@article {pmid41952397,
year = {2026},
author = {Mavroudis, P and Ragia, G and Pantazis, N and Dermitzaki, E and Stamati, A and Pallikarou, M and Velentza, L and Paflioti, E and Zarkotou, O and Gerakari, S and Giannitsioti, E and Gravanis, A and Manolopoulos, VG},
title = {Association of ADIPOQ rs1501299 with long-COVID syndrome: a single-center cross-sectional study.},
journal = {Annals of medicine},
volume = {58},
number = {1},
pages = {2654244},
doi = {10.1080/07853890.2026.2654244},
pmid = {41952397},
issn = {1365-2060},
mesh = {Humans ; *Adiponectin/genetics/blood ; Cross-Sectional Studies ; Male ; Female ; Middle Aged ; Polymorphism, Single Nucleotide ; *COVID-19/genetics/complications/blood ; Adult ; SARS-CoV-2 ; Aged ; Genetic Predisposition to Disease ; Genotype ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: Long-COVID syndrome is a public health issue, affecting millions of individuals worldwide. However, the pathophysiological mechanisms underlying the syndrome's sequelae are still under investigation. Adiponectin has been implicated with acute SARS-CoV2 infection, while its role in Long-COVID remains obscure. The aim of this study is to investigate the potential association of adiponectin and SNPs of adiponectin pathway with Long-COVID.

MATERIALS AND METHODS: A single-center cross-sectional observational study was conducted, investigating the potential association of adiponectin and SNPs of adiponectin pathway with Long-COVID in 159 individuals, who were presented at the COVID-19 outpatient re-evaluation office. Adiponectin blood levels and detection of SNPs ADIPOQ rs1501299, ADIPOQ rs2241766, ADIPOR2 rs16928751, PPARA rs1800206 and PPARG rs1801282 were measured 3 months after acute COVID-19.

RESULTS: ADIPOQ rs1501299 was the only SNP significantly associated with the progression of symptoms after the acute SARS-CoV2 infection and the development of Long-COVID syndrome. Homozygous GG genotype individuals exhibited increased risk for sequelae of Long-COVID (OR 2.0, 95% CI 1.1, 3.7, p = 0.023), particularly fatigue (OR 2.4, 95% CI 1.2, 5.0, p = 0.014), compared to the T allele carriers, independently of age, sex, BMI, waist to hip ratio, comorbidities and severity of acute infection (OR 2.2, 95% CI 1.2, 4.3, p = 0.013 and OR 3.1, 95% CI 1.4, 6.7, p = 0.004 respectively). Adiponectin levels were correlated with obesity and severity of acute SARS-CoV2 infection, but not with Long-COVID symptoms.

CONCLUSION: ADIPOQ rs1501299 could potentially serve as a genetic marker, contributing to risk stratification of developing Long-COVID syndrome.},
}

Humans
*Adiponectin/genetics/blood
Cross-Sectional Studies
Male
Female
Middle Aged
Polymorphism, Single Nucleotide
*COVID-19/genetics/complications/blood
Adult
SARS-CoV-2
Aged
Genetic Predisposition to Disease
Genotype
Post-Acute COVID-19 Syndrome

@article {pmid41953516,
year = {2026},
author = {Qu, HQ and Kao, C and Hakonarson, H},
title = {Redefining the role of the thiol-based agent N-acetylcysteine in human health and disease and elucidating potential advantages of its amide derivative.},
journal = {RSC medicinal chemistry},
volume = {},
number = {},
pages = {},
pmid = {41953516},
issn = {2632-8682},
abstract = {N-Acetylcysteine (NAC) is the established antidote for acetaminophen toxicity and an approved mucolytic agent. Beyond these traditional uses, increasing evidence highlights its broader role as a modulator of thiol-redox biology. Rather than functioning as a nonspecific antioxidant, NAC modulates glutathione metabolism, redox-sensitive signaling, immune checkpoints, thiol-based post-translational modifications, ferroptosis susceptibility, and glutamatergic neurotransmission. This review synthesizes mechanistic, preclinical, and clinical evidence across pulmonary, hepatic, neuropsychiatric, metabolic, cardiovascular, and oncologic disorders, emphasizing how variability in baseline redox state, pharmacogenetics, and delivery contributes to heterogeneous outcomes. Strategies to improve pharmacokinetics and tissue targeting include structural derivatives such as N-acetylcysteine amide (NACA), and combination regimens such as NAC with probenecid or GlyNAC. Emerging applications span long COVID, neurodegeneration, psychiatric disorders, microbiome-redox interactions, environmental toxicology, and cancer immunotherapy. NAC and NACA exemplify the evolution of redox-targeted therapeutics. NAC is well established for safety and clinical utility, but its pharmacokinetic and tissue distribution properties constrain broader efficacy. NACA, a lipophilic amide derivative, enhances membrane permeability and cellular uptake, suggesting it may achieve higher tissue exposure at lower doses. Future progress will rely on biomarker-guided, precision approaches that optimize dosing, formulation, and delivery while exploring rational combinations across disease contexts defined by redox biology.},
}

@article {pmid41955274,
year = {2026},
author = {Wu, D and Dasgupta, A and Hora, JS and Chen, KH and Banerjee, A and Archer, SL},
title = {SARS-CoV-2 targets mitochondria, exacerbating COVID-19 pneumonia.},
journal = {The Journal of physiology},
volume = {},
number = {},
pages = {},
doi = {10.1113/JP290297},
pmid = {41955274},
issn = {1469-7793},
support = {SEA-20-015//Southeastern Ontario Academic Medical Organization/ ; MM1181122/CAPMC/CIHR/Canada ; },
abstract = {Mitochondrial damage is a conserved feature of coronavirus infection, occurring with human (SARS-CoV-2, HCoV-OC43) and murine (MHV-1) coronaviruses. Coronaviruses damage mitochondria in airway epithelial cells (AEC), pulmonary artery smooth muscle cells (PASMC), pulmonary artery endothelial cells, immune cells and cardiomyocytes by causing rapid transcriptomic changes in nuclear-encoded genes regulating mitochondria and by viral proteins interacting with host mitochondrial proteins. Coronavirus infection causes mitochondrial depolarization, mitochondrial transition pore (MTP) opening, inhibition of the electron transport chain (ETC) and ATP synthetic apparatus, increased mitochondrial fission, apoptosis, and impaired mitochondrial oxygen sensing. Within hours of infection, SARS-CoV-2 induces transcriptional reprogramming of genes relevant to the mitochondrial matrix in AECs, downregulating mRNA encoding ETC complex I components and the ATP synthesis complex. These bioenergetic consequences of SARS-CoV-2 mitochondriopathy may contribute to long COVID. Infection also upregulates dynamin-related protein 1 (DRP1), activating mitochondrial fission while promoting apoptosis by activating apoptosis inducing factor (AIF) and caspase 7. Even without infection, transfection with specific coronaviral proteins opens the MTP and depolarizes the mitochondria, or activates DRP1 and AIF, promoting AEC damage or apoptosis, thereby contributing to diffuse alveolar damage. In human PASMCs, coronaviral M and Nsp9 proteins suppress hypoxic pulmonary vasoconstriction (HPV), a homeostatic mechanism in PASMCs that uses a mitochondrial oxygen sensor to redistribute blood flow to well-ventilated lung regions during pneumonia. Impairment of HPV, seen as intrapulmonary shunting, contributes to the profound hypoxaemia in COVID-19 pneumonia. Coronavirus-induced mitochondriopathy may have therapeutic relevance as blocking AIF-induced apoptosis or enhancing HPV appears beneficial in a MHV-1 model of COVID-19 pneumonia.},
}

@article {pmid41947189,
year = {2026},
author = {Zhou, L and Sun, Y and Yang, R and Zhao, Q and Xiao, M},
title = {Latent profile analysis of the symptoms for posttraumatic stress disorder and psychological resilience in Chinese adolescents experiencing post Covid-19: a quantetative study.},
journal = {BMC psychology},
volume = {},
number = {},
pages = {},
doi = {10.1186/s40359-026-03987-8},
pmid = {41947189},
issn = {2050-7283},
support = {2024CQ059//Humanities and Social Science Fund of Ministry of Education of China/ ; JY20240202//Chongqing Medical University/ ; CYYY-DSTDXM-202409//The First Affiliated Hospital of Chongqing Medical University/ ; },
}

@article {pmid41951239,
year = {2026},
author = {Casassus, B},
title = {Long covid's £8bn bill: OECD report warns pandemic continues to cast a "long shadow".},
journal = {BMJ (Clinical research ed.)},
volume = {393},
number = {},
pages = {s662},
doi = {10.1136/bmj.s662},
pmid = {41951239},
issn = {1756-1833},
}

@article {pmid41951431,
year = {2026},
author = {Tamariz, L and Rozenfeld, I and Iglesias, R and Bast, E and Avecillas, S and Shehadeh, L and Klimas, N and Palacio, A},
title = {Dysautonomia in Long COVID is Prevalent and Could Explain the Frequency of Symptoms.},
journal = {Clinical medicine & research},
volume = {24},
number = {1},
pages = {28-34},
doi = {10.3121/cmr.2025.2054},
pmid = {41951431},
issn = {1554-6179},
mesh = {Humans ; Female ; Male ; Middle Aged ; *COVID-19/complications/epidemiology/physiopathology ; *Primary Dysautonomias/epidemiology/physiopathology/diagnosis ; Cross-Sectional Studies ; Prevalence ; Heart Rate ; Aged ; Adult ; SARS-CoV-2 ; Blood Pressure ; },
abstract = {Background: Long COVID presents with a variety of symptoms, some of which could be related to autonomic dysfunction. Our aim was to evaluate the prevalence of autonomic dysfunction in long COVID patients.Methods: We conducted a cross-sectional study and included all consecutive patients enrolled in several clinical research studies. We performed the following autonomic dysfunction markers: heart rate variability, heart rate, systolic and diastolic blood pressure changes during NASA Lean Test, cardiopulmonary exercise testing and a Composite-Autonomic-Symptom-Score (COMPASS)-31 scale. We used linear regression to calculate the contribution of each dysautonomia measure on symptom burden as measured by the modified COVID-19 Yorkshire scale.Results: We included 100 patients for this study. Our sample population had a mean age of 56+/-11 years, included 53% minorities, and 32% were women. Dysautonomia, as defined by an abnormal COMPASS-31, was seen in 82% (95% confidence interval [CI] 72-89) of our study population, while cardiovascular resting dysautonomia, as represented by an abnormal heart rate variability, was seen in 60% (95% CI 48-70) of our study population. Orthostatic hypotension was observed in 12% of our study population, and postural orthostatic tachycardia syndrome (POTS) was found in 10% of our study population. In our adjusted analysis, we found that the beta coefficient for the COMPASS-31 score (0.37) was significant on changes in a self-reported long COVID symptom burden. The orthostatic intolerance and gastrointestinal domains of the COMPASS-31 were associated with the highest long COVID symptom burden.Conclusion: Dysautonomia is common in long COVID patients and contributes to the overall symptoms seen in long COVID. Identifying dysautonomia has important diagnostic and therapeutic implications.},
}

Humans
Female
Male
Middle Aged
*COVID-19/complications/epidemiology/physiopathology
*Primary Dysautonomias/epidemiology/physiopathology/diagnosis
Cross-Sectional Studies
Prevalence
Heart Rate
Aged
Adult
SARS-CoV-2
Blood Pressure

@article {pmid41951954,
year = {2026},
author = {King, R and Ford, T and Coleman, Z and Hammond, E and Henley, D and Hirschtick, JL},
title = {Racial Disparities in Long COVID: Why Black Americans are Likely Underrepresented in Long COVID Estimates.},
journal = {Journal of racial and ethnic health disparities},
volume = {},
number = {},
pages = {},
pmid = {41951954},
issn = {2196-8837},
}

@article {pmid41943185,
year = {2026},
author = {Maziero, MP and Lee, EA and Colpo, GD and Couture, L and Merrill, LC and Baskin, L and Cahuiche, AE and Petway, A and Fan, H and Reese, E and Anderson, KM and McCullough, LD and Schulz, PE and Ortiz, GJ},
title = {Cognitive Trajectories After Hospitalization for COVID-19: A 36-Month Longitudinal Study.},
journal = {The Journal of neuropsychiatry and clinical neurosciences},
volume = {},
number = {},
pages = {appineuropsych20250267},
doi = {10.1176/appi.neuropsych.20250267},
pmid = {41943185},
issn = {1545-7222},
abstract = {OBJECTIVE: Neurological symptoms are commonly reported among individuals with postacute sequelae of COVID-19 (PASC), with cognitive impairment being the most common feature, but cognitive trajectories in PASC have not been clearly defined. The authors determined long-term cognitive changes in a cohort of individuals hospitalized with COVID-19, characterized their distinct cognitive trajectories, and identified factors associated with each trajectory at 36 months posthospitalization.

METHODS: The sample comprised 630 patients who were hospitalized with severe COVID-19 symptoms; 214 patients returned for at least one follow-up assessment over a 36-month period. Cognitive function, including attention, cognitive flexibility, processing speed, and memory, was evaluated by using BrainCheck, a validated digital platform, at 3-6, 12, 24, and 36 months posthospitalization. Longitudinal changes in cognitive performance and their associations with demographic factors, medical history, and neuropsychiatric symptoms were analyzed with linear mixed-effects models.

RESULTS: Four distinct cognitive trajectories over 36 months were identified and characterized. Group 1 (N=103, 48%) exhibited consistent normal cognitive function, group 2 (N=14, 7%) transitioned from unimpaired to impaired, group 3 (N=29, 14%) changed from impaired to unimpaired, and group 4 (N=68, 32%) showed persistent impairment across all domains. Poorer cognitive outcomes were associated with Hispanic ethnicity, although effects varied across domains.

CONCLUSIONS: As with many viral encephalitides, some patients showed stable normal or abnormal cognition or improved cognition over time. Surprisingly, however, a fourth subset exhibited delayed cognitive decline. This observation suggests that PASC-associated mechanisms, perhaps including chronic cerebral inflammation, may cause progressive cognitive impairment well after the initial infection clears.},
}

@article {pmid41944489,
year = {2026},
author = {Jóźwiak, A and Lewandowska, A and Sawicka, D and Jędrzejewska, A and Braczko, A and Romanowska-Kocejko, M and Żarczyńska-Buchowiecka, M and Deptuła, M and Zawrzykraj, M and Pikuła, M and Kutryb-Zając, B and Hellmann, M and Mierzejewska, P},
title = {Post-COVID increase in N-methyl-2-pyridone-5-carboxamide (Met2PY) and N-methyl-4-pyridone-3-carboxamide (Met4PY) associates with inflammatory and endothelial activation markers.},
journal = {Nucleosides, nucleotides & nucleic acids},
volume = {},
number = {},
pages = {1-14},
doi = {10.1080/15257770.2026.2650677},
pmid = {41944489},
issn = {1532-2335},
abstract = {COVID-19 is associated with long-term vascular complications, but the underlying mechanisms remain incompletely understood. During infection, NAD[+] homeostasis becomes dys-regulated, with excessive NAD[+] consumption and enhanced catabolic flux through nicotinamide methylation pathways. This imbalance leads to NAD[+] depletion accompanied by accumulation of pyridone metabolites, including N-methyl-2-pyridone-5-carboxamide (Met2PY) and N-methyl-4-pyridone-3-carboxamide (Met4PY). These derivatives have been linked to oxidative stress, endothelial dysfunction, and cardiovascular risk, yet their role in long COVID remains unclear. We enrolled 26 post-COVID patients with persistent cardiovascular symptoms and 8 healthy controls. Serum concentrations of Met2PY and Met4PY were quantified by LC/MS. High-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-alpha (TNFα), interleukin-10 (IL-10), and soluble intercellular adhesion molecule-1 (sICAM-1) were measured to assess systemic inflammation and endothelial activation. Statistical analyses included group comparisons and correlation analyses. We observed significantly elevated Met2PY levels (0.770 ± 0.08 vs. 0.389 ± 0.09 µmol/l) and a trend toward increased Met4PY (0.095 ± 0.01 vs. 0.055 ± 0.01 µmol/l) in post-COVID patients compared with controls. Both metabolites positively correlated with hsCRP. Importantly, Met2PY was associated with an unfavorable cytokine profile (higher TNFα/IL-10 ratio) and increased sICAM-1 levels, whereas no such associations were observed for Met4PY. Persistent dysregulation of NAD[+] metabolism and accumulation of pyridone metabolites, particularly Met2PY, are associated with markers of chronic endothelial activation and inflammation in long COVID. These findings support the potential utility of Met2PY as a biomarker to identify patients at higher risk for endothelial dysfunction and cardiovascular events, enabling more personalized risk stratification and follow-up.},
}

@article {pmid41946631,
year = {2026},
author = {Bartels, W and Kümpel, L and Ledebur, M and Jeitler, M and Heintze, C and Döpfmer, S},
title = {[Challenges and needs in the care for post-COVID patients in primary care practices in Berlin and Brandenburg - A qualitative study].},
journal = {Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.zefq.2026.02.004},
pmid = {41946631},
issn = {2212-0289},
abstract = {INTRODUCTION: General practitioners (GPs) play a central role as the first point of contact for patients with post-COVID. The aim of this qualitative study was to explore challenges and needs in the care for post-COVID patients from the perspective of GPs.

METHODS: Between October 2023 and May 2024, one face-to-face and two online focus groups were conducted with a total of 17 GPs from Berlin and Brandenburg. A self-developed guide was used, and data were analysed using framework analysis. In October 2024, results were validated in follow-up discussions with seven of these GPs.

RESULTS: Across all focus groups, GPs reported multiple challenges. These included diagnostic and therapeutic uncertainties, a lack of robust evidence, and gaps in service provision, such as long waiting times in specialised care facilities and feelings of helplessness in dealing with affected patients. Several care needs emerged from these challenges: low-threshold access to specialised outpatient clinics, the development of tailored rehabilitation concepts, and structured, up-to-date information for patients. In addition, GPs highlighted the need for stronger recognition and support of their role in post-COVID care.

DISCUSSION: GPs provide the lion's share of care for people affected by post-COVID, and thus their perspective should be given greater consideration in order to strengthen ambulatory care. The findings uncover genuine opportunities to address gaps in care and improve patient support.

CONCLUSION: GPs require support through structured care pathways and closer collaboration with specialised services. Further research is needed to develop cross-sectoral models of care that both improve patient outcomes and alleviate the burden on primary care.},
}

@article {pmid41947042,
year = {2026},
author = {Sahu, D and Van Nynatten, LR and Tweddell, D and Daley, M and Fraser, DD},
title = {Computational proteomics to enhance personalized treatment of COVID-19 and Long COVID.},
journal = {Clinical proteomics},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12014-026-09601-8},
pmid = {41947042},
issn = {1542-6416},
}

@article {pmid41938337,
year = {2026},
author = {Saranya, K and Joseph, ER and Kalaiarasi, T and Karthiga, M},
title = {Generative AI in drug repurposing and biomarker discovery: a multimodal approach.},
journal = {Frontiers in bioinformatics},
volume = {6},
number = {},
pages = {1755412},
pmid = {41938337},
issn = {2673-7647},
abstract = {INTRODUCTION: Computational drug repurposing has been widely explored using similarity-based methods, network diffusion, matrix factorization, deep learning, and graph neural networks (GNNs). However, recent heterogeneous GNN models, such as TxGNN and GAT-based models, demonstrate serious limitations for real-world biomedical applications, including poor generalization to sparsely annotated diseases, limited disease-level adaptation, and inability to effectively combine heterogeneous evidence from curated databases, multi-omics profiles, and unstructured biomedical literature.

METHODS: This article proposes a heterogeneous attention-based meta-learning graph neural network named HAMGNN, which employs three major innovations: (i) relation-sensitive multi-head attention to prioritize biologically significant interactions among heterogeneous edge types, (ii) a disease-focused meta-learning framework enabling rapid adaptation to newly observed or under-informed diseases, and (iii) a literature-enhanced knowledge graph construction pipeline encoding high-confidence, LLM-extracted therapeutic information. The model was tested on a large multimodal biomedical knowledge graph assembled from DrugBank, DisGeNET, and Hetionet, comprising more than 2.2 million edges, using a stringent disjoint disease-based (cold-start) evaluation protocol.

RESULTS: HAMGNN achieved a receiver operating characteristic-area under the curve (ROC-AUC) of 0.98 and precision of 0.95, representing a 10%-15% improvement over TxGNN and GAT-GNN on unseen disease generalization. Translational applicability was demonstrated through Alzheimer's disease and Long COVID case studies, identifying clinically plausible repurposing candidates and disease-associated biomarker signatures via mechanistic pathways.

DISCUSSION: HAMGNN offers a generalized, biologically grounded, and unified framework for evidence-based drug repurposing and biomarker discovery in complex and emerging diseases.},
}

@article {pmid41938682,
year = {2026},
author = {Lam, KS and Suryadi, T and Su, DC and Suhaimi, A and Allam, AE and Yoon, Y},
title = {Novel Ultrasound-Guided Bilateral Simultaneous Hydrodissection of the Cervical Sympathetic Chain and Vagus Nerves: A Detailed Technical Description With Anatomical Correlation.},
journal = {Cureus},
volume = {18},
number = {4},
pages = {e106250},
pmid = {41938682},
issn = {2168-8184},
abstract = {The vagus nerve and cervical sympathetic chain regulate autonomic function and are implicated in chronic pain and post-viral autonomic syndromes. Hydrodissection with 5% dextrose is established for peripheral nerves, but simultaneous ultrasound-guided hydrodissection of both cervical autonomic nerves has not been described. We describe a reproducible ultrasound-guided technique for bilateral simultaneous hydrodissection of the cervical sympathetic chain and vagus nerves using 5% dextrose without local anesthetic. The procedure uses a high-frequency linear transducer at C6-C7 and an in-plane lateral 25-gauge needle approach, performing the deeper sympathetic chain hydrodissection first (prevertebral fascia superficial to the longus colli), followed by vagus nerve hydrodissection within the carotid sheath. Injection is performed slowly (12-18 minutes per side) to permit full delivery and patient comfort. We report procedural outcomes in 10 patients (30 sessions) treated for post-COVID-related autonomic dysfunction. All procedures were completed successfully. Total injectate was 60 mL of 5% dextrose per side (approximately 30 mL for the sympathetic chain and 30 mL for the vagus nerve). The deep-to-superficial sequence preserved sonographic visualization and avoided air-bubble artifact. No procedural complications occurred (including bradycardia, hypotension, voice changes, dysphagia, hematoma, or infection). At a minimum 12-month follow-up, patients maintained clinical improvement without additional interventions. Ultrasound-guided bilateral simultaneous hydrodissection of the cervical sympathetic chain and vagus nerves with 5% dextrose is technically feasible and well tolerated. A deep-to-superficial injection sequence and very slow administration optimize visualization and delivery. Detailed clinical outcomes are presented separately.},
}

@article {pmid41939132,
year = {2026},
author = {Wunderle, M and Ribeiro, A and Lethen, I and Wicklein, R and Feneberg, E and Wöhnl, A and Negele, J and Kesseler, V and Niedermayer, S and Lech, M and Wallraven, T and Schmaderer, C},
title = {Serum NfL and GFAP in post-COVID syndrome: minimal evidence of CNS injury after adjusting for confounders.},
journal = {Frontiers in cellular neuroscience},
volume = {20},
number = {},
pages = {1750121},
pmid = {41939132},
issn = {1662-5102},
abstract = {BACKGROUND: Post-COVID syndrome (PCS) often includes neurological symptoms, but evidence for persistent CNS injury remains inconsistent. Serum neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are biomarkers of neuronal and astroglial injury. We investigated whether serum NfL and GFAP differ between PCS patients and recovered controls after adjusting for age and renal function.

METHODS: In this prospective single-center case-control study, serum NfL and GFAP were quantified using Simoa® (Quanterix) in 102 PCS patients and 102 recovered controls. Group comparisons employed Mann-Whitney tests and ANCOVA-style multivariable linear regression of log-transformed biomarkers adjusted for age, sex, and eGFR. Associations with eGFR were examined in multivariable models, and findings were validated in an age- and sex-matched cohort.

