflammatory response. ATP breakdown into adenosine further modulates immunity via A2A and A2B receptors. Targeting TLR4 and P2X7 offers a promising therapeutic strategy to mitigate hyperinflammation and improve outcomes in COVID-19 and related inflammatory diseases. In addition, we outline how the Contact System, the Kallikrein-Kinin System (KKS), the Renin-Angiotensin System (RAS), and the NLRP3 inflammasome provide the innate inflammatory backdrop through which opioids and P2 receptor signaling may shape immune dysregulation in COVID-19. Notably, direct clinical evidence for opioid-P2 receptor interactions in COVID-19 remains limited, highlighting the need for targeted translational studies.

RevDate: 2026-06-09
CmpDate: 2026-03-06

Saiding Q, Xiao F, Khan MM, et al (2026)

Lipid-Polymer Hybrid Nanoparticles (LPHNPs) for RNA Delivery.

Accounts of chemical research, 59(5):762-775.

RNA-based therapeutics are now revolutionizing modern medicine, with examples like COVID-19 mRNA vaccines and the siRNA drug Leqvio, validating their potential in infectious diseases and chronic diseases. However, the broad clinical translation of RNA therapeutics remains critically dependent on the development of safe and effective delivery systems that are capable of overcoming physiological barriers and achieving precise spatiotemporal upregulation or downregulation of target proteins. Lipid nanoparticles (LNPs) have attracted significant attention due to their clinical success, yet they still struggle to overcome context-specific delivery barriers, such as poor stability in blood or gastrointestinal fluids, lack of disease-microenvironment responsiveness, and insufficient cell-type targeting, which hinder the full implementation of RNA therapeutics across a broad spectrum of diseases. To tackle the unmet needs in RNA-based therapeutics, developing new types of delivery platforms with different nanoparticle structures is therefore highly attractive and needed. Over the past decade, our group has focused on developing novel lipid-polymer hybrid nanoparticles (LPHNPs) for the delivery of RNA therapeutics across diverse biomedical applications. By incorporating biodegradable polymers with tailored properties, for example, poly(lactic-co-glycolic acid) (PLGA) for structural stability, hyaluronic acid (HA) for CD44-mediated targeted delivery, and l-cysteine-based poly(disulfide amide) (Cys-PDSA) for redox-responsive release in the tumor microenvironment, these LPHNPs exhibit highly tunable architectures that integrate efficient RNA encapsulation, site-specific delivery, and controlled RNA release, providing more tools and choices for RNA delivery. In this Account, we summarize recent advances from our group in the design and synthesis of LPHNPs for RNA therapeutics, as well as their translational applications across diverse disease contexts. We highlight rational material pairings and design principles that optimize key performance metrics, including colloidal stability, RNA loading, cellular uptake, endosomal escape, and targeting efficacy. We also provide case studies demonstrating the translational potential of RNA-LPHNPs across various administration routes and disease models, including oral, inhaled, intravenous, and intravesical delivery, using the LPHNP platforms developed in our laboratory. These platforms have achieved promising therapeutic efficacy in models of cancers, inflammatory diseases, and respiratory conditions by enabling local or systemic delivery of mRNA or siRNA to immune cells, epithelial cells, and tumor microenvironments. By outlining optimized design strategies and future challenges, this Account aims to serve as a roadmap for researchers seeking to develop next-generation RNA delivery platforms that are modular, functionally versatile, and translatable.

RevDate: 2026-06-08

Ben Ghezala I, Peiffer-Smadja N, Solas C, et al (2026)

How Can Pharmacology Help Us Overcome the Challenges of Drug Repositioning as Antivirals to Treat Emerging Pathogens? The Example of Covid-19.

Clinical and translational science, 19(2):e70505.

The Covid-19 pandemic highlighted the urgent need for effective therapies against emerging pathogens. Drug repurposing, defined as the use of existing medications for new therapeutic purposes, was extensively pursued for SARS-CoV-2 but has not yielded successful treatments. This narrative review critically examines the pharmacological and methodological factors that contributed to these unsuccessful outcomes, paying particular attention to tests of azithromycin and hydroxychloroquine. There are many reasons the promise of repurposed drugs was not realized. Many repurposed compounds displayed promising in vitro antiviral activity that did not translate into clinical efficacy. Major pharmacokinetic (PK) limitations, for example, poor oral bioavailability, low concentrations in pulmonary tissue, and extensive plasma protein binding, prevented these drugs from reaching therapeutic levels in humans. Preclinical research often relied on non-human cell lines and animal models that inadequately reflected human physiology, leading to misleading experimental outcomes. Clinical trials were often undermined by methodological limitations, including endpoints with uncertain clinical significance, suboptimal comparators, and insufficient attention paid to key PK and pharmacodynamic (PD) parameters such as half maximal effective concentration (EC50) values. This narrative review emphasizes the importance of integrating comprehensive PK/PD assessments, relevant experimental models, and rigorous trial design to strengthen drug development during future health crises. The relative success of antivirals including molnupiravir, nirmatrelvir, and remdesivir, which were either novel or previously unapproved compounds, suggests the value of designing and developing targeted antivirals. We must coordinate global research, develop pharmacologically sound strategies, and use evidence-based decision-making to effectively prepare for future pandemics and quickly produce effective treatments.

RevDate: 2026-06-08

Dhawan S, Hughes J, Matveyenko AV, et al (2026)

Staying Functional Through Connection and Adaptation: When Islets Inspire Islet Biologists.

Diabetes, 75(4):596-602.

In response to the lockdowns and travel bans during the coronavirus disease 2019 pandemic, Peter C. Butler at the University of California, Los Angeles (UCLA), started a virtual islet biology seminar series. After the authors of this article joined him as co-organizers, this initiative became the Islet Research Seminar Series (IRSS). Like islets of Langerhans adapt to their changing environment, the islet biology community quickly embraced this new format. The IRSS evolved into a lasting scientific forum that convenes weekly and is attended by islet biologists from the U.S., Canada, Europe, and Israel. The series covers a range of topics in islet biology, with presentations from scientists representing all career stages. It has proven particularly valuable for trainees and early-stage investigators in exposing them to a variety of topics in islet biology without travel required and facilitating more spontaneous interactions with senior scientists than at in-person meetings. While the online format is not meant to replace live scientific conferences, we believe that the IRSS plays a unique role in keeping the islet biology community connected and abreast of the most recent scientific discoveries in our field. The success of this platform stands as a testament to the scientific community to adapt and thrive through challenges. This article is dedicated to Peter C. Butler, UCLA, who initiated the IRSS.