RESULTS: Age emerged as the primary determinant of NfL and GFAP concentrations. The inverse correlations with renal function (NfL ρ = -0.23; GFAP ρ = -0.33) and the initially higher GFAP in PCS (60.4 vs. 52.3 pg/mL; p = 0.002) were largely explained by age. After adjustment for age, sex, and eGFR, neither biomarker showed independent differences between groups (adjusted GMRs: NfL 1.04 [0.91-1.18], p = 0.59; GFAP 1.10 [0.96-1.26], p = 0.15). In an age- and sex-matched cohort (71 pairs), adjusted analyses confirmed no difference in NfL (p = 0.48), while GFAP demonstrated a significant increase in PCS (β = 0.15, p = 0.025).

CONCLUSION: GFAP concentrations were modestly elevated in PCS in an age- and sex-matched cohort and persisted after adjustment for kidney function, whereas NfL showed no group differences. These findings argue against widespread neuroaxonal injury in PCS and suggest only a subtle astroglial signal in a subset of patients. Rigorous adjustment for confounders-particularly age, sex, and renal function-is essential for valid interpretation of serum neuroinjury biomarkers in PCS.},
}

@article {pmid41939224,
year = {2026},
author = {Silva, AI and Byrne, KC and Pollak, L and Gundry, K and Manousakis, GE and Metzler, AI and Lenglet, C and Eberly, LE and Kendall-Thomas, J and Kantarci, OH and Zeydan, B and Mukerji, SS and Yasar, S and Ashizawa, T and Kantarci, K and Ratai, EM and Öz, G and , },
title = {Factors associated with severe neurological sequelae of COVID-19: findings from the multicenter COVID-BRAIN imaging cohort.},
journal = {Frontiers in human neuroscience},
volume = {20},
number = {},
pages = {1754342},
pmid = {41939224},
issn = {1662-5161},
abstract = {INTRODUCTION: Neurological post-acute sequelae of COVID-19 (neuroPASC) are associated with persistent cognitive dysfunction and quality-of-life decline. We aimed to identify clinical, behavioral and sociodemographic factors associated with neuroPASC symptom burden two years after COVID-19 among individuals without prior neurological disease.

METHODS: In this prospective, observational study, individuals with neuroPASC (n = 102) and controls without symptomatic COVID-19 (n = 74), all without prior neurological, psychiatric, or post-viral conditions, were enrolled between February 2022 and June 2024 across five academic sites. An unsupervised algorithm identified clusters with differing self-reported neurological symptom burden within the neuroPASC group. Functional differences between clusters were evaluated using quality-of-life, neurological and cognitive evaluations. Demographics, behavioral history, comorbidities, and blood biomarkers were compared across clusters and controls. Multivariable logistic regression assessed predictors of neuroPASC severity, including demographics, body-mass-index, Charlson Comorbidity Index, Framingham Risk Score, pre-existing endocrine/metabolic and/or gastrointestinal/hepatobiliary conditions, COVID-19 vaccination prior to infection, hospitalization during acute infection, and cumulative alcohol use.

RESULTS: Two clusters emerged based on neurological symptom burden, labeled "high-burden" and "low-burden" neuroPASC, reflecting differences in the number and frequency of symptoms. Both clusters had deficits in quality-of-life and cognitive function compared to controls, with greater impairment in high-burden than low-burden neuroPASC. The clusters did not differ by sex, education, tobacco and cannabis use, blood pressure, body-mass-index, HbA1C, days since infection, hospitalization during COVID-19, pre-COVID vaccination rate, antibody-positivity, inflammation, and neurodegeneration biomarkers. The high-burden cluster was older and exhibited higher comorbidity burden and greater cumulative alcohol use compared with the low-burden cluster and controls. Pre-existing endocrine/metabolic and gastrointestinal/hepatobiliary conditions were more common in high-burden (63%) than in low-burden neuroPASC (35%). After adjusting for clinical and demographic factors, these pre-existing conditions remained the only independent predictor of severity, conferring a 3.5-fold increase in the odds of high-burden versus low-burden neuroPASC.

DISCUSSION: Older age, higher comorbidity burden, greater cumulative alcohol use, and endocrine/metabolic and gastrointestinal conditions, rather than acute COVID-19 severity, were observed in the high-burden neuroPASC cluster. After multivariable adjustment, only pre-existing endocrine/metabolic and/or gastrointestinal/hepatobiliary conditions remained independently associated with high-burden neuroPASC, conferring a 3.5-fold increase in odds and highlighting the need for targeted post-infection monitoring in at-risk patients.},
}

@article {pmid41939860,
year = {2026},
author = {Limongelli, A and Bozzano, F and Hajabbas Farshchi, A and Bellucci, M and Bavastro, M and Castellano, C and Pesce, G and Antonini, F and Incensi, A and Giannoccaro, MP and Uccelli, A and Del Zotto, G and Moretta, L and Donadio, V and Benedetti, L and De Maria, A},
title = {Immune correlates underlying small fiber neuropathy presenting as vaccine-associated post-acute SARS- coronavirus syndrome.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1752120},
pmid = {41939860},
issn = {1664-3224},
mesh = {Humans ; Male ; Female ; *Small Fiber Neuropathy/immunology/etiology/diagnosis ; Middle Aged ; *COVID-19/immunology/prevention & control ; *SARS-CoV-2/immunology ; Adult ; *COVID-19 Vaccines/adverse effects/immunology ; Aged ; Angiotensin-Converting Enzyme 2/immunology ; Post-Acute COVID-19 Syndrome ; Neuropilin-1/immunology ; Vaccination/adverse effects ; },
abstract = {BACKGROUND: A spectrum of adverse events overlapping with Post-acute Sequelae of SARS-CoV-2 infection (PASC) occurs in some patients following SARS-CoV-2 vaccination including small fiber neuropathy (SFN) and cognitive symptoms.

AIMS: Accruing information regarding disease course and immune response imbalances in these patients.

METHODS: We studied 71 previously healthy patients with neurological symptoms following SARS-CoV-vaccination. All had negative neurological workup for central/peripheral involvement (MR, EMG/EN). Cutaneous biopsy (21pts.) and peripheral blood sampling (20pts) were performed for anti-idiotype Ab analysis (ACE-2,NRP-1) (ELISA, IF) and for Flowcytometric analysis.

RESULTS: Paresthesia, cognitive impairment and autonomic symptoms agreed with SFN international definition. Comparative differences included abrupt onset, presence of simultaneous diverse paresthesia across multiple body regions frequently affecting the facial and cervical regions (44%) and the trunk (26%), associated to dysautonomia. Median time from vaccination to symptom manifestation was 3 days (mean ± SD: 8.76 ± 17.4 days). Symptom severity was still high (5.9 ± 1.9 mean+SD) at the time of evaluation and sampling, (382 ± 133 days from onset. Reduced small fiber density was observed in 19/21 biopsies. Anti-ACE-2 antibodies in 9/71pts. (12%) and 4/19 (21%) vaccinated HD sera and NRP-1 reactivity in 14/71 (20%) patient and 1/19 (5%) HD sera were not significantly increased. Peripheral NKG2D+CD8+ and NKG2D+DNAM-1+CD4+ T-cells were increased. Circulating inflammatory CD34+ cells were increased and generated in vitro a prevalence of NKG2D+DNAM-1+ T-cells.

CONCLUSION: PASC-vac SFN is associated with persistent immune imbalances common to other immune-mediated diseases. Additional effort to identify immune mechanisms unleashing PASC-vac SFN will contribute to modulate future early interventions for these patients and refine vaccine design.},
}

Humans
Male
Female
*Small Fiber Neuropathy/immunology/etiology/diagnosis
Middle Aged
*COVID-19/immunology/prevention & control
*SARS-CoV-2/immunology
Adult
*COVID-19 Vaccines/adverse effects/immunology
Aged
Angiotensin-Converting Enzyme 2/immunology
Post-Acute COVID-19 Syndrome
Neuropilin-1/immunology
Vaccination/adverse effects

@article {pmid41940032,
year = {2026},
author = {Cazzola, M and Rogliani, P and Calzetta, L and van Haren, FMP and Page, C and Matera, MG},
title = {Redox signaling in chronic airway diseases: pathogenic mechanisms and therapeutic implications.},
journal = {Frontiers in physiology},
volume = {17},
number = {},
pages = {1734890},
pmid = {41940032},
issn = {1664-042X},
abstract = {Chronic airway diseases, including asthma, chronic obstructive pulmonary disease (COPD), and bronchiectasis, impose a significant global health burden. A central unifying feature of these diseases is redox imbalance, which is characterized by an excess of reactive oxygen and nitrogen species (ROS/RNS) that overwhelms the body's antioxidant defenses, causing cellular dysfunction, inflammation, and tissue damage. Physiological ROS/RNS are essential for immune regulation and transcriptional control, but chronic oxidative stress disrupts these processes, driving disease progression. In asthma, eosinophil- and epithelial-derived ROS worsen airway hyperresponsiveness, induce mucus overproduction, and reduce steroid effects. COPD involves neutrophil-dominated inflammation, mitochondrial dysfunction, protease- and oxidant-mediated extracellular matrix degradation, and accelerated senescence. Bronchiectasis features persistent neutrophilic oxidative injury, microbial colonization, impaired mucociliary clearance, and progressive airway destruction. Exogenous oxidants, cigarette smoke, biomass fuels, pollutants, and pathogens further burden antioxidant systems, including superoxide dismutases, catalase, glutathione peroxidase, and Nrf2-regulated pathways. Redox dysregulation also contributes to post-COVID sequelae, promoting ongoing airway inflammation, fibrosis, and systemic complications. Therapeutic strategies targeting redox imbalance, mainly thiol-based antioxidants, Nrf2 activators, NADPH oxidase inhibitors, and mitochondria-targeted antioxidants, show mechanistic promise but face challenges in specificity, bioavailability, and clinical translation. Advancing precision redox medicine requires biomarker-guided patient stratification, high-resolution redox proteomics, single-cell and organoid models, and spatial imaging to identify disease-specific redox endotypes. Modulating pathological oxidative stress while preserving physiological signaling offers a novel avenue to improve outcomes. Understanding redox biology in airway disease highlights the potential of precision antioxidant strategies as adjuncts to conventional therapies, representing a paradigm shift in managing chronic airway disorders.},
}

@article {pmid41941235,
year = {2026},
author = {Alhasawi, MAI and Farwa, U and Muteeb, G and Aatif, M and El Oirdi, M and Raza, MA and Farhan, M},
title = {Neuropsychiatric Sequelae of COVID-19: A Systematic Review of Acute and Prolonged Effects.},
journal = {CNS & neurological disorders drug targets},
volume = {},
number = {},
pages = {},
doi = {10.2174/0118715273424823260119063256},
pmid = {41941235},
issn = {1996-3181},
abstract = {INTRODUCTION: Following the global emergence of SARS-CoV-2, it has become evident that COVID-19 can produce persistent, multisystemic symptoms known as "long COVID." Neurocognitive and neuropsychiatric symptoms are reported in approximately 40% of patients, often resulting in significant difficulties with daily functioning, workplace challenges, increased healthcare consumption, and a substantial economic burden. This condition is further linked to serious neurological complications, such as encephalitis, stroke, seizures, and Guillain-Barré syndrome.

METHODS: This study comprised a comprehensive literature review to identify and understand existing research on the long-term neurological impacts of COVID-19. The process involved evaluating investigations into multisystemic symptoms and reviewing documented clinical cases of neurological complications by searching relevant databases for studies published between January 2020 and December 2024.

RESULTS: The work identified that while the neurological burden of long COVID-19 is high, there are currently very few treatments described in the literature. Furthermore, the treatments that do exist are often inadequately defined, leaving a gap in standardized clinical protocols for managing neurocognitive decline post-infection.

DISCUSSION: The persistence of these symptoms suggests a need for a deeper understanding of the underlying mechanisms of post-viral neurological damage. The discussion centres on the intersection of cognitive impairment and economic impact, emphasizing that the lack of defined therapeutic pathways hinders recovery and increases the long-term societal burden of the pandemic.

CONCLUSION: This review summarizes current evidence on the neurological and neuropsychiatric sequelae of long COVID-19. It highlights the urgent need for emerging therapeutic approaches and structured management strategies to alleviate cognitive and neuropsychiatric impairments in this patient population effectively.},
}

@article {pmid41941341,
year = {2026},
author = {Kulkarni, C and Haase, E and Esparza, E and Blancke, A and Sathyamoorthy, M},
title = {Retrospective Analysis of Clinical Repurposing of Dipyridamole and L-Arginine for Treatment of Long COVID Endothelitis.},
journal = {Current cardiology reviews},
volume = {},
number = {},
pages = {},
doi = {10.2174/011573403X435762251202114307},
pmid = {41941341},
issn = {1875-6557},
abstract = {INTRODUCTION: The effect of treatment with L-arginine and dipyridamole for the reduction of symptoms of fatigue, difficulty performing activities of daily living (ADLs), dyspnea, and mental health decline in patients with Long COVID endothelitis was studied in this research, leading to conclusions that are presented.

METHODS: Forty-four patients with documented Long COVID endothelitis were enrolled in this retrospective, IRB-approved analysis evaluating clinician-directed treatment strategies initiated during the COVID-19 pandemic. Patients received either dipyridamole alone, L-arginine alone, or combination therapy. Clinical responses were assessed at 6 weeks and 6 months postinitiation, and a subset of nine patients also completed a structured, patient-reported outcomes survey approximately two years after starting treatment.

RESULTS: Of the 44 subjects identified, clinical follow-up at 6 weeks demonstrated a significant overall symptom improvement (p=0.0115). At 6 months, symptom improvement remained substantial but lost statistical significance (p=0.09). Combination therapy (dipyridamole and Larginine) showed sustained improvement at both 6 weeks (68.8%) and 6 months (62.5%). Dipyridamole alone demonstrated high early response (80%) but markedly reduced efficacy at 6 months (20%). Statistical comparisons between combination therapy and monotherapy groups did not yield significant results, likely due to limited sample sizes. Patient-reported outcomes supported clinical findings, with combination therapy yielding the lowest symptom burden in fatigue, dyspnea, and depression, and the highest functional capacity.

DISCUSSION: This study addressed a critical unmet need in Long COVID management, a condition affecting middle-aged and older adults with substantial symptom burden, including fatigue (reported in up to 45% of patients), dyspnea, and cognitive dysfunction. The therapeutic benefit observed with dipyridamole and L-arginine likely stems from their complementary mechanisms: dipyridamole's antiplatelet and anti-inflammatory effects may reduce microvascular dysfunction and microthrombosis, while L-arginine enhances nitric oxide production, supporting endothelial function and vascular homeostasis. Both agents possess favorable safety profiles, making them reasonable options in the absence of validated alternatives for Long COVID endothelitis.

CONCLUSION: Treatment with dipyridamole and L-arginine, particularly in combination, was associated with meaningful improvements in fatigue, dyspnea, ability to perform ADLs, and mental health symptoms in patients with Long COVID. These preliminary findings underscore the potential benefit of these therapeutic agents, though larger, randomized controlled studies are necessary to confirm efficacy and enhance statistical power.},
}

@article {pmid41936816,
year = {2026},
author = {Reeder, HT and Kleinman, LC and Stockwell, MS and Thaweethai, T and Pant, DB and Rhee, KE and Jernigan, TL and Snowden, JN and Salisbury, AL and Kinser, PA and Milner, JD and Tantisira, KG and Warburton, D and Mohandas, S and Wood, JC and Fitzgerald, ML and Carmilani, M and Krishnamoorthy, A and Foulkes, AS and Gross, RS and , },
title = {School Difficulties and Long COVID in Children and Adolescents.},
journal = {Academic pediatrics},
volume = {},
number = {},
pages = {103314},
doi = {10.1016/j.acap.2026.103314},
pmid = {41936816},
issn = {1876-2867},
abstract = {OBJECTIVE: Pediatric Long COVID (LC) is an infection-associated chronic condition following SARS-CoV-2 infection. While research has begun to elucidate clinical phenotypes, functional impacts are not well described.

METHODS: Cross-sectional data from the NIH-funded Researching COVID to Enhance Recovery (RECOVER) pediatric observational cohort was analyzed to assess associations in school-age children (6 to 11 years) and adolescents (12 to 17 years) between LC and caregiver-reported school-related functional outcomes. LC was defined using RECOVER age group-specific symptom-based LC research indices. The primary outcome was worsening of child grades. Secondary outcomes included difficulty paying attention, limited fun with friends, and having an Individualized Education Program (IEP). Using age-stratified analyses, children with and without LC were matched based on age, sex, and dates of infection and enrollment, to estimate risk ratios (RRs) between LC and each outcome.

RESULTS: The cohort included 1,976 children (406 school-age, 1,570 adolescent). 18% of school-age children and 29% of adolescents with LC had reported worsened grades, compared to 7% and 11% without LC, respectively [school-age: adjusted RR 2.18 (95% CI: 1.15-4.11); adolescent: adjusted RR 2.39 (95% CI: 1.86-3.06)]. In both age groups, children with LC were more likely to have difficulty paying attention, limited fun with friends, and IEPs.

CONCLUSIONS: LC in school-age children and adolescents was negatively associated with functional school-related outcomes, including academic performance, attention, and peer interactions. As LC affects a substantial proportion of U.S. children, these findings highlight the urgent need to develop, provide, and evaluate school-related services for children and adolescents with LC.},
}

@article {pmid41933948,
year = {2026},
author = {Nygren-Bonnier, M and Holland, AE},
title = {Physiotherapy management of long COVID in adults.},
journal = {Journal of physiotherapy},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jphys.2026.03.001},
pmid = {41933948},
issn = {1836-9561},
}

@article {pmid41934421,
year = {2026},
author = {Shakeel, A and Sircar, K and Popli, DB},
title = {Xerostomia after COVID-19 recovery: A preliminary investigation.},
journal = {The Indian journal of medical research},
volume = {163},
number = {1},
pages = {122-125},
doi = {10.25259/IJMR_1570_2025},
pmid = {41934421},
issn = {0971-5916},
mesh = {Humans ; *Xerostomia/epidemiology/virology/etiology/physiopathology ; *COVID-19/complications/epidemiology/virology/physiopathology ; Male ; Female ; Middle Aged ; SARS-CoV-2 ; Adult ; Aged ; Surveys and Questionnaires ; },
abstract = {Background and objectives Xerostomia, or dry mouth, was frequently reported during COVID-19 infection, but its persistence after recovery remains underexplored. This study aimed to assess the prevalence and duration of xerostomia following recovery from COVID-19 infection. Methods This observational study included 50 participants who had recovered from COVID-19. They were surveyed using a xerostomia assessment questionnaire and underwent the modified Schirmer test (MST) to measure their salivary flow rate. Results Overall, n=31(62%) of participants reported one or more xerostomia-related symptoms after recovery. "Feeling of dry mouth" (n=22, 44%) was the most common, followed by nocturnal water intake (n=18, 36%), difficulty swallowing dry food (n=7, 14%), and reliance on liquids during swallowing (n=6, 12%). Hyposalivation (MST <15 mm at 3 min) was observed in 10% (n=5) of participants, all of whom were infected during the second wave (Delta variant). A significant association was noted between self-reported dry mouth and MST findings (P=0.029). Symptoms persisted up to 15 months post-recovery. Interpretation and conclusions Xerostomia may persist after COVID-19 recovery, with potential implications for oral health. Early recognition and management are warranted.},
}

Humans
*Xerostomia/epidemiology/virology/etiology/physiopathology
*COVID-19/complications/epidemiology/virology/physiopathology
Male
Female
Middle Aged
SARS-CoV-2
Adult
Aged
Surveys and Questionnaires

@article {pmid41928318,
year = {2026},
author = {Atkins, T and Glasziou, P and Chakraborty, S and Turner, T and Rada, G and Byambasuren, O},
title = {Living evidence syntheses for long COVID therapeutics: combining rigorous protocols to build efficiency while maintaining rigour.},
journal = {Systematic reviews},
volume = {},
number = {},
pages = {},
doi = {10.1186/s13643-026-03178-x},
pmid = {41928318},
issn = {2046-4053},
support = {2035160//Australian Government 2023 Medical Research Future fund PASC grant/ ; 2034238//Australian Government 2023 Medical Research Future fund PASC grant/ ; 2032847//Australian Government 2023 Medical Research Future fund PASC grant/ ; },
abstract = {BACKGROUND: Given the rapidly changing evidence, the creation and maintenance of a living systematic review database of therapeutics for long COVID is an ideal and necessary approach considering the rapidly changing evidence that continues to be identified. This paper describes methods and results of a collaboration between three teams who produced a living literature review on long COVID therapeutics-Australian Living Evidence Collaboration (ALEC), Bond University, and Epistemonikos COVID-19 L.OVE (Living Overview of Evidence) database.

METHODS: We took a collaborative and iterative approach to analyse the commonalities and differences between each project and develop an agreed comprehensive, collective approach. A plan for ongoing (monthly) updates and dissemination was built.

RESULTS: Despite minor differences, there was also a clear alignment of goals between the three teams. Differences in search strategy, search methods and screening criteria were identified, investigated, and resolved. A comparison of overlaps helped establish a common collaborative approach. A combined library of 218 randomised controlled trials and 56 systematic reviews was created which led to the optimised search strategy. The combined 218 RCT library covered 20 different treatment categories of which 14 were pharmacological and 6 were non-pharmacological. Further refinements and collaborations led to a transformed initial database library of 102 randomised controlled trials as of June 2024 before the team commenced monthly updates.