RevDate: 2026-05-29
CmpDate: 2026-05-27

Wang Z, Ren B, Rawaf S, et al (2026)

Impact of the COVID-19 pandemic on cancer screening in Europe: A systematic review of disruptions, barriers, and policy responses.

Cancer treatment and research communications, 47:101115.

BACKGROUND: Cancer screening is a cornerstone of cancer control, but the COVID-19 pandemic caused unprecedented disruption to preventive healthcare worldwide. In Europe, national screening programmes were severely affected, with consequences extending beyond screening to diagnosis, treatment, and equity. While several country-specific studies exist, cross-regional syntheses remain scarce. Understanding the scale, determinants, and outcomes of these disruptions is crucial to building resilient, equiTable screening systems.

AIM/OBJECTIVE: This systematic review synthesises evidence on the impact of the COVID-19 pandemic on cancer screening across Europe, examining differences by cancer type, screening modality, and national context. It also explores downstream effects, barriers, enablers, and policy responses to guide future preparedness.

METHODS: Following PRISMA guidelines, six databases and grey literature sources were searched for studies published between December 2019 and January 2025. Eligible studies included quantitative and qualitative analyses of screening activity during the pandemic. Data were extracted on study characteristics, outcomes, and contextual factors. Given the heterogeneity of measures, findings were summarised using descriptive statistics and thematic synthesis.

RESULT: Forty-five studies from 18 European countries revealed a 30-60 % reduction in screening participation at peak disruption, varying by cancer type and country. Consequences included delayed diagnoses, stage migration, increased projected mortality, and widening inequalities. Major barriers included service suspension, staff redeployment, and fear of infection. Enablers comprised adaptive communication, safety protocols, and digital innovations.

CONCLUSION: COVID-19 caused substantial and uneven disruption to European cancer screening. Protecting continuity, institutionalising innovations, and addressing inequities are critical to enhancing resilience for future health crises.

RevDate: 2026-06-08

Hazenberg P, CJ Duncan (2026)

Human genetics of susceptibility to live-attenuated viral vaccines.

Current opinion in virology, 75:101512.

Alongside the development of antibiotics, vaccination is the medical innovation with arguably the greatest impact on human health. Testament to its success is the eradication of infectious diseases, such as smallpox, that devastated human populations for almost 4000 years. Live-attenuated vaccines (LAV), which retain the capacity for infection and replication, were the first to be developed and remain highly efficacious, underpinning successful human vaccination campaigns (e.g. polio virus, measles virus, yellow fever virus). The cost of this success is the capacity of LAVs to cause disease in a small proportion of recipients, typically owing to overt or previously unappreciated immunodeficiency. From the careful investigation of such rare events, major clinical and scientific lessons about human antiviral immunity have been drawn. Here, we review features of pathogenic LAV dissemination, which continue to inform our understanding of critical steps in the immune control of LAVs. We discuss recent data on specific variants identified in geographically isolated populations and reflect on more common phenocopies of these monogenic defects, with potential implications for vaccine practice and policy. Collectively, these insights may inform approaches to the growing population of individuals rendered more vulnerable to LAVs by aging, multimorbidity or medical intervention. They also serve to highlight the clinical need for therapeutic strategies to combat pathogenic LAV dissemination.

RevDate: 2026-06-08

Torres Munguía JA, I Martínez-Zarzoso (2026)

Global trends of pandemic-prone and epidemic-prone disease outbreaks in 2024.

BMJ global health, 11(2):.

During 2024, the number of pandemic-prone and epidemic-prone disease outbreaks worldwide was estimated at 301. The data highlight a shift in disease outbreak patterns, with a decline in the number of countries reporting public health events of concern linked to COVID-19 and a rise in those reporting outbreaks of viral diseases transmitted by vectors.About 90% of the outbreaks in 2024 were associated with COVID-19, dengue, yellow fever, Oropouche virus disease and influenza (linked to identified zoonotic or pandemic influenza virus). Although disease outbreaks can affect any country anywhere, they tend to disproportionately occur in countries facing many other socio-economic development, climatic and humanitarian challenges. In this regard, sub-Saharan Africa and the subregion of Latin America and the Caribbean-home to just 23.3% of the world's population-reported the highest number of disease outbreaks in 2024 with about 57% of the total. Particularly, the sub-Saharan Africa region has been the site of nearly 32% of recorded outbreaks since 1996. Future research should include efforts to improve the quality and availability of disease outbreaks data-particularly in the most exposed or vulnerable regions-and to promote the scientific use of such information for foresight purposes and for forecasting future health events of concern to support anticipatory action.

RevDate: 2026-02-18

Tuschick E, Smith J, Harrison B, et al (2026)

Food Insecurity in Families With Children or Young People With Autism: A Systematic Review and Meta-Analysis.

Nutrition bulletin [Epub ahead of print].

Food insecurity is frequently reported among families of children with autism spectrum conditions (ASC), yet there is limited evidence synthesising its prevalence and impact. This systematic review aimed to examine and meta-analyse the existing literature on food insecurity in families of children and young people with ASC. A comprehensive search across nine databases identified 39 papers, of which 11 met the inclusion criteria. Studies were included if they involved autistic children or young people under the age of 25 (and/or their family members) and focused on food insecurity. Eligible studies were critically appraised, and data were synthesised using both narrative and meta-analytic approaches. Meta-analyses of nine studies estimated a pooled prevalence of food insecurity at 29% (SE: 5%; 95% CI: 17%-40%; z = 5.35, p < 0.001), which increased to 31% following adjustment for publication bias. The review also found that food insecurity worsened during the COVID-19 pandemic, contributing to increased caregiver stress and disruptions in eating behaviours. This review demonstrates the high prevalence of food insecurity among families of children with ASC and the complex interplay of social, economic and behavioural challenges they face. Addressing food insecurity in autistic households requires policy responses that extend beyond financial aid to consider the sensory, behavioural and nutritional needs specific to ASC. Future research should adopt standardised measures and prioritise the development and evaluation of inclusive, tailored food support systems that reflect the lived experiences of neurodiverse families.

RevDate: 2026-02-18
CmpDate: 2026-02-18

Dost G (2025)

Belongingness and loneliness in higher education: a meta-analysis of pre- and post-pandemic trends.

Frontiers in psychology, 16:1625957.

INTRODUCTION: This meta-analysis seeks to explore how the complex relationship between loneliness and belongingness in higher education students can be explained by a set of pre- and post-COVID-19 pandemic dynamics.

METHODS: A meta-analysis including 56 studies and involving a total of 30,062 participants was conducted, and the review explores direct relations and moderation through age, education, and country.