CONCLUSIONS: Despite initial differences, a comprehensive search strategy based on the collaboration of the three teams was developed. Ongoing monthly updates were initiated and are now planned for well into the future to make continual and rapid updates to the library of evidence surrounding therapeutics for long COVID. Where global public health is concerned, it is valuable to review and refine processes in the early stages, so that they can be reliable. We recommend open collaboration to achieve the goal of creating accessible, efficient, and reliable evidence syntheses.},
}

@article {pmid41930109,
year = {2026},
author = {Friedberg, F and LeBaron, TW},
title = {Molecular hydrogen as a treatment for ME/CFS: a mini-review of clinical evidence and mechanistic rationale.},
journal = {Frontiers in medicine},
volume = {13},
number = {},
pages = {1760210},
pmid = {41930109},
issn = {2296-858X},
abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating multisystem illness characterized by profound fatigue, post-exertional malaise, cognitive impairment, and autonomic dysfunction, yet it currently lacks FDA-approved treatments. Molecular hydrogen (H2), administered primarily as hydrogen-rich water (HRW), has emerged as a potential therapeutic candidate due to its selective antioxidant effects, anti-inflammatory activity, and support of mitochondrial and cellular homeostasis. These mechanisms align with several biological abnormalities implicated in ME/CFS, including oxidative stress, chronic inflammation, and impaired energy metabolism. This narrative mini-review summarizes mechanistic evidence relevant to ME/CFS and evaluates three developmental clinical studies of HRW in this population. Although early trials are small and methodologically limited, moderate-dose HRW consumed over extended durations has demonstrated feasibility and preliminary benefits in reducing fatigue and improving physical function, with generally mild side effects. Overlapping findings in Long COVID further suggest potential applicability across related post-viral fatigue conditions. Key limitations include small sample sizes, reliance on self-report outcomes, and the absence of objective biomarkers. Future research should prioritize larger, rigorously controlled trials incorporating remote biometric and biochemical assessments to clarify mechanisms of action and identify responsive subgroups. Overall, molecular hydrogen represents a promising, low-burden adjunctive therapy warranting further investigation in ME/CFS.},
}

@article {pmid41932118,
year = {2026},
author = {Juszczyk, M and Nawaz, S and Mahdi, A and Lewinter, C and Ricci, F and Ståhlberg, M and Fedorowski, A},
title = {Post-COVID Postural Orthostatic Tachycardia Syndrome and Inappropriate Sinus Tachycardia: Prevalence, Overlap, and Clinical Characteristics.},
journal = {JACC. Advances},
volume = {5},
number = {5},
pages = {102702},
doi = {10.1016/j.jacadv.2026.102702},
pmid = {41932118},
issn = {2772-963X},
}

@article {pmid41932346,
year = {2026},
author = {Soares, L and Romatowski, CH and Assaf, G and de Canson, C},
title = {The case for routine patient review in long COVID research.},
journal = {The Lancet. Infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/S1473-3099(26)00134-9},
pmid = {41932346},
issn = {1474-4457},
}

@article {pmid41932347,
year = {2026},
author = {Camici, M and Piano Mortari, E and Del Duca, G and Cimini, E and Mazzotta, V and De Ponte, C and Mastrorosa, I and Mazzotta, S and Pinnetti, C and Notari, S and Bordoni, V and Gili, S and Prencipe, G and Maggi, F and Carsetti, R and Girardi, E and Antinori, A and Agrati, C},
title = {Intravenous immunoglobulin treatment for long COVID: a case report of clinical and immunological findings.},
journal = {The Lancet. Infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/S1473-3099(26)00063-0},
pmid = {41932347},
issn = {1474-4457},
abstract = {A previously healthy 39-year-old man developed highly symptomatic post-COVID-19 condition (also known as long COVID) marked by cognitive dysfunction, disabling fatigue, and autonomic symptoms unresponsive to multiple multidisciplinary interventions. Given the presence of markedly elevated serum autoantibodies against G protein-coupled receptors, high-dose intravenous immunoglobulin therapy was initiated at 400 mg/kg per day for 5 consecutive days. After 4 weeks, a maintenance dose of 500 mg/kg was administered for 1 day, followed by two further maintenance cycles consisting of 500 mg/kg per day for 3 consecutive days, each given at 4-week intervals. In parallel, the patient underwent a cognitive stimulation intervention. Neurological symptoms were assessed with the Fatigue Assessment Scale and the WHO Disability Assessment Schedule 2.0, and the immunological profile was longitudinally analysed during intravenous immunoglobulin treatment. Fatigue scores normalised, neurocognitive performance returned to normal value, and quality of life improved after the first infusion and fully recovered within 1 year. Immunological profiling revealed the presence of an inverted CD4 to CD8 T-cell ratio that persisted during the whole follow-up. We also identified a CD8[+] T cell-monocyte complex and spontaneous IFNγ release. Intravenous immunoglobulin therapy was associated with a significant reduction of these complexes, spontaneous IFNγ and TNF production, markers of endothelial inflammation, and circulating autoantibody titres. This patient provides exploratory evidence that high-dose intravenous immunoglobulin was associated with sustained clinical recovery from long COVID over 1 year of follow-up, accompanied by immunological changes consistent with modulation of post-viral immune dysregulation, including a reduction in pathogenic T cell-monocyte synapses. Although causal inference cannot be established from a single patient, these findings suggest that this cellular interaction can contribute to long COVID and that immunomodulation could represent a rational therapeutic approach to be evaluated in selected patients.},
}

@article {pmid41933012,
year = {2026},
author = {Haack, M and Chan, J and Engert, LC and Dang, R and Wang, H and Borducchi, EN and Shah, K and Liu, J and Sun, H and Ganglberger, W and Karlson, EW and Prather, AA and Barouch, DH and Mullington, JM},
title = {The effect of pre-existing sleep disturbance on T cell responses to SARS-CoV-2 variants, pro-inflammatory and pro-resolving mediators, and glucocorticoid sensitivity in Long COVID.},
journal = {Scientific reports},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41598-026-47039-y},
pmid = {41933012},
issn = {2045-2322},
}

@article {pmid41933051,
year = {2026},
author = {Moreels, S and Smith, P and Charafeddine, R and Castanares-Zapatero, D and van Cauteren, D and Speybroeck, N},
title = {Identifying Long Covid phenotypes and their association with personal characteristics, healthcare use, and daily life burden: population-based study in Belgium.},
journal = {Scientific reports},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41598-026-47228-9},
pmid = {41933051},
issn = {2045-2322},
abstract = {Long Covid (LC), a multisystem disorder with persistent symptoms > 4 weeks post COVID-19, has impacted healthcare systems substantially. As information is scarce for Belgium, this study aimed to identify LC phenotypes and assess participant characteristics, healthcare use and daily life burden by phenotype. The last survey wave of COVimpact (a longitudinal online cohort study among Belgian adults recruited after SARS-CoV-2 infection) focused on LC with questions on healthcare utilization and perceived daily impact. A latent class analysis (LCA) identified phenotypes, based on symptom type, disease duration, and LC-related disability. Backward multivariable multinomial logistic regression explored predictors of LC class membership. Among 1,840 respondents self-reporting LC, four phenotypes emerged. Class 1 presented mild clinical outcomes, class 2 and 3 presented moderate clinical outcomes, differentiated by symptoms of memory problems and brain fog (class 2), and respiratory problems and muscle/joint pain (class 3), and class 4 included the most severe clinical outcomes. Compared to class 1, being older, female, lower educated, non-European, obese and experiencing moderate to severe acute COVID-19 symptoms predicted higher class severity. Diagnosis, healthcare use and support differed among adults with moderate and severe LC, many reported insufficient healthcare access and major disruption to daily life, including absenteeism from work/school. People with severe LC were the most financially impacted. By distinguishing LC phenotypes, this study enhances understanding of varying healthcare trajectories and daily life impacts. Healthcare planning and support should be more effectively tailored to the specific needs of those affected by LC.},
}

@article {pmid41933338,
year = {2026},
author = {Ostojic, SM},
title = {Beyond plasma signatures: reframing bioenergetic disruption in long COVID as a neurological disorder.},
journal = {Journal of translational medicine},
volume = {24},
number = {1},
pages = {},
pmid = {41933338},
issn = {1479-5876},
}

@article {pmid41924624,
year = {2026},
author = {Hasan, H and Hohmann, D and Hysko, K and Ibahrine, S and Skeries, V and Dold, K and Pöhler, GH and Wetzke, M and Hansmann, G},
title = {Cardiovascular phenotyping of children and adolescents with post-COVID syndrome (PCS) at initial diagnosis - a prospective observational single-center study.},
journal = {Frontiers in cardiovascular medicine},
volume = {13},
number = {},
pages = {1665734},
pmid = {41924624},
issn = {2297-055X},
abstract = {BACKGROUND: Post-COVID Syndrome (PCS) is an emerging, highly relevant topic in public health as it negatively affects quality of life and educational/work performance at all ages. To date, there is hardly any robust data on cardiac function in PCS (Long-COVID) available, particularly not in children and adolescents. The aim of this study was to conduct deep cardiovascular phenotyping in pediatric patients with PCS at initial presentation using cardiac MRI and echocardiography, including strain/tissue tracking analysis.

METHODS: Prospective, single center cohort study at Hannover Medical School, Germany (10207_BO_K_2022). PCS was defined as follows: persistent symptoms such as reduced physical performance, poor concentration, mood symptoms, headaches, sleep disorders and dysosmia, for at least 12 weeks after PCR-confirmed SARS-CoV-2 infection. A total of 100 pediatric patients (age 7-18 years, 56 female) and 20 age/gender matched healthy controls (age 8-18 years, 12 female) were enrolled between 03/2022 and 11/2023. Data collection consisted of 12-lead electrocardiogram (ECG), protocol-driven echocardiography (Echo; Philips EPIQ 7 ultrasound system, Philips Medical Systems), including tissue Doppler Echo and biventricular strain analysis (TOMTEC, Philips). 42 of the 100 PCS patients (age 9-18 years, 26 female) and 28 age/gender matched healthy controls (age 8-18 years, 14 female) received comprehensive cardiac magnetic resonance imaging (CMR; 3.0 T MRI system Magnetom Vida, Siemens Healthineers), including cine mass/volumes quantification in short axis (SAX) and tissue tracking (strain) analysis of the RV and LV (cvi 42). Laboratory studies included serum NTproBNP and Troponin c. Data are presented as mean ± SEM.

RESULTS: CMR-derived RV global radial strain (RVGRS) (22.6 ± 1.00% vs. 27.1 ± 1.13%; p = 0.003), and RV global circumferential strain (RVGCS) (-13.5 ± 0.55 vs. -15.2 ± 0.51%; p = 0.045) were significantly decreased in PCS vs. CON. Children with PCS also tended to have mildly reduced RVEF (50.9 ± 0.80 vs. 53.5 ± 0.66%; p = 0.259). RV mass index was increased in PCS compared to CON (19.06 ± 0.47 vs. 16.4 ± 0.53 g/m[2]; p = 0.0002), though in normal range referred to age-appropriate normal values. In contrast, CMR-derived LV variables (LVEF, LVEDV, LVESV, LV mass), including tissue tracking (strain) analysis (LVGLS, LVGCS, LVGRS), revealed similar values in PCS and control subjects. ECG and Echo data analysis did not show significant differences in PCS vs. CON.

CONCLUSION: PCS is associated with decreased CMR-based radial and circumferential RV contractility (RVGRS, RVGCS) and slightly increased RV mass in children with PCS compared to healthy, age/gender matched controls. In contrast, LV contractility (strain) and mass were not affected. CMR feature tracking (strain) appears to be more sensitive than echocardiographic strain analysis. Whether the aforementioned RV alterations are causal for the reported cardiopulmonary exercise limitations in pediatric PCS is unknown, and should be investigated further.},
}

@article {pmid41924648,
year = {2026},
author = {Al-Qerem, W and Baaj, R and Jarab, A and Al Bawab, AQ and Hasan Agha, MI and Eberhardt, J and Al-Sa'di, L and Obidat, R and Abu Hour, S},
title = {Validation of the Arabic Version Post-COVID-19 Symptom Scale (PCSS-Ar) for Assessing Long COVID-19 Severity Among Arabic-Speaking Populations: A Factor Analysis and Rasch Analysis Study.},
journal = {Risk management and healthcare policy},
volume = {19},
number = {},
pages = {572130},
pmid = {41924648},
issn = {1179-1594},
abstract = {PURPOSE: The COVID-19 pandemic has led to long COVID-19, a condition characterized by persistent, multisystemic symptoms. This study validated the Arabic version of the Post-COVID-19 Symptom Scale (PCSS-Ar) to assess long COVID-19 severity in Jordan.

PATIENTS AND METHODS: A cross-sectional online survey was conducted with 582 Jordanian adults (aged ≥18 years), recruited via social media. The PCSS-Ar underwent content validity evaluation by an expert panel, followed by confirmatory factor analysis (CFA) and Rasch analysis to assess its psychometric properties.

RESULTS: The final 24-item, five-factor model demonstrated an excellent fit (CFI = 0.95, TLI = 0.95, SRMR = 0.02) and strong internal consistency (Cronbach's α ≥ 0.97). Rasch analysis confirmed the tool's ability to differentiate symptom severity levels effectively. Key findings indicated that higher frequencies of COVID-19 infection were significantly associated with more severe long COVID-19 symptoms, whereas mild initial infections were linked to lower symptom severity. Notably, lower income was associated with higher PCSS-Ar scores, suggesting socioeconomic disparities in post-COVID-19 recovery. Female participants had lower PCSS-Ar scores, contrasting with previous studies, indicating a potential population-specific effect.

CONCLUSION: The PCSS-Ar is a validated and reliable tool for assessing long COVID-19 symptoms in Arabic-speaking populations. Its application in both clinical and research settings can help monitor symptom progression and guide targeted interventions.},
}

@article {pmid41926033,
year = {2026},
author = {Gierthmuehlen, M and Schmieder, K and Thon, N and Gierthmuehlen, PC},
title = {Transcutaneous Auricular Vagal Nerve Stimulation Against Fatigue Syndrome in Patients with Long COVID: Results of the Randomized, Placebo-Controlled Clinical Pilot Trial COVIVA.},
journal = {Neurology and therapy},
volume = {},
number = {},
pages = {},
pmid = {41926033},
issn = {2193-8253},
abstract = {INTRODUCTION: Fatigue is the most prevalent symptom in "long COVID", affecting 6-7% of patients after COVID-19 infection. Its pathophysiology remains unclear, with viral persistence, immune dysregulation, and mitochondrial dysfunction among proposed mechanisms. Transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive neuromodulatory approach, has been suggested as a potential treatment.

METHODS: We conducted a randomized, sham-controlled, single-blinded pilot study to evaluate adherence and clinical effects of taVNS in long COVID-related fatigue. Forty-five patients were randomized 1:1:1 to sham stimulation, sub-threshold taVNS, or above-threshold taVNS for 4 weeks using the Conformité Européenne (CE)-certified tVNS-L device (25 Hz, 250 µs, 4 h/day). The primary co-endpoints were fatigue severity (MFI-20) and adherence, defined as mean daily stimulation duration. Secondary endpoints included depressive symptoms (BDI-II), health-related quality of life (SF-36), and post-COVID symptom burden (PCS).

RESULTS: Of 45 enrolled patients (mean age 42.4 years; 73% female), 4 (8.9%) dropped out early. Mean stimulation time was 236 min/day, fulfilling the adherence criterion in > 80% of participants. Adverse events were mild, including skin irritation (6.7%) and vertigo (6.7%). Across all groups, questionnaire scores improved over time; however, no statistically significant differences were observed between the sham and active stimulation groups. Baseline fatigue and quality-of-life scores were markedly impaired compared with normative data.

CONCLUSION: taVNS was safe, feasible, and associated with high adherence in long COVID-related fatigue, but showed no superiority over sham stimulation. Larger multicenter trials with more homogeneous populations and objective biomarkers are required to determine whether taVNS confers therapeutic benefit in this condition.

TRIAL REGISTRATION: The trial was approved by the ethics committee (23/7798) and registered at the German Clinical Trials Register, identifier DRKS00031974.},
}

@article {pmid41926871,
year = {2026},
author = {Palacio, AM},
title = {Owning the moment: A call for humanism in medicine to address complex chronic illness.},
journal = {Patient education and counseling},
volume = {149},
number = {},
pages = {109609},
doi = {10.1016/j.pec.2026.109609},
pmid = {41926871},
issn = {1873-5134},
}

@article {pmid41918009,
year = {2026},
author = {Raine, G and Khouja, C},
title = {Exploring duplication in reviews of Long COVID: 2020-2023.},
journal = {Systematic reviews},
volume = {},
number = {},
pages = {},
doi = {10.1186/s13643-026-03174-1},
pmid = {41918009},
issn = {2046-4053},
abstract = {BACKGROUND: The unnecessary duplication of reviews is a recognised problem in the field of evidence synthesis. This paper reports findings from a study exploring potential duplication of effort in reviews on the frequency and/or risk of Long COVID that were published during the first 3 years of the COVID-19 pandemic.

METHODS: We extracted and summarised the aims and key characteristics of 112 reviews identified from 5 published evidence summaries commissioned by the National Institute for Health and Care Research (NIHR) for the Department of Health and Social Care (DHSC), England, which covered the period from January 2020 to January 2023.

RESULTS: There was significant similarity in the aims and characteristics of the 112 reviews. We identified 43 reviews reporting on any persistent symptoms/effects and 69 that focused on specific symptoms/effects; overlap in the conditions studied was common. The majority of reviews focused on individuals of any age (n = 62); where restrictions were applied (n = 50), all but six reviews focused on adults. Most reviews focused on both hospitalised and non-hospitalised patients (n = 97), and authors searched the same time periods. Half of authors reported publishing a protocol prospectively (n = 58), and only a minority received specific review funding (n = 39).

CONCLUSIONS: Our findings raise concerns about unnecessary duplication of effort and the extent to which all reviews we assessed will have added substantially to the Long COVID evidence base. Researchers should seek to minimise research redundancy and only conduct new reviews when a genuine knowledge gap exists.},
}

@article {pmid41918727,
year = {2026},
author = {Stallmach, A and Layer, P and Katzer, K and Reuken, PA},
title = {Lessons from irritable bowel syndrome: potential for understanding and managing post-COVID.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1717324},
pmid = {41918727},
issn = {1664-3224},
mesh = {Humans ; *Irritable Bowel Syndrome/therapy/diagnosis/etiology ; *COVID-19/complications ; *SARS-CoV-2 ; },
abstract = {Post-COVID presents a complex medical challenge characterized by persistent symptoms following SARS-CoV-2 infection. Similarities between post-COVID and post-infectious Irritable Bowel Syndrome (PI-IBS) suggest that the latter can serve as a useful model for understanding pathophysiological mechanisms and developing therapeutic approaches. Both conditions are functional disorders triggered by an acute infection, with multifactorial etiology and limited biomarker-based diagnostics. The variability of symptoms and the high frequency of comorbidities make these disorders particularly difficult to diagnose. Diagnostic efforts may be further hindered by the stigmatization of such disorders among healthcare providers, the health insurance industry, and the general public. This article explores the parallels between PI-IBS and post-COVID, highlighting, on the one hand, what can be learned from the management of IBS to better address the needs of patients with post-COVID long-term sequelae, and, on the other hand, raising doubts-based on decades of research into drug therapy development for IBS-about the likelihood of a rapidly available treatment for post-COVID.},
}

Humans
*Irritable Bowel Syndrome/therapy/diagnosis/etiology
*COVID-19/complications
*SARS-CoV-2

@article {pmid41919824,
year = {2026},
author = {Modesto, MMO and Oliveira, NN and Pereira, ND and Baccon, WC and Carreira, L and Salci, MA},
title = {Influence of alcohol on the worsening of COVID-19 and the occurrence of long COVID.},
journal = {Revista latino-americana de enfermagem},
volume = {34},
number = {},
pages = {e4813},
doi = {10.1590/1518-8345.7679.4813},
pmid = {41919824},
issn = {1518-8345},
mesh = {Humans ; *COVID-19/epidemiology/complications ; Male ; Cross-Sectional Studies ; Female ; Middle Aged ; Retrospective Studies ; *Alcohol Drinking/epidemiology/adverse effects ; Adult ; Aged ; Young Adult ; Hospitalization/statistics & numerical data ; Brazil/epidemiology ; Adolescent ; },
abstract = {OBJECTIVE: to analyze the alcohol consumption patterns of adults and older adults before the development of COVID-19 and the influence of alcohol consumption on the outcomes and complications of long COVID.

METHOD: cross-sectional study based on data from a retrospective cohort conducted with adults and older adult who had COVID-19 and who consumed alcohol before infection with the disease. A standardized electronic form was used to collect sample data and a path model was adjusted to prove the theoretical model on the influence of alcohol consumption on negative outcomes for COVID-19.

RESULTS: sample of 1,171 participants who responded to the question about alcohol. Of these, 408 (34.84%) reported alcohol consumption prior to the disease. The majority were male, younger, highly educated, and had children over the age of 18. The presence of chronic noncommunicable diseases leads to an 11% increase in the chance of hospitalization and a 12% increase in the chance of long COVID. The age of the participants affected alcohol use and directly affected the need for hospitalization.

CONCLUSION: It is important to adopt intervention strategies aimed at reducing alcohol consumption, especially in contexts of syndemic, to mitigate the associated risks.},
}

Humans
*COVID-19/epidemiology/complications
Male
Cross-Sectional Studies
Female
Middle Aged
Retrospective Studies
*Alcohol Drinking/epidemiology/adverse effects
Adult
Aged
Young Adult
Hospitalization/statistics & numerical data
Brazil/epidemiology
Adolescent

@article {pmid41920383,
year = {2026},
author = {Buchholz, I and Lüdtke, L and Härter, M and Janssen, MFB},
title = {Psychometric validation of a cognition and social participation bolt-on for the EQ-5D-5L in SARS-CoV-2 infected German healthcare workers.},
journal = {Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation},
volume = {35},
number = {5},
pages = {},
pmid = {41920383},
issn = {1573-2649},
}

@article {pmid41921919,
year = {2026},
author = {Welfordsson, P and Brodén, M and Niemi, M and Diwan, V and Shah, K and Pattanadara, V and Hallgren, M},
title = {Feasibility and preliminary effects of a yoga program developed for adults with post COVID-19 condition (Breathe Easy): pilot randomized controlled trial.},
journal = {Complementary therapies in medicine},
volume = {},
number = {},
pages = {103367},
doi = {10.1016/j.ctim.2026.103367},
pmid = {41921919},
issn = {1873-6963},
abstract = {INTRODUCTION: Effective medical management of post COVID-19 condition (post COVID) remains challenging. Symptoms are heterogenous, debilitating, and impact health-related quality of life (HR-QoL). Complementary treatments are needed that can be self-managed and improve health. Yoga is a promising strategy that may help reduce post-COVID symptoms but remains understudied.

METHODS: We co-designed a unique yoga intervention for adults with post COVID and evaluated its feasibility and preliminary effects. Two-group parallel, pilot randomized controlled trial with blinded follow-up. Participants were randomized (1:1) to the 12-week yoga program or a health promotion (HP) intervention. All participants received usual medical treatment for post COVID. Twenty-nine participants aged 30-65 years were recruited and randomized (86% follow-up). The primary outcome was feasibility and the secondary outcome was HR-QoL (SF-36). Data were analysed as intention-to-treat using linear mixed modelling. The trial was prospectively registered and approved by the Swedish Ethical Review Authority (2023/06518-01).

RESULTS: Through a consensus development process involving yoga experts in India and Sweden, post COVID researchers, and patient advocates, we successfully co-designed and pilot tested a yoga program developed for adults with post COVID. The intervention was feasible with high adherence (≥2 sessions/week = 65%; ≥1 session/week = 95%) and no serious adverse events reported. Preliminary (underpowered) analyses showed no pre-to-post intervention group differences (SF-36 physical health: B = -1.30, 95% CI = -3.60, 1.00, p =.269; mental health: B = 3.49, 95% CI = -0.06, 7.04, p =.054).

CONCLUSION: Participation in a yoga program developed for patients with post COVID was feasible. Adequately powered trials are needed to assess whether yoga may help to improve symptoms associated with the condition.},
}

@article {pmid41922885,
year = {2026},
author = {van der Bie, J and Bakker, J and Verschoor, EJ and Nutma, E and Middeldorp, J and Beaino, W and Kassiou, M and Danon, JJ and Langermans, JAM and Windhorst, AD and Stammes, MA},
title = {Comparison of [[18]F]DPA-814 with [[18]F]DPA-714 for TSPO Imaging in an Experimental Model.},
journal = {Molecular imaging and biology},
volume = {},
number = {},
pages = {},
pmid = {41922885},
issn = {1860-2002},
abstract = {PURPOSE: [[18]F]DPA-714 is a valuable tracer for studying (neuro)inflammation, with well-characterized tracer kinetics and an established imaging window. However, its clinical utility is restricted by the TSPO polymorphism (rs6971), which influences binding affinity in humans. The newly developed tracer [[18]F]DPA-814 overcomes this limitation and has shown promising results in a preclinical rat model. To further assess its clinical potential, we compared [[18]F]DPA-814 to [[18]F]DPA-714 for inflammation imaging in SARS-CoV-2-infected macaques in a longitudinal setting.

PROCEDURES: Dynamic positron emission tomography (PET) imaging was conducted in four healthy macaques to identify the optimal imaging window for [[18]F]DPA-814. Four additional macaques were infected with SARS-CoV-2 and monitored for 12 months using whole-body PET-computed tomography (CT) with both tracers. Baseline scans were compared to PET-CTs obtained at 4, 9 and 16 days and at 6 and 12 months post-infection, covering the head, thorax and abdomen. Tracer uptake was assessed in several organs.

RESULTS: At baseline, [[18]F]DPA-814 showed higher lung uptake with minimal washout compared to [[18]F]DPA-714. Although lung lesions developed after infection, [[18]F]DPA-814 did not demonstrate lesion-specific uptake, unlike [[18]F]DPA-714. In the brain, the tracers also displayed divergent uptake patterns despite comparable TSPO levels across animals and regions.