RESULTS: Results indicate a moderate-to-strong negative relationship between loneliness and belongingness (r = -0.48, 95% CI [-0.529, -0.422]), such that a consistent association was found across situations such that increases in one's level of loneliness is associated with decreases in one's level of belongingness. Nevertheless, there was no small-degree of inter-study heterogeneity (Q = 1058.86, p < 0.0001, I[2] = 94.33%), which is a potential reason for the differences in the study populations and methods, employing a random-effects model to account for these discrepancies. After further scrutiny of the results, location, and year of study, and country did not moderate the effect size, which in turn reflects the stability of the association across context and time. In the subgroup analysis the effect size of the relationship between the level of the Information Technology (IT) usage and the externalisation was lower in the time of the pandemic than in the time preceding the pandemic. The effect size of the pre-pandemic group is -0.515 (95% CI: -0.589 to -0.441, p < 0.001 < 0.001) and the effect size of pandemic group is slightly smaller with -0.427 (95% CI: -0.502 to -0.352, p < 0.001 < 0.001). This means that although the level of loneliness have normalised, there have been a subtonic influence on perceived belonging of the novelty stressor caused by breakdowns in social connection from pandemic-level influences. In addition, no significant publication bias was observed.

DISCUSSION: Overall, these findings confirm the strong negative association between loneliness and sense of belonging and emphasise the important role in providing community support for students, especially during social disruptions.

RevDate: 2026-06-08
CmpDate: 2026-03-07

Goren T, Vashdi DR, I Beeri (2026)

Political trust and health compliance during a health crisis: A systematic literature review from the COVID-19 pandemic.

Social science & medicine (1982), 395:119093.

Political trust is considered crucial for enhancing civic compliance with government policies and instructions, particularly during a health crisis. However, evidence from the COVID-19 pandemic, a major global health crisis, suggest a more nuanced relationship. Aiming to explore and clarify the nature of and the conditions for the political trust and civic compliance relationship in the context of a health crisis in the general population, at the overall societal-level, this study systematically reviews relevant literature from the COVID-19 pandemic, across 62 countries. Our findings indicate that the positive relationship between political trust and compliance is not self-evident, as 42% of the reviewed studies (63 of 151) report non-significant, mixed or negative results. Moreover, conceptual and methodological features seem to affect the likelihood of this association, such as the object of trust and compliance behavior, the behavior's execution timeframe and its legal status, and the manner in which political trust and compliance are measured. Potential consequences are discussed.

RevDate: 2026-06-08

Xu Q, Zhao M, Wang Q, et al (2026)

Chronic fatigue syndrome: From etiology and mechanism to diagnosis and treatment.

Journal of psychiatric research, 196:171-184.

Myalgic encephalomyelitis (ME), commonly known as chronic fatigue syndrome (CFS), is a long-lasting neurological disease. The cause of ME remains uncertain, characterized by unrelenting or recurring fatigue not alleviated by rest. In recent times, CFS incidence has been on the rise annually, showing a tendency towards younger sufferers. Especially post-COVID-19, its prevalence has surged, posing a significant threat to 21st-century health. CFS symptoms are intricate and diverse. Patients typically endure extreme fatigue lasting over six months, accompanied by physical and neuropsychiatric symptoms like sore throat, muscle/joint pain, anxiety, and distress. These severely disrupt daily life and work, heightening illness risks and financial strain. With the unknown etiology, current treatments have limited success and may induce psychological issues such as anxiety and depression. This paper delivers an extensive and thorough overview of the latest developments in the studies concerning the pathogenesis, diagnostic standards, and therapeutic approaches for chronic fatigue syndrome. Integrating and assessing the existing knowledge body related to this field systematically, we aim to facilitate continuous research and gain a deeper understanding of this complex medical problem whose mechanism remains largely unknown. Moreover, valuable insights and practical recommendations for future related treatments and research are also provided.

RevDate: 2026-06-08
CmpDate: 2026-02-18

Radtke T, Pham-Ngoc H, Hua-Huy T, et al (2026)

Pulmonary diffusing capacity for nitric oxide in disease: a scoping review.

European respiratory review : an official journal of the European Respiratory Society, 35(179):.

OBJECTIVE: This scoping review aims to map the available studies on single-breath pulmonary diffusing capacity for nitric oxide (D LNO) in various clinical diseases and identify gaps for future research.

METHODS: We followed the JBI methodology for scoping reviews. A systematic literature search was conducted in Embase, MEDLINE (EBSCOhost), PubMed, Scopus, Web of Science and the Cochrane Library to identify studies on D LNO from 1983 to 2025. Two reviewers screened abstracts using Rayyan software and extracted data using standardised templates implemented into REDCap (Research Electronic Data Capture).

RESULTS: We identified 1638 studies, of which 69 met the eligibility criteria. These studies represented respiratory (n=22), immunological/genetic/systemic (n=14), post-COVID-19 sequelae (n=13), cardiovascular (n=9), metabolic/endocrine/renal (n=6), environmental-related (n=3) and other (n=2) conditions. There was substantial heterogeneity in disease categories, sample sizes and reporting methods. Nearly half of the studies (49.3%) used convenience sampling, where participant selection processes are often poorly described; 62.3% included <50 participants. Only 18.8% reported a sample size calculation, and 10.1% registered or published a study protocol. Disparate findings within disease categories were often difficult to interpret; and small sample sizes limited generalisability. In some specific conditions, D LNO showed sensitivity in detecting interstitial and fibrotic changes compared to conventional single-breath pulmonary diffusing capacity for carbon monoxide (D LCO) while simultaneous D LNO-D LCO measurements permitted the detection of pulmonary vascular-haematological perturbations.

CONCLUSION: Single-breath D LNO-D LCO may provide additional pathophysiological insight by assessing the relative contributions from membrane and blood resistance of diffusion. Larger studies are required to clarify its interpretation across disease states.

RevDate: 2026-06-08
CmpDate: 2026-02-19

Park JJ, Na SH, Park H, et al (2026)

Layout Types and Efficiency Improvement Strategies for Open Points of Dispensing in Vaccine and Antibiotic Distribution: A Scoping Review.

Prehospital and disaster medicine, 41(1):e1 pii:S1049023X26108838.

INTRODUCTION: Regarding pandemics or bioterrorism incidents, prompt and secure distribution of vaccines and prophylactic antibiotics is crucial. Open Points of Dispensing (PODs) are established to serve the public, and their effectiveness depends on the internal spatial layout and operational workflow design. However, studies on systematic classifications of open POD configurations and comprehensive syntheses of strategies for enhancing operational efficiency are lacking.