CONCLUSIONS: [[18]F]DPA-814 exhibits a distinct whole-body distribution, particularly in the lungs and brain, in both naïve and SARS-CoV-2-infected macaques compared with [[18]F]DPA-714, likely reflecting differences in tracer kinetics. Based on these data, [[18]F]DPA-814 may not fully replace [[18]F]DPA-714 for lung and brain imaging, and further studies are required to evaluate its suitability in other anatomical regions.},
}

@article {pmid41913858,
year = {2026},
author = {Shahid, MM and Neequaye, NN and Shifera, AS},
title = {Multiple Evanescent White Dot Syndrome (MEWDS) Following COVID-19 Infection: A Presumed Recurrence.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e104405},
pmid = {41913858},
issn = {2168-8184},
abstract = {Multiple evanescent white dot syndrome (MEWDS) is a transient self-limiting likely post-viral inflammatory condition involving the outer retina and inner choroid and has been reported following several vaccinations and viral infections, including COVID-19. Photopsias are a common presenting symptom but rarely persist after the acute phase of MEWDS. We present a case of an otherwise healthy 29-year-old woman who developed persistent photopsias of the right eye following COVID-19 infection. These photopsias persisted for several months and worsened after a second COVID-19 infection, which is atypical of MEWDS. Fundus autofluorescence (FAF) demonstrated several characteristic punctate hyperautofluorescent spots. Her symptoms and fundus lesions resolved after a few weeks of diagnosis without treatment. COVID-19 has several reported ocular manifestations, including MEWDS. While most cases of MEWDS following COVID-19 infection are singular instances, our case was a presumed recurrence. MEWDS is often self-limiting, but in this case, symptoms persisted for several months, suggesting the possibility of long COVID, which is a poorly understood phenomenon.},
}

@article {pmid41914122,
year = {2026},
author = {Singhal, A and Patle, A and Patil, S and Lakkireddy, M and Raja, S and Pyati, A and Arora, A and Dhole, S and Varathrajan, S and Patil, P and Sahoo, D and Taranikanti, M and John, NA and Ravi, N},
title = {Covid-19 and Its Arthritic Footprint: Clinical, Laboratory and Imaging Insights from a Cross Sectional Study in a Tertiary Center in Telangana.},
journal = {Mymensingh medical journal : MMJ},
volume = {35},
number = {2},
pages = {641-648},
pmid = {41914122},
issn = {2408-8757},
mesh = {Humans ; Female ; *COVID-19/complications ; Cross-Sectional Studies ; Middle Aged ; Male ; Prospective Studies ; Adult ; Tertiary Care Centers ; *Arthritis/etiology/diagnostic imaging/diagnosis/virology ; Aged ; SARS-CoV-2 ; Arthralgia/etiology ; },
abstract = {The post-Covid-19 syndrome, also referred to as "Long Covid", can present with arthritic symptoms. A cross-sectional, prospective study was done on post Covid-19 patients at a tertiary centre in Telangana. This study included a total of 139 RT-PCR-confirmed Covid-19 patients, who were diagnosed with arthritis in the time interval between 1 to 6 months post Covid recovery. Demographic data, clinical data, blood investigations, inflammatory markers and imaging investigations were recorded. Majority of the patients (65.5%; n=91) were women and the mean age of the participants was 50.8 years. 77.0% (n=107) had arthralgia, 44.6% (n=62) had joint swelling, 25.2% (n=35) had myalgia and 5.8% (n=8) had fatigue. The most common joint affected was the knee (92.0%; n=128), followed by wrist (10.25%; n=4) and ankle (n=1). Abnormal Hb levels (43.9%; n=61), RBC counts (9.4%; n=13), WBC counts (13.7%; n=19) and ESR (26.6%; n=37), D-dimer (50.4%; n=70), LDH levels (49.6%; n=69), uric acid (36.0%; n=50), ferritin (35.5%; n=49) and rheumatoid factor (10.8%; n=15), were recorded in participants. Joint arthritic changes on radiographs and ultrasoundwere recorded in 77.0% had 95.7% of the participants respectively. Covid arthritis is one of the common features of Long Covid patients. Many patients suffer from joint aches and swelling which cause sufficient impairment causing majority of the individuals.},
}

Humans
Female
*COVID-19/complications
Cross-Sectional Studies
Middle Aged
Male
Prospective Studies
Adult
Tertiary Care Centers
*Arthritis/etiology/diagnostic imaging/diagnosis/virology
Aged
SARS-CoV-2
Arthralgia/etiology

@article {pmid41914490,
year = {2026},
author = {Koberssy, Z and Daher, J and Durieux, JC and Atieh, O and Baissary, J and Abboud, M and Ailstock, K and Cummings, M and Funderburg, N and McComsey, GA},
title = {Comparison of Immune Activation and Gut Barrier Dysfunction between Long COVID and HIV infection.},
journal = {The Journal of infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1093/infdis/jiag146},
pmid = {41914490},
issn = {1537-6613},
abstract = {BACKGROUND: Human Immunodeficiency Virus (HIV) infection is characterized by persistent immune dysregulation and inflammation, with emerging evidence suggesting overlapping pathophysiological mechanisms with Long COVID. Biomarkers of systemic inflammation and gut integrity may provide insight into shared and distinct pathways underlying these conditions. The status of the anti-inflammatory vitamin K may play a role in sustained inflammation in these conditions.

METHODS: This cross-sectional study enrolled participants belonging to one of 3 groups: individuals with Long COVID (Long COVID; n=108) without HIV, participants with HIV (PWH), virologically suppressed with no previous COVID-19 infection (HIV+; n=256), and controls without Long COVID or HIV (controls; n=193). Plasma samples were analyzed for inflammatory, gut integrity biomarkers, and dephosphorylated-uncarboxylated Matrix Gla Protein (dp-ucMGP) as an established marker of vitamin K status. Associations were assessed using multivariable linear and logistic regression models adjusted for demographic, metabolic, and lifestyle covariates.

RESULTS: 557 participants were included. Long COVID was independently associated with elevated oxLDL (β=0.39 vs. HIV, β=0.54 vs. controls; P<0.001 for both). PWH had higher odds of worse vitamin K status [OR: 1.5; 95% CIs (1.02-2.2), P=0.04]. Independent of Long COVID or HIV status, worse vitamin K status was strongly associated with higher levels of inflammatory markers.

CONCLUSION: Long COVID and HIV share chronic immune dysregulation features but demonstrate distinct inflammatory profiles. Those findings highlight the importance of large longitudinal studies to delineate shared versus unique inflammatory pathways to guide potential Long COVID therapeutic strategies.},
}

@article {pmid41914537,
year = {2026},
author = {Nezamdoust, B},
title = {Rethinking Risk: Intersectional Inequalities in Long COVID in the United States.},
journal = {Sociology of health & illness},
volume = {48},
number = {4},
pages = {e70174},
doi = {10.1111/1467-9566.70174},
pmid = {41914537},
issn = {1467-9566},
mesh = {Humans ; United States/epidemiology ; *COVID-19/epidemiology/ethnology/complications ; Female ; Male ; *Health Status Disparities ; Adult ; Middle Aged ; Socioeconomic Factors ; *Social Class ; SARS-CoV-2 ; Sex Factors ; Black or African American/statistics & numerical data ; White People/statistics & numerical data ; Aged ; *Health Inequities ; Risk Factors ; Prevalence ; White ; },
abstract = {Post-acute sequelae of coronavirus disease 2019 (PASC), also known as Long COVID, is a chronic, multisystem condition affecting millions of U.S. adults, with profound social, medical and economic consequences. Despite its widespread impact, disparities in who is most affected remain poorly understood, especially through an intersectional sociological lens. Using a sociological and intersectional framework, this study analyses a national sample (N = 535,300) from the Household Pulse Survey to explain disparities in Long COVID risk across race, gender and socioeconomic status. The analysis demonstrates that socioeconomic advantage does not equally protect all groups; specifically, higher-SES Black women show significantly elevated Long COVID prevalence compared to White counterparts, challenging claims of racial parity in Long COVID rates. Moreover, although women generally show higher Long COVID risk, intersectional analysis uncovers that the gender gap narrows among high-SES White women, suggesting that social privilege can mitigate health risks. These findings emphasise that structural inequalities, rather than biology, may primarily drive Long COVID inequities and highlight the importance of intersectional sociological analyses for understanding health disparities. The results call for equity-focused interventions addressing the unequal social burden of Long COVID and advancing sociological theory on the social determinants of health.},
}

Humans
United States/epidemiology
*COVID-19/epidemiology/ethnology/complications
Female
Male
*Health Status Disparities
Adult
Middle Aged
Socioeconomic Factors
*Social Class
SARS-CoV-2
Sex Factors
Black or African American/statistics & numerical data
White People/statistics & numerical data
Aged
*Health Inequities
Risk Factors
Prevalence
White

@article {pmid41914684,
year = {2026},
author = {Brüssow, H},
title = {Antivirals Targeting Coronavirus RNA-Dependent RNA Polymerase and Main Protease: From Mechanisms of Action to Outcomes in COVID-19 Clinical Trials.},
journal = {Microbial biotechnology},
volume = {19},
number = {4},
pages = {e70342},
doi = {10.1111/1751-7915.70342},
pmid = {41914684},
issn = {1751-7915},
mesh = {Humans ; *Antiviral Agents/therapeutic use/pharmacology ; *COVID-19 Drug Treatment ; *SARS-CoV-2/drug effects/enzymology ; Clinical Trials as Topic ; COVID-19/virology ; Hydroxylamines/therapeutic use/pharmacology ; *Coronavirus RNA-Dependent RNA Polymerase/antagonists & inhibitors ; Cytidine/analogs & derivatives/therapeutic use ; Alanine/analogs & derivatives/therapeutic use ; Animals ; Adenosine Monophosphate/analogs & derivatives/therapeutic use ; Coronavirus 3C Proteases/antagonists & inhibitors ; },
abstract = {The rapid global spread of SARS-CoV-2 triggered an unprecedented effort to develop effective antivirals. Among the first approved agents was remdesivir, an injectable nucleoside analogue developed by Gilead Sciences, that led to chain termination of viral RNA synthesis and showed broad antiviral activity against RNA viruses. Early clinical results were mixed: The US ACTT-1 trial reported an accelerated recovery and reduced mortality in treated patients, while the WHO Solidarity and a European trial revealed no impact of remdesivir on mortality. In contrast, a US trial in outpatients demonstrated a clear clinical benefit when treatment was administered early. Molnupiravir, an orally applicable nucleoside analogue developed by Merck, induces lethal mutations in the viral genome rather than chain termination. Molnupiravir showed in vivo antiviral activity against coronaviruses in different animals. In MOVe-OUT trials, molnupiravir reduced the rate of hospitalisation in treated outpatients. In the PANORAMIC trial, molnupiravir reduced the time to recovery in outpatients but not their rate of hospitalisation. No drug effect of molnupiravir was seen in the RECOVERY trial with hospitalised COVID-19 patients. Using structural biology and medicinal chemistry approaches, Pfizer developed nirmatrelvir, an oral inhibitor of the major coronavirus protease. In high-risk but not in standard-risk COVID-19 patients, the combination nirmatrelvir/ritonavir reduced the rate of hospitalisation (EPIC HR and SR trials). Retrospective cohort studies showed treatment effects in defined patient groups. This review compares the efficacy and clinical performance of different antivirals, including emerging drugs such as obeldesivir and alternative protease inhibitors (lopinavir, simnotrelvir). It further examines their roles in prophylaxis, treatment of long covid symptoms, pharmacological considerations and antiviral resistance. Particular attention is given to factors underlying variable outcome of the trials, including viral variant evolution, population immunity increases, disease severity changes and timing of therapy initiation.},
}

Humans
*Antiviral Agents/therapeutic use/pharmacology
*COVID-19 Drug Treatment
*SARS-CoV-2/drug effects/enzymology
Clinical Trials as Topic
COVID-19/virology
Hydroxylamines/therapeutic use/pharmacology
*Coronavirus RNA-Dependent RNA Polymerase/antagonists & inhibitors
Cytidine/analogs & derivatives/therapeutic use
Alanine/analogs & derivatives/therapeutic use
Animals
Adenosine Monophosphate/analogs & derivatives/therapeutic use
Coronavirus 3C Proteases/antagonists & inhibitors

@article {pmid41915390,
year = {2026},
author = {Wee, LE and Abdul Malek, MIB and Tan, YY and Lim, JT and Tan, WC and Ngiam, JN and Lee, M and Vong, EKY and Chiew, CJ and Li, RJ and Tan, IBH and Lye, DC and Tan, KB},
title = {Postacute Sequelae Following Omicron COVID-19 in Patients With Cancer.},
journal = {JAMA network open},
volume = {9},
number = {3},
pages = {e264037},
doi = {10.1001/jamanetworkopen.2026.4037},
pmid = {41915390},
issn = {2574-3805},
mesh = {Humans ; *COVID-19/complications/epidemiology ; *Neoplasms/complications/epidemiology ; Female ; Male ; Middle Aged ; Retrospective Studies ; Aged ; SARS-CoV-2 ; Singapore/epidemiology ; Adult ; Post-Acute COVID-19 Syndrome ; Severity of Illness Index ; },
abstract = {IMPORTANCE: Information on the burden of postacute sequelae of SARS-CoV-2 infection (or long COVID) in patients with cancer during endemicity is limited.

OBJECTIVE: To evaluate the risk of postacute diagnoses and/or symptoms compatible with long COVID in a population-based cohort of patients with cancer and high rates of vaccination and/or boosting who were infected during Omicron predominance compared with those with negative test results (hereinafter, noninfected patients). Results were additionally stratified by COVID-19 severity and receipt of therapeutics.

This retrospective, population-based cohort study used health care claims databases to construct cohorts of adult patients with cancer in Singapore who were infected with SARS-CoV-2 during Omicron predominance (January 1 through December 31, 2022), and contemporaneous noninfected patients. Patients were followed up to 300 days from the index date and data were analyzed from February 1, 2022, through October 27, 2023.

EXPOSURE: SARS-CoV-2 infection.

MAIN OUTCOMES AND MEASURES: Competing risks regression (death as a competing risk), with overlap weights applied, was used to estimate risks of new-incident diagnoses and/or symptoms compatible with long COVID following SARS-CoV-2 infection in patients with cancer compared with noninfected patients. Risks of postacute sequelae following COVID-19 hospitalization in patients with cancer were further contrasted against influenza hospitalizations (January 1, 2017, to December 31, 2022).

RESULTS: A total of 76 807 patients with cancer were included in the analysis (48 279 [62.9%] female); 39 256 had SARS-CoV-2 infection and 37 551 were noninfected patients. The mean (SD) age was 63.9 (13.7) years. The mean (SD) follow-up time was 263.1 (36.2) days for patients infected with SARS-CoV-2 and 264.8 (32.5) days for noninfected patients. Most patients had solid-organ cancer (72 497 of 76 807 [94.4%]) and were boosted (71 550 of 76 807 [93.2%]); only a minority with SARS-CoV-2 infection (3571 of 39 256 [9.1%]) required acute hospitalization. No significant difference in risk of postacute diagnoses compatible with long COVID was observed in patients with SARS-CoV-2 infection (hazard ratio [HR], 0.98; 95% CI, 0.92-1.04) compared with noninfected patients. While risk of postacute symptoms following COVID-19 was modestly increased (HR, 1.09; 95% CI, 1.01-1.19; P = .048), statistical significance was not attained after adjustment for multiple comparisons. However, significantly increased risk of postacute sequelae was observed among patients hospitalized for COVID-19 compared with noninfected patients (HR for any diagnosis, 1.36 [95% CI, 1.18-1.56]; HR for any symptom, 1.48 [95% CI, 1.22-1.76]; P < .001 for both); risks remained elevated even among hospitalized cases receiving COVID-19 therapeutics. Risks of postacute sequelae following COVID-19 hospitalization in patients with cancer did not significantly differ from those associated with seasonal influenza hospitalizations.

CONCLUSIONS AND RELEVANCE: The findings of this cohort study suggest that among highly boosted patients with cancer, the overall risk of postacute sequelae following Omicron SARS-CoV-2 infection was not significantly elevated compared with noninfected patients; however, patients who were hospitalized for COVID-19 remained at increased risk of postacute sequelae despite administration of COVID-19 therapeutics. These findings further suggest that COVID-19 vaccination and boosting remain important in mitigating the risk of long COVID among immunocompromised patients during endemicity.},
}

Humans
*COVID-19/complications/epidemiology
*Neoplasms/complications/epidemiology
Female
Male
Middle Aged
Retrospective Studies
Aged
SARS-CoV-2
Singapore/epidemiology
Adult
Post-Acute COVID-19 Syndrome
Severity of Illness Index

@article {pmid41917225,
year = {2026},
author = {Bonuck, K and Gao, Q and Congdon, S and Kim, RS},
title = {Long COVID disability burden in US adults.},
journal = {Communications medicine},
volume = {6},
number = {1},
pages = {},
pmid = {41917225},
issn = {2730-664X},
abstract = {BACKGROUND: Five years since the scientific and patient communities first identified the syndrome now known as Long COVID, affected individuals lack treatments, and the US lacks population-based data on its disability burden and correlation with National Institutes of Health (NIH) funding. Moreover, akin to other debilitating conditions it often co-occurs with, e.g., Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and dysautonomia, Long COVID disproportionately impacts females whose concerns are often marginalized.

METHODS: We quantify Long COVID years lived with disability (YLDs= prevalence x disability weight) in US adults and its actual/YLD-commensurate average annual NIH FY2022-2024 funding versus 68 comparator conditions, by sex predominance. We derive Long COVID prevalence from Census Bureau surveys (9/2022-8/2023) and apply disability weights from the Global Burden of Disease Study.

RESULTS: Long COVID YLDs approximate those of Alzheimer's and Asthma. Long COVID received 14% of its disability commensurate funding: $106 million vs. $739.8 million. ME/CFS is the most under-funded condition, receiving <1% of its YLD proportionate funding. Among conditions analyzed, 24 are female-predominant (we estimate Long COVID funding two ways), 12 male-predominant, and 33 show no sex predominance. Among the 12 below-median funded/above-median YLD conditions, 7/12 are female-predominant, none are male-predominant. Median funding/per YLD is 5.2 times higher for male- vs. female-predominant conditions (7.0 vs 1.3 million per YLD, p = 0.007). Overall, YLDs explain 6.5% of funding variance in a linear regression model using YLD as the sole predictor (Adjusted R-squared: 0.065).

CONCLUSIONS: With chronic conditions like Long COVID rising, disability burden merits greater consideration in funding decisions, as does biological sex.},
}

@article {pmid41907807,
year = {2026},
author = {Kaleem, S and Sawano, M and Arun, AS and Warner, F and Zhou, T and Huang, C and Bhattacharjee, B and Lu, Y and Iwasaki, A and Nwanyanwu, K and Ahmed, IIK and Krumholz, HM},
title = {Ocular Symptoms in Long COVID: A Cross-Sectional Study.},
journal = {Clinical ophthalmology (Auckland, N.Z.)},
volume = {20},
number = {},
pages = {565596},
pmid = {41907807},
issn = {1177-5467},
abstract = {INTRODUCTION: This study compared demographics, socioeconomic characteristics, pre-pandemic health conditions, newly diagnosed health conditions, and long COVID symptoms between participants with and without self-reported new-onset ocular symptoms after COVID-19 infection.

MATERIAL AND METHODS: We performed a cross-sectional analysis of the Listen to Immune, Symptom, and Treatment Experiences Now (LISTEN) study. Adults who self-reported long COVID, completed surveys between May 2022 and October 2023, and did not report post-vaccination syndrome were included. Ocular symptoms were defined as self-reported new-onset blurring or loss of vision, dry eyes, or floaters/flashes of light attributed to long COVID. Group comparisons used percentages for categorical variables and median and interquartile range (IQR) for continuous variables as well as Bonferroni-adjusted P-values. A gradient-boosted tree model was used to identify symptoms that differentiated groups.

RESULTS: Among 595 participants (median age 46 years [IQR 38-56]; 73% female), 341 (57%) reported ocular symptoms. Pre-pandemic comorbidities were similar between groups. Participants with ocular symptoms had lower EuroQoL visual analogue scale health scores (median 40 [IQR 30-59] vs 51 [IQR 39-70], P < 0.001), greater financial difficulties (20% vs 8.8%, P < 0.001), increased worry about housing stability (16% vs 5.4%, P < 0.001), and higher rates of new-onset dysautonomia (38% vs 15%, P < 0.001) and myalgic encephalomyelitis/chronic fatigue syndrome (21% vs 9.1%, P = 0.005). Key differentiating symptoms included dizziness, cold intolerance, pressure at the base of the head, tinnitus, and tremors.

CONCLUSION: Individuals with long COVID with self-reported new-onset ocular symptoms after infection may represent a more severe phenotype, with poorer health status and greater socioeconomic challenges despite similar pre-pandemic health profiles.},
}

@article {pmid41908724,
year = {2026},
author = {Zavala-Arciniega, L and Lisabeth, L and Slocum, EM and Orellana, RC and Fleischer, NL},
title = {Sex differences in the prospective associations of long COVID with incident cardiometabolic and respiratory diseases from a population-based longitudinal study in Michigan.},
journal = {Preventive medicine reports},
volume = {65},
number = {},
pages = {103449},
pmid = {41908724},
issn = {2211-3355},
abstract = {AIM: To evaluate longitudinal associations of Long COVID with incident cardiometabolic and respiratory outcomes among adults.

METHODS: We used the Michigan COVID-19 Recovery Surveillance Study, a population-based longitudinal study of adults with PCR-confirmed COVID-19 in Michigan. We included adults with COVID-19 who responded to the baseline (data collection: 06/2020-12/2022) and follow-up survey (data collection: 01/2022-11/2023) and were free of each outcome at baseline. Long COVID was defined as recovery taking ≥90 days after infection or no recovery. We evaluated four self-reported incident outcomes: 1) diabetes, 2) hypertension, 3) heart disease, and 4) asthma. We conducted modified Poisson models to examine longitudinal exposures-outcomes association separately, overall and stratified by sex.

RESULTS: Long COVID was associated with higher past-year incidence of heart disease and asthma in multivariable models, when we stratified the models by sex, we observed statistically significant associations for females only between Long COVID and all measured outcomes, except hypertension (Females = diabetes: Incidence Risk Ratio (IRR) = 2.33 95% CI 1.15,4.73; heart disease: IRR = 1.98 95% CI 1.10,3.57; asthma: IRR = 2.99 95% CI 1.60,5.57).

CONCLUSION: Study findings reinforce the importance of preventing Long COVID and to monitor sequelae including incident disease outcomes for those who are experiencing Long COVID.},
}

@article {pmid41909842,
year = {2026},
author = {Yang, Y and Li, B and Yang, J},
title = {Editorial: Therapeutic targets and strategies for long COVID and post-viral syndrome.},
journal = {Frontiers in cellular and infection microbiology},
volume = {16},
number = {},
pages = {1820002},
doi = {10.3389/fcimb.2026.1820002},
pmid = {41909842},
issn = {2235-2988},
}

@article {pmid41911553,
year = {2026},
author = {Reis, G and Dos Santos Moreira Silva, EA and Medeiros Silva, DC and Thabane, L and Ferreira, TS and Reis, LLF and Figueiredo Guimaraes Almeida, AP and Menezes Amaral, M and Savassi, LCM and de Souza Campos, VH and Campos Simplicio, MI and Barra Ribeiro, L and de Souza Medeiros, T and Campos Siqueira, T and Vieira, TS and Drumond Rausse, N and Garofolo, TC and Fagundes Silva, EC and Harari, O and D'Urso, G and Forrest, JI and Park, J and Nachega, JB and Lindsell, C and Glenn, JS and Thorlund, K and Dybul, M and Mills, EJ and , },
title = {The Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID : An Adaptive Randomized Trial.},
journal = {Annals of internal medicine},
volume = {},
number = {},
pages = {},
doi = {10.7326/ANNALS-25-03959},
pmid = {41911553},
issn = {1539-3704},
abstract = {BACKGROUND: Postacute sequelae of SARS-CoV-2, or long COVID, presents a major therapeutic challenge, with fatigue being a prevalent and debilitating symptom.

OBJECTIVE: To assess the efficacy of fluvoxamine and metformin for long COVID fatigue.

DESIGN: Randomized, placebo-controlled, adaptive trial. (ClinicalTrials.gov: NCT06128967).

SETTING: Outpatient sites in Brazil.

PARTICIPANTS: 399 adults with fatigue persisting 90 or more days after confirmed SARS-CoV-2 infection.