STUDY OBJECTIVE: This scoping review aimed to classify open POD layout types used for vaccine and antibiotic distribution and to consolidate strategies that improve efficiency across various workflow stations.

METHODS: A scoping review was conducted following the PRISMA-ScR guidelines. A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases, spanning from January 2001 through July 2025. The search strategy involved incorporating keyword combinations related to "points of dispensing," "mass vaccination," "mass prophylaxis," and specific pathogens such as anthrax, influenza, and COVID-19. Extracted data included the POD layout typologies, process designs, and efficiency metrics. The findings were synthesized using a narrative approach.

RESULTS: Nineteen studies met the inclusion criteria and were analyzed. Vaccine PODs were classified into four primary layouts, namely station-based sequential-flow, cell-based, fixed-seat service, and pop-up PODs. Antibiotic PODs were categorized into two types, namely sequential processing and selective-expedited processing. Each layout exhibited unique operational characteristics, including sequential versus integrated clinical stations (for vaccine PODs) and standard versus expedited dispensing lines (for antibiotic PODs). Efficiency enhancement strategies across workflow stations included task integration, use of digital tools, simplification of documentation, optimization of medication preparation, and staffing adjustments guided by simulation modeling.

CONCLUSION: This review provides a systematic classification of open POD layouts and summarizes the strategies for improving efficiency across workflow stations. The derived insights offer practical guidance for planning and operating PODs in future public health emergency responses.

RevDate: 2026-02-19
CmpDate: 2026-02-19

Vatankhah H, Vatanparast M, Royani Z, et al (2026)

Lessons from a Low-Resource Country: A Narrative Review of Virtual Learning Adoption and Challenges in Medical Education in Iran During COVID-19.

Advances in medical education and practice, 17:561822.

OBJECTIVE: The global COVID-19 pandemic has had a profound impact on the education system. Education shifted to virtual methods, while there was not enough time to plan and choose a proper educational platform. In this study, we present an up-to-date review of the most commonly used virtual education platforms in Iran during the COVID-19 pandemic.

METHODS: This narrative review systematically searched Persian and English articles (2020-2024) in Medline, EMBASE, Scopus, Web of Science, ERIC, SID, CIVILICA, and PubMed using keywords: "COVID-19", "virtual learning", "online learning", "distance learning", "post-COVID infection", "real and virtual simulation", and "educational platforms".

RESULTS: Virtual classes have become increasingly popular during the pandemic. Adobe Connect, Sky Room, Skype, Big Blue Button, Google Meet, Gharar, Zoom, and Navaid System were the most commonly used platforms during the COVID pandemic in Iran. The most frequently utilized systems included Shad (predominant in general education and training) and Navid (leading in medical sciences). Shad had excelled in scalability and institutional integration but faced connectivity issues in rural areas. Despite its technical strengths, Navid was criticized because of insufficient interactivity and misalignment with learner needs in medical English.

DISCUSSION: During COVID-19, online medical education in Iran relied mainly on domestic platforms, which have some limitations. To ensure future equity and competency, a shift toward hybrid models incorporating offline-capable Learning Management Systems (LMS), simulation, and digital literacy training is essential.

RevDate: 2026-02-19
CmpDate: 2026-02-19

Andreadis I, S Vasilopoulou (2026)

The populism-euroscepticism nexus in a contested Europe: The EUPopLink COST Action.

Open research Europe, 6:27.

The EUPopLink COST Action (CA23102) addresses the complex and changing relationship between populism and Euroscepticism in contemporary Europe. While often viewed as "two sides of the same coin," the nexus between these two phenomena is contingent and strategic rather than deterministic. Not all populists are Eurosceptic, and Euroscepticism is not always populist in nature. This publication synthesizes current scholarly debates, highlighting how the European Union (EU) is frequently framed as the populist "other", i.e., a remote, technocratic elite standing in opposition to the "pure people". The nature of this opposition varies significantly across the ideological spectrum, e.g. right-wing populism targets the EU primarily through a "traditionalist-authoritarian-nationalist" (TAN) lens, viewing it as a threat to national sovereignty and cultural identity, while left-wing populism critiques the EU based on socio-economic cleavages, challenging neoliberal governance and austerity while often advocating for a more democratic "Social Europe". The analysis further explores how the polycrisis era-marked by financial instability, the COVID-19 pandemic, and geopolitical conflict-has led to a sophisticated two-level strategy among populist actors. This involves increased institutional pragmatism coupled with radicalized, opportunistic communication, particularly on social media. Finally, the publication outlines the EUPopLink mandate, which seeks to standardize conceptual frameworks and generate an unprecedented body of comparative data through forthcoming country reports. By linking the supply and demand sides of electoral competition, the project aims to provide policymakers and scholars with the tools necessary to mitigate the negative consequences of these disruptive political forces.

RevDate: 2026-06-08

Paterson A, Spies R, Zauchenberger CZ, et al (2026)

Effectiveness of stigma reduction interventions and outbreak response adaptations in infectious disease outbreaks: a systematic review.

Frontiers in public health, 14:1755092.

INTRODUCTION: Stigma is a common and recurring feature of infectious disease outbreaks where it may have detrimental effects on individual wellbeing and undermine outbreak response. This systematic review explores stigma reduction interventions in infectious disease outbreaks.

METHODS: Eligible studies were searched for in Medline, Embase, PsycINFO, and Global Health databases and through reference screening. Risk of bias was assessed using study design-specific tools and the results of included studies underwent narrative synthesis.

RESULTS: Eleven studies conducted across coronavirus disease 2019 (COVID-19), Ebola disease, mpox, severe acute respiratory syndrome (SARS), and a hypothetical infectious-disease scenario, met the inclusion criteria. Five studies reported reductions in stigma, four reported mixed or null results, and two reported increases in stigma. The most promising strategies for outbreak-related stigma reduction were embedding anti-stigma messaging within health communication, providing psychosocial support, and fostering genuinely participatory community involvement.

DISCUSSION: Evidence on how to effectively reduce stigma during outbreaks remains limited. Strengthening the theoretical foundations, measurement tools, and evaluation designs of stigma-reduction interventions will be essential to inform evidence-based outbreak preparedness and response policies. This would help decision-makers ensure that risk communication, community engagement, and service delivery minimise stigma and improve uptake of testing, care, and preventive measures.

RevDate: 2026-06-08

Kerai T, Woolhouse M, Nyazema NZ, et al (2026)

A narrative review of heterogeneity in SARS-CoV-2 infection outcomes and vaccine efficacy: strategizing pandemic preparedness in Africa.