INTERVENTION: Participants were randomly assigned to fluvoxamine (100 mg twice daily), metformin (750 mg twice daily), or matching placebo for 60 days.

MEASUREMENTS: The primary outcome was change in Fatigue Severity Scale (FSS) score.

RESULTS: Fluvoxamine showed a significant reduction in fatigue compared with placebo at day 60 (mean difference, -0.43 [95% credible interval {CrI},
-0.80 to -0.07]), with a sustained effect at day 90 (mean difference, -0.58 [CrI, -0.98 to -0.16]). Fluvoxamine also improved quality-of-life scores with high posterior probability. Metformin showed no significant benefit. Adverse events were less frequent with fluvoxamine (20.0%) than with metformin (28.8%) or placebo (29.7%). Grade 3 and higher adverse events were rare across all groups.

LIMITATIONS: The 90-day follow-up period limits conclusions about the durability of treatment effects, and the exclusive focus on fatigue as the primary outcome does not address other prevalent long COVID symptoms, leaving fluvoxamine's broader therapeutic utility uncertain.

CONCLUSION: Fluvoxamine, but not metformin, may be an effective treatment for reducing fatigue and improving quality of life in patients with long COVID.

PRIMARY FUNDING SOURCE: The Latona Foundation.},
}

@article {pmid41911555,
year = {2026},
author = {},
title = {Summary for Patients: Fluvoxamine and Metformin for Fatigue in Patients With Long COVID.},
journal = {Annals of internal medicine},
volume = {},
number = {},
pages = {},
doi = {10.7326/ANNALS-25-03959-PS},
pmid = {41911555},
issn = {1539-3704},
}

@article {pmid41903103,
year = {2026},
author = {Thakkar, K and Thamaree, R and Kyaw, MH and Chirila, I and Mendoza, CF and Dodd, J and Yarnoff, B and Kiertiburanakul, S},
title = {Potential Public Health Impact of Updated COVID-19 Vaccination Strategies in Thailand: Epidemiological Data Update.},
journal = {Pulmonary therapy},
volume = {},
number = {},
pages = {},
pmid = {41903103},
issn = {2364-1746},
abstract = {INTRODUCTION: This study evaluates the anticipated health and economic effects of multiple COVID-19 vaccination strategies using an updated vaccine in Thailand.

METHODS: A previously published hybrid decision tree and Markov model, originally developed for the USA, was calibrated using Thailand-specific epidemiological, demographic, and economic data from 2024. The model assessed several age- and risk-based vaccination strategies assuming vaccine uptake ranging from 20% to 50%. Health outcomes (cases, hospitalizations, deaths, and long COVID cases) and economic outcomes (long COVID costs, direct medical costs, and productivity losses) were projected from payer and societal perspectives. Vaccine effectiveness was assumed to be 50% against infection, 60% against symptoms, and 70% against severe disease, with a 6-month duration of protection.

RESULTS: Vaccinating individuals aged 60 years and above and high-risk individuals aged 6 months to 59 years was projected to prevent 318,700 infections, 9147 hospitalizations, and 1061 deaths in 1 year. This strategy was estimated to yield THB 3300 million in direct medical cost savings and THB 2695 million in productivity loss savings. Increasing coverage in this population to 50% could amplify these reductions by up to 150%.

CONCLUSIONS: With updated Thai data, analyses suggest that use of an adapted COVID-19 vaccine could continue to generate considerable public-health and economic gains, particularly when coverage among older adults and high-risk groups is expanded. These findings carry implications for sustaining preparedness and guiding national vaccination policy.},
}

@article {pmid41903617,
year = {2026},
author = {Katsarou, MS and Papasavva, M and Tsolakou, A and Christodoulou, A and Antonoglou, A and Raptis, A and Kontaxakis, A and Gavrielatos, M and Michalopoulos, I and Vassiliou, AG and Stefanatou, M and Pappas, G and Moschos, SA and Drakoulis, N and Katsaounou, P},
title = {Clinically Confirmed Cohort Reveals Antioxidant Genetic Polymorphisms as Potential Susceptibility Factors for Long COVID After Mild or Asymptomatic COVID-19.},
journal = {Free radical biology & medicine},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.freeradbiomed.2026.03.064},
pmid = {41903617},
issn = {1873-4596},
abstract = {Although the COVID-19 pandemic has now been down-graded, long COVID (LC) presents an ongoing risk of long-term disease for a significant percentage of the population, even after mild or no symptoms upon infection. LC post-viral effects have been associated with oxidative stress (OS), impacting canonical cell function. The aim of this study was to investigate the association of eight OS-related single nucleotide polymorphisms (SNPs) on LC susceptibility among patients with mild or no symptoms after SARS-CoV-2 infection, with emphasis on a clinically homogeneous population free from bias and overlap with other conditions. Blood samples were collected from 85 clinically confirmed LC patients and 96 unvaccinated controls (observational case control study) all with mild/asymptomatic infection, and analysed by targeted SNP genotyping in the GSTP1, SELENOS, CAT, SOD2, and EPHX1 OS-related genes. Τhe control individuals had been infected at least 6 months prior to enrollment and had not developed any symptoms related to long COVID. Our analysis revealed associations between SOD2 and EPHX1 polymorphisms and disease progression, with pre-existing thyroid disease and acute phase symptoms being significant aggravating factors. Machine Learning (ML) analysis produced a 10-factor predictive model for LC with a balanced accuracy over 0.74, released herein as an open-access LC risk rating webtool. Our findings suggest that individuals' genetic antioxidant capacity may plays an important role in long covid, fitting with current ideas of mitochondrial dysfunction and viral persistence. It is also shown how well diagnosed and bias free cohorts can reveal patterns often missed in self-reported cases and the potential for predictive tools that combine genetic and clinical data.},
}

@article {pmid41904442,
year = {2026},
author = {Martoreli Júnior, JF and Sousa, LRM and Pedroso, AO and Lima, LDES and Gusmão, CMP and Zamarioli, CM and Menegueti, MG and de Oliveira E Silva, AC and Ferreira, GRON and Gir, E and Reis, RK},
title = {Prevalence and predictive factors of long COVID in nurses in Brazil.},
journal = {BMC infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12879-026-13176-y},
pmid = {41904442},
issn = {1471-2334},
}

@article {pmid41905866,
year = {2026},
author = {Qiu, W},
title = {Comment on "association of symptoms of neuropsychological long COVID with imaging and plasma biomarkers".},
journal = {Journal of the neurological sciences},
volume = {},
number = {},
pages = {125883},
doi = {10.1016/j.jns.2026.125883},
pmid = {41905866},
issn = {1878-5883},
}

@article {pmid41898534,
year = {2026},
author = {Krüger, AL and Schmidt, F and Bloch, W and Haiduk, B and Grau, M},
title = {Personalized Exercise Training Modulates Red Blood Cell Rheology and Morphology in Long COVID.},
journal = {International journal of molecular sciences},
volume = {27},
number = {6},
pages = {},
doi = {10.3390/ijms27062671},
pmid = {41898534},
issn = {1422-0067},
mesh = {Humans ; *COVID-19/blood/therapy/physiopathology ; Male ; Female ; *Erythrocytes/pathology/cytology ; Middle Aged ; Erythrocyte Deformability ; *Exercise/physiology ; Adult ; Pilot Projects ; Longitudinal Studies ; SARS-CoV-2 ; Erythrocyte Aggregation ; Rheology ; Aged ; Hemorheology ; *Exercise Therapy/methods ; },
abstract = {Long COVID is associated with persistent fatigue, exercise intolerance, and microcirculatory dysfunction. Altered red blood cell (RBC) rheology, including impaired deformability and increased aggregation, may contribute to these symptoms, yet the effects of exercise interventions remain unclear. This longitudinal pilot study tested whether an individualized, symptom-responsive exercise program improves RBC rheology in Long COVID. A total of 170 (110 f/60 m) participants entered a five-phase training protocol; 15 completed all phases and formed a predefined finisher subgroup. RBC aggregation and deformability, hematological parameters, and coagulation- and iron-related markers were assessed across phases; RBC morphology was additionally analyzed in finishers at baseline and completion. In the total cohort, aggregation indices decreased across training phases, accompanied by prolonged aggregation half-time, while hematological, coagulation, and iron markers remained largely unchanged. The deformability changes were not uniform in the full cohort; however, finishers showed a deformability shift after completion. Importantly, morphologically abnormal RBC decreased in finishers, and these changes correlated with deformability, suggesting that improved rheology is linked to reduced RBC abnormalities. Prospectively, larger controlled studies are needed to confirm these results and to evaluate whether exercise-induced rheological improvements translate into functional and symptomatic benefits.},
}

Humans
*COVID-19/blood/therapy/physiopathology
Male
Female
*Erythrocytes/pathology/cytology
Middle Aged
Erythrocyte Deformability
*Exercise/physiology
Adult
Pilot Projects
Longitudinal Studies
SARS-CoV-2
Erythrocyte Aggregation
Rheology
Aged
Hemorheology
*Exercise Therapy/methods

@article {pmid41899098,
year = {2026},
author = {Wang, J and Liu, L and Zhou, N and Zhang, Y and Liu, H and Xu, C and Wu, Y and Zhang, J},
title = {The Clinical Research of the Chronic Cough After COVID-19 Infection.},
journal = {Journal of clinical medicine},
volume = {15},
number = {6},
pages = {},
doi = {10.3390/jcm15062174},
pmid = {41899098},
issn = {2077-0383},
abstract = {Objective: To investigate the epidemiology, clinical characteristics, and potential risk factors of chronic cough following SARS-CoV-2 infection. Methods: A total of 1434 patients with post-COVID-19 cough were categorized into acute, subacute, and chronic subgroups by cough duration, with clinical data analyzed across subgroups. Questionnaire surveys were conducted in chronic cough patients, followed by an 18-21-month follow-up. Results: 1. Significant intergroup differences were observed among the three groups in: the number of patients with rhinitis and/or pharyngitis history, cough with chest tightness, cough with pharyngeal symptoms, and sensitivity to irritating odors and cold air. 2. The chronic group had a significantly lower platelet count but higher eosinophil and basophil percentages than the acute group. 3. The chronic group showed significantly lower values than the subacute group in multiple pulmonary function indices: FVC, FEV1, FEV1/FVC, PEF, MEF25, MEF75, MEF50, MMEF75/25, MEF75%, MEF50%, MEF25%, MMEF75/25%, DLCO, and DLCO%. 4. Chest CT findings: the chronic group had significantly lower rates of infected lesions, cord-like opacities, and ground-glass shadows than the acute group, but a higher rate of micro-nodules than the subacute group. 5. At follow-up, the cough and non-cough groups differed significantly in nighttime cough scores and the proportion of cough with chest tightness, as well as in pulmonary function parameters: FVC, FEV1, PEF, PEF%, MEF75, DLCO, RV% and TLC. 6. Binary logistic regression analysis identified the nocturnal cough symptom score and cough accompanied by chest tightness as independent factors influencing persistent cough 18-21 months after SARS-CoV-2 infection. Conclusions: Patients with pre-existing upper airway inflammation, laryngeal symptoms, chemical hypersensitivity, elevated eosinophil/basophil percentages, and pulmonary micro-nodules are more likely to develop chronic post-COVID cough, presenting with partial ventilatory impairment and diffusing capacity impairments.},
}

@article {pmid41899187,
year = {2026},
author = {Miwa, K},
title = {Disequilibrium, Rather than Postural Orthostatic Tachycardia Syndrome, Is the Primary Determinant of Orthostatic Intolerance in Patients with Long COVID.},
journal = {Journal of clinical medicine},
volume = {15},
number = {6},
pages = {},
doi = {10.3390/jcm15062263},
pmid = {41899187},
issn = {2077-0383},
abstract = {Background: Orthostatic intolerance (OI) is an important factor affecting daily functional capacity in patients with long COVID. Traditionally, most OI symptoms have been attributed to exaggerated sympathetic nervous system activation associated with postural orthostatic tachycardia syndrome (POTS). Disequilibrium, also referred to as postural instability, may contribute to the development of OI in patients with long COVID. Methods: This study evaluated 32 patients with long COVID using neurological examinations and the active 10-min standing test. Disequilibrium was assessed using the Romberg and tandem gait tests. OI was defined as the inability to complete the active 10-min standing test. Results: Seven patients (22%) were diagnosed with OI. None of them had POTS, whereas six (86%) demonstrated disequilibrium, as detected by the Romberg and/or tandem gait test. POTS was observed in eight patients (25%), none of whom had OI. Disequilibrium was observed in nine patients (28%), six of whom (67%) had OI. Multiple regression analysis revealed that disequilibrium was positively associated with OI (r = 0.64, p < 0.001), whereas POTS was inversely associated (r = -0.38, p < 0.05). After 6 weeks of oral minocycline treatment in six patients and 2 weeks of repetitive transcranial magnetic stimulation therapy following minocycline in the other one patient, symptom amelioration was reported in six patients with OI. OI concomitant with disequilibrium recovered in five of the six patients treated and tested, although one patient who experienced symptom recovery failed to undergo the repeated standing test. Conclusions: Disequilibrium, rather than POTS, was the primary determinant of OI in patients with long COVID.},
}

@article {pmid41899272,
year = {2026},
author = {Suárez-Moreno, N and Gómez-Sánchez, L and Arroyo-Romero, S and Navarro-Cáceres, A and Domínguez-Martín, A and Lugones-Sánchez, C and González-Sánchez, S and Sánchez-Moreno, A and Rodríguez-Sánchez, E and García-Ortiz, L and Gómez-Marcos, MA and Gómez-Sánchez, M and Navarro-Matias, E},
title = {Association Between Metabolic Syndrome Components and Vascular Structure and Function in Subjects with a Diagnosis of Long COVID: The BioICOPER Study.},
journal = {Journal of clinical medicine},
volume = {15},
number = {6},
pages = {},
doi = {10.3390/jcm15062348},
pmid = {41899272},
issn = {2077-0383},
support = {PI25/00071//Instituto de Salud Carlos III/ ; GRS 2707/C/24; GRS 3007/C/2024//The government of Castilla y León/ ; },
abstract = {Background: Long COVID is characterised by persistent symptoms after SARS-CoV-2 infection, and its impact on cardiovascular health is a growing concern. This study aimed to evaluate the association between the presence and severity of metabolic syndrome and vascular structural and functional in patients with long COVID. Methods: We conducted a cross-sectional study of 304 adults diagnosed with long COVID. Vascular health was assessed using carotid intima-media thickness to evaluate arterial structure, and pulse wave velocity to assess arterial stiffness. Metabolic syndrome was defined according to international criteria. Multiple regression models were performed to analyse the association between the number of metabolic syndrome components and vascular parameters, adjusting for age, sex, lifestyle and pharmacological treatments. Results: All vascular measures show a positive association with artery pressure. All measures except cardio-ankle vascular index were positively associated with the number of metabolic syndrome components. Carotid intima-media thickness, carotid-femoral pulse wave velocity and vascular ageing index were positively associated with waist circumference. Brachial-ankle pulse wave was positively associated with all metabolic syndrome components and showed an inverse association with HDL-cholesterol. Cardio-ankle vascular index was inversely associated with waist circumference. Conclusions: In conclusion, among adults with long COVID, metabolic syndrome and the accumulation of its components are associated with poorer vascular structure, function, and vascular ageing.},
}

@article {pmid41900303,
year = {2026},
author = {Hommos, L and Gohil, H and Rob, M and Manyama, J and Ramy, H and Naseem, N and Nishan, H and Ibrahim, RS and Ibrahim, SS and Njoku, VCE and Al-Mutawa, I and Khan, AF and Holroyd, S and Zakaria, D},
title = {Long-Term Thyroid Complications Post-COVID-19: A Systematic Review.},
journal = {Microorganisms},
volume = {14},
number = {3},
pages = {},
doi = {10.3390/microorganisms14030543},
pmid = {41900303},
issn = {2076-2607},
abstract = {Coronavirus disease 2019 (COVID-19) is increasingly shown to be a multisystem disorder with long-term complications, including endocrine system complications. The thyroid gland is also susceptible, as it contains ACE2 receptors, making it exposed to both direct viral damage and autoimmune-mediated dysfunction. Recent reports document the various thyroid complications that persist well after the acute infection phase. This systematic review investigates the long-term thyroid complications in individuals with a history of SARS-CoV-2 infection. A comprehensive literature search across several databases was conducted. Eligible studies reported new onset long-term thyroid complications occurring post-COVID-19 infection. Abstract and full-text screening as well as data extraction and quality assessment was performed by two independent reviewers. Only 28 studies met our inclusion criteria, reporting 419 patients from 18 countries. These studies included case reports, case series, cohort, and cross-sectional studies. Reported thyroid disorders included subacute thyroiditis, thyrotoxicosis, hyperthyroidism (including Graves' disease), isolated high T3/T4, hypothyroidism, central hypothyroidism, and non-thyroidal illness syndrome (NTIS). While many of these eventually resolved, a significant portion persisted or recurred, especially autoimmune thyroiditis. COVID-19 is associated with a range of long-term thyroid complications. Although some cases are temporary, others last, especially autoimmune thyroid disorders. Proposed mechanisms include direct viral cytotoxicity, cytokine-mediated Hypothalamic-Pituitary-Thyroid (HPT) axis suppression, post-viral autoimmunity, vascular injury, and neuroendocrine disruption. Routine thyroid function monitoring in COVID-19 survivors, particularly those with severe disease or persistent symptoms is recommended, and larger prospective studies are needed to better understand incidence and outcomes.},
}

@article {pmid41890193,
year = {2026},
author = {Zhu, B and Qu, S and Li, J and Deng, W and Shen, WJ and Chen, J},
title = {The mechanisms underlying COVID-19 induced insulin resistance: a narrative review.},
journal = {Frontiers in endocrinology},
volume = {17},
number = {},
pages = {1781679},
pmid = {41890193},
issn = {1664-2392},
mesh = {Humans ; *Insulin Resistance/physiology ; *COVID-19/complications/metabolism ; SARS-CoV-2 ; Gastrointestinal Microbiome ; Diabetes Mellitus/etiology/metabolism ; },
abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, has resulted in a significant increase in insulin resistance and new-onset diabetes among recovered individuals. This review examines the multifactorial mechanisms underlying these metabolic complications, including activation of the immune system and inflammatory cascades, lifestyle changes, nutritional deficiencies, imbalances in amino acid metabolism, alterations in ketogenesis, disruptions in the gut microbiome, psychological impacts, and COVID-19 vaccines. We discuss how these factors collectively contribute to insulin resistance, particularly in the context of COVID-19, and highlight potential therapeutic strategies, such as dietary interventions and ACE2 activators, that may mitigate these effects. Our analysis underscores the need for targeted approaches to prevent and treat insulin resistance in post-COVID-19 patients, emphasizing the importance of understanding the pandemic's long-term metabolic consequences.},
}

Humans
*Insulin Resistance/physiology
*COVID-19/complications/metabolism
SARS-CoV-2
Gastrointestinal Microbiome
Diabetes Mellitus/etiology/metabolism

@article {pmid41890992,
year = {2026},
author = {Chakravarty, D and Dandekar, R and Lashkari, VD and Tilton, I and McAlpine, L and Chiarella, J and Nelson, A and Ngo, T and Chen, P and Wang, G and Saxena, A and Castillo-Rojas, B and Zorn, K and Tribble, DR and Burgess, TH and Rubin, LH and Richard, SA and Agan, BK and Pollett, SD and Farhadian, S and Spudich, S and Pleasure, SJ and Wilson, MR},
title = {Autoantibody landscapes in neurological Long COVID and post-COVID cognitive impairment show heterogeneity without a shared disease signature.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
doi = {10.64898/2026.03.19.26348833},
pmid = {41890992},
abstract = {BACKGROUND: Neurological Long COVID (n-LC) includes persistent cognitive and autonomic symptoms after SARS-CoV-2 infection. Prior studies of post-COVID conditions have described diverse humoral autoreactivity, but findings are heterogeneous, and it remains unclear whether n-LC is associated with a consistent CNS-directed humoral signature.

METHODS: We performed a cross-cohort case-control analysis to detect autoantibodies in cerebrospinal fluid (CSF) and serum from n-LC participants. In the Yale COVID Mind Study cohort, CSF from n-LC participants and from pre-pandemic and post-COVID asymptomatic controls was assessed by mouse brain immunofluorescence and proteome-wide phage immunoprecipitation sequencing (PhIP-Seq), with candidate reactivities evaluated by orthogonal assays and supervised modeling. In the Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases with Pandemic Potential (IDCRP EPICC) cohort, post-COVID sera collected prior to iPhone- or iPad-based cognitive screening were profiled by PhIP-Seq and compared between participants with and without cognitive impairment.

RESULTS: CSF immunoreactivity on mouse brain tissue was observed in both n-LC and controls, with similar overall frequencies, although n-LC participants more often showed nuclear-predominant staining patterns. PhIP-Seq identified sparse, largely patient-specific peptide reactivities to nuclear and neuronal proteins in CSF and serum. Supervised models provided limited discrimination between cases and controls. Candidate autoantigens had limited disease specificity on orthogonal testing. EPICC serum autoantibody profiling similarly failed to distinguish individuals with and without cognitive impairment.

CONCLUSIONS: Across cohorts and compartments, n-LC did not exhibit a shared autoantibody signature. These findings support the absence of a dominant, common CNS autoantibody-mediated mechanism in n-LC.

FUNDING: Grants HU00012020067, HU00012120103, HU00011920111, R01NS125693, R01MH125737, R01AI157488 from Defense health program and NIH.},
}

@article {pmid41891379,
year = {2026},
author = {Babaeipour, R and Fox, MS and Parraga, G and Ouriadov, A},
title = {Benchmarking Hybrid CNN-Transformer Versus Pure Transformer Architectures for Accelerated Hyperpolarized [129]Xe MRI Reconstruction.},
journal = {Journal of magnetic resonance imaging : JMRI},
volume = {},
number = {},
pages = {},
doi = {10.1002/jmri.70314},
pmid = {41891379},
issn = {1522-2586},
support = {R9245A04//Natural Sciences and Engineering Research Council of Canada/ ; },
abstract = {BACKGROUND: Hyperpolarized [129]Xe MRI faces technical challenges including low signal-to-noise ratio and breath-hold constraints. Current literature focuses on proprietary deep learning methods or image-domain enhancements.

PURPOSE: To present a comprehensive evaluation of transformer and hybrid CNN-transformer architectures integrating dual-domain (k-space and image) processing for HP [129]Xe MRI reconstruction.

STUDY TYPE: Retrospective.

POPULATION: Two hundred five participants (22 healthy [male and female, 18-85 years], 26 COPD [male and female, 50-85 years], 90 asthma [male and female, 18-70 years], 67 long-COVID [male and female, 18-70 years]) yielding 1640 2D slices. Dataset split: 80% training (1312 slices), 10% validation (164 slices), 10% test (164 slices).

FIELD STRENGTH/SEQUENCE: 3 T; 3D fast gradient-recalled echo.

ASSESSMENT: Five architectures were compared: KTMR (hybrid transformer-CNN), KIKI-net (pure CNN), ReconFormer, SwinMR, and MR-IPT (pure transformer) at acceleration factors of 3, 7, and 10. Performance was assessed using peak signal-to-noise ratio (PSNR), structural similarity index measure (SSIM), and normalized mean squared error (NMSE). Ventilation defect percentage (VDP) agreement with semi-automated analysis was evaluated.

STATISTICAL TESTS: Friedman test with post hoc Dunn's test and Benjamini-Hochberg correction for multiple comparisons. Significance level: p < 0.05.

RESULTS: At 10-fold acceleration, KTMR produced PSNR of 36.4 ± 2.8 dB and SSIM of 0.88 ± 0.12, significantly outperforming KIKI-net (32.5 ± 3.4 dB, 0.81 ± 0.12), ReconFormer (29.7 ± 2.6 dB, 0.76 ± 0.12), SwinMR (30.5 ± 2.8 dB, 0.76 ± 0.09), and MR-IPT (28.8 ± 2.4 dB, 0.74 ± 0.11). VDP measurements showed mean bias of 1.94% at 3-fold, 2.12% at 7-fold, and 2.69% at 10-fold acceleration.

DATA CONCLUSION: KTMR demonstrated superior performance for HP [129]Xe MRI reconstruction at high acceleration factors.

EVIDENCE LEVEL: 3.

TECHNICAL EFFICACY: Stage 1.},
}

@article {pmid41892619,
year = {2026},
author = {Guzmán Priego, CG and Villalpando, JMG and Baeza Flores, GDC and Ble Castillo, JL and Celorio Méndez, KDS and Juárez Rojop, IE and Martínez López, MC and López Villarreal, SM and Rodríguez Luis, OE and Quiroz Gómez, S and Romero Tapia, SJ and García Orozco, JM and López Nácar, WS and Salinas Terrazas, OO and Jiménez Aragón, KA},
title = {Cognitive and Neuropsychiatric Sequelae After SARS-CoV-2 Infection: A Narrative Review and Exploratory Cross-Sectional Study of Neurofilament Light Chain and GFAP.},
journal = {Brain sciences},
volume = {16},
number = {3},
pages = {},
doi = {10.3390/brainsci16030276},
pmid = {41892619},
issn = {2076-3425},
abstract = {Background: Persistent cognitive and neuropsychiatric symptoms have been increasingly reported as part of the post-COVID-19 condition. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are circulating biomarkers of neuronal and astrocytic injury that increase during acute SARS-CoV-2 infection; however, their role in long-term neuropsychiatric sequelae remains unclear. Objective: To provide a narrative overview of cognitive and neuropsychiatric sequelae following SARS-CoV-2 infection and to explore the association of plasma NfL and GFAP concentrations with cognitive impairment and neuropsychiatric symptoms in individuals recovered from COVID-19. Methods: A narrative review of the literature was conducted, followed by an exploratory cross-sectional study including 41 adults recovered from SARS-CoV-2 infection. Participants were classified according to acute disease severity into two groups. Cognitive function was assessed using MoCA, and neuropsychiatric symptoms were evaluated using DASS-21. Plasma NfL and GFAP concentrations were measured by ELISA. Group comparisons and Spearman correlation analyses were performed. Results: A total of 41 individuals were studied; they recovered from moderate or severe COVID-19 and exhibited a higher prevalence of cognitive impairment and neuropsychiatric symptoms compared with those who recovered from mild or asymptomatic infection. Plasma NfL and GFAP concentrations did not differ significantly between severity groups. NfL showed a weak association with the presence of post-COVID-19 condition. Conclusions: This study highlights the high burden of persistent cognitive and neuropsychiatric symptoms following moderate and severe SARS-CoV-2 infection. The absence of sustained elevations in circulating NfL and GFAP nearly two years after infection suggests that ongoing symptoms may involve mechanisms beyond overt neuronal or astrocytic injury.},
}

@article {pmid41895458,
year = {2026},
author = {Fehrer, A and Windzio, L and Schoening, S and Steiner, S and Aschenbrenner, AC and Babel, N and Behrends, U and Bellmann-Strobl, J and Cammà, G and Cash, A and Doehner, W and den Dunnen, J and Fluge, Ø and Franke, C and Hoffmann, K and Kedor, C and Kim, L and Löhden, W and Mella, O and Mihatsch, LL and Peluso, MJ and Puta, C and Putrino, D and Ramoji, A and Sato, W and Sawitzki, B and Schlieper, G and Schoenfeld, Y and Seifert, M and Sigurdsson, F and Slaghekke, A and Sommerfelt, K and Sotzny, F and Stein, E and Steinacker, JM and Stingl, M and Systrom, DM and Tronstad, KJ and Wirth, K and Wörmann, B and Wüst, RCI and Yamamura, T and Scheibenbogen, C},
title = {Expert perspectives on Myalgic encephalomyelitis/chronic fatigue syndrome - Insights from the 3[rd] International Conference of the Charité Fatigue Center.},
journal = {Autoimmunity reviews},
volume = {},
number = {},
pages = {104043},
doi = {10.1016/j.autrev.2026.104043},
pmid = {41895458},
issn = {1873-0183},
abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multisystemic disorder mostly triggered by viral infections, with core symptoms including post-exertional malaise (PEM), fatigue, pain, and cognitive dysfunction. Its prevalence has increased significantly in the context of the coronavirus disease 2019 (COVID-19) pandemic. Despite its severity and impact on patients' quality of life, ME/CFS remains poorly understood. On May 12 and 13, 2025, the 3[rd] International Conference hosted by the Charité Fatigue Center brought together nearly 200 researchers from various disciplines on-site, and around 3,700 participants online to discuss recent advances in ME/CFS research, diagnostics, clinical care, and therapeutic trials. The program featured 33 lectures by international experts on key topics such as post-COVID syndrome (PCS), care structures, and pathophysiological mechanisms including cardiovascular dysregulation, immune dysregulation, autoimmune mechanisms, and metabolic dysfunction. In addition, results from clinical trials addressing disease mechanisms, including those specifically targeting autoantibodies, were presented. While public awareness and funding opportunities have increased in the wake of the pandemic and the emergence of PCS, ME/CFS remains severely underresearched. Sustained and adequately funded research efforts are urgently required to advance understanding, identify diagnostic markers, and develop targeted therapeutic interventions.},
}

@article {pmid41881896,
year = {2026},
author = {Nakase, T},
title = {Response to the letter of the editor on "association of symptoms of neuropsychological long COVID with imaging and plasma biomarkers".},
journal = {Journal of the neurological sciences},
volume = {485},
number = {},
pages = {125882},
doi = {10.1016/j.jns.2026.125882},
pmid = {41881896},
issn = {1878-5883},
}

@article {pmid41882228,
year = {2026},
author = {Zeidan, RK and Al-Bluwi, N and Shukla, A and AlZubaidi, H and Awad, M and Hussein, A and Agha, R and Othman, D and Sharif, FMJ and Hussein, AC and Mahmoud, S and Obaideen, A and Younes, SB and AbuEbaid, M and Obaideen, AM and AlHano, Z and Mohammed, G and AlHajjaj, M and Halwani, R and Saddik, B},
title = {Symptoms, risk factors, and health outcomes of long COVID in the United Arab Emirates.},
journal = {Scientific reports},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41598-026-44682-3},
pmid = {41882228},
issn = {2045-2322},
support = {Grant code:150389//University of Sharjah/ ; },
}

@article {pmid41883772,
year = {2026},
author = {Jain, A and Saraswat, P and Sharma, A and Sharma, V and Jain, R},
title = {Persistent health complications in COVID-19 hospitalized patients at tertiary care hospital in Western India.},
journal = {World journal of critical care medicine},
volume = {15},
number = {1},
pages = {114620},
pmid = {41883772},
issn = {2220-3141},
abstract = {BACKGROUND: Long coronavirus disease (COVID) is a condition characterized by persistent health issues following severe acute respiratory syndrome coronavirus 2 infection. The condition remains poorly understood, especially in terms of long-term impact on health and the quality of life. This study hypothesized that majority of the discharged patients experience long-term post-COVID-19 complications.

AIM: To evaluate the long-term post-COVID-19 complications and its impact on the patients' quality of life.

METHODS: This retrospective cohort study, with telephonic interview-based follow-up, was conducted at a tertiary care hospital in western India between March and August 2024. The medical records of the patients hospitalized with COVID-19 during the second wave (between March and June 2021) and discharged, were reviewed. The data were collected from the patients via structured telephonic interviews that focused on post-infection sequelae across various bodily systems and was summarized using percentages and proportions.

RESULTS: A total of 1139 patients who met the inclusion criteria, participated in the study with a follow-up period of three years. Amongst the survivors (n = 1052) at the end of three years, 150 (14.25%) developed new or ongoing diseases after recovery from acute COVID-19, while 51 (4.8%) were still under treatment at the time of follow-up. Amongst these 150 long-COVID-19 patients, pulmonary disease (n = 27, 2.57%), body pain (n = 20, 1.90%), coronary artery disease or angioplasty, and diabetes mellitus (n = 17, 1.61% each), hypertension (n = 16, 1.52%), and fatigue (n = 13, 1.24%) were frequently reported. Although statistically insignificant, the patients who received three or more vaccine doses after the second wave of the pandemic reported slightly lower rates of post-COVID-19 morbidity and treatment requirements.

CONCLUSION: The current study highlights the burdens of long-term complications following COVID-19 infection, with a broad spectrum of post-infection sequelae. However, the impact of vaccination on the course of development and treatment of long COVID could not be ascertained. This finding emphasizes the need for continued research and healthcare planning to address the persistent impact of COVID-19 upon the survivors.},
}

@article {pmid41883830,
year = {2026},
author = {Chu, X and Hou, S and Zhu, Q and Chang, J and Gong, L and Wu, J},
title = {Analysis of Long COVID characteristics and risk factors in individuals infected with COVID-19: a follow-up study based on a cohort of 2,792 participants.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1760355},
pmid = {41883830},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/epidemiology/blood ; Male ; Female ; Middle Aged ; Risk Factors ; Follow-Up Studies ; Adult ; Prospective Studies ; SARS-CoV-2 ; Aged ; China/epidemiology ; },
abstract = {BACKGROUND: Since the emergence of SARS-CoV-2 in 2019, Long COVID has emerged as a significant global public health challenge. The identification of accessible biomarkers and risk factors is critical to enabling early intervention and improving long-term outcomes.

METHODS: This prospective cohort study enrolled 2,792 individuals with confirmed COVID-19 from Anhui Province in September 2024. A propensity score matching analysis was performed using a 1:4 ratio. Cases and matched controls were selected from cohort, serum sample were analyzed to assess hematological parameters. Multivariable logistic regression models were applied to identify independent risk factors associated with the development of Long COVID.

RESULTS: 2,792 participants (average age 51.64 years) identified 182 (6.52%) long COVID patients during follow-up. Common symptoms included fatigue, cough, insomnia, throat discomfort, and appetite loss. After propensity score matching, risk factors were age, more severe acute symptoms. Long COVID patients exhibited higher red blood cell counts but lower hemoglobin-related indices and platelet count.

CONCLUSION: This study confirms the persistent risk of Long COVID following reinfection, with heightened susceptibility associated with advanced age, specific acute-phase symptoms. Alterations in routine hematological parameters may serve as valuable biomarkers for the monitoring and management of Long COVID.},
}

Humans
*COVID-19/epidemiology/blood
Male
Female
Middle Aged
Risk Factors
Follow-Up Studies
Adult
Prospective Studies
SARS-CoV-2
Aged
China/epidemiology

@article {pmid41883910,
year = {2026},
author = {Montoya, S and Alvarez Ramirez, D and Chavarría, R and Zamora, EL and Soto Cordero, CA},
title = {Anesthesia in Patients With Long COVID or Post-infectious Respiratory Sequelae Undergoing Emergency Surgery: Clinical Challenges and Perioperative Strategies.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e104067},
pmid = {41883910},
issn = {2168-8184},
abstract = {The COVID-19 pandemic has left lasting health consequences that extend beyond the acute infection phase, with long COVID emerging as a complex multisystem condition that poses significant challenges in the perioperative setting. Patients with post-infectious respiratory or cardiovascular sequelae present an increased anesthetic risk due to persistent inflammation, pulmonary fibrosis, reduced lung compliance, and myocardial dysfunction. These alterations predispose to hypoxemia, arrhythmias, and hemodynamic instability during surgery, making preoperative assessment and individualized anesthetic planning essential. Comprehensive evaluation, including functional tests, cardiac and pulmonary imaging, and laboratory analysis, allows early identification of residual organ dysfunction that can compromise perioperative safety. Anesthetic management must be adapted to the patient's physiological condition, emphasizing lung-protective ventilation, cautious fluid therapy, and close hemodynamic monitoring. Regional anesthesia is preferred when feasible to minimize airway manipulation and reduce respiratory complications, while total intravenous anesthesia represents a safer option when general anesthesia is required. Postoperative care focuses on extended respiratory monitoring, multimodal analgesia to limit opioid use, and the implementation of pulmonary physiotherapy and antithrombotic prophylaxis to prevent complications. Psychological support is also recommended to address post-COVID anxiety and fatigue, contributing to holistic recovery. Although clinical guidelines provide useful recommendations, current evidence remains limited and heterogeneous. Further research is required to clarify the pathophysiological mechanisms of long COVID, evaluate anesthetic drug interactions, and develop validated risk stratification tools. Establishing standardized, evidence-based perioperative protocols is essential to improve outcomes and ensure patient safety in individuals with long COVID undergoing emergency surgery.},
}

@article {pmid41884491,
year = {2026},
author = {Ayoubkhani, D and Atchison, CJ and Banerjee, A and Brightling, C and Calvert, M and Diamond, I and Eggo, RM and Elliott, P and Evans, RA and Haroon, S and Herrett, E and Nafilyan, V and O'Mahoney, LL and Pinto Pereira, SM and Routen, A and Shafran, R and Stephenson, T and Sterne, J and Ward, H and Zaccardi, F and Khunti, K},
title = {Considerations for epidemiological studies investigating emerging post-acute infection syndromes: Long Covid as a case study.},
journal = {EClinicalMedicine},
volume = {94},
number = {},
pages = {103833},
pmid = {41884491},
issn = {2589-5370},
abstract = {Epidemiological research studies into Long Covid, currently defined by prolonged symptoms after SARS-CoV-2 infection, have reported widely varying prevalence estimates. As well as rapidly evolving scientific knowledge of Long Covid, these differences are partly driven by substantial methodological heterogeneity between studies, including the outcome definition of Long Covid; duration of follow-up; study design, period and population; sampling frame; data source; and the statistical techniques employed. Having a robust understanding of the prevalence of and risk factors for Long Covid is essential for informing treatment pathways, service provision and policy decisions. In preparation for the public health response to future epidemics and pandemics, this review outlines key epidemiological and statistical considerations and recommendations when designing studies of emerging post-acute infection syndromes, focussing on Long Covid as a case study.},
}

@article {pmid41884792,
year = {2026},
author = {Yamamoto, K and Iwanaga, N and Umemura, A and Sawai, T and Sumiyoshi, M and Hashiguchi, K and Mori, Y and Ishii, H and Futsuki, Y and Kiyohara, M and Ota, K and Kosai, K and Sasaki, D and Takamatsu, Y and Inoue, S and Morita, K and Tsutsui, S and Ashizawa, K and Takazono, T and Sakamoto, N and Hosogaya, N and Tashiro, M and Tanaka, T and Izumikawa, K and Yanagihara, K and Mukae, H},
title = {Symptom relief and cytokine modulation by clarithromycin in mild COVID-19 pneumonia: an exploratory, multicenter, randomized-controlled open-label trial (CAME-COVID study).},
journal = {Therapeutic advances in infectious disease},
volume = {13},
number = {},
pages = {20499361261431488},
pmid = {41884792},
issn = {2049-9361},
abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) remains an epidemic worldwide, and long COVID is a major social concern. Therapeutic options for relieving symptoms of COVID-19 pneumonia are limited. Clarithromycin (CAM), a macrolide antimicrobial, also functions as an immunomodulator.

OBJECTIVES: To assess the efficacy of CAM in improving clinical symptoms and attenuating inflammation in patients with mild COVID-19, with the aim of preventing progression to severe disease.

DESIGN: An exploratory, multicenter, randomized-controlled, open-label trial.

METHODS: This trial enrolled patients with mild COVID-19 pneumonia without oxygen supplementation from May 2021 through February 2022 in eight hospitals in Japan. Patients were randomly assigned in a 1:1:1 ratio to groups A (CAM 800 mg/day, 7 days), B (CAM 400 mg/day, 7 days), or C (standard treatment). The primary endpoint was the number of days required for 50% improvement in seven symptoms (fatigue, headache, cough, shortness of breath, taste/smell disturbance, and general unwellness) based on severity scores. Secondary endpoints included inflammatory cytokines, viral load, immunoglobulins, and pneumonia infiltrations.

RESULTS: A total of 56 patients were enrolled and randomized. The primary endpoint did not differ significantly between groups (A: 5.0 days, B: 4.0 days, C: 4.0 days), though the seven symptoms tended to disappear earlier in group A than group C (p = 0.08), and fatigue significantly decreased in group A (p = 0.005). Serum inflammatory cytokines, tumor necrosis factor (TNF)-α, granulocyte colony stimulating factor (G-CSF), interleukin (IL)-7, IL-15, and proliferation factors, transforming growth factor (TGF)-α, fibroblast growth factor (FGF)-2, and fms-like tyrosine kinase 3 ligand (Flt3-L), significantly decreased in group A. IL-8 and IFN-γ in nasal drip significantly decreased in both group A and B. Serious adverse events did not increase in CAM groups, though mild gastrointestinal and liver events occurred in group A.

CONCLUSION: CAM is safe and potentially useful for improving partial COVID-related symptoms and exerting immunomodulation during COVID-19 pneumonia.

TRIAL REGISTRATION: Japan Registry of Clinical Trials (jRCT; registration number: jRCTs071210011; https://jrct.mhlw.go.jp/latest-detail/jRCTs071210011) on April 13, 2021.},
}

@article {pmid41887765,
year = {2026},
author = {Wing, K and Morton, C and Mahalingasivam, V and Costello, RE and Cowling, T and Lin, LY and Inglesby, P and Walker, A and , and , and Bacon, S and Mehrkar, A and Goldacre, B and Evans, S and Douglas, I and Eggo, R and Tomlinson, L and Mansfield, KE},
title = {Occurrence and persistence of symptoms, diagnoses and prescriptions after community-diagnosed COVID-19: a matched cohort study using the OpenSAFELY platform.},
journal = {Journal of epidemiology and community health},
volume = {},
number = {},
pages = {},
doi = {10.1136/jech-2025-225474},
pmid = {41887765},
issn = {1470-2738},
abstract = {BACKGROUND: We aimed to explore the occurrence and persistence of symptoms, diagnoses and prescribing after COVID-19 among populations from earlier (wave 2) and later (wave 4) in the pandemic.

METHODS: With the approval of NHS England, we analysed data from English primary care using The Phoenix Partnership SystmOne through the OpenSAFELY data analytics platform. Individuals with community-diagnosed COVID-19 September 2020-January 2021 (wave 2) were matched to contemporary (2020-2021) and historical (2017-2018) comparators. Individuals with community COVID-19 December 2021-March 2022 (wave 4) were matched to contemporary comparators (last follow-up 31 March 2023). Occurrence of each of (1) long-COVID symptoms; (2) primary-care diagnoses and (3) new prescriptions was analysed at any time during 1 year after COVID-19 and at: 4-12 weeks, 12 weeks-6 months and 6 months-12 months after COVID-19 to assess persistence.

RESULTS: 902 885 COVID-19 cases (wave 2) matched to 4 449 265 contemporary (no-COVID-19) comparators. 1 553 160 COVID-19 cases (wave 4) matched to 7 624 770 contemporary comparators. Positive wave 2 associations after COVID-19 were observed for hair loss (OR 1.57, 95% CI 1.48 to 1.66), mobility impairment (1.41, 1.35 to 1.48), fatigue (1.46, 1.42 to 1.49), cognitive impairment (1.39, 1.34 to 1.44) and loss of taste or smell (1.38, 1.31 to 1.46). At 6-12 months reporting persisted for mobility impairment, fatigue and cognitive impairment. There were small increases in new prescriptions for NSAIDs (1.24, 1.23 to 1.26), drugs to treat infections (1.24, 1.23 to 1.25) and musculoskeletal problems (1.23, 1.22 to 1.25). Wave 4 associations were generally weaker than Wave 2.

CONCLUSIONS: Long-COVID symptoms and new prescribing generally reduce over time and are potentially less problematic following less severe illness. Fatigue/cognitive/mobility symptoms persist following COVID-19.},
}

@article {pmid41876769,
year = {2026},
author = {Azhir, A and Cheng, J and Tian, J and Murphy, SN and Estiri, H},
title = {Paxlovid shows organ-specific and age-specific impacts on risk of developing post-acute sequelae of COVID-19.},
journal = {Communications medicine},
volume = {},
number = {},
pages = {},
doi = {10.1038/s43856-026-01535-4},
pmid = {41876769},
issn = {2730-664X},
support = {R01AI165535//U.S. Department of Health & Human Services | NIH | National Institute of Allergy and Infectious Diseases (NIAID)/ ; },
abstract = {BACKGROUND: The impact of antiviral therapies, including Paxlovid, on post-acute sequelae of COVID-19 (PASC) remains inconclusive.

METHODS: We analyzed data from 19,413 patients (age > 18) from a validated PASC research cohort in New England who experienced at least one COVID-19 infection episode between January 1, 2022, and June 7, 2022, totaling 22,094 episodes. Multivariable logistic regression with inverse probability weights was used to infer the causal effects of Paxlovid treatment during acute infection and the risk of PASC overall (primary outcome), stratified by age group and organ system.

RESULTS: Across all age groups, Paxlovid shows no statistically significant effect in lowering overall PASC risk. Stratification by organ system reveals a 37% reduction in gastrointestinal PASC (OR: 0.63; 95% CI: [0.468, 0.850]; p < 0.05) but a 97.4% increase in the risk of eye and ear-related PASC (OR: 1.974; 95% CI: [1.048, 3.718]; p < 0.05). Among patients aged 65 to 75 years who were not hospitalized, Paxlovid is associated with a 16.8% reduction in PASC risk (OR: 0.832; 95% CI: [0.7, 0.989]; p < 0.05). No statistically significant effects is observed for other organ-specific outcomes.

CONCLUSIONS: Paxlovid demonstrates organ-specific effects on the risk of PASC, with a reduction in gastrointestinal symptoms and an increased risk of eye and ear-related symptoms. In older, non-hospitalized patients, Paxlovid modestly reduces overall PASC risk. These findings highlight the complexity of antiviral therapy's long-term impact and underscore the need for further research to clarify the mechanisms underlying these outcomes.},
}

@article {pmid41876788,
year = {2026},
author = {Diciolla, NS and Marques, A and Jiménez-Martín, A and Alecto-Aznar, E and Torres-Lacomba, M and Yuste-Sánchez, MJ},
title = {Physical activity coaching programme for people with Long COVID: a pilot randomised clinical trial.},
journal = {Scientific reports},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41598-026-44806-9},
pmid = {41876788},
issn = {2045-2322},
support = {FPI-UAH-20//Universidad de Alcalá/ ; III PI 2022/04//Professional College of Physiotherapists of the Community of Madrid/ ; },
}

@article {pmid41877909,
year = {2026},
author = {Wu, S and Huang, X and Liang, X and Liang, S and Wang, M and Hong, L and Chen, G and Wei, M and Ning, Y and He, Z},
title = {Clinical Characteristics and Glucocorticoids Efficacy in COVID-19 Patients with Type 2 Diabetes: A Multicenter Retrospective Study.},
journal = {Infection and drug resistance},
volume = {19},
number = {},
pages = {586849},
pmid = {41877909},
issn = {1178-6973},
abstract = {BACKGROUND: Type 2 diabetes mellitus (T2DM) patients infected with coronavirus disease 2019 (COVID-19) are at a higher risk of experiencing poorer prognoses and increased mortality. Glucocorticoids are recommended for the treatment of COVID-19, especially in patients with severe disease. However, the efficacy and safety of glucocorticoids in COVID-19 patients with T2DM remain a subject of debate.

METHODS: We conducted a multicenter, retrospective cohort study of hospitalized patients with T2DM and confirmed COVID-19 admitted between November 1, 2022 and January 31, 2023. Data on clinical manifestations, treatment strategies, and clinical outcomes were systematically collected and rigorously evaluated.

RESULTS: A total of 624 COVID-19 patients with T2DM were enrolled, comprising 259 patients with severe disease and 365 with non-severe disease. Compared with the non-severe group, the severe group demonstrated significantly elevated levels of inflammatory markers and more extensive multi-organ dysfunction. Multivariate logistic regression identified advanced age, male sex, cerebrovascular disease history, and poor fasting glucose control as independent predictors of progression to severe illness. Among patients with severe disease, glucocorticoid therapy was significantly associated with reduced in-hospital mortality and a shorter median length of stay; this association remained robust after adjustment for baseline glycemic status. Six-month post-discharge follow-up revealed no significant between-group differences in the incidence of long COVID-19 or interstitial pneumonia; however, among patients in non-severe group, those who received glucocorticoids exhibited a higher incidence of long COVID-19.