Frontiers in public health, 14:1761547.

Disease epidemiology during the COVID-19 pandemic differed greatly across the globe. In contrast to early pandemic predictions, Africa recorded the fewest SARS-CoV-2 related hospitalizations and deaths. Hypotheses proposed to explain this paradox include underreporting, age demographics, climate, national mitigation strategies, lifestyle factors, pre-existing cross-reactive protection, and host genetic determinants. This traditional, narrative review evaluates these hypotheses investigated in the published literature, and highlights knowledge gaps which limit our understanding and obscure validation of potential explanations. It also discusses how responses to vaccines, the primary intervention sought to control infectious disease outbreaks, may vary both within the African population and across other continents. Potential explanations in the literature include pre-existing immunity, poor nutrition, immune modulating co-infections, comorbidities, microbiome composition, genetic polymorphisms, and demographic factors. Previous studies have shown that pre-existing (infection-derived) immunity or cross-reactive immune responses can augment vaccine-elicited positive responses and can protect against reinfection in a way similar to immunization. Conversely, there are also studies showing that prior immunity interferes with the efficacy of new vaccines through mechanisms like original antigenic sin and immune imprinting. Thus, there is need for more immunology studies to understand the relative contribution of pre-existing cross-reactive immune responses to the epidemiology of new pathogens. These studies are particularly essential to understand the differences between pandemic preparedness and population vulnerability, as well as to inform vaccine development and vaccine effectiveness monitoring studies. SARS-CoV-2 serves as an important case study to understand heterogeneity between and within populations in immune responses to both the pathogen and to vaccination. This understanding is crucial in informing vaccine research and development aimed at supporting the 100-day mission for when the next pandemic threat emerges.

RevDate: 2026-02-19
CmpDate: 2026-02-19

Muzard C, Seguin J, Bonnefoy J, et al (2025)

Pre-clinical evaluation of mRNA-lipid nanoparticles' potency and toxicity: current practices and future directions.

In vitro models, 4(3-4):177-194.

Over the last few years, the success of COVID-19 mRNA vaccines has resulted in the emergence of RNA lipid nanoparticles (LNPs) with promising prospects for the prevention and treatment of various diseases. The context of the SARS-CoV-2 pandemic has led to the rapid development of vaccines with abbreviated non-clinical programs. However, there are currently no official guidelines defining the required standards for global marketing of mRNA based therapeutic products. Nevertheless, to guarantee a well-controlled product, it is essential to characterize both the drug substance and the final product in terms of their structure, composition, formulation, physico-chemical features, potency, and safety. This lack of guidance has resulted in a wide variety of heterogeneous in vitro tests being used to assess the potency and cytotoxicity of RNA-LNP. This review discusses the commonly used in vitro assays, primarily 2D monolayer assays, employed to evaluate the biological properties of RNA-LNP. We then explore novel alternative methods to bridge the gap between in vitro and in vivo results. We summarize (i) co-culture models, (ii) multilayer 3D assays and (iii) in vivo replacement models, exploring their potential applications in assessing the potency and safety of RNA-LNPs. Finally, we discuss the use of in silico and machine learning as models for optimizing and predicting the biological behavior of RNA-LNPs.

RevDate: 2026-02-19
CmpDate: 2026-02-19

Almohammadi AA (2026)

The role of vaccination and infection prevention in reducing perioperative complications: A public health-anesthesia nexus.

Saudi journal of anaesthesia, 20(1):166-173.

The intersection of vaccination strategies, infection prevention protocols, and perioperative care represents a critical nexus in modern anesthetic practice and public health. This comprehensive review examines the evolving role of immunization and infection control measures in reducing perioperative complications, with particular emphasis on the Saudi Arabian healthcare context. The coronavirus disease 2019 pandemic has highlighted the importance of vaccination timing in relation to elective surgery, while established infection prevention practices continue to form the cornerstone of safe perioperative care. In Saudi Arabia, national initiatives have demonstrated significant improvements in healthcare-associated infection rates, with central line-associated bloodstream infections decreasing from 2.5 per 1000 catheter-days in 2021 to 1.28 per 1000 catheter-days by 2024. The implementation of evidence-based vaccination protocols and comprehensive infection prevention strategies has shown measurable benefits in reducing surgical site infections, respiratory complications, and overall perioperative morbidity. Anesthesiologists play a pivotal role in this public health framework, serving as key stakeholders in perioperative optimization through vaccination status assessment, infection control adherence, and risk stratification. The Saudi healthcare system's commitment to infection prevention excellence, aligned with Vision 2030 objectives, provides a unique model for integrating public health principles into anesthetic practice. Current evidence supports the strategic timing of vaccinations relative to elective procedures, with recommendations for postponing elective surgery 3-7 days after inactivated vaccines and 14-21 days following live vaccines. This review synthesizes current evidence, identifies best practices, and proposes future directions for optimizing the vaccination-infection prevention-anesthesia nexus to improve patient outcomes and advance public health goals within the Saudi healthcare landscape.

RevDate: 2026-02-19
CmpDate: 2026-02-19

Alabdulhadi O, Almashari Y, M Alharbi (2026)

Virtual hospitals in the Kingdom of Saudi Arabia: A scoping review.

Saudi journal of anaesthesia, 20(1):188-196.

Virtual health hospitals have been on the rise significantly since COVID-19 globally. The Kingdom of Saudi Arabia has established several initiatives as part of Vision 2030, where Tele/Virtual Health is key part of this vision. The purpose of this review is to evaluate and establish the expected challenges and the potential value in virtual hospitals in Saudi Arabia. It also aims to identify and analyze gaps in existing knowledge to ideally aid the planning and commissioning of future research on this subject. Results of this review highlight several themes from the literature evolved as follow: 1) need for improvement in Saudi healthcare, 2) emergence of virtual healthcare due to COVID-19, 3) Virtual healthcare has many pros and cons to consider, and, 4) Virtual healthcare has many challenges.

RevDate: 2026-02-19
CmpDate: 2026-02-19

Chapman SR, Willner L, Abouafech A, et al (2026)

Diagnostic Performance of Artificial Intelligence in Detecting COVID-19 Pneumonia on Chest Imaging.

Cureus, 18(1):e101775.