CONCLUSION: Glucose control is of particular importance for COVID-19 patients with T2DM. In mild or moderate cases, systemic use of glucocorticoid therapy should be strictly evaluated. In severe or critical cases, cautious, appropriate use of glucocorticoids may be associated with improved short-term prognosis and reduced mortality.},
}

@article {pmid41878230,
year = {2026},
author = {Choi, S and Huda, MN and John, JR and Eapen, V},
title = {The Effectiveness of Non-Pharmacological Interventions in Treating Adolescents and Young Adults with Neuropsychiatric Symptoms of Long COVID: A Systematic Review and Meta-Analysis.},
journal = {Neuropsychiatric disease and treatment},
volume = {22},
number = {},
pages = {570223},
pmid = {41878230},
issn = {1176-6328},
abstract = {BACKGROUND: The management of persistent symptoms for long COVID (eg, fatigue, concentration difficulties, sleep difficulties, loss of appetite and taste, depression, and anxiety) has not been widely studied among adolescents and young adults (AYA). This systematic review and meta-analysis aimed to synthesise and review evidence on the effectiveness of non-pharmacological interventions for AYA aged 13-25 years, presenting with long COVID symptoms.

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

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

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

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

@article {pmid41878409,
year = {2026},
author = {Nübel, J and Beyer, AK and Kümpel, L and Eckert, G and Yessimova, D and Heldt, K and Mikolajewska, A and Sarganas, G},
title = {Long COVID in adults - a current review of the long-term health effects following SARS-CoV-2 infection.},
journal = {Journal of health monitoring},
volume = {11},
number = {},
pages = {02},
pmid = {41878409},
issn = {2511-2708},
abstract = {BACKGROUND: Long-term health effects associated with SARS-CoV-2 pose major challenges for public health and health research worldwide.

METHODS: Based on an ongoing literature review, a narrative review (as of June 2025) on the epidemiology and public health implications of long COVID in adults was compiled.

RESULTS: According to population-based, controlled studies, long COVID symptoms occur with a frequency of approximately 10 to 15 % in adults infected with SARS-CoV-2. In addition to COVID-19 vaccination status and virus variant, the risk of experiencing long COVID symptoms is primarily influenced by pre-existing health conditions and sociodemographic factors. In most affected individuals, long COVID symptoms resolve within a year. Particularly multiple and prolonged symptoms can be associated with significant impairments in quality of life, everyday functioning and social participation, as well as an increased need for healthcare. In addition, there is growing evidence of an infection-associated increase in newly diagnosed symptom complexes, organ damage and chronic diseases, contributing to the ongoing public health relevance of long COVID.

CONCLUSIONS: Long COVID is not only a major burden for those affected and their families, but also has unpredictable long-term consequences for public health and the healthcare system.},
}

@article {pmid41878417,
year = {2026},
author = {Ribeiro, A and Wallraven, T and Lech, M and Adorjan, K and Stubbe, HC and Seifert, M and Wöhnl, A and Kesseler, V and Negele, J and Schmaderer, C},
title = {SARS-CoV-2 spike S1-mediated HIF-2α activation in retinal endothelial cells suggests a mechanism contributing to post-COVID endothelial dysfunction.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1770758},
pmid = {41878417},
issn = {1664-3224},
mesh = {Humans ; *Endothelial Cells/metabolism ; *Spike Glycoprotein, Coronavirus/metabolism/immunology ; *COVID-19/complications/immunology/metabolism ; Male ; Female ; Middle Aged ; *SARS-CoV-2 ; *Basic Helix-Loop-Helix Proteins/metabolism ; Aged ; *Retina/pathology/metabolism ; Signal Transduction ; Vascular Endothelial Growth Factor A/metabolism ; Adult ; Cells, Cultured ; },
abstract = {BACKGROUND: Post-COVID-19 syndrome (PCS) is characterized by persistent symptoms such as fatigue, cardiovascular abnormalities, and cognitive impairment. Endothelial dysfunction (ED) has been proposed as a contributing factor, but underlying mechanisms remain unclear. We investigated whether SARS-CoV-2 spike protein subunit 1 (S1) is sufficient to induce ED in human retinal endothelial cells (HRECs) in vitro and whether pharmacologic inhibition of HIF-2α signaling modulates endothelial barrier integrity.

METHODS: In this study, we characterized 41 PCS patients and 24 pre-pandemic healthy controls. The effects of recombinant S1 and plasma from patients with severe PCS on endothelial function were assessed in HRECs. Belzutifan was used as a pharmacologic probe to assess the role of HIF-2α signaling in S1- and plasma-associated endothelial responses.

RESULTS: PCS patients exhibited elevated erythropoietin, VEGF, and MCP-1 levels compared with controls. VEGF correlated with anti-S1 IgG and was upregulated at the mRNA level in S1-exposed HRECs. Additionally, in vitro exposure to S1 induced ROS production, transient HIF-1α and sustained HIF-2α activation, VEGFR2 upregulation, and impaired endothelial barrier integrity. Plasma from patients with severe PCS increased ROS production and induced modest alterations in endothelial barrier function in HRECs. In both S1- and PCS-plasma-treated cells, pharmacologic HIF-2α inhibition with belzutifan improved endothelial barrier integrity.

CONCLUSION: These findings identify a spike-responsive, HIF-2α-associated ED pathway in retinal endothelial cells. Modulation of this pathway altered endothelial barrier responses to both recombinant S1 and plasma from patients with PCS, highlighting a candidate mechanism that may contribute to PCS-associated vascular dysfunction.},
}

Humans
*Endothelial Cells/metabolism
*Spike Glycoprotein, Coronavirus/metabolism/immunology
*COVID-19/complications/immunology/metabolism
Male
Female
Middle Aged
*SARS-CoV-2
*Basic Helix-Loop-Helix Proteins/metabolism
Aged
*Retina/pathology/metabolism
Signal Transduction
Vascular Endothelial Growth Factor A/metabolism
Adult
Cells, Cultured

@article {pmid41878441,
year = {2026},
author = {Ray, U and Schulze Selting, A and Perera, RP and Yang, Z and Lysenkov, V and Göpel, S and Bitzer, M and Salker, MS and Ossowski, S and Riess, O and Casadei, N and Singh, Y},
title = {Dysregulated NK-cell gene expression defines the enduring symptoms of long COVID-19.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1720551},
pmid = {41878441},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/genetics ; *Killer Cells, Natural/immunology/metabolism ; *SARS-CoV-2/immunology ; Male ; Female ; Middle Aged ; Adult ; Cytokines/blood ; Antibodies, Viral/blood ; Aged ; Gene Expression Profiling ; Transcriptome ; },
abstract = {INTRODUCTION: Long-term COVID-19 syndrome (LTCS) or "long COVID" is a debilitating post-viral condition affecting approximately 2%-8% of individuals after SARS-CoV-2 infection. It manifests typically ≥3 months post-infection with symptoms persisting for at least 2 months, including fatigue, pulmonary dysfunction, and cognitive impairment, in the absence of alternative diagnoses. The biological mechanisms underlying LTCS remain poorly defined, yet emerging evidence implicates immune dysregulation.

METHODS: We profiled plasma antibodies and cytokines from healthy controls (HC, N = 66), convalescents (CONV, N = 24), and LTCS patients (N = 94), followed by multiparametric 14-color flow cytometry of PBMCs from HC (N = 9), CONV (N = 6), and LTCS (N = 23) participants. To gain mechanistic insight, we performed single-cell transcriptomic profiling (scRNA-seq) on PBMCs from HC (N = 8), CONV (N = 6), and LTCS (N = 32) individuals.

RESULTS: LTCS patients exhibited elevated anti-SARS-CoV-2 IgG (spike S1/RBD/N) titers compared with HC, but displayed significantly reduced systemic cytokine levels, including IFN-γ, TNF-α, IL-6, and IL-10. Flow cytometry revealed marked depletion of CD56[+]CD16[+] NK cells and CD56[+]CD3[+] NKT cells, accompanied by altered T-cell activation states. scRNA-seq confirmed NK type I cell loss and uncovered broad transcriptional reprogramming with upregulation of PDCD4, CHD1, CXCR4, and SLC7A5 and downregulation of TGFBR3, RIPOR2, and MBNL1. Gene set enrichment analyses indicated activation of circadian and translational programs and suppression of olfactory receptor, neurotransmitter receptor, and GABA-gated ion-channel pathways. Functional assays validated reduced NK-cell inflammatory capacity in LTCS participants.

DISCUSSION: LTCS is characterized by systemic cytokine attenuation and a quantitative and functional NK-cell deficit coupled to neurosensory pathway suppression. These findings identify NK cells as key sentinels of LTCS pathophysiology and highlight an NK-centric neuroimmune axis as a promising target for biomarker discovery and therapeutic intervention.},
}

Humans
*COVID-19/immunology/genetics
*Killer Cells, Natural/immunology/metabolism
*SARS-CoV-2/immunology
Male
Female
Middle Aged
Adult
Cytokines/blood
Antibodies, Viral/blood
Aged
Gene Expression Profiling
Transcriptome

@article {pmid41880292,
year = {2026},
author = {Sun, X and Cappelleri, JC and Lupton, LL and Moran, MM and Lopez, SMC and Puzniak, L and Yehoshua, A and Di Fusco, M},
title = {Assessment of long COVID symptom burden in patients testing positive for SARS-CoV-2 at a nationwide retail pharmacy.},
journal = {PloS one},
volume = {21},
number = {3},
pages = {e0345639},
doi = {10.1371/journal.pone.0345639},
pmid = {41880292},
issn = {1932-6203},
mesh = {Humans ; *COVID-19/diagnosis/epidemiology/virology ; Female ; Male ; Middle Aged ; Adult ; Patient Reported Outcome Measures ; SARS-CoV-2/isolation & purification ; Fatigue ; Surveys and Questionnaires ; Pharmacies ; Aged ; Cost of Illness ; Quality of Life ; Symptom Burden ; },
abstract = {BACKGROUND: Numerous grouping and scoring methodologies have been proposed to assess long COVID symptomatology. One approach is to use symptom count as a simple, quantifiable measure of long COVID symptom burden.

METHODS: This was a secondary analysis of a nationwide patient-reported outcomes (PRO) study that recruited symptomatic adults testing positive for SARS-CoV-2 at a Retail Pharmacy in the spring of 2023. EQ-5D-5LTM, work productivity and impairment (WPAI), the Patient-Reported Outcomes Measurement Information System (PROMIS®) fatigue, and a long COVID symptom questionnaire were administered at Week 4, Month 3, and Month 6 after testing. Pre-infection EQ-5D-5L, WPAI, PROMIS fatigue were collected via recall. Cronbach's α assessed internal consistency of symptoms. Scree plots determined number of significant factors (symptoms) to retain for analysis. Spearman correlation coefficients were calculated between number of symptoms and EQ-5D-5L, WPAI, PROMIS fatigue scores and their changes from pre-COVID baseline. Categorization of long COVID burden using number of symptoms was proposed based on scores via equipercentile linking.

RESULTS: Of 505 patients, mean age was 46.3 years, 70.7% were female. Cronbach's α was 0.865, denoting good internal consistency of the symptom survey instrument. The scree plot supported use of one factor for the composite 30-symptom list. Number of symptoms correlated strongly with EuroQol Utility Index (r = -0.53), presenteeism (r = 0.51), activity impairment (r = 0.51) and fatigue (r = 0.56). Statistically significant differences in mean number of symptoms were found between patients with versus those without problems in any of the 5 domains of the EQ-5-dimensional descriptive system. Based on linked PRO scores, subjects could be classified into low (≤2), medium (3-9), and high (≥10) symptom burden.

CONCLUSIONS: Number of long COVID symptoms correlated with validated PRO measures and identified three symptom-based categories of long COVID burden. Number of symptoms is a valid and internally consistent measure to assess long COVID burden in outpatient settings.},
}

Humans
*COVID-19/diagnosis/epidemiology/virology
Female
Male
Middle Aged
Adult
Patient Reported Outcome Measures
SARS-CoV-2/isolation & purification
Fatigue
Surveys and Questionnaires
Pharmacies
Aged
Cost of Illness
Quality of Life
Symptom Burden

@article {pmid41880397,
year = {2026},
author = {Reis, GGD and Moreira, DA and Parente, TE and Müller, BLA and Moreira, AS and Alves, G and Chantre-Justino, M and Delmonico, L and Lopes, BA and Silvestre, RT and Ornellas, MH and Santos, LSD and Mattos-Guaraldi, AL},
title = {MicroRNA sequencing of peripheral blood mononuclear cells reveals significant expression changes in women with Long COVID.},
journal = {Anais da Academia Brasileira de Ciencias},
volume = {98},
number = {1},
pages = {e20250515},
doi = {10.1590/0001-3765202620250515},
pmid = {41880397},
issn = {1678-2690},
mesh = {Humans ; Female ; *COVID-19/genetics/blood ; *MicroRNAs/genetics/blood ; *Leukocytes, Mononuclear/metabolism ; Middle Aged ; SARS-CoV-2/genetics ; Adult ; High-Throughput Nucleotide Sequencing ; Sequence Analysis, RNA ; },
abstract = {Long COVID is a clinical condition marked by persistent symptoms like fatigue and brain fog, estimated to have affected many of post-SARS-CoV-2/COVID-19 infection patients. This study, conducted with adult female Long COVID patients from Pedro Ernesto University Hospital (HUPE) in Rio de Janeiro, investigated the role of microRNAs (miRNAs), key post-transcriptional gene expression regulators, in this new condition. Next-generation sequencing (NGS) and bioinformatics analysis of miRNAs extracted from Peripheral Blood Mononuclear Cells (PBMCs) revealed differential expression of 37 miRNAs (10 upregulated, 27 downregulated). Notably, 28 of these miRNAs have been previously linked to inflammation or COVID-19, a significant finding given Long COVID's association with a persistent inflammatory state and potential for serious adverse events. Validation by qPCR confirmed hsa-miR-1307-3p, hsa-miR-26a-5p, and miR-186-5p as potential Long COVID biomarkers. The continuous overexpression of hsa-miR-1307-3p, which bound to the initial SARS-CoV-2 variants, may have contributed to increased inflammatory factors. Understanding how miRNAs modulate the inflammatory cascade could be crucial in mitigating the global health impact of future pandemics.},
}

Humans
Female
*COVID-19/genetics/blood
*MicroRNAs/genetics/blood
*Leukocytes, Mononuclear/metabolism
Middle Aged
SARS-CoV-2/genetics
Adult
High-Throughput Nucleotide Sequencing
Sequence Analysis, RNA

@article {pmid41880671,
year = {2026},
author = {Garriga-Salvó, C and Navarro, E and Lidón-Moyano, C and Arévalo, A and Roca, R and Morera, M and Llistosella, M},
title = {Psychological interventions for individuals with long COVID: a systematic review and meta-analysis.},
journal = {Health psychology review},
volume = {},
number = {},
pages = {1-22},
doi = {10.1080/17437199.2026.2646179},
pmid = {41880671},
issn = {1743-7202},
abstract = {Introduction: Long COVID involves a variety of persistent symptoms after initial SARS-CoV-2 infection, affects multiple functional areas and requires multidisciplinary treatment. Objective: This study aimed to explore the available evidence about psychological interventions for individuals with long COVID and their effectiveness in reducing some prevalent symptoms, such as fatigue, anxiety or depression, among others, and improving patient quality of life. Methodology: A systematic review and meta-analysis were conducted following the PRISMA 2020 guidelines. Two independent reviewers performed study selection and data extraction using Web of Science, Scopus, and PubMed databases prior to March 2024. Data synthesis was performed via random-effects meta-analysis, with heterogeneity assessed using the I2 statistic. Results: Of the 1041 articles obtained, 19 were included in the systematic review and 14 in the meta-analysis. Results showed significant reductions in symptoms of anxiety [SMD = -0.64 (95% CI: -1.18 to -0.10)], depression [SMD = -0.41 (95% CI: -0.73 to -0.10)] and fatigue [SMD = -1.37 (95% CI: -2.48 to -0.26)]. Significant improvements were only registered in self-perceived health-related quality of life [SMD = 7.59 (95% CI: 3.70-11.48)]. Conclusion: Results showed improvements in anxiety, depression or fatigue, highlighting the potential role of psychological interventions in patient recovery.},
}

@article {pmid41881023,
year = {2026},
author = {Chen, HJ and Appelman, B and Willemen, HLDM and Bos, A and Prado, J and Mak, WA and Keijzer, N and Santos Ribeiro, PS and Goncalves, SV and Versteeg, S and Geyer, CE and Larsen, M and Schüchner, E and Bomers, MK and Lavell, AHA and , and Charlton, B and Wüst, R and Wiersinga, WJ and van Vugt, M and Vidarsson, G and Eijkelkamp, N and den Dunnen, J},
title = {Transfer of IgG from long COVID patients induces symptomology in mice.},
journal = {Cell reports. Medicine},
volume = {},
number = {},
pages = {102693},
doi = {10.1016/j.xcrm.2026.102693},
pmid = {41881023},
issn = {2666-3791},
abstract = {SARS-CoV-2 infections have led to a surge in long COVID, a post-infectious syndrome in which autoantibodies are proposed to play a pathogenic role, analogous to fibromyalgia. Here, we test this hypothesis by transferring total IgG from long COVID patients into mice. We stratified patients into three subgroups using plasma levels of glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL), and interferon-β, with subgroup-specific pathways supported by plasma proteomics. Transfer of pooled total IgG induces pronounced and persistent mechanical hypersensitivity. Notably, IgG collected 2 years later from the same long COVID patients who remained symptomatic reproduced mechanical allodynia in mice, demonstrating longitudinal stability of pathogenic activity. Proteome-wide autoantibody profiling identifies elevated, subgroup-linked autoreactivities that persist over time and are validated by independent assays. Together, these findings demonstrate that long COVID IgG can induce mechanical hypersensitivity in mice, support a causal role for autoantibodies in long COVID pathogenesis, and may establish a murine model for therapeutic development.},
}

@article {pmid41873548,
year = {2026},
author = {Joseph, R and Rabelo, L and Do Nascimento, EB},
title = {Evidence of impaired processing speed and cognitive control in recovered COVID-19 patients: The role of cognitive slowing in long COVID memory impairment.},
journal = {Applied neuropsychology. Adult},
volume = {},
number = {},
pages = {1-16},
doi = {10.1080/23279095.2026.2649334},
pmid = {41873548},
issn = {2327-9109},
abstract = {Cognitive impairment is among the most reported symptoms in post-acute sequelae of SARS-CoV-2 infection. These impairments, often termed "brain fog" include difficulties in memory, attention, executive function, and processing speed, significantly impacting individuals' quality of life and daily functioning. This study investigates the hypothesis that survivors may exhibit impaired processing speed (PS) and cognitive control (CC), crucial components of cognitive functioning that potentially underlie learning and memory disturbances. An observational study was conducted with 61 participants (mean age: 35.7 ± 8.7 years, 53% female, 47% male), categorized into three groups: control (CTL), COVID symptomatic (COV-S), and hospitalized (COV-H). Participants were recruited through a sociodemographic and screening questionnaire and assessed using various cognitive and psychological evaluation tools, including the Five-Digit Test (FDT) and Rey Auditory Verbal Learning Test (RAVLT). Results indicate that declines in processing speed and cognitive control are related to the clinical condition of COVID-19, with greater severity observed in hospitalized individuals. The study provides robust evidence that COVID-19 affects processing speed and cognitive control, directly leading to slowed learning stages and impairments in the RAVLT encoding stage, due to increased interference during memory formation, affecting episodic-semantic memory tasks.},
}

@article {pmid41873998,
year = {2026},
author = {Goh, GK and Foster, JA and Uversky, VN},
title = {Clues to Long COVID Linked to Virulence and Infectivity Found in Shell Proteins.},
journal = {Advances in respiratory medicine},
volume = {94},
number = {2},
pages = {},
doi = {10.3390/arm94020018},
pmid = {41873998},
issn = {2543-6031},
mesh = {Humans ; *COVID-19/virology ; *SARS-CoV-2/pathogenicity ; Virulence ; Animals ; },
abstract = {Clinical, experimental, and computational evidence of COVID-19 virulence and infectivity has been linked to SARS-CoV-2 shell disorder. A strong link was first discovered using an AI disorder-predicting tool, which detected an unusually hard (low disorder) outer shell among all SARS-CoV-2-related viruses but not in the 2003 SARS-CoV-1. This could account for the high infectivity found in SARS-CoV-2-but not in SARS-CoV-1-as it is believed that hard shells protect viral particles from the onslaught of the antimicrobial enzymes present in the respiratory system and saliva. As a result, much larger quantities of particles are shed by COVID-19 patients. Abnormally hard outer shells (M) are associated with burrowing animals, e.g., pangolins, and SARS-CoV-2 likely acquired these shells due to its long-term evolutionary interactions with pangolins. As for virulence, the inner shell of SARS-CoV-2 (N) has been found to exhibit lower disorder than that of SARS-CoV-1. This lower disorder is consistent with the fact that SARS-CoV-2 is less virulent than SARS-CoV-1, as higher disorder in the inner shell is associated with more efficient protein-protein binding during replication. The link between N/M disorder and virulence or infectivity falls under the umbrella of shell disorder models (SDMs), which can connect virulence, infectivity, and long COVID under one coherent concept. Evidence of the reliability and reproducibility of SDMs as applied to COVID-19 is examined. The hard M that is resisting the antimicrobial enzymes in the respiratory system can be extended to immunological enzymes, especially those found in phagocytes such as macrophages, which can therefore become a reservoir for the virus.},
}

Humans
*COVID-19/virology
*SARS-CoV-2/pathogenicity
Virulence
Animals

@article {pmid41875425,
year = {2026},
author = {Lerma-Irureta, D and Méndez-López, F and Navarro-Matías, E and Lerma-Puertas, D and Magallón-Botaya, R},
title = {Differential Factors Associated With the Presence of Persistent Symptoms in Individuals Diagnosed With Long COVID: Protocol for a Longitudinal Matched Case-Control Study.},
journal = {JMIR research protocols},
volume = {15},
number = {},
pages = {e67133},
doi = {10.2196/67133},
pmid = {41875425},
issn = {1929-0748},
mesh = {Humans ; *COVID-19/complications/epidemiology/physiopathology/diagnosis ; Case-Control Studies ; Longitudinal Studies ; Spain/epidemiology ; Quality of Life ; SARS-CoV-2 ; Adult ; Female ; Male ; Post-Acute COVID-19 Syndrome ; Middle Aged ; Research Design ; },
abstract = {BACKGROUND: Long COVID (postacute sequelae of SARS-CoV-2 infection) is a heterogeneous condition with persistent multisystem symptoms and substantial functional burden. Integrative longitudinal studies combining clinical phenotyping, lifestyle factors, and immunobiological markers are needed to clarify determinants of symptom persistence and inform risk stratification and targeted interventions.

OBJECTIVE: This study aims to identify clinical, biological/immunological, and sociodemographic factors associated with Long COVID status by comparing individuals with persistent symptoms to matched recovered controls, and to evaluate longitudinal changes in symptoms and secondary outcomes over follow-up.

METHODS: ARALongCOV is a longitudinal matched case-control observational study conducted in Aragón, Spain, including adults (≥18 years of age) with confirmed SARS-CoV-2 infection. Participants are recruited through 3 sources: the Long COVID Aragón Patient Association, the Aragón Health Service database, and primary care consultations. Long COVID and recovered participants are individually matched 1:1 (without replacement) on sex/gender (exact), age (±3 years), and date of acute COVID-19 diagnosis (±30 days). Outcomes include persistent symptoms and functioning and patient-reported outcomes (quality of life, physical activity, diet, sleep, mental health, functional status, cognitive performance, pain catastrophizing, and fatigue), alongside clinical variables and biochemical/immunological markers (including inflammatory and cytokine profiles, SARS-CoV-2 antispike immunoglobulin G serology, and viral reactivation serologies). Measurements are obtained at baseline (T0) and repeated at follow-up (T1) using standardized procedures.