The COVID-19 pandemic highlighted the need for rapid, accurate, and accessible diagnostic tools. Chest imaging modalities, including chest radiography (CXR) and computed tomography (CT), provided valuable diagnostic information and prompted the development of artificial intelligence (AI) systems to support image interpretation and improve workflow efficiency. This literature review synthesizes current evidence on the diagnostic performance, limitations, and clinical implications of AI models in COVID-19 pneumonia detection through CXR and CT evaluation. A PubMed search was conducted through October 2025 to identify studies evaluating AI systems for the detection of COVID-19 pneumonia using CXR and CT. Studies reporting diagnostic performance metrics, including sensitivity, specificity, accuracy, or area under the curve (AUC), were included. Study quality and risk of bias were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Eleven studies met the inclusion criteria. CXR-based AI systems demonstrated sensitivities from 80% to 98% and specificities from 82% to 96%, often comparable to radiologist performance. CT-based AI models achieved accuracies between 90% and 96%. AI models demonstrated strong internal diagnostic performance on CXR and CT but showed reduced accuracy with external validation, underscoring limitations related to generalizability and retrospective study designs. AI models demonstrate promising diagnostic performance for detecting COVID-19 pneumonia on chest imaging and may enhance radiologist efficiency. However, challenges related to generalizability, model adaptability, and clinician trust remain. Future research should prioritize external validation and transparent reporting to ensure the safe and effective integration of AI into clinical practice.

RevDate: 2026-06-09
CmpDate: 2026-06-09

Hatchett R, CA MacLennan (2026)

Lessons from COVID-19: the 100 Days Mission and antimicrobial resistance.

Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 381(1944):.

The COVID-19 pandemic demonstrated the capacity of the world to rapidly mobilize resources and political will when faced with an immediate, visible global threat. The accelerated development of effective vaccines inspired the Coalition for Epidemic Preparedness Innovations to promote the 100 Days Mission (100DM), an initiative to enable deployment of medical countermeasures within 100 days of identifying a pandemic threat. The success of the 100DM in uniting stakeholders highlights the power of framing challenges to inspire collective action. On the other hand, antimicrobial resistance (AMR) has had insufficient visibility and urgency to galvanize similar levels of political action. Framing AMR in a way that highlights the urgency, aligns incentives and builds multisectoral coalitions can help overcome some of these barriers. Ultimately, pandemic preparedness and AMR are both collective action problems, requiring sustained political will and systemic change. The AMR community must build systems that are agile and resilient and, by creating a unifying vision for AMR analogous to the 100DM, may promote global commitment to combating this slow-moving but devastating health crisis. This article is part of the Royal Society Science+ meeting issue 'Vaccines and antimicrobial resistance: from science to policy'.

RevDate: 2026-06-08

Chakraborty C, Bhattacharya M, Chatterjee S, et al (2026)

Long COVID-associated neurological symptoms and brain fog: Understanding the mechanism of neuroinflammation, BBB disruption, diagnostics, and therapeutics.

Molecular biology reports, 53(1):401.

Long COVID affects at least 10% of those with severe disease, and many experience neurological symptoms and brain fog. More than 200 symptoms are reported, yet a detailed understanding remains limited. This article summarizes current knowledge of neurological symptoms, brain fog, molecular mechanisms, neuroinflammation, blood-brain barrier disruption, diagnostics, and available therapeutics. Our review highlights the lack of diagnostics and treatments for these patients. We catalog the ongoing clinical trials, identify the urgent need for further therapeutics, and stress that advances in understanding pathophysiology will drive new treatments. We urge prioritizing animal model studies and improving diagnostics to accelerate the discovery and delivery of effective treatments for long COVID neurological symptoms.

RevDate: 2026-06-09
CmpDate: 2026-04-16

Jamieson DJ, Munoz FM, SA Rasmussen (2026)

Maternal Immunization.

Obstetrics and gynecology, 147(5):661-678.

Vaccines administered to women during pregnancy can provide protection against serious infectious diseases for the mother, the child, or both. Maternal immunization boosts the concentration of maternal antibodies that can be transferred across the placenta to directly protect children too young to be immunized. In addition, indirect protection through prevention of maternal infection and breast-milk antibodies can be achieved through maternal immunization. In general, inactivated vaccines are considered safe for pregnant women and fetuses, whereas live attenuated vaccines are avoided due to the theoretical potential risk of infection to the fetus. However, the potential risks of vaccines need to be weighed against the risk of the disease itself and the benefits of vaccination in terms of protection of the mother and child against infectious disease. Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap); influenza; coronavirus disease 2019 (COVID-19); and respiratory syncytial virus (RSV) vaccines are routinely recommended for all pregnant women in the United States. Maternal immunization has the potential to improve the health of mothers and young children; therefore, other diseases of relevance during this period are now targets of active research and vaccine development, including group B streptococcus (GBS). Similarly, several vaccines can be administered during pregnancy in special circumstances when maternal health, travel, or other special situations arise. This article reviews the current recommendations for vaccination of women during pregnancy.

RevDate: 2026-06-09
CmpDate: 2026-02-19

Wang X, Xie Y, Chen X, et al (2026)

Securing Federated Learning With Blockchain in the Medical Field: Systematic Literature Review.

Journal of medical Internet research, 28:e79052.

BACKGROUND: The exponential growth of medical data and advancements in artificial intelligence (AI) have accelerated the development of data-driven health care. However, the secure and efficient sharing of sensitive medical data across institutions remains a major challenge due to privacy concerns, data silos, and regulatory restrictions. Traditional centralized systems are prone to data breaches and single points of failure, while existing privacy-preserving techniques face high computational and communication costs.

OBJECTIVE: This study aims to provide a comprehensive review of the recent advances in blockchain-based federated learning (BCFL) within the medical field. By exploring the synergistic integration of federated learning and blockchain, this review evaluates how BCFL enhances data security, supports privacy-preserving cross-institutional collaboration, and facilitates practical applications in health care, including medical data sharing, Internet of Medical Things, public health surveillance, and telemedicine.

METHODS: We conducted a systematic literature review using databases such as PubMed, IEEE Xplore, Web of Science, and Google Scholar. Boolean logic and domain-specific keywords were used to retrieve studies from 2018 to 2025. After automated deduplication and multistage manual screening, over 100 high-quality papers were included. These works cover BCFL's theoretical foundations, system architectures, application domains, limitations, and future directions.

RESULTS: BCFL frameworks combine the decentralized trust and auditability of blockchain with the privacy-preserving collaborative learning capabilities of federated learning. This integration mitigates risks such as model tampering, data leakage, and a lack of incentives in federated systems. Applications span across cross-institutional medical data sharing, Internet of Medical Things, epidemic forecasting, and telemedicine. Architectures including fully coupled, flexibly coupled, and loosely coupled models offer varying trade-offs between efficiency, scalability, and security.

CONCLUSIONS: BCFL represents a transformative paradigm for secure, collaborative, and privacy-preserving medical AI. By combining decentralized trust, incentive-driven participation, and privacy-enhancing machine learning, BCFL paves the way for next-generation smart health care systems. Despite current technical and practical challenges, BCFL demonstrates strong potential to support precision medicine, global health data collaboration, and large-scale AI deployment in health care.

RevDate: 2026-06-08
CmpDate: 2026-04-19

Zhang X, Xu Y, Jiang Y, et al (2026)

From 2020 to 2025: Comprehensive review Decoding novel structural inhibitors for M[pro] of SARS-CoV-2.

Biochemical pharmacology, 248:117791.

While the immediate global threat of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has subsided, the virus remains a persistent cause of regional outbreaks and public health concerns. The main protease (M[pro]), essential for viral polyprotein processing and replication, remains one of the most validated and strategically important antiviral targets. In this comprehensive review, we critically evaluate the landscape of M[pro] inhibitor development from 2020 to 2025, encompassing four key categories: peptidomimetic inhibitors, non-peptide small molecules, natural product-derived compounds, and proteolysis-targeting chimeras (PROTACs). By integrating mechanistic insights with structural and technological advancements, this work highlights emerging opportunities for the rational design of next-generation M[pro]-targeted antivirals capable of addressing both current and future coronavirus threats.

RevDate: 2026-06-08

Kasai M, Sakuma H, Suzuki M, et al (2026)

Life-Threatening SARS-CoV-2-Associated Encephalopathy and Multiorgan Failure in Children, Asia and Oceania, 2022-2024.

Emerging infectious diseases, 32(2):169-179.

SARS-CoV-2 infections in children occasionally manifest with severe neurologic signs. We report a case series of life-threatening encephalopathy associated with SARS-CoV-2 in 25 children in Australia, Japan, Singapore, and Taiwan during February 2022-January 2024. All children had severe encephalopathy develop, characterized by rapidly progressive cerebral edema, conditions known as acute shock with encephalopathy and multiorgan failure or acute fulminant cerebral edema. Among the 25 patients, 22 (88%) eventually died; 11 (44%) children died within 24 hours of hospitalization. In addition, 18 (72%) had illness manifest with shock, and 14 (56%) had multiorgan failure develop within 6 hours of neurologic onset. Serum concentrations of cytokines/chemokines including interleukin 6 and tumor necrosis factor-α were significantly higher within 24 hours of onset than for controls. SARS-CoV-2-associated encephalopathy cases such as those described here represent an emerging neurologic crisis with high mortality rate resulting from rapidly progressive brain edema and multiorgan failure.

RevDate: 2026-06-08
CmpDate: 2026-02-20

Qtait M, Farajalla F, Alqaissi N, et al (2026)

Implementation and Impact of Tele-Intensive Care Unit (Tele-ICU) Models on Critical Care Outcomes: A Systematic Review.

Nursing in critical care, 31(2):e70401.

BACKGROUND: Tele-Intensive Care Unit (Tele-ICU) models have expanded rapidly in response to global critical care workforce shortages, rising patient acuity and the demands of the COVID-19 pandemic. Contemporary evidence shows substantial variation in Tele-ICU configurations and outcomes, underscoring the need for an updated synthesis that evaluates clinical, staff-related and system-level effects across diverse settings.

AIM: To examine the implementation and impact of Tele-ICU models on critical care outcomes and to compare results across hub-and-spoke, hybrid, consultative and tele-recovery configurations.

STUDY DESIGN: A systematic review was conducted and reported according to PRISMA 2020 and Joanna Briggs Institute guidelines. PubMed, CINAHL, Scopus, Web of Science and Google Scholar were searched for peer-reviewed studies published between January 2020 and October 2025. Owing to heterogeneity in Tele-ICU models, outcomes and effect measures, a narrative synthesis was performed.

RESULTS: Sixteen studies published between 2020 and 2025 were included, comprising quantitative, qualitative and mixed-methods designs conducted across high-, middle- and low-resource healthcare settings. Overall, Tele-ICU implementation was associated with reductions in ICU and hospital mortality, improved adherence to evidence-based clinical protocols, enhanced interprofessional communication and reduced clinician documentation burden. Hub-and-spoke and hybrid Tele-ICU models demonstrated the most consistent clinical and workforce benefits, whereas consultative and low-cost models primarily improved access to specialist care in resource-limited contexts. Across studies, nursing roles expanded to include digital patient surveillance, tele-round coordination, protocol facilitation and virtual family communication. Evidence regarding long-term sustainability and cost-effectiveness was limited and inconsistently reported.

CONCLUSIONS: Tele-ICU models enhance clinical performance, support nursing practice and improve system-level responsiveness across diverse contexts. While benefits are consistent, outcomes vary by model design, local infrastructure and implementation readiness. Longitudinal and economic evaluations are needed to inform sustainable, scalable Tele-ICU strategies.

Tele-ICU models support bedside nurses by improving access to specialist input, strengthening adherence to evidence-based care and enhancing patient safety. Evidence shows that Tele-ICU reduces workload, improves communication and enables nurses to coordinate digital monitoring and family updates, contributing to more consistent and equitable critical care delivery, particularly in high-acuity and resource-limited settings.

RevDate: 2026-06-08

Roe K (2026)

Lymphocyte Suppression and Exhaustion, Conventional, and Accelerated.

APMIS : acta pathologica, microbiologica, et immunologica Scandinavica, 134(2):e70175.

The essential mammalian immune system lymphocytes include T cells, B cells, and natural killer cells. Any impairments of their functionalities can have severe consequences, since these lymphocytes each contribute as an interactive team in responding to pathogen infections or cancers. Such impairments include lymphocyte exhaustion, such as T cell, B cell, or natural killer cell exhaustion, or lymphocyte suppression impairing one or more of these cells. Lymphocyte exhaustion can have any intensity from mild to severe, having a severity scale worsened by various exposures and time periods of constant antigenic activation. Lymphocyte exhaustion can potentially have a conventional timing pathway or a hypothesized accelerated (pipelined) timing pathway. Lymphocyte suppressions initiated from pathogen infections are also possible, and this can also impair multiple types of lymphocytes. Finally, accelerated T cell exhaustion is possible, and this can explain several puzzling characteristics of virulent viral pandemics, especially in individuals having pathogen or cancer comorbidities. For instance, accelerated T cell exhaustion can explain a substantial percentage of the SARS-CoV-2 pandemic fatalities and also explain the relatively small, but significant, numbers of hyperinflammatory diseases or autoimmune diseases which were initiated in small percentages of individuals by SARS-CoV-2 infections.