RESULTS: The study received ethics approval from the Clinical Research Ethics Committee of Aragón (PI21/278). Funding was provided by Instituto de Salud Carlos III through project PI22/01070 (cofunded by the European Union) for the period 2023-2027. Baseline assessments (T0) were initiated in late 2022/early 2023. As of February 2026, a total of 200 participants have been enrolled (n=100 Long COVID; n=100 recovered controls) and have completed T0; T1 assessments are scheduled for late 2025/early 2026 (~3-year follow-up for the earliest enrolled participants). Primary analyses will be conducted after completion of T1 assessments, with dissemination planned from the second half of 2026 and continuing through 2027.

CONCLUSIONS: This protocol describes a comprehensive, multidimensional longitudinal study designed to clarify determinants of Long COVID by integrating clinical, functional, lifestyle, and immunobiological data in matched cohorts. Findings are expected to support risk stratification, phenotype discovery, and identification of prognostic markers to inform preventive, diagnostic, and rehabilitative strategies.

TRIAL REGISTRATION: ISRCTN Registry ISRCTN27312680; https://tinyurl.com/33cbysrk.

DERR1-10.2196/67133.},
}

Humans
*COVID-19/complications/epidemiology/physiopathology/diagnosis
Case-Control Studies
Longitudinal Studies
Spain/epidemiology
Quality of Life
SARS-CoV-2
Adult
Female
Male
Post-Acute COVID-19 Syndrome
Middle Aged
Research Design

@article {pmid41875623,
year = {2026},
author = {Vianna, CM and de Figueiredo, AM and Camacho, LAB and Marques, CMC and Xavier, JR and da Gama, VC and Pizzini, GLC and Braga, RM and Santos, EAPD and Maia, MLS},
title = {Risk factors for post-COVID-19 condition: A case-control study in municipalities of Paraíba and Rio de Janeiro, Brazil.},
journal = {The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases},
volume = {30},
number = {2},
pages = {105807},
doi = {10.1016/j.bjid.2026.105807},
pmid = {41875623},
issn = {1678-4391},
abstract = {INTRODUCTION: Post-COVID-19 condition, refers to one or multiple symptoms that continue for several weeks or months following the COVID-19 infection. This study aims to assess the factors associated with post-COVID-19 condition in the Brazilians regions of Paraiba and Rio de Janeiro. Understanding this factor is crucial to public policies and improving care for high-risk individuals.

METHODS: This is a multicenter, retrospective case-control study. Cases were classified as individuals experiencing persistent symptoms for over 12-weeks following a confirmed COVID-19 diagnosis, whereas controls were those who recovered. Data on sociodemographic characteristics, medical history, lifestyle factors, and vaccination status were gathered, and logistic regression was used to analyze the relationship between these variables and the onset of post-COVID-19 condition.

RESULTS: Of the 1.350 participants, 734 were cases and 616 were controls, with a 54% frequency of post-COVID-19 condition. The study found significant associations between the syndrome and female sex (OR = 2.09; 95% CI 1.6‒2.74), middle age (OR = 2.03; 95% CI 1.31‒3.15 for 40- to 60-years) and over 60 (OR=1.84; 95% CI 1.06‒3.2), white people (OR = 1.41; 95% CI 1.07‒1.86), hypercholesterolemia (OR = 1.66; 95% CI 1.18‒2.32), chronic lung diseases (OR = 5.60; 95% CI 1.18‒26.65), mental illness such as anxiety and panic disorder (OR = 2.52; 95% CI 1.64‒3.87), family history of long COVID syndrome (OR = 2.07; 95% CI 1.45‒2.97), hospitalization (OR = 5.89; 95% CI 3.92‒8.86) and good pre-COVID health perception (OR = 0.69; 95% CI 0.53‒0.9).

CONCLUSIONS: The findings reinforce the importance of identifying groups more frequently affected by post-COVID-19 condition and supporting follow-up strategies aimed at mitigating its impact on individuals and health services.},
}

@article {pmid41876107,
year = {2026},
author = {Brierley, M and Vakilian, F and Rostami, M},
title = {When High Scores Hide Realities: Enhancing Patient Survey Data Through Joint Display.},
journal = {Annals of family medicine},
volume = {24},
number = {2},
pages = {153-158},
doi = {10.1370/afm.250474},
pmid = {41876107},
issn = {1544-1717},
mesh = {Humans ; *Patient Satisfaction/statistics & numerical data ; Alberta ; *COVID-19/epidemiology ; Surveys and Questionnaires ; Qualitative Research ; SARS-CoV-2 ; Female ; *Health Care Surveys/methods ; },
abstract = {PURPOSE: Patient surveys often include closed- and open-ended responses that are usually reported separately, and links between them rarely explored, limiting interpretive depth. We outline a strategy that integrates quantitative and qualitative survey data in a joint display which enables combined analysis and findings to inform and improve programs for patients.

METHODS: Data were drawn from a patient experience survey implemented in Alberta's long COVID Inter-professional Outpatient Program (IPOP). A joint display of Likert-scale satisfaction ratings and themed open-text feedback was developed to examine connections between the structured responses and qualitative insights.

RESULTS: We integrated quantitative survey satisfaction ratings with themes from the qualitative analysis of open-text comments in a joint display. Examining these data sets together added an analytical layer and uncovered nuanced experiences not evident in Likert-scale responses alone. By aligning satisfaction scores with themes, the joint display surfaced contradictory and paradoxical findings that would otherwise be hidden.

CONCLUSIONS: Aligning Likert-scale responses with thematic analysis of open-text reveals subtleties that may be obscured by scores alone. Understanding the narratives behind ratings is essential to evaluate health care programming, particularly when surveys are the primary mechanism for incorporating patient voices into service planning and delivery.},
}

Humans
*Patient Satisfaction/statistics & numerical data
Alberta
*COVID-19/epidemiology
Surveys and Questionnaires
Qualitative Research
SARS-CoV-2
Female
*Health Care Surveys/methods

@article {pmid41869098,
year = {2026},
author = {Becker, KN and Hagood, M and Creeden, JF and Heck, H and Haak, PT and Larder, C and Tipton, C and Schroeder, J and Eisenmann, KM},
title = {Baseline Clinician Attitudes and Practices Regarding Long-Term Neurological Follow-Up for COVID-19 Patients: Early Pandemic Insights With Contemporary Relevance.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e103837},
pmid = {41869098},
issn = {2168-8184},
abstract = {OBJECTIVES: This study aimed to investigate clinician opinions and practices regarding long-term neurological follow-up for COVID-19 patients during the early pandemic period (June-August 2020), before formal long COVID recognition, and identify the gaps between clinician awareness and clinical practice implementation.

METHODS:  We conducted a cross-sectional survey of 199 physicians and advanced practice providers (APPs; including nurse practitioners, physician assistants, certified registered nurse anesthetists (CRNAs), and similar roles) across Northwest Ohio and Southeast Michigan healthcare systems (June-August 2020). The survey assessed clinician awareness of long-term neurological risks, screening behaviors, referral practices, and attitudes toward long-term neurological follow-up using an original adaptive questionnaire administered via Qualtrics. Bivariate associations were tested using Pearson's chi-square and Fisher's exact test (p ≤ 0.05). This study was approved by the University of Toledo Institutional Review Board (Protocol #300681, exempt status).

RESULTS:  Most respondents (54/96, 56.3%) believed that more than 50% of COVID-19 patients should receive long-term neurological follow-up, primarily by neurology specialists (66/134, 49.3%). However, only 13/93 (14.0%) were actively referring more than 50% of their COVID-19 patients for such care. Average referral rates increased modestly from 14.1% pre-pandemic to 19.9% during the pandemic, with 100/130 (76.9%) reporting no change in practices. Self-reported familiarity with neurological manifestations of COVID-19 (114/179, 63.7%) was substantially lower than general COVID-19 familiarity (178/180, 98.9%).

CONCLUSIONS:  Substantial disconnect existed between clinician beliefs about appropriate care and actual referral practices, revealing infrastructure barriers, including inadequate specialty capacity and lack of standardized protocols. These baseline findings document the state of clinical practice before formal long COVID guidelines were established.

POLICY IMPLICATIONS:  Healthcare systems require enhanced infrastructure for long-term neurological monitoring of COVID-19 survivors, including increased specialty capacity and standardized protocols, informing pandemic preparedness for chronic disease complications.},
}

@article {pmid41870866,
year = {2026},
author = {di Filippo, L and Terenzi, U and Bolamperti, S and Bechini, C and Bossoni, S and Campaniolo, M and Gifuni, L and Doga, M and Giustina, A},
title = {Chronic cholecalciferol supplementation and adequate vitamin D status are associated with reduced risk of Long COVID.},
journal = {Journal of endocrinological investigation},
volume = {},
number = {},
pages = {},
pmid = {41870866},
issn = {1720-8386},
support = {ABIONC06//ABIOGEN SPA/ ; },
}

@article {pmid41870982,
year = {2026},
author = {Fernández, GA and Baratta, MSG and Klajn, DS},
title = {Long COVID in children and adolescents: Incidence and clinical characteristics in Buenos Aires, 2021-2023.},
journal = {Archivos argentinos de pediatria},
volume = {},
number = {},
pages = {e202510958},
doi = {10.5546/aap.2025-10958.eng},
pmid = {41870982},
issn = {1668-3501},
abstract = {Introduction. Long COVID affects approximately 8.5% of the pediatric and adolescent population after SARS-CoV-2 infection, and vaccination could reduce its incidence. Objectives. To determine the incidence of long COVID in children and adolescents aged 5 to 18 years, describe symptoms and duration, analyze differences by age and sex, estimate reinfections and school absenteeism, and evaluate its relationship with vaccination. Population and methods. Prospective cohort study conducted between August 1, 2021, and February 1, 2023. To calculate incidence, patients with COVID-19 treated at a general acute care hospital in the Autonomous City of Buenos Aires were included; for characterization, cases referred from other centers were included as well. Descriptive and comparative analyses were performed, estimating incidence with 95% CI; STATA 14.0 was used (p <0.05). The study was approved by the Ethics Committee. Results. Of 496 patients, 475 were included, and 21 were excluded due to severe comorbidities. The incidence of long COVID was 7.79% (95% CI 5.37-10.21). Those affected had a higher mean age (12.57 vs. 11.20 years; p = 0.02) and a higher incidence in unvaccinated or partially vaccinated individuals (11.48% vs. 5.48%; p = 0.018). The most common symptoms were fatigue, cough, and myalgia. Conclusion. The incidence of long COVID was comparable to that reported in other pediatric series. A lower incidence was observed in children and adolescents with complete vaccination schedules, and fatigue was the most frequent clinical manifestation. These findings reinforce the need to continue generating evidence.},
}

@article {pmid41864480,
year = {2026},
author = {Rauf, M and Naveed, A and Asghar, MU},
title = {Post-acute sequelae of COVID-19: A disorder of impaired innate immune resolution - A narrative review.},
journal = {Clinical immunology (Orlando, Fla.)},
volume = {285},
number = {},
pages = {110701},
doi = {10.1016/j.clim.2026.110701},
pmid = {41864480},
issn = {1521-7035},
abstract = {Post-acute sequelae of COVID-19 (PASC) affect millions of people worldwide and are increasingly recognized as a disorder of failed innate immune resolution rather than a persistent viral infection. Emerging evidence shows that residual SARS-CoV-2 antigens, host-derived alarmins, reactivated latent viruses, and mucosal microbiome-derived products from oral-nasopharyngeal and gut reservoirs sustain the chronic activation of pattern-recognition receptors, inflammasomes, and complement pathways. In parallel, deficits in specialized pro-resolving mediators, impaired efferocytosis, and persistent tissue injury prevent physiological termination of inflammation. These unresolved cues drive long-lasting epigenetic and metabolic reprogramming of hematopoietic stem cells and myeloid lineages, creating maladaptive trained immunity states characterized by hyper-responsiveness or exhaustion of these cells. Thromboinflammatory processes, including aberrant NETosis and sustained interface signalingling, further reinforce self-perpetuating inflammatory circuits. Together, these pathways give rise to reproducible molecular endotypes, including thromboinflammatory, interferon-driven, and neuroinflammatory phenotypes, which explain clinical heterogeneity. Framing PASC as a disorder of impaired immune resolution within a mucosal microbial viral context provides a unifying mechanistic scaffold for biomarker identification and host-directed therapies. This review proposes that restoring active resolution programs, rebalancing metabolic-epigenetic networks, and dismantling pathogenic innate feedback loops are promising strategies for reversing the chronic immune imprint of PASC.},
}

@article {pmid41862909,
year = {2026},
author = {Khalid, K and Abdullah, ADI and Lim, HX and Ali, RAR},
title = {Pharmacological and non-pharmacological management of long COVID.},
journal = {Virology journal},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12985-025-02991-5},
pmid = {41862909},
issn = {1743-422X},
abstract = {Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a major global health burden in terms of acute infection and long-term consequences. Approximately 10% of infected experience autonomic dysfunction, cardiovascular complications, and neurological impairments. While immune dysregulation, persistent viral reservoirs, chronic inflammation, gut dysbiosis, and vascular dysfunction are implicated, the exact pathophysiological mechanisms of Long COVID remain unclear. Additionally, treatment options are limited and challenging to prescribe due to symptom heterogeneity. Non-pharmacological interventions such as increased salt intake, elimination diets for gastrointestinal symptoms, and cognitive pacing for fatigue may not be sufficient for severe symptoms. Moreover, pharmacological interventions such as β-blockers, calcium channel blockers, pyridostigmine, antihistamines, and low-dose naltrexone can improve tachycardia, fatigue, and brain fog but there are no standardized guidelines. In light of evidence supporting a strong association of Long COVID with gut dysbiosis, probiotics have emerged as a promising intervention. Clinical studies have shown that Bacillus coagulans, Bacillus subtilis, Lactobacillus acidophilus, and Bifidobacterium species can improve fatigue, gastrointestinal health, and overall physical and mental well-being in Long COVID patients. Large-scale randomized controlled trials are warranted to validate probiotic efficacy in Long COVID and reduce burden on individual health and healthcare institutions.},
}

@article {pmid41862917,
year = {2026},
author = {Luo, S and Zheng, Z and Karimi, L and Plebanski, M and Lankatillake, C and Sheahan, J and Anderson, K and Jovanovski, N and Seal, EL and Cockshaw, W and Wollersheim, D and Cleary, S and El-Ansary, D and Flanagan, KL and Jessup, R and Abrahamson, S and Whyler, N and Fineberg, D and Scoullar, MJL and Seeley, MC and Tippett, E and Xenos, S and Itsiopoulos, C},
title = {Between silence and solutions: a global guideline review of long COVID care and services in Australia.},
journal = {BMC health services research},
volume = {},
number = {},
pages = {},
doi = {10.1186/s12913-026-14268-w},
pmid = {41862917},
issn = {1472-6963},
}

@article {pmid41857005,
year = {2026},
author = {Gandhi, MM and Moser, C and Currier, JS and Ritz, J and Eron, JJ and Daar, ES and Wohl, DA and Fischer, WA and Singh, U and Hughes, MD and Smith, DM and Evering, TH and Chew, KW and , },
title = {Association of long COVID with health-related quality-of-life outcomes.},
journal = {Scientific reports},
volume = {},
number = {},
pages = {},
doi = {10.1038/s41598-026-36189-8},
pmid = {41857005},
issn = {2045-2322},
support = {UM1AI068634//National Institute of Allergy and Infectious Diseases/ ; UM1AI068636//National Institute of Allergy and Infectious Diseases/ ; },
abstract = {The association of long COVID with health-related quality-of-life (HrQOL) has not been well-characterized. Participants who received blinded placebo in the ACTIV-2/A5401 outpatient COVID-19 treatment trial were included in an analysis of the association of long COVID with HrQOL (both pre-specified exploratory trial endpoints) 9 months after acute COVID-19. Long COVID was defined as presence of self-assessed COVID-19 symptoms and HrQOL was assessed with EQ-5D-5L and SF-36v2 questionnaires. Associations were evaluated by Fisher's exact tests and Wilcoxon rank-sum tests. Of 546 participants, 13% had long COVID. Long COVID was associated with greater risk of reported problems in the EQ-5D-5L dimensions of mobility, usual activities, pain/discomfort, and anxiety/depression (risk ratios 3.45-6.00, all p < 0.001) and worse self-reported health scores (median 80 vs. 95, p < 0.001). Participants with long COVID also had worse SF-36v2 composite physical and mental component scores (both p < 0.001) and individual SF-36 domain scores (physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role, and mental health; all p < 0.001). Associations were similar regardless of baseline (pre-COVID-19) medical history. Long COVID is associated with impaired HrQOL across multiple domains, highlighting the need to develop preventative and therapeutic interventions for this protean condition.},
}

@article {pmid41857445,
year = {2026},
author = {Friedberg, A and McConnell, E and Stanwick, S and Perez, L and MacEwan, S and Rush, LJ and Bowman-Burpee, S and Smith, RM and Joshi, S and Woschkolup, K and Grandominico, J and McAlearney, AS and Schamess, A},
title = {Outcomes of Patients with Neurocognitive Symptoms Attending a Long COVID Clinic: A Longitudinal Cohort Study.},
journal = {Journal of general internal medicine},
volume = {},
number = {},
pages = {},
pmid = {41857445},
issn = {1525-1497},
abstract = {BACKGROUND: Data are lacking on longitudinal outcomes of patients treated in primary care-led long COVID (LC) clinics.

OBJECTIVE: Assess changes in health-related quality of life (HRQoL) in patients with LC and neurocognitive symptoms from enrollment in a LC clinic to 6 months post-enrollment.

DESIGN: Observational cohort study.

SETTING: Primary care-led LC clinic at an academic medical center.

PARTICIPANTS: One hundred fifty patients with long COVID and neurocognitive symptoms who completed the PROMIS29 inventory at clinic enrollment and 6 months post-enrollment.

INTERVENTIONS: Multimodality care consisting of disease education and behavioral management, rehabilitative therapies, and pharmacotherapy for LC symptoms.

MAIN MEASURES: Treatments received and change in PROMIS29 t-scores from enrollment to 6-month follow-up.

KEY RESULTS: T-scores (mean, SE) at clinic entry were worse than the population mean (50) for fatigue (65.6, 1.05), sleep disturbance (57.3, 1.00), anxiety (60.0, 1.26), physical function (37.9, 0.87), social role participation (40.2, 0.84), pain (60.1, 1.24), and depression (57.3, 1.11). Patients received multimodality treatment consisting of disease education and behavioral management (all patients), combined rehabilitation and pharmacotherapy (44%), rehabilitation only (22%), or pharmacotherapy only (16%). There were statistically significant improvements in mean t-scores in all PROMIS29 domains at 6 months. Clinically significant improvement (change in t-score of ≥ 2.5) was seen for physical functioning (+ 2.9, 0.58), fatigue (- 4.9, 0.80), social functioning (+ 3.4, 0.68), and pain (- 2.8, 0.88). Change in t-score > 5 was seen in fatigue with symptom-titrated physical rehabilitation, in fatigue and pain with amantadine and memantine, and in sleep disturbance and pain with trazodone and amitriptyline.

CONCLUSION: Multimodal symptom-directed interventions incorporating rehabilitation alongside targeted pharmacotherapy were associated with significantly improved HRQoL in patients with LC and neurological symptoms.},
}

@article {pmid41859298,
year = {2026},
author = {Blitshteyn, S and Doherty, TA and Steinman, L},
title = {Postural Orthostatic Tachycardia Syndrome, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID as Neuroimmune Disorders.},
journal = {ImmunoTargets and therapy},
volume = {15},
number = {},
pages = {581262},
pmid = {41859298},
issn = {2253-1556},
abstract = {Postural orthostatic tachycardia syndrome (POTS), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID are heterogeneous disorders with overlapping complex, multi-factorial and multi-systemic pathophysiology. POTS and ME/CFS are the most common phenotypes of Long COVID that can lead to significant disability and functional impairment. The exact pathophysiologic mechanisms of these disorders alone or in combination are still being investigated, but important mechanistic factors have been identified, such as autonomic dysfunction, immune dysregulation, autoimmunity, mitochondrial dysfunction, cerebral hypoperfusion, and neuroinflammation. To this end, we believe that these conditions should be viewed as neuroimmune disorders and should be included in the field of neuroimmunology, with its educational curriculum, training, and clinical care pathways. Including these disorders as part of neuroimmunology subspecialty is the key to advancing the science and clinical care of this underserved patient population with these complex and disabling conditions.},
}

@article {pmid41860011,
year = {2026},
author = {Houchen-Wolloff, L and Bell, J and Pritchard, R and Poinasamy, K and Holmes, K and Walker, S and Smith, N and Hastie, C and Rogers, N and Adams, D and Nathu, R and Gill, R and Bunker, J and Staunton, L and Chalmers, J and Ho, LP and Harris, V and Horsley, A and Marks, M and Raman, B and Wain, LV and Brightling, C and Evans, R},
title = {Consortium-Based Patient and Public Involvement and Engagement for Long COVID Research: A Pirit-Focused Impact Evaluation of the PHOSP-COVID Study.},
journal = {Health expectations : an international journal of public participation in health care and health policy},
volume = {29},
number = {2},
pages = {e70591},
doi = {10.1111/hex.70591},
pmid = {41860011},
issn = {1369-7625},
support = {+ MRC: MR/V027859/1//National Institute for Health and Care Research/ ; COV0319//National Institute for Health and Care Research/ ; },
mesh = {Humans ; *COVID-19/epidemiology ; *Patient Participation ; *Community Participation ; SARS-CoV-2 ; *Survivors ; Pandemics ; },
abstract = {BACKGROUND: At the start of the coronavirus disease-2019 (COVID-19) pandemic in early 2020, the long-term outcomes for survivors of COVID-19 were unknown. The PHOSP-COVID cohort study was set up at scale and pace in Spring 2020 to determine the short- to long-term health consequences of COVID-19 in post-hospitalisation survivors; to understand the impact of interventions during and after the acute illness on these long-term sequelae and to build the foundation for multiple in-depth studies. A consortium infrastructure of hospital trusts, academic partners, industry, patients and charities was created. From the study inception, patients were central to the PHOSP-COVID consortium, whereby a Patient and Public involvement and Engagement (PPIE) group was convened, including charity groups, people with lived experience recruited through clinical care from NHS sites, and patient support groups through Long Covid Support. Embedding high-quality, meaningful PPIE within a large consortium brings challenges and benefits. In this article, we describe our experiences of setting up and sustaining the PHOSP-COVID Consortium PPIE group, including a PIRIT-focussed evaluation of the impact of our PPIE work and provide top tips for researchers to take forward when embedding PPIE in future consortium research.

METHODS: This article outlines the set-up and sustainability of the PHOSP-COVID study PPIE group, in consultation with the National Institute for Health and Care Research (NIHR) guidance. To evaluate PPIE impact, we used PIRIT (Public Involvement in Research Impact Tool, 2023- Cardiff), and we provide our honest reflections of our PPIE work according to the PIRIT planning tool. The results highlight the benefits of a consortium approach to PPIE as well as the challenges, with quotes from PPIE contributors and academics. In addition, we have created top tips for researchers to take forward when embedding PPIE in future consortium research, linked to the NIHR standards.

LEARNING AND REFLECTION: This manuscript has identified gaps in PPIE considerations for the PHOSP-COVID study and specific challenges around a consortium-based approach for PPIE. These are largely due to time scale (i.e. the pace of setting up the study within a pandemic) and communication factors (diverse and large numbers of people to include/inform). Through reflection on the challenges and successes experienced in the PHOSP-COVID consortium PPIE via a PIRIT-focused impact evaluation, we have developed recommendations to support future good practice.

Patients and members of the public were involved in all aspects of this work from idea inception, design and conduct of the work, analysis and interpretation of the data. Eight patients prepared the manuscript and are included as co-authors.},
}

Humans
*COVID-19/epidemiology
*Patient Participation
*Community Participation
SARS-CoV-2
*Survivors
Pandemics