RevDate: 2026-02-20
CmpDate: 2026-02-20

Bannister-Tyrrell M, Teague K, Strachan DL, et al (2026)

Performance and utility of contact tracing for COVID-19 in the WHO South-East Asia Region: implications for future pandemic preparedness.

The Lancet regional health. Southeast Asia, 45:100728.

UNLABELLED: Contact tracing was widely implemented during the COVID-19 pandemic, but its real-world performance and utility for decision-making remain poorly understood. A qualitative study was conducted to appraise the performance and utility of contact tracing for COVID-19 in the WHO South-East Asia Region, based on interviews with government and non-governmental organisation technical staff and decision makers in Indonesia, Nepal and Thailand. Our findings highlight the good performance of contact tracing when sufficiently resourced and when case load is low, but reveal declining utility as case incidence increases. This study presents key definitions and a pragmatic approach for appraising contact tracing performance and utility throughout a major health emergency response. Countries should prospectively define objectives for contact tracing, establish monitoring and evaluation frameworks, adjust their contact tracing approaches informed by risk assessments, and consider other available public health interventions when its performance and utility decline.

FUNDING: Governments of Germany and Australia.

RevDate: 2026-02-20
CmpDate: 2026-02-20

Palwankar P, Palaniappan J, Kuttappan K, et al (2026)

Oral and maxillofacial manifestations of COVID-19.

GMS hygiene and infection control, 21:Doc05.

An overview of oral and maxillofacial manifestations associated with COVID-19 is provided. The symptoms range from white, red and mixed inflamed mucosal areas, necrosis, swelling, ulcers, vesicle, bulla, pustule, pigmentation, depapillated and fissured tongue and bleeding in the ulcers. Pre-COVID symptoms included complete loss of taste, along with reduced sense of taste and alterations in the taste perception.

RevDate: 2026-06-08
CmpDate: 2026-03-26

Cucunawangsih C, Ansori ANM, Vatvani AD, et al (2026)

Impact of nirmatrelvir/ritonavir on the risk of long COVID in outpatients: a systematic review and meta-analysis.

Expert review of anti-infective therapy, 24(2):271-284.

BACKGROUND: This study systematically synthesized existing evidence to evaluate whether outpatient treatment with nirmatrelvir/ritonavir during the acute phase reduces the incidence of long COVID.

METHODS: We conducted a systematic search of Europe PMC, Medline, Scopus, and the Cochrane Library from inception to 15 September 2025. Eligible studies compared COVID-19 outpatients prescribed nirmatrelvir/ritonavir during the acute phase with those who did not receive the drug. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model.

RESULTS: Nineteen studies met inclusion criteria. Overall, nirmatrelvir/ritonavir use during acute infection was associated with a significant reduction in the likelihood of developing post-COVID-19 condition (OR 0.85; 95% CI: 0.80-0.91; p < 0.00001; I[2] = 99%). Protective effects were consistently observed across multiple clinical domains, including cardiovascular (arrhythmia, ischemic disease, heart failure), pulmonary (dyspnea, COPD), thromboembolic (DVT, PE), neurological (stroke, cognitive impairment, headache), psychiatric (depression), gastrointestinal, metabolic (new-onset diabetes), renal (AKI), and general symptoms (malaise and fatigue). Conversely, no significant differences were noted for cough, asthma, dysautonomia, anxiety, PTSD, sleep disturbances, musculoskeletal pain, or olfactory/gustatory dysfunction.

CONCLUSIONS: Early outpatient treatment with nirmatrelvir/ritonavir may mitigate the risk of developing several domains of long COVID, though its benefits are not uniform across all symptom categories.

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RJR Experience and Expertise

Researcher

Robbins holds BS, MS, and PhD degrees in the life sciences. He served as a tenured faculty member in the Zoology and Biological Science departments at Michigan State University. He is currently exploring the intersection between genomics, microbial ecology, and biodiversity — an area that promises to transform our understanding of the biosphere.

Educator

Robbins has extensive experience in college-level education: At MSU he taught introductory biology, genetics, and population genetics. At JHU, he was an instructor for a special course on biological database design. At FHCRC, he team-taught a graduate-level course on the history of genetics. At Bellevue College he taught medical informatics.

Administrator

Robbins has been involved in science administration at both the federal and the institutional levels. At NSF he was a program officer for database activities in the life sciences, at DOE he was a program officer for information infrastructure in the human genome project. At the Fred Hutchinson Cancer Research Center, he served as a vice president for fifteen years.

Technologist

Robbins has been involved with information technology since writing his first Fortran program as a college student. At NSF he was the first program officer for database activities in the life sciences. At JHU he held an appointment in the CS department and served as director of the informatics core for the Genome Data Base. At the FHCRC he was VP for Information Technology.

Publisher

While still at Michigan State, Robbins started his first publishing venture, founding a small company that addressed the short-run publishing needs of instructors in very large undergraduate classes. For more than 20 years, Robbins has been operating The Electronic Scholarly Publishing Project, a web site dedicated to the digital publishing of critical works in science, especially classical genetics.

Speaker

Robbins is well-known for his speaking abilities and is often called upon to provide keynote or plenary addresses at international meetings. For example, in July, 2012, he gave a well-received keynote address at the Global Biodiversity Informatics Congress, sponsored by GBIF and held in Copenhagen. The slides from that talk can be seen HERE.

Facilitator

Robbins is a skilled meeting facilitator. He prefers a participatory approach, with part of the meeting involving dynamic breakout groups, created by the participants in real time: (1) individuals propose breakout groups; (2) everyone signs up for one (or more) groups; (3) the groups with the most interested parties then meet, with reports from each group presented and discussed in a subsequent plenary session.

Designer

Robbins has been engaged with photography and design since the 1960s, when he worked for a professional photography laboratory. He now prefers digital photography and tools for their precision and reproducibility. He designed his first web site more than 20 years ago and he personally designed and implemented this web site. He engages in graphic design as a hobby.

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

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Collection of publications by R J Robbins

Reprints and preprints of publications, slide presentations, instructional materials, and data compilations written or prepared by Robert Robbins. Most papers deal with computational biology, genome informatics, using information technology to support biomedical research, and related matters.

Research Gate page for R J Robbins

ResearchGate is a social networking site for scientists and researchers to share papers, ask and answer questions, and find collaborators. According to a study by Nature and an article in Times Higher Education , it is the largest academic social network in terms of active users.

Curriculum Vitae for R J Robbins

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Curriculum Vitae for R J Robbins

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